Microscopic examination Of Urine Flashcards

1
Q

Most glomerular disorders are caused by:

A

Immunologic disorders

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2
Q

Dysmorphic RBC casts would be a significant finding with

A

Good pasture syndrome

Acute glomerulonephritis

Henoch-Schönlein purpura

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3
Q

Dysmorphic RBC casts would not be a significant finding with

A

Chronic pyelonephritis

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4
Q

Occasional episodes of macroscopic hematuria over periods of 20 or more years are seen with :

A

IgA nephropathy

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5
Q

Antiglomerular basement membrane antibody is seen with

A

Goodpasture syndrome

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6
Q

Antineurophilic cystoplasmic antibody is diagnostic for:

A

Wegner Granulomatosis

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7
Q

Respiratory and renal symptoms are associated with

A

IgA nephropathy

Wegener granulomatosis

Henoch-Schönlein purpura

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8
Q

Respiratory and renal symptoms is not associated with

A

Goodpasture syndrome

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9
Q

The presence of fatty casts is associated with

A

Nephrotic syndrome

Focal segmental glomerulosclerosis

Minimal change disease

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10
Q

The presence of fatty casts is not associated with

A

Nephrogenic diabetes insipidus

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11
Q

Highest levels of proteinuria are seen with

A

Nephrotic syndrome

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12
Q

Ischemia frequently produces

A

Acute renal tubular necrosis

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13
Q

A disorder associated with polyuria and low specific gravity is:

A

Nephrogenic diabetes insipidus

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14
Q

An inherited disorder producing a generalized defect in tubular readsorption is:

A

Fanconi syndrome

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15
Q

A teenage boy who develops gout in his big toe and has a high serum uric acid should be monitored for:

A

Uromodulin-associated kidney disease

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16
Q

The only protein produced by the kidney is:

A

Uromodulin

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17
Q

Presence of renal tubular epithelial cells and casts is an indication of:

A

Acute tubular necrosis

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18
Q

Differentiation between cystitis and pyelonephritis is aided by the presence of

A

WBC casts

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19
Q

Presence of WBCs and WBC casts with no bacteria is indicative of:

A

Acute interstitial nephritis

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20
Q

End-stage renal disease is characterized by all of the following except:

A

Hypersthenuria

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21
Q

Prerenal acute renal failure could be caused by:

A

Massive hemmorrhage

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22
Q

The most common composition of renal calculi is

A

Calcium oxalate

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23
Q

Urinalysis on a patient with a severe back pain being evaluated for renal calculi would be most beneficial if it showed:

A

Miscroscopic hematuria

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24
Q

Warming of urine at 37deg C

A

Dissolves some crystals

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25
Q

Refrigeration of urine

A

Precipitation of amorphous urates/phosphates and other non-pathologic crystals

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26
Q

Centrifugation

A

5 minutes in 4000RCF

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27
Q

LPO detects

A

General composition of sediment

Casts

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28
Q

HPO indentifies

A

Urinary sediments

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29
Q

Sternheimer-Malbin stain

A

Most used in urinalysis

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30
Q

Crystal violet and Safranin O

A

Sternheimer-Malbin stain

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31
Q

Sedi stain and KOVA stain

A

Sternheimer-Malbin stain

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32
Q

Confirm.presence of triglycerides, neutral fats, and cholesterol

A

Lipid stains, Oil red O, Sudan III and Polarizing microscopy

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33
Q

Identification of bacterial casts

A

Gram stain

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34
Q

Crystal violet, Iodine, Alcohol Safranin

A

Gram stain

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35
Q

Purple/Violet

A

Gram(+) bacteria

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36
Q

Red

A

Gram(-) bacteria

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37
Q

Preferred stain for urinary eosinophils (In cases of drug-induced allergic reaction producing inflammation of the
renal interstitium)

A

Hansel stain

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38
Q

Methylene blue and Eosin Y

A

Hansel stain

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39
Q

Prussian blue stain

A

Stain for iron

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40
Q

Aids in identification of Treponema Pallidum

A

Dark-Field microscopy

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41
Q

Hyaline casts, mixed cellular casts, mucous threads and Trichomonas

A

Phase-Contrast microscopy

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42
Q

Cholesterol, oval fat bodies, fatty casts and crystals

A

Polarizing microscopy

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43
Q

Three dimensional microscopy

A

Interference contrast

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44
Q

Associated with damage to the glomerular membrane or vascular injury within the genitourinary tract

A

Red Blood Cell

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45
Q

Frequently associated with advanced glomerular damage but is also seen with damage to the vascular integrity of the urinary tract caused by trauma, acute infection or inflammation, and coagulation disorders.

