OS 214 Renal Pathology Pictures Flashcards
1
Q
Identify the pointed structure (from Rosai & Ackerman)
A
Foot processes (epithelial aspect of BM). Electron micrograph of normal glomerulus. EN (endothelial cell); EP (epithelial cell); ME (mesangium).
2
Q
Identify (from Rosai & Ackerman).
A
Minimal change disease (minimal abnormality in LM). Glomerulus normocellular, BM normal thickness. Most common cause of nephrotic syndrome in children. Characterized by diffuse effacement of foot processes in EM.
3
Q
Identify (from Rosai & Ackerman).
A
Minimal Change Disease in EM. Note effacement of foot processes.
4
Q
Identify (from trans)
A
FSGS under LM. With segmental sclerosis (pointed), and obliteration of glomerular capillaries.
5
Q
Identify (from trans).
A
FSGS under LM with hyalinosis (pointed).
6
Q
Identify (from Rosai & Ackerman)
A
FSGS under IF. (+) segmental deposition of IgM.
To differentiate from MCD:
Under LM, FSGS is already present. MCD looks normal.
Under IF: MCD is usually negative for Igs and C3.
7
Q
Identify (from trans).
A
Membranous glomerulopathy (LM). Note normal to diffuse thickening of capillary wall. (+) foam cells in interstitium.
8
Q
Identify (from Rosai & Ackerman)
A
MGN. Silver preparation showing “spike” formation along thickened BM.
9
Q
Identify (be specific) (from Rosai & Ackerman).
A
MGN Stage I (EM). BM normal thickness. (+) subendothelial deposits (arrows). Epithelial foot processes obliterated.
10
Q
Identify (be specific) (from Rosai & Ackerman).
A
MGN Stage II. Subepithelial deposits at regular interval, separated by projections of BM.
11
Q
Identify (be specific) (from Rosai & Ackerman).
A
MGN Stage III. BM markedly thickened; deposits appear to be surrounded by newly formed BM (arrows).
12
Q
Identify (be specific) (from Rosai & Ackerman).
A
MGN Stage IV. BM markedly irregular; deposits lysed, leaving large electron-lucent areas;
“moth-eaten appearance”
13
Q
Identify (from Rosai & Ackerman).
A
MGN. (+) Peripheral GRANULAR deposits of IgG +/- C3.
14
Q
Identify (from trans).
A
Membranoproliferative GN - (+) mesangial cell proliferation, BM thickening, & leukocyte infiltration (top image); MPGN under IF (bottom image).
15
Q
Identify A & B (from trans).
A
A - MPGN Type I.
B - MPGN Type II/”Dense Deposit Disease”
16
Q
Identify (from Rubin’s, not Robbin’s haha)
A
FSGS (PAS stain). Note perihilar areas of segmental sclerosis and adjacent adhesions to Bowman’s capsule.
17
Q
Identify (from Rubin’s).
A
FSGS in HIV nephropathy (silver stain).
18
Q
Identify (from Rubin’s; don’t mind the number haha)
A
Membranous glomerulonephritis. Glomerulus slightly enlarged and shows diffuse thickening of capillary walls. No hypercellularity.
19
Q
Identify (from Rubin’s)
A
Membranous glomerulopathy, Stage II (EM). Deposits of electron-dense material (arrows), with intervening projections of BM material.
20
Q
Identify (from Rubin’s).
A
Membranous glomerulopathy (IF). (+) granular deposits of IgG outlining capillary loops.
21
Q
Identify (from Rubin’s).
A
Diabetic glomerulosclerosis (PAS stain). There is increase in mesangial matrix, forming several nodular lesions. Some capillary BM thickened, dilation of glomerular capillaries evident.
22
Q
Identify (from Rubin’s).
A
Amyloid nephropathy.
23
Q
Identify (from Rubin’s).
A
Amyloid nephropathy (congo red stain). Amyloid deposits show characteristic APPLE-GREEN BIREFRINGENCE.
24
Q
Identify (from Rubin’s).
