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MTAP1: AUBF > CHAPTER 7: MICROSCOPIC EXAM > Flashcards

CHAPTER 7: MICROSCOPIC EXAM Flashcards

1
Q

May cause precipitation of amorphous urates and phosphates and other nonpathologic crystals that can obscure other elements in the urine sediment

A

Refrigeration

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2
Q

Standard amount of urine

A

10 - 15 mL (12mL: frequently used)

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3
Q

Recommended volume when using the conventional glass-slide method

A

20 uL (0.02 mL)

*covered by a 22 x 22 mm glass cover slip

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4
Q

How many fields should be observed and in what power?

A

Min. of 10 fields, under both low (10x) and high (40x) power

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5
Q

The slide is examined in this power to detect casts and ascertain the general composition of the sediment.

A

low power

*locate near the edges of the cover slip

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6
Q

Note:

R e p o r t i n g
1) casts: ave #/10 lpf
2) RBCs & WBCs: ave#/10 hpf
3) epithelial & crystals: rare, few, mod, many (1+, 2+, ….)

A
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7
Q

Developed the first procedure to standardize the quantitation of formed elements in the urine microscopic analysis in 1926

A

Addis

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8
Q

Most frequently used stain in urinalysis which consists of crystal violet and safranin O

A

Sternheimer-Malbin stain

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9
Q

Used for the visualization of elements with low refractive indices (hyaline casts, cellular casts, mucous threads, Trichomonas)

A

Phase-contrast microscopy

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10
Q

Used for the identification of cholesterol in Oval Fat Bodies and crystals

A

Polarizing microscopy

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11
Q

This stain delineates the structure and contrasting colors of the nucleus and cytoplasm.

ID: WBCs, epithelial cells, and casts

A

Sternheimer-Malbin

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12
Q

This stain enhances nuclear detail.

Differentiates WBCs and RTE

A

Toluidine blue

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13
Q

This stain lyses RBCs and enhances nuclei of WBCs.

Distinguishes RBCs from WBCs, yeast, oil droplets, and crystals

A

2% acetic acid

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14
Q

Stains triglycerides and neutral fats orang-red. It does not stain cholesterol.

A

Oil Red O and Sudan III (Lipid stains)

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15
Q

A stain that identifies bacterial casts either positive or negative.

A

Gram stain

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16
Q

This stain identifies urinary eosinophils

A

Hansel stain

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17
Q

Stains structures containing iron.

Identifies yellow-brown granules of hemosiderin in cells and casts

A

Prussian blue stain

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18
Q

NV:

1) RBCs
2) WBCs

A

1) 0-2 or 0-3/hpf
2) 0-5 or 0-8/hpf

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19
Q

In _______________ urine, the cells shrink due to loss of water and may appear crenated or irregularly shaped.

A

hypersthenuric/ hypertonic/concentrated

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20
Q

In _____________ urine, the cells absorb water, swell, and lyse rapidly, releasing their hemoglobin and leaving only the cell membrane.

A

dilute/hypotonic/hypothenuria

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21
Q

Large empty cells

A

ghost cells

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22
Q

RBCs that vary in size, have cellular protrusions, or are fragmented and have been associated primarily with glomerular bleeding

A

Dysmorphic

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23
Q

The dysmorphic cell most closely associated with glomerular bleeding

A

Acanthocyte with multiple protrusions

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24
Q

Predominant WBC found in the urine sediment.

A

Neutrophils

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25
Q

Brownian movement of the granules within these large wbcs produces a sparkling appearance, and they are referred to as _____________.

A

Glitter cells

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26
Q

Its presence in the urine is associated with drug-induced interstitial nephritis, UTI, and renal transplant rejection.

A

Eosinophils

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27
Q

Significant percentage of eosinophils in urine

A

> 1%

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28
Q

Quantitative measure of formed elements or urine using hemacytometer

A

Addis count

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29
Q

Specimen for Addis Count and preservative used.

A

12 hr urine; formalin

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30
Q

Increase in urinary WBCs that indicates infection or inflammation in the genitourinary system.

A

Pyuria

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31
Q

The largest cells found in the urine sediment

A

squamous epithelial cells

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32
Q

A variation of the squamous epithelial cell
which does have pathologic significance and are indicative of vaginal infection by the bacterium Gardnerella vaginalis.

A

Clue cells

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33
Q

Cells that are smaller than squamous cells and appear in several forms, including spherical, polyhedral, and caudate

A

Transitional (Urothelial) Cells

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34
Q

Increased numbers of these cells are seen singly, in pairs or in clumps (syncytia) which are present following invasive urologic
procedures such as catheterization and are of no clinical significance.

A

Transitional (Urothelial) Cells

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35
Q

For RTE cells,

1) rectangular, columnar/convoluted
2) round/oval

a. PCT
b. DCT

A

1) rectangular, columnar/convoluted
- PCT
2) round/oval
- DCT

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36
Q

Cells often present as a result of tissue destruction (necrosis)

A

RTE cells

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37
Q

Number of RTE cells per hpf that indicates tubular injury

A

> 2

38
Q

Contain the characteristic yellow-brown hemosiderin granules

A

RTE cells

39
Q

Lipid containing RTE cells

A

Oval Fat Body

40
Q

Examination of oval fat bodies using polarized light results in the appearance of characteristic _____________ formations in droplets containing
cholesterol.

A

maltese cross

41
Q

RTE cells containing large, nonlipid-filled vacuoles seen along with normal renal tubular cells and oval fat bodies in Acute Tubular Necrosis.

