MICROSCOPIC EXAM OF URINE

Question 1

spx for addis count

Answer 1

12 hour urine

Question 2

preservative used for addis count

Answer 2

formalin

Question 3

used to clean the optical surfaces of the microscope

Answer 3

lens paper

Question 4

performs initial focusing (used for LPO and SO)

Answer 4

coarse adjustment knob

Question 5

secondary magnification

Answer 5

oculars or eyepiece

Question 6

lenses which form primary/initial image of specimen

Answer 6

objectives

Question 7

order from light source to oculars

Answer 7

light source > condenser > stage > objectives > oculars

Question 8

microscope used for routine urinalysis

Answer 8

bright field microscope

Question 9

microscope used that enhances visualization of translucent elements (low refractive indices like casts)

Answer 9

phase contrast microscope

Question 10

microscope that detects the presence or absence of birefringence

Answer 10

polarizing microscope

Question 11

microscopy used for identification of cholesterol in oval fat bodies, fatty casts, and crystals

Answer 11

polarizing microscopy

Question 12

to convert bright field into polarizing, add _____ filters

Answer 12

2 filters

Question 13

microscopy used for the identification of Treponema pallidum

Answer 13

dark field microscopy

Question 14

to convert bright field to dark field, __________ with a darkfield condenser that contains an opaque disk

Answer 14

replace the condenser

Question 15

3D microscopy image and layer by layer imaging of a specimen

Answer 15

interference contrast microscopy

Question 16

________ can be adapted for interference contrast microscopy

Answer 16

bright field microscopes

Question 17

two types interference contrast micrscope

Answer 17

Nomarski (differential interference contrast)
Hoffman ( Modulation contrast)

Question 18

delineates structure and constructing colors of the nucleus and cytoplasm

Answer 18

sternheimer-malbin

Question 19

components of sternheimer malbin stain

Answer 19

crystal violet and safranin O

Question 20

differentiates wbcs and rte cells

Answer 20

toluidine blue

Question 21

most commonly used supravital stain

Answer 21

sternheimer malbin stain

Question 22

distinguishes rbcs from wbcs, yeast, oil droplets and crystals

Answer 22

2% acetic acid

Question 23

stains triglycerides and neutral fats orange red

Answer 23

lipid stains (oil red o and sudan III)

Question 24

identifies hemosiderin granules

Answer 24

prussian blue (rous test)

Question 25

stains DNA

Answer 25

phenathridine (orange)

Question 26

stains nuclear membranes, mitochondrial, and cell membrane

Answer 26

carbocyanine (green)

Question 27

stains used by sysmex UF-100 urine cell analyzer

Answer 27

phenathridine carbocyanine

Question 28

rbcs normal value per HPF

Answer 28

0-2 or 0-3

Question 29

appearance of rbc in hypotonic urine

Answer 29

swell/lyse (ghost cells) / shadow cells

Question 30

rbcs appearance in glomerular membrane damage

Answer 30

dysmorphic with projections fragmented (acanthocytes)

Question 31

sources of error in rbc sediment

Answer 31

yeast, oil droplets, air bubbles, monohydrate calcium oxalate crystals

Question 32

remedy for rbc error

Answer 32

add 2% acetic acid

Question 33

most predominant wbc seen in pyuria

Answer 33

neutrophils

Question 34

in _____ urine, neutrophils swell, and granules undergo ________ ________ producing sparkling appearance (______ ______)

