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Clinical Microscopy > HARR (URINE MICROSCOPY) > Flashcards

HARR (URINE MICROSCOPY) Flashcards

1
Q 
1. Which of the following dyes are used in
Sternheimer–Malbin stain?
A. Hematoxylin and eosin
B. Crystal violet and safranin
C. Methylene blue and eosin
D. Methylene blue and safranin
A

B

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2
Q
  1. Which of the following statements regarding
    WBCs in urinary sediment is true?
    A. “Glitter cells” seen in the 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
A

D

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3
Q
  1. Which description of sediment with
    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

A

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4
Q
  1. SITUATION: A 5-mL urine specimen is submitted
    for routine urinalysis and analyzed immediately.
    The SG of the sample is 1.012 and the pH is 6.5.
    The dry reagent strip test for blood is a large
    positive (3+) and the microscopic examination
    shows 11–20 RBCs per HPF. The leukocyte
    esterase reaction is a small positive (1+), and the
    microscopic examination shows 0–5 WBCs per
    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
A

C

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5
Q
  1. 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 in shape
    D. Squamous epithelium line the vagina, urethra,
    and wall of the urinary bladder
A

B

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6
Q
  1. Which of the statements regarding examination
    of unstained 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
A

B

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7
Q
  1. 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
A

B

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8
Q
  1. 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
A

C

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9
Q
  1. Renal tubular epithelial cells are shed into the
    urine in largest numbers in which condition?
    A. Malignant renal disease
    B. Acute glomerulonephritis
    C. Nephrotic syndrome
    D. Cytomegalovirus (CMV) infection of the kidney
A

D

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10
Q 
10. The ova of which parasite may be found in the
urinary sediment?
A. T. vaginalis
B. Entamoeba histolytica
C. Schistosoma hematobium
D. Trichuris trichiura
A

C

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11
Q 
11. Oval fat bodies are often seen in:
A. Chronic glomerulonephritis
B. Nephrotic syndrome
C. Acute tubular nephrosis
D. Renal failure of any cause
A

B

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12
Q
  1. All of the following statements regarding urinary
    casts are true except:
    A. Many hyaline casts may appear in sediment after
    jogging or exercise
    B. An occasional granular cast may be seen in a
    normal sediment
    C. Casts can be seen in significant numbers even
    when protein tests are negative
    D. Hyaline casts will dissolve readily in alkaline urine
A

C

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13
Q 
13. Which condition promotes the formation of casts
in the urine?
A. Chronic production of alkaline urine
B. Polyuria
C. Reduced filtrate formation
D. Low urine SG
A

C

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14
Q 
14. 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
A

C

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15
Q 
15. “Pseudocasts” are often caused by:
A. A dirty cover glass or slide
B. Bacterial contamination
C. Amorphous urates
D. Mucus in the urine
A

C

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16
Q
  1. 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
A

D

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17
Q 
17. 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
A

C

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18
Q 
18. Urine sediment characterized by pyuria with
bacterial and WBC casts indicates:
A. Nephrotic syndrome
B. Pyelonephritis
C. Polycystic kidney disease
D. Cystitis
A

B

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19
Q 
19. Which type of casts signals the presence of chronic
renal failure?
A. Blood casts
B. Fine granular casts
C. Waxy casts
D. Fatty casts
A

C

20
Q
  1. 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 the urine is 6.5. What test should be
    performed to positively identify the crystals?
    A. Confirmatory test for bilirubin
    B. Cyanide–nitroprusside test
    C. Polarizing microscopy
    D. Prussian blue stain
A

D

21
Q
  1. When examining urinary sediment, which of the
    following is considered an abnormal finding?
    A. 0–2 RBCs per HPF
    B. 0–1 hyaline casts per low-power field (LPF)
    C. 0–1 renal cell casts per LPF
    D. 2–5 WBCs per HPF
A

C

22
Q
  1. 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. Request a new urine specimen
    B. Suspend the sediment in prewarmed saline,
    then repeat centrifugation
    C. Acidify a 12-mL aliquot with three drops of
    glacial acetic acid and heat to 56°C for
    5 minutes before centrifuging
    D. Add five drops of 1N HCl to the sediment and
    examine
A

B

23
Q
  1. How can hexagonal uric acid crystals be
    distinguished from cystine crystals?
    A. Cystine is insoluble in hydrochloric acid but uric
    acid is soluble
    B. Cystine gives a positive nitroprusside test after
    reduction with sodium cyanide
    C. Cystine crystals are more highly pigmented
    D. Cystine crystals form at neutral or alkaline pH,
    uric acid forms at neutral to acidic pH
A

