Microscopic Urinalysis Flashcards
What elements will you see on a microscopic evaluation of urine?
Cells Casts Crystals Microorganisms Misc findings
What kind of cells will you see?
Erythrocytes Leukocytes Squamous epithelial cells Transitional epithelial cells Renal epithelial cells
What three factors may affect how the erythrocytes look on the microscope?
Urine concentration
pH
time elapsed from collection
What do erythrocytes look like in a fresh sample?
Small, round, smooth edges
What do erythrocytes look like in an older, concentrated sample?
Shrunk, crenated
What do erythrocytes look like in a dilute urine sample?
Swollen and lysed
What is the normal amount of erythrocytes to see on a slide?
2 to 3/ hpf
How can you tell the difference between RBCs and fat?
Add a drop of 3% acetic acid (dilute vinegar) to the sediment.
The RBCs will lyse and the fat will remain
Pyuria
Excess white blood cells in urine
When there are more than 2-3 WBC/hpf what does that indicate?
An inflammatory response
What do neutrophils look like under a microscope?
Glitter cells
Mostly neutrophils so they appear granular
What does an increased number of epithelial cells indicate?
Inflammation
What are the three types of epithelial cells?
Squamous Epithelial Cells
Transitional Epithelial Cells
Renal Tubular Epithelial Cells
What kind of epithelial cells are usually not significant?
Squamous Epithelial Cells
What kind of epithelial cells comes from the sloughing of the distal urethra, vagina, vulva, and prepuce and have a “cornflake” appearance?
Squamous Epithelial Cells
What kind of epithelial cells are not found on cysto or catheter samples?
Squamous Epithelial Cells
What kind of epithelial cells line the urinary bladder or ureters?
Transitional epithelial cells
What kind of epithelial cells increase with catheterization, cystitis, pyelonephritis?
Transitional epithelial cells
What are round, sometimes pear or caudate, and have a round nucleus?
Transitional epithelial cells
What causes a “boat” of transitional cells?
Catheterization
What are the “boats” of transitional epithelial cells?
When the catheter sucks up cells from the wall of the urinary bladder
What are the smallest epithelial cells, and the most clinically significant epithelial cells? These may be confused with WBCs
Renal Tubular Epithelial Cells
What does a higher number of renal tubular epithelial cells indicate?
Kidney disease
What shape are renal tubular epithelial cells when they are in position on the tubules and what are their shape when released?
Cuboidal and round
What kind of cancer is associated with transitional epithelial cells
Transitional Cell Carcinoma
List the 5 cells found in urine from largest to smallest
Squamous epithelial cells Transitional epithelial cells Renal tubular epithelial cells Leukocytes Erythrocytes
