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AUBF Lab (FINALS) > Microscopic Examination of Urine > Flashcards

Microscopic Examination of Urine Flashcards

1
Q

What are the nonpathological causes of finding RBCs in urine?

A

● Strenuous exercise
● Menstrual contamination

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2
Q

What are the pathological clinical significance of finding RBCs in urine? State atleast three

A

● Hematuria
●Glomerulonephritis
● Renal calculi Malignancy
● Vascular injury within the genitourinary tract

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3
Q

In a hypotonic urine, RBCs appear?

A

Ghost cells

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4
Q

In a hypertonic urine, RBCs appear?

A

Crenated

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5
Q

Describe the appearance of a RBC

A

Biconcave,
anucleate discs , and 7 μm in
diameter

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6
Q

In a glomerular membrane damage, RBCs appear?

A

Dsymorphic

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7
Q

What are the sources of identification error of RBCs

A
  • Yeast cells
  • Oil droplets
  • Air bubbles
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8
Q

Reporting for microscopic RBCs:

A

Average number per 10 HPFS

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9
Q

Complete urinalysis
correlations of RBCs

A

Reagent strip blood reaction

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10
Q

What is the normal value of RBCs in urine?

A

0-2/HPF

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11
Q

These are larger than RBCs, measuring an average of about
12 mm in diameter

A

WBCs

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12
Q

The predominant WBC found in the urine sediment is:

A

Neutrophil

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13
Q

In a hypotonic urine, WBCs appear as?

A

Glitter cells

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14
Q

What are the sources of identification error of WBCs

A

Renal tubular epithelial cells

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15
Q

Describe the appearance of WBCs

A

● Non-nucleated biconcave disks
● Larger than RBCs, an average of about 12 mm in diameter
● Granulated, multilobed neutrophils
● Glitter cells in hypotonic urine
● Mononuclear cells with abundant cytoplasm

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16
Q

What are the clinical significance of finding WBCs (above normal values) in urine?

A

● Pyelonephritis
● Cystitis
● Prostatitis
● Urethritis
● Glomerulonephritis
● Lupus erythematosus
● Interstitial nephritis
● Tumors

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17
Q

Neutrophils lyse rapidly in __________ urine and begin to lose nuclear detail.

A

dilute alkaline

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18
Q

What is the possible non pathologic significance of finding WBCs in urine?

A

Glitter cells

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19
Q

The presence of urinary ______ is primarily associated
with drug-induced interstitial nephritis

A

eosinophils

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20
Q

Reporting for microscopic WBCs:

A

Average number per 10 hpfs

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21
Q

Complete urinalysis correlations of WBCs

A
  • Leukocyte esterase
  • Nitrite
  • Specific gravity
  • pH
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22
Q

Describe the appearance of a squamous epithelial cell

A

Largest cells in the sediment with abundant, irregular cytoplasm and prominent nuclei

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23
Q

Reporting for squamous epithelial cells in urine:

A

Rare, few, moderate, or many per LPF

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24
Q

Describe the appearance of transitional cells

A

Spherical, polyhedral, or caudate
with centrally located
nucleus

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25
Q

Reporting for transitional cells in urine:

A

Rare, few, moderate, or many per HPF

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26
Q

Describe the appearance of RTE cells

A

Rectangular, colomnar, round, oval or cuboidal with an eccentric nucleus

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27
Q

Reporting for RTE cells in urine:

A

Average number per 10 HPFs

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28
Q

Describe the appearance of oval fat bodies

A

Highly refractile RTE cells

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29
Q

Reporting for oval fat bodies in urine:

A

Average number per HPF

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30
Q

It is the most clinically significant of the epithelial cells

A

RTE cells

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31
Q

What is the clinical significance of finding squamous epithelial cells (above the normal values) in urine?

A
  • Clue cells (indicative of vaginal infection by Gardnerelia vaginalis)
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32
Q

What are the clinical significance of finding RTE cells in urine?

A
  • Tubular necrosis
  • Glomerular disorders
  • Severe tubular injury with basement membrane disruption
  • Salicylate poisoning
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33
Q

What is the clinical significane of finding transitional epithelial cells in urine?

A

Malignancy or viral infection

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34
Q

Decribe the appearance of bacteria in urine

A

Small spherical and rod-shaped
structures

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35
Q

Reporting of bacteria in urine:

A

Few, moderate, or many per HPF (the presence of WBCs may
be required)

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36
Q

It appears as small, oval, refractile structures with buds and/or mycelia

A

Yeast

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37
Q

Reporting of yeast in urine:

A

Rare, few, moderate, or many per HPF (the presence of WBCs may be required)

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38
Q

It appears pear-shaped, motile, flagellated

A

Trichomonas

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39
Q

Reporting of Trichomonas in urine:

A

Rare, few, moderate, or many per HPF

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40
Q

It appears as single or clumped threads with a low refractive index

A

Mucus

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41
Q

Reporting of mucus in urine:

A

Rare, few, moderate, or many per LPF

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42
Q

These structures are reported as rare, few, moderate, or many per HPF

A
  • Bacteria
  • Yeast
  • Trichomonas
  • Crystals
    (mucus is reported per LPF)
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43
Q

Casts are formed in which parts of the kidney nephron?