A
Alport Syndrome (hereditary nephritis). Note “BASKET WEAVE” appearance - lamina densa of glomerular BM is laminated (arrows) rather than forming a single dense band.
Due to mutations in genes that encode Type IV collagen (alpha 3,4,5 chains).
25
Identify (from Rubin's).
Acute poststreptococcal glomerulonephritis (Masson-Trichome stain) with numerous neutrophils.
26
Identify (from Rubin's).
Acute postinfectious glomerulonephritis (EM). With numerous subepithelial "HUMPS" (arrows).
27
Identify (from Rubin's).
MPGN Type I. Glomerular lobulation accentuated; increased cells and matrix in the mesangium and thickening of capillary walls are noted.
28
Identify (from Rubin's).
MPGN Type II. Capillary wall thickening, hypercellularity, and a small crescent are evident.
29
Identify (from Rubin's).
MPGN Type II / "Dense deposit disease" with RIBBON-like appearance due to linear deposition of PAS-positive material along BM.
30
Identify (from Rubin's).
MPGN Type I (IF). Granular to band-like staining for C3 in capillary walls and mesangium.
31
Identify (from Rubin's).
MPGN Type II (IF). Bands of capillary wall staining and coarsely granular mesangial staining for C3.
32
Identify (from Rubin's).
Proliferative lupus glomerulonephritis (LM). Hypercellularity and thickening of capillary walls present.
33
Identify (from trans) + type of RPGN.
SLE (IF). Type II RPGN. - characteristic "FULL HOUSE" configuration (for higher learning lang haha, since can't be differentiated without the proper marker testing)
34
Identify (from Rubin's).
IgA nephropathy (Berger's disease) (IF). Deposits of IgA in mesangial areas.
35
Identify (from Rubin's).
IgA nephropathy (PAS stain). Segmental mesangial HYPERcellularity and matrix expansion caused by mesangial immune deposits.
36
Identify (from Rubin's).
IgA nephropathy (EM). With prominent dense deposits in mesangial matrix (arrow).
37
Identify + type of RPGN (from trans).
SLE. Type II RPGN (immune-complex). Fingerprinting and curvilinear pattern.
38
Identify + type of RPGN (from Rubin's).
Anti-GBM glomerulonephritis. LINEAR deposits. Type I RPGN. Associated with pulmonary hemorrhage.
39
Identify + type of RPGN (from Rubin's).
Anti-GBM, type I RPGN. Bowman space filled with cellular crescent (Masson-trichome stain).
40
Identify + Type of RPGN (from Rubin's).
ANCA glomerulonephritis. RPGN Type III (pauci-immune). Segmented fibrinoid necrosis illustrated.
41
Identify (from trans).
Chronic GN. With sclerosis, fibrosis, atrophy, and thickening of blood vessels.
Poststrep GN, RPGN, MGN, MPGN, FSGS, IgA can all lead to Chronic GN.
42
Identify (from Lab Trans).
Acute GN. Shows enlarged hypercellular glomeruli due to:
- infiltration of neutrophils and monocytes
- proliferation of endothelial and mesangial cells
- crescent formation (proliferation of the parietal epithelium)
43
Identify (from Lab Trans).
Acute Tubular Necrosis.
-evidenced by
the disrupted cell
architecture, granular,
eosinophilic cytoplasm and
desquamation of the
tubular epithelium
-in urinalysis: with MUDDY BROWN CASTS
44
Identify (from Rosai & Ackerman).
Polyarteritis nodosa. Fibrinoid necrosis involving two medium-sized arteries.
45
Identify (from trans).
Thin Basement Membrane Disease. Shows thinning of GBM (arrows) and effacement (minimal change disease).
46
Identify (from trans).
Diabetic glomerulosclerosis.
47
Identify A & B (from trans).
(A) Fibrillary GN showing slightly curved fibrils
(12-16mm in diameter) relatively thinner than
(B) Immunactoid
GN presenting with thick fibrils (48-55mm in diameter),
appearing as microtubules with electron lucent center
48
Identify (from trans).
