7 MICROSCOPIC EXAMINATION OF URINE Flashcards
Macroscopic screening of urine specimens is used to:
A. Provide results as soon as possible
B. Predict the type of urinary casts present
C. Increase cost-effectiveness of urinalysis
D. Decrease the need for polarized microscopy
C. Increase cost-effectiveness of urinalysis
Variations in the microscopic analysis of urine include all of the following except:
A. Preparation of the urine sediment
B. Amount of sediment analyzed
C. Method of reporting
D. Identification of formed elements
D. Identification of formed elements
All of the following can cause false-negative microscopic results except:
A. Braking the centrifuge
B. Failing to mix the specimen
C. Diluting alkaline urine
D. Using midstream clean-catch specimens
D. Using midstream clean-catch specimens
The two factors that determine relative centrifugal force
are:
A. Radius of rotor head and RPM
B. Radius of rotor head and time of centrifugation
C. Diameter of rotor head and RPM
D. RPM and time of centrifugation
C. Diameter of rotor head and RPM
When using the glass-slide and cover-slip method, which of the following might be missed if the cover slip
is overflowed?
A. Casts
B. RBCs
C. WBCs
D. Bacteria
A. Casts
Initial screening of the urine sediment is performed using
an objective power of:
A. 4×
B. 10×
C. 40×
D. 100×
B. 10×
Which of the following should be used to reduce light intensity in bright-field microscopy?
A. Centering screws
B. Aperture diaphragm
C. Rheostat
D. Condenser aperture diaphragm
C. Rheostat
Which of the following are reported as number per lpf?
A. RBCs
B. WBCs
C. Crystals
D. Casts
D. Casts
The Sternheimer-Malbin stain is added to urine
sediments to do all of the following except:
A. Increase visibility of sediment constituents
B. Change the constituents’ refractive index
C. Decrease precipitation of crystals
D. Delineate constituent structures
C. Decrease precipitation of crystals
Nuclear detail can be enhanced by:
A. Prussian blue
B. Toluidine blue
C. Acetic acid
D. Both B and C
D. Both B and C
Which of the following lipids is/are stained by Sudan III?
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both B and C
D. Both B and C
Which of the following lipids is/are capable of polarizing light?
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both A and B
A. Cholesterol
The purpose of the Hansel stain is to identify:
A. Neutrophils
B. Renal tubular cells
C. Eosinophils
D. Monocytes
C. Eosinophils
Crenated RBCs are seen in urine that is:
A. Hyposthenuric
B. Hypersthenuric
C. Highly acidic
D. Highly alkaline
B. Hypersthenuric
Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except:
A. Observation of budding in yeast cells
B. Increased refractility of oil droplets
C. Lysis of yeast cells by acetic acid
D. Lysis of RBCs by acetic acid
C. Lysis of yeast cells by acetic acid
A finding of dysmorphic RBCs is indicative of:
A. Glomerular bleeding
B. Renal calculi
C. Traumatic injury
D. Coagulation disorders
A. Glomerular bleeding
Leukocytes that stain pale blue with Sternheimer-Malbin
stain and exhibit brownian movement are:
A. Indicative of pyelonephritis
B. Basophils
C. Mononuclear leukocytes
D. Glitter cells
D. Glitter cells
Sometimes mononuclear leukocytes are mistaken for:
A. Yeast cells
B. Squamous epithelial cells
C. Pollen grains
D. Renal tubular cells
D. Renal tubular cells
When pyuria is detected in a urine sediment, the slide should be checked carefully for the presence of:
A. RBCs
B. Bacteria
C. Hyaline casts
D. Mucus
B. Bacteria
Transitional epithelial cells are sloughed from the:
A. Collecting duct
B. Vagina
C. Bladder
D. Proximal convoluted tubule
C. Bladder
The largest cells in the urine sediment are:
A. Squamous epithelial cells
B. Urothelial epithelial cells
C. Cuboidal epithelial cells
D. Columnar epithelial cells
A. Squamous epithelial cells
A squamous epithelial cell that is clinically significant is the:
A. Cuboidal cell
B. Clue cell
C. Caudate cell
D. Columnar cell
B. Clue cell
Forms of transitional epithelial cells include all of the following except:
A. Spherical
B. Caudate
C. Convoluted
D. Polyhedral
C. Convoluted
Increased transitional cells are indicative of:
A. Catheterization
B. Malignancy
C. Pyelonephritis
D. Both A and B
D. Both A and B
A primary characteristic used to identify renal tubular epithelial cells is:
A. Elongated structure
B. Centrally located nucleus
C. Spherical appearance
D. Eccentrically located nucleus
D. Eccentrically located nucleus
After an episode of hemoglobinuria, RTE cells may contain:
A. Bilirubin
B. Hemosiderin granules
C. Porphobilinogen
D. Myoglobin
B. Hemosiderin granules
The predecessor of the oval fat body is the:
