WorksheetsAUBF MODULE 6 QUIZ
Total questions: 100
Worksheet time: 1hrs 11mins
When urine sediment is viewed, stains and various microscopic techniques are used to:
1. enhance the observation of fine detail.
2. confirm the identity of suspected components.
3. differentiate formed elements that look alike.
4. facilitate the visualization of low-refractile
components
1, 2, and 3 are correct
1 and 3 are correct.
4 is correct
All are correct.
The microscopic identification of hemosiderin is enhanced when the urine sediment is stained with
Gram stain
Hansel stain
Prussian blue stain
Sudan III stain
When the laboratorian performs the microscopic examination of urine sediment, which of the following are enumerated using low-power magnification?
Bacteria
Casts
Red blood cells
Renal tubular cells
A urine sediment could have which of the following formed elements and still be considered “normal”?
Two or fewer hyaline casts
Five to 10 red blood cells
A few bacteria
A few yeast cells
Which of the following statements about red blood cells in urine is true?
Red blood cells crenate in hypotonic urine
Red blood cell remnants are called “ghost cells.”
Alkaline and hypotonic urine promotes red blood cell disintegration
Dysmorphic red blood cells often are associated with renal tubular disease
Hemoglobin is a protein and will
not react in the protein reagent strip test.
interfere with the protein reagent strip test, producing erroneous results
always contribute to the protein reagent strip result, regardless of the amount of hemoglobin present.
contribute to the protein reagent strip result only when large concentrations of hemoglobin are present
Which urinary sediment component(s) when observed microscopically can resemble red blood cells?
1. Yeasts
2. Air bubbles
3. Oil droplets
4. Calcium oxalate crystals
1, 2, and 3 are correct
1 and 3 are correct
4 is correct
All are correct
Which of the following is not a characteristic of neutrophils found in the urine sediment?
They are approximately 10 to 14 µm in diameter
They form “ghost cells” in hypotonic urine.
They shrink in hypertonic urine but do not crenate.
As they disintegrate, vacuoles and blebs form and their nuclei fuse.
Which statement regarding lymphocytes found in urine sediment is correct?
They are not normally present in the urine.
They produce a positive leukocyte esterase test.
Their number is increased in patients with drug hypersensitivity.
Their number is increased in patients experiencing kidney transplant rejection.
Urinary casts are formed in
the distal and collecting tubules
the distal tubules and the loops of Henle.
the proximal and distal tubules
the proximal tubules and the loops of Henle.
Urinary casts are formed with a core matrix of
albumin
Bence Jones protein
transferrin
uromodulin
Which of the following does not contribute to the size, shape, or length of a urinary cast?
The concentration of protein in the core matrix of the cast
The configuration of the tubule in which the cast is formed
The diameter of the tubular lumen in which the cast is formed
The duration of time the cast is allowed to form in the tubule
All of the following enhance urinary cast formation except
an alkaline pH
urinary stasis
an increase in the solute concentration of the ultrafiltrate
an increase in the quantity of plasma proteins in the ultrafiltrate
When the laboratorian is using brightfield microscopy, a urinary cast that appears homogeneous with well-defined edges, blunt ends, and cracks is most likely a
fatty cast
granular cast
hyaline cast
waxy cast
All of the following can be found incorporated into a cast matrix except
bacteria
crystals
transitional epithelial cells
white blood cells
Which of the following urinary casts are diagnostic of glomerular or renal tubular damage?
Bacterial casts
Red blood cell casts
Renal tubular cell casts
White blood cell casts
Which of the following characteristics best differentiates waxy casts from fibers that may contaminate urine sediment?
Waxy casts do not polarize light; fibers do.
Waxy casts are more refractile than fibers.
Waxy casts have rounded ends; fibers do not.
Waxy casts are thicker at their margins; fibers are thicker in the middle
Which of the following does not affect the formation of urinary crystals within nephrons?
