Microscopic examination of urinary sediment

Question 1

1. Which of the following methods is NOT commonly performed in the microscopic examination of urine sediment?
   a. Bright field with the use of stains
   b. Differential interference contrast
   c. Phase contrast microscopy
   d. Polarized and compensated light

Answer 1

b. Differential interference contrast

Question 2

2. What changes in urine sediment can take place over time if the urine is not examined as soon after collection as possible? (Select all that apply.)
   a. Bacteria lyse
   b. Casts dissolve
   c. Crystals dissolve
   d. Crystals form
   e. Erythrocytes crenate
   f. Microorganisms multiple

Answer 2

b. Casts dissolve
c. Crystals dissolve
d. Crystals form
f. Microorganisms multiple

Question 3

3. How will erythrocytes appear in hypertonic
   urine?
   a. Biconcave discs
   b. Crenated
   c. Lysed
   d. Swollen

Answer 3

b. Crenated

Question 4

4. Glitter cells are:
   a. Crenated erythrocytes
   b. Infected tubular cells
   c. Macrophages with inclusions
   d. Swollen leukocytes

Answer 4

d. Swollen leukocytes

Question 5

5. Prime conditions for cast formation include (select all
   that apply):
   a. Marked decrease in urine flow
   b. Acidic pH
   c. Alkaline pH
   d. High solute concentration
   e. Presence of abnormal ions

Answer 5

a. Marked decrease in urine flow
b. Acidic pH
d. High solute concentration
e. Presence of abnormal ions

Question 6

6. In what part of the nephron does cast formation NOT
   take place?
   a. Collecting tubules
   b. Distal convoluted tubule
   c. Distal portion in loop of Henle
   d. Proximal convoluted tubule

Answer 6

d. Proximal convoluted tubule

Question 7

7. Casts are classified on the basis of their:
   a. Color
   b. Contents
   c. Length
   d. Site of formation

Answer 7

b. Contents

Question 8

8. The order of cast degradation is:
   a. Cellular > granular > waxy
   b. Cellular > hyaline > waxy
   c. Hyaline > cellular > waxy
   d. Hyaline > granular > waxy

Answer 8

a. Cellular > granular > waxy

Question 9

9. Crystals in the urine are NOT:
   a. Confirmed by reagent strip tests
   b. Dependent upon pH and temperature
   c. Formed during pathologic processes
   d. Observed in normal specimens

Answer 9

a. Confirmed by reagent strip tests

Question 10

1 0. Parasites seen in the urine are:
a. Confirmed by reagent strip tests
b. Confused for red blood cells
c. Unstainable with Sternheimer-Malbin
d. Usually fecal or vaginal contaminants

Answer 10

d. Usually fecal or vaginal contaminants

Question 11

Match these crystals to their associated pH.
A. Acid
B. Alkaline

11. Ammonium biurate
12. Ammonium magnesium phosphate
    1 3. Bilirubin
13. Calcium carbonate
    1 5. Calcium oxalate
    1 6. Cystine
    1 7. Hippuric acid
    1 8. Leucine
    1 9. Tyrosine
14. Uric acid

Answer 11

11. Ammonium biurate (B.Alkaline)
12. Ammonium magnesium phosphate (B.Alkaline)

1 3. Bilirubin (A. Acid)
14. Calcium carbonate (B.Alkaline)
1 5. Calcium oxalate (A. Acid)
1 6. Cystine (A. Acid)
1 7. Hippuric acid (A. Acid)
1 8. Leucine (A. Acid)
1 9. Tyrosine (A. Acid)
20. Uric acid (A. Acid)

Question 12

21. In Figure 9-90
    a. What is the name of the shape displayed in this image?
    - a. Maltese cross

b. What method of microscopy is used in visualizing this phenomenon?
- b. polarized light

c. Name three structures that can be found in urinary sediment which create this effect.

• c. cholesterol, leucine, starch

Question 13

22. In Figure 9-91
    a. Identify these structures.
    b. What term describes their presence in urine?
    c. What reagent strip test may indicate their presence?

Answer 13

a. Identify these structures.
- Red blood cells

b. What term describes their presence in urine?
- Hematuria

c. What reagent strip test may indicate their presence?
- Hemoglobin