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AUBF MIDTERM > Microscopic Examination > Flashcards

Microscopic Examination Flashcards

1
Q

Screening test:
Color

Significance:

A

Blood

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2
Q

Screening test:
Clarity

Significance:

A

Hematuria vs hemoglobinuria/ myoglobinuria

Confirm pathogenic or non-pathogenic cause of turbidity

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3
Q

Screening test:
Blood

Significance:

A

RBCs/RBC casts

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4
Q

Screening test:
Protein

Significance:

A

Casts/Cells

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5
Q

Screening test:
Nitrite

Significance:

A

Bacteria/ WBCs

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6
Q

Screening test:
Leukocyte esterase

Significance:

A

WBCs/WBC casts/ Bacteria

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7
Q

Screening test:
Glucose

Significance:

A

Yeast

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8
Q

Person involve in Hemocytometer

A

Thomas Addis (1926)

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9
Q

Used primarily to monitor the course of diagnosed cases of renal disease.

A

Hemocytometer

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10
Q

Type of specimen used in Hemocytometer?

A

12-hour specimen

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11
Q

Microscopic material observed in Hemocytometer?

A

RBCs, WBCs, Casts, and Epithelial cells

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12
Q

Urine used in Preparation of Urine sediment

A

Freshly voided urine

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13
Q

Type of urine specimen used in Preparation of Urine sediment

A

Midstream clean-catch specimen

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14
Q

Urine volume needed for urine sediment

A

10 - 15 mL (12 mL)

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15
Q

In Preparation of Urine sediment the urine is being centrifuged for…

A

5 mins at 400RCF

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16
Q

How to get the representative of urinary sediments?

A

Decantation

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17
Q

Volume of urine left after decantation

A

0.5 - 1.0 mL

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18
Q

1 drop = __ mL

A

0.02 mL (20 micro liter)

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19
Q

Size of cover slip used

A

22x22 mm

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20
Q

In examination of urine sediment, observe minimum of how many field?

A

10 field (both LPO and HPO)

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21
Q

Objective lense used for detection of casts and general composition

A

Low power objective lense (LPF) 10X

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22
Q

Objective lense used for identification

A

High power objective lense (HPF) 40X

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23
Q

Microscopy used for unstained sediment

A

Bright field microscopy

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24
Q

T/F:

Urinary sediments are smaller than Artifacts

A

True

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25
Q

Epithelial cells, crystals, and other elements manner of reporting

A

Semi-quantitative terms

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26
Q

Manner of reporting:
Occasional

Comment:

A

0-1, 0-3/ HPF at 10 field

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27
Q

Manner of reporting:
Few

Comment:

A

0-4, 2-5/ HPF at 10 fields

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28
Q

Manner of reporting:
Some

Comment:

A

3-5, 8-10/ HPF at 10 fields

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29
Q

Manner of reporting:
Moderate

Comment:

A

More than 10/HPF at 10 fields

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30
Q

Manner of reporting:
Many

Comment:

A

Abundant/HPF

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31
Q

Manner of reporting:
TMTC

Comment:

A

Too numerous to count (loaded)

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32
Q

Stains:

Delineates structure and contrasting colors of the nucleus and cytoplasm

A

Sternheimer-Malbin (Crystal violet & Safranin O)

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33
Q

Stains: Function

Identifies WBCs, epithelial cells, and casts

A

Sternheimer-Malbin (Crystal violet & Safranin O)

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34
Q

Stains:

Enhances nuclear detail

A

Toluidine blue (metachromatic stain)

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35
Q

Stains: Function

Differentiates WBCs and renal tubular epithelial (RTE) cell

A

Toluidine blue (metachromatic stain)

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36
Q

Stains:

Lyses RBCs and enhances nuclei of WBCs

A

2% acetic acid

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37
Q

Stains: Function

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

A

2% acetic acid

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38
Q

Stains:

