7.2 Urine Microscopy and Clinical Correlations Flashcards
Which of the following dyes are used to make Sternheimer-Malbin stain?
A. Hematoxylin and eosin
B. Crystal violet and safranin
C. Methylene blue and eosin
D. Methylene blue and safranin
B. Crystal violet and safranin
Which of the following statements regarding WBCs in urinary sediment is true?
A. “Glitter cells” seen in urinary sediment are a sign of renal disease
B. Bacteriuria in the absence of WBCs indicates lower urinary tract infection (UTI)
C. WBCs other than PMNs are not found in urinary sediment
D. WBC casts indicate that pyuria is of renal, rather than lower urinary, origin
D. 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?
A. Transitional epithelium: cytoplasm pale blue, nucleus dark blue
B. Renal epithelium: cytoplasm light blue, nucleus dark purple
C. Glitter cells: cytoplasm dark blue, nucleus dark purple
D. Squamous epithelium: cytoplasm pink, nucleus pale blue
A. 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?
A. Myoglobin is present in the sample
B. Free hemoglobin is present
C. Insufficient volume is causing microscopic results to be underestimated
D. Some WBCs have been misidentified as RBCs
C. Insufficient volume is causing microscopic results to be underestimated
Which of the following statements regarding epithelial cells in the urinary system is correct?
A. Caudate epithelial cells originate from the upper urethra
B. Transitional cells originate from the upper urethra, ureters, bladder, or renal pelvis
C. Cells from the proximal renal tubule are usually round
D. Squamous epithelium line the vagina, urethra, and wall of the urinary bladder
B. Transitional cells originate from the upper urethra, ureters, bladder, or renal pelvis
Which of the statements regarding examination of unstained urinary sediment is true?
A. Renal cells can be differentiated reliably from WBCs
B. Large numbers of transitional cells are often seen after catheterization
C. Neoplastic cells from the bladder are not found in urinary sediment
D. RBCs are easily differentiated from nonbudding yeast
B. Large numbers of transitional cells are often seen after catheterization
Which of the following statements regarding cells found in urinary sediment is true?
A. Transitional cells resist swelling in hypotonic urine
B. Renal tubular cells are often polyhedral and have an eccentric round nucleus
C. Trichomonads have an oval shape with a prominent nucleus and a single anterior flagellum
D. Clumps of bacteria are frequently mistaken for blood casts
B. 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?
A. Yeast cells will lyse in dilute acetic acid but RBCs will not
B. RBCs are often swollen in hypertonic urine
C. RBCs of glomerular origin often appear dysmorphic
D. Yeast cells will tumble when the cover glass is touched, but RBCs will not
C. RBCs of glomerular origin often appear dysmorphic
Renal tubular epithelial cells are shed into urine in largest numbers in which condition?
A. Malignant renal disease
B. Acute glomerulonephritis
C. Nephrotic syndrome
D. Cytomegalovirus (CMV) infection of the kidney
D. Cytomegalovirus (CMV) infection of the kidney
The ova of which parasite is likely be found in the urinary sediment?
A. Trichomonas vaginalis
B. Entamoeba histolytica
C. Schistosoma hematobium
D. Trichuris trichiura
C. Schistosoma hematobium
Oval fat bodies are often seen in:
A. Chronic glomerulonephritis
B. Nephrotic syndrome
C. Acute tubular nephrosis
D. Renal failure of any cause
B. Nephrotic syndrome
Which statement regarding urinary casts is true?
A. Many hyaline casts may appear in urinary sediment after jogging or exercise
B. The finding of even a single cast indicates renal disease
C. Casts can be seen in significant numbers even when protein tests are negative
D. Hyaline casts will dissolve readily in acid urine
A. Many hyaline casts may appear in urinary sediment after jogging or exercise
Which condition promotes the formation of casts in urine?
A. Chronic production of alkaline urine
B. Polyuria
C. Reduced filtrate formation
D. Low urine SG
C. Reduced filtrate formation
The mucoprotein that forms the matrix of a hyaline cast is called:
A. Bence-Jones protein
B. β-Microglobulin
C. Tamm-Horsfall protein
D. Arginine-rich glycoprotein
C. Tamm-Horsfall protein
“Pseudocasts” are often caused by:
A. A dirty cover glass or slide
B. Bacterial contamination
C. Amorphous urates
D. Mucus in urine
C. Amorphous urates
Which of the following statements regarding urinary casts is correct?
A. Fine granular casts are more significant than coarse granular casts
B. Cylindruria is always clinically significant
C. The appearance of cylindroids signals the onset of end-stage renal disease
D. Broad casts are associated with severe renal tubular obstruction
D. Broad casts are associated with severe renal tubular obstruction
A sediment with moderate hematuria and RBC casts most likely results from:
A. Chronic pyelonephritis
B. Nephrotic syndrome
C. Acute glomerulonephritis
D. Lower urinary tract obstruction
C. Acute glomerulonephritis
Urine sediment characterized by pyuria with bacterial and WBC casts indicates:
A. Nephrotic syndrome
B. Pyelonephritis
C. Polycystic kidney disease
D. Cystitis
B. Pyelonephritis
