Week 10: Abnormal UA Seds • • • • 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 • • • • 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 • • • • 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 • • • • 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 QuickTime™ and a Int el Indeo® Video R3.2 decompressor are needed to see this picture. 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 • • • • • • 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)