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MEDL 203 > microscope exam > Flashcards

microscope exam Flashcards

1
Q

ghost cells

A

lysis/swelling of the RBCs

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2
Q

glitter cells

A

lysis/swelling of WBCs

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3
Q

hematuria

A

increased # of RBCs

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4
Q

pyuria

A

increased # of WBCs

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5
Q

pyuria is associated with…

A

an inflammatory process in or adjacent to the urinary tract

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6
Q

urine should not be left in refrigerated for more than ** hours

A

2 hours

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7
Q

yeast cells are smaller than?

A

RBCs and clump together

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8
Q

WBCs usually bigger than?

A

RBCs

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9
Q

where are RTEs found

A

from the tubules of the nephrons in the kidney

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10
Q

where are transitional cells found

A

from the renal pelvis, ureters, urinary bladder and proximal 2/3 of the urethra

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11
Q

where are squamous cells found

A

the terminal end of the urethra and from the vagina

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12
Q

increased # of RTEs in the sediment indicate?

A

inflammation within the kidney or lower urinary tract
due to:
- agents like heavy metals
- renal infections such as pyelonephritis (damage to kidney)
- blood is not reaching the kidney (necrosis)

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13
Q

RBCs companied with casts is an indication of?

A

bleeding from kidney

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14
Q

affect on urine sample sitting for over 2 hours

A

start to get bacterial growth

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15
Q

progressive loss of functioning nephrons that occurs over time?

A

chronic renal failure

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16
Q

WBC 30/HPF + RBC 10 - 15/HPF + bacteria?

A

urinary tract infection (notice no casts)

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17
Q

glucose interferences

A

false negative: high levels of ascorbic acid, improperly stored specimens

false positive: oxidizing agents like hydrogen peroxide or bleach contamination

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18
Q

bilirubin interferences

A

false negative: (same as glucose + nitrites) ascorbic acid, nitrites, improper storage

false positive: medications that induce colour in urine (phenazopyridine, indican, lodine)

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19
Q

false positive medication in bilirubin

A

phenazopyridine (UTI)
indican (over growth of anaerobic bacteria)
lodine (arthritis)

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20
Q

interferences of urobilinogen

A

false negative: nitrites, formalin, urine not at room temp or fresh

false positive: some drugs, atypical urines

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21
Q

what analytes does not react to tests?

A

urobilinogen and conjugated bilirubin

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22
Q

what analyte is insoluble and less reactive

A

conjugated bilirubin

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23
Q

what are the 3 ketone bodies & their percent

A

acetone 2%
acetoacetic acid 20%
B-hydroxybutyric acid 78%

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24
Q

ketonuria

A

elevated levels of ketone bodies in blood that results in their excretion into the urine

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25
Q

ketosis or ketoacidosis

A

diabetes mellitus and decreased carbohydrates supply

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26
Q

diabetes mellitus

A

body unable to use carbohydrates as an energy source, uses fat stores instead

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27
Q

symptoms of decreased carbohydrates

A

starvation, fever, prolonged exercise, dietary imbalance

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28
Q

interferences of ketones

A

false negative: improper storage specimens

false positive: highly pigmented urine, compounds containing free sulfhydral groups

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29
Q

what are the compounds containing free sulfhydral groups?

A

phthaleins (in laxatives) and levodopa (used to treat parkinsons)

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30
Q

low SG

A

dilute
- over hydration
- diabetes insipidus
- renal tubular damage
- diuretics

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31
Q

high SG

A

concentrated
- dehydration
- glycosuria
- proteinuria
-xray contrast dye

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32
Q

ketone interferences for SG

A

false low SG: (diluted urine) urines containing large amounts of nonionic solutes (ex glucose)
- these solutes are not readily detected on the dipstick

false high SG: (concentrated urine) patients that have elevated protein levels or patients with ketoacidosis (increased ketones)

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33
Q

if the pH of the urine is >6.5 how much do i add to the SG reader?

A

0.005

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34
Q

kohler illumination

A

provides optimum contrast and resolution by focusing and centring the light path by spreading it evenly over the field of view.