Stains triglycerides and neutral fats orange-red

A

Lipid Stains: Oil Red O and Sudan III

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39
Q

Stains: Function

Identifies free fat droplets and lipid-containing cells and casts

A

Lipid Stains: Oil Red O and Sudan III

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40
Q

Stains:

Differentiates gram-positive and gram-negative bacteria

A

Gram stain

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41
Q

Stains: Function

Identifies bacterial casts

A

Gram stain

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42
Q

Stains:

Methylene blue and eosin Y stains eosinophilic granules

A

Hansel stain

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43
Q

Stains: Function

Identifies urinary eosinophils

A

Hansel stain

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44
Q

Stains:

Stains structures containing iron

A

Prussian blue stain

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45
Q

Stains: Function

Identifies yellow-brown granules of hemosiderin in cells and casts

A

Prussian blue stain

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46
Q

Expected Staining Reactions of Sediment Constituent:

RBCs

Neutral -

A

Pink to purple

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47
Q

Expected Staining Reactions of Sediment Constituent:

RBCs

Acid -

A

Pink (unstained)

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48
Q

Expected Staining Reactions of Sediment Constituent:

RBCs

Alkaline -

A

Purple

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49
Q

Expected Staining Reactions of Sediment Constituent:

Hyaline casts

A

Pale pink or pale purple

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50
Q

Expected Staining Reactions of Sediment Constituent:

Coarse granular Inclusion casts

A

Dark purple granules in purple matrix

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51
Q

Expected Staining Reactions of Sediment Constituent:

Finely granular Inclusion casts

A

Fine dark purple granules in pale pink or pale purple matrix

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52
Q

Expected Staining Reactions of Sediment Constituent:

WBCs (dark-staining cells)

Nuclei -
Cytoplasm -

A

Purple

Purple granules

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53
Q

Expected Staining Reactions of Sediment Constituent:

Glitter cells (sternheimer-malbin positive cells)

Nuclei -
Cytoplasm -

A

Colorless or light blue

Pale blue or gray

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54
Q

Expected Staining Reactions of Sediment Constituent:

Renal Tubular epithelial cells

Nuclei -
Cytoplasm -

A

Dark shade of blue-purple

Light shade of blue purple

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55
Q

Expected Staining Reactions of Sediment Constituent:

Bladder tubular epithelial cells

Nuclei -
Cytoplasm -

A

Blue-purple

Light purple

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56
Q

Expected Staining Reactions of Sediment Constituent:

Squamous epithelial cells

Nuclei -
Cytoplasm -

A

Dark shade of orange-purple

Light purple or blue

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57
Q

Expected Staining Reactions of Sediment Constituent:

Waxy casts

A

Pale pink or pale purple

(Darker than hyaline casts; broken ends)

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58
Q

Expected Staining Reactions of Sediment Constituent:

Fat Inclusion casts

A

Fat globules unstained in a pink matrix

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59
Q

Expected Staining Reactions of Sediment Constituent:

Red cell Inclusion casts

A

Pink to orange-red

(Intact cells can be seen in matrix)

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60
Q

Expected Staining Reactions of Sediment Constituent:

Blood (hemoglobin) casts

A

Orange-red

(No intact cells)

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61
Q

Expected Staining Reactions of Sediment Constituent:

Bacteria

A

Motile: Do not stain

Nonmotile: Stain purple

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62
Q

Expected Staining Reactions of Sediment Constituent:

Trichomonas vaginalis

A

Light blue-green

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63
Q

Expected Staining Reactions of Sediment Constituent:

Mucus

A

Pale pink or pale blue

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64
Q

Expected Staining Reactions of Sediment Constituent:

Background

A

Pale pink or pale purple

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65
Q

Cytodiagnostic Urine Testing, preparation of permanent slides using…

A

Cytocentrifugation

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66
Q

Cytodiagnostic Urine Testing stain used

A

Papanicolaou stain

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67
Q

It detect the malignancies of the lower urinary tract

A

Cytodiagnostic Urine Testing

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68
Q

Cytodiagnostic Urine Testing urine specimen

A

First morning specimen

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69
Q

T/F:
Cytodiagnostic Urine Testing, provides more indefinite information about RT changes associated with transplant rejection

