2S [LEC]: MISCROSCOPIC ANALYSIS Flashcards
1
Q
Identify the epithelial cell:
Largest cells in the sediment with abundant, irregular cytoplasm and prominent nuclei
A
Squamous cells
2
Q
Identify the epithelial cell:
Spherical, polyhedral, or caudate with centrally located nucleus
A
Transitional cells
3
Q
Identify the epithelial cell:
Rectangular, columnar, round, oval, or cuboidal with an eccentric nucleus possibly bilirubin-stained or hemosiderin-laden
A
RTE cells
4
Q
Folded squamous cells may resemble ___
A
Casts
5
Q
Spherical forms of transitional cells may resemble ___
A
RTE cells
6
Q
RTE cells may resemble ___
A
Granular casts
7
Q
Most clinically significant epithelial cell in clinical microscopy of urine
A
RTE cells
8
Q
Location of nucleus in RTE cells
A
Eccentric
9
Q
Manner of reporting of RTE cells
A
Average number per HPFs
10
Q
WBCs are often mistaken as ___
A
RTE cells
11
Q
Microscopic finding that is described as ghost cells in hypotonic urine
A
Microscopic RBCs
12
Q
Manner of reporting of microscopic RBCs and WBCs
A
Average number per 10 HPFs
13
Q
If the specimen is hypertonic, what will be the appearance and state of RBCs?
A
Crenated
14
Q
Appearance of microscopic RBCs with glomerular membrane damage
A
Dysmorphic
15
Q
T/F: When a medtech finds lysed RBCs in hypotonic urine, this is reported as ghost cells
A
False (reported as RBCs only)
16
Q
Manner of reporting of squamous epithelial cells
A
Semi-quantitative (rare, few, moderate, many per lpf)
17
Q
Other term for transitional cells
A
Urothelial cells
18
Q
Manner of reporting of transitional cells
A
Semi-quantitative in HPF
19
Q
Squamous cells with G. vaginalis is called ___
A
Clue cells
20
Q
Shape of RTE coming from distal convoluted tubule
A
Circular/ Oval
21
Q
Shape of RTE coming from collecting ducts
A
Cuboidal
22
Q
Microscopic findings in patients with renal tubular necrosis and damage
A
RTE cells
23
Q
Normal RTE cell count
A
<0-2 per HPF
24
Q
T/F: RTE cells can easily absorb liquids
A
True
25
If the RTE cell absorbs non-lipid, it is called ___
Bubble cell
26
If the RTE cell absorbs lipid, it is called ___
Oval fat bodies
27
The presence of lipid in oval fat bodies is confirmed through ___
Polarizing microscope
28
The presence of triglycerides in oval fat bodies is confirmed through ___
Oil Red O
Sudan III
29
High refractile RTE cells
Oval fat bodies
30
Patients with oval fat bodies should be correlated with what other findings?
Free fat droplets/ fatty casts
31
Oval fat bodies are present in patients with what condition?
Nephrotic syndrome
32
Small spherical and rod-shaped structure
Bacteria
33
The microscopic finding of bacteria in urine is correlated with what other findings?
Presence of WBCs
34
Manner of reporting of bacteria in urine
Semi-quantitative in HPF
35
Small, oval, refractile structures with buds and/or mycelia
Yeast
36
Pear-shaped, motile, flagellated
Trichomonas
37
Common microscopic finding in patients with strawberry cervix
Trichomonas
38
Chemical finding that is usually correlated with yeast cells
Glucose
39
Single or clumped threads with a low refractive index
Mucus
40
Common protein component of mucus
Tamm Horsfall Protein
41
Microscope that is usually used to visually analyze mucus threads
Phase-contrast
42
Normal hyaline cast count in urine
<2 per HPF
43
Most common type of cast
Hyaline cast
44
In what structure are casts produced?
Distal convoluted tubule
45
Presence of cast in the urine is known as ___
Cylindruria
46
A cast with irregular shape and tapered end is called ___
Cylindroids
47
Prototype of casts
Hyaline cast
48
What epithelial cell component is included in an epithelial cast?
RTE cells
49
Which type of casts are always considered pathological?
Red blood cell cast
Granular cast
50
Cast that can indicate vasculitis
Red blood cell cast
Granular cast
51
Cast that can indicate glomerular damage and glomerulonephritis
Red blood cell cast
Granular cast
52
Cast that can indicate inflammation or infection
WBC cast
53
Dehydrated and lysed cells can cause what type of cast based on appearance?
Coarsely granular cast
54
Cast that can indicate pyelonephritis
WBC cast
55
Cast that can indicate allergic interstitial nephritis
WBC cast
56
Cast that can indicate post-streptococcal glomerulonephritis
WBC cast
57
Cast that can indicate nephrotic syndrome
WBC cast
58
Remnants of the coarsely granular cast are from ___
Lysosome of RTE cells
59
Extended urine stasis transforms the cast into ___
Finely granular cast
60
Extended dehydration transforms into ___
Waxy cast
61
Cast that has a brittle characteristic that is a refractile and has a broken glass-appearance
Waxy cast
62
Waxy cast is commonly indicated in what condition?
Glomerulonephritis
63
Extreme urine stasis commonly has what finding?
