INTERN: CLINICAL MICROSCOPY > Urine Sediments > Flashcards

Urine Sediments Flashcards

(65 cards)

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1
Q

Appear as smooth, non-nucleated, biconcave disks, average diameter of 7um

A

Erythrocytes

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2
Q

Normal value in urine of RBC

A

0-2 RBCs/HPF (Henry)
0-3 RBCs/HPF (Stras)

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3
Q

RBCs in concentrated urine (Hypersthenuric/Hypertonic)

A

Crenated, shrink, or irregularly shaped

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4
Q

RBCs un dilute urine (Hyposthenuric/Hypotonic)

A

Swell, Hemolyze, Ghost cells

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5
Q

Description of RBC in non-glomerular hematuria

A

Isomorphic (intact red cells)

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6
Q

Description of RBC in glomerular hematuria

A

Dysmorphic (with cellular protrusions or fragmentations)

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7
Q

Possible sources of error in Erythrocytes

A
  1. Yeast cells
  2. Oil droplets
  3. Air bubbles
  4. Monohydrate calcium oxalate crystals
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8
Q

Remedy for the possible source of error of Erythrocyte

A

Add 2% acetic acid

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9
Q

Larger than RBCs, average diameter of 12 um

A

White blood cells

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10
Q

Normal value in urine of WBC

A

<5 WBCs/HPF

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11
Q

Increased number of leukocytes in urine

A

Pyuria

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12
Q

Predominant WBCs in the urine

A

Neutrophils

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13
Q

Findings of >1% among leukocyte population is significant

A

Eosinophils

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14
Q

WBCs that is primarily associated with drug-induced interstitial nephritis

A

Eosinophils

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15
Q

WBC in dilute urine

A

Glitter cells/Sternheimer-Malbin cells

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16
Q

Brownian movement of the cells produces sparkling appearance

A

Glitter cells/Sternheimer-Malbin cells

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17
Q

Sternheimer-Malbin stain results

A

Pale blue = Glitter cells
Pale pink = Leukocytes

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18
Q

Lyzed WBCs are seen in ____

A

Long standing urine (approx. 50% are lost after 2-3 hours of long standing)

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19
Q

Possible sources of errors of WBC

A
  1. Renal tubular cell
  2. Red blood cells
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20
Q

Possible sources of errors of WBC

Maybe mistaken for mononuclear cells

A

Renal tubular cells

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21
Q

Possible sources of errors of WBC

Larger and more polyhedral than WBC

A

Renal tubular cell

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22
Q

Possible sources of errors of WBC

Maybe mistaken for lymphocytes

A

Red blood cells

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23
Q

Derived from the linings of the genitourinary system

A

Epithelial cells

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24
Q

Represent normal sloughing of cells

A

Epithelial cells

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25
Epithelial cells in Urine specimens
1. Squamous cell 2. Transitional (Urothelial) Cells 3. Renal Tubular Cells
26
Point of reference
Squamous cell
27
Largest cell w/ abundant, irregular cytoplasm & prominent (central) nucleus about the size of RBC
Squamous cell
28
Largest cell in the urine sediment
Squamous cell
29
From linings of vagina, female urethra & lower male urethra (more commonly found in female patients)
Squamous cells
30
Variation of Squamous cell
Clue cell
31
Squamous cell covered with coccobacillus
Clue cell
32
Clue cell is related of the infection with
Gardnerella vaginalis
33
Spherical, polyhedral or caudate with centrally located nucleus
Transitional epithelial (Urothelial/Bladder) cell
34
Increased following catheterization: may be seen singly, in pairs, or in clumps (syncytia)
Transitional epithelial (Urothelial/Bladder) cell
35
Transitional cells originate from
- the lining of the renal pelvis - calyces - ureters - bladder - upper portion of the male urethra
36
Transitional cells may be indicative of
Malignancy and viral infection
37
Most clinically significant epithelial cell
Renal tubular cell
38
Rectangular, polyhedral, cuboidal or columnar w/ eccentric nucleus
Renal tubular cells
39
Variations of Renal Tubular cells
1. Bubble cells 2. Oval fat bodies
40
RTE cell with non-lipid vacuoles
Bubble cell
41
Injured cells in which the endoplasmic reticulum has dilated prior to cell death
Bubble cell
42
Bubble cell are seen in
Acute tubular necrosis
43
Lipid containing RTE cell (may also be a monocyte/macrophage)
Oval fat bodies
44
Oval fat bodies are seen in
Nephrotic syndrome
45
The only elements found in the urinary sediment that are unique to the kidney
Casts
46
Casts are formed primarily within the lumen of the
Distal convoluted tubule and Collecting duct
47
Oval Fat Body are identified by:
Lipid stains (TAG and neutral fats) Polarizing microscope (Cholesterol - "MALTESE CROSS" formation)
48
Major constituent of cast, forms the matrix of casts
Uromodulin (Tamm-Horsfall protein)
49
Presence of urinary casts
Cylindroiduria
50
Order of degeneration of casts
Hyaline cast ➡️ Cellular cast ➡️ Degenerating cellular cast ➡️ Coarsely granular cast ➡️ Finely granular cast ➡️ Waxy cast
51
Cast formation increases in
1. Acidic ph 2. Increased ionic concentration (high salt concentration) 3. Stasis or obstruction 4. Increased plasma proteins entering the tubules
52
Matrix casts
1. Hyaline 2. Waxy
53
Hyaline cast is also known as
Prototype cast
54
Normal value of hyaline cast
0-2/LPF
55
Beginning of all types of cast
Hyaline cast
56
Most frequently encountered & the most difficult cast to discover
Hyaline cast
57
Hyaline cast consists almost entirely of
Tamm-Horsfall protein
58
Hyaline in brightfield microscopy
Translucent and Homogenous
59
Hyaline with staining
Pink and homogenous
60
Final degenerative form of all types of casts
Waxy cast
61
Brittle, highly refractile, with jagged ends
Waxy cast
62
Ground glass appearance
Waxy cast
63
Waxy cast is also known as
Renal failure cast
64
Significance = Stasis of urine flow, chronic renal failure
Waxy cast
65
Reflect the final phase of dissolution of the fine granules of granular cast and hyaline cast matrix
Waxy cast

INTERN: CLINICAL MICROSCOPY (20 decks)

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