front 1 12mL | back 1 volume of urine recommended for urinalysis |
front 2 10-15mL | back 2 volume range of urine recommended for urinalysis |
front 3 1 mL | back 3 amount of sediment obtained |
front 4 RBCs, WBCs, and casts | back 4 components that should be counted and classified |
front 5 crystals, bacteria, and mucus | back 5 components that should be assessed qualitatively |
front 6 10 LPF or HPF | back 6 minimum fields assessed for urine components depending on specific components |
front 7 supra vital stains | back 7 used to enhance visualization |
front 8 crystal-violet and safranin (Sternheimer-Malbin) | back 8 most common supra vital stain for urine |
front 9 0.5% toluidine blue solution | back 9 distinguishes various cell components differently to help in identification |
front 10 acetic acid | back 10 brings out nuclear detail of WBCs and lyses RBCs |
front 11 Sudan III and oil red O | back 11 fat stains that identify fat inside cells or free floating; within renal cells or macrophages (oval fat bodies) |
front 12 cholesterol | back 12 does not stain and must be confirmed with polarizing microscopy |
front 13 gram stain | back 13 used to identify bacteria and yeast; rarely used in UA |
front 14 Prussian blue | back 14 stains iron in hemosiderin granules blue; can be free floating or inside cells |
front 15 Hansel stain | back 15 methylene blue and eosin-Y; for identification of eosinophils |
front 16 brightfield | back 16 most commonly used microscope technique in urinalysis |
front 17 phase-contrast | back 17 ideal for urine sediments; allows more detailed visualization of RBC morphology and translucent or low-refractive components and living cells |
front 18 polarizing | back 18 confirms presence of cholesterol; also used on crystals |
front 19 cholesterol | back 19 forms a maltese cross pattern with polarized light |
front 20 interference contrast | back 20 gives 3-D images; high cost |
front 21 cytocentrifugation | back 21 a technique used to produce permanent microscope slides of urine sediment and body fluids; produces a monolayer of sediment components |
front 22 pictures | back 22 pg 132-3. 192-210, Table 7.5 pg. 137, ph 140, 144-5 |
front 23 0-3/HPF | back 23 red blood cell reference interval |
front 24 0-8/HPF | back 24 white blood cell reference interval |
front 25 0-2/LPF | back 25 hyaline cast reference interval |
front 26 few/LPF | back 26 squamous epithelial cell reference interval |
front 27 few/HPF | back 27 transitional epithelial cell reference interval |
front 28 few (0-1)/HPF | back 28 renal epithelial cell reference interval |
front 29 negative/HPF | back 29 bacteria and yeast reference interval |
front 30 non/LPF | back 30 abnormal crystal reference interval |
front 31 10x | back 31 LPF |
front 32 40x | back 32 HPF |
front 33 erythrocytes | back 33 small, biconcave disks, approximately 8um in diameter and 3um deep with no nucleus |
front 34 crenated | back 34 RBC hypertonic (concentrated) urine |
front 35 ghost cells | back 35 RBC hypotonic (dilute) urine |
front 36 hypertonic | back 36 concentrated urine |
front 37 hypotonic | back 37 dilute urine |
front 38 renal bleed | back 38 increased RBC casts and significant protein |
front 39 bleeding below kidney or contamination | back 39 increased RBCs no casts or protein |
front 40 RBCs lysed or false positive | back 40 positive strip test no RBCs seen; false positive |
front 41 vitamin C or look-alike (yeast, crystals, bubbles) | back 41 false negative RBC strip test |
front 42 neutrophils | back 42 most common WBC in blood and urine |
front 43 glitter cells | back 43 WBCs in hypotonic urine |
front 44 degenerated blebs | back 44 WBCs in hypertonic urine |
front 45 upper urinary tract infection | back 45 WBCs, WBC casts along with positive protein |
front 46 lower urinary tract infection | back 46 increased WBCs, no casts and no protein (or lower level) |
front 47 leukocyturia | back 47 increased WBCs in urine |
front 48 eosinophiluria | back 48 predictor of acute interstitial nephritis due to drug sensitivity |
front 49 Hansel stain | back 49 used to detect eosinophils |
front 50 lymphocyturia | back 50 seen in viral infections kidney transplant rejection |
front 51 histiocytes | back 51 monocytes and macrophages |