A

False

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70
Q

Information obtained in Cytodiagnostic Urine Testing:

A

Viral, fungal, and parasitic infections
Cellular inclusion
Pathologic casts
Inflammatory condition

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71
Q

Technique’s Function:

Used for routine urinalysis

A

Bright-field microscopy Technique

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72
Q

Technique’s Function:

Enhances visualization of elements with low refractive indices, such as hyaline casts, mixed cellular cats, mucous threads, and Trichomonas.

A

Phase-contrast microscopy Technique

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73
Q

Technique’s Function:

Aids in identification of cholesterol in oval fat bodies, fatty casts, and crystals

A

Polarizing microscopy Technique

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74
Q

Technique’s Function:

Aids in identification of Treponema pallidum

A

Dark-field microscopy Technique

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75
Q

Technique’s Function:

Allows visualization of naturally florescent microorganisms or those stained by a fluorescent dye.

A

Florescence microscopy Technique

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76
Q

Technique’s Function:

Produces a three-dimensional microscopy-image and layer-by-layer imaging of a specimen

A

Interference-contrast technique

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77
Q

Urine sediment constituents

A

RBCs
WBCs
Epithelial cells (squamous)
Epithelial cells (Transitional/Urothelial)
Epithelial cells (Renal tubular)
Oval Fat Bodies
Bacteria
Yeast
Parasite (Trichomonas)
Spermatozoa
Mucus

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78
Q

Urine casts

A

Hyaline casts
RBCs casts
WBCs casts
Bacterial casts
Epithelial cell casts
Fatty casts
Granular casts
Waxy casts
Broad casts

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79
Q

Normal Crystal Seen in Acidic urine

A

Uric acid
Amorphous urates
Calcium oxalate

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80
Q

Normal Crystal Seen in Neutral/Alkaline urine

A

Amorphous phosphates
Calcium phosphate

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81
Q

Normal Crystal Seen im Alkaline urine

A

Triple phosphate
Ammonium biurate
Calcium carbonate

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82
Q

Abnormal crystal seen in Acid urine

A

Cystine
Cholesterol
Bilirubin
Radiographic dye

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83
Q

Abnormal crystal seen in Acid/Neutral urine

A

Leucine
Tyrosine
Sulfonamides
Ampicillin

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84
Q

Urinary sediment artifacts

A

Starch Granule
Oil Droplets
Air Bubbles
Pollen grains
Hair and fibers from clothing and diapers
Fecal artifacts

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85
Q

RBC

__________ in hypertonic urine
__________ in hypotonic/hyposthenuric urine
_________ with glomerular membrane damage

A

Crenated in hypertonic urine
Ghost cells in hypotonic/hyposthenuric urine
Dysmorphic with glomerular membrane damage

86
Q

RBCs sources of identification error

A

Yeast cells
Oil droplets
Air bubbles

87
Q

RBCs, Complete urinalysis correlation

A

Color
Reagent strip blood reaction

88
Q

Morse type: WBCs

Larger than RBCs
Agranulocytes
Ghost cells in hypotonic urine
Mononuclear cells with a abundant cytoplasm

A

2 correct

89
Q

WBCs, sources of identification error

A

Renal tubular epithelial cells

90
Q

WBCs, Complete urinalysis correlation

A

Leukocyte esterase
Nitrite
Specific gravity
pH

91
Q

Largest cells in the sediment with abundant, irregular cytoplasm and prominent nuclei