Essential Mixed Cryoglobulinemia under EM
showing (left) deposits within phagolysosomes of mononuclear
phagocytes and (right) deposits with microtubular profiles.
49
Identify (from trans).
Plasma cell dyscrasias
showing (A) light
chain myeloma casts with fractures, polychromasia, leukocytic
reaction, and tubule cell damage [H&E]; (B) light chain deposition
glomerulus with increased lobulation and hypercellularity [H&E];
(C) IF showing bright linear stains of lambda light chains [TBM, no
stain for kappa]; (D) EM showing fine granular deposits within
GBM
50
Identify (be specific) (from Rubin's).
Ischemic acute tubular necrosis. Note lack of interstitial inflammation and presence of some regenerative-appearing epithelial cells.
51
Identify (be specific) (from Rubin's).
Toxic acute tubular necrosis. Interstitial inflammation minimal; there is widespread necrosis of proximal tubular epithelial cells, with sparing of distal and collecting tubules.
52
Identify (from Rubin's).
ACUTE pyelonephritis. There is extensive infiltrate of neutrophils present in collecting tubules and interstitial tissue. "Parang nilalanggam".
53
Identify (be specific) (From Rubin's).
CHRONIC pyelonephritis. With many tubules containing eosinophilic hyaline casts resembling colloid of of thyroid follicles (THYROIDIZATION). The interstitium is scarred and contains a chronic inflammatory infiltrate.
54
Identify (from Lab Trans).
Xanthogranulomatous Pyelonephritis. Characterized by accumulation of FOAMY MACROPHAGES mixed with plasma cells, lymphocytes, leukocytes, and a few giant cells.
Usually related to PROTEUS infection and/or obstruction.
55
Identify (from Lab Trans).
Renal Infarction.
Usually of the
coagulative or “white”
type, due to lack of
collateral blood supply
• Wedge-shaped, pale
areas with apex at the
medulla, and showing
coagulative necrosis
56
Identify (from Lab Trans).
Benign Nephrosclerosis.
• Thickening and hyalinization
of arteriolar walls and small
arteries (hyaline
arteriolosclerosis)
• May be accompanied by
medial and intimal
thickening of the interlobar
and arcuate arteries
(fibroelastic hyperplasia)
• Vascular narrowing may
cause patchy ischemia with
tubular atrophy, instertitial
fibrosis, and glomerular
alterations
57
Identify (from Lab Trans).
Renal Cell Carcinoma (Conventional Type)
• Solid, trabecular or tubular
proliferation of large, round
to polygonal cells. Cytoplasm
varies form clear with sharply
outlines boundaries
(vegetable cells), to deeply
granular
• May be occasional central,
rounded luminal spaces with
lightly eosinophilic serous
fluid
• Contains regular network of
small, thin-walled blood
vessels
• Nuclei are usually
centrally located; and
the level of its atypia is
used for histologic
grading
58
Identify (from Lab Trans).
Infiltrating Transitional Cell Carcinoma.
• Arises from urothelium of
renal pelvis , and is
histologically similar to
bladder counterparts
• Infiltrating type has
cohesive nests of cells
with moderate to
abundant amphophilic
cytoplasm
• Palisading of nuclei may
be seen at edges of large
nests
• Cells have large,
hyperchromatic,
pleomorphic nuclei with
irregular contours and
angular profiles. Nucleoli
are variable
59
Identify (from Lab Trans).
Angiomyolipoma.
• Composed of variable
mixture of mature fat,
thick-walled poorly
organized blood vessels,
and smooth muscles that
appear to radiate from
the blood vessels walls
• Sharp demarcation from
surrounding kidney, with
occasional entrapped
renal tubules at its
periphery
60
Identify (from Lab Trans).
Renal Tuberculosis.
• Presence of chronic
granulomatous
inflammation with
caseation necrosis and
Langhan type giant cells
in the renal parenchyma
61
Identify (from Lab Trans).
Uteritis.
