AUBF- MICROSCOPIC EXAMINATION OF THE URINE

Microscopic Examination

Detect and identify insoluble materials present in the urine

1926

The year where the first procedure for standardizing quantitation of formed elements was developed

Addis count

Procedure for standardizing quantitation of formed elements

Addis count

Used to monitor course of diagnosed cases of renal disease

True

(true or false) Samples must be examined while fresh and adequately preserved

True

Formed elements easily disintegrate in dilute alkaline urine

False

Formed elements easily disintegrate in dilute acidic urine

False

Formed elements don't disintegrate in dilute alkaline urine

Refrigeration

This process may cause precipitation of amorphous urates and phosphates

10-15 mL

Urine specimen volume range

5

Centrifugation time in minutes where we can produce optimum urine sediment (answer value only)

400

Centrifugation RCF where we can produce optimum urine sediment (answer value only)

False

During centrifugation, we use braking system (true or false)

True

Braking mechanism should be avoided during centrifugation

True

Tubes must be capped during centrifugation

20

VOLUME OF SEDIMENT EXAMINED in uL. (answer the value only)

0.02

VOLUME OF SEDIMENT EXAMINED in mL. (answer the value only)

10

During examination of sediment, there will be minimum of ________ fields under both LPO and HPO (answer value only)

lpf

REPORTING OF MICROSCOPIC EXAMINATION:

Cast : average number per _______

hpf

REPORTING OF MICROSCOPIC EXAMINATION:

RBC & WBC : average number per _____

rare, few, moderate, many

REPORTING OF MICROSCOPIC EXAMINATION:

EC, crystals, other elements.

True

Bright field microscopy is used for unstained microscopy. (True or False)

True

Artifacts are larger than urinary sediments (True or False)

False

Urinary sediments are larger than artifacts (True or False)

lpf

Cast: (lpf or hpf)

hpf

RBCs (lpf or hpf)

hpf

WBCs (lpf or hpf)

Occasional or rare

0-1, 0-3/HPF at 10 fields

Few

0-4, 2-5/HPF at 10 fields

Some

3-5, 8-10/HPF at 10 fields

Moderate

More than 10/HPF at 10 fields

Many

Abundant/HPF

TNTC

Too numerous to count (loaded)

Sternheimer-Malbin

Stain that delineates structure and contrasting colors of the nucleus and cytoplasm

Sternheimer-Malbin

Stain that identifies WBCS, EC, and casts

Toluidine blue

Stain that enhances nuclear detail

Toluidine blue

Stain that differentiates WBCS with RTEs

2% acetic acid

Stain that lyses RBCs and enhances nuclei of WBCs

2% acetic acid

Stian that distinguishes RBCs from WBCs, yeast, oil droplets, and crystals

Lipid Stains: Oil Red O and Sudan III

Stains triglycerides and neutral fats orange-red

Lipid Stains: Oil Red O and Sudan III

Stain that identifies free fat droplets and lipidcontaining cells and casts

Gram stain

Stain that differentiates gram-positive and gram- negative bacteria

Gram stain

Stain that identifies bacterial casts

Hansel stain

This is a combination of Methylene blue and eosin Y that stains eosinophilic granules

Hansel stain

This stain identifies urinary eosinophils

Prussian blue stain

Stains structures containing iron

Prussian blue stain

Identifies yellow-brown granules of hemosiderin in cells and casts

Red blood cells

Non-nucleated biconcave disks

Crenated

RBCs are __________ in hypertonic urine

Ghost cells

RBCs became __________ in hypotonic urine

Red blood cells

Dysmorphic with glomerular membrane damage

Red blood cells

Sources of Identification error: Yeast cells, Oil droplets, Air bubbles

Red blood cells

Complete urinalysis correlation: Color, Reagent strip blood reaction

False

Reporting of the RBCs in urine is: average number per 10 lpfs (True or False)

