Urine Sediments: Cells And Crystals Flashcards Preview

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Flashcards in Urine Sediments: Cells And Crystals Deck (31):
0

What is the recommended volume, centrifugation time and speed for microscopic evaluation

Volume: 10-15 mL (12 preferred)
Time: 5 minutes
Speed: 400-450 g

1

Proper magnification for enumerating casts

Low

2

Proper magnification for enumerating mucus

Low

3

Proper magnification for enumerating crystals, cells and yeast?

High power

4

How do RBCs act in hyper/hypotonic urine

Hyper: crenated
Hypo: swelled, lyced, or ghost cells

6

How do WBCs act in hyper/hypotonic solutions

Hyper: shrink but not crenate
Hypo: enlarge and may lyse

7

How do you differentiate RBCs from yeast?

Yeast varies in size, not biconcave, budding

8

How do you differentiate RBCs from air bubbles/oil droplets

They are refractile, variation in size, uniformity in appearance

9

How do you differentiate RBCs from calcium oxalate crystals

enveloped shaped

10

Significance of WBCs in the urine

Pyuria is seen in infections and autoimmune conditions (infections, lupus, TB etc)
- Pyuria, WBC casts, cellular casts, or granular casts, usually high protein = upper UTI
- Pyuria without casts and low protein (to none) = lower UTI

11

Significance of RBCs in the urine

Hematuria indicates damage to the kidney or urinary tract
- RBCs/RBC Casts/Protein = renal origin either glomerular or tubular
- RBCs/no casts/no protein = bleeding "below" the kidney or contamination

12

Squamous epithelial Cells
- appearance

Flat with irregular shapes, central round nucleus

13

Squamous epithelial Cells
- location

vaginal contamination in urines from women

14

Squamous epithelial Cells
- clinical Significance

rare diagnostic significance

15

Transitional Epithelial Cells
- appearance

Round, pear shaped, or tail like projection, central round nucleus

16

Transitional Epithelial Cells
- location

originate in renal pelvis, calyces, ureter, urinary bladder and upper part of urethra in males

17

Transitional Epithelial Cells
- clinical significance

Increased numbers: UTI, Viral illness, Catheterization, malignancy (transitional cell carcinoma)

18

Renal Tubular Epithelial Cells
- appearance

Polyhedral-flat, cuboidal, columnar, eccentric nucleus (BIG nucleus)

19

Renal Tubular Epithelial Cells
- location

originate in lining of the renal tubules and collecting ducts

20

Renal Tubular Epithelial Cells
- clinical significance

MOST SIGNIFICANT epi cell
- Pathologic: pyelonephritis, kidney damage from meds or toxins, tubular necrosis, renal transplant rejection, viral infections (HEP B)

21

Origin of an oval fat body

Renal tubular epic cell with absorbed lipids

22

Contrast cholesterol and neutral fats with respect to stains and birefringence

Cholesterol is birefringent (use polarizing microscope)
Neutral fats are not birefringent but can be stained with Sudan Red or Oil Red O

23

Difference between oval fat bodies, air bubbles and starch granules

Starches have maltese cross pattern under polarized light
Oils are refractive, vary in size and uniformity in appearance

24

Significance of spermatozoa in urine

Males: rencent ejaculation or nocturnal emission
Females: vaginal contamination

25

Normal Acidic Crystals

Uric Acid
Amorphous Urates
Calcium Oxalate
Hippuric Acid
Sodium Urate

26

Abnormal Acidic Crystals

Tyrosine
Leucine
Bilirubin
Cystine
Cholesterol
Sulfonamide
Radiographic Dye

27

Alkaline Crystals (no abnormal crystals in alkaline urine)

Amorphous phosphates
Triple phosphates
Calcium Carbonates
Calcium Phosphates
Ammonium Biurates

28

Presence of WBCs in the urine

pyruia

29

Presence of RBCs in the urine

hematuria

30

Neutrophils that have swelled in a hypotonic solution and their refractile cytoplasmic granules move by Brownian movement and "glitter"

glitter cells

31

Fat in the urine

lipiduria