Microscopic Examination

Chemical sieving -

Macroscopic screening or also known as?

10-15mL -

Standard amount of urine for macroscopic screening?

12mL -

Amount needed for multiparameter reagent strip, it is also the average amount to be centrifuged

5 minutes -

how long should the centrifugation be?

0.5 or 1 mL -

Quantity of decanted Urine

20 uL -

Quantity of transferred specimen to a glass slide with 22x22 mm coverslip

Addis count -

Quantitative measure of formed elements of urine using hemacytometer

12 hour urine -

Specimen for Addis count

Formalin -

Preservative for Addis count

0-500 000/12 hour urine -

Normal values in Addis count for RBCs

0-1 800 000/12 hour urine -

Normal values in Addis count for WBCs & ECs

0-5 000/ 12 hour urine -

Normal values in Addis count for Hyaline casts

400 RCF -

What is the relative centrifugal force needed for centrifugation?

10 fields -

How many fields are you going to report?

crenated -

in concentrated (hypersthernuric) urine RBC is seen as?

swell / hemolyze (ghost cell) / shadow cell -

In dilute (hyposthenuria) urine RBC is seen as?

Ghost cells -

Large empty cells of RBC because of hyposthenuria is known as?

Dysmorphic -

RBCs that vary in size, have cellular protrusion, or are fragmented are termed?

Glomerular membrane damage -

Dysmorphic RBCs are indicative of?

0-2 or 0-3/hpf -

NV for RBC in urine?

Glitter cell -

Sparkling appearance of Neutrophils caused by Brownian movement of granules within cells

0-5 or 0-8 /hpf -

NV of WBC in urine

Neutrophil -

Predominant WBC found in urine sediment

Eosinophil -

WBC that is not usually found in the urine and the presence of this type of WBC is primarily associated with Drug induced interstitial nephritis can also be seen in in small number of UTI and renal transplant rejection

1% -

NV of urinary Eosinophils

\>1% -

Significant value of urinary eosinophils associated with interstitial nephritis

Lymphocyte -

Mononuclear cells that indicate early stages of renal transplant rejection

Macrophages and histiocytes -

Large mononuclear cells and may appear vacuolated or may contain inclusions, associated with chronic inflammation and radiation therapy

Clue cells -

Squamous epithelial cells covered with Gardnerella coccobacillus

Gardnerella vaginalis -

Clue cells are associated with vaginal infections of?

Syncytia -

Clumps of uroethelial (RTE) cells following catheterization

Oval fat body -

Lipid-containing RTE cells

Necrosis -

Presence of RTE from the Collecting duct signifies?

a -

RTE cells that contain large, non-lipid-filled vacuoles and can be seen in renal tubular necrosis:
a. Bubble cells
b. Oval fat bodies
c. Clue cells
d. Glitter cells

Retrograde ejaculation -

Sperm is expelled in the bladder instead of the urethra

Squamous epithelial cell -

Largest cell with abundant irregular cytoplasm & prominent nucleus

Transitional Epithelial Cell -

Spherical polyhedral or caudate with centrally located nucleus

renal pelvis, calyces, ureter, urinary bladder, upper male urethra -

Transitional epithelial cells are derived from?

Renal tubular epithelial cells -

Rectangular, polyhedral, cuboidal or columnar cells with eccentric nucleus

Tubular injury -

\>2 RTE / hpf is indicative of

nephron -

RTE originates from

Enterobacteriaceae -

most common cause of UTI

Motility -

What differentiates Enterobacteriaceae from amorphous urates & phosphates?

Yeasts -

Small, refractile oval structures that may or may not bud

Candida albicans -

Yeast seen in DM and vaginal moniliasis

Branched, mycelial forms -

What forms of yeasts are seen in severe infections?

Trichomonas vaginalis -

Most frequently encountered parasite in urine

Trichomonas vaginalis -

Agent of Ping Pong Disease

jerky motility -

Motility of the pear-shaped flagellate commonly seen in urine?

Enterobius vermicularis -

Most common parasite associated with fecal contamination

Schistosoma haematobium egg -

Blood fluke with terminal spine causing hematuria

bladder cancer -

Schistosoma haematobium is associated with what cancer?

Nuclear Matrix Protein (NMP), Bladder Tumor Antigen (BTA) -

Urinary Bladder Cancer Markers

LPF -

Epithelial cells are quantitated per

0-5 -

Rare epithelial cells grading

5-20 -

Few epithelial cells grading

20-100 -

Moderate epithelial cells grading

\>100 -

Many epithelial cells grading

HPF -

Crystals are quantitated per

0-2 -

Rare crystals grading

2-5 -

Few crystals grading

5-20 -

Moderate crystals grading

\>20 -

Many crystals grading

HPF -

Crystals are quantitated per

0-10 -

Rare bacteria grading

10-50 -

Few bacteria grading

50-200 -

Moderate bacteria grading

\>200 -

Many bacteria grading

cylindruria -

Excretion of Casts in urine is termed as?

Casts -

Represents a biopsy of an individual tubule; most difficult & important urinary sediment constituent

DCT and collecting duct -

Casts are primarily formed in the?

Uromodulin (Tamm-Horsfall protein) -

Major constituent of Casts and mucus

coverslip edges with subdued light -

Examination of casts is perfomed on which part of the coverslip?

Hyaline \> Degenerating Cellular \> Coarsely Granular \> Finely Granular \> Waxy -

Order of cast degeneration

Hyaline Casts -

Most frequently seen cast; parallel sides and rounded ends, cylindroid form, wrinkled of convoluted form (aging)

0-2/LPF -

Normal value for Hyaline casts

stress, strenuous exercise -

Physiologic causes of hyaline casts

glomerulonephritis, pyelonephritis, CHF, CKD -

Pathologic causes of Hyaline casts

RBC Casts -

This cast is indicative of bleeding within the nephron; associated with damage to the glomerulus (Glomerulonephritis)

WBC Casts -

This cast signifies infection or inflammation within the nephron; pyelonephritis (upper UTI)

Pseudoleukocyte cast -

Clump of leukocytes that are seen in lower UTI

RTE Cast -

Casts signifying advance tubular destruction, tubular damage

Bacterial Casts -

This casts is Bacilli within and bound to the protein matrix; may be pure bacterial cast or mixed with RBC

Gram Stain -

Confirmatory test for Bacterial casts

Epithelial Cell Casts -

Casts containing DCT cells

Fatty Casts -

Casts seen in conjunction with oval fat bodies and free fat droplets in disorders causing lipiduria

Granular cast -

cast with sandpaper appearance

lysosomes -

The origin of granular casts in nonpathologic conditions appears to be from \______ secreted by the RTE cells

Waxy Casts -

This casts is indicative of extreme urinary stasis \= chronic renal failure

Waxy Casts -

Final degenerative form of all types of casts

Broad Casts -

Also known as Renal Failure Casts

Pigmented cast -

This casts is a hyaline matrix with coloration due to pigment incorporation

Mixed cellular cast -

Cast containing multiple cell types

Glomerulonephritis -

Mixed cellular cast: RBC + WBC casts
Indicates?

Pyelonephritis -

Mixed cellular cast: WBC & RTE casts or WBC and Bacterial casts
Indicates:

Crystal casts -

Casts containing urates, calcium oxalate, and sulfonamides (occasionally)

Crystalluria -

Excretion of Crystals in urine is termed as?

pH, Solute concentration, Temperature -

Factors that contribute to crystal formation

LPF -

Abnormal crystals may be averaged and reported per

acidic urine -

All abnormal Crystals are found in?