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Pathology > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

What is pictured? What are some causes?

A

Red blood cells (crenated due to hypertonic urine).

Causes of hematuria: Renal or lwr UT disease

Ex: Urinary calculi, polycystic kidney, etc.

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2
Q

What is pictured? Possible causes?

A

RBCs, Distorted from passage through small holes of GBM.

Causes: Renal or lwr UT disease.

Ex: Urinary calculi, Polycystic kidney disease, etc.

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3
Q

What is pictured? Possible causes?

A

Neutrophils (WBCs) in urine.

Causes:

  1. Acute Glomerulonephritis
  2. Infection
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4
Q

What is pictured? Possible causes?

A

Oval fat bodies

Causes:

  1. Nephrotic syndrome
  2. Hyperlipidemia
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5
Q

What is pictured? Possible causes?

A

“Maltese cross” formation of oval fat bodies

Causes:

  1. Nephrotic syndrome
  2. Hyperlipidemia
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6
Q

What is pictured? Composition? Site of formation? Possible causes?

A

Hyaline cast

Gelled protein (Tamm-Horsfall protein from tubule cells)

Distal convoluted tubule

Causes: Tubular or GBM necrosis

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7
Q

What is pictured? Possible causes?

A

Hyaline Cast stained with bile (hyperbilirubinemia)

Causes:

  1. Hepatocellular disease
  2. Biliary obstruction
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8
Q

What is pictured? Composition? Site of formation? Possible causes?

A

RBC cast in urine

RBCs

Distal convoluted tubule

Causes: GBM or tubular damage (glomerulonephritis)

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9
Q

What is pictured? Composition? Site of formation? Possible causes?

A

RBC cast

RBCs

Distal convoluted tubule

Causes: GBM or tubular damage (glomerulonephritis)

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10
Q

What is pictured? Composition? Site of formation? Possible causes?

A

WBC cast

leukocytes

Causes:

  1. pyelonephritis
  2. interstitial nephritis
  3. acute glomerulonephritis
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11
Q

What is pictured? Composition? Site of formation? Possible causes?

A

Renal tubular epithelial cells

Severe tubular damage

Causes:

  1. Renal tubular epithelial cells
    - necrosis

-pyelonephritis
2. Transitional epithelial cells from the
renal pelvis, ureter or bladder
-Inflammation

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12
Q

What is pictured? Composition? Site of formation? Possible causes?

A

Course Granular Cast

Degenerated epithelial cells

Cause:

  1. Cellular cast that has remained in nephron for some time
  2. Associated with Proteinuria
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13
Q

What is pictured? Composition? Site of formation? Possible causes?

A

Fine Granular Cast

Degeneration from epithelial cell cast then Coarse granular cast

Causes:

  1. Prolonged time in nephron
  2. Associated with Proteinuria
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14
Q

What is pictured? Composition? Site of formation? Possible causes?

A

Waxy cast

End stage degeneration of epithelial cell cast

Causes:

  1. Chronic nephron obstruction associated with advanced renal disease
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15
Q

What is pictured? Composition? Site of formation? Possible causes?

A

Broad waxy cast

Formed in dilated tubules

Suggest acute tubular necrosis

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16
Q

What is pictured? Composition? Site of formation? Possible causes?

A

Broad cast in urine

Formed in dilated tubules

Suggest acute tubular necrosis

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17
Q

What is pictured?

A

Candida (fungal infection)

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18
Q

What is pictured?

A

Trichomonas (Parasite)

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19
Q

What is pictured?

A

HSV (Viral infection)

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20
Q

What is pictured?

A

CMV (viral infection)

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21
Q

What is pictured? Possible causes?

A

Calcium oxalate crystals

Cause: Acidic urine from metabolic or respiratory acidosis

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22
Q

What is pictured? Possible causes?

A

Ammonium magnesium phosphate crystals (“coffin lid crystals”)

Cause: Alkaline urine from:

  1. respiratory or metabolic alkylosis
  2. UTIs from bugs that produce urease
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23
Q

What is pictured? Possible causes?

A

Tyrosine crystals (can also form cystine or leucine crystals)

Cause: Severe liver disease

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24
Q

Cause of red/brown urine

A

Food dyes

Beets

Drug

Hemoglobin

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25
Q

Cause of yellow-brown or green-brown urine

A

Bile pigments

(bilirubinuria)

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26
Q

Cause of Turbid urine

A

Recipitation of salts

Cells

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27
Q

Ammonia-smelling urine

A

bateria

28
Q

Musty-smelling urine

A

Phenylketonuria

29
Q

Pungent and aromatic-smelling urine

A

cirrhosis

30
Q

Acetone-smelling urine

A

ketonuria

31
Q

Significance of high/low Specific gravity of urine

A

Proportion to urine osmolality

High value = dehydration

or

diabetes (high volume + glucosuria)

Low value = overhydration

or

renal tubular injury

32
Q

Causes of proteinuria (>150mg/day)

