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2.) UA Exam 2 > Microscopic UA: Part 1, 2, 3 > Flashcards

Microscopic UA: Part 1, 2, 3 Flashcards

1
Q

Describe the recommended methods for standardizing specimen preparation, volume, centrifugation, sediment preparation, volume and examination, and reporting of results.

A

Ask Caroline

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2
Q

State the purpose of Sternheimer-Malbin

A

delineates(portrays) nucleus and cytoplasm. Used for WBC, epithelial cells and casts (purple).

-It is a general purpose stain. The MOST COMMON stain for MICROSCOPIC sediment.

This stain consist of CRYSTAL VIOLET and SAFRANIN O.

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3
Q

True or False: Sternheimer-Malbin or Sedi-stain will not stain fat cells.

A

It will only stain specific elements and this is not one of them.

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4
Q

State the purpose of acetic acid

A

-Used to dissolve amorphous phosphates.
-Used to enhance nuclear detail of WBC
-WILL LYSE RBC’s, but not yeast or bacteria.

-Used to differentiate RBC from WBC, yeast, etc. (dissolves WBC granules) and to dissolve amorphous phosphates (to see bacteria).

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5
Q

State the purpose of toluidine blue

A

delineates nuclear detail. Used to differentiate WBC from RTE (blue).

Toluidine blue helps us see more clearly the inside of WBC from the inside of Renal tubular epithelial cells.

Urine specimens that contain a large amount of mononuclear cells (except for epithelial cells) may need to be referred to cytology. —-> Difficulty may arise when differentiating WBC’s from mononuclear cells (including RTE’s). RTE’s are larger than WBC, but not as round, and the nucleus is usually prominent.

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6
Q

State the purpose of Sudan III and oil red O

A

Lipid stain
-Used to stain triglycerides and neutral fat.
-Used to identify fat except for cholesterol (reddish color)

It differentiates lipids like Oval fat bodies. In an unstained urine oval fat body will like like clear small cells all clumped up together. When we apply the stain it will stain red and that will help us confirm lipids.

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7
Q

True or False triglycerides and neutral fats stain orange-red and cholesterol stains yellow.

A

False. Triglycerides and neutral fats will stain orange-red, but cholesterol will not stain.

We will need to use polarized light to help in identifying cholesterol. In polarized light, cholesterol will have those characteristics of Maltese-cross formation. It looks like for ovals and a diamond in the middle.

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8
Q

State the purpose of Gram in the examination of the urine sediment

A

In urinalysis it is used mainly to identify BACTERIAL casts (can be confused with granular casts).

Many granular casts’ appearance is very granular that it’s difficult to determine if its bacteria that is causing the appearance or if it is just things in the filtrate that got caught, that it is causing the granular appearance.

So if we are concern that there’s an infection in the tubular itself, we might want to do a Gram stain to double check.

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9
Q

State the purpose of Hansel stain

A

Used to identify eosinophils from other WBC.
-Used to identify eosinophils in urinary sediment (reddish)

–
WBC’s seen in urine are usually neutrophils associated with microbial infections (not eosinophils). —–> In allergic reactions (drug-induced, etc) producing inflammation of the renal interstitium (inflammation within the nephron), eosinophils will be present.

-It is the most common stain done in urinalysis outside that of steinheimer stain.

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10
Q

State the purpose of Prussian blue stains in the examination of the urine sediment

A

stains structures containing iron
-Used to identify hemosiderin (blue) granules

Unstained hemosiderin granules are a yellow-brown color (seen in renal tubular epithelial cells and casts after hemoglobinuria). Once they are stained the hemosiderin granules will be stained blue.

–> Side note: they actually look like tiny undefinable (not set shape or size), but differently we will see them with RTE cells.

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11
Q

Describe the basic principle of bright-field and their relationship to sediment examination

A

-routine for urinalysis

-basic principle is that objects/specimens appear dark against a light background.

–
Sediment constituents with a low refractive index will be overlooked when subjected to light of high intensity. Therefore, sediments must be examined using decreased light controlled by adjusteding the rheostat on the light source, not by lowering the condenser. Staining of the sediment also increased the visualization of these elements when using bright-field.

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12
Q

What is the most common type of microscopy?

A

bright field

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13
Q

Describe the basic principle of phase-contrast and their relationship to sediment examination

A

-enhances low refractive objects (such as hyaline casts, mucous, etc).

