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Clinical Microscopy > Urinalysis - Microscopic Examination > Flashcards

Urinalysis - Microscopic Examination Flashcards

1
Q

Urinary Sediments Examined in Routine Urinalysis

A

PREBAM

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2
Q

10 LPF

A

Epithelial Cells
Amorphous
Mucus Threads

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3
Q

10 HPF

A

Pus cells
RBCs
Bacteria

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4
Q

Microscope in routine UA

A

Brightfield Microscopy

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5
Q

Microscope for elements with low refractive indices

A

Phase Contrast Microscope

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6
Q

Darkfield Microscope

A

Identification of Treponema pallidum

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7
Q

Microscope in identification of cholesterol in oval fat

bodies, fatty casts, and crystals

A

Polarizing Microscopy

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8
Q

Detect the presence or absence of Birefringence

A

Polarizing Microscopy

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9
Q

Uses 3D Microscopy

A

Differential Interference Contrast Microscope

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10
Q

Component of STERNHEIMER-MALBIN

A

Crystal violet + Safranin O

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11
Q

Oil Red O and Sudan Black stains ______, ______ but NOT _________

A

Oil Red O and Sudan Black stains TAG, Neutral Fats but NOT CHOLESTEROL

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12
Q

Stains Eosinophilic granules

A

Hansel Stain

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13
Q

Lenses which form PRIMARY (initial) image of specimen

A

Objective

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14
Q

Produces the SECONDARY image magnification of the specimen

A

Eyepiece

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15
Q

Gathers and focuses the illumination light onto the specimen for viewing

A

Condenser

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16
Q

Stain for differential WBCs & RTE cells

A

Toluidine Blue

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17
Q

RBCs in Hypotonic urine (Swollen RBC)

A

Ghost cells/Shadow Cells

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18
Q

Marker for glomerular bleeding

A

Dysmorphic RBCs

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19
Q

WBCs in hypotonic Urine(Swollen WBC)

A

Glitter Cells

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20
Q

Most Common WBC in Urine

A

Neutrophil

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21
Q

Sources of Errors of RBCs

A

Yeasts
Air bubbles
Oil droplets
CaOx (monohydrate)

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22
Q

Sternheimer-Malbin Stain

Glitter cells:
WBCs:

A

Sternheimer-Malbin Stain

Glitter cells: Pale blue
WBCs: Pale pink

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23
Q

Clinically Significant - Eosinophils

A

> 1%

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24
Q

True UTI - High Levels of _________ and ______

A

Bacteria
WBCs

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25
Q

Most common cause of UTI

A

E. coli

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26
Q

Commonly significant in Females

A

Squamous Epithelial Cells

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27
Q

Squamous Epithelial Cells are used as “_____________” for _______ microscope

A

Point of Reference - Focusing Microscope

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28
Q

Most Clinically significant ECs

A

Renal Tubular ECs

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29
Q

Only epithelial cell seen in casts

A

RTE

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30
Q

Squamous ECs with G. vaginalis

A

Clue Cells

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31
Q

Most Frequently seen, Largest and Least Significant

A

Squamous ECs

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32
Q

> 2/HPF

A

Tubular Injury/ Necrosis of tubules

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33
Q

Variations of RTE cells

Oval Fat Body (Lipid): 
Bubble Cells (Non-lipid):
A

Variations of RTE cells

Oval Fat Body: Nephrotic Syndrome
Bubble Cells: Acute Tubular Necrosis

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34
Q

Most common Yeast in Urine

A

C. albicans

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35
Q

Most common Parasite in Urine

A

T. vaginalis

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36
Q

Most Common Urine contaminant

A

E. vermicularis

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37
Q

Schistosoma seen in Urine

A

S. haematobium

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38
Q

Major Constituent of Mucus Threads

A

Tamm-Horsfall protein (uromodulin)

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39
Q

Casts Origin

A

DCT
CT

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40
Q

Not site of cast formation

A

PCT

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41
Q

Major constituent of Casts

A

Uromodulin

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42
Q

Casts in Urine

A

Cylinduria

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43
Q

Order of Cast Degeneration

A

HYALINE > CELLULAR > GRANULAR COARSE > GRANULAR FINE > WAXY

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44
Q

Hylaine cast

A

Prototype” cast

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45
Q

Most frequently Encountered Cast

A

Hyaline Cast

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46
Q

Cellular Casts

A

RBC Cast
WBC Cast
RTE Cast

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47
Q

Cast seen in Glomerulonephritis

A

RBC cast

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48
Q

Casts that resemble RTE cells

A

WBC casts

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49
Q

Significance of WBC casts

A

Pyelonephritis (Upper UTI)
Acute Interstitial Nephritis
Renal Inflammation

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50
Q

Used to differentiate WBC Cast from RTE Casts

A

Toluidine blue

Supravital Stain

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51
Q

Renal Failure Cast

A

Broad Cast

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52
Q

Broad Cast is due to _______________________

A

Widening of the Tubule

53
Q

Refractive index

Hyaline Casts:
Waxy Casts:

A

Refractive index

Hyaline Casts: Low Refractility
Waxy Casts: High Refractility

54
Q

Giving Dirty Brown appearance in Dirty Brown Cast

A

Methemoglobin

55
Q

Granular Casts could be from;

Pathologic:
Non-pathologic:

A

Granular Casts could be from:

Pathologic: Disintegration of cellular casts
Non-pathologic: Lysosomes of RTE

56
Q

Granular Casts

Coarse:
Fine:

A

Granular Casts

Coarse: Black, Large Granules
Fine: Gray Pale yellow

57
Q

Final Degenerative Form of Casts

58
Q

Significance - Waxy Cast

A

Chronic Renal Failure

59
Q

Cast with oval fat body and free fat granules

A

Fatty Cast

60
Q

Cholesterol is viewed by ______________

A

Polarize Microscope

61
Q

Crystals are formed by ________ of urine solutes.

A

Precipitation

62
Q

Factors in Crystal Formation

A

pH
Solute concentration
Temperature

63
Q

Non-pathologic ACIDIC Crystals

A 
Amorphous urates
Uric Acid
Calcium Oxalate
Calcium Sulfate
Hippuric Acid
Sodium Urates
64
Q

Amorphous Urates

Microscopic:
Macroscopic:

A

Amorphous Urates

Microscopic: Brick Red Dust/
Macroscopic: Pink Sediment (Uroerythrin)

65
Q

Crystals appears after refrigeration with no form and no shape

A

Amorphous Urates

66
Q

Uric Acid

Shape:
Color:
Significance:

A

Uric Acid

Shape: Lemon shaped
Color: Yellow - Brown/Colorless
Significance: Gout, Lesch-Nyhan Syndrome

67
Q

Most pleomorphic crystals

68
Q

Calcium Oxalate - Shape

Monohydrate:
Dihydrate:

A

Calcium Oxalate - Shape

Monohydrate: Oval/Dumbbell shaped
Dihydrate: Enveloped shaped

69
Q

Most common form of Calcium Oxalate

A

Dihydrate Calcium Oxalate

70
Q

Crystal seen in Antifreeze/Ethylene Glycol Poosoning

A

Monohydrate Calcium Oxalate

71
Q

Exists in ACID, NEUTRAL, ALKALINE urine

A

Calcium Oxalate

72
Q

Calcium oxalate is ___________ in polarized light

A

BIREFRINGENT

73
Q

Forms of CaOx

Whewellite:
Wheddelite:

A

Forms of CaOx

Whewellite: MONOhydrate
Wheddelite: DIhydrate

74
Q

Cigarette-butt appearance

A

Calcium Sulfate

75
Q

Hippuric Acid

Characteristic:
Shape:
Cause:

A

Hippuric Acid

Characteristic: Brown or Colorless Needles
Shape: Elongated Prism
Cause: Ingestion of BENZOIC ACID

76
Q

Needle Shaped

A

Sodium Urates

77
Q

Apatite

A

Calcium Phosphate

78
Q

Calcium Apatite

Characteristic:
Shape:
Resemblance:
Differentiate:

A

Calcium Apatite

Characteristic: Colorless flat rectangular plates
Shape: Thin prisms in** Rosette Forms**
Resemblance: Sulfonamide Crystals
Differentiate: Acetic Acid

79
Q

Differentiate Calcium Phosphate vs. Sulfonamide
Add Acetic Acid

Dissolves:
Remains:

A

Differentiate Calcium Phosphate vs. Sulfonamide
Add Acetic Acid

Dissolves: Calcium Phosphate
Remains: Sulfonamide

80
Q

Calcium Apatite

A

Colorless flat rectangular plates

81
Q

Thorny Apples

A

Ammonium Biurate

82
Q

Ammonium Biurate

Characteristic:
Shape:
Common:

A

Ammonium Biurate

Characteristic: Thorny Apples
Shape: Yellow brown spicule covered spheres
Common: OLS SPECIMENS

83
Q

ONLY URATE IN ALK URINE AND COMMON IN OLD SPECIMEN

A

Ammonium Biurate

84
Q

Ammonium Biurate turns Uric acid crystals after addition of __________________ and _____

A

Ammonium Biurate turns Uric acid crystals after addition of GLACIAL ACETIC ACID and HEAT