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35
Q

eye piece (ocular)

A

magnifies the image formed by the objective and produces a virtual picture

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36
Q

inter-pupillary adjustment

A

allows for individual adjustment for the distance between my pupils

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37
Q

ergonomic head and body tube

A

holds objectives and oculars in proper alignment

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38
Q

light path selector

A

pull out lever directs the image to a camera

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39
Q

revolving nose piece

A

holds the objectives and allows the changing from one objective to another

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40
Q

objective lenses

A

produces initial, magnified, real image of object

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41
Q

stage

A

platform on which a slide is placed for viewing

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42
Q

slider holder

A

holds a slide securely in position

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43
Q

coaxial stage controls

A

moves stage on horizontal plane; back and forth and side to side

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44
Q

condenser assembly

A

lens system that focuses light onto the specimen (includes aperture diaphragm, centring screws and height adjustment))

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45
Q

condenser aperture diaphragm

A

adjusted in kohler illumination to match the numerical aperture of the objective in use and improve resolution

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46
Q

condenser centering screws

A

adjuster in kohler to ensure light is in the center of the field of view

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47
Q

condenser height adjustment

A

adjusts the condenser position up or down. used in kohler to focus light onto specimen

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48
Q

coarse focus

A

moves the stage up and down for initial focusing. used only with low power objectives (10X)

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49
Q

fine focus

A

final focusing of specimen. may be used with all objective sizes

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50
Q

radiant field diaphragm (RFD)

A

controls the amount of light from the light source to the condenser lens

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51
Q

brightness control

A

adjusts the intensity of light

52
Q

light source

A

electrical lamp located in the backside of the base

53
Q

base and arm

A

supports the microscope parts

54
Q

hpf for RBCs

A

3-5 hpf

55
Q

hpf for WBCs

A

6-10 hpf

56
Q

example of cellular casts

A

RTE, RBC, and WBC casts

57
Q

example of non cellular casts

A

hyaline, granular, fatty, waxy casts

58
Q

lipids/fats + massive proteinuria is what condition?

A

nephrotic syndrome

59
Q

casts with long renal transit time is what condition?

A

waxy casts

60
Q

increased WBCs + WBC casts + minimal proteinuria is what condition

A

pyelonephritis

61
Q

epithelial casts are an indication of what condition?

A

tubular necrosis

62
Q

miscellaneous elements are

A

yeast, bacteria, spermatozoa etc

63
Q

if the SG is high what will happen?

A

RBCs will appear shrunken or crenated

64
Q

if the SG is low what happens

A

RBCs will be swollen or will rapidly break apart

65
Q

the matrix of casts are primarily composed of

A

tamm-horsefall protein & uromodulin

66
Q

the presence of casts in urine is what condition?

A

cylinduria

67
Q

hyaline casts are

A

colourless and transparent

68
Q

RBC casts are an indication of what condition?

A

glomerulonephritis

69
Q

waxy casts typically have

A

cracked or notched outlines

70
Q

free fat casts are

A

globular and a yellow brown colour

71
Q

oval fat bodies are

A

RTEs in which fat has accumulated

72
Q

crystals are found in urine when?

A

chemicals are present in excess of their solubility and the excess solutes in the urine form a solid

73
Q

most crystals are

A

diagnostically insignificant

74
Q

budding or branching is what cell?

A

yeast

75
Q

irregular shapes with dark outlines is what cell?

A

artifact

76
Q

what cell doesn’t have a nucleus?

A

RBCs

77
Q

what cell is large, flat, and may be rolled?

A

squamous

78
Q

what cell is nucleated, round or oval?

A

WBCs

79
Q

what cell has a round central nucleus?

A

RTEs

80
Q

what cell has a lumpy nucleus and granular?

A

transitional cell

81
Q

amorphous phosphates are?

A

white precipitate and can NOT be dissolved when warmed

82
Q

triple phosphate are?

A

described as “coffin lids”

83
Q

what crystal is colourless dumbbells, retractile envelopes?

