UNIT 5

Question 1

smooth,Non-nucleated biconcave
disks measuring approximately 7

Answer 1

microscopic RBC

Question 2

Larger than RBCs, measuring an
average of about 12 mm in diameter

Answer 2

microscopic WBCs

Question 3

The predominant WBC found in the
urine sediment

much easier to
identify than RBCs because they
contain granules and multilobed
nuclei

lyse rapidly in dilute
alkaline urine and begin to lose
nuclear detail.

Answer 3

neutrophils

Question 4

Brownian movement of the
granules within these larger
cells produces a sparkling
appearance
○ no pathologic significance

Answer 4

glitter cells in hypotonic urine

Question 6

Largest cells in the sediment with
abundant, irregular cytoplasm and
prominent nuclei about the size of an
RBC
●Hallmark (Point of Reference)

Answer 6

squamous cells

Question 7

Rarely encountered, folded cells may
resemble casts and will begin to
disintegrate in urine that is not fresh.

Answer 7

squamous epithelial cells

Question 8

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

Answer 8

pyuria

Question 9

Specimens containing an increased amount of mononuclear cells that cannot be
identified as epithelial cells should be referred for

Answer 9

cytodiagnostic urine testing

Question 10

are usually larger than WBCs with an eccentrically located nucleus.

Answer 10

RTE

Question 11

Rare, few, moderate, or man per
lpf
They are reported in terms of
low-power or high-power
magnification based on laboratory
protocol.

Answer 11

squamous epithelial

Question 12

the first structures observed when the urine sediment is examined under lph.

Answer 12

squamous epithelial

Question 13

cells originate from the linings of the vagina and female urethra and the lower portion of the male urethra.
○ represent normal cellular sloughing and have no pathologic significance.

Answer 13

squamous cells

Question 14

are indicative of vaginal infection by the bacterium

Answer 14

clue cells

gardenella vaginalis

Question 15

They appear as squamous epithelial cells covered with the

Answer 15

clue cells

gardenella coccobacillus

Question 16

To be considered a clue cell, the bacteria should cover most of the cell surface and extend beyond the edges of the cell.

Answer 16

TRUE

Question 17

Routine testing for clue cells is performed by examining a

Answer 17

vaginal wet preparation

Question 18

Spherical, polyhedral, or caudate with
centrally located nucleus

Answer 18

transitional cells

Question 19

These differences are caused by the
ability of transitional epithelial cells
to absorb large amounts of water.

Answer 19

TRUE

Question 20

are the
most often seen TCs
in microscopic exams

Answer 20

spherical TC

Question 21

The presence of a centrally located
rather than eccentrically placed nucleus,
and supravital staining, can aid in the
differentiation.

Answer 21

TRANSITIONAL CELLS

Question 22

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

Answer 22

transitional epithelial cells

Question 23

Increased numbers of transitional cells seen singly, in pairs, or in clumps (syncytia) are present following invasive urologic procedures such as
catheterization and are of no clinical significance

Answer 23

TRUE

Question 24

Rectangular, columnar, round, oval or,
cuboidal with an eccentric nucleus
possibly bilirubin-stained or
hemosiderin-laden

Answer 24

RTE CELLS

Question 25

Most often seen is the Round Oval Cytoplasm is granular

Answer 25

RTE CELLS

Question 26

bigger than WBC

Answer 26

RTE

Question 27

larger than other RTE Cells. Cytoplasm is coarsely granular ■ Resembles casts.

Answer 27

CELLS FROM PCT

Question 28

are smaller than those from the PCT Round or Oval ■ Can be mistaken for WBC and Spherical Transitional Epithelial Cells

Answer 28

CELLS FROM DCT

Question 29

cuboidal and never round. ■ Presence of at least one straight edge differentiates them from spherical and polyhedral transitional cells.

Answer 29

COLLECTING DUCTS RTE

Question 30

appears in groups of three or more are called

Answer 30

cells from collecting duct renal fragments

Question 31

most clinically significant of the epithelial cells.

Answer 31

RTE CELLS

Question 32

presence of more than two RTE cells per high-power field indicates

Answer 32

tubular injury

Question 33

Highly refractile RTE cells ●Polarizing Microscope ○Maltese Cross Formation

Answer 33

oval fat bodies - type of RTE cell

Question 34

ovl fat bodies are confirmed using

Answer 34

sudan III or oil red O

Question 35

used in specimen collection must be considered when only free-floating fat droplets are present.

