Microscopic Urinalysis

Question 1

What elements will you see on a microscopic evaluation of urine?

Answer 1

Cells
Casts
Crystals
Microorganisms
Misc findings

Question 2

What kind of cells will you see?

Answer 2

Erythrocytes
Leukocytes
Squamous epithelial cells
Transitional epithelial cells
Renal epithelial cells

Question 3

What three factors may affect how the erythrocytes look on the microscope?

Answer 3

Urine concentration
pH
time elapsed from collection

Question 4

What do erythrocytes look like in a fresh sample?

Answer 4

Small, round, smooth edges

Question 5

What do erythrocytes look like in an older, concentrated sample?

Answer 5

Shrunk, crenated

Question 6

What do erythrocytes look like in a dilute urine sample?

Answer 6

Swollen and lysed

Question 7

What is the normal amount of erythrocytes to see on a slide?

Answer 7

2 to 3/ hpf

Question 8

How can you tell the difference between RBCs and fat?

Answer 8

Add a drop of 3% acetic acid (dilute vinegar) to the sediment.
The RBCs will lyse and the fat will remain

Question 9

Pyuria

Answer 9

Excess white blood cells in urine

Question 10

When there are more than 2-3 WBC/hpf what does that indicate?

Answer 10

An inflammatory response

Question 11

What do neutrophils look like under a microscope?

Answer 11

Glitter cells

Mostly neutrophils so they appear granular

Question 12

What does an increased number of epithelial cells indicate?

Answer 12

Inflammation

Question 13

What are the three types of epithelial cells?

Answer 13

Squamous Epithelial Cells
Transitional Epithelial Cells
Renal Tubular Epithelial Cells

Question 14

What kind of epithelial cells are usually not significant?

Answer 14

Squamous Epithelial Cells

Question 15

What kind of epithelial cells comes from the sloughing of the distal urethra, vagina, vulva, and prepuce and have a “cornflake” appearance?

Answer 15

Squamous Epithelial Cells

Question 16

What kind of epithelial cells are not found on cysto or catheter samples?

Answer 16

Squamous Epithelial Cells

Question 17

What kind of epithelial cells line the urinary bladder or ureters?

Answer 17

Transitional epithelial cells

Question 18

What kind of epithelial cells increase with catheterization, cystitis, pyelonephritis?

Answer 18

Transitional epithelial cells

Question 19

What are round, sometimes pear or caudate, and have a round nucleus?

Answer 19

Transitional epithelial cells

Question 20

What causes a “boat” of transitional cells?

Answer 20

Catheterization

Question 21

What are the “boats” of transitional epithelial cells?

Answer 21

When the catheter sucks up cells from the wall of the urinary bladder

Question 22

What are the smallest epithelial cells, and the most clinically significant epithelial cells? These may be confused with WBCs

Answer 22

Renal Tubular Epithelial Cells

Question 23

What does a higher number of renal tubular epithelial cells indicate?

Answer 23

Kidney disease

Question 24

What shape are renal tubular epithelial cells when they are in position on the tubules and what are their shape when released?

Answer 24

Cuboidal and round

Question 25

What kind of cancer is associated with transitional epithelial cells

Answer 25

Transitional Cell Carcinoma

Question 26

List the 5 cells found in urine from largest to smallest

Answer 26

Squamous epithelial cells
Transitional epithelial cells
Renal tubular epithelial cells
Leukocytes
Erythrocytes