M1: Urine Sediments (Part 1) Flashcards
Red Blood Cells, White Blood Cells, Epithelial Cells (97 cards)
1
Q
Described as colorless, non-nucleated, smooth biconcave
disk with average size of 7 um (6-8) in diameter
A
Red Blood Cell
2
Q
Average size of red blood cell?
A
7 um (6-8) in diameter
3
Q
Red Blood Cells
In concentrated or hyperstherunic urine, there is a presence of what?
A
hypertonic and crenated cell
small cell with crinkled border or spheres with spicules
4
Q
Red Blood Cells
In dilute or hyposthenuria urine, there is a presence of what?
A
presence of hypotonic and ghost/shadow cell
faint, colorless circle - intact cell with no hemoglobin
5
Q
RBCs are frequently confused with what type of cells?
A
WBCs, yeast cells, air bubbles, and oil droplets
6
Q
T or F: WBCs and yeast cells dissolve in 2 to 5% acetic acid while RBCs do not
A
False
teh baliktad yan wtf
7
Q
Yeast cells differ from RBCs because they exhibit what?
A
Budding
8
Q
Oil droplets and air bubbles differ from RBCs because?
A
They have irregular sizes and are highly refractile when the fine adjustment is focused up and down
9
Q
What is the reference range for RBCs?
A
0 - 2 RBC/hpf
10
Q
RBCs with protrusion or fragmentation is known as?
A
Dysmorphic RBC
11
Q
This type of RBC indicates renal or glomerular bleeding
A
Dysmorphic RBC
12
Q
What stain is used for dysmorphic RBCs?
A
Wright’s Stain
hypochromic, presence of cellular blebs and protrusions
13
Q
Dysmorphic RBC
Described as rounded outgrowth on the surface of a cell
A
Blebs :p
14
Q
Clinical Significance of RBCs in Urine
What are the clinical significances of RBCs in urine?
Familiarize yourselves na lang fleece, thank you mwa.
A
- Glomerular membrane damage (glomerulonephritis
- Vascular injury with the genitourinary tract
- Renal Calculi
- Malignancy
- Hematuria (Macroscopic and Microscopic)
15
Q
Clinical Significance of RBCs in Urine
Increased RBCs + RBC casts mean?
A
Bleeding is renal in origin
16
Q
Clinical Significance of RBCs in Urine
Increased RBCs + no RBC casts mean?
A
Bleeding site is distal to the kidney
17
Q
Clinical Significance of RBCs in Urine
Undistorted RBCs and uniform appearance mean?
A
Non-glomerular bleeding
18
Q
T or F: The presence of not only RBCs but also hyaline, granular, and RBC casts may be seen following strenous exercises.
A
True the fire
Non-pathologic and disappear after rest.
19
Q
What are the two types of hematuria?
A
Macroscopic and microscopic
20
Q
Hematuria
- Urine appears cloudy with a red to brown color
- Reported in terms of greater than 100 per hpf
- Frequently associated with advanced glomerular damage
A
Macroscopic hematuria
21
Q
Hematuria
- Critical to the early diagnosis of glomerular disorders and malignancy of the urinary tract and to tract the presence of renal calculi
A
Microscopic hematuria
22
Q
T or F: RBCs are larger than WBCs
A
F
teh amaccana
23
Q
What is the average size of WBCs?
A
12 um (10-14) in diameter
24
Q
What is yje predominant WBC found in urine sediment?
A
Neutrophil
Much easier to identify because they contain granules and multilobed nuclei.
25
What type of cells are WBCs frequently confused with?
RBCs and RTEs (renal tubular epithelial cells)
26
What is the reporting of WBCs?
average/10 hpfs
27
What is the normal value of WBCs?
0 - 5 WBCs/hpf
28
T or F: WBCs lyse rapidly in dilute alkaline urine and begin to lose nuclear detail.
T
29
Neutrophils exposed to dilute or hypotonic urine absorb water and swell
Glitter Cells
30
# Glitter Cells
What type of movement within granules is observed within WBCs that produce a sparkling appearance?
Brownian Movement
31
# Glitter Cells
What stain is used to stain the glitter cells light blue as opposed to the violet color usually seen on neutrophils?
