MLT 111 Exam 3 (Ch. 7)

What do you see in this image?

RBC’s (some are crenated)

What do you see in this image?

White Blood Cells (neutrophils)

What do you see in this image?

Squamous — Epithelial cell

What do you see in this image? Location of origin?

Transitional Epithelial Cells — (lining of renal/bladder)

What do you see in this image? Indication?

RTE - Renal Tubular Epithelial — (renal tubule issues)

What do you see in this image? What can it indicate?

Calcium Oxalate (dihydrate) — kidney stones

What do you see in this image? Indication?

Triple Phosphate — UTI or kidney stones

What does the arrow point out in urine? What may it indicate?

Yeast (indicates UTI or contamination)

What do you see in this image? Indication?

RBC Cast

Indicator of glomerular damage

What do you see in this image? Is it normal or abnormal?

Hyaline Cast, Normal

What do you see in this image?

Is it clinically significant (normal or abnormal)?

What can it indicate?

Waxy Cast — ‘Skyrim whips wrappings’

Abnormal, renal failure

What do you see in this image? Abnormal or normal?

WBC Cast — abnormal

What do you see in this image? What does it indicate?

Granular Cast — Indicates Renal Disease

What do you see in this image?

Bacteria (indicated by reduced nitrates)

What sediment is in the image?

Amorphous Urates ; Acidic ; Normal

What do you see in this image? What can it indicate?

Calcium phosphate ; Kidney Disease

What do you see in this image? Is it clinically significant?

Calcium Carbonate ; Normal

What do you see in this image? What can it indicate?

Cystine — Metabolic disorder

What do you see in this image? What can it indicate?

Tyrosine — Amino acid metabolic disorder

What do you see in this image?

Is it clinically significant?

Acidic or Alkaline?

What can it indicate?

Uric Acid

Acidic

What do you see in this image?

Is it clinically significant?

Acidic or Alkaline?

What can it indicate?

Leucine

Significant

Acidic

Hepatic disorder

What do you see in this image?

Is it clinically significant?

Acidic or Alkaline?

What can it indicate?

Starch Crystals

What do you see in this image?

Is it clinically significant?

Acidic or Alkaline?

What can it indicate?

Ammonium Biurate

Insignificant

Alkaline

What do you see in this image?

Is it clinically significant?

Acidic or Alkaline?

What can it indicate?

Bilirubin

Significant

Acidic

Metabolic disorder

What do you see in this image?

Is it clinically significant?

Acidic or Alkaline?

What can it indicate?

Cholesterol

Significant

Acidic

Nephrotic Syndrome

Calcium carbonate

Alkaline ; normal

Calcium phosphate

Alkaline ; normal

Ammonium Biurate

Alkaline ; normal

Triple phosphate

Alkaline ; abnormal

Amorphous phosphates

Alkaline ; abnormal

Amorphous urates

Acidic ; normal

Uric acid

Acidic ; normal

Calcium oxalate

Acidic ; abnormal

Cystine

Acidic ; abnormal

Cholesterol

Acidic ; Abnormal

Tyrosine

Acidic ; abnormal

Bilirubin

Acidic ; abnormal

Leucine

Acidic ; abnormal

carbonate, biurate, phosphates are…

alkaline

urates and oxalates are…

acidic

A medical laboratory technician (MLT) student consistently obtains lower RBC counts than the instructor. A possible reason for this might be:

Failure to completely resuspend the sediment specimen

Using too much stain

Reading the same cells twice

Counting all crenated cells twice

Failure to completely resuspend the sediment specimen

What’s the needed volume of urine to put in a conical tube for centrifugal spinning for urine sediment?

