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Body Fluids > Urine Microscopy > Flashcards

Urine Microscopy Flashcards

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1
Q

Preparation for urine sediment

A

10-15mL to be centrifuged at 400rcf for 5 min
sediment is prepped, 0.5-1.0mL

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2
Q

Sternheimer-malbin stain

A

Wet prep stain that stains cytoplasm and nuclear contents
toludine blue

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3
Q

Dry prep stain

A

lipid stain (oil, red0 and sudan III) ie gram stain

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4
Q

Resolution

A

ability to differentiate small objects close together

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5
Q

Contrast

A

Differentiating the cell from the background

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6
Q

Brightfield microscopy, advantages and disadvantages

A

light is transmitted through the sample and absorbed
ADV: good resolution, true color, true dimensions
DisADV: unstained are not high absorbing, wet=artifact, dry=dead cells

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7
Q

Dark Field Illumination, advantages and disadvantages

A

Light is directed through sample from different directions and reflects off of the objects
ADV: excellent contrast, max detectability
DisADV: not for measurements, lower resolution, dust can interfere

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8
Q

Phase contrast, advantages and disadvantages

A

first method used to visualize live cells. Light is passing through the sample slower
ADV: improved contrast for live cells, orientation independent, no polarizers, plastic is ok
DisADV: reduced resolution, not good for thick samples

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9
Q

Polarizing advantages and disadvantages

A

polarized light=illumination, changes when passed through sample
ADV: ID crystals and lipids, biofringent samples
DisADV: need a polarizer, sensitive to orientation, no plastic

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10
Q

Fluorescent advantages and disadvantages

A

UV light hits object, excites e- to give off colors and patterns
ADV: good resolution and many applications
DisADV: fixed, thin sample and very expensive

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11
Q

Interference Contrast Microscopy

A

polarization+phase contrast

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12
Q

RBC’s in a microscopy sample

A

Normal= 5 per high power field (40x)
usually look like standard RBCs
RBC ghost=diluted sample or high pH

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13
Q

Crenated RBCs

A

Found in samples with high SG

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14
Q

WBCs in microscopy

A

Lymphocytes, neutrophil, monocyte, esinophils
Enter through urine tract, not kidneys
wright stain differentiates

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15
Q

Glitter cells

A

WBC in hypotonic solution, granules wiggle

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16
Q

Pyuria

A

high WBC count due to inflammation

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17
Q

Lymphocyte in urine reason

A

transplant rejection

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18
Q

Neutrophil in urine reason

A

bacterial infection

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19
Q

monocyte in urine reason

A

tissue damage

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20
Q

Eosinophil in urine reason

A

Allergic reaction

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21
Q

Epithelial cells microscopy

A

line urinary tract and nephron tubules. Squamous, transitional, and renal tubular

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22
Q

Squamous epithelial cells in Urine

A

no clinical significance, small central nucleus, largest cell found in urine, will slough off occasionally

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23
Q

Transitional cells in urine

A

Ureters and portions of bladder. Many in urine means viral infection or bladder cancer

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24
Q

Renal tubular cells (RTE) in urine

A

lines tubules in kidney, small but larger than any WBC. Should not be found in urine. If there are many, then kidney was exposed to a toxin

