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AUBF MICROSCOPIC URINE EXAMINATION > ABNORMAL URINARY CRYSTALS > Flashcards

ABNORMAL URINARY CRYSTALS Flashcards

1
Q

In which type of urine are abnormal urinary crystals most often found?

A

* Are most often found in acidic urine, although they are rarely found in neutral urine.

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2
Q

What distinguishes cystine crystals from uric acid crystals?
A) Colorless appearance
B) Highly birefringent nature
C) Confirmation through the Cyanide-Nitroprusside Test
D) Association with metabolic disorders

A

B) Highly birefringent nature

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3
Q

How would you describe the APPEARANCE of cystine crystals?
A) Yellow, Rhomboid Crystals
B) Colorless, Hexagonal Plates [thick or thin]
C) Brown, Needle-Like Crystals
D) Red, Cubic Crystals

A

B) Colorless, Hexagonal Plates [thick or thin]

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4
Q

What is the preferred method for confirming the presence of cystine crystals?
A) Microscopic examination
B) X-ray analysis
C) Cyanide-Nitroprusside Test
D) Urinalysis

A

C) Cyanide-Nitroprusside Test

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5
Q

What metabolic disorder is associated with cystine crystals, preventing the reabsorption of cysteine by renal tubules?
A) Alkaptonuria
B) Cystinosis
C) Maple syrup urine disease
D) Tyrosinemia

A

B) Cystinosis

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6
Q

Which characteristic best describes the appearance of cholesterol crystals under a microscope?

A) Rectangular plates with a notch on one or more corners
B) Spherical structures with spiky projections
C) Colorless, hexagonal plates
D) Needle-shaped crystals with pointed ends

A

** A) Rectangular plates with a notch on one or more corners**

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7
Q

Which condition is associated with the presence of cholesterol in the urine?
A) Nephrotic Syndrome
B) Renal calculi
C) Urinary tract infection
D) Chronic kidney disease

A

A) Nephrotic Syndrome

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8
Q

What characteristic of cholesterol can be compared to radiographic dye regarding its property for differentiation?

A) Refractive index
B) Solubility
C) Specific gravity
D) Crystal structure

A

C) Specific gravity

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9
Q

What is the characteristic appearance of RADIOGRAPHIC DYE crystals?
A) Colorless, Hexagonal Plates
B) Colorless flat plates, similar to CHOLESTEROL Crystals
C) Yellow needles
D) Brown spherical clusters

A

B) Colorless flat plates, similar to CHOLESTEROL Crystals

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10
Q

What property of RADIOGRAPHIC DYE distinguishes it from other crystals?
A) Highly birefringent
B) Markedly Elevated Specific Gravity
C) Positive Cyanide-Nitroprusside Test
D) Formation of Renal Calculi

A

B) Markedly Elevated Specific Gravity

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11
Q

Which statement accurately describes characteristics of SULFONAMIDES?

A) They dissolve upon addition of Dilute Acetic Acid
B) Appearance includes Colorless to Yellow-Brown crystals in various shapes
C) Indistinguishable from Calcium Phosphate crystals
D) Crystallization is not influenced by patient hydration

A

B) Appearance includes Colorless to Yellow-Brown crystals in various shapes

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12
Q

How can sulfonamide crystals be distinguished from calcium phosphate?
A) Sulfonamides does not dissolve in dilute acetic acid, whereas calcium phosphate does.

B) Sulfonamides appear as colorless hexagonal plates, while calcium phosphate forms spherical crystals.

C) Sulfonamides exhibit birefringence under polarized light, unlike calcium phosphate.

A

A) Sulfonamides does not dissolve in dilute acetic acid, whereas calcium phosphate does.

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13
Q

Which factor primarily contributes to Sulfonamide crystallization in patients?

A) High Calcium Intake
B) Inadequate Hydration
C) Excessive Vitamin C consumption
D) Low Sodium Levels

A

B) Inadequate Hydration

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14
Q

Which chemical compound among the following is distinguished from Calcium Phosphate?

A) Sulfonamides
B) Sulfates
C) Phosphites
D) Carbonates

A

A) Sulfonamides

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15
Q

What is a common characteristic of the appearance of Ampicillin when refrigerated?
A) It turns yellow
B) It forms colorless needles
C) It becomes a gel-like substance
D) It develops a grainy texture

A

B) It forms colorless needles

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16
Q

What is the indicated use of AMPICILLIN?

A) Treatment of fungal infections
B) Prevention of viral infections
C) Precipitation of antibiotics following massive dosage
D) Reduction of inflammation in allergies

A

C) Precipitation of antibiotics following massive dosage

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17
Q

What is the characteristic appearance of Leucine?