-the basic principle is that when light passes through cells, small phase shift occur, which are invisible to the human eye. In a phase contrast microscope, these phase shifts are converted into changes in amplitude, which can be observed as differences in image contrast.

–
A lot of hospitals use these!

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14
Q

Describe the basic principle of polarizing and their relationship to sediment examination

A

-used to identify cholesterol and crystals

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15
Q

Describe the basic principle of interference-contrast microscopy and their relationship to sediment examination.

A

-used to enhance detail (three dimension)
-basic principle is that it involves two coherent beams of light (from the same small light source) and image contest achieved with gradients in optical path. It produces clear optical sections of which transparent specimens and a 3D shadowed image.

–
not very common in hospital labs

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16
Q

Differentiate between normal and abnormal sediment constituents

A

Normal :
- 0-5 WBC/hpf
- 0-2 RBC/hpf

  • less than 0-2/hpf of transitional epithelia cells
    -0-2/hpf of Renal tubular epithelial cells

Abnormal:
-Eosinophils (more tha 1%)
-Bacteria
->2/hpf of RTE

Check with Caroline

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17
Q

Identify urine artifacts :

What is number 1?

A

Talcum Powder

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18
Q

Identify urine artifacts :

What is number 2?

A

Starch

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19
Q

Identify urine artifacts :

What is number 3?

A

Air

-Highly refractile

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20
Q

Identify urine artifacts :

What is number 4?

A

Oil

-Highly refractile

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21
Q

Identify urine artifacts :

What is number 5?

A

Pollen

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22
Q

Identify urine artifacts :

What is number 6?

A

clothing fiber

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23
Q

Identify urine artifacts:

What is number 8?

A

diaper fiber

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24
Q

Identify urine artifacts :

What is number 9?