Sternheimer-Malbin stain
32
T or F: Glitter cells are no pathologic significance
T
33
# Clinical Significance of WBCs in Urine
An increase in WBCs that indicates the presence of an infection or inflammation in the genitourinaary system is called?
Pyuria
34
If there is a presence of WBC cast, it indicates what?
Infection or inflammation is **renal** in origin
35
# Clinical Significance of Neutrophils in Urine
What are the bacterial infections associated with WBCs in urine?
| Familiarize ulit hehe mwa.
1. Pyelonephritis
2. Cystitis
3. Prostatitis
4. Urethritis
| Frequent causes of pyuria
36
# Clinical Significance of Neutrophils in Urine
What are the non-bacterial disorders associated with WBCs in urine?
| Familiarize pa ulit hehe.
1. Glumerolonephritis
2. Lupus erythematosus
3. Interstitial nephritis
4. Tumors
37
These types of WBCs are not normally seen in the urine.
Eosinophils
38
T or F: The finding of more than 1% eosinophils is considered significant.
T
39
What is the preferred stain for eosinophil?
Hansel Stain
40
T or F: Wright's Stain cannot be used for eosinophils.
F
41
What is the composition of Hansel stain?
Methylene blue in Eosin Y
42
The percentage of eosinophils in ____ to 500 cells is determined.
100
43
# Clinical Significance of Eosinophils in Urine
What is the presence of eosinophils in urine primarily associated with?
Associated with hypersensitivity to drugs like penicillin *(drug-induced interstitial nephritis*
44
# Clinical Significance of Eosinophils in Urine
What are the other clinical significances?
| Familiarize ulit mwa.
1. UTI and Renal Transplant Rejection *(small numbers)*
2. Tubulointerstitial disease
45
These types of WBCs may be seen in increased numbers in the early stages of renal transplant rejection.
Mononuclear cells
46
What is the primary concern in the identification of WBCs?
The differentiation of mononuclear cells and disintegrating neutrophils from round RTE cells
47
WBCs differ from RTE cells in such a way that?
RTE cells are usually larger with an eccentrically located nucleus
48
T or F: WBCs in the process of ameboid motion is difficult to distinguish from epithelial cells because of their irregular shapes.
T
49
T or F: It is not unusual to find epithelial cells in the urine.
T
50
Why is it not unusual to find epithelial cells in the urine?
Because they are derived from the linings of the genitourinary system
51
Largest cells found in the urine
Epithelial cells
52
What are the different types of epithelial cells found in urine?
1. Squamous
2. Transitional (Urothelial)
3. Renal Tubular
53
What are the sites of origin of the renal tubular epithelial cells?
PCT, DCT, collecting duct
54
What are the sites of origin of the transitional epithelial cells?
upper 2/3 of the urethra pelvis, bladder, upper urethra
55
What are the sites of origin of the squamous epithelial cells?
lower 1/3 of the urethra, vulva, vagina
56
Most frequently seen and least significant epithelial cell
Squamous Epithelial Cell
57
# Epithelial Cells
Large cells with abundant cytoplasm and small round central nucleus
Squamous Epithelial Cell
58
Average size of the squamous epithelial cell?
40 to 60 um
59
# Epithelial Cell
Originate from the linings of the vagina and female urethra
and the lower portion (distal 1/3) of the male urethra
Squamous Epithelial Cell
60
# Epithelial Cells
Indicative of vaginal infection by the bacterium Garnerella vaginalis
Clue Cells
61
# Squamous Epithelial Cellls
To be considered a clue cell, the bacteria should?
## Footnote
Clue: It gives the cell a granular, irregular appearance.
Should cover most of the cell surface *and* extend beyond the edges of the cell
62
This epithelial cell originates from the lining of the renal pelvis, bladder, ureters, and upper urethra
Transitional (Uroepithelial) Cells
63
Average size of transitional epithelial cells?
20 to 40 um
64
T or F: Squamous epithelial cells are larger than transitional epithelial cells
True
65
How would you describe the shape of transitional epithelial cells?
Round or pear-shaped contour or tail-like projections
## Footnote
This called caudate epithelial cells
66
What causes the differences of squamous epithelial cell and transitional epithelial cell?
The ability of transitional epithelial cells to absorb large amounts of water
67
All forms of transitional epithelial cells have?
