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Mercy CLS 3: Urinalysis > 4. Microscopic Exam > Flashcards

4. Microscopic Exam Flashcards

(96 cards)

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1
Q

“macroscopic screening”

A

protocols whereby microscopic examination of the urine sediment is performed only on specimens meeting specified criteria

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2
Q

centrifugation speed (RCF and RPMs)

A

400-450 RCF
1500-2000 RPMs

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3
Q

calculation for RCF

A

RCF = (1.118 x 10^-5)(radius of rotor head in cm)(RPM^2)

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4
Q

centrifuge for —- min

A

5

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5
Q

volume used for microscopic exam

A

0.5 mL - 1.0 mL

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6
Q

concentration factor =

A

concentration factor = volume of urine centrifuged/sediment volume

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7
Q

examined on low power

A

SECs
casts
mucus

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8
Q

how do stains work?

A

change the refractive index of sediment

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9
Q

most frequently used stain

A

Sternheimer-Malbin

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10
Q

crystal violet + safranin O

A

Sternheimer-Malbin

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11
Q

function of Sternheimer-Malbin

A

IDs WBCs, epithelial cells, casts

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12
Q

0.5% solution metachromatic stain

A

toluidine blue

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13
Q

function of toluidine blue

A

enhances nuclear detail
diff. WBC and renal tubular epithelial cells

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14
Q

lyses RBCs; helps differentiate

A

2% acetic acid

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15
Q

oil red O + sudan III

A

lipid stain

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16
Q

function of lipid stain

A

stain fats except cholesterol

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17
Q

methylene blue + eosin Y

A

hansel stain

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18
Q

function of hansel stain

A

IDs eosinophils
drug-induced allergic rxn

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19
Q

function of prussian blue stain

A

ID structures containing iron
IDs hemosiderin

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20
Q

preparation of permanent slides for detecting & monitoring renal disease

A

cytodiagnostic urine testing

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21
Q

function of Papanicolaou’s stain

A

cytodiagnostic urine testing

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22
Q

how does phase contrast work?