• Inflammation of the
ureter, usually not
associated with infection
and of little consequence
• Mucous may have fine
cysts (ureteritis cystica)
or germinal centers
(ureteritis follicularis)
62
Identify (from Rubin's).
Staghorn calculi.
63
Identify (from Rubin's).
Hydronephrosis.
64
Identify (from Rubin's).
Wilm's tumor.
65
Identify (from Rubin's).
Clear cell renal cell carcinoma.
Yellow areas correspond to lipid-containing cells.
66
Identify (from Rubin's).
Clear cell renal cell carcinoma. Island of neoplastic cells with abundant clear cytoplasm.
67
Identify (from Rubin's).
Papillary renal cell carcinoma. (+) Papillary fronds covered by neoplastic cells.
68
Identify (from Rubin's).
Chromophobe renal cell carcinoma.
-pale acidophilic granular cells with prominent cell borders.
69
Identify (from Rubin's).
Acute cystitis.
70
Identify (from Rubin's).
Acute cystitis. With PMN leukocytes infiltrate the mucosa.
71
Identify (from Rubin's).
Chronic cystitis.
-nonspecific inflammatory infiltrate
composed of lymphocytes and plasma cells is present in the edematous
lamina propria.
72
Identify (from Rubin's).
Uteritis cystica.
73
Identify (from Rubin's).
Urothelial cell carcinoma in situ.
-mucosa
shows nuclear pleomorphism and lack of polarity from the basal layer
to the surface, without evidence of maturation
74
Identify (from Rubin's).
Urothelial carcinoma of the bladder.
-exophytic tumor situated above the bladder neck
75
Identify (from Rubin's).
Low grade papillary urothelial carcinoma.
-consists of exophytic
papillae that have a central connective tissue core and are lined by slightly disorganized transitional epithelium.
76
Identify (from Rubin's).
High grade papillary urothelial carcinoma.
C. High-grade
papillary urothelial carcinoma shows prominent architectural disorganization of the epithelium, which contains cells with
pleomorphic hyperchromatic nuclei.
D. Invasive high-grade papillary urothelial carcinoma consists of irregular nests of
hyperchromatic cells invading into the muscularis.
77
Identify (from Patho Plenary trans).
Wilm's Tumor.
-Pale staining
stroma (light pink) alternating with darkly staining undifferentiated
blastemal component (dark violet. Not leukocytes). Within the
blastema, epithelial differentiation in the form of irregular ribbons
and tubules is seen (encircled)
78
Identify (from Patho Plenary Trans).
Wilm's tumor.
79
Identify (from Patho Plenary Trans).
Renal cell carcinoma, clear cell type.
This 8 cm carcinoma of the lower pole of
the kidney shows extension beyond the cortical surface, but it does
not infiltrate the perinephric adipose tissue. It is well delineated,
with cystic spaces, lobulated (due to septae), dark yellow in color
(due to lipids). Hemorrhagic necrosis present.
80
Identify (from Patho Plenary Trans).
Renal cell carcinoma, clear cell type.
81
Identify (from Gross Lab Trans).
Hydronephrosis.
82
Identify (from Gross Lab Trans).
Renal tuberculosis. Cheesy friable material (pointed).
83
Identify (from Gross Lab Trans).
Simple cyst.
1.Perinephric
-came from somewhere else
that seeded into the kidney
(usually hematogenous spread)
2. Nephric
-Came from within the kidney
itself
84
Identify (from Gross Lab Trans).
Multicystic disease.
types:
1. Autosomal dominant
polycystic kidney disease
(shown in picture)
-adult onset
-with hematuria, mass,
flank pain, htn, renal
failure
2. Autosomal recessive
polycystic kidney disease
-onset: childhood/infancy
-maaga namamatay
85
Identify (from Gross Lab Trans).
Renal cell carcinoma.
Usual site of metastasis: lungs and bones.
86
Identify (from Gross Lab Trans).
Urothelial CA/Transitional cell CA
• 2 types of growths:
1. Exophytic/fungating
2. Endophytic
• Bad prognosis since in could travel out to
bladder, ureter etc.
87
Identify (from Urologic Tumors Trans).