A. Histiocyte
B. Urothelial cell
C. Monocyte
D. Renal tubular cell
D. Renal tubular cell
A structure believed to be an oval fat body produced a Maltese cross formation under polarized light but does not stain with Sudan III. The structure:
A. Contains cholesterol
B. Is not an oval fat body
C. Contains neutral fats
D. Is contaminated with immersion oil
A. Contains cholesterol
The finding of yeast cells in the urine is commonly
associated with:
A. Cystitis
B. Diabetes mellitus
C. Pyelonephritis
D. Liver disorders
B. Diabetes mellitus
The primary component of urinary mucus is:
A. Bence Jones protein
B. Microalbumin
C. Uromodulin
D. Orthostatic protein
C. Uromodulin
The majority of casts are formed in the:
A. Proximal convoluted tubules
B. Ascending loop of Henle
C. Distal convoluted tubules
D. Collecting ducts
C. Distal convoluted tubules
Cylindruria refers to the presence of:
A. Cylindrical renal tubular cells
B. Mucus-resembling casts
C. Hyaline and waxy casts
D. All types of casts
D. All types of casts
A person submitting a urine specimen after a strenuous exercise routine normally can have all of the following in the sediment except:
A. Hyaline casts
B. Granular casts
C. RBC casts
D. WBC casts
D. WBC casts
Before identifying an RBC cast, all of the following should be observed:
A. Free-floating RBCs
B. Intact RBCs in the cast matrix
C. A positive reagent strip blood reaction
D. All of the above
D. All of the above
WBC casts are associated primarily with:
A. Pyelonephritis
B. Cystitis
C. Glomerulonephritis
D. Viral infections
A. Pyelonephritis
The shape of the RTE cell associated with RTE casts is primarily:
A. Elongated
B. Cuboidal
C. Round
D. Columnar
C. Round
When observing RTE casts, the cells are primarily:
A. Embedded in a clear matrix
B. Embedded in a granular matrix
C. Attached to the surface of a matrix
D. Stained by components of the urine filtrate
C. Attached to the surface of a matrix
The presence of fatty casts is associated with:
A. Nephrotic syndrome
B. Crush injuries
C. Diabetes mellitus
D. All of the above
D. All of the above
Nonpathogenic granular casts contain:
A. Cellular lysosomes
B. Degenerated cells
C. Protein aggregates
D. Gram-positive cocci
A. Cellular lysosomes
All of the following are true about waxy casts except they:
A. Represent extreme urine stasis
B. May have a brittle consistency
C. Require staining to be visualized
D. Contain degenerated granules
C. Require staining to be visualized
Observation of broad casts represents:
A. Destruction of tubular walls
B. Dehydration and high fever
C. Formation in the collecting ducts
D. Both A and C
D. Both A and C
All of the following contribute to urinary crystals formation except:
A. Protein concentration
B. pH
C. Solute concentration
D. Temperature
A. Protein concentration
The most valuable initial aid for identifying crystals in a urine specimen is:
A. pH
B. Solubility
C. Staining
D. Polarized microscopy
A. pH
Crystals associated with severe liver disease include all of the following except:
A. Bilirubin
B. Leucine
C. Cystine
D. Tyrosine
C. Cystine
All of the following crystals routinely polarize except:
A. Uric acid
B. Cholesterol
C. Radiographic dye
D. Cystine
D. Cystine
Casts and fibers usually can be differentiated using:
A. Solubility characteristics
B. Patient history
C. Polarized light
D. Fluorescent light
C. Polarized light
Match the following crystals seen in acidic urine with
their description/identifying characteristics:
Amorphous urates:
A. Envelopes
B. Thin needles
C. Yellow-brown, whetstone
D. Pink sediment
E. Ovoid
D. Pink sediment
Match the following crystals seen in acidic urine with
their description/identifying characteristics:
Uric acid:
A. Envelopes
B. Thin needles
C. Yellow-brown, whetstone
D. Pink sediment
E. Ovoid
C. Yellow-brown, whetstone
Match the following crystals seen in acidic urine with
their description/identifying characteristics:
Calcium oxalate monohydrate:
A. Envelopes
B. Thin needles
C. Yellow-brown, whetstone
D. Pink sediment
E. Ovoid
E. Ovoid
Match the following crystals seen in acidic urine with
their description/identifying characteristics:
Calcium oxalate dihydrate:
A. Envelopes
B. Thin needles
C. Yellow-brown, whetstone
D. Pink sediment
E. Ovoid
A. Envelopes
Match the following crystals seen in alkaline urine with
their description/identifying characteristics:
Triple phosphate:
A. Yellow granules
B. Thin prisms
C. “Coffin lids”
D. Dumbbell shape
E. White precipitate
F. Thorny apple
C. “Coffin lids”
Match the following crystals seen in alkaline urine with
their description/identifying characteristics:
Amorphous phosphate:
A. Yellow granules
B. Thin prisms
C. “Coffin lids”
D. Dumbbell shape
