7.2 Urine Microscopy and Clinical Correlations Flashcards
Which of the following dyes are used to make Sternheimer-Malbin stain?
Crystal violet and safranin
Which of the following statements regarding WBCs in urinary sediment is true?
WBC casts indicate that pyuria is of renal, rather than lower urinary, origin
Which description of urinary sediment with the Sternheimer-Malbin stain is correct?
Transitional epithelium: cytoplasm pale blue, nucleus dark blue
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?
Insufficient volume is causing microscopic results to be underestimated
Which of the following statements regarding epithelial cells in the urinary system is correct?
Transitional cells originate from the upper urethra, ureters, bladder, or renal pelvis
Which of the statements regarding examination of unstained urinary sediment is true?
Large numbers of transitional cells are often seen after catheterization
Which of the following statements regarding cells found in urinary sediment is true?
Renal tubular cells are often polyhedral and have an eccentric round nucleus
Which of the following statements regarding RBCs in the urinary sediment is true?
RBCs of glomerular origin often appear dysmorphic
Renal tubular epithelial cells are shed into urine in largest numbers in which condition?
Cytomegalovirus (CMV) infection of the kidney
The ova of which parasite is likely be found in the urinary sediment?
Schistosoma hematobium
Oval fat bodies are often seen in:
Nephrotic syndrome
Which statement regarding urinary casts is true?
Many hyaline casts may appear in urinary sediment after jogging or exercise
Which condition promotes the formation of casts in urine?
Reduced filtrate formation
The mucoprotein that forms the matrix of a hyaline cast is called:
Tamm-Horsfall protein
“Pseudocasts” are often caused by:
Amorphous urates
Which of the following statements regarding urinary casts is correct?
Broad casts are associated with severe renal tubular obstruction
A sediment with moderate hematuria and RBC casts most likely results from:
Acute glomerulonephritis
Urine sediment characterized by pyuria with bacterial and WBC casts indicates:
Pyelonephritis
Which type of casts signals the presence of chronic renal failure?
Waxy casts
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?
Prussian blue stain
When examining urinary sediment, which of the following is considered an abnormal finding?
1 renal cell cast per LPF
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?
Suspend the sediment in prewarmed saline, and then repeat centrifugation
How can hexagonal uric acid crystals be distinguished from cystine crystals?
Cystine gives a positive nitroprusside test after reduction with sodium cyanide
The presence of tyrosine and leucine crystals together in urinary sediment usually indicates:
Chronic liver disease