Answer 35

lubricants

Question 36

most frequently associated with damage to the glomerulus caused by the nephrotic syndrome

Answer 36

lipiduria

Question 37

small spherical and rod-shaped structures ●can be seen in stool smears either rods or cocci ●Hallmark: motile

Answer 37

bacteria

Question 38

Pear-shaped, motile, flagellated

Answer 38

trichomonas

Question 39

most frequent parasite encountered in the urine

Answer 39

trichomonas

Question 40

Small, oval, refractile structures with buds and/or mycelia

Answer 40

yeast

Question 42

In severe infections, they may appear as branched, mycelial forms

Answer 42

yeast

Question 43

A true yeast infection should be accompanied by the presence of

Answer 43

WBCs

Question 44

Single or clumped threads with a low refractive index

Answer 44

mucus

Question 45

Mucous Threads came from.

Answer 45

genitalia

Question 46

major constituent of mucus.

Answer 46

uromodulin

Question 47

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

Answer 47

uromodulin

Question 48

appears microscopically as thread-like structures with a low refractive index.

Answer 48

mucus

Question 49

Subdued light is required when using bright-field microscopy

Answer 49

mucus

Question 50

Mucus is more frequently present in _____ urine specimens

Answer 50

female

Question 51

Mucus threads are reported as rare, few, moderate, or many per

Answer 51

lpf

Question 52

Most common type of cast ○ consists almost entirely of uromodulin.

Answer 52

hyaline casts

Question 53

Pathologically, hyaline casts are ______ in acute glomerulonephritis, pyelonephritis, chronic renal disease, and congestive heart failure.

Answer 53

increased

Question 54

Tamm-Horsfall protein Dehydration or exercise

Answer 54

hyaline casts

Question 55

appear colorless in unstained sediments and have a refractive index similar to that of urine; thus, they can easily be overlooked if specimens are not examined under subdued light.

Answer 55

hyaline casts

Question 56

Sternheimer-Malbin stain produces a ____ color in hyaline casts

Answer 56

pink

Question 57

Always pathological Glomerular Damage Glomerulonephritis Vasculitis

Answer 57

RBC CAST

Question 58

have also been observed in healthy individuals following participation in strenuous contact sports. _____ are easily detected under low power by their orange-red color.

Answer 58

RBC CASTS

Question 59

They are more fragile than other casts and may exist as fragments or have a more irregular shape as the result of tightly packed cells adhering to the protein matrix.

Answer 59

RBC CASTS

Question 60

Inflammation or infection Pyelonephritis Allergic interstitial nephritis Nephrotic Syndrome Post-streptococcal glomerulonephritis

Answer 60

WBC CASTS

Question 61

are visible under low-power magnification but must be positively identified using high power. Most frequently, ______ are composed of neutrophils; therefore, they may appear granular, and, unless disintegration has occurred, multilobed nuclei will be present.

Answer 61

WBC CASTS

Question 62

Colorless, homogeneous matrix

Answer 62

hyaline

Question 63

presence of casts in urine tamm-horsfall protein

Answer 63

cylinduria

Question 64

Orange-red color, cast matrix containing RBCs

Answer 64

RBC

Question 65

highly refractile cast with jagged ends and notches

Answer 65

waxy

Question 66

The brittle, highly refractive cast matrix from which these casts derive their name is believed to be caused by degeneration of the hyaline cast matrix and any cellular elements or granules contained in the matrix. are more easily visualized than hyaline casts because of their higher refractive index

Answer 66

waxy casts

Question 67

With supravital stains, waxy casts stain a homogenous,

Answer 67

dark pink

Question 68

Often referred to as renal failure casts,

Answer 68

broad

Question 69

represent extreme urine stasis.

Answer 69

broad

Question 70

Manner of Reporting: rare, few, moderate, or many per hpf

Answer 70

normal crystals

Question 71

Manner of Reporting: averaged per lpf

Answer 71

abnormal crystals

Question 72

presence of crystals in the urine

Answer 72

crystalluria

Question 73

Color: Coffin-lids structure. pH: Alkaline

Answer 73

triple phosphate

Question 74

Color: Envelope shaped, oval, dumbbell pH: Acid/Neutral (alkaline)

Answer 74

calcium oxalate

Question 75

Color: Yellow brown (rosettes, wedges) pH: Acid

Answer 75

uric acid

Question 76

Color: Yellow pH: Acid Disorders: Liver Disease ● Present in hepatic disorders producing large amounts of bilirubin in the urine.