front 52 squamous epithelial cells | back 52 the most common and largest of the epithelial cells; use low power; rarely significant, usually caused by contamination |
front 53 transitional (urothelial) epithelial cells | back 53 line calyces, renal pelvis, ureters, and bladder; various size and shape; seen in UTI, urinary procedures, and carcinoma (in sheets) |
front 54 renal tubular epithelial cells | back 54 convoluted tubular and collecting duct cells enumerated; seen in acute ischemic or toxic renal tubular disease from heavy metals or drug (ahminoglycosides) toxicity |
front 55 casts | back 55 formed in distal and convoluted tubules with a core matrix of uromodulin (Tamm-Horsfall protein) secreted by renal tubular cells; seen in acidic urine |
front 56 hyaline or finely granular | back 56 types of casts that are normal in small amounts |
front 57 hyaline casts | back 57 most commonly observed casts in the urine sediment; two or few/lpf are normal; seen in excess in strenuous exercise, dehydration, fever, emotional stress, CHF, and renal disease |
front 58 waxy casts | back 58 indicates prolonged stasis (take as long as 48 hours or more to form) and tubular obstruction; believed to be advanced stages of other casts; found in chronic renal failure, acute renal disease, hypertension, and renal allograft rejection |
front 59 red blood cell casts | back 59 casts diagnostic of intrinsic renal disease; most often of glomerular origin, but may result from tubular damage; accompanied by proteinuria |
front 60 proteinuria | back 60 must accompany increased numbers or abnormal casts |
front 61 WBC cast | back 61 casts that indicates renal inflammation or infection |
front 62 granular casts | back 62 casts composed primarily of uromodulin protein; not usually clinically significant casts unless they are very broad which may indicate poor prognosis; may be formed by degradation of other cellular casts |
front 63 fatty casts | back 63 casts with oval fat bodies indicating renal tubular death; signify a severe renal pathological condition, accompanied by significant proteinuria |
front 64 casts | back 64 must be correlated with chemical tests |
front 65 mucous threads, fibers, and crystals | back 65 three cast look-alikes |
front 66 crystals | back 66 result of precipitation of urine solutes, not usually present in freshly voided urine; significant in fresh voided indicates tubular damage |
front 67 concentration of urine, urine pH, and slow flow of urine | back 67 factors influencing crystal formation |
front 68 amorphous urates, acid urates, monosodium urate, uric acid, calcium oxalate | back 68 crystals present in acidic urine |
front 69 amorphous phosphates, triple phosphate, calcium and magnesium phosphates, ammonium bitrate, calcium carbonate | back 69 crystals present in alkaline urine |
front 70 bilirubin, cystine, tyrosine and leucine, cholesterol | back 70 crystals present in metabolic conditions |
front 71 drug crystals, bacteria, yeast, trichomonads, Gardnerella, parasites, fat, lipidemia, mucus, hemosiderin, sperm | back 71 crystals present in iatrogenic origin |
front 72 1 | back 72 2 |
front 73 amorphous urate crystals | back 73 present in urine 5.7-7.0; have no clinical significance; may appear as brick dust due to uroerythrin |
front 74 acid urate crystals | back 74 sodium, potassium, and ammonium salts of urine acid that appear as small yellow-brown balls or spheres; no clinical significance |
front 75 uric acid crystals | back 75 occur in many forms, most common is rhombic or diamond shape, also cubes, barrels, or bands and can form rosettes; appear only when urine pH is less than 5.7; commonly seen in gout or after cytotoxic drug administration |
front 76 monosodium urate crystals | back 76 appear as colorless to light-yellow slender, pencil-like prisms; no clinical significance |
front 77 calcium oxalate crystals | back 77 most frequently observed crystals in human urine; form at any pH, commonly formed in high ascorbic acid diets or during refrigeration; seen in ethylene glycol (antifreeze ingestion) and during severe chronic renal disease; envelope crystals |
front 78 amorphous phosphates | back 78 found in alkaline and neutral urine; indistinguishable from amorphous urates; precipitate appears white or gray; no clinical significance |