Answer 34

hypotonic urine ; brownian movement ; glitter cells

Question 35

normal value of eosinophil in pyuria

Answer 35

1%

Question 36

significant value of eosinophil seen in pyuria

Answer 36

>1%

Question 37

>1% eosinophil is seen in what condition

Answer 37

acute interstitial nephritis

Question 38

sternheimer malbin cells that appear pale blue

Answer 38

glitter cells

Question 39

sternheimer malbin cells that appear pale pink

Answer 39

leukocytes

Question 40

largest cell

Answer 40

squamous epithelial cell

Question 41

squamous epithelial cell covered with Gardnerella vaginalis

Answer 41

clue cells

Question 42

associated with bacterial vaginosis

Answer 42

clue cells

Question 43

spherical, polyhedral or caudate with CENTRALLY LOCATED NUCLEUS

Answer 43

transitional epithelial (urothelial) cell

Question 44

epithelial cell derived from renal pelvis, calyces, ureter

Answer 44

transitional epithelial cells

Question 45

most clinically significant epithelial cell

Answer 45

renal tubular epithelial cell

Question 46

epithelial cell with eccentric nucleus

Answer 46

renal tubular epithelial cell

Question 47

shape of rte cell if found in collecting duct

Answer 47

cuboidal with flat edge, polygonal, columnar

Question 48

>2 RTE / hpf indicates

Answer 48

tubular injury

Question 49

renal tubular fat bodies

Answer 49

oval fat bodies

Question 50

highly refractile RTE cell

Answer 50

oval fat bodies

Question 51

seen in lipiduria (nephrotic syndrome)

Answer 51

oval fat bodies

Question 52

sediment that forms MALTESE CROSS FORMATION as seen in polarizing microscope

Answer 52

cholesterol

Question 53

- rte cell with non lipid vacuoles - injured cells in which the endoplasmic reticulum has dilated prior to cell death - seen in acute tubular necrosis

Answer 53

bubble cells

Question 54

most frequent parasite encountered in urine

Answer 54

Trichomonas vaginalis

Question 55

agent of ping pong disease

Answer 55

t. vaginalis

Question 56

parasite associated with bladder cancer

Answer 56

schistosoma hematobium

Question 57

urinary bladder cancer markers

Answer 57

NMP - nuclear matrix protein BTA - bladder tumor antigen

Question 58

urinary sediment with low refractive index

Answer 58

mucus threads

Question 59

major constituents of mucus threads

Answer 59

tamm-horsefall protein (uromodulin)

Question 60

BACTERIA: rare

Answer 60

0-10

Question 61

BACTERIA: few

Answer 61

10-50

Question 62

NORMAL CRYSTALS: moderate

Answer 62

5-20

Question 63

NORMAL CRYSTALS: moderate

Answer 63

5-20

Question 64

squamous epithelial cells reporting

Answer 64

rare, few, moderate, or many per LPF

Question 65

transitional epithelial cells, yeast reporting

Answer 65

rare, few, moderate, or many per HPF

Question 66

renal tubular epithelial cells reporting

Answer 66

average number per 10 HPFs

Question 67

oval fat bodies reporting

Answer 67

average number per HPF

Question 68

abnormal crystals, cast reporting

Answer 68

average number per LPF

Question 69

casts primarily formed in the

Answer 69

DCT, CD

Question 70

major constituent of cast

Answer 70

uromodulin / tamm horsefall protein

Question 71

cylindroids have the same significance as cast ( true or false)

Answer 71

trueeee

Question 72

examination of cast is performed in what region of slide

Answer 72

along coverslip edges with subdued light

Question 73

prototype cast most frequently encountered and most difficult to discover

Answer 73

hyaline cast

Question 74

type of cast that is colorless and translucent ; subdued light is required when using bright field microscope