A

cotton fiber

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25
Describe and illustrate urine sediment constitutes
ask Caroline
26
Discuss the significance of red blood cells (RBCs) in the urinary sediment.
-Normal to have 0-2 RBC/hpf -No nucleus If there is RBC in the urine that means hematuria. --- Note: presence of absence of RBC's may not correlate with urine color or blood chemical result -> 1-4 RBC/hpf but chem strip is negative -> Chem strip is positive, but no RBC seen microscopically -----> Typically lysed RBC, or hemoglobin or myoglobin -Side note crenated RBC's may be mistaken for WBC's b/c when they shrink, they appear to have granules under the microscope --> Acetic acid will lyse RBC, but not yeast, oil droplets, nor WBCs.
27
What kind of disease or disorder is associated with dysmorphic rbc's (such as ringed rbcs with blebs ) looks like a donut with Mickey Mouse ears or one ear (Number 9 picture)
Glomerular bleeding
28
Discuss the significance of white blood cells (WBCs) in the urinary sediment.
-Normal value is 0-5 WBC/hpf -Significance amount or increase amount of WBC's in the urine is known as Pyuria. -This usually denotes an infection or inflammation in the GU (genitourinary tract). This may be due to many causes like .... -bacterial infection -glomerulonephritis -lupus erythematosus -intersitial nephritis (Eosinophils - drug-induced/uti/parasites/renal transplant rejection) -tumors
29
Name the three types of epithelial cells found in the urinary sediment
- Squamous -Transitional -Renal
30
Describe the three types of epithelial cells found in the urinary sediment
- Squamous are largest cells found in the urinary sediment. It has a prominent nucleus the size of a RBC and are easily seen under low power (10x). They may fold, may look like casts, and degenerate easily. -Transitional Epithelial cells are smaller than Squamous. Typically have CENTRALLY located nuclei. Numerous forms and a WELL DEFINED OUTER EDGE, and a bit larger than RTE. (PEAR/AVOCADO shape) - Renal tubule cells are smaller than squamous and most transitional, but larger than WBC. They can have a cuboidal, columnar or round shape, typically flattened edge. The NUCLEI tend to be ECCENTRICALLY located (typically off the side). May contain elements, yellow-brown granules
31
Give the origin of the three types of epithelial cells found in the urinary sediment
-Squamous cells' origin are the linings of the vagina, female urethra, and lower portion of the male urethra. -Transitional Epithelial cells originate from the lining of the renal pelvis, calyces, ureters, bladder, and upper portion of the male urethra. -The Renal tubule cells originate from the proximal, distal, and collecting duct.
32
Give the significance of the three types of epithelial cells found in the urinary sediment
- Squamous cells have no pathological significance as they represent normal cellular sloughing. -For Transitional epithelial cells, normal amounts are <0-2/HPF. Incr amounts may be seen in invasive urologic procedures like catherization, but THIS IS NOT PATHOLOGIC in this case. Anything weird like abnormal morphology (vacuoles or irregular nuclei ) we send it to cytology. -For Renal tubule cells, normal amounts are 0-2/hpf. Greater than 2 hpf, tells us there is damage or necrosis (death of body tissue) to renal tubules. Ex: infection, drug toxicity, heavy metals, allergic reactions.
33
What are clue cells?
Squamous Epithelial Cells with bacteria. Clue cells are pathogologic when present in large numbers. HOWEVER they are NOT reported in Urine at most hospitals. -- -These cells are indicative of bacterial vaginosis (when in large quantity). -Squamous epithelial cells covered with bacteria (Gardnerella vaginialis). The cells will appear granular and irregular, due to the bacteria covering the cell.
34
Discuss the significance of oval fat bodies
-Oval fat bodies are Renal tubular epithelial cells that have absorbed lipids from the glomerular filtrate. They are highly pathological, very rare. They are associated with lipiduria (fat in urine), which is associated with -NEphrotic syndrome: damage to glomerulus -Tubular necrosis (damage to tubules) -Diabetes melitus (blood sugar is too high) -Trauma (bone marrow fat release in urine) -overall lipid storage diseases -- -The lipid material appears highly refractile -They are typically seen along with free fat droplets or fatty casts.
35
Compare and contrast the three types of lipid found in urine and how to identify each type
-Triglycerides and neutral fats stain orange-red with Oil Red O and Sudan III. -Cholesterol will not stain with Oil Red O and Sudan III, so we need to use a polarize light next to help identify. It will have a Maltese cross formation ---> oval fat bodies -Fya, for all fats we do oil red O and Sudan III.
36
Explain the process of cast formation and their sequence of degradation
1. Tamm-Horsfall (Uromodulin) protein aggregates to RTE cells to form protein fibrils (small or slender fiber). 2. Fibrils form a loose network (components in urine can get trapped 3. Further interweaving of fibrils form solid structure: Matrix 4. Urine components attach to matrix 5. Cast detaches from RTE, exits nephron Granular cast pick up material from urine, material stat to degrade forming "granularity" such as -crystals -RBC -WBC -Cellular material from RTE * Destruction of the cells may occur from free cells in the tubular lumen and then incorporated when the cast is formed or the cells may undergo destruction when the cast is already formed as a cellular cast. -- -Casts formed only in the nephron of the kidney, specifically in the loop of Henle, Distal tubule, and collecting duct.
