Urine Sediments and Crystallography

A Comprehensive collection of vocabulary cards covering urinary sediments, including blood cells, epithelial cells, casts, crystals, and artifacts based on lecture notes.

Ghost cells

Red blood cells found in hyposthenuric urine that have lost their hemoglobin, appearing as faint circles.

Dysmorphic RBCs

Red blood cells that vary in size, have cellular protrusions, or are fragmented; associated with glomerular bleeding.

Acanthocyte

A specific dysmorphic red blood cell with multiple protrusions, most commonly associated with glomerular bleeding.

Neutrophils

The predominantly seen white blood cells in urine; they are granulated, multilobed, and larger ($12\,mm$) than RBCs.

Glitter cells

Neutrophils found in hypotonic urine that exhibit Brownian movement of their granules.

Pyuria

An increase in urinary white blood cells, indicating the presence of an infection or inflammation in the genitourinary system.

Eosinophils

White blood cells whose presence ($>1\%$) is considered significant and primarily associated with drug-induced acute interstitial nephritis (AIN).

Clue cells

Squamous epithelial cells covered with Gardnerella vaginalis coccobacillus, where bacteria cover $70\%$ of the cell surface.

Syncytia

Increased numbers of transitional epithelial cells appearing in pairs or clumps, often present after invasive urological procedures like catheterization.

Renal Tubular Epithelial (RTE) cells

The most clinically significant epithelial cells; presence of $>2/HPF$ indicates necrosis of the renal tubules.

Renal fragments

Groups of three or more renal tubular epithelial cells originating from the collecting ducts, often appearing as large sheets.

Oval fat bodies

Lipid-containing Renal Tubular Epithelial (RTE) cells, most frequently associated with Nephrotic Syndrome and identified by a Maltese cross formation under polarized light.

Bubble cells

Renal Tubular Epithelial (RTE) cells containing non-lipid-filled vacuoles, representing injured cells in cases of acute tubular necrosis.

Enterobacteriaceae

Gram-negative rods that are the bacteria most frequently associated with urinary tract infections (UTI).

Trichomonas vaginalis

A pear-shaped, flagellated parasite characterized by an undulating membrane and tumbling or rapid darting motility.

Uromodulin

Also known as Tamm-Horsfall protein; a glycoprotein excreted by RTE cells that serves as a major constituent of mucus and the basic matrix of all casts.

Hyaline cast

The prototype and most frequently seen cast, consisting almost entirely of uromodulin; normal values are $0-2/LPF$.

Waxy casts

The final degenerative form of all types of casts; they are brittle and refractile with jagged ends, representing extreme urine stasis and chronic renal failure.

Broad casts

Referred to as "renal failure casts," these represent extreme urine stasis and the widening/destruction of tubular walls.

Amorphous Urates

Yellow-brown granules found in acidic urine that produce a "pink brick dust" sediment due to the pigment uroerythrin.

Uric Acid crystals

Pleomorphic crystals (rhombic, whetstone, hexagonal) that are highly birefringent; increased levels are associated with Lesch-Nyhan syndrome and gout.

Weddelite

The dihydrate form of calcium oxalate, recognized as colorless, octahedral envelope or pyramidal shapes.

Whewelite

The monohydrate form of calcium oxalate, appearing as oval or dumbbell shapes; associated with ethylene glycol (antifreeze) poisoning.

Ammonium Biurate

Yellow-brown "thorny apple" crystals found in old specimens, associated with the presence of ammonia produced by urea-splitting bacteria.

Triple Phosphate

Colorless, three-to-six-sided prisms with oblique ends (referred to as "coffin lids"), associated with Struvite and Proteus infections.

Cystine crystals

Colorless hexagonal plates found in the urine of people with cystinuria, an inherited disorder preventing reabsorption of COLA (cystine, ornithine, lysine, and arginine).

Cholesterol crystals

Rectangular plates with a notch in one or more corners, exhibiting a staircase pattern; associated with Nephrotic Syndrome.

Leucine crystals

Yellow-brown spheres with concentric circles and radial striations, usually seen in conjunction with tyrosine crystals.

Tyrosine crystals

Fine colorless needles that form clumps or rosettes; associated with hepatic disorders and a positive bilirubin reagent strip.

Sulfonamide crystals

Crystals appearing as sheaves of wheat, rosettes, or needles; they produce a positive yellow-orange result in the Lignin test.

Starch granules

The most common urinary artifact; they are refractile spheres with a dimpled center that produce a Maltese cross formation when polarized.