Microscopic Examination of Urine and Body Fluids

Comprehensive vocabulary flashcards covering microscopic urine analysis, including RBCs, WBCs, epithelial cells, casts, bacteria, parasites, and crystals.

Ghost Cells

Swollen, circular red blood cells with lost hemoglobin that appear as faint rings in hyposthenuric (diluted) urine.

Crenated RBCs

Red blood cells with a wavy, irregular membrane that form when exposed to hypersthenuric (concentrated) urine.

Dysmorphic RBCs

Red blood cells with distorted membranes or missing parts (such as acanthocytes or blebs), indicating glomerular bleeding or strenuous exercise.

Pyuria

An increased number of white blood cells in urine, indicating infection or inflammation within the genitourinary tract.

Glitter Cells

Neutrophils found in hypotonic urine that swell and display Brownian movement of their granules, giving a sparkling appearance; pale blue when stained and nonpathologic.

Hansel Stain

A specialized stain used to identify urinary eosinophils by staining their granules pink or reddish, where greater than 1% eosinophils is clinically significant.

Sternheimer-Malbin Stain

A stain used in urinalysis to delineate and differentiate white blood cells and renal tubular epithelial cells.

Squamous Epithelial Cells

The largest cells found in urine sediment, originating from the lower urethra or vagina, commonly used as a reference point for focusing the microscope.

Clue Cells

Squamous epithelial cells covered with Gardnerella vaginalis (coccobacillus) bacteria extending over their edges, indicating vaginal infection.

Transitional Epithelial Cells

Urothelial cells originating from the renal pelvis, calyces, ureters, bladder, or upper male urethra, occurring in spherical, caudate, or polyhedral forms with a central nucleus.

Syncytia

Clumps of transitional (urothelial) cells typically seen following catheterization or in cases of urinary tract malignancy.

Renal Tubular Epithelial (RTE) Cells

The most clinically significant epithelial cells in urine, containing an eccentric nucleus; their presence indicates tubular necrosis or severe renal damage.

Oval Fat Bodies

Renal tubular epithelial cells or macrophages that have absorbed lipids from the filtrate, exhibiting a Maltese cross pattern under polarized light.

Lipiduria

The presence of lipids or fats in the urine, highly associated with nephrotic syndrome, acute tubular necrosis, diabetes, and crush syndrome.

Tamm-Horsfall Protein

A mucoprotein secreted by RTE cells in the distal convoluted tubule and collecting duct that forms the basic matrix of all urinary casts.

Cylindroids

Cast-like structures that possess tapered ends on one or both sides, sharing the same clinical significance as urinary casts.

Hyaline Casts

The most frequently encountered urinary casts, composed entirely of Tamm-Horsfall protein with a low refractive index; 0 to 2 per low power field is normal.

RBC Casts

Orange-red urinary casts containing embedded red blood cells, indicating bleeding within the nephron or glomerular damage.

WBC Casts

Urinary casts containing embedded white blood cells (mostly neutrophils), indicating tubule infection or inflammation such as pyelonephritis.

Epithelial Casts

Casts containing renal tubular epithelial cells within the protein matrix, indicating severe tubular destruction and renal damage.

Fatty Casts

Highly refractile casts containing oval fat bodies and free fat droplets, characteristic of nephrotic syndrome and acute tubular necrosis.

Granular Casts

Casts containing coarse or fine granules derived from RTE lysosomes or cellular degeneration, which further degenerate into waxy casts.

Waxy Casts

Brittle, highly refractile casts with jagged ends and notches, formed during extreme urine stasis and chronic renal disease.

Broad Casts

Wide urinary casts formed in dilated distal tubules or collecting ducts during severe urine stasis, often termed renal failure casts.

Amorphous Urates

Normal yellow-brown granular precipitation found in acidic urine (pH greater than 5.5) that produces a reddish-pink sediment due to uroerythrin.

Uric Acid Crystals

Normal yellow-brown acidic urine crystals appearing as rhombic, whetstone, or rosette shapes that strongly polarize light; elevated in gout and chemotherapy.

Calcium Oxalate Crystals

Urinary crystals found across acidic to alkaline pH, occurring as dihydrate (envelope-shaped) or monohydrate (dumbbell-shaped) forms; major constituent of kidney stones.

Triple Phosphate Crystals

Normal colorless crystals found in alkaline urine appearing as three-dimensional prisms or coffin-lid shapes.

Ammonium Biurate Crystals

Normal yellow-brown spherical crystals covered with spicules (thorny apples) found in old, alkaline urine specimens (pH greater than 8).

Cystine Crystals

Abnormal hexagonal plate crystals found in acidic urine of individuals with cystinuria, an inherited inability to reabsorb cystine.

Cholesterol Crystals

Abnormal rectangular plate crystals with notched corners seen in refrigerated urine from patients with nephrotic syndrome.

Bilirubin Crystals

Abnormal clumped yellow needles or granules in acidic urine indicating viral hepatitis with renal tubular damage.

Tyrosine Crystals

Abnormal fine yellow needles arranged in bundles or rosettes, seen in inherited amino acid disorders alongside leucine crystals.

Leucine Crystals

Abnormal yellow-brown spheres with concentric circles and radial striations, associated with severe liver disease.