37
What does Cylinduria mean?
Casts in Urine -- -Cast formation occurs more readily if: -->Urine flow is decreased (urinary stasis) -->pH is acidic (casts can dissolve in alkaline pH) -->Electrolytes are increased -Causes of cast formation can be pathological and non-pathological: -->due to exercise or dehydration -->renal conditions
38
True or False: Formation of casts can block urine flow within nephron
True
39
Describe and discuss the significance of hyaline casts
-Most common -Come from loop of Henle, distal tubule and collecting duct. -Normal value: 0-2/Lpf -Non-pathological causes: strenuous exercises, dehydration, heat exposure. -Pathological causes: acute glomerulonephritis, pyelonephritis, chronic renal disease, congestive heart failure. Structure/morphology: -Parallel sides with rounded ends -Cylindroid forms and wrinkled forms sometimes seen -May have a few components inside of matrix -Cells will stick to them, so be careful not to call a cellular cast
40
Describe and discuss the significance of RBC casts
Significance: Indicates bleeding in the nephron. Passage of RBC through glomerular membrane, may see proteinuria. Associated with glomerulonephritis Structure/morphology: -RBC are imbedded in the matrix (not stuck on outside) -You can see the gel matrix -Typically see free floating RBCs (positive for blood on strip test)
41
If hemoglobinuria is present, red blood cell casts will appear... If hemoglobin has broken down to methemoglobin, the cast will appear to have a ....
-orange-red or red-brown. -brownish color.
42
Describe and discuss the significance of WBC casts
Significance: Pathological - Associated with infection or inflammation in the nephron. -Pyleonephritis: kidney infection - Upper UTI (presence of bacteria may be significant -Acute intestinal nephritis (WBCs in the intestinal nephritis) --> Absence of bacteria, may see eosinophils -Glomerular nephritis Structure/morphology: -WBC's impeded in matrix (mostly neutrophils) -Granular appearance
43
What is Pyelonephritis? The presence of what may be significant?
Upper UTI. -Inflammation of the substance of the kidney as a result of bacterial infection. The presence of bacteria may be significant
44
***True or False: Cystitis produce WBC casts
False. Cystitis (lower UTI) does NOT produce WBC casts. Cystitis produced in the bladder. Casts are formed in the kidneys (in the nephrons).
45
Describe and discuss the significance of bacterial casts
Significance: associated with pyleonephritis (may be significant), need confirmation with gram stain. VERY RARE. Structure/morphology: -Bacteria in the cast, not attached to outside of hyaline cast -WBC and free floating bacteria present
46
Describe and discuss the significance of epithelial cell casts
Significance: Very serous, very rare. Due to tubular destruction. Must be differentiated from a WBC cast, use staining (look at size and mononuclear structure. Structure/morphology: -RTE cells in cast -USE Sternheimer-Malbin stain
47
Describe and discuss the significance of granular casts
Significance: yes Structure/morphology: -Coarse to fine -Starts as coarse, as time progresses, granules disintegrate -a few granules in a hyaline cast is NOT a granular cast -MUST HAVE URINARY STATIS OCCURING for a granular cast to form.
48
Urinary Stasis must occur for what to form?** What is urinary stasis?
granular cast Urinary stasis is the stopping of urine.
49
Describe and discuss the significance of waxy casts
Significance: associated with chronic renal failure. long term urinary stasis (extreme stopping of urine). Structure/morphology: -these occur from the further breakdown of granules contained within granular casts (also associated with the destruction of the hyaline matrix). -They are darker in appearance -Brittle and have high refractile index -Fragmented or squared ends -Indentations or "notches" on sides -Stained dark pink and ThicK (They look like a WORM)
50
What cast is associated with chronic renal failure?*** How do these casts occur?
Waxy cast They occur from long term urinary stasis!
51
True or False: Waxy casts are not usually seen along with other casts.
False! Waxy casts are usually seen along with other casts.
52
Describe and discuss the significance of fatty casts
Significance: Pathological - Nephrotic syndrome, tubular necrosis, crush injuries - Lipiduria Structure/Morphology: -Composed of fat droplets or oval fat bodies. -Fat appear refractile -Confirm with polarized light and fat stain (Sudan III or IV or Oil red O. -- Side note: will not stain with sternheimer-malbin
53
Describe and discuss the significance of broad casts
Significance: associated with renal failure Structure/morphology: -wider (2-6x) than the typical casts and usually occur from very long term urine stasis. -Broad casts can form from any type of cast. Most common are granular or waxy type.
54
What cast is frequently referred as "renal failure cast"?
Broad casts
55
Identify the picture #10 What two types are there of this type of crystal(s)? Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
-Amorphous Crystals -The two types are Urates (Acidic urine) and Phosphates (Alkaline Urine) -These are normal crystals found in urine. In Urates Amorphous it is acidic, has a pink sediment and is soluble in heat and alkaline. In Phosphate Amorphous it is alkaline, sediment is white and it is soluble in acetic acid. -No clinical significance Written description: Non-crystalline - no defined shape
