MIDTERM-microscopic exam - urinary sediments - 11111

Question 1

what are the urine sediments constituents

Answer 1

red blood cells
white blood cells
epithelial cells
bacteria
yeast
parasites
spermatozoa
mucus
casts
urinary crystals

Question 2

___
determine the actual concentration of the sediment and, there
fore, the number of elements that may be present in a microscopic field.

Answer 2

urine sediment preparation methods

Question 3

Of all the urine sediment elements, which sediment is the most difficult for students to recognize.

Answer 3

RBCs

Question 4

In hyposthenuria, rbc tends to swell and burst leaving only the cell membrane.

These large empty
cells are called ____ and can be easily missed if specimens are not examined under reduced light

Answer 4

ghost cells

Question 5

why do rbc is the hardest sediment to recognize among the urine sediments ?

Answer 5

lack of characteristics structures
variations in size
close resemblance to other urine sediment constituents

Question 6

3 sediments that rbc’s are misidentified due to high resemblancy

Answer 6

yeast
oil droplets
air bubbles

Question 7

what will aid us in differentiating yeast, oil droplets, and air bubbles from rbc?

Answer 7

yeast exhibits budding
oil ad air bubbles is highly refractile when the fine adjustment is focused up and down

Question 8

The rough appearance of crenated RBCs may resemble the ___, but they are much smaller
than it.

Answer 8

granules seen in WBCs

Question 9

____ staining can be used to confirm the presence of rbc and differentiate with wbc, yeast, oil, and air.

Answer 9

Supra vital

Question 10

Should the identification continue to be doubtful, adding ___ to a portion of the sediment will lyse the RBCs, leaving the yeast, oil droplets, and WBCs intact. Supra
vital staining may also be helpful.

Answer 10

acetic acid

Question 11

RBCs that vary in size, have cellular protrusions, or are fragmented are
termed __ and have been associated primarily with glomerular bleeding.

Answer 11

dysmorphic

Question 12

The presence of RBCs in the urine is associated with damage
to the ___ or __ within the
genitourinary tract.

Answer 12

glomerular membrane or vascular injury

Question 13

Macroscopic hematuria is fre
quently associated with advanced glomerular damage but is
also seen with damage to the vascular integrity of the urinary
tract caused by ___ , __, and ___

Answer 13

trauma, acute infection or inflammation, and
coagulation disorders.

Question 14

The observation of microscopic hematuria can be critical
to the early diagnosis of glomerular disorders and malignancy
of the urinary tract and to confirm the presence of ___

Answer 14

renal calculi

Question 15

The presence of not only RBCs but also hyaline, granular, and rbc cast. It sometimes can be caused by

Answer 15

strenuous exercise

Question 16

The predominant WBC found in the urine sediment is
the ___.

Answer 16

neutrophil

Question 17

Neutrophils are much easier to identify than
RBCs because they contain ___ and ___

Answer 17

granules and multilobed nuclei

Question 18

Neutrophils lyse rapidly in ____ and begin to lose nuclear detail.

Answer 18

dilute alkaline urine

Question 19

Neutrophils exposed to hypotonic urine absorb water and
swell. Brownian movement of the granules within these larger
cells produces a sparkling appearance, and they are referred to
as “____.”

Answer 19

glitter cells

Question 20

neutrophils in hypotonic urine produces sparkling appearance and can be stained by __ appearing colored ____

Answer 20

sternheimer-malbin stain appearing colored light blue

Question 21

The presence of urinary eosinophils is primarily associated
with ___.

Answer 21

drug-induced interstitial nephritis

Question 22

The preferred urinary eosinophil test stain is __

Answer 22

Hansel stain

Question 23

ifthere’s no hansel stain for eosinophil test, what stain we can used instead?

Answer 23

wright’s stain

Question 24

Eosinophils are not normally seen in the
urine; therefore, the finding of more than how many percent eosinophils is
considered significant.

Answer 24

1%

Question 25

WBC Resembles RTE or renal tubular epithelial cells. the difference is

Answer 25

RTE is larger with eccentrically located nucleus

Question 26

what are the mononuclear cells

Answer 26

lymphocytes, monocytes, macrophages, and histiocytes

Question 27

wbc that are large cells and may appear vacuolated or contain inclusions.

Answer 27

MONOCYTE, MACROPHAGES, HISTIOCYTES

Question 28

WBCs in the process of ameboid motion may be difficult to distinguish from epithelial cells because of their irregular shape. ___ or the addition of ___ can be used to enhance nuclear detail if necessary.