Answer 74

hyaline cast

Question 75

_______ light used to for hyaline cast when using bright field microscope

Answer 75

subdued light

Question 76

hyaline cast normal value

Answer 76

0-2 per lpf

Question 77

physiologic cause of hyaline cast

Answer 77

strenuous exercise, stress

Question 78

cast that indicates bleeding

Answer 78

rbc cast

Question 79

easily identified by its orange red color

Answer 79

rbc cast

Question 80

rbc cast clinical significance

Answer 80

strenuous exercise

Question 81

indicates inflammation or infection within the nephron

Answer 81

wbc cast

Question 82

cast seen in tubular damage

Answer 82

epithelial (rte) cast

Question 83

casts seen in strenuous exercise

Answer 83

hyaline cast rbc cast bacterial cast

Question 84

final degenerative form of all type of cast

Answer 84

waxy cast

Question 85

cast seen in chronic renal failure

Answer 85

waxy cast

Question 86

often referred to as the renal failure cast

Answer 86

broad cast

Question 87

this cast indicates destruction or widening of the tubular walls

Answer 87

broad cast

Question 88

most common type of broad cast

Answer 88

waxy and granular

Question 89

factors that contribute to crystal formation

Answer 89

pH SOLUTE CONCENTRATION TEMPERATURE

Question 90

normal crystals are reported as

Answer 90

rare, few, moderate, many per HPF

Question 91

abnormal crystals are reported as

Answer 91

average number per LPF

Question 92

normal acid crystals

Answer 92

amorphous urates uric acid calcium oxalate (dihydrate and monohydrate)

Question 93

fluffy orange or pink sediment (BRICK DUST) due to erythryin

Answer 93

amorphous urates

Question 94

a normal acid crystal with yellow brown granules

Answer 94

amorphous urates

Question 95

a normal acid crystal that is soluble in heat (60 deg c) and alkali

Answer 95

amorphous urates

Question 96

rhombic (diamond) 4-sided flat plate (whetstone), LEMON SHAPED

Answer 96

URIC ACID CRYSTAL

Question 97

hexagonal forms may be mistaken as cystine crystals

Answer 97

uric acid crystal

Question 98

envelope/pyramidal/octahedron crystal

Answer 98

caox dihydrate

Question 99

oval/dumbbell shaped crystal

Answer 99

caox monohydrate

Question 100

cigarette butt appearance

Answer 100

calcium sulfate

Question 101

yellow brown or colorless elongated prism

Answer 101

hippuric acid

Question 102

“pickup sticks” when in clusters

Answer 102

sodium urates

Question 103

yellow brown “thorny apples”

Answer 103

ammonium biurate

Question 104

prism shaped or coffin lid ; fern lid

Answer 104

triple phosphate (magnesium ammonium phosphate, struvite)

Question 105

feathery appearance when they disentegrate

Answer 105

triple phosphate (magnesium ammonium phosphate, struvite)

Question 106

rhomboid plates, end or corner may be notched

Answer 106

magnesium phosphate

Question 107

flat plate, thin prisms in ROSETTE FORM that may resemble sulfonamide crystals

Answer 107

calcium phosphate

Question 108

solubility of uric acid in dilute HCl

Answer 108

insoluble

Question 109

solubility of cystine in dilute HCl

Answer 109

soluble

Question 110

birefringence is present

Answer 110

uric acid

Question 111

absence or weak (thick) of birefringence

Answer 111

cystine

Question 112

cyanide nitroprusside reaction in uric acid

Answer 112

negative

Question 113

cyanide nitroprusside reaction in cystine

Answer 113

positive

Question 114

rectangular plate with notch in one or more corners (staircase pattern)

Answer 114

cholesterol

Question 115

it resembles cholesterol crystal

Answer 115

radiographic dye

Question 116

fine colorless to yellow needles

Answer 116

tyrosine

Question 117

spheres with concentric circles and radial striations

Answer 117

leucine

Question 118

precipitated with tyrosine after adding alcohol

Answer 118

leucine

Question 119

fan shaped needles, SHEAVES OF WHEAT, rosettes, arrowheads, PETALS, round shaped. whetstones

Answer 119

sulfonamide

Question 120

colorless needles that tend to form bundles following refrigeration

Answer 120

ampicillin

Question 121

stain for hemosiderin in ROUS TEST

Answer 121

prussian blue stain

Question 122

capable of maltese cross formation

Answer 122

oval fat bodies fatty casts fat droplets starch granules

Question 123

spheres with dimpled center ( y indentation)

Answer 123

starch granules

Question 124

mistaken for parasite ova

Answer 124

pollen grains