MLT 111 > CHAPTER 7 > Flashcards

CHAPTER 7 Flashcards

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1
Q

Sediment Examination “Sediment Stains”; Sternheimer-Malbin Stain.

A

Most common.
crystal violet+safranin O.
Sedi-Stain.
Absorbed by WBC’s, Epithelial cells, Cells.

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2
Q

Sediment Examination “Sediment Stains”; Toluidine Blue Stain

A

Enhances nuclear detail.
Differentiate between WBC’s + renal epithelial cells.

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3
Q

Sediment Examination “Sediment Stains”; 2% Acetic Acid

A

Lysis of RBC’s

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4
Q

Sediment Examination “Sediment Stains”; Lipid Stains.

A

Oil red O + Sudan 3
Triglycerides + neutral fats stain orange red.
Polarizing microscopy.

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5
Q

Sediment Examination “Sediment Stains”; Gram Stain.

A

Used in Microbiology.

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6
Q

Sediment Examination “Sediment Stains”; Hansel Stain.

A

Methylene blue + Eosin Y for esinophilis.

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7
Q

Sediment Examination “Sediment Stains”; Prussian Blue Stain.

A

Hemosiderin = blue stainning of yellow- brown granules seen in renal tubular epithelial cells.

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8
Q

Bright-field that is most common in UA?

A

Microscopy.

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9
Q

RBC’s physical description?

A

Smooth, non-nucleated, biconcave discs.
Diameter = 7mm

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10
Q

RBC’s that lose H2O and are crenated?

A

HYPERsthenuric

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11
Q

RBC’s that absorb H2O and are ghost cells.

A

HYPOsthenuria. (confused with artifact.)

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12
Q

What are RBC’s associated with?

A

Damage to the glomerular membrane or vascular injury within genitourinary tract.
Early diagnosis is critical of glomerular disorders.

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13
Q

RBC’s are confused with?

A

Artifact (Air bubbles, oil droplets, yeast.)

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14
Q

WBC’s are what size compared to RBC’s?

A

Larger.

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15
Q

WBC’s most common?

A

neutrophilis

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16
Q

Neutrophilis

A

Contain granules
Glitter cells (Sparkling appearance)
Brownian movement.

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17
Q

Brownian movement

A

Irregular motion of small particles suspended in liquid.

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18
Q

Pyuria

A

Presence of WBC’s (pus) in urine.
Indicates infection in genitourinary system.

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19
Q

Eosinophilis

A

Associated w/ drug induced interstitial nephritis.
may be seen w/ uti or renal transplant rejection.
Hansel or Wright stain.

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20
Q

Mononuclear cells

A

A. Monocytes, macrophages, histiocytes. = large cellsthat appear vacuolated. + Cyodiagnostic urine testing.
B. Lymphocytes = small WBCs resemble RBCs

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21
Q

Squamous epithelial cells

A

Largest cells in sediment
Few seen.
May clump and appear folded
Clue cells are epithelial cells covered w/ a bacteria that indicates vag infections.

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22
Q

Transitional (urothelial) epithlial cells.

A

Smaller then squamous
Spherical, Polyhedral, & Caudate
Differs from ability to absorb h2o
Centrally located nucleus
Syncytia = clump cells with adjoining cell walls.

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23
Q

Renal Tubular Epithelial cells

A

Very in shape and size
Eccentrically located round nucleus
Renal fragments indicate severe tubular injury.

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24
Q

Oval fat bodies

A

Lipid containing RTE cells
Seen w/ fat droplets
Composed of triglycerides, neutral fats, & cholesterol
Lipiduria = associated w/ damage to the glomerulus caused by nephrotic syndrome.