A

>150mg/day = nephritic syndrome

> 3.5g/day = nephrotic syndrome

Persistant protein

33
Q

Causes of proteinuria >3.5g/day

A

> 3.5g/day = nephrotic syndrome

34
Q

Causes of Glucosuria

A

diabetes

Cushings syndrome

Glycogen storage diseases

renal tubular disease

Liver disease

35
Q

Causes of Bilirubinuria

A

hepatocellular disease

biliary obstruction

36
Q

Causes of urobilinogen in urine

A

hemolytic anemia

hepatocellular disease

37
Q

Causes of ketouria

A

Diabetic ketosis

Severe calorie restriction

(complete metabolization of FAs)

38
Q

Positive nitrite test signifies

A

Bacteriuria (gram negative)

39
Q

Positive leukocyte esterase test signifies

A

detects whole or lysed WBCs

pyuria (infection)

40
Q

Causes of hematuria

A

renal or lwr UT disease

41
Q

Causes of hemoglobinuria

A

UT bleeding with hemolysis

or

intravascular hemolysis

42
Q

Causes of myoglobinuria

A

traumatic muscle injury

burns

muscle disease

severe exercise

43
Q

Composition and Cause of chylous effusion

A

fluid rich in protien, triglycerides, and LDLs

leakage of thoracic duct

44
Q

Causes of serosanguineous pericardial exudate

A

TB

neoplasia

uremia (failure of renal excretory function)

Viral infection

45
Q

Cause of glucose lvl <40mg/dL in CSF

A

Bacterial infection

46
Q

Amylase lvl in pleural effusions >125u/l

A

Pancreatitis

Malignancy

47
Q

WBC>500uL in peritoneal effusion

A

bacterial peritonitis

48
Q

Indications for lumbar pucture

A

Meningitis

Encephalitis

CNS leukemia

subarachnoid hemorrage

49
Q

How to distinguish between traumatic puncture or hemhorrage if there is blood in the CSF

A

Sequential collection

Traumatic = less bloody in each successive tube

Hemorrhage = equally bloody

50
Q

common cause of xanthochromia in CSF

A

xanthochromia = colored supernatant

Cause: RBC lysis

51
Q

When does clotting occur in CSF?

A

traumatic puncture

Elevated CSF protein

TB meningitis

Meningeal inflammation

52
Q

Causes of Neutrophil pleocytosis in CSF

A

meningitis by pyogenic bugs

53
Q

Causes of Lymphocyte pleocytosis in CSF

A

Viral or syphilitic meningitis

meningoencephalitis

54
Q

Causes of Eosinophilic pleocytosis in CSF

A

parasites

coccidioidomycosis

55
Q

Causes of low protein in CSF

A

leakage of CSF

56
Q

Causes of elevated CSF proteins

A

meningitis

meningoencephalitis

Brain abcess

degenerative CNS disease

neoplasia

diabetic neuropathy

57
Q

Causes of elevated IgG in CSF

A

MS

infection

58
Q

Cause of increased C-reactive protein in CSF

A

bacterial infection

59
Q

What is hypoglycorrhachia? Possible causes in CSF?

A

low glucose lvls

Bacterial or fungal infections (CSF)

60
Q

Positive VDRL serology test in CSF

A

syphilis

61
Q

Causes of positive Nucleic acid amplification tests

A

enteroviruses

herpesviruses

arboviruses

62
Q

Diagnose the patient:

200-750 mm Hg, faint xanthochromia, purulent with 500-20,000 cells/ìl, neutrophilic
pleocytosis, 15–50 mg/dL protein, 0-45 mg/dL glucose

A

Bacterial meningitis

Diagnose by microscopic examination, serology, culture

63
Q

Diagnose the patient:

150-750 mm Hg, faint xanthochromia, opalescent with 25-500 cells/ìl, lymphocytic

pleocytosis, 45-500 mg/dL protein, 0-45 mg/dL glucose

A

TB meningitis

Diagnose by microscopic examination and culture

64
Q

Diagnose the Patient:

130-750 mm Hg, may be xanthochromic, clear, cloudy, or turbid with 5-5000 cell/ìl,
mixed or lymphocytic pleocytosis, 20-200 mg/dL protein, normal glucose

A

Aseptic (viral) meningitis

Diagnose by culture, NAAT, serology

65
Q

Diagnose the Patient:

Normal to 300 mm Hg, colorless, clear, 10-150 cells/ul, lymphocytic pleocytosis, 45-150
mg/dL protein, normal glucose

A

Neurosyphilis

Diagnose by microscopic examination, serology

66
Q

Diagnose the Patient:

Normal-450 mm Hg, colorless, clear, 10-150 cells/ìl, lymphocytic pleocytosis, 15-110
mg/dL protein, normal glucose

A

Viral meningoencephalitis

Diagnose by culture, NAAT, serology

67
Q
A

Pathology (27 decks)

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