Microscopic examination of urine (cells)

Addis count

quantitative measure of formed elements of urine using hemacytometer

Brightfiled microscope

Microscope for routine UA

Phase contrast microscopy

enhances visualization of translucent elements (elements with low refractive index)

Polarizing microscope

identification of cholesterol in oval fat bodies, fatty casts, and crystals

Dark field microscopy

used in the identification of Treponema pallidum

Fluorescence microscopy

Visualization of fluorescent microorganisms or those stained by a fluorescent dye

Interference-contrast microscope (Nomarski and Hoffman)

3-D microscopy image and layer by layer imaging of a specimen; Bright field microscopes can be adapted

Sternheimer-Malbin (Crystal violet + safranin O)

Delineates structure and contrasting colors of the nucleus and cytoplasm

Toluidine blue

enhances NUCLEAR DETAIL; supravital stain;Differentiates WBCs and RTE cells

2% acetic acid

Lyses RBCs, enhances nuclei of WBCs; distinguishes RBCs from WBCs, yeast, oil droplets and crystals

Lipid stains (Oil Red O and Sudan III)

Stains triglycerides and neutral fats orange-red

Gram stain

Differentiates gram-positive and negative bacteria

Hansel stain (Eosin Y + Methylene blue)

Stains EOSINOPHILIC granules ; identifies urinary eosinophil

Phenathridine (Orange)

Stains DNA

Carbocyanine (green)

Stains nuclear membranes, mitochondria and cell membranes

0-2 or 0-3/HPF

normal value for RBC:

crenate/ shrink

Hypertonic urine can _____ RBCs

Swell/hemolyze (Ghost cells)

Hypotonic urine can ______ RBCs

Dysmorphic

Glomerular membrane damage can produce _______ RBCs

Yeast, air bubble, monohydrate calcium oxalate crystal

Can be mistakenly identified as RBC and vice versa

add 2% acetic acid

Remedy for error in identifying RBCs:

0-5 or 0-8/HPF

Normal value for WBCs:

WBCs

Increased number indicates presence of infection or inflammation

Neutrophil

Most predominant WBC in urine; granulated and multilobed

brownian movement

In hypotonic urine, they swell and granules undergo brownian movement producing glitter cells

1%

Normal value for urine eosinophil

Interstitial nephritis

Increased urine eosinophil signifies:

Squamous epithelial cell

Largest cell with abundant, irregular cytoplasm and prominent nucleus

Clue cell

SEC covered with Gardnerella vaginalis; associated with bacterial vaginosis

Transitional epithelial (Urothelial) cell

Spherical, Polyhedral, or caudate with CENTRALLY LOCATED NUCLEUS

Renal tubular epithelial cell

Most significant epithelial cell; origin is in the nephron; with ECCENTRIC NUCLEUS

tubular injury

2 RTE/hpf signifies:

Oval fat body

Lipid containning RTE cell; seen in lipiduria (Nephrotic syndrome)

Maltese cross

Cholesterol exhibits _______ formation in polarizing microscope

Bubble cell

RTE cell with non-lipid vacuoles; injured cells in which the ER has dilated prior to cell death; seen in acute tubular necrosis

Bacteria with WBCs

True UTI exhibits (2):

Motility

_____ differentiates bacteria from amorphous urates and phosphates

Yeast with WBCs

True yeast infection exhibits (2):

Candida albicans

fungi seen in DM and vaginal moniliasis

Trichomonas vaginalis

Most frequently encountered parasite in the urine

E. vermicularis

Most common fecal contaminant

S. haematobium egg

Blood fluke with terminal spine; causes hematuria; associated wit bladder cancer

Nuclear matrix protein and Bladder tumor antigen

Urinary bladder cancer marker (2):

Tamm-horsfall protein (now Uromodulin)

Major constituent of mucus threads

/hpf

RBCs and WBCs are reported in:

ave./LPF

Abnormal crystals and Casts are reported in:

Quali and Semi-quanti

SEC and TEC are reported as:

Ave./10 HPFs

RTE cells are repoted as:

ave/HPF

Oval fat bodies are reported as: