Urine Microscopic Eval (Exam 1)

Question 1

Are RBCs under the microscope intact or lysed?

Answer 1

intact

Question 2

Presence of RBCs under microscope could indicate what?

Answer 2

-tumors like bladder cancer
-kidney stones
-glomerulonephritis
-infections
-trauma
-acute tubular necrosis
-prostatitis
-pyelonephritis

Question 3

Presence of WBCs under microscope most commonly is caused by?

Answer 3

UTIs

Question 4

cystitis occurs where?

Answer 4

bladder

Question 5

pyelonephritis occurs where?

Answer 5

kidneys

Question 6

What are the 2 types of UTIs based on location?

Answer 6

cystitis (bladder) and pyelonephritis (kidney)

Question 7

Are UTIs worse in the bladder or kidney?

Answer 7

kidney

Question 8

Bacteria may be found in urine due to contamination from….

Answer 8

skin

Question 9

What is the fancy word for yeast/fungal infection?

Answer 9

candida or candida albicans

Question 10

What would cause yeast in urine (seen under microscope)?

Answer 10

-diabetes
-immunocompromised patients
-vaginal yeast infection
-indwelling catheters

Question 11

What would you see under microscope for fungal/yeast infection?

Answer 11

budding yeast with hyphae present

Question 12

What are the 3 types of epithelial cells found in urine?

Answer 12

1) squamous
2) transitional (urothelium)
3) renal tubular epithelium (RTE)

Question 13

large number of what epithelial cell is due to skin contamination?

Answer 13

squamous epithelium (comes from lower urethra in males and females or vagina)

Question 14

Which epithelial cell is the largest type of epithelium in urine?

Answer 14

squamous

Question 15

What is the appearance of squamous epithelium in urine under microscope?

Answer 15

large, fried egg appearance

Question 16

What is the most common type of epithelial cell found in urine?

Answer 16

squamous cell

Question 17

Is squamous cell epithelium found in urine pathological?

Answer 17

no!!!!

Question 18

When would someone have increased squamous epithelium in the urine?

Answer 18

dehydration

Question 19

What are the 2 epithelial cells that are pathological when found in urine?

Answer 19

1) transitional (urothelium)
2) renal tubular epithelium (RTE)

Question 20

Where is transitional epithelium (urothelium) normally found?

Answer 20

mucosal lining of ureters, urethra, and urinary bladder

Question 21

Is it okay to have transitional epithelium in urine?

Answer 21

only trace amounts, after that it could indicate urothelial carcinoma

Question 22

Is it okay to have renal tubular epithelium (RTE) in urine?

Answer 22

only trace amounts

Question 23

Where is renal tubular epithelium normally found?

Answer 23

single layer of cells lining the renal tubules

Question 24

What may cause increased renal tubular epithelium (RTE) in urine?

Answer 24

-acute tissue necrosis
-myoglobin
-drugs
-sepsis
-transfusion reaction
-injury to renal tubular/kidney
-active renal disease

Question 25

What are oval fat bodies?

Answer 25

renal tubular epithelium (RTE) or macrophages filled with fat or lipid droplets like cholesterol and TGs

Question 26

Oval fat bodies are often seen with _____________ and _______________ in the urine sediment and are associated with MASSIVE PROTEINURIA test q

Answer 26

fatty casts, fat droplets

Question 27

How do we measure the exact amount of protein in urine?

Answer 27

24 hour urine for protein

Question 28

What causes oval fat bodies?

Answer 28

-nephrotic syndrome -long bone fractures (fat from bone marrow is leaking out of medullary cavity) -crash injuries

Question 29

Urinary casts is unique to what organ?

Answer 29

kidney

Question 30

Where are urinary casts formed?

Answer 30

DCT and collecting ducts of nephrons

Question 31

Are urinary casts cellular or acellular?

Answer 31

both it depends

Question 32

What are urinary casts mostly composed of?

Answer 32

mucoprotein called uromodulin/Tamm horsfall protein

Question 33

What are the 4 types of acellular casts?

