aubf microscopic

volume is used because multiparameter reagent strips are easily immersed in this volume,

12 ml

When using the conventional glass-slide method, the recommended volume is

20 ul

Microscopic examination should be performed in a consistent

manner and include observation of a minimum of ___ and under ___, ____

10 field and under low and high power objective

Identifies WBCs, epithelial cells, and casts

sternheimer malbin stains

Differentiates WBCs from RTE cells

toluidine blue

Distinguishes RBCs from WBCs, yeast, oil droplets, and crystals

2% acetic acid

Identify free fat droplets and lipid-containing cells and casts

oil red o and sudan III

Identifies bacterial casts

gram stain

Identifies urinary eosinophils

hansel stains

Identifies yellow-brown granules of hemosiderin in cells and casts

prussian blue stain

Used for routine urinalysis

bright field microscopy

Enhances visualization of elements with low refractive indices, such as hyaline casts, mixed cellular casts, mucous threads, and Trichomonas vaginalis

phase-contrast microscopy

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

polarizing microscopy

Aids in identification of Treponema pallidum

dark field micrscopy

Allows visualization of naturally fluorescent microorganisms or those stained by a fluorescent dye, including labeled antigens and antibodies

fluorescence microscopy

Produces a three-dimensional microscopy image and layer-by-layer imaging of a specimen

interference contrast

In dilute (hyposthenuria) urine, the cells absorb water, swell, and lyse rapidly, releasing their hemoglobin and leaving only the cell membrane. These large empty cells are called

ghost cell

The presence of RBCs in the urine is associated with

damage to glomerular membrane or vascular injury to urinary tact

The predominant WBC found in the urine sediment is

neutrophils

Neutrophils exposed to hypotonic urine absorb water and

swell. Brownian movement of the granules within these larger

cells produces a sparkling appearance, and they are referred to

glitter cells

is associated primarily with drug-induced interstitial nephritis

eosinophils

eosinophils primary stain

hansel stain

are the smallest WBCs, they may resemble RBCs.

lymphocytes

lymphocytes seen in urine when

renal transplant rejection

ae the largest cells found in the urine sediment.

They contain abundant, irregular cytoplasm and a prominent

nucleus about the size of an RB

squammous epithelial cell

They appear as squamous epithelial cells covered with the Gardnerella coccobacillus

clue cell

for a suqammous cell to be considered as a clue cell they need to be covered

70 %

are smaller than squamous cells and appear in several forms, including spherical, polyhedral, caudate

urothelial cell

are the most clinically significant of the epithelial cells. The presence of increased amounts is indicative of necrosis of the renal tubules, with the possibility of affecting overall renal function

rte cells

RTE cells absorb lipids that are present in the glomerular fil- trate.

oval fat bodies

is associated most frequently with damage to the glomerulus caused by nephrotic syndrome

lipiduria

are seen in the urine of patients who are either diabetic or immunocompromised, as well as in women with vaginal moniliasis.

yeast, candida albicans

yeast cells are accompanied by

wbc

The parasite encountered most frequently in the urine

trichomonas vaginalis

trichomonas trophozoite has

pear shaped and undulating membrane

are easily identified in the urine sediment by their oval, slightly tapered heads and long, flagella-like tails

spermatozoa

are the only elements found in the urinary sediment that are unique to the kidney.

cast

cast are formed

in kidney

Small spherical and rod-shaped structures

bacteria appearance

In fact, the presence of urinary casts is termed

cylinduria

The cast seen most frequently is the

hyaline cast

represent the presence of advanced tubular destruction, producing urinary stasis along with disruption of the tubular linings.

epithelial cells cast

are seen in conjunction with oval fat bodies and free fat droplets in disorders causing lipiduria. They are associated most frequently with nephrotic syndrome, but they also are seen in toxic tubular necrosis, diabetes mellitus, and crush injuries.

fatty cast

Considering that a variety of cells may be present in the urinary filtrate, it is not uncommon to observe casts containing multiple cell types

mixed cellular cast

are representative of extreme urine stasis, indicating chronic renal failure.

waxy cast

Often referred to as renal failure casts, broad casts, like waxy casts, represent extreme urine stasis.

broad cast

are formed by the precipitation of urine solutes, including inorganic salts, organic compounds, and medications (iatrogenic compounds).

crystals

A valuable aid in the identification of crystals is

ph of the specimen

appear microscopically as yellow-brown granules (Fig. 7-72). They may occur in clumps

amorphous urates

are seen in a variety of shapes, including rhombic, four-sided flat plates (whetstones), wedges, and rosettes. They usually appear yellow-brown but may be colorless and have a six-sided shape

uric acid crystals

uric acid crystals are seen in patients with

high levels of purines and nucleic acid, receiving chemo, lesch nayan syndrome

Appear as larger granules and may have spicules similar to the ammonium biurate crystals seen in alkaline urine. are needle shaped and are seen in synovial fluid during episodes of gout, but they also may appear in the urine

sodium crystals

are seen frequently in acidic urine, but they can be found in neutral urine and, even rarely, in alkaline urine. ALso colorless,

octahedral envelope or as two pyramids joined at their bases

calcium oxalate crystals

The finding of clumps of calcium oxalate crystals in fresh

urine may be related to

formation of renal calculi

Represent the majority of the crystals seen in alkaline urine

phosphate

are seen commonly in alkaline urine. In their routine

form, they are identified easily by their prism shape that fre-

quently resembles a “coffin lid

triple phosphate

Are small and colorless, with dumbbell or spherical shapes (Fig. 7-86). They may occur in clumps that resemble amorphous material, but they can be distinguished by the formation of gas after the addition of acetic acid

calcium carbonate crystals

They may appear as colorless, flat rectangular plates or thin prisms often in rosette formations.

calcium phosphate crystals

exhibit the characteristic yellow-brown color of the urate crystals seen in acidic urine. Frequently they are described as “thorny apples” because of their appearance as spicule-covered spheres

ammonium biurate crystals

Colorless (hexagonal plates)

cystine

Colorless (notched plates)

cholesterol

Yellow (concentric circles)

leucine

Colorless–yellow (needles)

tyrosine

Yellow

bilirubin

Varied

sulfonamides

Colorless (flat plates)

radiographic dye

Colorless (needles)

ampicillin