A) Yellow-Brown spheres [concentric circles with radial striations]
B) Transparent prisms
C) Red irregular crystals
D) Colorless cubic structures

A

A) Yellow-Brown spheres [concentric circles with radial striations]

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18
Q

What substance, when observed microscopically, resembles pollen grains and is associated with liver disorders, often accompanied by Tyrosine crystals?

A) Leucine
B) Glutamine
C) Serotonin
D) Cysteine

A

A) Leucine

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19
Q

What is the typical appearance of Tyrosine crystals?

A) Blue spheres
B) Fine, Colorless to Yellow needles [in clumps or rosettes]
C) Red hexagons
D) Irregular brown plates

A

B) Fine, Colorless to Yellow needles [in clumps or rosettes]

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20
Q

Which other substance is commonly seen in conjunction with Tyrosine crystals and shows a positive chemical test for Bilirubin?

A) Uric Acid
B) Cystine
C) Leucine
D) Cholesterol

A

C) Leucine

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21
Q

Which of the following conditions is Tyrosine commonly associated with?

A) Diabetes
B) Kidney stones
C) Liver disorders
D) Respiratory infections

A

C) Liver disorders

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22
Q

What is the characteristic appearance of Bilirubin crystals?

A) White, fine needles
B) Yellow, clump needles or granules
C) Green, spherical clusters
D) Red, irregular spheres

A

B) Yellow, clump needles or granules

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23
Q

Which physical appearance and clinical manifestation are associated with Bilirubin?

A

* Bilirubin presents as yellow, clump needles, or granules in appearance, and its presence in urine indicates a possible liver disorder.

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24
Q

What is the characteristic appearance of STARCH artifacts under microscopic examination?

A) Colorless to Yellow needles
B) Yellow-Brown spheres with concentric circles
C) Highly refractile sphere with dimpled center
D) Fine, Colorless to Yellow needles in clumps or rosettes

A

C) Highly refractile sphere with dimpled center

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25
Q

Which of the following artifacts may be observed in microscopic examination of a urine sample?
A) Highly refractile sphere with a dimpled center
B) Yellow, clump needles or granules
C) Yellow-brown spheres with concentric circles and radial striations
D) Oil droplets and air bubbles

A

D) Oil droplets and air bubbles

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26
Q

Pollen grains in microscopy appear as:
A) Cuboid structures with smooth surfaces
B) Spheres with a cell wall and concentric circles
C) Elongated fibers with irregular edges
D) Ribbon-like structures with branching patterns

A

B) Spheres with a cell wall and concentric circles

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27
Q

Which of the following is true regarding the appearance of fibers/hair in microscopic analysis?

A) They often appear with air bubbles
B) They resemble starch spheres
C) Fibers may resemble casts and show polarization, while casts do not
D) They exhibit a highly refractile appearance

A

C) Fibers may resemble casts and show polarization, while casts do not

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28
Q

What artifact may resemble plant and meat fibers or appear as brown amorphous material due to fecal contamination in a microscopic examination?

A) Starch
B) Oil droplets
C) Fibers/hair
D) Fecal contamination

A

D) Fecal contamination

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29
Q

Which of the following descriptions best characterizes hyaline casts under microscopic examination?

A) Jagged and irregular edges
B) Containing cellular components
C) Spherical with granular texture
D) Parallel and rounded edges

A

D) Parallel and rounded edges

30
Q

What setting on the microscope is recommended for observing a normal count of hyaline casts?

A) High magnification
B) Medium brightness
C) Low brightness
D) Oil immersion

A

C) Low brightness

31
Q

What is the typical appearance of HYALINE CASTS when viewed unstained under the microscope?

A) Pink and granular
B) Colorless
C) Yellow with clump needles
D) Highly refractile spheres with dimpled centers

A

B) Colorless

32
Q

What color do hyaline casts appear when stained with Sternheimer-Malbin stain?

A) Blue
B) Green
C) Red
D) Pink

A

D) Pink

33
Q

Which condition commonly leads to an increase in hyaline casts?

A) Hypothermia
B) Rest after a meal
C) Strenuous exercise
D) Sedentary lifestyle

A

C) Strenuous exercise

34
Q

What pathological conditions are commonly associated with a pathologic increase in hyaline casts?

A) Diabetes mellitus
B) Hypertension
C) Acute Glomerulonephritis, Pyelonephritis, chronic renal disease, Congestive heart failure
D) Hyperthyroidism

A

C) Acute Glomerulonephritis, Pyelonephritis, chronic renal disease, Congestive heart failure

35
Q

What is another term for a cast that appears as “blood cast” or “muddy brown cast”?

A. Hyaline cast
B. Granular cast
C. Waxy cast
D. RBC cast

A

D. RBC cast

36
Q

What condition may lead to the presence of RBC casts, resembling a “blood cast” or “muddy brown cast”?

A) Acute Glomerulonephritis
B) Strenuous Contact Sport
C) Chronic Renal Disease
D) Congestive Heart Failure

A

B) Strenuous Contact Sport

37
Q

Which of the following statements is true regarding RBC CASTS?