56
Identify the picture #11 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Sodium Urate -normal -acidic pH -soluble in heat and alkaline -no clinical significance -WD: Thin rectangular sticks
57
Identify the picture #12 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Uric Acid Crystals - normal in low concentrations - acidic pH - soluble in alkali and heat -cs - pathological: increased amounts = inc levels of purines and nucleic acids (Gout, acute febrile conditions, chronic nephritis, Lesch-Nyhan syndrome - build up uric acid) WD: Barrel, rhombic rosettes, 6-sided/ Colorless, yellow, brown, birefringent.
58
Which crystal is barrel, rhombic rosettes, 6-sided, and is birefringent under polarized light? Look at picture #13
uric acid crystals
59
True or False: cystine crystals are highly birefringent under polarized light
False. Cystine crystals are not highly birefringent so it does not show effect under polarized light.
60
Identify the picture #14 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Calcium oxalate Found in normal urine pH: neutral to slightly alkaline pH soluble: HCL insoluble: acetic acid clinical significance: is the major component of kidney stones -- Pathologic conditions: Renal calculi (kidney stones), oxalic acid poisoning, liver disease, ethylene glycol (antifreeze) poisoning. WD: Can be dumbbell, rectangular, octahedral "envelope", ovoid shaped.
61
The most common form of _______ is dehydrate form. This is a colorless, enveloped-shaped form (resembles two pyramids joined at their bases
calcium oxalate norma is 0-3+, abnormal is 4+
62
The _________ form of calcium oxalate appears oval or _______ or rectangular shaped crystals (biconcave discs resembling RBC's)
monohydrate, dumbbell
63
The long, ________ form of calcium oxalate is frequently associated with ethylene glycol poisoning
monohydrate
64
Identify the picture #15 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Hippuric acid normal pH: found in acid urine (but also neutral or alkaline urine) soluble: alkali, hot H2O Clinical significance: rare, seen in liver dysfunction / associated with diets high in fruits and veggies that contain high quantities of benzoic acid WD: Colorless six sided prisms, needs, or rhombic plates
65
Identify the picture #16 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Ammonium Biurate normal urine pH: alkaline soluble: acetic acid, heat clinical sig: only significant if seen in freshly voided urine ----> usually an artifact of old or improperly stored urine WD: "Thorny apples", yellow-brown color
66
Identify the picture #17 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Calcium Carbonate found in normal urine pH: alkaline soluble: effervescences with HCL and acetic acid clinical significance: WD: Dumbbell, spherical shape, or granules (they will create little bubble) DON’T CONFUSE THEM WITH YEAST!
67
Identify the picture #18 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Calcium Phosphate found in normal urine pH: alkaline solubility: dilute acetic acid clinical significance: may be seen with kidney stones WD: appear as colorless, large flat plates (no nucleus) , rosettes formations wedge-shaped prisms
68
Identify the picture #19 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Triple phosphate normal pH: alkaline solubility: acetic acid Helpful microscopy: polarized light - birefringent WD: Prism shaped, “Coffin lid”, triangle
69
As _______ ______ dissolves the appearance changes to a “feathery” shape, like a butterfly.
Triple phosphate. This is frequently seen in alkaline urine due to bacteria that splits urea into ammonia and CO2.
70
Identify the picture #20 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Cystine abnormal in urine pH: acidic soluble: HCL, NaOH, NH4OH Clinical significance: YES! ——-> Most frequently cause of kidney stones in children —-> found in inherited, metabolic disorder “cystinuria” — prevents reabsorption of cystine by renal tubules. WD: HEXagonal plates, colorless, thin
71
Identify the picture #21 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Cholesterol abnormal in urine pH: Acidic Solubility: chloroform Clinical significance: YES!! —> seen in excessive tissue breakdown (nephritis, nephrotic conditions), also chyluria due to obstruction of lymph drainage (tumor, filariasis, enlargement of abnormal lymph nodes). WD: flat plates with a notch in one or more corners, colorless, and birefringent — rarely seen in urine: -lipids remain in droplet form, -refrigeration causes formation
72
Identify the picture #22 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Tyrosine abnormal in urine pH: acidic solubility: HCL, NH4OH Clinical significance: YES!!! —> seen in severe liver disorders, inherited disorders of amino-acid metabolism WD: fine needles with sharp points, may also be in sheaves, or rosettes Helpful test/notes: bilirubin positive and found with leucine crystals.
73
Identify the picture #22 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Tyrosine abnormal in urine pH: acidic solubility: HCL, NH4OH Clinical significance: YES!!! —> seen in severe liver disorders, inherited disorders of amino-acid metabolism WD: fine needles with sharp points, may also be in sheaves, or rosettes Helpful test/notes: bilirubin positive and found with leucine crystals.
74
