microscopic UA pt 1

Question 1

describe ghost cells

Answer 1

red blood cells lysed in dilute urine with membrane intact

Question 2

describe how to differentiate yeast, oil and air from RBC

Answer 2

• yeast will bud and will NOT lyse in acetic acid
• oil is refractile
• air is refractile

Question 3

describe dysmorphic RBCs

Answer 3

• rare
• protrusions, varying size etc
• associated with glomerular bleeding (enlarged pores)
• needs 2nd opinin

Question 4

list the normal RBC value in urine

Answer 4

0-2/hpf

Question 5

list the normal WBC value in urine

Answer 5

0-5/hpf

Question 6

WBC reaction in hypertonic vs hypotonic

Answer 6

• hyper= shrink and no granule release
• hypo = swell and brownian movement (glitter)

Question 7

define pyuria

Answer 7

increased WBCs in urine

Question 8

what does pyuria indicate

Answer 8

infeciton or inflammation of genitourinary tract
- bacterial infection
- glomerulonephritis
- lupus
- interstitial nephritis
- tumors

Question 9

when are mononuclear WBCs seen

Answer 9

• lymphocytes normally but rare to see
• early stages of renal transplant rejection

Question 10

what are eosinophils associated with

Answer 10

• drug induced interstitial nephritis (primary)
• UTI
• parasites
  -> eosinophils not normally in urine

Question 11

what amount of eosinophils is considered significant

Answer 11

whan >1% of total WBC

Question 12

list epithelial cells in order of size

Answer 12

(largest): squamous (bottom/outside)
transitional (upper urethra)
(smallest) renal (nephron lining)

Question 13

describe squamous epithelial cells

Answer 13

• largest in urinary sediment
• prominent nucleus size of RBC
• not pathologically significant

Question 14

describe clue cells

Answer 14

squamous epithelial cells with bacteria
- pathological in large numbers
- inidcate bacterial vaginosis
-> not reported usually

Question 15

describe transitional epithelial cells

Answer 15

• central nuclei with defined edge
• larger than RTE but smaller than squamous

Question 16

when are transitional cells not pathologic

Answer 16

increased amounts seen in invasive urologic procedures

Question 17

when are transitional cells referred to cytology

Answer 17

abnormal morphology
- indicates viral infection or malignancy

Question 18

describe renal tubule cells

Answer 18

• variation in shape due to location in nephron
• flattened edge with eccentric nuclei
• 0-2/hpf = normal
• > 2 = damage or necrosis to tubules

Question 19

what is the purpose of RTE cells

Answer 19

reabsorb glomerular filtrate
- may contain elements

Question 20

describe oval fat bodies

Answer 20

• RTEs that have absorbed lipis from glomerular filtrate
• highly refractile
• see w/ free fat droplets/fatty casts
  -> pathogenic

Question 21

define lipiduria

Answer 21

fat in urine
- nephrotic syndrome
- tubular necrosis
- diabetes melitus
- trauma
- histocytes (inside RTE) = lipid storage disease

Question 22

what stain is used to determine oval fat bodies

Answer 22

• oil red O or sudan III -> neutrals/trigs stain red
• polarize to see cholesterol

Question 23

describe the characteristic presentation of oval fat bodies under polarizing microscope

Answer 23

maltese cross when cholesterol is present

Question 24

if a UTI is present, what results will show

Answer 24

• bacteria in urine
• nitrate pos, leukocyte esterase pos
• culture pos

Question 25

how is yeast and RBC differentiated

Answer 25

• yeast bud and may have hyphae
• yeast will not lyse in acetic acid

Question 26

when is yeast mainly present

Answer 26

• candida albicans mostly
• diabetes mellitus (inc pH and inc glucose)
• immunocompromised patients
• vaginal yeast infections

Question 27

is a yeast infection is present what else will be present

Answer 27

WBCs

Question 28

describe mucous

Answer 28

• protein substance by glands of epithelial cells of lower tract and RTE
• Tamm-Horsfall protein component (and uromodulin)

Question 29

how does increase semen impact urinalysis

Answer 29

• may produce positive protein
• immobile in urine