A

Squamous Epithelial cell

92
Q

Squamous epithelial cell, sources of identification error

A

Rarely encountered, folded cells may resemble casts

93
Q

Squamous epithelial cell, Complete urinalysis correlation

A

Clarity

94
Q

Spherical, polyhedral, or caudate with centrally located nucleus

A

Transitional (Urothelial) epithelial cell

95
Q

Transitional (Urothelial) Epithelial cell, sources of identification error

A

Spherical forms resemble RTE cells

96
Q

Transitional (Urothelial) epithelial cell, Complete urinalysis correlation

A

Clarity
Blood, if malignancy-associated

97
Q

Rectangular, columnar, round, oval or, cuboidal with an eccentric nucleus possibly bilirubin-stained or hemosiderin-laden

A

Renal tubular epithelial cell

98
Q

Renal tubular epithelial cell, sources of identification error

A

Spherical transitional cells Granular casts

99
Q

Renal tubular epithelial cell, Complete urinalysis correlation

A

Leukocyte esterase and nitrite (pyelonephritis)
Color
Protein
Blood
Clarity
Bilirubin (Hepatitis)

100
Q

Renal tubular epithelial cell

Pyelonephritis

A

Leukocyte esterase and nitrite

101
Q

Renal tubular epithelial cell

Bilirubin

A

Hepatitis

102
Q

Highly refractile RTE cells

A

Oval fat bodies

103
Q

Oval fat bodies, sources of identification error

A

Confirm with fat stains and polarized microscopy

104
Q

Oval fat bodies, Complete urinalysis correlation

A

Clarity
Blood
Protein
Free fat droplets/fatty casts

105
Q

Small spherical and rod-shaped structures

A

Bacteria

106
Q

Bacteria, sources of identification error

A

Amorphous phosphates and urates

107
Q

Bacteria, complete urinalysis correlation

A

pH
Nitrite
Leukocyte
WBCs

108
Q

Small, oval, refractile structures with buds and/or mycelia

A

Yeast

109
Q

Yeast, sources of identification error

A

RBCs

110
Q

Yeast, Complete urinalysis correlation

A

Glucose
Leukocyte
WBCs

111
Q

Pear-shaped, motile, Flagellated

A

Parasite (Trichomonas)

112
Q

Parasite, sources of identification error

A

WBCs
Renal tubular epithelial cells

113
Q

Parasites, Complete urinalysis correlation

A

Leukocyte
WBCs

114
Q

Tapered oval head with long, thin tail

A

Spermatozoa

115
Q

Spermatozoa, sources of identification error

A

None

116
Q

Spermatozoa, Complete urinalysis correlation

A

Protein

117
Q

Single or clumped threads with a low refractive index

A

Mucus

118
Q

Mucus, sources of identification error

A

Hyaline casts

119
Q

Mucus, Complete urinalysis correlation

A

None

120
Q

It is unique yo kidney

A

Urine casts

121
Q

Urine casts are formed within …

A

The lumen of Distal convoluted tubule and Collecting ducts

122
Q

Urine casts provide microscopic view of condition within

A

Nephron

123
Q

Detection/Scanning around cover slip edge

A

LPF

124
Q

Low refractive index, observe in subdued light

A

Cast matrix

125
Q

Glycoprotein excreted by the RTE cells of the CDT and upper collecting ducts

A

Tamm-Horsfall protein

126
Q

Factors affecting the Tamm-Horsfall protein

A

Stress and exercise

127
Q

Urine-flow stasis, acidity, Na+, Ca++

A

Protein gel

128
Q

Formed at the junction of ALH and DCT

A

Tapered end

129
Q

Presence of urinary cast

A

Cylindruria

130
Q

Colorless homogenous matrix

A

Hyaline casts

131
Q

Hyaline casts, sources of identification error

A

Mucus
Fibers
Hair
Increased lighting

132
Q

Hyaline casts, Complete urinalysis correlation

A

Protein
Color (exercise)
Blood (exercise

133
Q

Clinical significance:

Glomerulonephritis
Pyelonephritis
Chronic renal disease
Congestive heart failure
Stress and exercise

