Amorphous Phosphates are normally found in ________ urine.
Alkaline
Which Amorphous crystal forms a white precipitate?
Amorphous Phosphate produces a white precipitate
Amorphous Urates are normally found in ________ urine.
Acidic
Which Amorphous crystal forms a pink precipitate when refrigerated?
Amorphous Urate produces a pink precipitate in refrigerated urine.
Calcium Carbonate is normally found in ________ urine.
Alkaline
Triple Phosphate is normally found in ________ urine.
Alkaline
Calcium Phosphate is normally found in ________ urine.
Alkaline or neutral
Uric Acid is normally found in ________ urine.
Acidic
Calcium Oxalate is normally found in ________ urine.
Acidic, but sometimes alkaline
Ammonium Biurate is normally found in ________ urine.
Acidic, but sometimes alkaline
What type of casts will be present in AGN?
RBC casts, Hyaline casts, WBC casts
What type of casts will be present in Acute pyelonephritis?
WBC & Epithelial casts
What type of casts will be present in Chronic renal failure or renal stasis?
Waxy casts, Renal epithelial casts, Squamous epi casts and Hyaline casts
What type of casts will be present in heavy metal poisoning?
Epithelial casts
What type of casts will be present in strenuous exercise?
Hyaline casts, RBC casts and Epi casts
What type of casts will be present in breakdown of cellular casts?
Granular casts
Bilirubin crystals are normal or abnormal?
Abnormal
Triple Phosphate crystals are normal or abnormal?
Normal
Tyrosine crystals are normal or abnormal?
Abnormal
Uric Acid crystals are normal or abnormal?
Normal
Leucine crystals are normal or abnormal?
Abnormal
Cholesterol crystals are normal or abnormal?
Abnormal
How much urine should be centrifuged in order to standardize the results of the urine microscopic exam?
10 to 15 milliliters, but ideally 12 mL
which urine sediment components are reported on low power?
Crystals
which urine sediment components are reported on high power?
RBC's, WBC's, Epithelial cells, Oval fat bodies, bacteria, and casts
What are two components of the steinheimer-mayben stain?
Crystal Violet and safranin O
what can be added to a urine sediment to determine RBCs from other cellular elements?
2% acetic acid
name five urinary crystals which are birefringent.
Calcium oxalate, triple phosphate, uric acid, cholesterol, calcium carbonate, and starch
what is the definition of ghost cells?
Red blood cells that have lost their hemoglobin and become transparent
what is the definition of glitter cells?
White blood cells better swollen and granules exhibit brownian movement
what is the definition of a clue cell?
Squamous epithelial cells covered with gram negative bacteria typically this is Gardnerella vaginalis
What is the term used to indicate the presence of white blood cells in the urine?
Pyuria
which type of epithelial cell is normal if found in urine in low numbers?
Squamous epithelial cells
name a condition in which Oval fat bodies would be present in the urine.
nephrotic syndrome
Name three groups of patients who are more susceptible to urinary yeast infections.
females, diabetics, and immune-compromised patients
what protein forms the matrix of all casts?
Tamm Horsfall protein
in an acidic urine what would you expect for specific gravity?
Increased specific gravity
In an alkaline or basic urine, what would you expect for specific gravity?
decreased specific gravity
what are physical and chemical correlations for RBC's seen on microscopic exam?
On physical exam turbid and red color; on chemical exam blood positive
what are the physical and chemical correlations for WBC's seen on microscopic exam?
Visibly turbid sample; chemical exam positive for protein nitrite and L E
what physical and chemical correlations you would expect if epithelial cells are seen on microscopic exam?
Visibly turbid sample; nothing correlates on chemical exam
what are the physical and chemical correlations for bacteria seen on a microscopic exam?
Visibly turbid sample; positive result for p H, nitrite and L E
What are the physical and chemical correlations you would expect if crystals are seen on microscopic exam?