A
  • Lumen of the distal convoluted tubule
  • collecting ducts
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44
Q

Why should casts be observed under subdued light?

A

Because cast matrix has a low refractive index

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45
Q

Reporting casts in urine:

A

Average number per 10 LPFs

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46
Q

What is the major constituent of casts?

A

uromodulin
(other protiens present are albumin and immunoglobulins)

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47
Q

The presence of urinary casts is termed:

A

cylindruria

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48
Q

Normal values of hyaline cast in urine

A

0-2 per LPF

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49
Q

What are th nonpathological causes of finding increased numbers of hyaline cast in urine?

A
  • Strenous exercise
  • Dehydration
  • Heat exposure
  • Emotional stress
50
Q

What are the pathological causes of finding increased numbers of hyaline cast in urine?

A
  • Acute glomerulonephritis
  • Pyelonephritis
  • Chronic renal disease
  • Congestive heart failure
51
Q

This stain produces a pink color in hyaline casts

A

Sternheimer-Malbin stain

52
Q

Increased visualization of (hyaline) casts can be obtained by using what type of a microscope?

A

Phase microscope

53
Q

What is the specific significance of finding RBC cast in urine?

A

Bleeding within the nephron; glomerulonephritis

54
Q

Nonpathological cause of RBC cast in urine

A

Strenuous contact sports

55
Q

The appearance of this cast in the urine signifies infection or inflammation within the nephron

A

WBC cast

56
Q

Clinical significance of WBC casts in urine are?

A
  • Pyelonephritis
  • Acute interstitial nephritis
57
Q

Describe the appearance of a RBC cast in urine

A

Orange-red color, cast matrix containing RBCs

58
Q

Describe the appearance of Hyaline casts in urine

A
  • Colorless, homogenous matrix
59
Q

This cast contains WBCs in its matrix

A

WBC cast

60
Q

It appears as a bacilli bound to protein matrix

A

Bacterial cast

61
Q

Describe the appearance of epithelial cells in urine

A

RTE cells attached to protein matrix

62
Q

Describe the appearance of Granular casts in urine

A

Coarse and fine granules in a cast matrix

63
Q

Cite the clinical significance of finding an abnormal value of bacterial casts in urine

A

Pyelonephritis

64
Q

What is the clinical significance of finding abnormal values of epithelial casts in urine?

A

Renal tubular damage

65
Q

What are the clinical significance of finding abnormal values of fatty casts in urine?

A
  • Nephrotic syndrome
  • Toxic tubular necrosis
  • Diabetes mellitus
  • Crush injuries
66
Q

What is the clinical significance of finding abnormal values of broad casts in urine?

A
  • Extreme urine stasis (remember this basin mogawas chariz)
  • Renal failure
67
Q

What is the clinical significance of finding abnormal values of waxy casts in urine?

A
  • Stasis of urine flow (same2 sa broad casts pero extreme lang sa broad :P)
  • Chronic renal failure
68
Q

The matrix of this cast appears wider than normal

A

Broad cast

69
Q

Fat droplets and oval fat bodies are attached to the protein matrix of this cast

A

Fatty cast

70
Q

These cells are seen in cases of hepatitis

A

Bilirubin- stained RTE cells

71
Q

This cast is highly refractile under bright-field microscopy

A

Fatty casts

72
Q

Reporting of crystals in urine:

A

Rare, few, moderate, or many per HPF

73
Q

Reporting of abnormal crystals in urine:

A

Average per LPF

74
Q

This is a valuable aid in the identification of crystals

A

pH of the specimens

75
Q

This crystal precipitates in both acidic and neutral urine

A

Calcium oxalate

76
Q

ALL abnormal crystals are found in what type of urine?

A

Acidic urine (rarely in neutal urine)

77
Q

The most common crystals found in acidic urine is?

A

Urates (consisting of amorphous urates, uric acid, acid urates, and sodium urates)

78
Q

This crystal is fequently encountered in
specimens that have been refrigerated and produce a very characteristic pink sediment

A

Amorphous urates

79
Q

This crystal is found in acidic urine with a pH greater than 5.5

A

Amorphous urates

80
Q

This crystal is seen in a variety of shapes, including rhombic, four-sided flat plates (whetstones), wedges, and rosettes

A

Uric acid

81
Q

This crystal is highly birefringent under polarized light

A

Uric acid

82
Q

These crystals are frequently seen in acidic urine, but they can be found in neutral urine and even rarely in alkaline urine.