A

Hyaline casts

134
Q

Orange-red color, cast matrix containing RBCs

A

RBC casts

135
Q

RBC casts, sources of identification error

A

RBC clumps

136
Q

RBC casts, complete urinalysis correlation

A

RBCs
Blood
Protein

137
Q

Clinical significance:

Glomerulonephritis
Strenuous exercise

A

RBC casts

138
Q

Casts matrix containing WBC

A

WBC casts

139
Q

WBC casts, sources of identification error

A

WBC clumps

140
Q

WBC casts, complete urinalysis correlation

A

WBCs
Protein
Leukocyte

141
Q

Clinical significance:

Pyelonephritis
Acute interstitial nephritis

A

WBC casts

142
Q

Bacilli bound to protein matrix

A

Bacterial casts

143
Q

Bacterial casts, sources of identification error

A

Granular casts

144
Q

Bacterial casts, complete urinalysis correlation

A

WBC cast
Leukocyte
Protein
WBCs
Nitrite
Bacteria

145
Q

Clinical significance:

Pyelonephritis

A

Bacterial casts

146
Q

RTE cells attached to protein matrix

A

Epithelial cell casts

147
Q

Epithelial cell casts, sources of identification error

A

WBC casts

148
Q

Epithelial cell cast, complete urinalysis correlation

A

Protein RTE cells

149
Q

Clinical significance:

Renal Tubular damage

A

Epithelial cell casts

150
Q

Fat droplets and oval fat bodies attracted to protein matrix

A

Fatty casts

151
Q

Fatty casts, sources of identification error

A

Fecal debris

152
Q

Fatty casts, complete urinalysis correlation

A

Protein
Free fat droplets
Oval fat bodies

153
Q

Clinical significance:

Nephrotic syndrome
Toxic tubular necrosis
Diabetes mellitus - Crush injuries

A

Fatty casts

154
Q

Coarse and line granules in a cast matrix

A

Granular casts

155
Q

Granular casts, sources of identification error

A

Clumps of small crystals
Columnar RTE cells

156
Q

Granular casts, complete urinalysis correlation

A

Protein
Cellular casts
RBCs and WBCs

157
Q

Clinical significance:

Glomerulonephritis
Pyelonephritis
Stress and Exercise

A

Granular casts

158
Q

Highly refractile cast with jagged ends and notches

A

Waxy casts

159
Q

Waxy casts, sources of identification error

A

Fibers
Fecal material

160
Q

Waxy casts, complete urinalysis correlation

A

Protein
Cellular casts
Granular casts
WBCs and RBCs

161
Q

Clinical significance:

Stasis of urine flow
Chronic renal failure

A

Waxy casts

162
Q

Wider than normal casts matrix

A

Broad casts

163
Q

Broad cast, sources of identification error

A

Fecal material
Fibers

164
Q

Broad casts, complete urinalysis correlation

A

Protein
WBCs and RBCs
Granular casts
Waxy casts

165
Q

Clinical significance:

Extreme urine stasis
Renal failure

A

Broad casts

166
Q

It detect the presence of the relativity few abnormal types of liver disease, inborn errors of metabolism, and renal damage

A

Urine crystals

167
Q

Formed by the precipitation of urine solutes

A

Urine crystals

168
Q

Urine crystals are subject to:

A

Changes of temperature
Solute concentration
pH (affect solubility)

169
Q

T/F:

Urine crystal, Rapid precipitation at low temperature

A

T

170
Q

T/F

High specific gravity - presence of crystal in fresh urine

A

T

171
Q

Crystals in acidic pH

A

Organic and Iatrogenic compounds

172
Q

Crystals in neutral and alkaline solution

A

Inorganic salts

173
Q

CaOx present in what urine pH condition

A

Acidic and neutral urine

174
Q

Color and shape:
Yellow-brown (rhombic/4-sided/rosette)

Solubility:
Alkali soluble

A

Uric acid

175
Q

Color and shape:
Brick dust or yellow brown granules

Solubility:
Alkali and heat

A

Amorphous urates

176
Q

Color and shape:
Colorless (envelopes, oval, dumbbell, octahedral)