A

calcium oxalate

84
Q

what crystal comes in a variety of shapes?

A

amorphous urates

85
Q

what crystal has a pink precipitate and can be dissolved when warmed

A

uric acid

86
Q

what abnormal crystal is delicate needles, red brown in colour?

A

bilirubin

87
Q

what abnormal crystal is colourless transparent plates with notched corners?

A

cholesterol

88
Q

what abnormal crystal is yellow, oily looking spheres with radial striations?

A

leucine

89
Q

what abnormal crystal is colourless hexagonal plates?

A

cystine

90
Q

what abnormal crystal is fine needles or sheaves?

A

tyrosine

91
Q

what miscellaneous element has dark outline and irregular shapes and sizes?

A

artifacts

92
Q

what miscellaneous element is same size as leukocytes, and motile due to flagella?

A

trichomonas vaginalis

93
Q

what miscellaneous element is oval in shape, slightly smaller than RBCs, buds?

A

yeast

94
Q

what miscellaneous element is long, ribbon like strands with tapered ends?

A

mucus threads

95
Q

what miscellaneous element is not identified by motility, but by morphology?

A

spermatozoa

96
Q

what are the 5 abnormal crystals?

A

bilirubin, leucine, tyrosine, cholesterol, cystine

97
Q

what is the most common type of leukocyte seen in urine sediment?

A

neutrophil

98
Q

what is the most common cast seen in microscopic urine examinations?

A

hyaline casts

99
Q

is cholesterol found in acidic urine?

A

yes

100
Q

are cystine crystals found in normal urine?

A

no

101
Q

do amorphous urates or amorphous phosphates dissolve by warming the outside of the tube?

A

amorphous urates DO

102
Q

the order of setting kohler

A

close RFD
open condenser aperture
raising condenser to highest position

103
Q

the renal threshold of glucose is approximately

A

10mmol/L

104
Q

which gland sits on the top of each kidney?

A

adrenal

105
Q

dysuria

A

painful urination

106
Q

daily volume of urine excretion for an average adult is

A

1000 mL to 2000 mL per day

107
Q

where are urinary cast formed?

A

DCT and CD

108
Q

which of the following sediment elements has clinical significance in a microscopic examination?

A

waxy granular cast

109
Q

what is one way to differentiate between RBC and WBC?

A

check the leukocyte result on the chemical dipstick

110
Q

which crystal appears as granular sediment in an acidic urine?

A

amorphous urates

111
Q

which crystal is best describes as ‘coffin lid’ and are seen in alkaline urine?

A

triple phosphate

112
Q

what portion of the spun urine is used for microscopic examination?

A

bottom 1mL sediment

113
Q

what protein is the commercial reagent dipstick specific for?

A

albumin

114
Q

which protein do renal tubular epithelial cells exude?

A

uromodulin

115
Q

which hormone is being tested for using a urine pregnancy test kit

A

human chorionic gonadotropin

116
Q

which enzyme activity is being measured on the leukocyte test strip on the commercial dipstick?

A

granulocytic esterase

117
Q

key components involved in the kohler procedure

A

RFD, height adjustment & centering screws, and condenser aperture diaphragm

118
Q

if cloudy urine what is the microscopic findings

A

WBC, RBC, bacteria, yeast, crystals, mucous

119
Q

if red colour what is the microscopic findings

A

RBCs

120
Q

if High SG what is the microscopic findings

A

crystals and CRENATED RBCs

121
Q

if Low SG what is the microscopic findings

A

glitter cells

122
Q

if acid pH what is the microscopic findings

A

crystals

123
Q

if alkaline pH what is the microscopic findings

A

crystals, WBCs, bacteria

124
Q

if glucose positive what is the microscopic findings

A

yeast

125
Q

if protein positive what is the microscopic findings

A

casts, WBC, RBC, and bacteria

126
Q

if nitrite positive and or leukocyte positive what is the microscopic findings

A

bacteria and WBCs

MEDL 203 (4 decks)

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