Book: Microscopic Examination 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
Provide results as soon as possible
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
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. Dilute alkaline urine
D. Using midstream clean-catch specimens
Dilute alkaline urine
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
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
Casts
Initial screening of the urine sediment is performed using
an objective power of:
A. 4×
B. 10×
C. 40×
D. 100×
10x
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
Rheostat
Which of the following are reported as number per lpf?
A. RBCs
B. WBCs
C. Crystals
D. Casts
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
Decrease precipitation of crystals
Nuclear detail can be enhanced by:
A. Prussian blue
B. Toluidine blue
C. Acetic acid
D. Both B and C
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
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
Cholesterol
The purpose of the Hansel stain is to identify:
A. Neutrophils
B. Renal tubular cells
C. Eosinophils
D. Monocytes
Eosinophils
Crenated RBCs are seen in urine that is:
A. Hyposthenuric
B. Hypersthenuric
C. Highly acidic
D. Highly alkaline
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
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
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
Glitter cells
Mononuclear leukocytes are sometimes mistaken for:
A. Yeast cells
B. Squamous epithelial cells
C. Pollen grains
D. Renal tubular cells
Renal tubular cells
When pyuria is detected in a urine sediment, the slide
should be carefully checked for the presence of:
A. RBCs
B. Bacteria
C. Hyaline casts
D. Mucus
Bacteria
Transitional epithelial cells are sloughed from the:
A. Collecting duct
B. Vagina
C. Bladder
D. Proximal convoluted tubule
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
Squamous epithelial cells
A clinically significant squamous epithelial cell is the:
A. Cuboidal cell
B. Clue cell
C. Caudate cell
D. Columnar cell
Clue cell
Forms of transitional epithelial cells include all of the following except:
A. Spherical
B. Caudate
C. Convoluted
D. Polyhedra
Convoluted
Increased transitional cells are indicative of:
A. Catheterization
B. Malignancy
C. Pyelonephritis
D. Both A and B
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
Eccentrically located nucleus
Following an episode of hemoglobinuria, RTE cells may contain:
A. Bilirubin
B. Hemosiderin granules
C. Porphobilinogen
D. Myoglobin
Hemosiderin granules
The predecessor of the oval fat body is the:
A. Histiocyte
B. Urothelial cell
C. Monocyte
D. Renal tubular cell
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
Contains cholesterol
The finding of yeast cells in the urine is commonly associated with:
A. Cystitis
B. Diabetes mellitus
C. Pyelonephritis
D. Liver disorders
Diabetes mellitus
The primary component of urinary mucus is:
A. Bence Jones protein
B. Microalbumin
C. Uromodulin
D. Orthostatic protein
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
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
All types of casts
A person submitting a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment except:
A. Hyaline casts
B. Granular casts
C. RBC casts
D. WBC casts
WBC casts
Prior to identifying an RBC cast, all of the following
should be observed except:
A. Free-floating RBCs
B. Intact RBCs in the cast
C. Presence of a cast matrix
D. A positive reagent strip blood reaction
Intact RBCs in the cast
WBC casts are primarily associated with:
A. Pyelonephritis
B. Cystitis
C. Glomerulonephritis
D. Viral infections
Pyelonephritis
The shape of the RTE cell associated with renal tubular
epithelial casts is primarily:
A. Elongated
B. Cuboidal
C. Round
D. Columnar
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
Embedded in a clear matrix
The presence of fatty casts is associated with:
A. Nephrotic syndrome
B. Crush injuries
C. Diabetes mellitus
D. All of the above
All of the above
Nonpathogenic granular casts contain:
A. Cellular lysosomes
B. Degenerated cells
C. Protein aggregates
D. Gram-positive cocci
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
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
Both A and C
All of the following contribute to urinary crystals formation except:
A. Protein concentration
B. pH
C. Solute concentration
D. Temperature
Protein concentration
The most valuable initial aid for identifying crystals in a
urine specimen is:
A. pH
B. Solubility
C. Staining
D. Polarized microscopy
pH
Crystals associated with severe liver disease include all of the following except:
A. Bilirubin
B. Leucine
C. Cystine
D. Tyrosine
Cystine
All of the following crystals routinely polarize except:
A. Uric acid
B. Cholesterol
C. Radiographic dye
D. Cystine
Cystine
Casts and fibers can usually be differentiated using:
A. Solubility characteristics
B. Patient history
C. Polarized light
D. Fluorescent light
Polarized light
Match the following crystals seen in acidic urine with their
description/identifying characteristics:
Amorphous urates
Uric acid
Calcium oxalate monohydrate
Calcium oxalate dihydrate
Pink sediment
Yellow-brown whetstone
Ovoid
Envelopes
Match the following crystals seen in acidic urine with their
description/identifying characteristics:
Triple phosphate
Amorphous phosphate
Calcium phosphate
Ammonium biurate
Calcium carbonate
Coffin lids
White precipitate
Thin prisms
Thorny apple
Dumbbell shape
Match the following abnormal crystals with their
description/identifying characteristics:
Cystine
Tyrosine
Cholesterol
Leucine
Ampicillin
Radiographic dye
Bilirubin
Hexagonal plates
Fine needles seen in
liver disease
Notched corners
Concentric circles,
radial striations
Bundles following
refrigeration
Flat plates, high
specific gravity
Match the following types of microscopy with their
descriptions:
Bright-field
Phase
Polarized
Dark-field
Fluorescent
Interference contrast
Low refractive index
objects may be overlooked
Forms halo of light around
object
Objects split light into two
beams
Indirect light is reflected
off the object
Detects specific wavelengths
of light emitted from objects
Three-dimensional images