front 79 triple phosphate | back 79 colorless and appear in different forms; most common is coffin lid; found in alkaline or neutral urine; little clinical significance, but found in conjunction with UTIs |
front 80 calcium and magnesium phasphates | back 80 common and have no clinical significance; found in neutral and slightly alkaline (sometimes slightly acidic) urine |
front 81 ammonium biurate | back 81 thorny apple appearance (yellow brown spheres with striations on surface); normal urine solute seen after storage; significant in fresh urine indicating renal tubular damage |
front 82 calcium carbonate | back 82 appear as tiny, colorless granular crystals usually found in pairs or tetrads; no frequently found and no clinical significance |
front 83 bilirubin crystals | back 83 indicate large amounts of bilirubin in the urine; only form in acidic urine; appear as small clusters of fine needles |
front 84 cystine | back 84 colorless, hexagonal plates with uneven sides; present primarily in acidic urine; clinically significant indicating disease (hereditary cystinosis or cystinuria); |
front 85 tyrosine and leucine | back 85 form in acidic urine and dissolve in alkaline urine; rarely seen but indicate abnormal process such as severe liver disease or a rare inherited metabolic disorder |
front 86 cholesterol | back 86 clear, thin parallelogram plates with notched corners; indicate large amounts of cholesterol and ideal conditions that allowed them to precipitate out into the urine; usually accompany oval fat bodies, fatty casts, and large amounts of protein; signify nephrotic syndrome, kidney disease |
front 87 iatrogenic crystals | back 87 form due to treatment administered such as drugs, dyes, contrast media |
front 88 rod-shaped bacili | back 88 most common bacteria in urine |
front 89 bacteria | back 89 presence indicates UTI (accompanied by leukocytes) or contamination; reported as few, moderate, or many per HPF |
front 90 yeast | back 90 colorless ovoid cells resembling RBCs; seen often as vaginal contaminant |
front 91 KOH prep | back 91 prepared to view yeast |
front 92 Trichomonads vaginalis | back 92 most common cause of parasitic gynecologic infection in females as an STD; turnip-shaped flagellates and have jerky motility in wet preps; reported as present |
front 93 Gardnerella vaginalis | back 93 an anaerobic bacterium; clue cells present; characteristic of bacterial vaginosis |
front 94 clue cells | back 94 squamous epithelial cells from the vaginal mucosa with large numbers of bacteria adhering to them |
front 95 parasites | back 95 common are Enterobius vermicularis (pinworm), Giardia lamblia and Schistosoma haematobium (schistosomiasis) |
front 96 mucus | back 96 a protein produced by the renal tubular epithelium; no clinical significance |
front 97 fat | back 97 found in urine in three forms; free-floating droplets, oval fat bodies, or within fatty casts; triglycerides and/or cholesterol |
front 98 triglycerides | back 98 will stain with Sudan III or an oil red O stain |
front 99 cholesterol | back 99 will not stain, but will demonstrate birefringence with polarizing microscopy |
front 100 cholesterol droplets | back 100 produce a distinctive maltese cross pattern |
front 101 lipiduria | back 101 always clinically significant; present in a variety of renal diseases and may occur after severe crush injuries; always accompanied by proteinuria |
front 102 hemosiderin | back 102 form of iron that results in ferritin denaturation; may be seen in urine after a severe hemolytic episode (transfusion reaction); Prussian blue used to identify |
front 103 sperm | back 103 indicates ejaculation or recent sexual intercourse |
front 104 fibers | back 104 hair, cotton, fabric threads, diapers and hygiene products often appear in urine sediment |
front 105 starch | back 105 originate from body powders or gloves; not perfectly round with a centrally located dimple; exhibits pseudo-maltese pattern with polarized microscopy |
front 106 fecal matter | back 106 come from improper collection or through abnormal connection between urinary tract and the bowel |
front 107 correlation | back 107 process of using entire analysis: physical, chemical, and microscopic |
front 108 disease process, functional change, hereditary disease, or iatrogenic agent | back 108 purposes of findings in urine sediment |