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

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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 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

Plant cell

Fecal Material

Pollen

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)