True

Reporting of the RBCs in urine is: average number per 10 hpfs (True or False)

White blood cells

Larger than RBCs (12μm diameter)

Glitter cells

WBCs become __________ in hypotonic urine

Renal tubular epithelial cells

Sources of Identification error of WBCs

True

Reporting of the WBCs in urine is: average number per 10 hpfs (True or False)

False

Reporting of the WBCs in urine is: average number per 10 lpfs (True or False)

White blood cells

Complete urinalysis correlation: Leukocyte esterase, Nitrite, Specific gravity, pH

Squamous/Transitional/ Urothelial epithelial cells

Spherical, polyhedral, or caudate with centrally located nucleus

Squamous/Transitional/ Urothelial epithelial cells

Sources of Identification error: Spherical forms resemble RTE cells

Squamous/Transitional/ Urothelial epithelial cells

Complete urinalysis correlation: Clarity, blood, if malignancyassociated

Renal tubular epithelial cells

Rectangular, columnar, round, oval or, cuboidal with an eccentric nucleus possibly bilirubin-stained or hemosiderin-laden

Renal tubular epithelial cells

Sources of Identification error: Spherical transitional cells Granular casts

Renal tubular epithelial cells

Complete urinalysis correlation: Leukocyte esterase and nitrite (pyelonephritis), Color Clarity, Blood Bilirubin (hepatitis), Protein

OVAL FAT BODIES

Highly refractile RTE cells

OVAL FAT BODIES

Confirm with fat stains and polarized microscopy

OVAL FAT BODIES

Complete urinalysis correlation: Clarity, Blood, Protein, Free fat droplets/fatty casts

YEAST

Small, oval, refractile structures with buds and/or mycelia

YEAST

Sources of Identification error: RBCs

YEAST

Complete urinalysis correlation: Glucose, LE, WBCs

BACTERIA

Small spherical and rodshaped structures

BACTERIA

Sources of Identification error: Amorphous phosphates and urates

BACTERIA

Complete urinalysis correlation: pH, Nitrite, LE, WBCs

Trichomonas vaginalis

Pear-shaped, motile, flagellated

Trichomonas vaginalis

Sources of Identification error: WBCs, renal tubular epithelial cells

PARASITES (Trichomonas vaginalis)

Complete urinalysis correlation: LE, WBCs

SPERMATOZOA

Tapered oval head with long, thin tail

SPERMATOZOA

Reporting should indicate "Present", based on laboratory protocol

SPERMATOZOA

Complete urinalysis correlation: Protein

MUCUS

Single or clumped threads with a low refractive index

MUCUS

Sources of Identification error: Hyaline casts

Hyaline cast

Colorless homogenous matrix

Hyaline cast

Sources of Identification error: Mucus, fibers, hair, increased lighting

Hyaline cast

Complete urinalysis correlation: Protein -Blood (exercise), Color (exercise)

Hyaline cast

Clinical significance: Glomerulonephritis, Pyelonephritis, Chronic renal disease, Congestive heart failure, Stress and exercise

RBC CAST

Orange-red color, cast matrix containing RBCs

RBC CAST

Sources of Identification error: RBC clumps

RBC CAST

Complete urinalysis correlation: RBCs, Blood, Protein

RBC CAST

Clinical significance: Glomerulonephritis, Strenuous exercise

WBC CAST

Cast matrix containing WBCs

WBC CAST

Sources of Identification error: WBC clumps

WBC CAST

Clinical significance: Pyelonephritis, Acute interstitial nephritis

BACTERIAL CAST

Bacilli bound to protein matrix

BACTERIAL CAST

Sources of Identification error: Granular casts

BACTERIAL CAST

Complete urinalysis correlation: WBC cast, WBCs, LE, Nitrite, Protein, Bacteria

BACTERIAL CAST

Clinical significance: Pyelonephritis

FATTY CAST

Fat droplets and oval fat bodies attached to protein matrix