12 mL (milliliters)

A urine specimen refrigerated overnight is cloudy and has a pH of 6. The turbidity is probably due to:

Triple phosphate crystals

Amorphous urates

Calcium oxalate crystals

Amorphous phosphates

Amorphous urates

Centrifugation of less than the recommended 12 mL of urine for the microscopic examination will:

Produce a false-negative sulfosalicylic acid (SSA)

Increase the number of cellular elements

Produce a false-positive SSA

Decrease the number of cellular elements

Decrease the number of cellular elements

Collection of a midstream clean-catch specimen will alleviate contamination by:

Transitional epithelial cells

RBCs

Squamous epithelial cells

Renal tubular epithelial cells

Squamous epithelial cells

Glitter cell is a term used to describe a specific type of cell that associates with a bacterial infection:

Ketone body

Oval fat body

Renal tubular epithelial cell

Neutrophil

Neutrophil

Initial microscopic focusing on the urinary sediment is frequently performed by referencing:

Mucus

Squamous epithelial cells

Hyaline casts

RBCs

Squamous epithelial cells

Oval fat bodies are:

WBCs that have phagocytized lipids

Squamous epithelial cells that contain lipids

Renal tubular epithelial cells that contain lipids

People who fail to work out regularly

Renal tubular epithelial cells that contain lipids

The major constituent of urinary casts is:

Amino acids

Bence Jones protein

Uromodulin protein

Lipoprotein

Uromodulin protein

The organisms attached to a clue cell are:

Escherichia coli

Gardnerella vaginalis

Candida albicans

Trichomonas vaginalis

Gardnerella vaginalis

The primary factor that favors the formation of urinary casts is:

Positive blood

Low specific gravity

Urinary stasis

High pH

Urinary stasis

The recommended centrifugation setting for preparation of the urine sediment is:

400 RPM for 10 minutes

1,000 RCF for 10 minutes

1,000 RPM for 5 minutes

400 RCF for 5 minutes

400 RCF for 5 minutes

The type of cells that line the bladder and ureters are called:

Basal

Renal tubular

Transitional

Squamous

Transitional

Urinary casts are formed in the:

Proximal tubules and loops of Henle

Distal tubules and loops of Henle

Distal and collecting tubules

Proximal and distal tubules

Distal and collecting tubules

Urine sediment artifacts frequently differ from true sediment constituents by their:

Appearance

Number present

Refractility

Location in the specimen

Refractility

Waxy casts are most easily differentiated from hyaline casts by their:

Refractivity

Color

Granules

Size

Refractivity

Which crystal appears as a thorny apple?

Triple phosphate

Ammonium biurate

Cystine

Calcium carbonate

Ammonium biurate

Which crystal appears to have notched corners?

Cystine

Triple phosphate

Cholesterol

Ammonium biurate

Cholesterol

Which of the following are reported as the quantity per low-power field?

Bacteria

White blood cells

Casts

Red blood cells

Casts

Which of the following does not affect the formation of crystals?

Urine pH

Urine specific gravity

Urinary casts

Urine Temperature

Urinary casts

Which would not help differentiation among RBCs, yeast, and oil droplets?

Observation of budding in yeast cells

Lysis of yeast cells by acetic acid

Increased refractivity of oil droplets

Lysis of RBCs by acetic acid

Lysis of yeast cells by acetic acid

What is this section of this centrifuged urine sample?

supernatant

What is this section of this centrifuged urine sample?

sediment

A urine of a patient who has been diagnosed with diabetes mellitus will have a high specific gravity and low volume.

False

A urine from a patient who has liver damage will have what color urine?

Amber

Name the cell.

transitional epithelial

If a cast is seen in a urine microscopic, you would expect what chemical test on the dipstick to be positive?

protein

RBC casts are seen in patients with glomerular nephritis.

True

Which crystal in a urine microscopic would have a hexagonal shape?

cystine

A glitter cell is a specific term used to describe a:

neutrophil

Amorphous urates come from a urine that has been refrigerated with a pH of 6.0 (acidic).

True

When you first look at your urine microscopic what element is recommended to focus on first?

squamous epithelial cell

Waxy cast are often seen in nephrotic syndrome patients?

True

What are oval fat bodies?

renal tubular epithelial cell that contain lipids

Solute content in is higher outside the cells vs inside…

hypertonic (urine)

Solute content is higher inside the cell vs outside of the cell…

hypotonic (urine)