Urinalysis Images + diseases

Credit to PeaceLuvHappiness on Quizlet, ive refined the notes to represent our content this year

WBC

• Mostly neutrophils

squamous epithelial cell

• Folded skirt

• Small nucleus, large cell

• Lines urethra

transitional epithelial cell

• Lines bladder, ureters

• Smaller than squamous

Renal tubular epithelial cells

• Circular

• Confirm with lipid stain

oval fat body

• Many bulbs

• Confirmed with lipid stains

Bacteria

• You may see them swimming or splitting

Yeasts

• Most common for UTI is Candida albicans

• Will not be lysed by acetic acid

Sperm

• Oval head with thin long tail

Trichomonas

• Usually in vaginal infection STI

• Appears in white cells

• Motion of organism is required to make ID

Enterobuis vermicularis

• Worm looking organism

• Larva will appear dark with a shell

Hyaline cast

• Pure uromodulin

• Parallel sides with rounded caps

RBC cast

• Caused by trauma

WBC cast

• Sign that issue is within the kidneys

RTE cast

• Associated with drug toxicity

Mixed cell cast

• Mix of cells in a cast

Fatty cast

• Highly refractive cast with fats

Granular cast

• composed of cellular remnants and byproducts of degradation

Waxy cast

• Smooth, cylindrical, highly retractile

• Sign of kidney failure

Broad cast

• Thick, wide cast

• Associated with end stage renal disease

Amorphous urates

• Acidic urine

• Granules

(C)

Calcium oxalate

• Acidic to neutral urine

• Has envelop, dumbbell and oval form

• Associated with kidney stones and antifreeze ingestion

uric acid crystals

• Acidic urine

• Wedges

• Can be in patients undergoing chemo

ammonium biurate crystal

• Basic urine

• “Thorny apple”

• Old specimens

calcium phosphate crystals

• Rare

leucine crystal

• Yellow concentric circles

• Liver disorder

triple phosphate crystal

• Highly basic urine

• Square

• Associated with urease positive bacteria

bilirubin crystal

• Acidic urine

• Clumped needle

• Associated with liver issues

cholesterol crystals

• Associated with nephrotic syndrome

• Refracts and shows bright cut crystals

• Seen with fatty casts

cystine crystal

• Hexagonal plates

• Associated with inherited disorders

  • Children with kidney stones

tyrosine crystals

• Needle

• Liver disease

Mucous thread

• Made by uromodulin that hasn't formed into casts

Air bubble

• Artifact

Fiber

• Artifact

• Longer than any cast

starch

• Artifact from powdered gloves

Fat

• artifact

• Confirm with Sudan stain

Acute kidney injury

Kidney suddenly stops filtering

• Oliguria and anuria

• Pre-renal

  • Reduced blood flow and high specific gravity

• Inter-renal

  • Tubular necrosis

  • low specific gravity

Acute glomerulonephritis

Inflammation of glomerulus due to immune complex

• Hematuria and proteinuria

Chronic glomerulonephritis

Loss of nephron mass

• Moderate hematuria, proteinuria

Nephrotic syndrome

Glomerulonephritis consequence

• Proteinuria

• Oval fat bodies or RTEs

Membraneous nephropathy

Deposition of immune complexes causing thickening of glomerular basement membrane

• Looks similar to glomerulonephritis

Minimal change disease

Nephrotic syndrome in children

• T cell dysfunction leads to podocyte injury and infection

Acute tubular necrosis

Damage to renal tubules from toxins or low oxygen

• Moderate proteinuria

  • RBCs, RTEs, RTE casts, granular casts

Renal tubular acidosis

Inability to produce acidic urine

• Basic urine

  • Metabolic acidosis

Fanconi syndrome

Generalized defect in proximal tubule impairing reabsorption

• Can be genetic or acquired

• Impaired growth

• Glucosuria, Aminoaciduria

Acute interstitial nephritis

Inflammation of renal interstitial via adverse reaction to drug therapy

• Oliguria

• WBC and WBC casts in urine

Renal calculi

Kidney stones

• Calcium oxalate

• Triple phosphate

• Ammonium phosphate

Chronic kidney disease

Kidney damage for >3 months

• Anuria, oliguria

• High urinary protein

• Waxy casts, broad casts

Jaundice

increased bilirubin in blood

• Pre-hepatic, negative urine bilirubin

• Haptoceullarl, negative to 1+ urine bilirubin

• Post-hepatic, 3+ to 4+

UTIs

Typically caused by E. coli (can be Kleb, Prot, Entero)

• Cystitis, in bladder

  • Increased pH, WBCs, possible nitrite

• Urethritis, in urethra

  • Increased pH, WBCs, possible nitrite

• Pyelonephritis, in kidneys

  • WBC casts, possible nitrite

Diabates mellatus

Metabolic disorder, cannot absorb glucose

• Glucose, possible ketones in urine

Diabetes insipidus

Metabolic disorder, endocrine issues

• Up to 20L of urine per day

• Clear, colorless urine

Galactosemia

Inability to metabolize galactose due to deficiency of galactokinase

• Jaundice, vomiting, slow baby growth

AMinoacidopathies

INherited enzyme defect involved in the metabolic pathway or transport of amino acids

Alkaptonuria

Autosomal recessive defiency, unable to degrade tyrosine

• Urine darkening overtime

Maple syrup urine disease

Autosomal recessive deficiency

• Sweet smelling urine

• Slow baby growth

Melanuria

Dark colored urine due to presence of melanin

• Associated with metastatic melanoma

Amyloidosis

Build up of amyloid proteins

• Proteinuria

Porphyria

MEtabolic disorder associated with dysfunctional enzymes in heme biosyntheses pathways

• Port wine urine