Transcript PowerPoint Presentation - Week 10: Abnormal UA Seds

Week 10: Abnormal UA Seds
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Oval fat bodies
Microorganisms
Abnormal crystals
Artifacts
Oval Fat Bodies
• Degenerated renal tubular epithelia
• Fat globules may show Maltese cross
pattern in polarized light
• Clinically significant
Oval Fat Bodies
Cystine
• Aminoaciduria may be due to overflow, inability
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to reabsorb, or abnormal amino acids
Cycstine is sulfur containing amino acid.
Clear hexagonal plate that may resemble uric acid
Cystinuria: hereditary impairment of proximal
tubule to reabsorb cystine, lysine, ornithine,
arginine. Cystine kidney stone.
Cystinosis: hereditary condition where cystine
deposits throughout the body. Most common cause
of Fanconi’s syndrome.
Cystine
Tyrosine
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Fine needles
May see in liver disease
Tyrosinosis: faulty tyrosine metabolism
Tyrosine is a naturally occurring amino
acid. Product of phenylalanine metabolism
and precursor of melanin, catecholamines,
thyroid hormones.
Tyrosine
Leucine
• Concentric sphere
• Naturally occurring amino acid
• May see in liver disease along with tyrosine
Leucine
Cholesterol
• Rhomboid plate with notched corner
• Weakly birefringent
Acetaminophen (Tylenol)
• Looks like Caplet
Sulfa Drugs (Sulfonamides)
• Bacteriostatic
• Older drugs less soluble
Bilirubin
Bacteria
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Usually accompany increased leukocytes
May be hidden within leukocytes
Commonly Escherichia coli
Reflex Culture and Sensitivity test
Bacteriuria
Yeast
• Budding and mycelial (pseudo-hyphae)
forms
• Often seen in diabetics and
immunocompromised patients
• Likely Candida albicans
Trichomonads
• Flagellated protozoa from urethra
• Motility quickly decreases as specimen
cools
• Trichomonas vaginalis is a type of STD
Trichomonas vaginalis
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Schistosomiasis
• Only species seen in UA is Schistosoma
hematobium that can deposit eggs in the
bladder
• Common in Africa and SW Asia
Schistoma hematobium
Artifacts
• Sperm and corpora
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amylacea
Starch and talc
Fibers
Oil droplets
Air bubbles
Glass fragments
Plant cells
• Pollen
• Fecal contaminants
• Enterobius vermicularis
(pinworm)
• Phthirus pubis (louse)
• Mite
• X-ray contrast media IVP
Sperm
Corpora amylacea
Talc
Fibers
Oil Droplets
Air Bubble
Glass Fragments
Pollen
Plant cell
Fecal Material
Enterobius vermicularis
Pubic Louse
Mite
IVP
High Specific Gravity
• IVP and certain antibiotics may cause
extremely high SG
• If SG >1.035 or 1.040 is not explained by
glucosuria, etc., check history
• Dilution method
• Make 1:1 dilution with d H2O
• Read SG of diluted specimen
• Multiply the decimal fraction by 2
High Specific Gravity -- Example
• 1:1 diluted specimen = 1.025
• Double of 0.025 = 0.050
• Thus, undiluted specimen = 1.050
1.050 g/mL (original) + 1.000 g/mL(water) = 2.050 g/2mL
= 1.025 g/mL (diluted specimen)