A

Macroscopic hematuria

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46
Q

Critical to the early diagnosis of
glomerular disorders and malignancy of the urinary tract and to confirm the presence of renal calculi

A

Microscopic hematuria

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47
Q

Increased in urinary WBC which indicates the presence
of an infection or inflammation in the genitourinary system.

A

Pyuria

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48
Q

Drug-induced Interstitial Nephritis, UTI and renal
transplant rejection

A

Eosinophil

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49
Q

Resembles RBC

A

Lymphocytes

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50
Q

increased numbers in the early stages of renal transplant rejection

A

Lymphocytes

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51
Q

Used to enhance nuclear detail

A

Supravital staining/Addition of Acetic Acid

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52
Q

Largest cells found in urine sediment

A

Squamous EC

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53
Q

Originate from the lining of the renal pelvis, calyces,
ureters, and bladder, and from the upper portion of the
male urethra

A

Epithelial Cell

54
Q

Smaller than squamous cells and appear in several forms, including spherical, polyhedral and caudate.

A

Epithelial Cell

55
Q

Lipid containing RTE cells

A

Oval Fat Bodies

56
Q

Squamous EC covered with Gardnerella coccobacillus
(Bacterial Vaginosis)

A

Clue cells

57
Q

Bacteria accompanied with WBC

A

Significant UTI

58
Q

Small Refractile oval structures (may or may not contain bud)

A

Yeast

59
Q

most frequent parasite
encountered in the urine. Asymptomatic for male

A

Trichomonas vaginalis (ST):

60
Q

bladder parasite (ova). Bladder
Cancer

A

Schistosoma haematobium

61
Q

most common fecal contaminant

A

Enterobius vermicularis

62
Q

Significant: Male infertility, Retrograde Ejaculation (Sperm is
expelled into bladder instead of urethra)

A

Spermatozoa

63
Q

Uromodulin: major constituent

Thread-like structures (Low Refractive Index)

Frequently seen in Females

A

Mucus

64
Q

Presence of urinary cast

A

Cylinduria

65
Q

: True geometrically structure or amorphous
materials

A

Crystals

66
Q

appear as spheres with a cell wall and occasional concentric circles

A

Artifacts

67
Q

Pathologically increased in: Acute glomerulonephritis,
Pyelonephritis, Chronic Renal Disease, CHF

A

Hyaline

68
Q

Glomerular damage (glomerulonephritis) is associated with proteinuria and dysmorphic erythrocytes

A

RBC Casts

69
Q

Non-Bacterial inflammation

A

Acute Interstitial Nephritis

70
Q

Bacterial inflammation

A

Pyelonephritis

71
Q

May resemble granular cast

A

Bacterial Casts

72
Q

Frequently Associated with: Nephrotic syndrome

A

Fatty Casts

73
Q

Significantly increased in: Gout, Lesch-Nyhan Syndrome

A

Uric Acid

74
Q

Prism shape, resembles “COFFIN-LID”

A

Triple Phosphate/Ammonium Magnesium Phosphate

75
Q

Most often encountered in: OLD SPECIMEN associated with
ammonia produced by ammonia spitting bacteria

A

Ammonium Biurate

76
Q

Formation of kidneys stones at an early stage

A

Cystine

77
Q

Inadequate px hydration which is the primary cause of
Sulfonamide crystalization

A

Sulfonamides

78
Q

Immune-mediated

A

Glomerular

79
Q

INCREASED permeability of the GLOMERULI to the passage of plasma proteins (ALBUMIN)

