Urinary Sediment

Question 1

Smooth, Non-nucleated biconcave disc

Answer 1

Red Blood Cell

Question 2

Normal Value of RBC in urine

Answer 2

0-2 cells/10 HPF

Question 3

size of RBC

Answer 3

7mm

Question 4

(Concentrated): Shrink → Crenated

Answer 4

Hypersthenuric

Question 5

(Diluted): Swell and lyse → leaving cell membrane only → Ghost cell

Answer 5

Hyposthenuric

Question 6

(cellular protrusions, fragmented): Glomerular Bleeding

Answer 6

Dysmorphic

Question 7

Urine appears cloudy with a red to brown color

Answer 7

Macroscopic (Gross) hematuria

Question 8

Associated with advanced glomerular damage, can also be seen with damage to the vascular integrity of the urinary tract caused by trauma, acute infection or inflammation and coagulation disorders

Answer 8

Macroscopic (Gross) hematuria

Question 9

Presence of RBC can be seen only under the microscope, normal color

Answer 9

Microscopic hematuria

Question 10

Can be critical to the early diagnosis of glomerular disorder and malignancy of the urinary tract and to confirm the presence of renal calculi (kidney stones)

Answer 10

Microscopic hematuria

Question 11

Associated with damage to the glomerular membrane or vascular injury within genitourinary tract

Answer 11

RBC

Question 12

The number of cells present is indicative of the extent of damage and injury

Answer 12

RBC

Question 13

Increased in urinary WBC

Answer 13

Pyuria

Question 14

Predominant, has granules and multilobed

Answer 14

Neutrophil

Question 15

(absorbs water and swell)

Answer 15

Hypotonic

Question 16

granules exhibit Brownian movement → sparkling appearance or appear as

Answer 16

“Glitter cells”

Question 17

Drug-induced interstitial nephritis, small numbers can be seen in UTI and renal transplant rejection

Answer 17

Eosinophil

Question 18

Ex. of Mononuclear cells

Answer 18

Lymphocytes, Monocytes, Macrophage, Histiocytes

Question 19

resembles RBC because they are both small

Answer 19

Lymphocytes

Question 20

large cells with vacuoles, may or may not contain inclusions

Answer 20

Monocytes, Macrophage, Histiocytes

Question 21

increase in urinary WBCs which indicates the presence of an infection or inflammation in the genitourinary system

Answer 21

Pyuria

Question 22

seen in increased number in the early stages of renal transplant rejection

Answer 22

Lymphocytes

Question 23

(usually larger than WBCs with an eccentrically located nucleus)

Answer 23

renal tubular epithelia cells

Question 24

Primary concern in identification of WBC in urine:

Answer 24

differentiation of mononuclear cells and disintegrating neutrophils from round renal tubular epithelia cells

Question 25

used to enhance nuclear detail

Answer 25

Supravital staining / Addition of acetic acid

Question 26

Normal, Sloughing off

Answer 26

Squamous EC

Question 27

largest cells found in urine sediment, derived from the genitourinary tract

Answer 27

Squamous EC

Question 28

They represent normal cellular sloughing and have no pathologic significance

Answer 28

Squamous EC

Question 29

Urothelial

Answer 29

Transitional EC

Question 30

Smaller than squamous cells and appear in several forms, including spherical, polyhedral and caudate

Answer 30

Transitional EC

Question 31

These differences are caused by the ability of transitional epithelial cells to absorb large amounts of water

Answer 31

Transitional EC

Question 32

Originate from the lining of the renal pelvis, calyces, ureters, and bladders, and from the upper portion of the male urethra

Answer 32

Transitional EC

Question 33

(they are flexible and can change shape)

Answer 33

Transitional EC

Question 34

Increase in transitional cells → invasive urologic procedure → catheterization (no pathologic significance)

Answer 34

Transitional EC

Question 35

Clumps of transitional cell is called

Answer 35

synctia

Question 36

increase in abnormal morphology (has vacuoles or irregular nuclei)

