Microscopic Examination of Urine - Urine Sediment Constituents Flashcards
1
Q
Appear as smooth, non-nucleated, biconcave disk
A
RBCs
2
Q
Diameter of RBCs
A
7 µm
3
Q
Manner of reporting for RBCs
A
Average number seen per 10 hpf
4
Q
Appearance of RBC in Hypersthenuric urine
A
Crenated cells/ECHINOCYTES/Irregularly shaped
5
Q
Crenation of RBCs is caused by
A
Loss of water
6
Q
Appearance of RBC in Hyposthenuric urine
A
Swollen RBC/Ghost cells
7
Q
Swelling of RBCs is caused by
A
Absorption of water
8
Q
Most difficult urinary sediment to recognize
A
RBCs
9
Q
Other urinary sediments with close resemblance to RBCs
A
Starch
Air bubbles
Yeast cells
Oil droplets
Calcium oxalate
10
Q
Shape of RBC that indicates glomerular bleeding
A
Dysmorphic or Distorted RBC
11
Q
The presence of RBCs in the urine is associated with
A
Damage to the glomerular membrane
Vascular injury within the genitourinary tract
12
Q
The number of RBCs present indicates
A
Extent of the damage or injury
13
Q
Appearance of intact RBC in urine
A
Hematuria
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
15
Q
Appearance of erythrocytes when the specimen is not fresh
A
Faint, colorless circles or “shadow cells”
16
Q
Appearance of RBC when viewed from the side
A
Hourglass shape
17
Q
Appearance of RBC when viewed from above
A
Disks with a central pallor
18
Q
Normal RBC in urine
A
0-2 cells/hpf
19
Q
Abnormal value for urine RBC
A
> 3 cells/hpf
20
Q
Diameter of WBCs
A
12 µm
21
Q
Predominant WBC found in urine
A
Neutrophil
22
Q
Manner of reporting for WBCs
A
Average number seen in 10 hpfs
23
Q
Neutrophils lyse rapidly in dilute acidic urine. True or False?
A
False; alkaline
24
Q
Appearance of WBC in hypotonic urine
A
Swells and become spherical balls
25
Rate of WBC lysis in alkaline urine at room temperature
50% in 2-3 hours
26
WBC with sparkling appearance due to Brownian movement of the granules
Glitter Cells
27
Glitter Cells are pathologic. True or False?
False; non-pathologic
28
Color of WBC when stained with Sternheimer-Malbin
Light blue
29
Appearance of WBC in hypertonic urine
Smaller as water is lost
30
The presence of urinary eosinophils is primarily associated with:
Drug-induced interstitial nephritis
Urinary tract infection (UTI)
Renal transplant rejection
31
Amount of urine eosinophil that is considered significant
>1% eosinophils
32
The preferred eosinophil stain
Hansel
33
Smallest WBCs
Lymphocytes
34
WBC that may resemble RBCs
Lymphocytes
35
Increased numbers of lymphocytes are seen in
Early stages of renal transplant rejection
36
The primary concern in the identification of WBCs
Differentiation of mononuclear cells and disintegrating neutrophils from round renal tubular epithelial (RTE) cells
37
It is used to enhance nuclear detail
Supravital staining
Addition of acetic acid
38
How to differentiate WBCs from RTE cells
RTE cells are usually larger than WBCs with an eccentrically located nucleus
39
Increase in urinary WBCs
Pyuria or leukocytoruia
40
Normal WBC in urine
0-5 WBC/hpf for male
0-8 WBC/hpf for female
41
Origin of squamous epithelial cells
Linings of the vagina and female urethra and the lower portion of the male urethra
42
Appearance of squamous epithelial cells in urine indicates
Normal cellular sloughing and have no pathologic significance
43
Largest cells found in the urine sediment
Squamous epithelial cells
44
Appearance of squamous epithelial cells
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
45
Manner of reporting for squamous epithelial cells
Rare, few, moderate, or many
Low-power or high-power magnification
46
Variation of the squamous epithelial cell
Clue cells
47
Clue cells have no pathological significance. True or False?
False; pathologically significant
48
Clue cells is an indication of
Vaginal infection by the bacterium Gardnerella vaginalis
49
Origin of transitional epithelial cells
Lining of the renal pelvis, calyces, ureters, and bladder, and from the upper portion of the male urethra
50
Appearance of transitional epithelial cells in urine indicates
Normal cellular sloughing
51
Manner of reporting for transitional epithelial cells
Rare, few, moderate, or many / high power field
52
Transitional epithelial cells are smaller than squamous cells. True or False?
True
53
Shape of transitional epithelial cells
Spherical
Polyhedral
Caudate
54
Differences in shape of transitional epithelial cells is due to
Ability to absorb large amounts of water
55
Transitional epithelial cells are two to four times as large as white cells. True or False?
True
56
Transitional epithelial cells may be round, pear-shaped, or may have taillike projections. True or False?
