Routine Urinalysis- Microscope Exam of Urine Flashcards
Steps for proper speciman
Collection, Rapid transport to lab, and prompt examination (within 30 minutes-hour limit)
Volume of urine evaluated
12 mL (10-15mL range)
Centrifugation (speed and time)
400-450g for 5 minutes
Urine volume to resuspend sediment ratio
12:1
How many field of views for examination under microscope?
10-12
In what type of urine do you see RBCs crenate
Hypertonic urine
In what type of urine will you see RBC swell
Dilute or hypotonic urine (ghost RBC)
WBC in urine is called __________ and indicates an __________________ and the normal WBC/hpf is _________
Leukocyturia, infection (bacterial, non-bacterial), 0-8WBC/hpf
Non-granular WBC (lymphocytes) WILL or WILL NOT react with reagent strip creating a _______ ___________
WILL NOT react creating a FALSE NEGATIVE
What is the most common type of epithelial cell found in urine?
Squamous epithelial cell
Where do Squamous epithelial cells originate from?
superficial lining of urethra and vagina
Transitional cell originate where?
lining of renal pelvis, ureters, BLADDER, upper urethra
Increased numbers of Transitional epithelial cells may indicate what?
UTI, collection by catheterization, or malignancy
Renal tubular epithelial cells originate in lining of renal tubules and increased numbers indicate…
tubular necrosis
A clue cell is what type of cell with bacteria adhering to it? And presence of clue cells indicates what?
A squamous epithelial cell and may indicate bacterial vaginal infection.
Transitional epithelial cells are much larger than WBC because of abundant cytoplasm. What is the nucleus to cytoplasm ratio?
~1:5
Oval fat bodies (OFB) is what type of cell with absorbed fat?
Renal tubular epithelial
The lab must see what using polarized microscopy to verify cell is OFB?
maltese cross
OFB indicates what?
Pathology- associate with high protein in urine
Large amounts of these may indicate improper collection technique
Squamous Epithelial cells
Presence of casts reflect the health of the…
Renal tubules
Normally, you can see few _________ casts or _______ casts
hyaline or granular
Cast formation is increased by (4 things)
Acidity of urine, increased solute concentration, urine stasis, presence of plasma proteins
The __________ cast is the most common cast seen in normal individuals (0-2 casts/lpf). Increased amounts seen with what?
Hyaline casts: seen with dehydration, fever, emotional stress, strenuous exercise
RBC, WBC, epithelial, waxy, fatty, and broad casts are always
Pathologic
True or false:
1) Casts are formed in the urine?
2) Acid pH and urine stasis are conductive for cast formation?
3) Casts are enumerated using high power objective?
4) Hyaline and RBC are not pathologic?
1) False
2) True
3) False
4) False
If crystals are found in urine it is….
Pathologic
All clinically significant crystals are found in (Acid urine/ alkaline urine)?
Acid urine
Crystal formation is enhanced by (4 things)
Increased solute concentration, urine pH, urine stasis, and temperature (cooler temps)
Normal acid pH crystals: (3)
Amorphous urates, uric acid, calcium oxalate
The most frequently observed crystal in urine is
Calcium oxalate
Normal Alkaline pH Crystals (3)
Amorphous phosphates, triple phosphate, ammonium biurate
The most frequently observed crystal in alkaline urine is:
Triple phosphate crystals (coffin lid crystals)
Pathologic crystals (acid, neutral pH): (5)
Cystine, tyrosine, leucine, cholesterol, bilirubin
A positive ictotest will confirm what type of crystals
Bilirubin
True or False:
1) Crystals are identified by shape and urine pH?
2) Uric acid crystals are found in acid urine and are shaped like a coffin lid?
3) Presence of ammonium biurate crystals indicate the urine is old?
4) Presence of bilirubin crystals indicate severe liver disease?
1- true
2- False
3- True
4- True
Bacteria presence in urine may indicate what?
UTI or contamination
You correlate nitrite reagent strip with what in urine?
Bacteria
With bacteria in the urine, it is normally a ______ pH?
Alkaline
This will not lyse with acetic acid or KOH
Yeast
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