The pH of the ultrafiltrate
The diameter of the tubular lumen
The flow of urine through the tubules
The concentration of solutes in the ultrafiltrate
Microscopic Description: Colorless “coffin lid” form
Ammonium biurate
Amorphous phosphates
Calcium oxalate
Triple phosphate
Cholesterol
Microscopic Description: Colorless hexagonal plates
Cystine
Amorphous phosphates
Calcium oxalate
Triple phosphate
Cholesterol
Microscopic Description: Colorless “envelope” form
Cystine
Amorphous phosphates
Calcium oxalate
Triple phosphate
Cholesterol
Microscopic Description: Colorless rectangular plates
with notched corners
Cystine
Amorphous phosphates
Calcium oxalate
Triple phosphate
Cholesterol
Microscopic Description: Yellow-brown “thorny apple”
form
Amorphous urates
Amorphous phosphates
Calcium oxalate
Ammonium biurate
Cholesterol
Microscopic Description: Colorless to yellow; diamond-shaped or rhombic, can form layer
Amorphous urates
Uric acid
Calcium oxalate
Ammonium biurate
Sulfonamides
Microscopic Description: Yellow-brown sheaves of
wheat
Amorphous urates
Uric acid
Calcium oxalate
Ammonium biurate
Sulfonamides
Which of the following crystals, when found in the urine sediment, most likely indicates an abnormal metabolic condition
Bilirubin
Sulfonamides
Triple phosphate
Uric acid
During the microscopic examination of a urine sediment, cystine crystals are found. The laboratorian should perform which of the following before reporting the presence of these crystals?
1. Perform a confirmatory chemical test
2. Ensure that the urine specimen has an acid
pH
3. Assess the number of crystals per high-power
field
4. Check the current medications that the
patient is taking
1, 2, and 3 are correct
1 and 3 are correct
4 is correct
All are correct
Mucous threads can be difficult to differentiate from
fibers
hyaline casts
pigmented casts
waxy casts
Which of the following is not a distinguishing characteristic of yeast in the urine sediments
Motility
Budding forms
Hyphae formation
Colorless ovoid forms
Fat can be found in the urine sediment in all of the following forms except
within casts
within cells
as free-floating globules
within hemosiderin granules
Which of the following statements regarding the characteristics of urinary fat is true?
Cholesterol droplets stain with Sudan III stain
Triglyceride or neutral fat stains with Oil Red O stain
Cholesterol droplets do not form a Maltese cross pattern under polarized light
Triglycerides and neutral fat are anisotropic and form a Maltese cross pattern under polarized light
Which of the following statements regarding the microscopic examination of urine sediment is false?
If large numbers of leukocytes are present microscopically, then bacteria are present
If urinary fat is present microscopically, then the chemical test for protein should be positive
If large numbers of casts are present microscopically, then the chemical test for protein should be positive
If large numbers of red blood cells are present microscopically, then the chemical test for blood should be positive
The following are initial results obtained during a routine urinalysis. Which results should be investigated further?
Negative protein; 2 to 5 waxy casts
Cloudy, brown urine; 2 to 5 red blood cell
Urine pH 7.5; ammonium biurate crystals
Clear, colorless urine; specific gravity 1.010
The following are initial results obtained during a routine urinalysis. Which results should be investigated further?
Negative protein; 0 to 2 hyaline casts
Urine pH 6.0; calcium oxalate crystals
Cloudy, yellow urine; specific gravity 1.050
Amber urine with yellow foam; negative bilirubin by reagent strip; positive Ictotest
Which of the following when found in the urine sediment from a female patient is not considered a vaginal contaminant?
Fat
Clue cells
Spermatozoa
Trichomonads
Macroscopic screening of urine specimens is used to:
Provide results as soon as possible
Predict the type of urinary casts present
Increase cost-effectiveness of urinalysis
Decrease the need for polarized microscopy
Variations in the microscopic analysis of urine include all
of the following except:
Preparation of the urine sediment
Amount of sediment analyzed
Method of reporting
Identification of formed elements
All of the following can cause false-negative microscopic results except:
Braking the centrifuge
Failing to mix the specimen
Dilute alkaline urine
Using midstream clean-catch specimens
The two factors that determine relative centrifugal force are:
Radius of rotor head and rpm
Radius of rotor head and time of centrifugation
Diameter of rotor head and rpm
RPM and time of centrifugation
When using the glass slide and cover-slip method, which of the following might be missed if the cover slip is overflowed?
