PowerPoint Presentation Week 9 Urinary SedimentsPowerPoint演示文稿 9周尿沉渣.pptVIP

Week 9: Urinary Sediments Formed elements: epithelia, red cells, white cells Crystals Mucus Renal casts Microorganisms Sternheimer-Malbin stain Microscopic UA Correlate with cloudiness and other findings Quality control Consistent volume Centrifugation Well mixed fresh specimen Microscopy (wet mount, use low light) Sternheimer-Malbin stain Epithelia Squamous epithelia Large flat cell with central oval nucleus Transitional (bladder) epithelia Spindle shaped with large oval nucleus Maybe in sheet Renal tubular epithelia Small cell with large oval nucleus Most clinically significant Leukocytes Pus, or pyuria May indicate urinary tract infection UTI if more than 10/HPF Glitter cells in dilute alkaline urine Erythrocytes Hematuria may indicate renal damage Menstrual contamination May be crenated or ghost cells Renal Casts Cylindruria Renal stasis Acidic pH Proteinuria Concentrated urine Tamm-Horsfall mucoprotein matrix Renal Casts Hyaline Least significant Not refractile Coarse and fine granular Cellular Classified by cells in the cast Waxy End stage renal disease Mucus Usually of no clinical significance Common Crystals in Acid pH Amorphous urate Orange powder May clear with warming or saline Uric acid Brown lemon shaped or star shaped Birefringent with polarized light Calcium oxalate Envelope Common Crystals in Alkaline pH Amorphous phosphate White powder May clear with saline Triple phosphate Coffin lid Ammonium biurate Thorn apple Calcium carbonate Effervesce with SSA Uric Acid Polarized Calcium Oxalate * * Squamous Epithelia Transitional Epithelia Renal Tubular Epithelia Pyuria Bacteriuria Hematuria Hyaline Cast How many casts do you see? Fine Granular Casts Coarse Granular Cast RBC Casts WBC Casts Epithelial Casts Fatty Cast Broad Cast Waxy Casts Amorphous Urate Uric Acid *