Renal Papillary Adenoma.
Gross and microscopic presentation of RPA. (L) Gross:
discrete, well-circumscribed nodule. (R) Microscope: complex,
branching papillomatous structures with numerous complex
fronds.
• Arise from the renal tubular epithelium
88
Identify (from Urologic Tumors Trans).
Angiomyolipoma.
89
Identify (from Urologic Tumors Trans).
Oncocytoma.
-Fairly uniformed cells with sheets or nests appearance
of cells.
90
Identify (from Urologic Tumors Trans).
Renal papillary carcinoma.
Note the papillae and foamy macrophages in the stalk.
91
Identify (from Urologic Tumors Trans).
Chromophobe carcinoma.
Note the pale eosinophilic cell with HALO arranged in
solid sheets.
92
Identify A,B,C & D (from Urologic Tumors Trans).
(A) Carcinoma in situ – full thickness but does not
infiltrate BM; (B) Papillary TCCA; (C & D) TCCA infiltrative
93
Identify (from Urologic Tumors Trans).
Papillomas.
(L) Cross section of the bladder with upper section
showing a large papillary tumor. Lower section demonstrates
multifocal smaller papillary neoplasm.
(R) Papilloma consisting of
small papillary fronds lined by normal appearing urothelium.
94
Which is low grade, and high grade papillary urothelial carcinoma (from Urologic Tumors Trans)?
Low grade (L) vs. High grade (R). Low grade PUCA
with an overall orderly appearance, thicker lining than papilloma
and scattered hyperchromatic nuclei and mitotic figure. High
grade PUCA on the other hand shows marked cytologic atypia.
95
MEMORIZE & UNDERSTAND. Swear. Haha (from Urologic Tumors Trans).:
1. Papillary urothelial neoplasms of low malignant
potential (PUNLMP)
Same as papilloma but with thicker urothelium
Rare progression to tumors of higher grade
2. LOW-GRADE papillary urothelial carcinomas
Orderly architectural and cytologic appearance
Polarity maintained and cells cohesive
Mild atypia – scattered hyperchromatic nuclei,
infrequent mitotic figures, slight variation in nuclear
size and shape
3. HIGH GRADE papillary urothelial cancers
Dyscohesive cells with large hyperchromatic
nuclei
Some cells highly anaplastic
Frequent mitoses, some atypical
Disarray and loss of polarity
Higher incidence of invasion, progreesion, and
metastasis
96
Identify (from Urologic Tumors Trans).
Squamous cell carcinoma (bladder tumor).
(+) KERATIN PEARLS
97
Identify (from Urologic Tumors Trans).
Adenocarcinoma of the bladder.
98
Identify (from Radio Lab Trans).
Medullary nephrocalcinosis.
99
Identify (from Radio Lab Trans).
Nephrolithiasis.
100
Identify (from Radio Lab Trans).
Nephrolithiasis.
101
Identify (from Radio Lab Trans).
Ureterolithiasis, left
102
Identify (from Radio Lab Trans).
Cystolithiasis.
Calcific density floating within the bladder.
103
Identify (from Radio Lab Trans).
Hydronephrosis.
104
Identify (from Radio Lab Trans).
Hydronephrosis.
105
Identify (from Radio Lab Trans).
Ureteral obstruction secondary to fibrosis. Note: dilation proximal to stricture.
106
Identify (from Radio Lab Trans).
Renal tuberculosis.
107
Identify (from Radio Lab Trans).
Bacterial pyelonephritis with abscess formation.
108
Identify (from Radio Lab Trans).
Bacterial pyelonephritis.
Infected and swollen kidney
Notes:
Not all large kidneys are compensating/hypertrophied kidneys or masses, consider
edema. R kidney is edematous and seen to be almost touching the anterior
abdominal wall
109
Identify (from Radio Lab Trans).
Transitional cell carcinoma of the renal pelvis.
Notes: looks homogenous, and seems to be growing upward
110
Identify (from Radio Lab Trans).
Renal carcinoma (MRI).