Casts
RBCs
WBCs
Bacteria
Initial screening of the urine sediment is performed using
an objective power of
4x
10x
40x
100x
Which of the following should be used to reduce light
intensity in bright-field microscopy?
Centering screws
Aperture diaphragm
Rheostat
Condenser aperture diaphragm
Which of the following are not reported as number per hpf?
RBCs
WBCs
Crystals
Casts
The Sternheimer-Malbin stain is added to urine sediments to do all of the following except:
Increase visibility of sediment constituents
Change the constituents’ refractive index
Decrease precipitation of crystals
Delineate constituent structures
Nuclear detail can be enhanced by
Prussian blue
Toluidine blue
Acetic acid
Both Toluidine blue and Acetic Acid
Which of the following lipids is/are stained by Sudan III?
Cholesterol
Neutral fats
Triglycerides
Triglycerides & Neutral fats
Which of the following lipids is/are capable of polarizing
light?
Cholesterol
Neutral fats
Triglycerides
Cholesterol & Neutral fats
The purpose of the Hansel stain is to identify:
Neutrophils
Renal tubular cells
Eosinophils
Monocytes
Crenated RBCs are seen in urine that is:
Hyposthenuric
Hypersthenuric
Highly acidic
Highly alkaline
Differentiation among RBCs, yeast, and oil droplets may
be accomplished by all of the following except
Observation of budding in yeast cells
Increased refractility of oil droplets
Lysis of yeast cells by acetic acid
Lysis of RBCs by acetic acid
A finding of dysmorphic RBCs is indicative of
Glomerular bleeding
Renal calculi
Traumatic injury
Coagulation disorders
Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit brownian movement are:
Indicative of pyelonephritis
Basophils
Mononuclear leukocytes
Glitter cells
Mononuclear leukocytes are sometimes mistaken for:
Yeast cells
Squamous epithelial cells
Pollen grains
Renal tubular cells
When pyuria is detected in a urine sediment, the slide
should be carefully checked for the presence of:
RBCs
Bacteria
Hyaline casts
Mucus
Transitional epithelial cells are sloughed from the:
Collecting duct
Vagina
Bladder
Proximal convoluted tubule
The largest cells in the urine sediment are
Squamous epithelial cells
Urothelial epithelial cells
Cuboidal epithelial cells
Columnar epithelial cells
A clinically significant squamous epithelial cell is the:
Cuboidal cell
Clue cell
Caudate cell
Columnar cell
Forms of transitional epithelial cells include all of the following except
Spherical
Caudate
Convoluted
Polyhedral
Increased transitional cells are indicative of:
Catheterization
Malignancy
Pyelonephritis
Catheterization and Malignancy
A primary characteristic used to identify renal tubular epithelial cells is:
Elongated structure
Centrally located nucleus
Spherical appearance
Eccentrically located nucleus
Following an episode of hemoglobinuria, RTE cells may
contain:
Bilirubin
Hemosiderin granules
Porphobilinogen
Myoglobin
The predecessor of the oval fat body is the:
Histiocyte
Urothelial cell
Monocyte
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:
Contains cholesterol
Is not an oval fat body
Contains neutral fats
Is contaminated with immersion oil
The finding of yeast cells in the urine is commonly associated with:
Cystitis
Diabetes mellitus
Pyelonephritis
Liver disorders
The primary component of urinary mucus is
Bence Jones protein
Microalbumin
Uromodulin
Orthostatic protein
The majority of casts are formed in the:
Proximal convoluted tubules
Ascending loop of Henle
Distal convoluted tubules
Collecting ducts
Cylindruria refers to the presence of
Cylindrical renal tubular cells
Mucus-resembling casts
Hyaline and waxy 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:
Hyaline casts
Granular casts
RBC casts
WBC casts
