microscopic UA pt 1 Flashcards
describe ghost cells
red blood cells lysed in dilute urine with membrane intact
describe how to differentiate yeast, oil and air from RBC
- yeast will bud and will NOT lyse in acetic acid
- oil is refractile
- air is refractile
describe dysmorphic RBCs
- rare
- protrusions, varying size etc
- associated with glomerular bleeding (enlarged pores)
- needs 2nd opinin
list the normal RBC value in urine
0-2/hpf
list the normal WBC value in urine
0-5/hpf
WBC reaction in hypertonic vs hypotonic
- hyper= shrink and no granule release
- hypo = swell and brownian movement (glitter)
define pyuria
increased WBCs in urine
what does pyuria indicate
infeciton or inflammation of genitourinary tract
- bacterial infection
- glomerulonephritis
- lupus
- interstitial nephritis
- tumors
when are mononuclear WBCs seen
- lymphocytes normally but rare to see
- early stages of renal transplant rejection
what are eosinophils associated with
- drug induced interstitial nephritis (primary)
- UTI
- parasites
-> eosinophils not normally in urine
what amount of eosinophils is considered significant
whan >1% of total WBC
list epithelial cells in order of size
(largest): squamous (bottom/outside)
transitional (upper urethra)
(smallest) renal (nephron lining)
describe squamous epithelial cells
- largest in urinary sediment
- prominent nucleus size of RBC
- not pathologically significant
describe clue cells
squamous epithelial cells with bacteria
- pathological in large numbers
- inidcate bacterial vaginosis
-> not reported usually
describe transitional epithelial cells
- central nuclei with defined edge
- larger than RTE but smaller than squamous
when are transitional cells not pathologic
increased amounts seen in invasive urologic procedures
when are transitional cells referred to cytology
abnormal morphology
- indicates viral infection or malignancy
describe renal tubule cells
- variation in shape due to location in nephron
- flattened edge with eccentric nuclei
- 0-2/hpf = normal
- > 2 = damage or necrosis to tubules
what is the purpose of RTE cells
reabsorb glomerular filtrate
- may contain elements
describe oval fat bodies
- RTEs that have absorbed lipis from glomerular filtrate
- highly refractile
- see w/ free fat droplets/fatty casts
-> pathogenic
define lipiduria
fat in urine
- nephrotic syndrome
- tubular necrosis
- diabetes melitus
- trauma
- histocytes (inside RTE) = lipid storage disease
what stain is used to determine oval fat bodies
- oil red O or sudan III -> neutrals/trigs stain red
- polarize to see cholesterol
describe the characteristic presentation of oval fat bodies under polarizing microscope
maltese cross when cholesterol is present
if a UTI is present, what results will show
- bacteria in urine
- nitrate pos, leukocyte esterase pos
- culture pos
how is yeast and RBC differentiated
- yeast bud and may have hyphae
- yeast will not lyse in acetic acid
when is yeast mainly present
- candida albicans mostly
- diabetes mellitus (inc pH and inc glucose)
- immunocompromised patients
- vaginal yeast infections
is a yeast infection is present what else will be present
WBCs
describe mucous
- protein substance by glands of epithelial cells of lower tract and RTE
- Tamm-Horsfall protein component (and uromodulin)
how does increase semen impact urinalysis
- may produce positive protein
- immobile in urine