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25
Bacteria
Few present as result of vaginal, urethral, external genitalia, or collection-container contamination
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Yeast
Small, refractile oval structures indicative of severe infections.
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Parasites
Trichomonas vaginalis – most common = pear shaped flagellate + rapid darting movement.
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Spermatozoa
Oval, slightly tapered heads & long flagella-like tails Toxic urine Following intercourse.
29
Mucus
Protein material produced by glands & epithelial cells of lower genitourinary tract & RTE cells Thread like structures.
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Casts
Unique to kidney Formed within lumens of distal convoluted tubules & collecting ducts
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Uromodulin
glycoprotein excreted by RTE cells of distal convoluted tubules & upper collecting ducts major constituent excreted at a constant rate Not detected by reagent strip Cylindruria = Presence of casts in urine.
32
Hyaline casts
Most frequently seen, mostly uromodulin Following extreme exercise. Colorless Sternheimer-Malbin produces pink casts Parallel sides, round ends, cylindroid forms, & wrinkled or convoluted shapes indicating aging of cast matrix
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RBC casts
Nephron bleeding. Damage to the glomerulus May exist as fragments
34
WBC casts
Nephron infection/inflammation associated w/ pyelonephritis
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Bacterial casts
Contain Bacilli (or cocci) within & bound to matrix seen in pyelonephritis Resemble granular casts
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Epithelial casts
RTE containing casts = advanced tubular destruction, urinary stasis, & tubular lining disruption Associated with heavy metal & chemical or drug-induced toxicity, Small round oval similar to WBC
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Fatty casts
Seen w/ oval fat bodies & free fat droplets in disorders causing lipiduria Associated w/ nephrotic syndrome, toxic tubular necrosis, diabetes mellitus, & crush injuries
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Mixed cellular casts
Glomerulonephritis - RBC & WBC casts - Predominantly RBC casts Pyelonephritis – WBC/RTE or WBC/bacterial casts - Predominantly WBC casts
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Granular casts
Coarse or Fine Nonpathological conditions - granules from lysosomes excreted by RTE cells during metabolism
40
Broad casts
Renal failure casts represent extreme urine stasis Indicates destruction (widening) of tubular walls
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Waxy casts
Represents extreme urine stasis, indicating renal failure Fragmented w/ jagged ends & notches in their sides
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List casts
hyaline rbc wbc bacterial epithethial fatty mixed cellular granular waxy broad
43
Urinary crystals
Detect presence of few abnormal crystals representing liver disease, inborn errors of metabolism, or renal damage caused by crystallization of medication compounds within the tubules
44
Crystal formation
Iatrogenic – pertaining to a condition caused by treatment, medications, or diagnostic procedures Subject to changes in temperature, solute concentration, & pH (solubility) Low temp causes formation - majority takes place w/ RT or refrigerated specimens All abnormal crystals are found in acid urine
45
Normal crystals in acidic urine?
Amorphous urates, Uric Acid, Calcium oxalate, Na & acid urates
46
Amorphous urates
Yellow-brown granules microscopically Urine sediment has pink color due to the pigment uroerythrin attaching on surface of granules Often in clumps; may resemble casts pH usually greater than 5.5 NONMOTILE unlike bacteria
47
Uric Acid Crystals
Rhombic, whetstones, wedges, rosettes Yellow-brown color May resemble cystine crystals but always polarize Associated with increased purines & nucleic acids, Chemotherapy for leukemia, Lesch-Nyhan syndrome patients, & Gout
48
Calcium Oxalate Crystals
most found in acidic uurine. can be nnuetral Dihydrate – octahedral envelope or two-pyramid–shaped – Most common Associated w/ food high in oxalic acid (end product of Ascorbic acid metabolism) Monohydrate - oval or dumbbell-shaped Associated w/ Antifreeze poisoning Major component of renal calculi
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Normal Crystals in Alkaline Urine
Amorphous phosphate, Triple phosphate, & Calcium phosphate, Calcium carbonate, Ammonium biurate
51
Amorphous phosphate
Similar to urates, does NOT dissolve when warming specimen Differentiate from urates w/ pH & white sediment color
52
Triple phosphate
Colorless, prism, or coffin-lid shaped Highly alkaline urine and urinary tract infections (UTIs) Polarize No clinical significance
53
Calcium phosphate
Flat rectangles & thin prisms in rosettes No clinical significance but a common constituent of renal calculi
54
Calcium carbonate
Small, dumbbell, and spherical shapes Gas produced with addition of acetic acid No clinical significance
55
Ammoniium Biurate
Yellow-brown “Thorny apples” Dissolve @ 60˚C Add glacial acetic acid = converts to uric acid Encountered w/ old specimens Associated w/ ammonia produced by urea-splitting bacteria
56
Abdnormal crystal - Cystine crystal
Hexagonal, thin and thick plates Similar to Uric acid (polarizes) but only thick cystine crystals polarize Cystinuria - inability to reabsorb cystine Confirm w/ cyanide nitroprusside test - rapid qualitative test reduces cystine to produce Red-purple color
57
Abnormal crystal - cholesterol crystal
Rectangular plate w/ a notch in one or more corners Refrigerated specimens Associated with lipiduria disorders (nephrotic syndrome) w/ fatty casts & oval fat bodies Highly birefringent w/ polarized light
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Crystals associated w/ Liver disease
Tyrosine, Leucine, Bilirubin crystals
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Tyrosine crystal
Fine colorless to yellow needles form clumps or rosettes Positive bilirubin reagent strip & seen w/ leucine crystals Encountered in patients w/ inherited amino acid metabolism disorders
60
Leucine crystal
Yellow-brown spheres with concentric circles and radial striations Should be accompanied by tyrosine crystals
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Bilirubin cystal
Clumped needles or granules Characteristic yellow color Viral hepatitis with tubular damage Positive reagent strip for bilirubin
62
Iatrogenic Crystals
radiographic dye crystal Sulfa crystal Ampicillin crystals
63
hippuric acid crystals
Rare yellow-brown or clear, and they often resemble needle-like prisms or plates Hippuric acid crystals are often found clustered together Sometimes caused by an acidic urine pH, can also occur in healthy urine
64
Artifacts
Starch, oil droplets, Air bubbles, pollen grains, fibers, & fecal contamination
MLT 111
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