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CLINICAL MICROSCOPY > Microscopic Examination of Urine - Urine Sediment Constituents > Flashcards

Microscopic Examination of Urine - Urine Sediment Constituents Flashcards

1
Q

Appear as smooth, non-nucleated, biconcave disk

A

RBCs

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2
Q

Diameter of RBCs

A

7 µm

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3
Q

Manner of reporting for RBCs

A

Average number seen per 10 hpf

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4
Q

Appearance of RBC in Hypersthenuric urine

A

Crenated cells/ECHINOCYTES/Irregularly shaped

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5
Q

Crenation of RBCs is caused by

A

Loss of water

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6
Q

Appearance of RBC in Hyposthenuric urine

A

Swollen RBC/Ghost cells

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7
Q

Swelling of RBCs is caused by

A

Absorption of water

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8
Q

Most difficult urinary sediment to recognize

A

RBCs

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9
Q

Other urinary sediments with close resemblance to RBCs

A

Starch
Air bubbles
Yeast cells
Oil droplets
Calcium oxalate

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10
Q

Shape of RBC that indicates glomerular bleeding

A

Dysmorphic or Distorted RBC

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11
Q

The presence of RBCs in the urine is associated with

A

Damage to the glomerular membrane
Vascular injury within the genitourinary tract

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12
Q

The number of RBCs present indicates

A

Extent of the damage or injury

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13
Q

Appearance of intact RBC in urine

A

Hematuria

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14
Q

The observation of microscopic hematuria can be critical to the early diagnosis of

A

Glomerular disorders
Malignancy of the urinary tract
Renal calculi

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15
Q

Appearance of erythrocytes when the specimen is not fresh

A

Faint, colorless circles or “shadow cells”

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16
Q

Appearance of RBC when viewed from the side

A

Hourglass shape

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17
Q

Appearance of RBC when viewed from above

A

Disks with a central pallor

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18
Q

Normal RBC in urine

A

0-2 cells/hpf

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19
Q

Abnormal value for urine RBC

A

> 3 cells/hpf

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20
Q

Diameter of WBCs

A

12 µm

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21
Q

Predominant WBC found in urine

A

Neutrophil

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22
Q

Manner of reporting for WBCs

A

Average number seen in 10 hpfs

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23
Q

Neutrophils lyse rapidly in dilute acidic urine. True or False?

A

False; alkaline

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24
Q

Appearance of WBC in hypotonic urine

A

Swells and become spherical balls

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25
Q

Rate of WBC lysis in alkaline urine at room temperature

A

50% in 2-3 hours

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26
Q

WBC with sparkling appearance due to Brownian movement of the granules

A

Glitter Cells

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27
Q

Glitter Cells are pathologic. True or False?

A

False; non-pathologic

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28
Q

Color of WBC when stained with Sternheimer-Malbin

A

Light blue

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29
Q

Appearance of WBC in hypertonic urine

A

Smaller as water is lost

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30
Q

The presence of urinary eosinophils is primarily associated with:

A

Drug-induced interstitial nephritis
Urinary tract infection (UTI)
Renal transplant rejection

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31
Q

Amount of urine eosinophil that is considered significant

A

> 1% eosinophils

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32
Q

The preferred eosinophil stain

A

Hansel

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33
Q

Smallest WBCs

A

Lymphocytes

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34
Q

WBC that may resemble RBCs

A

Lymphocytes

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35
Q

Increased numbers of lymphocytes are seen in

A

Early stages of renal transplant rejection

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36
Q

The primary concern in the identification of WBCs

A

Differentiation of mononuclear cells and disintegrating neutrophils from round renal tubular epithelial (RTE) cells

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37
Q

It is used to enhance nuclear detail

A

Supravital staining
Addition of acetic acid

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38
Q

How to differentiate WBCs from RTE cells

A

RTE cells are usually larger than WBCs with an eccentrically located nucleus

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39
Q

Increase in urinary WBCs

A

Pyuria or leukocytoruia

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40
Q

Normal WBC in urine

A

0-5 WBC/hpf for male
0-8 WBC/hpf for female

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41
Q

Origin of squamous epithelial cells

A

Linings of the vagina and female urethra and the lower portion of the male urethra

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42
Q

Appearance of squamous epithelial cells in urine indicates

A

Normal cellular sloughing and have no pathologic significance

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43
Q

Largest cells found in the urine sediment

A

Squamous epithelial cells

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44
Q

Appearance of squamous epithelial cells

A

Contain abundant, irregular cytoplasm
Prominent nucleus about the size of an RBC
Appear as flagstone-shaped with distinct cell borders
Folded, possibly resembling a cast

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45
Q

Manner of reporting for squamous epithelial cells

A

Rare, few, moderate, or many
Low-power or high-power magnification

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46
Q

Variation of the squamous epithelial cell

A

Clue cells

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47
Q

Clue cells have no pathological significance. True or False?

A

False; pathologically significant

48
Q

Clue cells is an indication of

A

Vaginal infection by the bacterium Gardnerella vaginalis

49
Q

Origin of transitional epithelial cells

A

Lining of the renal pelvis, calyces, ureters, and bladder, and from the upper portion of the male urethra

50
Q

Appearance of transitional epithelial cells in urine indicates

A

Normal cellular sloughing

51
Q

Manner of reporting for transitional epithelial cells

A

Rare, few, moderate, or many / high power field

52
Q

Transitional epithelial cells are smaller than squamous cells. True or False?

53
Q

Shape of transitional epithelial cells

A

Spherical
Polyhedral
Caudate

54
Q

Differences in shape of transitional epithelial cells is due to

A

Ability to absorb large amounts of water

55
Q

Transitional epithelial cells are two to four times as large as white cells. True or False?