Note: the whole thing is the mass.
111
Identify (from Radio Lab Trans).
Renal Carcinoma (MRI).
112
Identify (from Radio Lab Trans).
Bilateral Wilm's Tumor.
113
Identify (from Radio Lab Trans).
Hematoma surrounding the bladder.
114
Identify (from Radio Lab Trans).
Urinary bladder CA (MRI).
115
Familiarize on scout film.
Psoas line, kidney shadow.
- R kidney: smaller and lower
- L kidney: larger and higher
Make sure kidneys are intact, check for
hematomas, retroperitoneal opacities,
obstruction of the psoas line
Plain KUB film -\> Nephrogram Phase (3 mins) -\>Pyelogram phase (5 mins)-\>Bladder filling (10 mins)-\>full bladder film -\> Post-void film
116
Identify (from Radio Lab Trans).
Enlarged prostate (UTZ)
Note: see protrusion into bladder.
117
Identify (from Radio Lab Trans).
Cystitis (UTZ).
118
Identify (from 2015 reviewer).
Acute pyelonephritis (gross).
119
Identify (from 2015 reviewer).
Papillary necrosis (gross).
120
Identify (from 2015 reviewer).
Chronic pyelonephritis (gross).
121
Identify (from 2015 reviewer).
Chronic pyelonephritis (LM).
122
Identify (from 2015 reviewer).
Chronic pyelonephritis.
Note thyroidization
123
Identify (from 2015 reviewer).
Benign nephrosclerosis (gross).
124
Identify (from 2015 reviewer).
Benign nephrosclerosis (LM).
125
Identify (from 2015 reviewer).
Benign nephrosclerosis (LM).
126
Identify (from 2015 reviewer).
Benign nephrosclerosis.
127
Identify (from 2015 reviewer).
Malignant hypertension (gross).
Note: FLEA-BITTEN appearance (due to petechial hemorrhages).
128
Identify (from 2015 reviewer).
Malignant hypertension (LM).
Note: ONION-SKIN APPEARANCE due to layering of collagen.
129
Identify (from 2015 reviewer).
Malignant hypertension (LM).
Onion-skin appearance.
130
Identify (from 2015 reviewer).
Renal infarct.
131
Identify (from 2015 reviewer).
Angiomyolipoma (gross).
132
Identify (from 2015 reviewer).
Angiomyolipoma.
133
Identify (from 2015 reviewer).
Oncocytoma (gross).
134
Identify (from 2015 reviewer).
Oncocytoma (LM).
135
Identify (from 2015 reviewer).
Oncocytoma.
136
Identify (from 2015 reviewer).
Collecting duct/Bellini duct carcinoma.
137
Identify (from 2015 reviewer).
Sarcomatoid renal cell carcinoma.
138
Identify (from 2015 reviewer).
Papillary urothelial carcinoma of the renal pelvis.
139
Identify (from 2015 reviewer).
Wilm's tumor (LM).
140
Identify (from 2015 reviewer).
Urothelial papilloma, LM (LPO).
141
Identify (from 2015 reviewer).
Urothelial papilloma, LM.
142
Identify (from 2015 reviewer).
Papillary urothelial neoplasm of low malignant potential (PUNLMP).
143
Identify (from 2015 reviewer).
PUNLMP.
144
Identify (from 2015 reviewer).
Low grade papillary urothelial carcinoma.
145
Identify (from 2015 reviewer).
High grade papillary urothelial carcinoma.
146
Identify (from 2015 reviewer).
Carcinoma in situ (flat urothelial carcinoma).
Note: only urothelium will be affected.
147
Identify (from 2015 reviewer).
Invasive urothelial cancer (gross).
148
Identify (from 2015 reviewer).
Invasive urothelial cancer.
149
Identify (from 2015 reviewer).
Squamous cell CA of the bladder.
150
Identify (from 2015 reviewer).
Leiomyoma (mesenchymal tumor of the bladder).
151
Identify (from 2015 reviewer).
Leiomyosarcoma.
152
Identify (from 2015 reviewer).
