7.2 Urine Microscopy and Clinical Correlations Flashcards

1
Q

Which of the following dyes are used to make Sternheimer-Malbin stain?

A

Crystal violet and safranin

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2
Q

Which of the following statements regarding WBCs in urinary sediment is true?

A

WBC casts indicate that pyuria is of renal, rather than lower urinary, origin

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3
Q

Which description of urinary sediment with the Sternheimer-Malbin stain is correct?

A

Transitional epithelium: cytoplasm pale blue, nucleus dark blue

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4
Q

SITUATION: A 5-mL urine specimen is submitted for routine urinalysis and is analyzed immediately. The SG of the sample is 1.012, and the pH is 6.5. The dry reagent strip blood test result is a large positive (3+), and the microscopic examination shows 11 to 20 RBCs/HPF. The leukocyte esterase reaction is a small positive (1+), and the microscopic examination shows 0 to 2 WBCs/HPF. What is the most likely cause of these results?

A

Insufficient volume is causing microscopic results to be underestimated

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5
Q

Which of the following statements regarding epithelial cells in the urinary system is correct?

A

Transitional cells originate from the upper urethra, ureters, bladder, or renal pelvis

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6
Q

Which of the statements regarding examination of unstained urinary sediment is true?

A

Large numbers of transitional cells are often seen after catheterization

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7
Q

Which of the following statements regarding cells found in urinary sediment is true?

A

Renal tubular cells are often polyhedral and have an eccentric round nucleus

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8
Q

Which of the following statements regarding RBCs in the urinary sediment is true?

A

RBCs of glomerular origin often appear dysmorphic

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9
Q

Renal tubular epithelial cells are shed into urine in largest numbers in which condition?

A

Cytomegalovirus (CMV) infection of the kidney

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10
Q

The ova of which parasite is likely be found in the urinary sediment?

A

Schistosoma hematobium

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11
Q

Oval fat bodies are often seen in:

A

Nephrotic syndrome

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12
Q

Which statement regarding urinary casts is true?

A

Many hyaline casts may appear in urinary sediment after jogging or exercise

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13
Q

Which condition promotes the formation of casts in urine?

A

Reduced filtrate formation

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14
Q

The mucoprotein that forms the matrix of a hyaline cast is called:

A

Tamm-Horsfall protein

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15
Q

“Pseudocasts” are often caused by:

A

Amorphous urates

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16
Q

Which of the following statements regarding urinary casts is correct?

A

Broad casts are associated with severe renal tubular obstruction

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17
Q

A sediment with moderate hematuria and RBC casts most likely results from:

A

Acute glomerulonephritis

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18
Q

Urine sediment characterized by pyuria with bacterial and WBC casts indicates:

A

Pyelonephritis

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19
Q

Which type of casts signals the presence of chronic renal failure?

A

Waxy casts

20
Q

SITUATION: Urinalysis of a sample from a patient suspected of having a transfusion reaction reveals small, yellow-brown crystals in the microscopic examination. Dry reagent strip tests are normal with the exception of a positive blood reaction (moderate) and trace positive protein. The pH of urine is 6.5. What test should be performed to positively identify the crystals?

A

Prussian blue stain

21
Q

When examining urinary sediment, which of the following is considered an abnormal finding?

A

1 renal cell cast per LPF

22
Q

SITUATION: A urine sample with a pH of 6.0 produces an abundance of pink sediment after centrifugation that appears as densely packed yellow- to reddish-brown granules under the microscope. The crystals are so dense that no other formed elements can be evaluated. What is the best course of action?

A

Suspend the sediment in prewarmed saline, and then repeat centrifugation

23
Q

How can hexagonal uric acid crystals be distinguished from cystine crystals?

A

Cystine gives a positive nitroprusside test after reduction with sodium cyanide

24
Q

The presence of tyrosine and leucine crystals together in urinary sediment usually indicates:

A

Chronic liver disease

25
Q

Which of the following crystals is considered nonpathological?

A

Ammonium biurate

26
Q

At which pH are ammonium biurate crystals usually found in urine?

A

Alkaline urine only

27
Q

Which of the following crystals is seen commonly in alkaline and neutral urine?

A

Magnesium ammonium phosphate

28
Q

Which crystal appears in urine as a long, thin hexagonal plate and is linked to ingestion of large amounts of benzoic acid?

A

Hippuric acid

29
Q

Small, yellow needles are seen in the sediment of a urine sample with a pH of 6.0. Which of the following crystals can be ruled out?

A

Cholesterol crystals

30
Q

Oval fat bodies are derived from:

A

Renal tubular epithelium

31
Q

Oval fat bodies are often associated with:

A

Lipoid nephrosis

32
Q

Urine of constant SG ranging from 1.008 to 1.010 most likely indicates

A

Renal tubular failure

33
Q

Which of the following characterizes prerenal failure, and helps to differentiate it from acute renal failure caused by renal disease?

A

BUN:creatinine ratio of 20:1 or higher

34
Q

Which of the following conditions characterizes chronic glomerulonephritis and helps differentiate it from acute glomerulonephritis?

A

Polyuria

35
Q

Which of the following conditions is seen in acute renal failure and helps differentiate it from prerenal failure?

A

Abnormal urinary sediment

36
Q

Which of the following conditions characterizes acute renal failure and helps differentiate it from chronic renal failure?

A

Hyperkalemia

37
Q

The serum concentration of which analyte is likely to be decreased in untreated cases of acute renal failure?

A

Calcium

38
Q

Which of the following conditions is associated with the greatest proteinuria?

A

Nephrotic syndrome

39
Q

Which of the following conditions is often a cause of glomerulonephritis?

A

Systemic lupus erythematosus (SLE)

40
Q

Acute pyelonephritis is commonly caused by:

A

Bacterial infection of medullary interstitium

41
Q

Which of the following is associated with nephrotic syndrome?

A

Hyperlipidemia

42
Q

Which of the following conditions is a characteristic finding in patients with obstructive renal disease?

A

Azotemia

43
Q

Whewellite and weddellite kidney stones are composed of:

A

Calcium oxalate

44
Q

Which of the following abnormal crystals is often associated with formation of renal calculi?

A

Cystine

45
Q

Which statement about renal calculi is true?

A

Calcium oxalate and calcium phosphate account for about three-fourths of all stones