Answer 76

bilirubin

Question 77

COHORT C Color: Colorless (Notched Plates) pH: Acid Disorders: Nephrotic Syndrome

Answer 77

cholesterol

Question 78

Color: Yellow pH: Acid Disorders: Liver Disease ● Hemolytic Disorders ● yellow-brown spheres that demonstrate concentric circles and radial striations

Answer 78

LEUCINE

Question 79

Color: Yellow-brown (“Thorny Apples”) pH: Alkaline

Answer 79

ammonium biurate

Question 80

Color: Colorless pH: Alkaline / neutral

Answer 80

calcium phosphate

Question 82

Color: Colorless (hexagonal plates) pH: Acid Disorders: Inherited cystinuria

Answer 82

cysteine

Question 83

Color: Colorless - Yellow pH: Acid / Neutral Disorders: Liver Disease

Answer 83

tyrosine

Question 84

appear as fine colorless to yellow needles that frequently form clumps or rosettes ● Usually seen in conjunction with leucine crystals in specimens with positive chemical test results for bilirubin.

Answer 84

tyrosine crystals

Question 85

Color: Colorless to Yellow pH: Acid/Neutral Disorders: Infection

Answer 85

sulfonamide

Question 86

primary cause of sulfonamide crystallization.

Answer 86

inadequate patient hydration

Question 87

Shapes ○ Needles ○ Rhombics ○ Whetstone ○ Sheaves of Wheat

Answer 87

sulfonamide

Question 88

Color: Colorless (dumbbells) pH: Alkaline

Answer 88

calcium carbonate

Question 89

Sandlike Similar structure with Urates that is why you need to determine the pH in order to differentiate.

Answer 89

amorphous

Question 90

Color: Colorless (flat plates) pH: Acid Disorders: Radiographic

Answer 90

radiographic dye

Question 91

Color: Colorless (Needles) pH: Acid / Neutral Disorders: ● Precipitation of antibiotics is not frequently encountered except for the rare observation of ampicillin crystals following massive doses of this penicillin compound without adequate hydration. ● ______appear as colorless needles that tend to form bundles following refrigeration

Answer 91

ampicillin

Question 93

used for routine urinalysis

Answer 93

bright field

Question 94

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

Answer 94

phase contrast microscopy

Question 95

Aids in identification of cholesterol in oval fat. bodies, fatty casts, and crystals

Answer 95

polrizing microscopy

Question 96

Aids in identification of Treponema pallidum, Leptospira, Campylobacter jejuni, endospores

Answer 96

dark field microscopy

Question 97

Allows visualization of. naturally fluorescent microorganisms or those stained by a fluorescent dye including labeled antigens and antibodies

Answer 97

fluorescence microscopy

Question 98

Produces a three-dimensional microscopy image ang layer-by-layer imaging of a specimen

Answer 98

interference contrast

Question 99

Identifies WBCs, epithelial cells, and casts

Answer 99

sternheimer malbin

Question 100

Differentiates WBCs from RTE cells

Answer 100

toluidine blue

Question 101

Distinguishes RBCs from WBCs, yeast, oil droplets, and crystals

Answer 101

2% acetic acid

Question 102

Identify free fat droplets and lipid-containing cells and casts

Answer 102

oil red O and sudan III

Question 103

Identifies bacterial casts

Answer 103

gram stain

Question 104

Identifies urinary eosinophils

Answer 104

hansel

Question 105

Identifies yellow-brown granules of hemosiderin in cells and casts

Answer 105

prussian blue stain

Question 106

Delineates structure and contrasting colors of the nucleus and cytoplasm

Answer 106

sternheimer malbin

Question 107

Enhances nuclear detail

Answer 107

toluidine blue

Question 108

Lyses RBCs and enhances nuclei of WBCs

Answer 108

2% acetic acid

Question 109

Stain triglycerides and neutral fats orange-red; do not stain cholesterol

Answer 109

lipid stains

Question 110

stains eosinophilic granules

Answer 110

methylene blue eosin Y

Question 111

Stains structures containing iron

Answer 111

prussian blue stain

Question 112

This method cannot be used for initial sediment analysis because RBCs are lysed by

Answer 112

2% acetic acid

Question 113

Casts

Answer 113

average number per lpf

Question 114

RBCs, WBCs

Answer 114

average number per hpf

Question 116

Epithelial cells, Crystals

Answer 116

semiquantitative terms

Question 119

protein material produced by the glands and epithelial cells of the lower genitourinary tract and the RTE cells

Answer 119

mucus