Embryonal rhabdomyosarcoma.
153
Identify (from 2015 reviewer).
Benign prostatic hyperplasia.
154
Identify (from 2015 reviewer).
Benign prostatic hyperplasia (LM).
155
Identify (from 2015 reviewer).
Benign prostatic hyperplasia.
156
Identify (from 2015 reviewer).
Benign prostatic hyperplasia.
157
MEMORIZE!
158
Prostatic adeno CA (from 2015 reviewer).
Gleason score?
Gleason 2.
159
Prostatic adeno CA (from 2015 reviewer).
Gleason score?
Gleason 3.
160
Prostatic adeno CA (from 2015 reviewer).
Gleason score?
Gleason 4.
161
Prostatic adeno CA (from 2015 reviewer).
Gleason score?
Gleason 5.
162
Identify (from 2015 reviewer).
Prostatic adenoCA with crystalloids.
163
Color of urine dipstick if negative for glucose test?
Blue
164
What test to use for reducing sugars?
CuSO4 test
165
Color for (-) bilirubin on urine dipstick
light yellow
166
Color of urine dipstick if +++ for bilirubin
Pink
167
Color for (-) ketone
Light tan
168
Ketone urine dipstick test only measures what?
acetoacetate
169
Interference in specific gravity testing?
Alkaline urine.
170
Sugar NOT measured by CuSO4 testing
## Footnote
A. Galactose
B. Lactose
C. Sucrose
D. Maltose
C. Sucrose
171
Color of hemolyzed blood trace in urine dipstick
Yellow-green
172
Type of urine dipstick test whose limitation is the "run-over effect"
pH testing (will lead to false acidic reading).
Keep strip horizontal after dipping in urine to prevent this run over effect.
173
Protein testing in urine dipstick is most sensitive to what protein?
Albumin
174
(+) Nitrite test suggests presence of what?
Gram-negative bacteriuria
175
Identify.
Dysmorphic RBCs with some normal RBCs.
| (Normal RBCs: \> 10 per HPF)
176
Identify the pointed structures.
PMN cells.
Neutrophils: glitter cells
177
Identify.
Benign tubular epithelial cells.
178
Identify.
Benign transitional epithelial cells from bladder.
L: w/o stain
R: w/ stain
179
Identify the structure and what it indicates.
Oval fat body with Maltese Cross appearance.
Indicates nephrosis.
180
Identify.
Yeast exhibiting budding + crenated RBC
181
Type of cast
RBC casts
182
Type of cast. Also identify the pointed structures.
WBC casts (also called glitter cells) stuck together by
Tamm Horsfall protein (pointed)
183
Type of cast
Granular cast
184
Type of cast
Hyaline cast (consists almost entirely of Tamm Horsfall protein)
185
Type of cast and what it indicates
Waxy cast
-represents urine stasis or CRF
186
Type of cast
Fatty cast
- associated with nephrotic syndrome, toxic tubular necrosis, DM, and crash injuries
- may consist of multiple Maltese crosses
187
Type of crystal and identify if normal/abnormal
Calcium oxalate crystals. Normal.
188
Type of crystal and identify if normal/abnormal
Triple phosphate crystals. Normal.
"Coffin lid appearance"
Signifies alkaline pH
189
Type of crystal and identify if normal/abnormal.
Urate crystals. Normal.
Most commonly seen as AMORPHOUS urates,
uric acid, acid urates, and sodium urates.
190
Type of crystal and identify if normal/abnormal.
Tyrosine crystals. ABNORMAL.
Associated with LIVER DISORDERS.
191
Type of crystal and identify if normal/abnormal
Cystine crystals. ABNORMAL.
Associated with hereditary cystinuria.
192
Type of crystal and identify if normal/abnormal
Ammonium biurate crystals. Normal.
Yellow brown crystals. "Thorny apple"
193
Type of crystal and identify if normal/abnormal
Cholesterol crystals. ABNORMAL.
Colorless rectangular with notched edges/plates
Lipiduria-like nephrotic sydrome
