WBC & RTE Cell Differentiation PDF

- Differentiates WBC and RTE cells C. 2% Acetic Acid B. WBCs - Lyses ______ and enhance nuclei of WBC - _______________ - Distinguishes RBCs from WBCs, yeast, oil - NV drople...

- Differentiates WBC and RTE cells C. 2% Acetic Acid B. WBCs - Lyses ______ and enhance nuclei of WBC - _______________ - Distinguishes RBCs from WBCs, yeast, oil - NV droplets, and crystals 0-5 or 0- D. Lipid stains 8/HPF - __________________________ Increase - Stain TAG and Neutral fats orange-red number - Identifies free fat droplets and lipid indicates containing cells and casts presence of E. Gram stain infection or - Differentiate Gram pos and neg bacteria inflammation - Identifies bacterial casts - Neutrophils F. Hansel stain Most predominant - ______________________ Granulated and multilobed - Stains eosinophilic granules Hypotonic urine - Identifies urinary eosinophils Swell G. Prussian blue Granules undergo ___________ - Rous test movement producing a sparkling - Stains structure containing iron appearance-______________ - Identifies hemosiderin granules When dying, form blebs and finger like H. Phenathridine projection called myelin forms - Stains DNA _________ - Eosinophils I. Carbocyanine NV - Stains nuclear membranes, mitochondria, 4% and cell membranes Significant= >4% associated with III. CELLS ________________ - Mononuclear cells A. RBCs Lymphocytes, monocytes, - __________ macrophages, histiocytes - NV Normally present in small numbers 0-2 or 0-3/ HPF Inc lymphocyte - Smooth, non nucleated, biconcave disks Renal transplant rejection - Hypertonic urine Inc Monocytes, histiocytes _______________ Chronic inflammation and radiation - Hypotonic urine therapy _______________ (ghost cell) - Glomerular membrane damage Dysmorphic with projections, fragmented - Source of error Using Sternheimer-Malbin stain Yeasts Oil droplets Glitter Cells (pale blue) Air bubbles Leukocytes (Pale pink) Monohydrate calcium oxalate crystals - Remedy for source of error Add 2% acetic acid Acetic acid will lyse the RBCs but not the others 3 MT-AP NOTES COLLATED BY ANTHONY SIO, RMT. PLEASE DO NOT SPREAD IF NOT PERMITTED  C. Squamous Epithelial Cells - 2 RTE /hpf - _____________ with abundant, irregular Tubular injury cytoplasm and prominent nucleus - Variations - Cell size is about 30-50um OFB 5-7x the size of RBC Also known as renal tubular fat - The nucleus is about the size of an RBC bodies - From linings of vagina, female urethra, and Lipid containing RTE cell lower male urethra Seen in lipiduria (nephrotic - _____________ syndrome) SEC covered with _____________ Identified by: Associated with _______________ o Lipid Stains (TAG & Neutral fats) o Polarizing microscope (cholesterol-MALTESE CROSS formation) Bubble Cell RTE cell with non-lipid vaquoles Injured cells in which the endoplasmic reticulum has dilated prior to cell death Seen in acute tubular necrosis D. Transitional epithelial cells - Also known as urothelial or bladder cells - Cell size 20-30um (4-6x RBC) - Spherical, polyhedral or caudate with centrally located nucleus - from renal pelvis, calyces, ureters, urinary bladder, and _________________ - Increased in: Catheterization- singly, pairs, or clumps (syncytia) - Abnormal morphology Malignancy or viral infx F. Bacteria - True UTI ________________ - Most common cause of UTI _________________ - Can also be cause by Staphylococcus, E. Renal Tubular Epithelial Cells Enterococcus - _________________________ epithelial - Motility differentiates them from amorphous cells urates and phosphates - From Lining of renal tubules - Size is 3-5x of RBC - Rectangular, polyhedral, cuboidal, or columnar with eccentric nucleus - Sometimes bilirubin-stained or hemosiderin- laden - RTE cells from the DCT may be mistaken for WBC 4 MT-AP NOTES COLLATED BY ANTHONY SIO, RMT. PLEASE DO NOT SPREAD IF NOT PERMITTED  G. Yeasts Associated with bladder cancer - True yeast infection __________________ - Small, refractile oval structure that may or may not bud - Branched, mycelial forms are seen in severe infections - ___________________ Seen in DM and Vaginal moniliasis URINARY BLADDER CANCER MARKER NMP- Nuclear Matrix Protein BTA- Bladder Tumor Antigen - Other parasites seen Trichuris Strongyloides Giardia Various amoeba Various insects/bugs (lice, fleas, H. Parasites bedbugs, mites, ticks) - Trichomonas vaginalis I. Spermatozoa Most frequently encountered parasite in - Oval, slightly tapered head urine - Long, flagella-like tail Pear-shaped flagellate with jerky motility - After sexual intercourse Agent of ping-pong disease Reporting Rare, few, moderate, many /HPF When not moving may resemble WBC, TEC, or RTE J. Mucus Threads - Has low RI - Major constituent Tamm-horsfall protein (uromodulin) - Enterobius vermicularis egg Most common fecal contaminant - Schistosoma haematobium egg Blood fluke with terminal spine Causes _________ 5 MT-AP NOTES COLLATED BY ANTHONY SIO, RMT. PLEASE DO NOT SPREAD IF NOT PERMITTED