Microscopic Flashcards
(234 cards)
1
Q
May indicate the presence
of certain sediments
A
color
2
Q
Pathologic or non-pathologic
causes of turbidity
A
Clarity
3
Q
RBCs, RBC Cast
A
Blood
4
Q
Casts, cells
A
Protein
5
Q
Bacteria, WBCs
A
Nitrite
6
Q
A
7
Q
WBCs, WBC Casts, bacteria
A
LE
8
Q
Yeast
A
Glucose
9
Q
Quantitative measure of formed elements using a
hemocytometer
A
addis count
10
Q
urine specimen for addis count?
A
12 hour urine
11
Q
preservative for addis coubt?
A
NaF
12
Q
Delineates
structure and
contrasting colors
of the nucleus
and cytoplasm
A
SternheimerMalbin
(CV + Safranin
O)
13
Q
sediment stain: WBCs, ECs, and
casts
A
SternheimerMalbin
(CV + Safranin
O)
14
Q
sediment stain: Enhances nuclear
detail
A
0.5% Toluidine
Blue
15
Q
sediment stain: Differentiates
WBCs and RTE
cells (oval;
nucleus centered)
A
0.5% Toluidine
Blue
16
Q
Lyses RBCs and
enhances nucleus
of WBCs
A
2% Acetic acid
17
Q
Distinguishes
RBCs
from WBCs,
yeasts, oil
droplets and
crystals
A
2% Acetic acid
18
Q
Stains TAG and
neutral fats
(orange-red)
A
Lipid stains
(ORO and Sudan
III)
19
Q
Stain: Identifies free fat
droplets and lipidcontaining cells &
casts
A
Lipid stains
(ORO and Sudan
III)
20
Q
Differentiates
Gram (-) to Gram
(+) bacteria
A
GS
21
Q
sediment stain: casts
GS Differentiates
Gram (-) to Gram
(+) bacteria
Bacterial casts
A
GS
22
Q
Stains
eosinophilic
granules
A
Hansel Stain
(Eosin Y +
Methylene blue)
23
Q
sediment stain: urinary eosinophils
A
Hansel Stain
(Eosin Y +
Methylene blue)
24
Q
Stains
sediments
containing iron
A
Prussian Blue
25
Identifies
hemosiderin
granules in casts
and cells
Prussian Blue
26
microscopy: Visualization of elements
with low refractive indices
(hyaline, mixed cellular cast,
MT, Trichomonas)
Phase-Contrast
Microscopy
27
microscope: Used for routine urinalysis
Bright-Field Microscopy
28
micro: Identification of cholesterol
molecules in OFB, fatty casts
and crystals
Polarizing Microscopy
29
micro: Identification of Treponema
spp
darkfield microscopy
30
micro;For fluorescent
microorganisms or those
stained with a fluorescent
dye
Fluorescence Microscopy
31
micro;3-D microscopy image and
layer-by-layer imaging of a
specimen
Interference-Contrast
Microscopy
32
*Bright Field microscopes
can be adapted
Interference-Contrast
Microscopy
33
differential microscopy
nomarski
34
modulation microscopy
hoffman
35
rbc normal value?
0-4/hpf
36
Smooth, non-nucleated, biconcave disks-shaped
sediment (7um in diameter)
RED BLOOD CELLS (HEMATURIA)
36
rbc in urine is called
hematuria
37
rbc in hypertonic urine
shrink
38
rbc in hypotonic urine
ghost cell or large empty cell
39
Glomerular bleeding/damage =
rbc casts
40
Sources of error of rbc in urine
Yeast, oil droplets, air bubbles,
CaOx monohydrate
41
remedy of RBC in urine
Addition of 2% HAc to lyse RBCs
42
Clinical Significance:
o Glomerular membrane damage, vascular
injury within GUT, glomerular bleeding,
glomerulonephritis, renal calculi,
malignancies, Schistosomiasis, strenuous
exercise
RED BLOOD CELLS (HEMATURIA)
43
wbc normal value in urine
0-5/hpf
44
predominant wbc in urine
neutrophils
45
Granulated and multilobed
Neutrophils (predominant)
46
Swells in hypotonic (dilute and alkaline) urine
Neutrophils (predominant)
47
granules undergo Brownian Movement
(Glitter Cells) *clinically insignificant
Neutrophils (predominant)
48
Shrinks in hypertonic (acidic) urine
Neutrophils (predominant)
49
eosinophils normal value range
<1%
50
clinical signi; (associated with drug-induced interstitial
nephritis)
eosinophils
51
Present in small amount
Mononuclear cells (Lympho, Mono, Macro, Histio)
52
An increase indicates an inflammatory
response or renal transplant rejection
Mononuclear cells (Lympho, Mono, Macro, Histio)
53
Clinical Significance:
- Infection or inflammation in the GUT
Mononuclear cells (Lympho, Mono, Macro, Histio)
54
Clinical Significance:Bacterial infection: cystitis,
pyelonephritis, prostatitis, urethritis
Mononuclear cells (Lympho, Mono, Macro, Histio)
55
Clinical Significance: - Non-bacterial infection:
glomerulonephritis, SLE, tumors
Mononuclear cells (Lympho, Mono, Macro, Histio)
56
Largest cell (30-
40 um) with
abundant,
irregular
cytoplasm and
prominent
nucleus
squamous epithelial cells
57
Folded cell may
resemble casts.