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25
Lipids in urine
Should not see normally, present if there is glomerular damage. Looks like small bubbles and is highly refractive. Diabetes mellitus, tubular necrosis, bone crushing trauma, nephrotic syndrome
26
Oval Fat Bodies
RTE's filled with lipid. Not normal. Same causes as lipids. Is mainly cholesterol and triglycerides
27
Bacteria in urine
should not have. UTI or Kidney infection. Rods or cocci, WBC's present signifies UTI.
28
Maltese cross
cholesterol, starch(rare)
29
Clue cells
contamination from vaginal secretions
30
yeast in urine
ovoid and budding. Large amount should check glucose. Diabetes mellitus
31
pseudo hyphae
long yeast, severe infection
32
Trichomonas vaginalis
most common parasite found in urine, pear shaped and has flagella
33
Enterobious vermicularis
uncommon parasite, pinworm and egg form
34
sperm
rarely clinically significant. Only reported in people younger than 13
35
Mucus
uromodulin (tamm-horsfall) glycoprotien. Low refractive index, no clinical significance. Usually in women or after stress or exercise
36
Casts
made of uromodulin. occurs in distal convoluted tubule and collecting duct. Cylindrical
37
Factors in cast formation
increased stasis, decreased flow. Increased acidity, specific gravity and uromodulin
38
Hyaline cast
cylindrical, clear, colorless. Low refractive index, normal to see 0-2. More after exercise, stress, dehydration. 2+ is heart failure, liver disease
39
RBC cast
hyaline cast with RBC's, can have a red tinge, fragile. Normal to see 0-2, could be after a heavy contact sport. Could be kidney filter damage
40
WBC cast
hyaline cast with WBC's, more refractive, should not have. any= infection/inflammation, damage to glomerulus or allergic to penicilln
41
RTE casts
hyaline cast with RTE's, larger than WBC cast. not normal, damage to renal tubules from toxin or virus
42
Fatty casts
normally not seen. looks like elongated OFB's with same significance of OFBs
43
Granular casts
tube with a lot of spots (coarse or fine) can be colorless or yellow. Can have 0-2 with strenuous exercise. Increased cellular metabolism
44
Waxy cast
colorless/gray, has blunt corners/cracks. Should not see normally. Extreme renal stasis, tumor, kidney stone, renal failure
45
Broad cast
renal failure cast. Waxy casts in collecting ducts (broader) should not ever see.
46
Telescoped urine
all types of casts are found, seen in lupis, hypertension, diabetes mellitus. Result in period of renal shutdown
47
Crystal formation in urine
can be normal, usually insignificant. Precipitation of soluble substances after refrigeration.
48
Factors in crystal formation
decreased temperature, increased SG, change in pH
49
Amorphous urates
brown/red in color, granules, precipitates out in acidic urine and can change to different crystal types
50
Normal crystals in neutral-acidic urine
Amorphous urates, uric acid, calcium oxalate dihydrate
51
Uric acid crystals
brown/yellow/colorless. Many shapes. Form when purine is broken down. Gout=clinical significance. pH<5.5. Birefringent
52
Calcium oxalate dihyrate
colorless diamonds, breakdown of oxalate from food is normal. birefringent, large amounts increases risk of kidney stones
53
Calcium oxalate monohydrate
abnormal crystal in acidic urine, dumbbell shaped. Clinical significance=etheline-glycol poisoning (antifreeze)
54
Normal crystals in alkaline urine
amorphous phosphates, triple phosphate, calcium phosphate, calcium carbonate, ammonium bicarbonate
55
Amorphous phosphates
look like urates, normal
56
triple phosphate
looks like coffin lids, more elongated. Can be seen in leaf/needles birefringent
57
Calcium phosphate
colorless needles (star formation possible) less common, no significance
58
calcium carbonate
spears+dumbbells, birefringent, soluble in acetic acid and will form bubbles.
59
ammonium bicarbonate
brown sphere with points (thorny apples). old samples
60
Abnormal crystals
only form in acidic urine. include bilirubin, tyrosine, leucine, cysteine and cholesterol
61
Crystals associated with liver disease
Bilirubin, tyrosine, leucine
62
Cystine crystals
amino acid crystal, hexagonal, clear, colorless. non birefringent. Confirmed with sodium nitroprusside (turns purple) more likely for kidney stones
63
Cholesterol crystals
flat, transparent square like with a notched out corner. Seen after refrigeration. Birefringent. nephrotic syndrome, excessive tissue breakdown
64
Tyrosine crystals
spikey star like colorless to yellow, needle shaped. Can be inborne error of metabolism
65
Leucine
Yellow-brown spheres w concentric striations. Never seen without tyrosine
66
Bilirubin crystals
usually yellow-brown, needles or tube with bubble. Hepatic disorder or liver disease. Older urine
67
Sulfonamide crystals
formed from medications, needles or rhombus shape. soluble in acetone
68
radiographic dye crystals
flat plates, dissolves in NaOH
69
Contaminants in urine
pubic hair, fecal matter, talcum powder, pollen, bubbles, starch

Body Fluids (8 decks)

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