A

converting variations in refractive index to variation in contrast

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23
Q

function of polarizing microscopy

A

ID of cholesterol in oval fat bodies, fatty casts, and crystals

“maltese cross” pattern and crystals

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24
Q

Produces a 3-D microscopy image and layer-by-layer imaging of a specimen

A

Interference-contrast

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25
hematuria clinical significance
Glomerulonephritis Acute infections Toxic and immunologic reactions Malignancies Contamination (menstruation) Strenuous exercise
26
RBC stacking
rouleaux
27
messed up RBCs
dysmorphic forms
28
possible explanation for + blood on dipstick but = RBC on microscopic
myoglobin
29
clumps of WBCs associated with...
proteinuria
30
glitter cells are in ------- urine
hypertonic/dilute
31
appearance of WBCs in elderly patients or those on chemo
“Blebs” (vacuoles) and finger/wormlike projections (myelin forms)
32
explanation for = LE on dipstick but + WBC on microscopic
lymphocytes
33
abnormal epithelials clinical significance
Pyelonephritis Toxic reactions Viral infections Transplant rejection Secondary effects of glomerulonephritis
34
bladder cells
transitional/urothelial cells
35
transitional cells origin
lining of the renal pelvis, ureters, bladder, and upper urethra
36
syncytia
sheets of transitional epithelials seen after catheterization
37
renal tubular epithelial cells origin
linings of renal tubules
38
RTEs can indicate -------, except in this population
tubular necrosis newborns (normal)
39
renal fragments
3 or more collecting duct RTEs
40
oval fat bodies
RTEs that are filled with absorbed lipids
41
OFB clinical significance
glomerular dysfunction with renal tubular cell death and leakage of plasma components (protein and fat) into the urine
42
if RTE or OFB are present...
protein and casts should also be present
43
bacteria without WBCs can indicate...
poor specimen handling
44
yeast are seen in --------- patients because...
diabetic ↑ glucose
45
pseudohyphae
mycelial elements
46
parasites in urine
Trichomonas vaginalis Schistosoma haematobium ova Enterobius vermicularis ova
47
males are often asymptomatic carriers
trich
48
parasite from bladder wall mucosa Africa/middle East
S. haematobium
49
parasite from fecal contamination
pinworm E. vermicularis
50
sperm clinical significance
- sex - male infertility - retrograde ejaculation - SA (children, nursing home etc)
51
major constituent of mucus
uromodulin
52
only elements found in sediment that are unique to the kidney
casts
53
casts reflect --------- and are seen with ------ or ------
status of renal tubules urinary protein levels urinary stasis
54
normal casts
hyaline granular
55
casts clinical significance (general)
- renal disease - diuretic therapy - athletic pseudonephritis
56
major constituent of casts
uromodulin/Tamm-Horsfall protein
57
uromodulin production ↑ during...
exercise stress
58
broad casts indicate...
tubular distension
59
factors that enhance cast formation
- ↓ pH - ↑ in solute concentration - ↓ in rate of urine flow (urinary stasis) - Proteinuria (particularly albumin)
60
cylindruria
casts in urine
61
hyaline cast composition
uromodulin
62
hyaline cast clinical significance
Strenuous exercise Dehydration Emotional stress Glomerulonephritis Pyelonephritis Chronic renal disease Congestive heart failure
63
RBC cast clinical significance
Acute glomerulonephritis (Strep sequelae) Tubular damage Strenuous exercise Incompatible blood transfusions
64
WBC cast clinical significance
Pyelonephritis (upper UTI)—bacteria + Acute interstitial nephritis—bacteria =
65
bacterial cast clinical significance
pyelonephritis
66
RTE cast clinical significance
renal tubular damage
67
granular cast composition
disintegrated cell casts
68
granular cast clinical significance
Normal Exercise Renal disease
69
waxy casts indicate...
extreme urine stasis, indicating chronic renal failure
70
formation of waxy cast
degeneration of the hyaline cast matrix and any cellular elements or granules contained in the matrix
71
casts that do not polarize
waxy
72
waxy cast clinical significance
Chronic renal failure Tubular obstruction Acute renal disease (Glomerulonephritis, Nephrotic syndrome) Malignant HTN Renal allograft rejection
73
fatty casts are seen with...
OFBs and free fat droplets
74
fatty casts clinical significance
Nephrotic syndrome Toxic tubular necrosis DM Crushing injuries
75
broad casts are mostly either ----- or ----- casts and indicate...
granular or waxy extreme urinary stasis
76
pathologic crystals (organic + iatrogenic) are formed in ----- urine
acidic
77
factors that enhance crystal formation
↑ concentration of solute in urine pH of urine Urinary stasis allowing time for formation ↓ Temperature
78
normal crystals seen in acidic urine
- amorphous urates - uric acid - acid urates - sodium urates - calcium oxalate
79
normal crystals seen in alkaline urine
- amorphous phosphates - triple phosphate - calcium phosphate - calcium carbonate - ammonium biurate
80
abnormal crystals
- cystine - cholesterol - leucine - tyrosine - bilirubin - radiographic dye - sulfa - ampicillin - hemosiderin - hippuric acid
81
uric acid crystals abnormal numbers
Increased levels of purines and nucleic acids (diet) Gout Chemotherapy Kidney stones
82
acid urates + sodium urates abnormal numbers
gout
83
calcium oxalate abnormal numbers
foods (tomatos, asparagus, vit C) kidney stones ethylene glycol poisoning
84
ethylene glycol antidote
🥂
85
triple phosphate abnormal numbers
UTI from urease + bacteria
86
calcium phosphate/carbonate abnormal numbers
renal calculi
87
ammonium biurate abnormal numbers
iatrogenically induced improperly handled urine
88
cystine crystals clinical significance
Metabolic disorder that prevents reabsorption of cystine by the renal tubules (cystinuria) Renal tubular damage Renal calculi
89
cholesterol clinical significance
Lipiduria Nephrotic Syndrome
90
leucine clinical significance
IEM severe liver disease seen with tyrosine
91
tyrosine clinical significance
IEM severe liver disease seen with leucine and + bilirubin
92
bilirubin clinical significance
hepatic disorders viral hepatitis
93
usually makes iatrogenic crystals go away
adequate patient hydration
94
hemosiderin seen when?
2-3 days after severe hemolytic episode
95
hippuric acid clinical significance
ethylene glycol poisoning
96
starch seen in...
contamination from gloves, talcum powder

Mercy CLS 3: Urinalysis (10 decks)

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