Solubility:
Dilute HCl

A

Calcium oxalate

177
Q

Color and shape:
White-colorless (granular/white ppt)

Solubility:
Dilute acetic acid

A

Amorphous phosphates

178
Q

Color and shape:
Colorless (flat rectangle plates/ thin prisms often in rosette formation)

Solubility:
Dilute acetic acid

A

Calcium phosphate

179
Q

Color and shape:
Colorless (prism shape “coffin lids)

Solubility:
Dilute acetic acid

A

Triple phosphate

180
Q

Color and shape:
Yellow-brown (spicule-covered spheres “thorny apples”)

Solubility:
Acetic acid with heat

A

Ammonium biurate

181
Q

Color and shape:
Colorless (dumbbells/spherical)

Solubility:
Gas from acetic acid

A

Calcium carbonate

182
Q

Color and shape:
Colorless
Hexagonal plates

Solubility:
Ammonia dilute HCl

A

Cystine

183
Q

Cystinuria and Confirmation test

A

Cystine

184
Q

Cystine:

Confirmation test

A

Cyanide-nitroprusside test

185
Q

Color and shape:
Colorless notched plates

Solubility:
Chloroform

A

Cholesterol

186
Q

Seen in refrigerated specimen (droplet form lipids) and in Nephrotic syndrome

A

Cholesterol

187
Q

Color and shape:
Yellow
Clumped needles or granules

Solubility:
Acetic acid, HCl, NaOH, ether, Chloroform

A

Bilirubin

188
Q

Present in hepatic disorders

A

Bilirubin

189
Q

Color and shape:
Colorless
Cholesterol crystal like

Solubility:
10% NaOH

A

Radiographic dye

190
Q

Markedly high specific gravity when measured by refractometer

A

Radiographic dye

191
Q

Color and shape:
Yellow-brown
Spheres (concentric circles and radial striations)

Solubility:
Hot alkali or alcohol

A

Leucine

192
Q

Crystals associated with liver disorder
Accompanied by tyrosine crystals

A

Leucine

193
Q

Color and shape:
Colorless-yellow
Fine needle (clump or rosette form)

Solubility:
Alkali or heat

A

Tyrosine

194
Q

Seen in conjunction with leucine crystals in positive chemical test results fro bilirubin

A

Tyrosine

195
Q

Encountered in inherited disorders of amino-acid metabolism

A

Tyrosine

196
Q

Color and shape:
Varied (colorless to yellow-brown)
Needles, rhombics, whetstones, sheaves of wheat, and rosettes

Solubility:
Acetone

A

Sulfonamides

197
Q

Seen in inadequate patient hydration
If forming in nephron may indicate tubular damage

A

Sulfonamides

198
Q

Color and shape:
Colorless
Needles (form bundles following refrigeration)

Solubility:
Refrigeration forms bundles

A

Ampicillin

199
Q

Seen in massive doses of this penicillin compound without adequate hydration

A

Ampicillin

200
Q

Contaminant from improper collection

A

Urinary sediment artifacts

201
Q

Resemble fat droplets when polarized and dimpled center

A

Starch Granule

202
Q

From cornstarch used as glove powder and highly refractile sphere

A

Starch Granule

203
Q

From OIO contamination

A

Oil droplets

204
Q

Highly refractile and may resemble RBCs

A

Oil droplets

205
Q

Occur when the specimen is placed under a cover slip

A

Air bubbles

206
Q

Concentric circles

A

Pollen grains

207
Q

Spheres with a cell wall and occasional concentric circles

A

Pollen grains

208
Q

Mistaken for casts usually much linger and more refractile

A

Hair and fibers from clothing and diapers

209
Q

Presence at a fistula between the intestinal and urinary tracts

A

Fecal Artifacts

210
Q

Appears as plant and meat fibers or as brown amorphous material

A

Fecal Artifacts

AUBF MIDTERM (2 decks)

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