A. Blood cast indicates decreased stasis of urine under left lateral decubitus position (LPO).
B. Blood cast is unrelated to the stasis of urine in any position.
C. Blood cast suggests greater stasis of urine under left lateral decubitus position (LPO).
D. Blood cast is an indicator of increased urine flow regardless of body position.

A

C. Blood cast suggests greater stasis of urine under left lateral decubitus position (LPO).

38
Q

What is the primary indication for the presence of RBC casts in the urine?

A) Urinary tract infection
B) Dehydration
C) Bleeding within the Nephron
D) Diabetes mellitus

A

C) Bleeding within the Nephron

39
Q

What is the likely cause of the orange-red color observed in RBC casts?

A) Presence of bilirubin
B) High levels of uric acid
C) Hemoglobin contamination
D) Increased eosinophils in urine

A

C) Hemoglobin contamination

40
Q

What is the typical association of glomerular damage (glomerulonephritis) with regard to RBC casts?

A) Hematuria and Normal Erythrocytes
B) Proteinuria and Dysmorphic Erythrocytes
C) Polyuria and Spherical Erythrocytes
D) Glycosuria and Fragmented Erythrocytes

A

B) Proteinuria and Dysmorphic Erythrocytes

41
Q

Which type of casts degenerate into pigment, granular cast, especially in conditions of greater stasis of urine?

A) White Blood Cell (WBC) Casts
B) Red Blood Cell (RBC) Casts
C) Hyaline Casts
D) Epithelial Casts

A

B) Red Blood Cell (RBC) Casts

42
Q

Which of the following best describes WBC casts?

A) Red blood cells embedded in hyaline cast matrix.
B) Platelets embedded in hyaline cast matrix.
C) Leukocytes embedded in hyaline cast matrix.
D) Epithelial cells embedded in hyaline cast matrix.

A

C) Leukocytes embedded in hyaline cast matrix.

43
Q

Which condition is characterized by the presence of WBC casts without bacterial inflammation?

A) Pyelonephritis
B) Glomerulonephritis
C) Acute Interstitial Nephritis
D) Renal Cell Carcinoma

A

C) Acute Interstitial Nephritis

44
Q

Which type of white blood cells is most commonly found in casts and appears as granular?

A) Lymphocytes
B) Monocytes
C) Neutrophils
D) Eosinophils

A

** C) Neutrophils**

45
Q

In which medical condition associated with bacterial inflammation is the presence of WBC casts commonly observed?

A

* WBC casts are frequently found in the urine of individuals with pyelonephritis

46
Q

What does the presence of WBC casts in urine signify?

A) Normal kidney function
B) Dehydration
C) Liver dysfunction
D) Infection or inflammation within the nephron

A

D) Infection or inflammation within the nephron

47
Q

What is the primary function of WBC casts in urine analysis?

A) Identifying cystitis in lower urinary tract infections (UTI)
B) Distinguishing between pyelonephritis and cystitis
C) Indicating the presence of red blood cell (RBC) casts
D) Diagnosing urethritis in upper urinary tract infections

A

B) Distinguishing between pyelonephritis and cystitis

48
Q

Which type of urinary tract infection is associated with WBC casts?

A) Pyelonephritis (Upper UTI)
B) Cystitis (Lower UTI)
C) Both A and B
D) Neither A nor B

A

C) Both A and B

49
Q

Which of the following is associated with bacterial inflammation leading to pyelonephritis?

A) Fungal casts
B) Viral casts
C) Bacterial casts
D) Parasitic casts

A

C) Bacterial casts

50
Q

What is a characteristic feature observed in bacterial casts associated with pyelonephritis?

A) Presence of Fungi within the Protein Matrix
B) Absence of Bacilli in the Protein Matrix
C) Bacilli both within and bound to the Protein Matrix
D) Protein Matrix without any microbial presence

A

C) Bacilli both within and bound to the Protein Matrix

51
Q

What is the composition of bacterial casts?

A) Only red blood cells (RBCs)
B) Only white blood cells (WBCs)
C) Pure bacterial cast or mixed with wbcs
D) Only epithelial cells

A

c) Pure bacterial cast or mixed with wbc

52
Q

Which of the following statements is true regarding bacterial casts?

A) Bacterial casts are smooth and transparent.

B) Bacterial casts are composed of crystals.

C) Bacterial casts may resemble granular casts.

D) Bacterial casts are exclusively found in urine of healthy individuals.

A

C) Bacterial casts may resemble granular casts.

53
Q

What is the recommended method for confirming the presence of bacterial casts?

A) Acid-fast staining
B) Ziehl-Neelsen staining
C) Gram stain
D) Wright’s stain

A

C) Gram stain

54
Q

What conditions or factors are commonly associated with the presence of epithelial cell casts in urine?