sec
58
Found in the
linings of vagina,
female urethra and lower portion
of male urethra
sec
59
Urothelial
tec
60
Spherical,
polyhedral or
caudate with
centrally located
nucleus
tec
61
From linings of
renal pelvis,
calyces, ureter,
urinary bladder
and upper
portion of male
urethra.
tec
62
Most clinically
significant
epithelial cell
rte
63
Oblong or
round to oval or
rectangular and
contain an
eccentric
nucleus and
coarsely
granulated
cytoplasm
64
Oblong or
round to oval or
rectangular and
contain an
eccentric
nucleus and
coarsely
granulated
cytoplasm
rte
65
SEC studded
with Gardnerella
vaginalis;
associated with
bacterial
vaginosis
CLUE CELLS:
66
Significant
numbers can be
seen after
catheterization
(single, pairs, or
in clumps
{syncytia})
tec
67
Not usually seen
in urine
tec
68
>2 RTE/HPF
indicates
TUBULAR
DAMAGE
69
- Lipid-containing RTE cell
Oval Fat Bodies
70
Seen in lipiduria (i.e. nephrotic syndrome)
Oval Fat Bodies
71
Polarizing Microscope: maltese cross
Oval Fat Bodies
72
RTE cell with nonlipid-filled vacuoles
Bubble cells
73
Seen in acute tubular necrosis
Bubble cells
74
Most frequently associated with UTI
BACTERIA
75
Most common cause of bacteria; UTI?
Enterobacteriaceae
76
Most frequent parasite encountered in urine
T. vaginalis
77
o Pear-shaped flagellate (rapid darting motility)
T. vaginalis
78
Method of reporting of t. vaginalis
RFMoMa
79
Blood fluke with terminal spine
S. haematobium ova (bladder)
80
parasite Causes hematuria; associated with bladder
cancer
S. haematobium ova (bladder)
81
urine specimen for S. haematobium ova (bladder)
24hr unpreserved urine
82
Most common fecal contaminant
E. vermicularis
83
True yeast infection
yeast + WBC
84
Small, refractile oval structures that may or may not
bud
YEASTS
85
(+) in RGT strip (Glucose)
yeast
86
yeast that seen in DM patients and Immunocompromised patients
candida albicans
87
Major constituent of mucus thread
tamm horsfall protein
88
tamm horsfall protein is also known as
uromodulin
89
95% water, mucin, CHONs, minerals, salts
and traces of lipid and nucleic acid
: Tamm-horsfall protein
90
cast in urine is termed
Cylindruria
91
Unique to the kidneys
CASTS (CYLINDRURIA)
92
Primarily formed in the DCT and collecting ducts
CASTS (CYLINDRURIA)
93
* Seen primarily along the coverslip edges with subdued
light
CASTS (CYLINDRURIA)
94
reporting of casts?
average number/10lpfs
95
major constituent of cast
uromodulin produced by RTE cells
96
ORDER OF CAST DEGENERATION
1. Hyaline
2. Cellular
3. Coarsely granular
4. Waxy granular (kidney failure)
97
casts: Beginning of all casts
Hyaline
cast
98
Most frequently
seen cast
Hyaline
cast
99
normal values of hyaline cast
NV: 0-2/lpf
100
Cast? Physiologic:
- Exercise,
dehydration,
heat
exposure,
emotional
stress
Hyaline
cast
101
casts? Pathologic:
- Acute
glomerulonep
hritis,
pyelonephritis
, CHF, CRD
hyaline casts
102
cast: nephron bleeding
rbc cast
103
rbc cast reporting;
number per lpf
104
cast; glomerulonephritis
rbc cast
105
Associated with
proteinuria and
dysmorphic RBCs
rbc cast
106
cast; Infection or
inflammation within
the nephron
wbc cast
107
cast; May be confused
with EC casts
wbc cast
108
cast: use phase
contrast or a supravital
stain
wbc cast
109
cast; pyelonephritis
wbc cast
110
cast; interstitial nephritis
wbc cast
111
Glomerulonephritis (w/
RBC casts)
wbc casts
112
cast; toxicity
rte cell cast
113
cast; viral infection
RTE CELL CAST
114
cast; advanced tubular destruction
rte cell cast
115
cast; allograft rejection
rte cell casts
116
cast; pyelonephritis with wbc cast
rte cell casts
117
Resemble granular
casts
Bacterial
cast
118
cast: Identification using
GS
bacterial cast
119
cast; pyelonephritis with wbc and rte cell cast
bacterial cast
120
cast; containing bacilli both
within and bound to the
protein matrix
bacterial cast
121
cast; are derived
from the lysosomes
of RTE cells during
normal metabolism
Granular
cast
122
cast: * Glomerulonephritis
* Pyelonephritis
* Stress
* Strenuous exercise
granular cast
123
cast; Identified using lipid
stains and polarizing
microscope
fatty cast
124
cast: Nephrotic syndrome
fatty cast
125
126
cast: (lipiduria – OVB
fatty cast
127
cast; Toxic tubular necrosis
fatty cast
128
cast; Diabetes mellitus
fatty casts
129
cast; crush injuries
fatty cast
130
Final degenerative
form of all types of
casts
waxy cast
131
cast; Brittle, highly
refractile with jagged
edges
waxy cast
132
waxy cast is what color under supravital stain
dark pink
133
cast; stasis of urine flow
waxy cast
134
cast; chronic renal failure
waxy cast
135
Renal failure cast
Broad cast
136
All types of casts may
occur in the broad
form; most
common: ?
