urinalysis practicum Flashcards
under what maginification are urine cells enumerated?
400x
how many TNTC(too numerous to count) RBC’s be dispersed so other sediment may be evaluated?
2% acetic acid will lyse the RBCs
Casts and ____ go hand in hand…
protein
identify possible causes of a false negative dipstick test for blood.
ascorbic acid
high SG
high nitrite
what crystals appear in acid urine?
ampicillin amorphous urate aspirin bilirubin calcium phosphate calcium oxalate cholesterol cysteine hemosiderin hippuric acid leucine sufonamide tyrosine uric acid x-ray media
which crystals appear in alkaline urine?
ammonium biurate amorphous phosphate calicum carbonate calcium phospahte calcium oxalate triple phosphate
asprine
CS: extremely rare indicates overdose of aspirin
Cause: excess aspirin excreted in urine causing the crystals to form.
cystine
CS: indicate congenital cysinosis or cystinuria. Deposit in tubules as calculi resulting in renal damage.
Cause: pyelonephritits, diet high in animal fat and protein.
bilirubin
CS: liver disease
Cause: formed when large amounts of bilirubin is present.
leucine
CS: aminoaciduria or severe liver disease
Cause: very water soluable so rarely seen
tyrosine
CS: animoaciduria or severe liver disease
Cause: water soluable so rarely seen but found often w/leucine
cholesterol
CS: rare, always accompanied by large amounts of protein and other fats
Cause: nephrotic shyndorme and conditions resulting inchyluria (rupture of lymphatic vessels into renal tubules)
uric acid
CS: can be non-pathogenic but large numbers seen in gout pts. and conditions of increased purine metabolism (cytoxic drugs used in leukemia)
Cause: crystals form as body tries to rid itself of excessive uric acid in the blood possibley caused by over weight, rich diet, exposure to lead or genetic predisposition.
calcium oxalate
CS: non-pathogenic with ingestion of high oxalate foods but also seen in ingestion of antifreeze and severe chronic renal disease.
Cause: oxalic acid (metabolite of ascorbic acid) will combine with Ca2+ in urine to form calcium oxalate.
ampicillin
CS: rare
Cause: indicates large doses of ampilicillian (antibiotic)
calcium phosphate
CS: none
Cause: calcium and phosphate combine in urine to form an insoluable complex
hippuric acid
CS: none
Cause: might be seen in ethylene glycol (antifreeze) intoxication or exposure to toluene in atmosphere
sulfonamide
CS: rare renal damage common
Cause: original drug was insoluable and formed crystals in renal tubules causing damage. Current drugs do not have solubility problems.
x-ray media
CS: none but may be mistaken for cholesterol
Cause:crystals can form in acid urine as body excretes the dye.
triple phosphate
CS: none but can be associated with UTI in alkaline pH.
Cause: Ammonium combines with magnesium and phosphate in alkaline urine to form “coffin lid” crystals.
ammonium biurate
CS: none unless found in fresh urine.
Cause: forms as urine ages. if seen must check collection time.
calcium carbonate
CS: none can be mistaken for bacteria.
Cause: can be seen after large consumption of vegetables.
amorphous urate & amorphous phosphate
CS: none but can make microscopy difficult. Enhanced when urine is refrigerated.
Cause: only be distinguished when acetic acid or heating is added to specimen. urate dissolve when heated, phosphate will not.
RBC’s
CS: increased # indicates renal bleed, either glomerular or tubular.
Cause: glomerulonephritis, pyelonephritis, cystitis, calculi, tumors or trauma. No casts or protein bleed in below the kidney.
WBC’s
CS: inflammation or UTI
Cause: bacterial/paratsitic infection or renal diseases
Eos
CS: discrimination of EOS from WBC often impossible
Cause: acute interstitial nephritis or chronic UTI’s
Lymphs
CS: small # usually present. Large # is significant
Cause: presnet in inflammatory conditions such as acute pyelonephritis or in renal rejection transplant.
monos & macrophages
CS: increase in viral conditions
Cause:drawn to site of inflammation resulting from renal infection or immune reactions
Transitional Epi
CS: indicates inflammation or renal damage if large # seen.
Cause: UTI. clusters/sheets seen after catherization but if no instrumentation used, indicates a pathological process.
squamous epi
CS: none
Cause: specimen contamination.