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Body Fluids > Urine Microscopy > Flashcards

Urine Microscopy Flashcards

1
Q

Preparation for urine sediment

A

10-15mL to be centrifuged at 400rcf for 5 min
sediment is prepped, 0.5-1.0mL

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2
Q

Sternheimer-malbin stain

A

Wet prep stain that stains cytoplasm and nuclear contents
toludine blue

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3
Q

Dry prep stain

A

lipid stain (oil, red0 and sudan III) ie gram stain

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4
Q

Resolution

A

ability to differentiate small objects close together

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5
Q

Contrast

A

Differentiating the cell from the background

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6
Q

Brightfield microscopy, advantages and disadvantages

A

light is transmitted through the sample and absorbed
ADV: good resolution, true color, true dimensions
DisADV: unstained are not high absorbing, wet=artifact, dry=dead cells

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7
Q

Dark Field Illumination, advantages and disadvantages

A

Light is directed through sample from different directions and reflects off of the objects
ADV: excellent contrast, max detectability
DisADV: not for measurements, lower resolution, dust can interfere

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8
Q

Phase contrast, advantages and disadvantages

A

first method used to visualize live cells. Light is passing through the sample slower
ADV: improved contrast for live cells, orientation independent, no polarizers, plastic is ok
DisADV: reduced resolution, not good for thick samples

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9
Q

Polarizing advantages and disadvantages

A

polarized light=illumination, changes when passed through sample
ADV: ID crystals and lipids, biofringent samples
DisADV: need a polarizer, sensitive to orientation, no plastic

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10
Q

Fluorescent advantages and disadvantages

A

UV light hits object, excites e- to give off colors and patterns
ADV: good resolution and many applications
DisADV: fixed, thin sample and very expensive

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11
Q

Interference Contrast Microscopy

A

polarization+phase contrast

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12
Q

RBC’s in a microscopy sample

A

Normal= 5 per high power field (40x)
usually look like standard RBCs
RBC ghost=diluted sample or high pH

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13
Q

Crenated RBCs

A

Found in samples with high SG

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14
Q

WBCs in microscopy

A

Lymphocytes, neutrophil, monocyte, esinophils
Enter through urine tract, not kidneys
wright stain differentiates

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15
Q

Glitter cells

A

WBC in hypotonic solution, granules wiggle

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16
Q

Pyuria

A

high WBC count due to inflammation

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17
Q

Lymphocyte in urine reason

A

transplant rejection

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18
Q

Neutrophil in urine reason

A

bacterial infection

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19
Q

monocyte in urine reason

A

tissue damage

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20
Q

Eosinophil in urine reason

A

Allergic reaction

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21
Q

Epithelial cells microscopy

A

line urinary tract and nephron tubules. Squamous, transitional, and renal tubular

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22
Q

Squamous epithelial cells in Urine

A

no clinical significance, small central nucleus, largest cell found in urine, will slough off occasionally

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23
Q

Transitional cells in urine

A

Ureters and portions of bladder. Many in urine means viral infection or bladder cancer

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24
Q

Renal tubular cells (RTE) in urine

A

lines tubules in kidney, small but larger than any WBC. Should not be found in urine. If there are many, then kidney was exposed to a toxin

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25
Q

Lipids in urine

A

Should not see normally, present if there is glomerular damage. Looks like small bubbles and is highly refractive.
Diabetes mellitus, tubular necrosis, bone crushing trauma, nephrotic syndrome

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26
Q

Oval Fat Bodies

A

RTE’s filled with lipid. Not normal. Same causes as lipids. Is mainly cholesterol and triglycerides

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27
Q

Bacteria in urine

A

should not have. UTI or Kidney infection. Rods or cocci, WBC’s present signifies UTI.

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28
Q

Maltese cross

A

cholesterol, starch(rare)

29
Q

Clue cells

A

contamination from vaginal secretions

30
Q

yeast in urine

A

ovoid and budding. Large amount should check glucose. Diabetes mellitus

31
Q

pseudo hyphae

A

long yeast, severe infection

32
Q

Trichomonas vaginalis

A

most common parasite found in urine, pear shaped and has flagella

33
Q

Enterobious vermicularis

A

uncommon parasite, pinworm and egg form

34
Q

sperm

A

rarely clinically significant. Only reported in people younger than 13

35
Q

Mucus

A

uromodulin (tamm-horsfall) glycoprotien. Low refractive index, no clinical significance. Usually in women or after stress or exercise