Waxy and granular
137
* Bile-stained broad,
waxy casts are seen
as the result of the
tubular necrosis
caused by viral
hepatitis
Broad cast
138
cast; Extreme urine stasis
* Renal failure
Broad cast
139
cast; Hyaline matrix with
coloration due to
pigmentation
incorporation
Pigmented
cast
140
pigmented cast color with incorporated bilirubin
golden brown
141
pigmented cast color with hemoglobin or myoglobin
yellow to red brown
142
Casts containing
multiple cell types
Mixed
cellular
cast
143
Glomerulonephritis
(RBC and WBCs)
* Pyelonephritis (WBC,
RTE casts or WBC and
bacterial casts
Mixed
cellular
cast
144
Casts containing
urates, CaOx, and
sulfonamides are
occasionally seen
Crystal
cast
145
cast: Deposition of crystals
in the tubule or
collecting duct
Crystal
cast
146
Formed by precipitation of urinary solutes (organic
compounds, salts, medication)
CRYSTALS (CRYSTALLURIA)
147
Factors that contribute to crystal formation:
Temperature
Solute conc.
pH
148
all abnormal cast are found in what urine?
acidic urine
149
crystal: Brick dust
Amorphous
urates
150
crystal:Yellow-brown granules
Amorphous
urates
151
crystal: in Refrigerated specimens
Amorphous
urates
151
amorphous urates is pH
pH >5.5
151
crystal:Dissolved when warm
Amorphous
urates
151
crystal: Dissolved by acetic
acid
amorphous phosphate
151
crystal: the only normal crystal that is colored in acidic urine
amorphous urates
152
crystal:Clumps - formation of
renal calculi (stone)
CaOx
153
crystal:Increased in food rich in
oxalic acid (tomatoes,
asparagus, and ascorbic
acid)
CaOx
154
crystal: soluble in Heat and Alkali
fluid
Amorphous
urates
155
crystal: Mistaken as RBC
Caox
156
crystal kind of CaOx: colorless, octahedral
envelope or as two
pyramids joined at their
bases
Dihydrate (Wheddelite)
157
crystal kind of CaOx: most common form;
enveloped form
Dihydrate (Wheddelite)
158
crystal kind of CaOx: - oval or dumbbell shaped
Monohydrate (Whewellite)
158
crystal kind of CaOx: ethylene glycol
(antifreeze) poisoning (in
children & pets; sweet &
tempting)
Monohydrate (Whewellite
158
crystal: soluble in * Dilute HCl;
* Insoluble in HAc
CaOx
158
crystal kind of Caox; both are birefringent under polarizing microcsope
Monohydrate (Whewellite), Dihydrate (Wheddelite
159
crystal:“Cigarette-butt” in
appearance
Calcium
sulfate
160
crystal: soluble in * Acetic acid
calcium sulfate
160
crystal:Yellow-brown or
colorless elongated
prisms
Hippuric
acid crystals
161
crystal:* Less significant
Hippuric
acid crystals
162
crystal: soluble in * Water and Ether
Hippuric
acid crystal
163
crystal:Misidentified w/ cystine
crystals
Uric acid crystal
163
crystal: Leukemia patients
receiving
chemotherapy
Uric acid crystal
163
crystal: * Yellow-brown or
colorless
Uric acid crystal
163
crystal:Pleomorphic - rhombic,
four-sided flat plates
(whetstones), wedges,
and rosettes
Uric acid crystal
164
crystal: Increased levels of
purine and nucleic
acid
Uric acid crystal
165
crystal:Gout
Uric acid crystal
165
crystal: Resembles ammonium
biurate in alkaline urine
Acid urate crystal
165
crystal: chemotherapy
- Lesch-Nyhan
syndrome (orangesand in diapers
Uric acid crystal
166
crystal: Large granules and may
have spicules
Acid urate crystal
167
crystal: * Slender prisms arranged
in fan or sheaf-like
structures
Sodium
urate crystal
168
crystal: Synovial fluid during
episode of gout
Sodium urate crystal
168
crystal: * Granular
* Refrigerated samples – white
precipitate
Amorphous
phosphate
169