Heavy PROTEINURIA (3.5g/day)

HYPOPROTEINEMIA (Plasma albumin usually <3g/dL – LIVER SYNTHESIS unable to compensate for the large amount of protein EXCERETED in the urine

HYPERLIPIDEMIA (INCREASED plasma levels of TRIGLYCERIDES, CHOLESTEROL, PHOSPHOLIPIDS & VLDL)

A

Nephrotic Syndrome

80
Q

One cause: Post-Streptococcal Infection → known as: ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS (Group A βhemolytic Streptococci – those with M PROTEIN in their cell wall induces this type of nephritis)

Blood: ELEVATED ASO Titer

NON-AGN: non-streptococcal agent (bacteria:pneumococci, viruses:mumps,Hepa B, parasitic infection:malaria)

A

Acute Glomerulonephritis

81
Q

SCLEROSIS of the GLOMERULI
FOCAL (Occurring in some glomeruli); SEGMENTAL (Affecting a
specific area of the glomerulus)

Predominant Feature: PROTEINURIA

A

Focal Segmental Glomerulonephritis

82
Q

Cellular Proliferation of the MESANGIUM along with LEUKOCYTE INFILTRATION & THICKENING OF THE GLOMERULAR BASEMENT MEMBRANE

A

Membranoproliferative Glomerulonephritis

83
Q

Most prevalent type of glomerulonephritis world wide

Deposition of IgA in the GLOMERULAR MESANGIUM

A

IgA Nephropathy

84
Q

Development: Slow and Silent

80%: have previously some form of glomerulonephritis

20%: form of glomerulonephritis that has been unrecognized

A

Chronic Glomerulonephritis

85
Q

Follows a HYPOTENSIVE event that result in decrease
perfusion of the kidneys followed by renal tissue ischemia

3 Principal Cause:
1.Sepsis
2.Shock
3.Trauma

A

Acute Tubular Necrosis: ISCHEMIC ATN

86
Q

exposure to NEPHROTOXIC AGENTS

A

Acute Tubular Necrosis: TOXIC ATN

87
Q

normal solutes or substances that become toxic when their concentration in the bloodstream is excessive:

a. hemoglobin – hemoglobinuria – severe hemolytic events

b. myoglobin – myoglobinuria - rhabdomyolyis

c. uric acid

d. immunoglobulin light chain

A

ENDOGENOUS NEPHROTOXIN

88
Q

substances ingested or absorbed
a. therapeutic agents
b. anesthetics
c. radiographic contrast media
d. chemotherapeutic drugs
e. recreational drugs
f. industrial chemicals

A

EXCOGENOUS NEPHROTOXIN

89
Q

Impaired ability to REABSORBED GLUCOSE

A

Renal Glucosuria

90
Q

Impaired ability to REABSORBED SPECIFIC AMINO ACIDS

A

Cystinuria (Cystine
and Dibasic AA)

Hartnup Disease (Monoamino – Monocarboxylic AA)

91
Q

Impaired ability to REABSORB SODIUM

A

Bartter’s Syndrome

92
Q

Impaired ability to REABSORB BICARBONATE

A

Renal Tubular Acidosis Type II

93
Q

Impaired ability to REABSORB CALCIUM

A

Idiopathic Hypercalciuria

94
Q

Excessive REABSORPTION of CALCIUM

A

Hypocalciuric Familial Hypercalcemia

95
Q

Excessive REABSORPTION of SODIUM

A

Gordon’s Syndrome

96
Q

EXCESSIVE REABSORPTION of PHOSPHATE

A

Pseudohypo parathyroidism

97
Q

Generalized LOSS OF PROXIMAL TUBULAR FUNCTION NOT REABSORBED form the ULTRAFILTRATE & EXCRETED in the URINE: (AA, Glucose, Water, Phosphorous, Potassium, & Calcium)

A

Fanconi Syndrome

98
Q

Impaired ability to REABSORB PHOSPHATE

A

Familial Hypophosphatemia
(Vitamin D Resistant Rickets)