Answer 28

Supravital staining; acetic acid

Question 29

complete urinalysis correlation of wbc

Answer 29

Leukocyte esterase Nitrite Specific gravity pH

Question 30

source of identification erroe of wbc

Answer 30

RTE cells

Question 31

An increase in urinary WBCs is called ___ and indicates the presence of an infection or inflammation in the genitourinary system

Answer 31

pyuria

Question 32

It is not unusual to find epithelial cells in the urine, because they are derived from the linings of the ___.

Answer 32

genitourinary system

Question 33

what are the Three types of epithelial cells are seen in urine:

Answer 33

squamous, transitional (urothelial), and renal tubular

Question 34

___are the largest cells found in the urine sediment.

Answer 34

Squamous epithelial cells

Question 35

morphology of SQUAMOUS epithelial cells

Answer 35

They contain abundant, irregular cytoplasm and a prominent nucleus about the size of an RBC

Question 36

They are often the first structures observed when the urine sediment is examined under low-power magnification.

Answer 36

squamous epithelial cells

Question 37

Squamous epithelial cells originate from the linings of the female orga such as the ___ and the lower portion of the male ___.

Answer 37

vagina and female urethra; urethra

Question 38

Difficulty identifying squamous cells is rare. However, they may occasionally appear folded, possibly resembling a ___, and will begin to disintegrate in urine that is not fresh

Answer 38

cast

Question 39

A variation of the squamous epithelial cell is the ___, which does have pathologic significance.

Answer 39

clue cell

Question 40

Increased amounts are more frequently seen in urine from ___ patients.

Answer 40

female

Question 41

Specimens collected using the __ technique contain less squamous cell contamination.

Answer 41

midstream clean-catch

Question 42

Clue cells are indicative of vaginal infection by the bacterium ___.

Answer 42

Gardnerella vaginalis

Question 43

To be considered a clue cell, the bacteria should cover most of the cell surface and extend beyond the edges of the cell. . This gives the cell a granular, irregular appearance true or false

Answer 43

true

Question 44

Transitional epithelial cells are smaller than squamous cells and appear in several forms, including ___

Answer 44

spherical, polyhedral, and caudate

Question 45

the differences of shape of transitional epithelial cells are due to the ability of transitional epithelial cells to___

Answer 45

absorb large amounts of water.

Question 46

IS TRASITIONAL EPITHELIAL CELLS LARGER THAN SQUAMOUS?

Answer 46

NO, smaller than squamous cells and appear in several forms

Question 47

among the forms of transitional epithelial cells, which is the largest when in contact with the urine?

Answer 47

spherical

Question 48

Transitional epithelial cells originate from the lining of the ____

Answer 48

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

Question 49

Increased numbers of transitional cells seen singly, in pairs, or in clumps are called

Answer 49

syncytia

Question 50

Increased numbers of transitional cells seen singly, in pairs, or in clumps (syncytia) are present following invasive urologic procedures such as __

Answer 50

catheterization and are of no clinical significance

Question 51

An increase in transitional cells exhibiting abnormal morphology such as vacuoles and irregular nuclei may be indicative of __ or __

Answer 51

malignancy or viral infection

Question 52

RTE cell's size and shape depends on its ____

Answer 52

location or the area they originate

Question 53

The cells from ___ are larger than other RTE cells.

Answer 53

the proximal convoluted tubule (PCT)

Question 54

The cells from proximal convoluted tubule sis much larger than other rte cells, which they tend to have ___ shape

Answer 54

rectangular shape

Question 55

The cells from proximal convoluted tubule sis much larger than other rte cells, which they tend to have rectangular shape and are commonly referred to as __ or ___

Answer 55

columnar or convoluted cells.

Question 56

RTE often resembles

Answer 56

cast

Question 57

how to differentiate RTE from cast

Answer 57

They should be closely examined for the presence of a nucleus, as a nucleus would not be present in a cast.

Question 58

Cells from the collecting duct that appear in groups of three or more are called ___

Answer 58

renal fragments.

Question 59

RTE cells are commonly present as a result of ___, the nucleus is not easily visible in unstained sediment

Answer 59

tissue destruction or necrosis

Question 60

Renal tubular epithelial cells ___ are cuboidal and are never round.

Answer 60

Collecting duct RTE cells

Question 61

renal tubular epithelial Cells from the___ are smaller than those from the PCT and are round or oval.