56
Q

Transitional epithelial cells may be round, pear-shaped, or may have taillike projections. True or False?

57
Q

Transitional epithelial cells may contain two nuclei. True or False?

58
Q

Location of nucleus of transitional epithelial cells

A

Centrally located

59
Q

Used to differentiate transitional epithelial cells from RTE cells

A

Location of nucleus
Supravital staining

60
Q

Increased numbers of transitional cells seen singly, in pairs, or in clumps (syncytia) are present following invasive urologic procedures such as catheterization and are of no clinical significance. True or False?

61
Q

Variation of the shape of RTE cells depends on

A

Area of the renal tubules from which they originate

62
Q

Presence of RTE cells are often a result of

A

Tissue destruction (necrosis)

63
Q

Manner of reporting for RTE cells

A

Rare, few, moderate, or many, or as the actual number per high-power field

64
Q

Shape of RTE cells from PCT

A

Rectangular shape and are referred to as columnar or convoluted cells

65
Q

RTE cells from PCT are smaller than other RTE cells. True or False?

A

False; larger

66
Q

Appearance of RTE cells from PCT

A

Cytoplasm is coarsely granular, and the RTE cells often resemble casts

67
Q

Shape of RTE cells from DCT

A

Round or oval

68
Q

Location of nucleus of RTE cells

A

Eccentrically located

69
Q

Shape of RTE cells from CD

70
Q

How to differentiate CD-RTE cells from polyhedral transitional epithelial cells?

A

RTE has eccentrically placed nucleus and the presence of at least one straight edge

71
Q

Cells from the collecting duct that appear in groups of three or more

A

Renal fragments

72
Q

Appearance of renal fragments

A

Large sheets of cells

73
Q

The presence of renal fragments is an indication of

A

Severe tubular injury with basement membrane disruption

74
Q

RTE cells value that indicates tubular injury

A

> 2 RTE/hpf

75
Q

The most clinically significant of the epithelial cells

76
Q

RTE cells are the precursor of oval fat bodies. True or False?

77
Q

RTE cells containing large, nonlipid-filled vacuoles that is mainly associated with acute tubular necrosis

A

Bubble cells

78
Q

These are lipid-containing RTE cells

A

Oval fat bodies

79
Q

They are highly refractile RTE cells

A

Oval fat bodies

80
Q

Oval fat bodies is composed of

A

Triglycerides
Neutral fats
Cholesterol

81
Q

Stain for the identification of oval fat bodies

A

Sudan III
Oil Red O

82
Q

Appearance of triglyceride and neutral fats after staining

A

Orange-red droplets

83
Q

Appearance of cholesterol after staining

A

Colorless; does not stain

84
Q

Microscope used to observe oval fat bodies

A

Polarized microscope

85
Q

Appearance of droplets containing cholesterol when examined using polarized light

A

Maltese cross formations

86
Q

Manner of reporting for oval fat bodies

A

Average number per hpf

87
Q

Lipid in urine

88
Q

Bacteria are not normally present in urine. True or False?

89
Q

Manner of reporting for bacteria

A

Rare, few, moderate, many per high-power field

90
Q

To be considered significant for UTI, bacteria should be

A

Accompanied by WBCs

91
Q

How to differentiate bacteria from similarly appearing amorphous phosphates and urates?

A

Bacteria are motile

92
Q

Microscopy technique used to visualize bacteria

A

Phase microscopy

93
Q

The presence of bacteria can be indicative of either lower or upper UTI. True or False?

94
Q

The bacteria most frequently associated with UTI

A

Enterobacteriaceae

95
Q

Small, refractile oval structures that may or may not contain a bud

A

Yeast cells

96
Q

Appearance of yeast in severe infections

A

Branched, mycelial forms

97
Q

Manner of reporting for yeast

A

Rare, few, moderate, or many per hpf

98
Q

Primary yeast cells found in urine of diabetic, immunocompromised patients and women with vaginal moniliasis

A

Candida albicans

99
Q

A true yeast infection should be

A

Accompanied by the presence of WBCs

100
Q

Favorable urine condition for yeast growth

A

Acidic glucose-containing urine

101
Q

Most frequent parasite encountered in urine

A

Trichomonas vaginalis

102
Q

Manner of reporting for parasites

A

Rare, few, moderate, or many per hpf

103
Q

Bladder parasite, associated with bladder tumors

A

Schistosoma haematobium

104
Q

Most common contaminant ova

A

Enterobius vermicularis

105
Q

Observed in urine sediment as the result of fecal contamination of infected individuals

A

Cyst of Giardia lamblia

106
Q

Microscopy technique used to enhance visualization of the flagella or undulating membrane of T. vaginalis

A

Phase microscopy

107
Q

Oval, slightly tapered heads and long, flagella-like tails

A

Spermatozoa

108
Q

Urine is toxic to spermatozoa; therefore, they rarely exhibit the motility observed when examining a semen specimen. True or False?

109
Q

When can we find spermatozoa in urine?

A

Following sexual intercourse, masturbation, or nocturnal emission

110
Q

Protein material produced by the glands and epithelial cells of the lower genitourinary tract and the RTE cells

111
Q

Mucus appears microscopically as

A

Thread-like structures with a low refractive index

112
Q

Major constituent or matrix of the mucus

A

Uromodulin/Tamm-Horsfall protein

113
Q

Clumps of mucus may be confused with

A

Hyaline casts

114
Q

Manner of reporting for mucus

A

Rare, few, moderate, or many per lpf

115
Q

Found in the urine sediment 2-3 days after a severe hemolytic episode

A

Hemosiderin granules

116
Q

Used to identify hemosiderin in the urine sediment and in tissues

A

Prussian blue reaction/Rous test

CLINICAL MICROSCOPY (20 decks)

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