Waxy/Broad cast
64
Cast that resembles the shape and size of the collecting duct
Broad cast
65
The broad cast is also known as ___
Renal failure cast
66
If there is nephrotic syndrome, the renal tubules may not be able to reabsorb, which may cause ___ cast
Fatty cast
67
Colorless, homogenous matrix of cast
Hyaline cast
68
Orange-red color, cast matrix containing RBC
RBC cast
69
If the waxy cast is present in the renal tubule for a long time, this might form ___
Broad cast
70
The only type of cast that is normally seen in urine
Hyaline cast
71
Presence of underdeveloped cast is called ___
Cylindroid
72
Casts are identified in which objective?
LPO
73
Presence of crystal in the urine
Crystalluria
74
Stress and exercise can cause the appearance of which cast?
RBC cast
75
Cast that is seen in upper UTI or pyelonephritis and acute interstitial nephritis
WBC cast
76
Bacilli bound to protein matrix
Bacterial cast
77
Coarse and fine granules in a cast matrix
Granular cast
78
RTE cells attached to protein matrix
Epithelial cells
79
Bacterial casts will only be seen in what condition?
Pyelonephritis
80
Fat droplets and oval fat bodies attached to protein
Fatty cast
81
Precursor form of oval fat bodies
RTE cells with lipid
82
Highly refractile cast with jagged ends and notches
Waxy cast
83
Manner of reporting of normal urine crystals
Semi-quantitative per HPF
84
T/F: Urine crystals are usually not pathologic
True (it will be pathologic only in increased amount)
85
Manner of reporting of abnormal urine crystals
Average per LPF
86
The single most important factor to differentiate crystals
pH
87
All abnormal crystals are found at what pH?
Acidic
88
Identify the urine crystal:
Yellowish with whetstone/ diamond shape
Uric acid
89
Patients with Lesch Nyhan Syndrome will commonly have what microscopic finding?
Uric acid
90
Identify the urine crystal:
Colorless, prism-shaped, seen in acidic pH
Hippuric acid
91
Identify the urine crystal:
Precipitated in refrigerator
Amorphous urate (acidic), Amorphous phosphate (alkaline)
92
T/F: Amorphous urates and amorphous phosphates are dissolved when heated
False (amorphous phosphate requires chemical to be dissolved, such as acetic acid)
93
pH range where calcium oxalate can be seen
Any (acidic, neutral, alkaline)
94
Identify the urine crystal:
Coffin/ prism crystals in basic urine
Triple phosphate
95
Identify the urine crystal:
Known as magnesium ammonium phosphate seen in urea-splitting bacteria
Triple phosphate
96
Identify the urine crystal:
Envelope-shaped, seen in basic urine
Calcium oxalate
97
The x-mark in the calcium oxalate is seen in which form?
Dihydrate form
98
Which calcium oxalate form is seen in ethylene glycol poisoning?
Monohydrate form
99
The spherical/ dumbbell-shaped calcium oxalate is seen in which form?
Monohydrate form
100
Identify the urine crystal:
Thorny apple-shaped, seen in neutral/ alkaline pH
Ammonium biurate
101
Ammonium biurate could be transformed into uric acid-like crystal in the addition of what substance?
Glacial acetic acid
102
Identify the urine crystal:
Prisms in rosette, mostly confused with sulfonamide crystals
Calcium phosphate
103
Calcium phosphate is soluble in what substance?
Acetic acid
104
Identify the urine crystal:
Seen in alkaline pH with varying shapes and produces gas/ fume formation with the addition of diluted acetic acid
Calcium carbonate
105
Presence of cysteine in the urine
Cystinuria
106
An inborn error in metabolism has which crystals in the urine as an indication?
Leucine, Cysteine
107
Identify the urine crystal:
Colorless, hexagonal in shape
Cysteine
108
Reagent used to distinguishes cysteine crystals, producing a red color
Sodium nitroprusside
109
Liver disorder crystals
Leucine
Bilirubin
Tyrosine
110
Identify the urine crystal:
Yellowish-brown, clumps of needle
Bilirubin
111
Identify the urine crystal:
Colorless, clumps of needle
Tyrosine
112
Identify the urine crystal:
With concentric radial striations
Leucine
113
What normal crystal is usually confused with sulfonamide crystal?
Calcium phosphate
114
Identify the urine crystal:
Described as broken glasses
Cholesterol crystal
115
The appearance of cholesterol crystal in the urine is confused with precipitated ___
Radiographic contrast media
116
Artifact that is confused with RBC that has a thick ring and is irregularly-shaped when dried
Air bubbles
117
Artifact that has a depression in the middle
Starch granule
118
Possible scenario with plant fiber in the urine
Fecal contamination
119
Remnants of RBC membrane
Ghost cells
120
WBCs in hypotonic urine appear as ___
Glitter cells
121
Microscope used in observing mucus thread
Phase-contrast microscope
122
Common bacteria found in bacterial casts
Bacilli
123
A normal urine crystal found in alkaline pH that is described as struvite
Triple phosphate
124
Manner of reporting of abnormal crystals in the urine
Average number per lpf
125
Shape of the RTE coming from DCT
Round/ Oval
126
Shape of the RTE coming from renal tubule
Columnar/ Rectangular
127
Shape of the RTE coming from collecting duct
Cuboidal