True
57
Transitional epithelial cells may contain two nuclei. True or False?
True
58
Location of nucleus of transitional epithelial cells
Centrally located
59
Used to differentiate transitional epithelial cells from RTE cells
Location of nucleus
Supravital staining
60
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?
True
61
Variation of the shape of RTE cells depends on
Area of the renal tubules from which they originate
62
Presence of RTE cells are often a result of
Tissue destruction (necrosis)
63
Manner of reporting for RTE cells
Rare, few, moderate, or many, or as the actual number per high-power field
64
Shape of RTE cells from PCT
Rectangular shape and are referred to as columnar or convoluted cells
65
RTE cells from PCT are smaller than other RTE cells. True or False?
False; larger
66
Appearance of RTE cells from PCT
Cytoplasm is coarsely granular, and the RTE cells often resemble casts
67
Shape of RTE cells from DCT
Round or oval
68
Location of nucleus of RTE cells
Eccentrically located
69
Shape of RTE cells from CD
Cuboidal
70
How to differentiate CD-RTE cells from polyhedral transitional epithelial cells?
RTE has eccentrically placed nucleus and the presence of at least one straight edge
71
Cells from the collecting duct that appear in groups of three or more
Renal fragments
72
Appearance of renal fragments
Large sheets of cells
73
The presence of renal fragments is an indication of
Severe tubular injury with basement membrane disruption
74
RTE cells value that indicates tubular injury
>2 RTE/hpf
75
The most clinically significant of the epithelial cells
RTE cells
76
RTE cells are the precursor of oval fat bodies. True or False?
True
77
RTE cells containing large, nonlipid-filled vacuoles that is mainly associated with acute tubular necrosis
Bubble cells
78
These are lipid-containing RTE cells
Oval fat bodies
79
They are highly refractile RTE cells
Oval fat bodies
80
Oval fat bodies is composed of
Triglycerides
Neutral fats
Cholesterol
81
Stain for the identification of oval fat bodies
Sudan III
Oil Red O
82
Appearance of triglyceride and neutral fats after staining
Orange-red droplets
83
Appearance of cholesterol after staining
Colorless; does not stain
84
Microscope used to observe oval fat bodies
Polarized microscope
85
Appearance of droplets containing cholesterol when examined using polarized light
Maltese cross formations
86
Manner of reporting for oval fat bodies
Average number per hpf
87
Lipid in urine
Lipiduria
88
Bacteria are not normally present in urine. True or False?
True
89
Manner of reporting for bacteria
Rare, few, moderate, many per high-power field
90
To be considered significant for UTI, bacteria should be
Accompanied by WBCs
91
How to differentiate bacteria from similarly appearing amorphous phosphates and urates?
Bacteria are motile
92
Microscopy technique used to visualize bacteria
Phase microscopy
93
The presence of bacteria can be indicative of either lower or upper UTI. True or False?
True
94
The bacteria most frequently associated with UTI
Enterobacteriaceae
95
Small, refractile oval structures that may or may not contain a bud
Yeast cells
96
Appearance of yeast in severe infections
Branched, mycelial forms
97
Manner of reporting for yeast
Rare, few, moderate, or many per hpf
98
Primary yeast cells found in urine of diabetic, immunocompromised patients and women with vaginal moniliasis
Candida albicans
99
A true yeast infection should be
Accompanied by the presence of WBCs
100
Favorable urine condition for yeast growth
Acidic glucose-containing urine
101
Most frequent parasite encountered in urine
Trichomonas vaginalis
102
Manner of reporting for parasites
Rare, few, moderate, or many per hpf
103
Bladder parasite, associated with bladder tumors
Schistosoma haematobium
104
Most common contaminant ova
Enterobius vermicularis
105
Observed in urine sediment as the result of fecal contamination of infected individuals
Cyst of Giardia lamblia
106
Microscopy technique used to enhance visualization of the flagella or undulating membrane of T. vaginalis
Phase microscopy
107
Oval, slightly tapered heads and long, flagella-like tails
Spermatozoa
108
Urine is toxic to spermatozoa; therefore, they rarely exhibit the motility observed when examining a semen specimen. True or False?
True
109
When can we find spermatozoa in urine?
Following sexual intercourse, masturbation, or nocturnal emission
110
Protein material produced by the glands and epithelial cells of the lower genitourinary tract and the RTE cells
Mucus
111
Mucus appears microscopically as
Thread-like structures with a low refractive index
112
Major constituent or matrix of the mucus
Uromodulin/Tamm-Horsfall protein
113
Clumps of mucus may be confused with
Hyaline casts
114
Manner of reporting for mucus
Rare, few, moderate, or many per lpf
115
Found in the urine sediment 2-3 days after a severe hemolytic episode
Hemosiderin granules
116
Used to identify hemosiderin in the urine sediment and in tissues
Prussian blue reaction/Rous test