85
Q

Struvite/Mg ammonium phosphate

A

Triple Phosphate

86
Q

Appearance of Struvite

A

Coffin lid shaped/Prism Shaped

87
Q

Triple phosphate is associated with ____________________

A

Urea splitting Bacteria - Proteus

88
Q

Calcium Carbonate

Shape:
Characteristic:

A

Calcium Carbonate

Shape: Spherical/ Dumbbell
Characteristic: forms GAS after acetic acid

89
Q

Calcium Carbonate form ______ after addition of Acetic acid

A

GAS FORMATION/Effervescence

90
Q

Amorphous Phosphates

Microscopic:
Macroscopic:

A

Amorphous Phosphates

Microscopic: White ppt
Macroscopic: Granular

91
Q

Non-Pathologic Alkaline Crystals

A 
Ammonium Phosphate
Ammonium Biurate
Calcium Phosphate - Apatite
Triple Phosphate - Struvite
Calcium Carbonate
92
Q

Abnormal Crystals

A 
Cysteine Crystals
Cholesterol Crystals
Sulfonamide Crystals
Tyrosine Crystals
Leucine Crystals
Bilirubin Crystals
93
Q

Colorless HEXAGONAL plates

A

Cysteine Crystals

94
Q

Cysteine Crystals

Characteristic:
Resemblance:
Confirmatory Tests:

A

Cysteine Crystals

Characteristic: Hexagonal plates
Resemblance: Hexagonal UA crystals
Confirmatory Tests: Cyanide Nitroprusside Test

95
Q

Staircase Pattern/Notched Plates

A

Cholesterol Crystals

96
Q

Cholesterol Crystals are SOLUBLE in __________

A

Chloroform

97
Q

Radiographic Dye Crystals

Appearance:
Resemblance:
Solubility:
SG:

A

Radiographic Dye Crystals

Appearance: Flat colorless, RHOMBIC plates
Resemblance: Cholesterol crystals
Solubility: 10% NaOH
SG: > 1.040

98
Q

Meglumine diatrizoate

A

Radiographic Dye Crystals

99
Q

Crystals Seen in Liver Disorders

Mnemonics: BiLaT

A

Bilirubin
Leucine
Tyrosine

100
Q

FINE Yellow-Colorless Needles in clumps or rosettes

101
Q

Yellow brown SPHERES

102
Q

Clumped Needles

103
Q

Tyrosine Crystals

Appearance:
Soluble:

A

Tyrosine Crystals

Appearance: Fine yellow-colorless needles in clumps/rosettes
Soluble: ALKALI and Heat

104
Q

In tyrosine crystals, ___________ crystals is present if bilirubin is positive

A

In tyrosine crystals, LEUCINE crystals is present if bilirubin is positive

105
Q

Bilirubin Crystals are SOLUBLE in:

A 
Acetic Acid
HCl
NaOH
Ether
Chloroform
106
Q

Yellow-Brown NEEDLES

A

Sulfonamide

107
Q

Sulfonamide

Appearance:
Positive Tests:

A

Sulfonamide

Appearance: Needles, Sheaves of Wheat
Positive Tests: Lignin test & Diazo reaction

108
Q

Colorless Needles formed after Refrigeration

A

Ampicillin Crystals

109
Q

FORMS MALTESE CROSS FORMATION

Mnemonics: OFFs

A

Oval Fat Bodies
Fatty casts
Fat droplets
Starch granules

110
Q

Lemon-shaped Crystal

111
Q

Resembles Cystine

112
Q

Enveloped shaped

A

Calcium oxalate (Dihydrate)

113
Q

Dumbell/Oval

A

Calcium oxalate (Monohydrate)

114
Q

Cigarrete butt shape

A

Calcium sulfate

115
Q

Thorny apples

A

Ammonium biurate

116
Q

Shgape/Appearance of Struvite

A

Feathery
Fern-like
Cofin-lid
Prism-shaped

117
Q

Flat plates, thin prisms in rosette

A

Calcium phosphate

118
Q

Dumbell, sperical-shaped

A

Calcium carbonate

119
Q

Resemble sulfunamide crystals

A

Rosette form of Calcium apatite

120
Q

Hexagonal plates (laminated)

121
Q

Staircase pattern

A

Cholesterol

122
Q

Four-sided plates with noched corner

A

radioghraphic dye

123
Q

Resembles cholesterol crystal

A

Radiographic dye

124
Q

Fine colorless to yellow needles

125
Q

Spheres with radial straitions

126
Q

Clumped needles

127
Q

Sulfonamide shapes

A

Sheaves of wheat
Petals
Fan-shaped
Whetstons

128
Q

Collorless needles that form bundles after refregiration

A

ampicillin

Clinical Microscopy (15 decks)

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