Prior to identifying an RBC cast, all of the following should be observed except:
Free-floating RBCs
Intact RBCs in the cast
Presence of a cast matrix
A positive reagent strip blood reaction
WBC casts are primarily associated with:
Pyelonephritis
Cystitis
Glomerulonephritis
Viral infections
The shape of the RTE cell associated with renal tubular epithelial casts is primarily:
Elongated
Cuboidal
Round
Columnar
When observing RTE casts, the cells are primarily
Embedded in a clear matrix
Embedded in a granular matrix
Attached to the surface of a matrix
Stained by components of the urine filtrate
The presence of fatty casts is associated with
Nephrotic syndrome
Crush injuries
Diabetes mellitus
All of the choices given
Nonpathogenic granular casts contain:
Cellular lysosomes
Degenerated cells
Protein aggregates
Gram-positive cocci
All of the following are true about waxy casts except they:
Represent extreme urine stasis
May have a brittle consistency
Require staining to be visualized
Contain degenerated granules
Observation of broad casts represents:
Destruction of tubular walls
Dehydration and high fever
Formation in the collecting ducts
Destruction of tubular walls and formation in the collecting ducts
All of the following contribute to urinary crystals formation except
Protein concentration
pH
Solute concentration
Temperature
The most valuable initial aid for identifying crystals in a
urine specimen is:
pH
Solubility
Staining
Polarized microscopy
Crystals associated with severe liver disease include all of the following except
Bilirubin
Leucine
Cystine
Tyrosine
All of the following crystals routinely polarize except:
Uric acid
Cholesterol
Radiographic dye
Cystine
Casts and fibers can usually be differentiated using:
Solubility characteristics
Patient history
Polarized light
Fluorescent light
Type of Microscope: Forms halo of light around
object
Bright-field
Polarized
Phase contrast
Fluorescent
Interference contrast
Type of Microscope: Detects specific wavelengths
of light emitted from objects
Bright-field
Polarized
Phase contrast
Fluorescent
Interference contrast
Identify the image.
Candida Albicans
Trichomonas
Enterobius
E. nana
Identify the image.
RBCs
Air Bubbles
Yeast cells
Oil
Identify the image.
RBCs
Air Bubbles
Yeast cells
Oil
Identify the image.
RBCs
Air Bubbles
Yeast cells
Oil
Identify the type of cast in the image.
Red Blood Cell Casts
White Blood Cell Casts
Fatty Casts
Hyaline Casts
Broad Casts
Identify the type of cast in the image.
Red Blood Cell Casts
White Blood Cell Casts
Fatty Casts
Hyaline Casts
Broad Casts
Identify the type of cast in the image.
Red Blood Cell Casts
Waxy Casts
Fatty Casts
Hyaline Casts
Broad Casts
Identify the type of cast in the image.
Granular Casts
Waxy Casts
Fatty Casts
Hyaline Casts
Broad Casts
Identify the type of cast in the image.
Granular casts
Waxy Casts
Fatty Casts
Hyaline Casts
Broad Casts
Identify the type of cast in the image.
Granular casts
Waxy Casts
Fatty Casts
Hyaline Casts
Broad Casts
Identify the type of crystals present in the image.
Cystine
Cholesterol
Triple Phosphate
Uric Acid
Bilirubin
Identify the type of crystals present in the image.
Cystine
Cholesterol
Triple Phosphate
Uric Acid
Calcium Oxalate
Identify the type of crystals present in the image.
Cystine
Cholesterol
Triple Phosphate
Uric Acid
Calcium Oxalate
Identify the type of crystals present in the image.
Cystine
Cholesterol
Triple Phosphate
Uric Acid
Calcium Oxalate
Identify the type of crystals present in the image.
Cystine
Cholesterol
Triple Phosphate
Uric Acid
Calcium Oxalate
Identify the type of crystals present in the image.
Cystine
Cholesterol
Triple Phosphate
Uric Acid
Calcium Oxalate
Identify the type of epithelial cells.
Squamous
Transitional
Renal Tubular
