Microscopic Examination

Question 1

Sediments in urine with these clinical significance:
1. renal disease
2. lower urinary tract disease
3. toxic reactions due to drugs
4. physiologic causses

Answer 1

RBCs

Question 2

salicylates and anticoagulant therapy produces what sediments in urine

Answer 2

RBCs

Question 3

what are the 4 rbc morphology that can be found in urine

Answer 3

• normal
• crenated
• ghost
• dysmorphic

Question 4

RBCs with ___ cells/hpf is considered abnormal.

Answer 4

> 3 cells/hpf

Question 5

Erythrocytes are found in ___ cells/hpf in normal urine

Answer 5

0-2 cells/hpf

Question 6

toxic drugs such as sulfonamides, methanamine can produce what sediment in urine?

Answer 6

RBCs

Question 7

RBC morphology where rbc is lysed and only cell membrane is left.

Answer 7

Ghost RBCs

Question 8

RBC morphology that can be found in hyposthenuria (low specific gravity)

Answer 8

ghost rbcs

Question 9

RBC morph where rbc shrinks, found in hypersthenuria

Answer 9

crenated rbcs

Question 10

7 um in diameter of RBCs is considered what rbc morphology

Answer 10

normal duh

Question 11

dysmorphic rbcs in urine is ___ in origin

Answer 11

glomerular

Question 12

doughnut shaped rbc with 1 or more membrane blebs

Answer 12

G1 cell

Question 13

May be more specific than dysmorphic cells for
diagnosing glomerular hematuria (Dinda, 1997)

Answer 13

G1 cell

Question 14

what are 2/3 sources of rbc identification errors

Answer 14

1. yeast
2. oil droplets
3. air bubbles

Question 15

what stain or chemical is used to differentiate RBCs errors such as yeast or oil droplets, and wbc

Answer 15

acetic acid

Question 16

sediment characteristic:
exhibit greater variation in size and are highly refractile

Answer 16

oil droplets and air bubbles

Question 17

___ leukocytes/hpf are seen in normal urine

Answer 17

<5

Question 18

increase in urinary WBCs (principally neutrophils)

Answer 18

Pyuria

Question 19

Chlamydia trachomatis, staphylococci, and coliforms are causative agents

Answer 19

Pyuria

Question 20

correlated with
- Leukocyte esterase
- Nitrite
- Specific Gravity
- pH

Answer 20

WBCs

Question 21

what is the significance of NITRITE screening test?

Answer 21

Bacteria/WBCs

Question 22

What is the significance of the screening test for PROTEINS?

Answer 22

casts/cells

Question 23

significance of screening test for GLUCOSE

Answer 23

yeast

Question 24

Provided evidence that chamber counts on centrifuged urine sediments are more reliable in predicting renal functional abnormalities than coventional method using cells per HPF

Answer 24

Kesson (1978)

Question 25

Normal value of these parameters in quantitative count. neutrophils? 5 to __/uL RBCs? 3 to __ /uL casts? 1 to __/ul

Answer 25

neutrophils = 5 to 30/uL RBCs = 3 to 20/uL casts = 1 to 2/uL

Question 26

When was Addis count developed

Answer 26

1926

Question 27

Standard amount of specimen centrifuged is ___ mL.

Answer 27

10 to 15 mL

Question 28

If not possible to obtain 12 mL specimen...

Answer 28

- specimen volume noted on report - for correction, results are multiplied by 2

Question 29

How many minutes do we centrifuge the specimen?

Answer 29

5 minutes @ 400 RCF (Relative centrifugal force) because it produces least chance of damage to elements

Question 30

Used when quantitating the number of elements per mL

Answer 30

Concentration factor

Question 31

What are the sediment volumes frequently used

Answer 31

0.5 and 1.0mL

Question 32

Reporting of CASTS in routine microscopic examination

Answer 32

per 10 LPFs

Question 33

reporting of RBCs and WBCs in routine microscopic examination

Answer 33

per 10 HPFs

Question 34

This stain is used for methylene blue and eosin y, for eosinophil granules

Answer 34

Hansel stain

Question 35

stains structures containing iron

Answer 35

Prussian blue stain

Question 36

identifies WBCs, epithelial cells, and casts

Answer 36

Sternheimer-Malbin

Question 37

Toluidine blue stain is for

Answer 37

enhancement of nuclear detail

Question 38

This is used for detection of malignancies of the lower urinary tract

Answer 38

Cytodiagnostic urine testing

Question 39

stain used in cytodiagnostic urine testing

Answer 39

Papanicolaou stain

Question 40

part of illumination system of the microscope which contains a number of leaves that the operator may open or close to increase the amount of light illuminating the object

Answer 40

iris diaphragm

Question 41

part of illumination system of the microscope which gathers the light coming from the light source and to concentrate that light in a collection of parallel beams into the specimen

Answer 41

condenser

Question 42

most common and simplest condenser

Answer 42

Abbe condenser

Question 43

most common filter used

Answer 43

blue since it absorbs some of the yellow to red light from illumination bulbs

Question 44

usual thickness of cover glass

Answer 44

0.17 mm

Question 44

filters are used for

Answer 44

enhanced contrast and color correction

Question 45

this is a technique used to optimize light quality and sharpness by aligning and adjusting each component of the optical system. performed whenever an objective is changed.

Answer 45

Kohler Illumination

Question 46

image in the microscope is upside down and reversed, what is this called?

Answer 46

virtual image

Question 47

most common type of microscope wherein object appear dark against a light background

Answer 47

Bright-field microscopy

Question 48

Enhances visualization of elements with low refractive indices, such as hyaline casts, mixed cellular casts, mucus threads, and Trichomonas eliminates the need to fix or stain living cells

Answer 48

Phase contrast microscopy

Question 49

calculated as the speed with which light travels in air divided by the speed with which light travels through the substance

Answer 49

refractive index

Question 50

aids in identification of birefringent elements: cholesterol on OFB, fatty casts, and crystals

Answer 50

Polarizing microscope

Question 51

Allows visualization of naturally fluorescent substances or those that have been stained with a fluorochrome or fluorophore to produce an image

Answer 51

Fluoroscence microscopy

Question 52

property by which atoms absorb light at a particular wavelength and emit light of a longer wavelength

Answer 52

Fluorescence

Question 53

Fluorescent compound with green emission at 517nm

Answer 53

FITC Fluorescein Isothiocyanate

Question 54

Fluorescent compound that is red emission at 580nm

Answer 54

TRITC Tetramethylrhodamine Isothiocyanate

Question 55

enhances visualization of elements with low refractive indices such as hyaline casts, mixed cellular casts, mucous threads, and trichomonas

Answer 55

phase-con mic

Question 56

aids in ID of **Treponoma pallidum**

Answer 56

Dark-field microscopy

Question 57

produces a three dimensional microscopy image and layer by layer imaging of a specimen

Answer 57

interference-contrast