Answer 33

1) hyaline 2) muddy granule 3) waxy 4) fatty casts

Question 34

What is the most common type of cast?

Answer 34

hyaline cast

Question 35

When do we see hyaline casts?

Answer 35

when normal individuals are dehydrated or did vigorous exercise

Question 36

When do we see muddy colored granular casts?

Answer 36

in acute tubular necrosis patients and rhabdomyolysis

Question 37

Which casts are the final stage of degeneration of fine granules in granular casts? test q

Answer 37

waxy cats

Question 38

When do we see waxy casts? test q

Answer 38

-renal failure -long standing kidney disease -very low urine flow (end stage renal disease)

Question 39

Which casts are formed by the breakdown of lipid rich epithelial cells?

Answer 39

fatty casts

Question 40

Which casts are hyaline casts with fat globule inclusions?

Answer 40

fatty casts

Question 41

Which cast is pathognomonic for nephrotic syndrome? test q!!!!!!!!!!!!!!!

Answer 41

fatty casts

Question 42

What are the 3 cellular casts?

Answer 42

1) RBCs 2) WBCs 3) renal tubular epithelial casts

Question 43

Are RBC casts pathological? test q

Answer 43

yes

Question 44

When would we see RBC casts? test q

Answer 44

-glomerulonephritis/ kidney infection -goodpasture's syndrome -SLE -nephritic syndrome

Question 45

WBC casts is indicative of?

Answer 45

inflammation or infection like interstitial nephritis, nephritic syndrome, post streptococcal acute glomerulonephritis, or PYELONEPHRITIS***

Question 46

When would we see renal tubular epithelial casts?

Answer 46

in patients with acute tubular necrosis

Question 47

T/F: crystals by themselves cause no symptoms until they form stones

Answer 47

true

Question 48

T/F: there are no symptoms with stones until they obstruct urinary tract

Answer 48

true

Question 49

What are the 3 types of non-pathological crystals?

Answer 49

1) calcium oxalate 2) uric acid 3) triple phosphate / coffin lid/ struvite stones

Question 50

Which crystals are hexagonal shape?

Answer 50

calcium oxalate

Question 51

What is the most common type of crystal?

Answer 51

calcium oxalate

Question 52

Renal calculi are most commonly made of what crystal?

Answer 52

calcium oxalate

Question 53

Which crystal is found in gout?

Answer 53

uric acid

Question 54

What are the 5 crystals of pathological clinical significance?

Answer 54

1) leucine 2) tyrosine 3) cystine 4) cholesterol 5) bilirubin crystals

Question 54

Which crystal is found in infections with proteus sp.?

Answer 54

triple phosphate / coffin lid/ struvite stones

Question 55

Which crystal is found with maple syrup urine disease? test q

Answer 55

leucine crystals

Question 56

Which crystal is found with severe liver disorders/disease? test q

Answer 56

severe= tyrosine crystals less severe= bilirubin crystals

Question 57

Which crystal is found in cystinuria? test q

Answer 57

cystine crystals

Question 58

Which crystal is found in nephrotic syndrome or kidney failure along with lipiduria with fatty casts and oval fat bodies?

Answer 58

cholesterol crystals

Question 59

Where is a UTI?

Answer 59

infection anywhere in urinary system

Question 60

Cystitis is inflammation of the bladder usually caused by bacterial infection. What are the signs and symptoms?

Answer 60

-dysuria -pyuria -frequency -foul odor -may have low grade fever

Question 61

What would have these lab findings? -WBCs in urine -nitrite positive (usually) -leukocyte esterase positibe -bacteria in microscope -potential proteinuria and hematuria -WBCs in CBC is normal

Answer 61

cystitis

Question 62

Cystitis is most often caused by E.coli. Where is E.coli normally found in our body?

Answer 62

bowel flora

Question 63

Cystitis can progress to....

Answer 63

kidneys (pyelonephritis) and become septic

Question 64

Pyelonephritis