A
  • heavy metal
  • chem drug induced
  • viral infection
  • allograft rejection + WBC
55
Q

What is the significant feature of an EPITHELIAL CELL CAST?

A) Presence of Red Blood Cells
B) Presence of Renal Tubular Epithelial (RTE) Cells
C) Presence of White Blood Cells
D) Presence of Crystal Deposits

A

B) Presence of Renal Tubular Epithelial (RTE) Cells

56
Q

What is the primary indication for the presence of an epithelial cell cast in urine?

A) Urinary tract infection
B) Glomerulonephritis
C) Advanced Tubular Obstruction
D) Dehydration

A

C) Advanced Tubular Obstruction

57
Q

What is the characteristic combination associated with the condition known as “LIPIDURIA”?

A) Fatty Casts + Oval Fat Bodies + Free Fat Droplets
B) Proteinuria + Hematuria
C) Glucosuria + Ketones
D) Leukocyturia + Bacteria

A

A) Fatty Casts + Oval Fat Bodies + Free Fat Droplets

58
Q

What medical conditions are frequently associated with FATTY CASTS?

A
  • Nephrotic Syndrome
  • Toxic Tubular Necrosis
  • Diabetes Mellitus (DM)
  • Crush Injuries
59
Q

What is the defining characteristic of mixed cellular casts?

A) Casts containing only red blood cells
B) Casts containing multiple cell types
C) Casts formed in the distal tubules
D) Casts composed solely of white blood cells

A

B) Casts containing multiple cell types

60
Q

What are the most frequently encountered types of mixed cellular casts in urine analysis and their associations?

A
  • RBC and WBC casts in Glomerulonephritis or WBC+ RTE
  • **WBC and RTE Cell Casts, or WBC and Bacterial Casts in Pyelonephritis or WBC+ BACTERIAL CELL CAST. **
61
Q

What is the primary cause of the formation of granular casts in the urine?

A) Bacterial infection
B) Accumulation of minerals
C) Cellular disintegration
D) Dehydration

A

C) Cellular disintegration

62
Q

What do granular casts may resemble once they disintegrate?

A) Fatty Casts
B) Waxy Casts
C) Hyaline Casts
D) Epithelial Casts

A

B) Waxy Casts

63
Q

What is the primary factor responsible for the transient increase of granular casts during periods of strenuous exercise?

A) Decreased cellular metabolism
B) Increased cellular metabolism
C) Elevated blood pressure
D) Reduced urine production

A

B) Increased cellular metabolism

64
Q

What happens to granular casts when they remain in the tubules for an extended period?

A) They become crystalline casts.
B) They transform into fatty casts.
C) They disintegrate, resulting in waxy casts.
D) They develop into hyaline casts.

A

C) They disintegrate, resulting in waxy casts.

65
Q

What is the characteristic appearance of WAXY CASTS?

A) Smooth and round
B) Fragments with jagged ends and notched on sides
C) Irregular and spiral-shaped
D) Transparent and colorless

A

B) Fragments with jagged ends and notched on sides

66
Q

Which of the following best describes the supravital staining of WAXY CASTS?

A) Speckled Light Blue
B) Homogenous Dark Pink
C) Variegated Green
D) Irregular Orange Stripes

A

B) Homogenous Dark Pink

67
Q

What is the primary indication for the presence of waxy casts in urine?

A) Acute urinary tract infection
B) Dehydration
C) Chronic renal failure
D) Diabetes mellitus

A

C) Chronic renal failure

68
Q

What do waxy casts represent in the context of renal pathology?

A) Initial stage of cast formation
B) Advanced stage of other cast types
C) Indicators of normal kidney function
D) Formed exclusively during hydration

A

B) Advanced stage of other cast types

69
Q

What type of casts are associated with renal failure?

A) Plaster Casts
B) Broadcasts
C) Renal Failure Casts
D) Fishing Casts

A

C) Renal Failure Casts

70
Q

What is the primary indication associated with the term “BROAD CASTS” in the context provided?

A) Thickening of the Tubular Walls
B) Narrowing of the Tubular Walls
C) Destruction “Widening” of the Tubular Walls
D) Formation of Tubular Buds

A

C) Destruction “Widening” of the Tubular Walls

71
Q

What is a characteristic of BROADCASTS in comparison to other options?

A) More focused
B) Limited reach
C) Narrower scope
D) Much broader than the others

A

D) Much broader than the others

72
Q

Which condition is associated with the presence of both bile stain and waxy cast in urine?

A) Glomerulonephritis
B) Tubular necrosis caused by viral hepatitis
C) Renal stones
D) Diabetes mellitus

A

**B) Tubular necrosis caused by viral hepatitis
**

AUBF MICROSCOPIC URINE EXAMINATION (13 decks)

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