Visibly turbid with a pink, yellow or white color; pH expected for the type of crystal seen
What is the normal value for red blood cells per HPF?
0 - 3 per HPF
What is the normal value for white blood cells per high power field?
0 - 8 per HPF
what is the normal value for casts per high power field?0 - 2 per HPF
...
what is the normal value for squamous epithelial cells per high power field?
Few / low power field
what is the normal value for bacteria per high power field?
Negative
what is the normal value for yeast per HPF?
Negative
what is the normal value for abnormal crystals per HPF?
Negative
What is the stain used for fats or lipids?
Red oil O or Sudan III
what is the stain used for your Eosinophil detection on nasal smears?
Hansel Stain
In a low specific gravity urine what red cell morphology would you expect?
Spherocytes or swollen, more water outside of cell than inside = Water entering cell
In a high specific gravity urine what red cell morphology would you expect?
Crenated, shriveled due to more solute less water
what type of RBC morphology would a low specific gravity plus an alkaline urine result in?
Ghost cells, Cells lyse and release contents, appear clear or ghostly on microscopic exam
What reasons might you see red blood cells in a urine microscopic exam?
Bleeding in the GI tract, early renal disease, infections, and menstrual or hemorrhoidal contamination
What can you add to a urine sample to differentiate red blood cells from yeast cells under the microscope?
2% acetic acid , will lyse the RBC's but not yeast cells
What PH level of urine would you expect to see litter cells in?
Alkaline or basic
What are possible causes for seeing white blood cells on a urine microscopic exam?
inflammation along the GI tract, U T I due to bacteria, pyelonephritis, cystitis, glomerulonephritis, and lupus.
Why would you see white blood cells on a microscopic exam but have a negative dipstick test for leukocyte esterase ?
white blood cells present are lymphocytes
why might you have a positive leukocyte esterase dipstick but not see white blood cells on a microscopic exam?
Old urine sample led to white blood cell lysis
why might you see Eosinophils on a urine microscopic exam?
Drug induced Interstitial nephritis due to penicillin
How would eosinophils appear different than neutrophils on a microscopic exam?
Eosinophils will be larger than neutrophils and have an Oval appearance
The presence of lymphocytes on a microscopic exam could be an indicator for ______?
Renal transplant rejection
What type of urine are bacteria more likely to be seen in, alkaline or basic?
Alkaline; with a p H range of 6.5 - 8
A patient's sample has a specific gravity of 1.005 and a pH of 7.5. What effect would this have on the WBC's and RBC's present in the sample?
Cells will lyse
What type of microscopy must be used to detect cast and mucus, which have very low refractive indexes and could be missed with brightfield microscopy?
Phase Contrast
What is the composition of the granular cast?
Plasma protein aggregates and cellular remnants.
Which cast is believed to be the final stage of degeneration of the fine granules of granular casts?
Waxy Casts
A technologist is trying to determine if a crystal is Cystine or uric acid. How is the best way to determine the difference.
Cysteine doesn't polarize with light, Uric acid does
Name three parasites that can be seen in urine.
Trichomonas vaginalis, Enterobius vermicularis & Schistosoma haematobium
How can you differentiate a cell you suspect is yeast from a red cell?
Add a drop of acetic acid by allowing it to flow under the edge of the coverslip. This will lyse RBC's but not Yeast. SHow would you differentiate a true urine crystal from starch on a slide? ~Add a drop or two of dilute iodine solution which will stain starch materials.
What structure is seen more often than hyaline casts?
Mucus
A Positive protein dipstick would correlate with what other dipstick results?
L E positive, Casts, blood, Leukocytes and or bacteria on microscope as well as possible positive blood and nitrite.
A positive p H dipstick would correlate with what other tests on the dipstick?
Leukocyte and or bacteria on microscope, L E positive, and possible nitrite positive.
A positive glucose dipstick would correlate with hat other dipstick tests?
Possible positive reaction for ketones and protein.