crystal: * Yellow-brown thorny apples
Ammonium
biurate
170
crystal: Seen in old specimens
Ammonium
biurate
171
crystal: Colorless, flat rectangular
plates
Calcium
Phosphate
/apatite
172
crystal:Thin prisms often in rosette
formations – resemble
sulfonamide crystals
Calcium
Phosphate
/apatite
173
crystal: Common constituent of
renal calculi
Calcium
Phosphate
/apatite
174
crystal: * Insoluble by heat
Calcium
Phosphate
/apatite
175
crystal kind of calcium phosphate; – basic
calcium phosphate
Hydroxyapatite –
175
crystal: calcium hydrogen
phosphate
Brushite
176
crystal: Long slender prisms with one
end pointed; found in clusters
Dicalcium
phosphate
177
crystal:Bacteria splitting
Triple
phosphate /
Struvite
178
crystal: * “Ammonium magnesium
phosphate” crystal
Triple
phosphate /
Struvite
179
crystal: Colorless, prism-shape or
“coffin-lid”
Triple
phosphate /
Struvite
180
crystal: Feathery appearance when
they disintegrate
Triple
phosphate /
Struvite
181
crystal: Fern-leaf (Harr)
Triple
phosphate /
Struvite
182
crystal: Small, colorless, dumbbellshaped
Calcium
carbonate
183
crystal:Formation of gas
(effervescence) after the
addition of acetic acid
Calcium
carbonate crystal
184
crystal: Colorless, hexagonal
plates
Cystine
185
a
metabolic disorder that
prevents reabsorption
of cystine by the renal
tubules
Cystinuria
186
crystal:* Mistaken as uric acid
crystals
Cystine
187
accumulation of cystine
in cells
* Cystinosis
188
crystal:
189
crystal: * Rectangular plates
with notched edges
(staircase pattern)
Cholesterol
crystal
190
crystal:* Nephrotic syndrome
(lipiduria)
Cholesterol
crystal
190
crystal:* Nephrotic syndrome
(OFB, fatty casts,
choles.cryst)
Cholesterol
crystal
191
crystal: Seen in conjunction
with fatty casts and
oval fat bodies
Cholesterol
crystal
192
crystal:Rosettes, arrowheads,
petals, or round
Sulfonamide
192
crystal: * Soluble in
Chloroform
Cholesterol
crystal
193
vcrystal: * Colorless to yellow
brown needles
Sulfonamide
(acid/neutral)
194
crystal:*
Mistaken as calcium
phosphate crystals
Sulfonamide
195
crystal test:- Newspaper:
Urine + 25%
HCl
= (+)
Yellow
Lignin test of sulfonamide
196
crystal:Possible tubular
damage
Sulfonamide
197
crystal: Primary cause:
inadequate patient
hydration
Sulfonamide
198
crystal:* Colorless needles that
form bundles after
refrigeration
Ampicillin
199
crystal:Precipitation of
antibiotics following
massive doses without
adequate hydration
Ampicillin
200
crystal:Overdose of penicillin
drugs
Ampicillin crystal
201
Uric acid color?
yellow brown
202
cystine color?
colorless
203
Oily
-looking
yellow
-brown
spheres with
concentric circles
and radial
striations
LEUCINE
204
* Fine colorless to
yellow needles
that frequently
form clumps or
rosettes
TYROSINE
205
* Usually seen in
conjunction with
leucine crystals
in specimens with
positive chemical
test results for
bilirubin
TYROSINE
206
* Inherited disorders
of amino
-acid
metabolism
TYROSINE
207
Hepatic
disorders
BILIRUBIN
208
Clumped needles
or granules with
the characteristic
yellow color of
bilirubin
BILIRUBIN
209
Cystine is positive in what reaction?
Cyanide nitroprusside reaction
210
Cystine or uric acid: solubility in dilute hcl?
Cystine
211
Associated with liver disease: concentric needles with radial striation
Leucine
212
Crystal: sheaves of wheat
Sulfonamide
213
Tubular damage in rte cell is indicated by?
>2rte/hpf
214
ncreased in food rich in
oxalic acid
CaOx
215
• Mistaken as RBC
CaOx
216
tomatoes,
asparagus, and ascorbic
acid)
CaOx
