Book: Microscopic Examination Flashcards by Tristan Buenvenida

Macroscopic screening of urine specimens is used to:

A. Provide results as soon as possible
B. Predict the type of urinary casts present
C. Increase cost-effectiveness of urinalysis
D. Decrease the need for polarized microscopy

Provide results as soon as possible

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Variations in the microscopic analysis of urine include all
of the following except:

A. Preparation of the urine sediment
B. Amount of sediment analyzed
C. Method of reporting
D. Identification of formed elements

Identification of formed elements

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All of the following can cause false-negative microscopic
results except:

A. Braking the centrifuge
B. Failing to mix the specimen
C. Dilute alkaline urine
D. Using midstream clean-catch specimens

Dilute alkaline urine

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The two factors that determine relative centrifugal force are:

A. Radius of rotor head and rpm
B. Radius of rotor head and time of centrifugation
C. Diameter of rotor head and rpm
D. RPM and time of centrifugation

Diameter of rotor head and rpm

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When using the glass slide and cover-slip method, which of the following might be missed if the cover slip is overflowed?

A. Casts
B. RBCs
C. WBCs
D. Bacteria

Casts

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Initial screening of the urine sediment is performed using
an objective power of:

A. 4×
B. 10×
C. 40×
D. 100×

10x

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Which of the following should be used to reduce light intensity in bright-field microscopy?

A. Centering screws
B. Aperture diaphragm
C. Rheostat
D. Condenser aperture diaphragm

Rheostat

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Which of the following are reported as number per lpf?

A. RBCs
B. WBCs
C. Crystals
D. Casts

Casts

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The Sternheimer-Malbin stain is added to urine sediments to do all of the following except:

A. Increase visibility of sediment constituents
B. Change the constituents’ refractive index
C. Decrease precipitation of crystals
D. Delineate constituent structures

Decrease precipitation of crystals

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Nuclear detail can be enhanced by:

A. Prussian blue
B. Toluidine blue
C. Acetic acid
D. Both B and C

Both B and C

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Which of the following lipids is/are stained by Sudan III?

A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both B and C

Both B and C

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Which of the following lipids is/are capable of polarizing
light?

A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both A and B

Cholesterol

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The purpose of the Hansel stain is to identify:

A. Neutrophils
B. Renal tubular cells
C. Eosinophils
D. Monocytes

Eosinophils

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Crenated RBCs are seen in urine that is:

A. Hyposthenuric
B. Hypersthenuric
C. Highly acidic
D. Highly alkaline

Hypersthenuric

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Differentiation among RBCs, yeast, and oil droplets may
be accomplished by all of the following except:

A. Observation of budding in yeast cells
B. Increased refractility of oil droplets
C. Lysis of yeast cells by acetic acid
D. Lysis of RBCs by acetic acid

Lysis of yeast cells by acetic acid

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A finding of dysmorphic RBCs is indicative of:

A. Glomerular bleeding
B. Renal calculi
C. Traumatic injury
D. Coagulation disorders

Glomerular bleeding

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Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit brownian movement are:

A. Indicative of pyelonephritis
B. Basophils
C. Mononuclear leukocytes
D. Glitter cells

Glitter cells

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Mononuclear leukocytes are sometimes mistaken for:

A. Yeast cells
B. Squamous epithelial cells
C. Pollen grains
D. Renal tubular cells

Renal tubular cells

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When pyuria is detected in a urine sediment, the slide
should be carefully checked for the presence of:

A. RBCs
B. Bacteria
C. Hyaline casts
D. Mucus

Bacteria

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Transitional epithelial cells are sloughed from the:

A. Collecting duct
B. Vagina
C. Bladder
D. Proximal convoluted tubule

Bladder

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The largest cells in the urine sediment are:

A. Squamous epithelial cells
B. Urothelial epithelial cells
C. Cuboidal epithelial cells
D. Columnar epithelial cells

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Squamous epithelial cells

A clinically significant squamous epithelial cell is the:

A. Cuboidal cell
B. Clue cell
C. Caudate cell
D. Columnar cell

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Clue cell

Forms of transitional epithelial cells include all of the following except:

A. Spherical
B. Caudate
C. Convoluted
D. Polyhedra

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Convoluted

Increased transitional cells are indicative of:

A. Catheterization
B. Malignancy
C. Pyelonephritis
D. Both A and B

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Both A and B

A primary characteristic used to identify renal tubular epithelial cells is: A. Elongated structure B. Centrally located nucleus C. Spherical appearance D. Eccentrically located nucleus