A

Bubble cells

42
Q

The bacteria most frequently associated with UTI

A

Enterobacteriaceae ( gram-negative rods)

  • also Staphylococcus and Enterococcus (cocci-shaped)
43
Q

Yeast cells seen in the urine of diabetic patients, immunocompromised patients, and women with vaginal moniliasis

A

Candida albicans

44
Q

Its presence counts for a true yeast infection

A

WBCs

45
Q

A trophozoite, pear-shaped flagellate with an undulating membrane, identified by its rapid darting movement

A

Trichomonas vaginalis

46
Q

Causes pingpong disease

A

T. vaginalis

47
Q

A bladder parasite whose ova can be seen in urine

A

S. haematobium

48
Q

Most common fecal contaminant

A

E. vermicularis

49
Q
A
50
Q

Major constituent of mucus

A

Uromodulin

51
Q

A protein material produced by the glands and epithelial cells of the lower genitourinary tract and the RTE cells that appear microscopically as threadlike structures.

A

Mucus

52
Q

Only elements found in the urinary sediment that are unique to the kidney

A

Casts

53
Q

Where the casts are formed providing the microscopic view of conditions within the nephron

A

DCT and CD

54
Q

Major constituent of casts

A

Tamm-Horsfall Protein (Uromodulin)

55
Q

Formation of casts at the junction of the ascending loop of Henle and the DCT may produce structures with a tapered end.

A

Cylindroids

56
Q

Refers to the presence of urinary casts

A

Cylinduria

57
Q

Stain produces a pink color in hyaline casts

A

Sternheimer-Malbin

58
Q

Most frequently seen cast

A

Hyaline

59
Q

This cast indicates bleeding within the nephron

A

RBC cast

60
Q

These casts in the urine signifies infection or inflammation within the nephron and are most frequently associated with pyelonephritis and are a primary marker for distinguishing pyelonephritis (upper UTI) from cystitis (lower UTI).

A

WBC casts

61
Q

Confirmation of bacterial casts is best made by performing a ______________ on the dried or cytocentrifuged sediment.

A

Gram stain

62
Q

Origin of the granular cast in nonpathological conditions

A

Lysosomes

63
Q

Formed from the disintegration of cellular casts

A

Fine/Course Granular Cast

64
Q

Seen in conjunction with oval fat bodies and free fat droplets in disorders causing lipiduria. These are associated most frequently with nephrotic syndrome.

A

Fatty casts

65
Q

These casts are representative of extreme urine stasis, indicating chronic renal failure. It is believed to be caused by degeneration of the hyaline cast matrix and any cellular elements or granules contained in the matrix (all)

A

Waxy casts

66
Q

Often appear fragmented with jagged ends and have notches in their sides

A

Waxy casts

67
Q

Often referred to as renal failure casts

A

Broad casts

68
Q

These casts indicates destruction (widening) of the tubular walls.

A

Broad casts

69
Q

Bile stained casts that are seen as the result of tubular necrosis caused by viral hepatitis

A

Broad, waxy

70
Q

Formed by the precipitation of urine solutes, including inorganic salts, organic compounds, and medications (iatrogenic compounds)

A

Crystals

71
Q

1) organic and iatrogenic compounds
2) inorganic salts

a. Acidic pH
b. Alkaline pH

A

1) organic/iatrogenic - acidic
2) inorganic - alkaline

72
Q

A crystal that precipitates in both acidic and neutral urine

A

Calcium oxalate

73
Q

The most valuable initial aid for identifying crystals in a urine specimen

A

pH

74
Q

Normal acidic crystals in urine

A

Uric Acid
Amorphous Urates
Sodium Urate

75
Q

Normal alkaline crystals

A

Calcium phosphate
Amorphous phosphate
Triple phosphate
Ammonium biurate
Calcium carbonate

76
Q

Crystals encountered frequently in specimens that have been refrigerated but disappear when the urine is warmed. They produce a very characteristic pink sediment caused by accumulation of the pigment uroerythrin on the surface of the granules

A

Amorphous urates

77
Q

Crystal with variety of shapes: Rhombic, wedge, rosette, hexagonal, four-sided plate (whetstone)

A

Uric acid

78
Q

Increased amounts of these crystals are seen in patients with leukemia who are receiving chemotherapy, in patients with Lesch-Nyhan syndrome, and sometimes in patients with gout.

A

Uric acid

79
Q

Crystals that are needle shaped and are seen in synovial fluid during episodes of gout, but they also may appear in the urine

A

Sodium urate

80
Q

The most common form of calcium oxalate crystals

A

Dihydrate (weddelite)

81
Q

Majority of the composition of renal calculi

A

Calcium oxalate

82
Q

Coffin lid, “Struvite”, staghorn appearance that indicates the presence of urea-splitting bacteria

A

Triple phosphate

83
Q

Colorless, flat rectangular plates or thin prisms often in rosette formation

A

Calcium phosphate

84
Q

Frequently they are described as “thorny apples” because of their appearance as spicule-covered spheres and are almost always associated with old specimen

A

Ammonium biurate

85
Q

Crystals that appear as colorless, hexagonal plates and may be thick or thin

A

Cysteine

86
Q

They have a most characteristic appearance, resembling a rectangular plate with a notch in one or more corners

A

Cholesterol

87
Q

Crystals usually seen in liver disease

A

Tyrosine, leucine, bilirubin

88
Q

Colorless to yellow needles crystals more common in liver disease

A

Tyrosine

89
Q

Yellow-brown spheres w/ concentric circles and radial striations

A

Leucine

90
Q

Crystals appearing as clumped needles or granules w/ yellow color

A

Bilirubin

91
Q

Primary cause of sulfonamide crystallization

A

Inadequate hydration

92
Q

Rare observation of these crystals after massive doses of this penicillin compound without adequate hydration

A

Ampicillin

MTAP1: AUBF (17 decks)

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