Identify the picture #23 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Leucine abnormal in urine pH: acidic solubility: NaOH, hot water Clinical significance: YES! —> seen in severe liver disorders where amino acid metabolism is impaired, maple syrup disease, severe viral hepatitis WD: Appear as yellow-brown spheroids with concentric rings around the outer edge with radial striations in the center. Helpful tip: frequently seen with tyrosine crystals. DON’T CONFUSE IT WITH sulfonamide crystals
75
Identify the picture #23 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Leucine abnormal in urine pH: acidic solubility: NaOH, hot water Clinical significance: YES! —> seen in severe liver disorders where amino acid metabolism is impaired, maple syrup disease, severe viral hepatitis WD: Appear as yellow-brown spheroids with concentric rings around the outer edge with radial striations in the center. Helpful tip: frequently seen with tyrosine crystals. DON’T CONFUSE IT WITH sulfonamide crystals
76
Identify the picture #24 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Bilirubin abnormal in urine pH: acidic Soluble: acetic acid, HCL, NaOH, acetone Clinical significance: YES!! Bilirubin positive! —> seen in severe liver disorders, patient history, presentation of jaundice. WD: yellow-brown/orange needles projections or granules, in clumps or sometime seen attached to cells (WBCs)
77
Identify the picture #25 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Radiographic Dye abnormal in urine pH: acidic solubility: n/a Clinical significance: Yes! —> pt history is very useful, specific gravity is usually very high, highly birefringent with polarized light WD: Flat needles or sheaves, colorless (may be confused with cholesterol, tyrosine, or sulfonamides)
78
Identify the picture #26 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Sulfonamide crystals abnormal pH: acidic solubility: acetone & alkali clinical sign: YES! seen in pt’s receiving sulfonamide antibodies —> may be associated with kidney stone formation, confirm with patient history. WD: flat Needles, “ wheat stacks”, sheaves of small needles , spheroids, brown in color,
79
Identify the picture #27 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Acyclovir normal or abnormal: depends, check the patient's history, for this is seen when a patient is receiving very large does of anti-viral medication. pH: neutral to slightly alkaline pH clinically signif: check the patient's history --> anti-viral medication WD: fine needles with sharp looks like tyrosine crystals - we can only confirm with patient history
80
Identify the picture #28 Is this normal or abnormal in urine? State the pH: Solubility? Clinical significance? Written description:
Ampicillin normal or abnormal: depends, check the patient's history, for this is seen when a patient is receiving very large doses of ampicillin without adequate hydration. pH:n/a solubility: n/a clinical signif: check the patient's history WD: colorless needles that tend to form bundles (especially after refrigeration)
81
What is the significance of cystine crystals?
Cystinuria - inability of renal tubules to reabsorb filtered cystine -Most frequent cause of kidney stones in children! renal disorder, this also causes lysine, arginine and ornithine not to be reabsorbed
82
What is the significance of cholesterol crystals?
Nephrotic syndrome Found in conditions: - excessive tissue breakdown (nephritis, nephrotic conditions - chyluria due to obstruction of lymph drainage (tumors, filariasis, enlargement of abdominal lymph nodes)
83
What is the significance of leucine crystals?
Liver disease Seen in severe liver disorders where amino acid metabolism is impaired, maple syrup disease, severe viral hepatitis
84
What is the significance of tyrosine crystals?
Liver disease Seen in severe liver disorders, inherited disorders of amino-acid metabolism
85
What is the significance of bilirubin crystals?
Liver disease Seen in severe liver disorders
86
What is the significance of sulfonamide crystals?
Medication Seen in patients receiving sulfonamide antibiotics
87
What is the significance of radiographic dye crystals?
Radiographic procedure Seen in patients receiving radiographic contrast media medication for x-rays
88
What is the significance of ampicillin crystals?
Medication Seen when a patient is receiving very large doses of ampicillin without adequate hydration
89
What typical parasites can be found in urine?
-Schistosoma haematobium -Trichomonas vaginalis - Enterobius vermicularis (Pinworm) - Giardia lamblia - Mites (Dust mite and Sarcoptes scabiei)
90
Identify this parasite and where it can be found: picture 29
-Schistosoma haematobium -lives in the bladder
91
Identify this parasite and where it can be found: picture 30
-Trichomonas vaginalis -arises in female urine due to contamination from VAGINAL secretions when a female has a T.vaginalis infection -Most frequent parasite seen in the urinary sediment
91
Identify this parasite and where it can be found: picture 31
-Enterobius vermicularis -intestinal parasite that enters the urine specimen from fecal contamination
92
Identify this parasite and where it can be found: picture 32
Giardia lamblia -An intestinal parasite that enters (rare) the urine specimen from fecal contamination beaver fever - looks back at you
93
Identify this parasite and where it can be found: picture 33
Dust mite - an external skin parasite; can be contamination
94
Identify this parasite and where it can be found: picture 34
Sarcoptes scabiei - an external skin parasite; can be contamination

2.) UA Exam 2 (2 decks)

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