Clin Path Lab 6 Urinalysis
Clin Path Lab 6 Urinalysis
Clin Path Lab 6 Urinalysis
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[email protected]
URINARY SEDIMENTS
1. Cells
- cells present in urinary sediment include WBCs, RBCs and epithelial cells. These cells can be anywhere in the urinary tract from
the tubules to the urethra.
Type Description Normal Clinical
Values implications
Red blood Uniform colorless 0-3/hpf Can originate from
cells smooth any part of the
biconcave disks urinary tract
7um Glomerulonephritis
Trauma
Systemic and renal
diseases
White Spherical with 0-5/hpf (M) Acute infection of
blood cells dull gray color. 0-8/hpf (F) kidney
Tend to be (pyelonephritis)
neutrophils. Cystitis (bladder)
10-12 um Urethritis (urethra)
Urinary tract
infections
Squamous Large, flat, irreg Few Occur in urethra and
epithelial shaped cells vagina
that contain Vaginal
small central contamination
nucleus
Abundant
cytoplasm
Cell size:23-40um
Renal Slightly larger Occasional Originate in
epithelia than WBC with convoluted and
round central collecting tubules
nucleus Increased numbers
Cell size: 20 um indicate tubular
injury and
damage to
epithelial BM
Transitional Can be round or Rare Line urinary tract
epithelial pear shaped from urinary
with tail like pelvis to upper
projections portion of urethra
Increased amounts
indicate disease
of bladder or
renal pelvis
Oval fat Renal epithelial Negative Result from tubular
bodies cells with lipid epithelial
that are highly degeneration of
refractive, nephron
coarse Are associated with
droplets in large amounts of
various sizes protein
Nephrotic syndrome
2. Casts
- Casts are cylindric structures formed primarily within the lumen of the distal convoluted tubule and collecting duct. The major
constituent of casts is Tamm-Horsfall protein, a glycoprotein excreted by the renal tubular cells.
Type Description N. Values Clinical Implications
Hyaline Colorless, 0-2/lpf Can indicate mild to
homogenous, severe renal disease
semi-transparent when increased in
numbers
Can be found in healthy
individuals after heavy
exercise
4. Crystals
- Crystals are frequently found in the urine. They are formed by the precipitation of urine salts subjected o changes in pH,
temperature or concentration, which affect their solubility. Crystals are identified by their appearance, solubility and pH.
Type Description pH Solubility Significance
Uric acid Color: yellow-brown Acid Alkali- Associated with renal
Shape: different soluble, stones, gout, high
shapes, most sodium purine metabolism,
common are hydroxide acute febrile
diamond, rhombic conditions, chronic
plates in clusters, nephritis
lemon shape
Calcium Colorless Acid/ HCl- Can be found in
oxalate Envelope with Neutral soluble normal individuals
intersecting Acetic after ingestion of
diagonal lines acid oxalate rich food
Birefringent insoluble and large doses of
vitamin C
Associated with renal
stones, diabetes
mellitus, liver
disease and
chronic renal
disease
Hippuric Color: yellow-brown Acid/ Soluble in Associated with diets
acid to colorless Neutral water, high in fruits and
Shape: elongated alkali vegetables
prisms/plates Insoluble containing large
with pyramidal in acetic quantities of
ends acid benzoic acid
Abnormal Crystals
Cystine Colorless and Acid Soluble in Amino acid crystal,
refractile HCl, inherited as a
Shape: hexagonal alkali, metabolic defect
with equal and and that prevents
unequal sides ammonia reabsorption of
Appear single or in cystine
clusters
Leucine Color: yellow to Acid Soluble in Maple syrup disease
brown hot acetic Severe liver disease
Shape: spheroids acid, hot
with radial alcohol
concentric and alkali
striations
Highly refractile
with oil-like
appearance
Tyrosine Color: black or Acid Soluble in Severe liver disease
yellow with HCl, and tyrosinosis
presence of NH4OH,
bilirubin dilute
Shape: highly mineral
refractile needles oil
occurring in
sheaves or
clusters
Cholesterol Color: transparent Acid/ Soluble in Excessive tissue
Shape: regular to Neutral chlorofor breakdown
irregular flat m, ether, Seen in nephritis and
plates with one hot nephritic syndrome
corner notched alcohol Lipiduria, lipidemia
out, may be single Insoluble and lymphatic
or in larger #s in alcohol obstruction due to
Most often found neoplasms
after refrigeration
Bilirubin Color: yellow to acid Soluble in Obstructive jaundice
brown to reddish chlorofor Bilirubin must be
Shape: Granules or m, present in urine
clusters acetone,
acid and
alkali
Demo Slides
Pus Cells Granular Cast Hylaline Cast RBCs
Squamous Cells Uric Acid crystal Yeast Cells