Urine Microscopy and Clinical Correlations

what normal crystals are found in acid/neutral urine

amorphous urates, uric acid, calcium oxalate

what normal crystals are found in alkaline urine

amorphous phosphates, triple phosphates, ammonium biurate, calcium carbonate

what do leucine and tyrosine crystals indicate

severe liver disease

what casts may be increased with strenuous exercise

hyaline and granular casts

what do RBC casts indicate

acute glomerulonephritis

what do WBC casts indicate

pyelonephritis

how are RBCs distinguished from yeast in urine specimens

2% acetic acid added to lyse RBCs

acute glomerulonephritis reagent strip findings

blood, protein

acute glomerulonephritis microscopic findings

RBCs, WBCs, RBC casts,

nephrotic syndrome reagent strip findings

large amount of protein

nephrotic syndrome microscopic findings

casts, fat, oval fat bodies, fatty casts

pyelonephritis reagent strip findings

protein, leukocyte esterase, nitrate

pyelonephritis microscopic findings

WBCs, WBC casts, bacteria

what is cystitis

bladder infection

how is pyelonephritis differentiated from cystitis

casts are present in pyelonephritis but not cystitis

what is pyelonephritis

kidney infection

what is sudan III stain used to confirm

presence of fat (oval fat bodies, fatty casts)

normal urine range of WBC

0-5 wbc/hpf

normal urine range of RBC

0-2 rbc/hpf

normal urine range of hyaline casts

0-2 hyaline casts/lpf

what is the major constituent of urinary casts

Tamm Horsfall protein

what casts are considered renal failure casts

broad waxy casts

what crystals may be seen in antifreeze poisoning

calcium oxalate

what are clue cells and what do they indicate

squamous epithelial cells with bacteria adhering to them - indicate bacterial vaginosis

what is the most commonly used test for glomerular filtration

creatinine clearance

what is the formula for creatinine clearance

(urine creatinine x volume excreted)/

(plasma creatinine x 1440)

multiply by 1.73/A if need to correct for body surface area (A)

what do renal tubular epithelial cells/casts indicate

kidney disease

what artifact is highly refractile and described by having a Maltese cross morphology

oval fat bodies

what do bilirubin crystals indicate

liver disease

when are yeast cells commonly seen

diabetes mellitus

what are glitter cells

neutrophils that are swollen due to absorption of water

what type of bilirubin is indicated by a positive bilirubin reagent strip test

conjugated bilirubin due to bile duct obstruction

what are cystine crystals associated with

kidney stones