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ELSEVIER AUBF > MICROSCOPIC EXAMINATION OF URINE: CASTS AND CRYSTALS > Flashcards

MICROSCOPIC EXAMINATION OF URINE: CASTS AND CRYSTALS Flashcards

1
Q

Composed of Tamm-Horsfall (uromodulin) protein excreted by renal tubular epithelial cells

A

Casts

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2
Q

When other urinary constituents are present they become enmeshed in the cast matrix or attached to the matrix

A

Casts

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3
Q

Formed in the distal convoluted tubule and collecting ducts (wider casts)

A

Casts

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4
Q

Reported as the number per low-power field

A

Casts

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5
Q

Colorless

A

Hyaline

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6
Q

Orange/red–containing RBCs

A

RBC

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7
Q

WBCs in cast matrix

A

WBC

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8
Q

RTE cells attached to cast matrix

A

Epithelial cell

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9
Q

Bacteria attached to cast matrix

A

Granular

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10
Q

Coarse or fine granules in the matrix

A

Granular

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11
Q

Highly refractile, jagged edges and notches

A

Waxy

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12
Q

Fat droplets and oval fat bodies attached to cast matrix

A

Fatty

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13
Q

Wider than normal

A

Broad

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14
Q

Mucus, fibers, increased light

A

Hyaline

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15
Q

RBC clumps (look for cast matrix)

A

RBC

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16
Q

WBC clumps (look for cast matrix)

A

WBC

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17
Q

WBC casts

A

Epithelial cell

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18
Q

Granular casts

A

Bacterial

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19
Q

Clumps of small crystals, columnar RTE cells

A

Granular

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20
Q

Fibers, fecal material

A

Waxy

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21
Q

Fecal material

A

Fatty

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22
Q

Fecal material, fibers

A

Broad

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23
Q

Glomerulonephritis, pyelonephritis, congestive heart failure, stress, exercise

A

Hyaline

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24
Q

Glomerulonephritis, strenuous exercise

A

RBC

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25
Q

Pyelonephritis, acute interstitial nephritis

A

WBC

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26
Q

Renal tubular damage

A

Epithelial cell

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27
Q

Pyelonephritis

A

Bacterial

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28
Q

Glomerulonephritis, pyelonephritis, stress, exercise

29
Q

Stasis of urine flow, chronic renal failure

30
Q

Nephrotic syndrome, diabetes mellitus, crush injuries

31
Q

Extreme urine stasis, renal failure

32
Q

Precipitation of urine solutes affected by

A

temperature, solute concentration, and pH

33
Q

are more abundant in refrigerated urine samples

34
Q

Polarized microscopy aids in their identification

35
Q

are found only in acidic or normal urine

A

Abnormal crystals

36
Q

Normal Crystals Seen in Acidic Urine

A

Uric acid crystals
Amorphous urates
Calcium oxalate crystals

37
Q

Normal Crystals Seen in Alkaline Urine

A

Triple phosphate crystals
Amorphous phosphate crystals
Calcium carbonate crystals
Ammonium biurate crystals

38
Q

Abnormal Crystals

A

Cystine crystals
Cholesterol crystals
Tyrosine crystals
Leucine crystals
Bilirubin crystals
Sulfonamide crystals
Ampicillin crystals

39
Q

Yellow-brown, flat-sided rhombic plates, wedges, and rosettes

A

Uric acid crystals

40
Q

Sources of error
○ Cystine crystals (uric acid crystals polarize and cystine crystals do not polarize)

A

Uric acid crystals

41
Q

Clinical significance
○ Patients receiving chemotherapy
○ Lesch-Nyhan disease

A

Uric acid crystals

42
Q

Small spheres producing brick-dust (uroerythrin) or yellow-brown sediment

A

Amorphous urates

43
Q

May also be seen in alkaline urine

A

Calcium oxalate crystals

44
Q

The dihydrate form is envelope shaped; clumps in fresh urine may indicate renal calculi

A

Calcium oxalate crystals

45
Q

The monohydrate form is oval or dumbbell shaped; presence of this form indicates ethylene glycol (antifreeze) ingestion

A

Calcium oxalate crystals

46
Q

Coffin-lid shaped

A

Triple phosphate crystals

47
Q

Associated with a very high pH and bacteria found in old specimens

A

Triple phosphate crystals

48
Q

Produce a white precipitate after refrigeration

A

Amorphous phosphate crystals

49
Q

Dumbbell and spherical shapes

A

Calcium carbonate crystals

50
Q

Produce gas with acetic acid

A

Calcium carbonate crystals

51
Q

Yellow-brown thorny apple-shaped crystals

A

Ammonium biurate crystals

52
Q

Associated with old specimens with bacteria

A

Ammonium biurate crystals

53
Q

Hexagonal flat plates

A

Cystine crystals

54
Q

Clinical significance
○ Aninherited disorder that inhibits the reabsorption of cystine by the renal tubules (cystinuria); renal calculi form at an early age

A

Cystine crystals

55
Q

Rectangular plates with notched corners, highly birefringent under polarized light

56
Q

Seen in refrigerated urine and accompanied by fatty casts and oval fat bodies

A

Cholesterol crystals

57
Q

Clinical significance
○ Nephrotic syndrome

A

Cholesterol crystals

58
Q

Yellow needle-shaped forms in clusters or rosettes

A

Tyrosine crystals

59
Q

Clinical significance
○ Severe liver disease

A

Tyrosine crystals

60
Q

Yellow-brown spheres with concentric circles

A

Leucine crystals

61
Q

Seen in conjunction with tyrosine crystals

A

Leucine crystals

62
Q

Clinical significance
○ Severe liver disease

A

Leucine crystals

63
Q

Bright yellow clumped needles and granules

A

Bilirubin crystals

64
Q

Clinical significance
○ Liver damage often from viral infections that damage the renal tubules, preventing reabsorption of bilirubin

A

Bilirubin crystals

65
Q

Needle, rosette, and rhombic shapes

A

Sulfonamide crystals

66
Q

Clinical significance
○ Inadequately hydrated patients taking sulfonamide medications

A

Sulfonamide crystals

67
Q

Colorless needles that form clumps after refrigeration

A

Ampicillin crystals

68
Q

Clinical significance
○ Inadequately hydrated patients

A

Ampicillin crystals

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