UA microscopic Flashcards
Urine stored at refrigerator temp looked turbid possibly due to amorphous urate crystals, what should be considered in this situation?
warm up the specimen at 37 C to dissolve amorphous crystals
Test Significance
Clarity ___________________
Blood ____________________
Protein ___________________
Nitrite ___________________
Leukocyte esterase ___________
Glucose ____________________
Clarity - could be pathological or non-pathological. Hematuria,
myoglobinuria or hemoglobinuria
Blood - RBCs, RBC cast
Protein - cast, cells
Nitrite - bacteria, WBCs
Leukocyte esterase - WBC, WBC cast, bacteria, trichomonas
Glucose - yeast
Stain Uses
Prussian blue _______________________
Sternheimer Malbin _______________________
Lipid stains ________________________
2 % acetic acid ________________________
Hansel stain ________________________
Prussian blue - confirm the presence of hemosiderin in the UA
sediment
Sternheimer Malbin - identify WBCs, epithelial cells and casts
Lipid stains - identify oval fat droplets, and lipid containing cells and
casts
2 % acetic acid - differentiate RBCs from yeast, oil droplets, crystals
and WBCs.
Hansel stain - eosinophils in urine
Gram stains- bacterial casts
The advantage to using phase microscopy in urinalysis is to
enhance constituents with a low refractive index
ghost cells
When RBCs are in dilute urine, they absorb water and lyse. The remaining, empty cell membranes are ghost cells
Crenated cells
When RBCs are in concentrated urine, they shrink due to loss of water and appear crenated.
Clinical significance of microscopic RBCs in the urine.
Associated with damage to the glomerular membrane or vascular injury within genitourinary tract (by trauma, acute infection, inflammation and coag disorders)
Glitter cells
Microscopic finding of WBCs in hypotonic urine
Microscopic WBCs and urinalysis correlations:
Nitrite, leukocyte esterase,
Clinical significance of increase WBCs in the urine
It is referred to pyuria
like RBCs, they enter thru glomerular or capillary trauma.
Infection or inflammation ( pyelonephritis, cystitis etc.)
Nonbacterial infection ( glomerulonephritis, lupus erythematosus, interstitial nephritis etc.)
A large number of squamous epithelial cells
vaginal contamination, no clinical significance
Clue cells
A clue cell is a squamous epithelial cell covered with the bacteria- Gardnerella vaginalis.
Caudate, spherical and polyhedral cells
Transitional epithelial cells which are smaller than squamous cells and in several forms.
Clinical significance of RTE cells
Most clinical significant of tubular necrosis
Oval fat bodies
- RTE cells that contain lipids, highly refractile, usually seen in conjunction with free floating fat droplets.
- polarizes
- Increased in nephrotic syndrome
The presence of bact are clinically significant for UTI when accompanied by ______________________.
WBCs
A small, oval, refractile structures with buds and/or mycelial form.
Most likely seen in the urine of patients who are diabetic or immunocompromised. Thrive in acidic pH and urine with glucose present. What is the name of it?
Yeast
A true yeast infection in the urine is accompanied by the ___________.
presence of WBCs.
A pear shaped, motile, flagellated parasite is ____________________.
Trichomonas Vaginalis
A 60-year old male present to the clinic as he is concerned about his bright red urine. You performed a urinalysis and following are the dipstick and microscopic results.
pH 5.0 Protein- Neg
SG- 1.020 Ketones- Neg
LE - Neg Bili- Neg
Nitrites- Neg Blood- Neg
Glucose- Neg Urobili- 2.0
WBC- 0-5/LPF, RBC - 0-3/LPF, Cast- 0/HPF
What is the most likely cause of the patient’s red urine?
The possible cause is beetroot ingestion!
The test for blood on a urine dipstick picks up hemoglobin (free or within red cells) and myoglobin.
The following are reported as number per _________?
A. RBCs _______________
B. WBCs _______________
C. Crystals _____________
D. Casts ______________
A. RBCs/HPF
B. WBCs/HPF
C. Crystals/HPF
D. Casts/LPF
Cast made up entirely of tammhorsfall protein is :
Hyaline cast
The addition of acetic acid into urine sediment will lyse _________?
RBC
An increased number of RBCs present in urine sediment may be associated with conditions such as_____________________________.
Glomerulonephritis , kidney stones, tumors, trauma
Acute and chronic UTI infection