A

Calcium oxalate

83
Q

Most common form of calcium oxalate. Appears as colorless octahedral envelope or as two pyramids joined at their bases

A

Dihydrate

84
Q

What are the clinical significance of finding clumps of calcium oxalate crystals in fresh urine? Pathologic and non-pathologic

A

Pathologic: Formation of renal calculi
Non-pathologic: Ingestion of foods high in oxalic acid such as tomatoes and asparagus, and ascorbic acid

85
Q

The primary
pathologic significance of calcium oxalate crystals is the:

A

very noticeable presence of monohydrate form in cases of ethylene glycol (antifreeze) poisoning

86
Q

These crystals are easily identified by their prism shape that frequently resembles a “coffin lid”

A

Triple phosphate (ammonium magnesium phosphate)

87
Q

These crystals have no clinical significance; however, they are often seen in highly alkaline urine associated with the presence of urea-splitting bacteria

A

Triple phosphate crystals

88
Q

They appear as colorless, flat rectangular plates or
thin prisms often in rosette formations

A

Calcium phosphate

89
Q

These crystals have no clinical significance, although is a common constituent of renal calculi

A

Calcium phosphate

90
Q

These crystals appears small and colorless, with dumbbell or spherical shape

A

Calcium carbonate crystals

91
Q

These crystals exhibit the characteristic yellow-brown color of the urate crystals seen in acidic urine. They are frequently described as “thorny apples”

A

Ammonium biurate

92
Q

These crystals resemble other urates in that they dissolve at 60°C and convert to uric crystals when glacial acetic acid is added

A

Ammonium biurate

93
Q

These crystals are almost always encountered in
old specimens and may be associated with the presence of the ammonia produced by urea-splitting bacteria

A

Ammonium biurate

94
Q

This crystal appears as colorless, hexagonal plates and
may be thick or thin

A

Cystine crystals

95
Q

These crystals are found in the urine of persons who inherit
a metabolic disorder that prevents reabsorption of cystine by the renal tubules (cystinuria)

A

Cystine crystals

96
Q

Positive confirmation of cystine crystals is made using what type of test?

A

Cyanide-nitroprusside test

97
Q

These crystals are rarely seen unless specimens have
been refrigerated, because the lipids remain in droplet form.

A

Cholesterol crystals

98
Q

These crystals have a most characteristic appearance,
resembling a rectangular plate with a notch in one or more corners

A

Cholesterol crystals

99
Q

They are associated with disorders producing lipiduria, such as the nephrotic syndrome, and are seen in conjunction with fatty casts and oval fat bodies

A

Cholesterol crystals

100
Q

This crystal appears as colorless flat plates and is associated iwth radiographic procedure

A

Radiographic dye crystals

101
Q

These abnormal crystals are associated with liver disorders

A

Tyrosine, leucine, and bilirubin

102
Q

These crystals appear as fine colorless to yellow needles
that frequently form clumps or rosette

A

Tyrosine crystals

103
Q

These crystals are may also be encountered in inherited disorders of amino acid metabolism

A

Tyrosine crystals

104
Q

These crystals appear as yellow-brown spheres that demonstrate
concentric circles and radial striations

A

Leucine

105
Q

These crystals are present in hepatic disorders producing
large amounts of bilirubin

A

Blirubin crystals

106
Q

These crystals appear as
clumped needles or granules with the characteristic yellow
color

A

Blirubin crystals

107
Q

Finding of these crystals in the urine of patients being treated
for UTIs was common

A

Sulfonamides crystals

108
Q

What is the primary cause of sulfonamide crystallization?

A

Inadequate patient hydration (inom lage’g tubig. This is your sign to drink water >:P )

109
Q

These crystals appear as colorless needles that tend to form bundles following refrigeration

A

Ampicillin crystals

110
Q

Disorder associated with tyrosine, leucine, and bilirubin crystals:

A

Liver disease

111
Q

These are abnormal crystals that can be found in both acid and neutal pH

A
  • Leucine
  • Tyrosine
  • Sulfonamides
  • Ampicillin
112
Q

Disorder associated with cholesterol crystals:

A

Nephrotic syndrome

113
Q

Disorder associated with both sulfonamides and ampicillin crystals:

A

infection treatment

114
Q

Disorder associated with Radiographic dye:

A

Radiographic procedure

115
Q

What are the most frequently encountered artifacts in urine?

A

starch, oil droplets, air bubbles, pollen grains, fibers, and fecal
contamination

116
Q

Note:

A

Reporting of artifacts is NOT necessary

117
Q

These artifacts are highly refractile and may resemble RBCs to inexperienced laboratory personnel.

A

Oil droplets and air bubbles

118
Q

These are seasonal contaminants that appear as spheres with a cell wall and occasional concentric circles

A

Pollen grains

119
Q

These are artifacts thay may initially be mistaken for cast

A

Hair and fibers

120
Q

These artifacts may appear as
plant and meat fibers or as brown amorphous material in a
variety of sizes and shapes

A

Fecal artifacts

121
Q

These crystals are easily identified by their prism shape that frequently resembles a “coffin lid”

A

Triple phosphate (ammonium magnesium phosphate)

AUBF Lab (FINALS) (3 decks)

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