E. White precipitate
F. Thorny apple
E. White precipitate
Match the following crystals seen in alkaline urine with
their description/identifying characteristics:
Calcium phosphate:
A. Yellow granules
B. Thin prisms
C. “Coffin lids”
D. Dumbbell shape
E. White precipitate
F. Thorny apple
B. Thin prisms
Match the following crystals seen in alkaline urine with
their description/identifying characteristics:
Ammonium biurate:
A. Yellow granules
B. Thin prisms
C. “Coffin lids”
D. Dumbbell shape
E. White precipitate
F. Thorny apple
F. Thorny apple
Match the following crystals seen in alkaline urine with
their description/identifying characteristics:
Calcium carbonate:
A. Yellow granules
B. Thin prisms
C. “Coffin lids”
D. Dumbbell shape
E. White precipitate
F. Thorny apple
D. Dumbbell shape
Match the following abnormal crystals with their
description/identifying characteristics:
CYSTINE
A. Bundles after refrigeration
B. Highly alkaline pH
C. Bright yellow clumps
D. Hexagonal plates
E. Flat plates, high specific gravity
F. Concentric circles, radial striations
G. Notched corners
H. Fine needles seen in liver disease
D. Hexagonal plates
Match the following abnormal crystals with their
description/identifying characteristics:
TYROSINE
A. Bundles after refrigeration
B. Highly alkaline pH
C. Bright yellow clumps
D. Hexagonal plates
E. Flat plates, high specific gravity
F. Concentric circles, radial striations
G. Notched corners
H. Fine needles seen in liver disease
H. Fine needles seen in liver disease
Match the following abnormal crystals with their
description/identifying characteristics:
CHOLESTEROL
A. Bundles after refrigeration
B. Highly alkaline pH
C. Bright yellow clumps
D. Hexagonal plates
E. Flat plates, high specific gravity
F. Concentric circles, radial striations
G. Notched corners
H. Fine needles seen in liver disease
G. Notched corners
Match the following abnormal crystals with their
description/identifying characteristics:
LEUCINE
A. Bundles after refrigeration
B. Highly alkaline pH
C. Bright yellow clumps
D. Hexagonal plates
E. Flat plates, high specific gravity
F. Concentric circles, radial striations
G. Notched corners
H. Fine needles seen in liver disease
F. Concentric circles, radial striations
Match the following abnormal crystals with their
description/identifying characteristics:
AMPICILLIN
A. Bundles after refrigeration
B. Highly alkaline pH
C. Bright yellow clumps
D. Hexagonal plates
E. Flat plates, high specific gravity
F. Concentric circles, radial striations
G. Notched corners
H. Fine needles seen in liver disease
A. Bundles after refrigeration
Match the following abnormal crystals with their
description/identifying characteristics:
RADIOGRAPHIC DYE
A. Bundles after refrigeration
B. Highly alkaline pH
C. Bright yellow clumps
D. Hexagonal plates
E. Flat plates, high specific gravity
F. Concentric circles, radial striations
G. Notched corners
H. Fine needles seen in liver disease
E. Flat plates, high specific gravity
Match the following abnormal crystals with their
description/identifying characteristics:
BILIRUBIN
A. Bundles after refrigeration
B. Highly alkaline pH
C. Bright yellow clumps
D. Hexagonal plates
E. Flat plates, high specific gravity
F. Concentric circles, radial striations
G. Notched corners
H. Fine needles seen in liver disease
C. Bright yellow clumps
Match the following descriptions with the appropriate type of microscopy:
Indirect light is reflected off the object:
A. Bright-field
B. Phase
C. Polarized
D. Dark-field
E. Fluorescent
F. Interference contrast
D. Dark-field
Match the following descriptions with the appropriate type of microscopy:
Objects split light into two beams:
A. Bright-field
B. Phase
C. Polarized
D. Dark-field
E. Fluorescent
F. Interference contrast
C. Polarized
Match the following descriptions with the appropriate type of microscopy:
Low-refractive-index objects may be overlooked:
A. Bright-field
B. Phase
C. Polarized
D. Dark-field
E. Fluorescent
F. Interference contrast
A. Bright-field
Match the following descriptions with the appropriate type of microscopy:
Three-dimensional images:
A. Bright-field
B. Phase
C. Polarized
D. Dark-field
E. Fluorescent
F. Interference contrast
F. Interference contrast
Match the following descriptions with the appropriate type of microscopy:
Forms halo of light around object:
A. Bright-field
B. Phase
C. Polarized
D. Dark-field
E. Fluorescent
F. Interference contrast
B. Phase
Match the following descriptions with the appropriate type of microscopy:
Detects specific wavelengths of light emitted from objects:
A. Bright-field
B. Phase
C. Polarized
D. Dark-field
E. Fluorescent
F. Interference contrast
E. Fluorescent
