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19 Cards in this Set
- Front
- Back
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what is the order of cellular elements by size
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tubular epithelial cell > WBC > RBC
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if you have 1-2 tubular epithelial cells per hpf - is this normal or abnormal
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normal
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what are tubular epithelial cells indicative of
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acute tubular necrosis
interstitial nephritis |
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WBC in urine
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larger than RBC w/ granular cytoplasm
see in: infection interstitial nephritis transplant rejection systemic disease |
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dysmorphic RBC in the urine indicates:
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glomeriular problem
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oval fat body
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tubular epithelial cell laden with lipids and protein
high in cholesterol - creates maltese cross pattern under polarized light see with nephrotic syndrome |
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casts
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all casts form in LOW flow states
indicate kidney glomerular problem tamm horsfall protein (uromodulin) takes shape of nephron lumen due to low flow |
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hyaline cast
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suggest low flow state - its nothing but tamm horsfall protein (no cellular component)
indicates pre-renal condition (low flow) |
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RBC cast
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RBCs in tamm-horsfall protein
indicates some form of glomerulonephritis |
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WBC cast
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WBC in tamm-horsfall protein
suggests infection, interstitial nephritis, transplant rejection, systemic disease |
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granular casts
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muddy brown cast
indicative of acute tubular necrosis |
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coarse granular cast
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mostly tubular epithelial cells, but with other debris
also indicative of acute tubular necrosis |
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tubular epithelial cell cast
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LARGE cells with central nucleus
indicates SEVERE acute tubular necrosis |
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calcium oxylate crystals
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envelope shape
see in: inflammatory bowel disease malabsorption states ethylene glycol ingestion |
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cystine crystals
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hexagonal
see in cystinuria - autosomal recessive AA transport disorder -> stone formation |
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triple phosphate (aka struvite) crystals
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staghorn calculi - coffin lid shape
form in alkaline urine pH due to chronic infection (UTI), often women, from bacteria urea-splitters - proteus |
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uric acid crystals
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rhomboid shaped crystals or needle shaped
uric acid stone formers - urate nephropathy see in people who have ostomies - more dehydrated |
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if blood is postive in the urine but sediment is negative for RBCs
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think rhabdomyolysis/myoglobinuria
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will dipstick eval for protein detect Ig light chains
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no need a SSA test to detect Ig light chains (which is positive charged)
dipstick evaluation tests for albumin and negatively charged protein |