B

24
Q
  1. The presence of tyrosine and leucine crystals
    together in a urine sediment usually indicates:
    A. Renal failure
    B. Chronic liver disease
    C. Hemolytic anemia
    D. Hartnup disease
A

B

25
Q 
25. Which of the following crystals is considered
nonpathological?
A. Hemosiderin
B. Bilirubin
C. Ammonium biurate
D. Cholesterol
A

C

26
Q 
26. At which pH are ammonium biurate crystals
usually found in urine?
A. Acid urine only
B. Acid or neutral urine
C. Neutral or alkaline urine
D. Alkaline urine only
A

D

27
Q 
27. Which of the following crystals is seen commonly
in alkaline and neutral urine?
A. Calcium oxalate
B. Uric acid
C. Magnesium ammonium phosphate
D. Cholesterol
A

C

28
Q
  1. Which crystal appears in urine as a long, thin
    hexagonal plate, and is linked to ingestion of large
    amounts of benzoic acid?
    A. Cystine
    B. Hippuric acid
    C. Oxalic acid
    D. Uric acid
A

B

29
Q
  1. 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. Sulfa crystals
    B. Bilirubin crystals
    C. Uric acid crystals
    D. Cholesterol crystals
A

D

30
Q 
30. Oval fat bodies are derived from:
A. Renal tubular epithelium
B. Transitional epithelium
C. Degenerated WBCs
D. Mucoprotein matrix
A

A

31
Q 
31. Oval fat bodies are often associated with:
A. Lipoid nephrosis
B. Acute glomerulonephritis
C. Aminoaciduria
D. Pyelonephritis
A

A

32
Q 
32. Urine of constant SG ranging from 1.008 to 1.010
most likely indicates:
A. Addison’s disease
B. Renal tubular failure
C. Prerenal failure
D. Diabetes insipidus
A

B

33
Q
  1. 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
    B. Urine:plasma osmolal ratio less than 2:1
    C. Excess loss of sodium in the urine
    D. Dehydration
A

A

34
Q
  1. Which of the following conditions characterizes
    chronic glomerulonephritis and helps to
    differentiate it from acute glomerulonephritis?
    A. Hematuria
    B. Polyuria
    C. Hypertension
    D. Azotemia
A

B

35
Q
  1. Which of the following conditions is seen in acute
    renal failure and helps to differentiate it from
    prerenal failure?
    A. Hyperkalemia and uremia
    B. Oliguria and edema
    C. Low creatinine clearance
    D. Abnormal urinary sediment
A

D

36
Q
  1. Which of the following conditions characterizes
    acute renal failure and helps to differentiate it from
    chronic renal failure?
    A. Hyperkalemia
    B. Hematuria
    C. Cylindruria
    D. Proteinuria
A

A

37
Q
  1. The serum concentration of which analyte is likely
    to be decreased in untreated cases of acute renal
    failure?
    A. Hydrogen ions
    B. Inorganic phosphorus
    C. Calcium
    D. Uric acid
A

C

38
Q 
38. Which of the following conditions is associated
with the greatest proteinuria?
A. Acute glomerulonephritis
B. Chronic glomerulonephritis
C. Nephrotic syndrome
D. Acute pyelonephritis
A

C

39
Q 
39. Which of the following conditions is often a cause
of glomerulonephritis?
A. Hypertension
B. Cytomegalovirus infection
C. Systemic lupus erythematosus
D. Heavy metal poisoning
A

C

40
Q
  1. Acute pyelonephritis is commonly caused by:
    A. Bacterial infection of medullary interstitium
    B. Circulatory failure
    C. Renal calculi
    D. Antigen–antibody reactions within the glomeruli
A

A

41
Q 
41. All of the following are common characteristics
of the nephrotic syndrome except:
A. Hyperlipidemia
B. Hypoalbuminemia
C. Hematuria and pyuria
D. Severe edema
A

C

42
Q 
42. Which of the following conditions is a
characteristic finding in patients with
obstructive renal disease?
A. Polyuria
B. Azotemia
C. Dehydration
D. Alkalosis
A

B

43
Q 
43. Whewellite and weddellite kidney stones are
composed of:
A. Magnesium ammonium phosphate
B. Calcium oxalate
C. Calcium phosphate
D. Calcium carbonate
A

B

44
Q
  1. Which of the following abnormal crystals is often
    associated with formation of renal calculi?
    A. Cystine
    B. Ampicillin
    C. Tyrosine
    D. Leucine
A

A

45
Q
  1. Which statement about renal calculi is true?
    A. Calcium oxalate and calcium phosphate account
    for about three-fourths of all stones
    B. Uric acid stones can be seen by x-ray
    C. Triple phosphate stones are found principally
    in the ureters
    D. Stones are usually comprised of single salts
A

A

Clinical Microscopy (21 decks)

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