Sediment Constituents (Cells) Flashcards
What does the Sternheimer-Malbin (SM) stain delineate?
Structure and contrasting colors of the nucleus and cytoplasm.
What does the Sternheimer-Malbin (SM) stain identify?
WBCs, epithelial cells, and casts.
What are the components of the Sternheimer-Malbin stain?
Crystal violet + Safranin O
Available as KOVA and Sedi Stain.
What does Toluidine blue (supravital stain) differentiate?
WBCs and RTE cells.
What does 2% acetic acid distinguish?
RBCs from WBCs, yeast, oil droplets, and crystals.
What does lipid stains (Oil Red O and Sudan III) stain?
Triglycerides and neutral fats (not chole); orange-red.
Identifies free fat droplets and lipid containing cells and casts
What does the Gram stain differentiate?
Gram positive and negative bacteria.
Identifies bacterial casts
What does the Hansel Stain identify?
Consists of Eosin Y + Methylene Blue
Urinary eosinophils and stains eosinophilic granules.
What does Prussian blue (Rous test) identify?
Hemosiderin granules and stains structures containing iron.
What does Phenathridine stain?
DNA
Orange
What does Carbocyanine stain?
Nuclear membranes, mitochondria, and cell membranes.
COLOR IS GREEN
Bilirubin-stained or hemosiderin-laden is used for
RTE cells
What is the normal value of RBCs in urine?
0-2/0-3/HPF.
What causes crenated/shrinked cells in urine?
Hypertonic conditions.
What causes swelling/ghost cells/shadow cells in urine?
Hypotonic conditions.
What does dysmorphic red cells with projections and fragments in urine indicate?
acanthocytes are seen from (GI cells)
Glomerular membrane damage.
What are sources of error in detecting RBCs?
Yeasts, oil droplets, air bubbles, monohydrate calcium oxalate crystals.
Oil droplets (rainbow color), Monohydrate CaOx (Most different).
What is the remedy for errors in RBC detection?
Add 2% acetic acid; lyse RBCs but not the others.
What is the normal value of WBCs in urine?
0-5 or 0-8/HPF.
What are the most predominant WBCs in urine?
Neutrophils.
What happens to WBCs in hypotonic urine?
They swell and undergo Brownian movement, producing a sparkling appearance known as glitter cells.
What do dying neutrophils in urine form?
Blebs and finger-like projections (myelin forms).
What is the normal value of eosinophils in urine?
1%.
What does a significant rise in eosinophils in urine (>1%) indicate?
Acute interstitial nephritis.
PLS REMEMBER EOSINOPHILS INCREASE
What does increased lymphocytes in urine indicate?
Renal transplant rejection.
What does increased monocytes and histiocytes in urine indicate?
Chronic inflammation and radiation therapy.
What color are Sternheimer-Malbin Stain glitter cells?
Pale blue.
What color are Sternheimer-Malbin Stain leukocytes?
Pale pink.
What is the largest cell seen in urine?
5-7x the size of an RBC, nucleus is about the size of RBC
might resemble a cast
Squamous epithelial cell (S.E.C).
What are clue cells in urine?
S.E.C covered with G. vaginalis; associated with bacterial vaginosis and has shaggy cytoplasm.
What are transitional epithelial cells (T.E.C) in urine?
Cells about 20-30 um (4-6x of an RBC), spherical, polyhedral or caudate with centrally located nucleus.
Where are transitional epithelial cells (T.E.C) derived from?
Renal pelvis, calyces, ureter, urinary bladder, and upper male urethra.
What does increased T.E.C after catheterization indicate?
May be singly, in pairs, or in clumps called syncytia.
What does abnormal morphology of T.E.C indicate?
Malignancy or viral infection.
What is the most clinically significant epithelial cell?
Origin is from nephron; Size is 3-5x the RBC; Eccentric nucleus
Renal Tubular epithelial cells.
What is the form of RTE cells originating from the PCT?
Large, oblong, or cigar-shaped, with grainy cytoplasm.
What is the form of RTE cells originating from the DCT?
Smaller, round to oval, may be mistaken for WBCs.
What is the form of RTE cells originating from the CD?
Columnar, polygonal, or cuboidal with flat edge.
’> 2 RTE/HPF in urine is indicative of
Tubular injury.
What are oval fat bodies in urine?
Highly refractive RTE cells seen in nephrotic syndrome; lipid containing RTEs seen in lipiduria.
How are oval fat bodies (RTE) identified?
Using lipid stains (TAG and neutral fats) and polarizing microscope (cholesterol (maltese cross)).
What are bubble cells?
RTE with non-lipid vacuoles; injured cells in which endoplasmic reticulum has dilated prior to cell death; seen in acute tubular necrosis.
What is a true UTI composed of?
Bacteria and WBCs.
What is the most common cause of UTI?
E. coli (Enterobacteriaceae); Staphylococcus, Enterococcus are also causative agents.
What is a true yeast infection composed of?
Yeasts and WBCs.
What are yeasts?
Small, refractile oval structures that may or may not bud; branched mycelial forms are seen in severe infections.
What is the most commonly seen yeast in DM and vaginal moniliasis?
Candida albicans.
What is the most frequently encountered parasite in urine?
Trichomonas vaginalis.
What does Trichomonas vaginalis look like?
Pear-shaped flagellate with undulating membrane and jerky motility; reported as rare, few, moderate, or many per HPF.
What is the non-motile T. vaginalis resemble?
WBC, T.E.C, RTE cells.
What is the most common fecal contaminant in urine?
E. vermicularis.
What is Schistosoma haematobium associated with?
Hematuria and bladder cancer.
What are urinary bladder cancer markers?
NMP - Nuclear Matrix Protein, BTA - Bladder Tumor Antigen.
What does mucus thread in urine consist of?
Low refractive index and has a major constituent of Tamm-Horsfall protein (uromodulin).
What cells are quantified using LPF?
Epithelial cells, mucus threads, casts.
What cells are quantified using HPF?
Crystals (normal), bacteria, RBCs, WBCs.
What is the quantitation of epithelial cells (E.C) at 0-5/LPF?
Rare.
What is the quantitation of epithelial cells (E.C) at 5-20/LPF?
Few.
What is the quantitation of epithelial cells (E.C) at 20-100/LPF?
Moderate.
What is the quantitation of epithelial cells (E.C) at >100/LPF?
Many.
What is the quantitation of crystals (normal) at 0-2/HPF?
Rare.
What is the quantitation of crystals (normal) at 2-5/HPF?
Few.
What is the quantitation of crystals (normal) at 5-20/HPF?
Moderate.
What is the quantitation of crystals (normal) at >20/HPF?
Many.
What is the quantitation of bacteria at 0-10/HPF?
Rare.
What is the quantitation of bacteria at 10-50/HPF?
Few.
What is the quantitation of bacteria at 50-200/HPF?
Moderate.
What is the quantitation of bacteria at >200/HPF?
Many.
What is the quantitation of mucus threads at 0-1/LPF?
Rare.
What is the quantitation of mucus threads at 1-3/LPF?
Few.
What is the quantitation of mucus threads at 3-10/LPF?
Moderate.
What is the quantitation of mucus threads at >10/LPF?
Many.
What is the quantitation of squamous epithelial cells?
Rare, Few, Moderate, Many per LPF.
What is the quantitation of transitional epithelial cells?
Rare, Few, Moderate, Many per HPF.
How is RTE quantitation measured?
Average number per 10 HPFs.
How is oval fat bodies quantitation measured?
Average number per HPF.
How is abnormal crystals and casts quantitation measured?
Average number per LPF.