99
Q

Impaired ability to REABSORB CALCIUM

A

Idiopathic Hypercalciuria

100
Q

Impaired ability to ACIDIFY URINE

A

Renal Tubular Acidosis, Types I and IV

101
Q

Impaired ability to RETAIN SODIUM

A

Renal Salt-Losing Disorder

102
Q

Impaired ability to CONCENTRATE URINE

A

Nephrogenic Diabetes

103
Q

Excessive reabsorption of SODIUM

A

Liddle’s Syndrome

104
Q

Inability to REABSORB INORGANIC PHOSPHATES

A

Renal Phosphaturia

105
Q

Urethra (Urethritis)

Bladder (Cystitis)

Painful Urination (Dysuria)

Burning Sensation

Frequent urge to urinate

A

LOWER UTI

106
Q

Renal Pelvis Alone (Pyelitis)

Renal Pelvis including Interstitium (Pyelonephritis)

A

Upper UTI

107
Q

Bacterial infection that involves the renal tubules,
interstitium, & renal pelvis

Mechanism:
1. Movement of bacteria from the lower urinary tract to the kidney

  1. Localization of the bacteria from the bloodstream in the kidneys
    (hematogenous infection)
A

Acute Pyelonephritis

108
Q

Develops when permanent inflammation of
renal tissue causes permanent scarring that involves the renal calyces
and pelvis

A

Chronic Pyelonephritis

109
Q

Allergic response to the interstitium of the kidney

Most common cause: Acute Allograft Rejection of a transplanted kidney

A

Acute Interstitial Nephritis

110
Q

Candida species (e.g. Candida albicans) – normal
flora of GIT & vagina

Proliferation of yeasts due to: changes in pH, adversely disrupted by antibiotics

A

Yeast Infections

111
Q

URINE SODIUM CONCENTRATION IS LOW – INCREASED AMOUNT OF SODIUM BEING REABSORBED

A

pre-renal

112
Q

INCRASED URINARY EXCRETION OF SODIUM

A

Renal

113
Q

Progressive LOSS of RENAL FUNCTION

“END-STAGE RENAL DISEASE” / “END-STAGE KIDNEYS”

A

Chronic Renal Failure

114
Q

Alkaptonuria (Homogentesic Acid)
MSUD
Melanoma (Melanin)
PKU

A

Ferric Chloride test

115
Q

Alkaptonuria (Homogentesic Acid)

A

Ammoniacal Silver Nitrite/Benedict’s Test

116
Q

Tyrosinuria

A

Nitrosonaphthol Test

117
Q

Porphyria (Porphobilinogen)

A

Hoesch Test/Watson-Schartz Test

118
Q

Inborn errors of metabolism Result from: INHERITED DEFECT

A

Primary Aminoaciduria

119
Q

SEVERE LIVER DISEASE or GENERALIZED TUBULAR
DYSFUNCTION

A

Secondary Aminoaciduria

120
Q

DEPOSITION OF CYSTINE in the LYSOSOMES of cells throughout the body

A

Cystinosis

121
Q

Most common & SEVERE FORM of Cystinosis

A

Nephropathic Cystinosis

122
Q

RARE FORM of Cystinosis

A

Intermediate Cystinosis/Ocular Cystinosis

123
Q

Autosomal Recessive

A

Cystinuria

124
Q

Deficient Enzyme: Branched-Chain α-Keto Acid Dehydrogenase (BCKD)

A

Maple Syrup Urine Disease

125
Q

INCREASED urinary excretion of PHENYLPYRUVIC ACID (a ketone) and its metabolites

Urine, Sweat & Breath: Characteristic MOUSY/MUSTY ODOR

A

Phenylketonuria

126
Q

Excretion of large amount of HOMOGENTISIC ACID (HGA) in the urine

A

Alkaptonuria

126
Q

Excretion of large amount of HOMOGENTISIC ACID (HGA) in the urine

A

Alkaptonuria

127
Q

Increased amount of TYROSINE in the urine → occurs when → tyrosine levels in PLASMA is abnormally high

A

Tyrosinuria

128
Q

Increased excretion of urinary melanin

A

Melanuria

129
Q

Defective melanin production

A

Hypomelanosis / Albinism