MIDTERM-microscopic exam - urinary sediments - 11111 Flashcards
what are the urine sediments constituents
red blood cells
white blood cells
epithelial cells
bacteria
yeast
parasites
spermatozoa
mucus
casts
urinary crystals
___
determine the actual concentration of the sediment and, there
fore, the number of elements that may be present in a microscopic field.
urine sediment preparation methods
Of all the urine sediment elements, which sediment is the most difficult for students to recognize.
RBCs
In hyposthenuria, rbc tends to swell and burst leaving only the cell membrane.
These large empty
cells are called ____ and can be easily missed if specimens are not examined under reduced light
ghost cells
why do rbc is the hardest sediment to recognize among the urine sediments ?
lack of characteristics structures
variations in size
close resemblance to other urine sediment constituents
3 sediments that rbc’s are misidentified due to high resemblancy
yeast
oil droplets
air bubbles
what will aid us in differentiating yeast, oil droplets, and air bubbles from rbc?
yeast exhibits budding
oil ad air bubbles is highly refractile when the fine adjustment is focused up and down
The rough appearance of crenated RBCs may resemble the ___, but they are much smaller
than it.
granules seen in WBCs
____ staining can be used to confirm the presence of rbc and differentiate with wbc, yeast, oil, and air.
Supra vital
Should the identification continue to be doubtful, adding ___ to a portion of the sediment will lyse the RBCs, leaving the yeast, oil droplets, and WBCs intact. Supra
vital staining may also be helpful.
acetic acid
RBCs that vary in size, have cellular protrusions, or are fragmented are
termed __ and have been associated primarily with glomerular bleeding.
dysmorphic
The presence of RBCs in the urine is associated with damage
to the ___ or __ within the
genitourinary tract.
glomerular membrane or vascular injury
Macroscopic hematuria is fre
quently associated with advanced glomerular damage but is
also seen with damage to the vascular integrity of the urinary
tract caused by ___ , __, and ___
trauma, acute infection or inflammation, and
coagulation disorders.
The observation of microscopic hematuria can be critical
to the early diagnosis of glomerular disorders and malignancy
of the urinary tract and to confirm the presence of ___
renal calculi
The presence of not only RBCs but also hyaline, granular, and rbc cast. It sometimes can be caused by
strenuous exercise
The predominant WBC found in the urine sediment is
the ___.
neutrophil
Neutrophils are much easier to identify than
RBCs because they contain ___ and ___
granules and multilobed nuclei
Neutrophils lyse rapidly in ____ and begin to lose nuclear detail.
dilute alkaline urine
Neutrophils exposed to hypotonic urine absorb water and
swell. Brownian movement of the granules within these larger
cells produces a sparkling appearance, and they are referred to
as “____.”
glitter cells
neutrophils in hypotonic urine produces sparkling appearance and can be stained by __ appearing colored ____
sternheimer-malbin stain appearing colored light blue
The presence of urinary eosinophils is primarily associated
with ___.
drug-induced interstitial nephritis
The preferred urinary eosinophil test stain is __
Hansel stain
ifthere’s no hansel stain for eosinophil test, what stain we can used instead?
wright’s stain
Eosinophils are not normally seen in the
urine; therefore, the finding of more than how many percent eosinophils is
considered significant.
1%
WBC
Resembles RTE or renal tubular epithelial cells.
the difference is
RTE is larger with eccentrically located nucleus
what are the mononuclear cells
lymphocytes, monocytes, macrophages, and histiocytes
wbc that are large cells and may appear vacuolated or contain inclusions.
MONOCYTE, MACROPHAGES, HISTIOCYTES
WBCs in the process of ameboid motion
may be difficult to distinguish from epithelial cells because
of their irregular shape. ___ or the addition of
___ can be used to enhance nuclear detail if necessary.
Supravital staining; acetic acid
complete urinalysis correlation of wbc
Leukocyte esterase
Nitrite
Specific gravity
pH
source of identification erroe of wbc
RTE cells
An increase in urinary WBCs is
called ___ and indicates the presence of an infection or inflammation in the genitourinary system
pyuria
It is not unusual to find epithelial cells in the urine, because
they are derived from the linings of the ___.
genitourinary system
what are the Three types of
epithelial cells are seen in urine:
squamous, transitional (urothelial), and renal tubular
___are the largest cells found in the urine sediment.
Squamous epithelial cells
morphology of SQUAMOUS epithelial cells
They contain abundant, irregular cytoplasm and a prominent nucleus about the size of an RBC
They are often the first structures observed when the urine sediment
is examined under low-power magnification.
squamous epithelial cells
Squamous epithelial cells originate from the linings of the
female orga such as the ___ and the lower portion of the male
___.
vagina and female urethra; urethra
Difficulty identifying squamous cells is rare. However, they
may occasionally appear folded, possibly resembling a ___,
and will begin to disintegrate in urine that is not fresh
cast