Answer 61

distal convoluted tubule (DCT)

Question 62

a renal tubular cells that are frequently seen as large sheets of cells.

Answer 62

collecting duct cells

Question 63

The presence of more than ____ RTE cells per high-power field indicates tubular injury, and such specimens should be referred for cytologic urine testing.

Answer 63

two

Question 64

___ are the most clinically significant of the epithelial cells

Answer 64

RTE cells

Question 65

The presence of increased amounts of RTE cells is indicative of ___

Answer 65

necrosis of the renal tubules,

Question 66

Conditions producing tubular necrosis include exposure to___

Answer 66

heavy metals, drug-induced toxicity, hemoglobin and myo globin toxicity, viral infections (hepatitis B), pyelonephritis, al lergic reactions, malignant infiltrations, salicylate poisoning, and acute allogenic transplant rejection.

Question 67

RTE cells may also be seen as secondary effects of __

Answer 67

glomerular disorders

Question 68

Single cuboidal cells are particularly noticeable in cases of ___

Answer 68

salicylate poisoning

Question 69

Renal fragments are an indication of ___ with __- disruption (collecting duct cells )

Answer 69

severe tubular injury with basement membrane disruption

Question 70

Because one of the functions of RTE cells is reabsorption of the glomerular filtrate, it is NOT UNUSUAL for them to contain substances from the filtrate. true or false

Answer 70

true

Question 71

aside from absorbing hemoglobin that was beenc onverted by the rte cells to hemosiderin, what is the component or sediment that it can absorb as well resulting it to become highly refractile

Answer 71

lipids and the RTE cells will be called as oval fat bodies

Question 72

These lipid-containing RTE cells are __

Answer 72

called oval fat bodies

Question 73

the oval fat bodies droplets are composed of

Answer 73

triglycerides, neutral fats, and cholesterol

Question 75

Urine sediments negative for fat after staining should still be checked using ___ in case only cholesterol is present.

Answer 75

polarized light

Question 76

To be considered significant for UTI, bacteria should be accompanied by __.

Answer 76

WBCs

Question 77

The use of ___microscopy aids in the visualization of bacteria

Answer 77

phase

Question 78

The presence of bacteria can be indicative of either ___ or __

Answer 78

lower or upper UTI.

Question 79

The bacteria most frequently associated with UTI are the ___

Answer 79

Enterobacteriaceae (referred to as gram negative rods)

Question 80

example of cocci shaped bacteria that can as well cause UTI

Answer 80

staphylococcus and enterococcus

Question 81

The actual bacteria producing an UTI cannot be identified with the microscopic examination true or false

Answer 81

true

Question 82

Yeast, In severe infections, they may appear as branched, ____

Answer 82

mycelial forms

Question 83

appear in the urine as small, refractile oval structures that may or may not contain a bud

Answer 83

yeast

Question 84

Yeast cells, primarily ____, are seen in the urine of diabetic patients, immunocompromised patients, and women with vaginal moniliasis.

Answer 84

Candida albicans

Question 85

Ideal medium for yeast to grow

Answer 85

acidic glucose-containing urine of diabetic patients

Question 86

A true yeast infection should be accompanied by the presence of ___.

Answer 86

WBCs

Question 87

The most frequent parasite encountered in the urine is ___

Answer 87

Trichomonas vaginalis

Question 88

a bladder parasite seen usually in US. It has been associated with bladder cancer in other countries

Answer 88

Schistosoma haematobium

Question 89

Fecal contamination of a urine specimen can also result in the presence of ova from intestinal parasites in the urine sediment. The most common contaminant is ova from the pinworm ___

Answer 89

Enterobius vermicularis

Question 90

are easily identified in the urine sediment by their oval, slightly tapered heads and long, flagella-like tails

Answer 90

spermatozoa

Question 91

is urine toxic for sperms?

Answer 91

yes, therefore, they rarely exhibit the motility observed when examining a semen specimen.

Question 92

which reagent strip indicator will turn positive if spermatozoa is present in the urine?

Answer 92

protein

Question 93

mucus are produced by ___

Answer 93

glands and the epithelial cells of the lower genitourinary tract and the RTE cells

Question 94

major constituent of mucus

Answer 94

uromodulin

Question 95

is a glycoprotein excreted by the RTE cells of the distal convoluted tubules and upper collecting ducts.

Answer 95

Uromodulin