36
Q

Casts

A

made of uromodulin. occurs in distal convoluted tubule and collecting duct. Cylindrical

37
Q

Factors in cast formation

A

increased stasis, decreased flow. Increased acidity, specific gravity and uromodulin

38
Q

Hyaline cast

A

cylindrical, clear, colorless. Low refractive index, normal to see 0-2. More after exercise, stress, dehydration.
2+ is heart failure, liver disease

39
Q

RBC cast

A

hyaline cast with RBC’s, can have a red tinge, fragile. Normal to see 0-2, could be after a heavy contact sport. Could be kidney filter damage

40
Q

WBC cast

A

hyaline cast with WBC’s, more refractive, should not have. any= infection/inflammation, damage to glomerulus or allergic to penicilln

41
Q

RTE casts

A

hyaline cast with RTE’s, larger than WBC cast. not normal, damage to renal tubules from toxin or virus

42
Q

Fatty casts

A

normally not seen. looks like elongated OFB’s with same significance of OFBs

43
Q

Granular casts

A

tube with a lot of spots (coarse or fine) can be colorless or yellow. Can have 0-2 with strenuous exercise. Increased cellular metabolism

44
Q

Waxy cast

A

colorless/gray, has blunt corners/cracks. Should not see normally. Extreme renal stasis, tumor, kidney stone, renal failure

45
Q

Broad cast

A

renal failure cast. Waxy casts in collecting ducts (broader) should not ever see.

46
Q

Telescoped urine

A

all types of casts are found, seen in lupis, hypertension, diabetes mellitus. Result in period of renal shutdown

47
Q

Crystal formation in urine

A

can be normal, usually insignificant. Precipitation of soluble substances after refrigeration.

48
Q

Factors in crystal formation

A

decreased temperature, increased SG, change in pH

49
Q

Amorphous urates

A

brown/red in color, granules, precipitates out in acidic urine and can change to different crystal types

50
Q

Normal crystals in neutral-acidic urine

A

Amorphous urates, uric acid, calcium oxalate dihydrate

51
Q

Uric acid crystals

A

brown/yellow/colorless. Many shapes. Form when purine is broken down. Gout=clinical significance. pH<5.5. Birefringent

52
Q

Calcium oxalate dihyrate

A

colorless diamonds, breakdown of oxalate from food is normal. birefringent, large amounts increases risk of kidney stones

53
Q

Calcium oxalate monohydrate

A

abnormal crystal in acidic urine, dumbbell shaped. Clinical significance=etheline-glycol poisoning (antifreeze)

54
Q

Normal crystals in alkaline urine

A

amorphous phosphates, triple phosphate, calcium phosphate, calcium carbonate, ammonium bicarbonate

55
Q

Amorphous phosphates

A

look like urates, normal

56
Q

triple phosphate

A

looks like coffin lids, more elongated. Can be seen in leaf/needles birefringent

57
Q

Calcium phosphate

A

colorless needles (star formation possible) less common, no significance

58
Q

calcium carbonate

A

spears+dumbbells, birefringent, soluble in acetic acid and will form bubbles.

59
Q

ammonium bicarbonate

A

brown sphere with points (thorny apples). old samples

60
Q

Abnormal crystals

A

only form in acidic urine. include bilirubin, tyrosine, leucine, cysteine and cholesterol

61
Q

Crystals associated with liver disease

A

Bilirubin, tyrosine, leucine

62
Q

Cystine crystals

A

amino acid crystal, hexagonal, clear, colorless. non birefringent. Confirmed with sodium nitroprusside (turns purple) more likely for kidney stones

63
Q

Cholesterol crystals

A

flat, transparent square like with a notched out corner. Seen after refrigeration. Birefringent. nephrotic syndrome, excessive tissue breakdown

64
Q

Tyrosine crystals

A

spikey star like colorless to yellow, needle shaped. Can be inborne error of metabolism

65
Q

Leucine

A

Yellow-brown spheres w concentric striations. Never seen without tyrosine

66
Q

Bilirubin crystals

A

usually yellow-brown, needles or tube with bubble. Hepatic disorder or liver disease. Older urine

67
Q

Sulfonamide crystals

A

formed from medications, needles or rhombus shape. soluble in acetone

68
Q

radiographic dye crystals

A

flat plates, dissolves in NaOH

69
Q

Contaminants in urine

A

pubic hair, fecal matter, talcum powder, pollen, bubbles, starch

Body Fluids (8 decks)

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