Eccentrically located nucleus

Following an episode of hemoglobinuria, RTE cells may contain: A. Bilirubin B. Hemosiderin granules C. Porphobilinogen D. Myoglobin

Hemosiderin granules

The predecessor of the oval fat body is the: A. Histiocyte B. Urothelial cell C. Monocyte D. Renal tubular cell

Renal tubular cell

A structure believed to be an oval fat body produced a Maltese cross formation under polarized light but does not stain with Sudan III. The structure: A. Contains cholesterol B. Is not an oval fat body C. Contains neutral fats D. Is contaminated with immersion oil

Contains cholesterol

The finding of yeast cells in the urine is commonly associated with: A. Cystitis B. Diabetes mellitus C. Pyelonephritis D. Liver disorders

Diabetes mellitus

The primary component of urinary mucus is: A. Bence Jones protein B. Microalbumin C. Uromodulin D. Orthostatic protein

Uromodulin

The majority of casts are formed in the: A. Proximal convoluted tubules B. Ascending loop of Henle C. Distal convoluted tubules D. Collecting ducts

Distal convoluted tubules

Cylindruria refers to the presence of: A. Cylindrical renal tubular cells B. Mucus-resembling casts C. Hyaline and waxy casts D. All types of casts

All types of casts

A person submitting a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment except: A. Hyaline casts B. Granular casts C. RBC casts D. WBC casts

WBC casts

Prior to identifying an RBC cast, all of the following should be observed except: A. Free-floating RBCs B. Intact RBCs in the cast C. Presence of a cast matrix D. A positive reagent strip blood reaction

Intact RBCs in the cast

WBC casts are primarily associated with: A. Pyelonephritis B. Cystitis C. Glomerulonephritis D. Viral infections

Pyelonephritis

The shape of the RTE cell associated with renal tubular epithelial casts is primarily: A. Elongated B. Cuboidal C. Round D. Columnar

Round

When observing RTE casts, the cells are primarily: A. Embedded in a clear matrix B. Embedded in a granular matrix C. Attached to the surface of a matrix D. Stained by components of the urine filtrate

Embedded in a clear matrix

The presence of fatty casts is associated with: A. Nephrotic syndrome B. Crush injuries C. Diabetes mellitus D. All of the above

All of the above

Nonpathogenic granular casts contain: A. Cellular lysosomes B. Degenerated cells C. Protein aggregates D. Gram-positive cocci

Cellular lysosomes

All of the following are true about waxy casts except they: A. Represent extreme urine stasis B. May have a brittle consistency C. Require staining to be visualized D. Contain degenerated granules

Require staining to be visualized

Observation of broad casts represents: A. Destruction of tubular walls B. Dehydration and high fever C. Formation in the collecting ducts D. Both A and C

Both A and C

All of the following contribute to urinary crystals formation except: A. Protein concentration B. pH C. Solute concentration D. Temperature

Protein concentration

The most valuable initial aid for identifying crystals in a urine specimen is: A. pH B. Solubility C. Staining D. Polarized microscopy

Crystals associated with severe liver disease include all of the following except: A. Bilirubin B. Leucine C. Cystine D. Tyrosine

Cystine

All of the following crystals routinely polarize except: A. Uric acid B. Cholesterol C. Radiographic dye D. Cystine

Cystine

Casts and fibers can usually be differentiated using: A. Solubility characteristics B. Patient history C. Polarized light D. Fluorescent light

Polarized light

Match the following crystals seen in acidic urine with their description/identifying characteristics: Amorphous urates Uric acid Calcium oxalate monohydrate Calcium oxalate dihydrate

Pink sediment Yellow-brown whetstone Ovoid Envelopes

Match the following crystals seen in acidic urine with their description/identifying characteristics: Triple phosphate Amorphous phosphate Calcium phosphate Ammonium biurate Calcium carbonate

Coffin lids White precipitate Thin prisms Thorny apple Dumbbell shape

Match the following abnormal crystals with their description/identifying characteristics: Cystine Tyrosine Cholesterol Leucine Ampicillin Radiographic dye Bilirubin

Hexagonal plates Fine needles seen in liver disease Notched corners Concentric circles, radial striations Bundles following refrigeration Flat plates, high specific gravity

Match the following types of microscopy with their descriptions: Bright-field Phase Polarized Dark-field Fluorescent Interference contrast

Low refractive index objects may be overlooked Forms halo of light around object Objects split light into two beams Indirect light is reflected off the object Detects specific wavelengths of light emitted from objects Three-dimensional images

Book: Microscopic Examination Flashcards

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