Distinct, centrally located nuclei, sometimes binucleated
68
Transitional epithelial cells usually present in small numbers in normal urine representing what?
Normal cell sloughing
69
# Clinical Significance of Transitional Epithelial Cells
What are the clinical significances of transitional epithelial cells?
| Familiarize yourselves mwa.
1. Present in invasive urologic procedures lie catheterization *(of no clinical significance)*
2. Indicative of malignancy or viral infection *(if they have abnormal morphology)*
3. Transitional Cell Cancer *(if in large clumps)*
70
# Epithelial Cells
Most significant of the epithelial cells in urine
Renal Tubular Epithelial Cells
71
T or F: RTE cells vary in size and shape depending on the area of renal tubules from which they originate.
True the fire
71
What are the three types of RTE cells?
## Footnote
Clue: Depends sa site of origin
1. RTE from PCT
2. RTE from DCT
3. RTE from the collecting duct
72
# Types of RTE Cells
Larger than the other RTE cells
RTE from PCT
73
# Types of RTE Cells
They are rectangular, columnar, or convulated in shape
RTE from PCT
74
# Types of RTE Cells
* Cytoplasm is coarsely granular, and the RTE cells often resemble casts
* Resemble granular or fatty casts
RTE from PCT
75
# Types of RTE Cells
* Occurs singly (14-60um)
* Smaller than those from the PCT
RTE from DCT
76
* Round or oval (oblong or egg-shaped) cells with coarse granules
* Can be mistaken for WBCs and spherical transitional
epithelial cells
RTE from DCT
77
# Types of RTE Cells
* Cuboidal or polygonal
* Has the presence of at least one straight edge which differentiated them from the other RTEs
* Nucleus occupies 60 to 70% of the cells
RTE from the collecting duct
78
# RTE from the collecting duct
When appearing in groups of three or more, they are called what?
Renal fragments
79
# RTE from the collecting duct
RTEs from the collecting duct are often seen as?
Large sheets of cells
80
What are the normal values of RTE cells in urine?
0-2/hpf
81
# Clinical Significances of RTE
What are the clinical significances of RTE cells in urine?
## Footnote
Di ko na lalagay yung conditions that produce tubular necrosis or tubular damage, just read it sa transes hehe.
1. Indicative of necrosis of renal tubules
2. Secondary effects of glomerular disorders
3. Indication of severe tubular injury with basement disrubtion
4. Salicylate poisoning *(single cuboidal cells)*
82
T or F: It is unusual for RTE cells to contain substances from the filtrate.
F
## Footnote
Their function is reabsorption of the glomerular filtrate kaya di siya unusual.
83
T or F: RTE cells absorb bilirubin present in the filtrate.
T
84
Lipid-containing RTE cells
Oval Fat Bodies
85
# RTE Cells
* Appear highly refractile
* The nucleus may be more difficult to observe
* Usually seen in conjunction with free-floating fat droplets
Oval Fat Bodies
85
T or F: RTE cells absorb lipids that are present in glomerular filtrate.
T
86
# Identification of Oval Fat Bodies
What stain is used for oval fat bodies?
Sudan III or Oil Red O fat stains
87
# Identification of Oval Fat Bodies
What are the compositions of the droplets?
Triglycerides
Neutral Fats
Cholesterol
88
# Identification of Oval Fat Bodies
The fat stains stain the triglycerides and neutral fats as what color?
Orange-red
89
# Identification of Oval Fat Bodies
Examining the sediments is possible through the use of?
Polarized microscopy
90
# Identification of Oval Fat Bodies
Polarized microscopy allows for the appearance of?
Maltese cross formations in droplets containing cholesterol
91
# Oval Fat Bodies
* Most frequently associated with damage to the glomerulus caused by the nephrotic syndrome
* Also seen with severe tubular necrosis, diabetes mellitus, and in trauma cases that cause release of bone marrow fat from the long bones
Lipiduria
92
In what cases are RTE cells containing large, nonlipid-filled vacuoles observed?
Acute tubular necrosis
93
They are RTE cells that contain large, non-lipid vacuoles
Bubble Cells
94
Appear to represent injured cells in which the endoplasmic reticulum has dilated prior to cell death
Bubble Cells
95
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