Answer 36

malignancy or viral infection

Question 37

Ex. of RTE Cell

Answer 37

PCT, DCT, CD

Question 38

(if they appear in groups of 3)

Answer 38

Renal Fragments

Question 39

Has pathologic significance, indication of tissue destruction necrosis

Answer 39

RTE Cell

Question 40

size and shape depending on the area of the renal tubules from which they originate

Answer 40

RTE Cell

Question 41

larger than any RTE cells, rectangular in shape referred to as columnar or convoluted cells

Answer 41

PCT

Question 42

resembles casts

Answer 42

PCT

Question 43

can be mistaken as WBC or spherical transitional cell

Answer 43

DCT

Question 44

smaller, round or oval

Answer 44

DCT

Question 45

cuboidal and are never round

Answer 45

RTE cell from Collecting duct

Question 46

Lipid-containing RTE cells

Answer 46

Oval Fat bodies

Question 47

contains non-lipid filled vacuoles

Answer 47

Bubble cells

Question 48

associated with Acute Tubular Necrosis

Answer 48

Bubble cells

Question 49

Squamous EC covered with Gardnerella coccobacillus

Answer 49

Clue Cells

Question 50

clue cells is indication or microscopic sediment used to diagnosed ___ ___

Answer 50

Bacterial Vaginosis

Question 51

Not normally present since urinary bladder is sterile

Answer 51

Bacteria

Question 52

Spherical-shaped

Answer 52

Cocci

Question 53

Rod shaped

Answer 53

Bacilli

Question 54

(gram negative) – most frequently associated with UTI

Answer 54

Enterobacteriaceae

Question 55

Bacteria should be accompanied by WBC

Answer 55

UTI

Question 56

Small refractile oval structures (may or may not contain bud)

Answer 56

Yeast

Question 57

yeast that primarily seen in urine of the patient with DM, Vaginal moniliasis, Immunocompromised individual

Answer 57

Candida albicans

Question 58

most frequent parasite encountered in the urine, sexually transmitted, associated with vaginal inflammation

Answer 58

Trichomonas vaginalis

Question 59

Resembles WBC if left standing for hours

Answer 59

Trichomonas vaginalis

Question 60

bladder parasite (ova); bladder cancer

Answer 60

Schistosoma haematobium

Question 60

Men are often asymptomatic

Answer 60

Trichomonas vaginalis

Question 61

most common fecal contaminant, D-shape

Answer 61

Enterobius vermicularis

Question 62

Spermatozoa seen in the urine of male and female

Answer 62

Normal. Do not report in routine urinalysis

Question 63

Significant Spermatozoa

Answer 63

Male infertility, Retrograde ejaculation

Question 64

(sperm is expelled into bladder instead of urethra)

Answer 64

Male infertility, Retrograde ejaculation

Question 65

toxic for sperm

Answer 65

Urine

Question 66

major constituent of mucus

Answer 66

Uromodulin

Question 67

Thread-like structures (Low refractive index)

Answer 67

Mucus

Question 68

usually missed out in microscopic

Answer 68

Mucus

Question 68

Frequently seen in females (if she didn’t wash prior to collection)

Answer 68

Mucus

Question 69

Only elements found in urine

Answer 69

Casts

Question 70

unique to the kidney

Answer 70

Casts

Question 71

presence of urinary cast

Answer 71

Cylinduria

Question 72

True geometrically structure or amorphous materials

Answer 72

Crystals

Question 73

highly refractile sphere with dimpled center

Answer 73

Starch

Question 74

appear as spheres with a cell wall and occasional concentric circles

Answer 74

Pollen grains

Question 75

may resemble casts however fibers polarized while casts do not

Answer 75

Fibers/Hairs

Question 76

appear as plant and meat fibers or as brown amorphous material

Answer 76

Fecal Contamination

Question 77

Ex. of Artifacts

Answer 77

* Starch * Oil droplets * Air bubbles * Pollen grains * Fibers/Hairs * Fecal Contamination