Body Fluids Quiz 2 (Unit 5-6)

1, 3, and 4

Correct performance of a urinary sediment examination should include:

1. Centrifugation of 12 ml of urine for 5 minutes

2. Addition of preservative prior to centrifugation

3. Resuspending the sediment in 0.5 mL of urine

4. Examining under low and high power

5. Reporting all constituents as number per high power field

polarized light

Identification of oval fat bodies can be verified using

radius of rotor head and RPM

The two factors that determine relative centrifugal force (RCF) are

casts

Which of the following elements would most likely be found in an acidic concentrated urine that contains protein?

renal calculi

A patient with severe back pain and 15-20 RBC/HPF in the urine sediment may have

lysis of yeast cells by acetic acid

. Differentiation among red blood cells, yeast, and oil droplets may be accomplished by all of the following except:

1. Observation of budding in yeast cells

2. Increased retractability of oil droplets

3. Lysis of yeast cells by acetic acid

4. Lysis of red blood cells by acetic acid

 

indicates the presence of hemoglobin or myoglobin

A positive chemical test for blood with no red blood cells found in the sediment

Ghost red blood cells

Dilute alkaline urine should be examined carefully for the presence of

pyuria

An increase in urinary white blood cells is called

glitter cells

Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit Brownian movement are

Tamm-Horsfall (uromodulin) protein

The matrix of casts consists of:

amorphous urates

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

warm the specimen

To confirm identification of “A urine specimen refrigerated overnight is cloudy and has a pH of 6” you should

calcium oxalate, uric acid, amorphous urates

Normal crystals found in acidic urine include

triple phosphate, amorphous phosphate, calcium carbonate, calcium phosphate

normal crystals found in alkaline urine

ammonium biurate

All of the following crystals are found in acid urine except:

1. Cholesterol

2. Tyrosine

3. Cystine

4. Ammonium biurate

a. leucine

b. tyrosine

c. cholesterol

d. cysteine

name the crystal

a. spherical, with concentric circles and radial striations

b. sheaths of fine needles

c. notches corners

d. hexagonal plates

lowered to reduce the light

In order to observe the presence of hyaline casts in urinary sediment, the condenser on the brightfield microscope should be

renal epithelial cells

Which of the following elements is the predecessor of the oval fat body

glomerular damage

RBC casts indicate the presence of

collecting duct

Broad casts, or “renal failure casts”, are formed in the

pollen grains

Under polarized light all of the following will exhibit Maltese cross formation except:

1. Starch granules

2. Oval fat bodies

3. Pollen grains

4.  Fatty casts

notify the nursing station to correct the error

While working on the evening shift, you receive a specimen and a requisition slip that do not match.  You should

1. RBCs- Yes, cloudy appearance & positive blood

2. WBCs- No, leukocytes are negative (nitrite may be false pos)

3. Casts- Yes, protein positive

4. Bacteria- Yes, nitrite positive

The following results were obtained on a urine specimen form a 30-year-old woman:

Color: brown                                  Ketones: negative

Appearance: cloudy                      Blood: moderate

Sp. Gr.: 1.027                                  Bilirubin: negative

pH: 5.5                                             Urobilinogen: 0.1 EU

Protein: 2+                                      Nitrite: positive

Glucose: negative                          Leukocyte esterase: negative

Will the following be seen in sediment

1. RBCs-

2. WBCs-

3. Casts-

4. Bacteria-

1. RBCs- Positive blood pad, alkaline pH may cause RBCs to lyse

2. WBCs- Positive nitrite & leukocyte esterase and patient’s clinical symptoms

3. Crystals- High pH favors the formation of triple phosphate crystals

4. Bacteria- Positive nitrite

A 22-year-old female college student comes to the university health center complaining of a burning sensation while voiding.  The urinalysis shows:

Color: straw                                    Ketones: negative

Appearance: hazy                         Blood: trace

Sp. Gr.: 1.008                                  Bilirubin: negative

pH: 8.0                                             Urobilinogen: 0.1 EU

Protein: trace                                 Nitrite: positive

Glucose: negative                          Leukocyte esterase: positive

Will the following be seen in sediment

RBC’s-

WBC’s-

Crystals-

Bacteria-

a.       Which opinion would you support? Instructor

b.       How could you prove your opinion? Repeat testing after student rests- Results should return to normal

c.       Explain the significance of each abnormal result. Concentrated urine with RBCs and casts

A medical laboratory student performs a urinalysis on himself after completing a marathon run.  The results are the following:

Color: dark yellow                         Bilirubin: negative

Appearance: clear                         Urobilinogen: 1.0 EU

Sp. Gr.: 1.030                                  Nitrite: negative

pH: 5.5                                             Leukocyte esterase: negative

Protein: 2+                                      0-4 hyaline casts/1hpf

Glucose: negative                          0-5 WBC/hpf

Ketones: negative                          Rare RBCs

Blood: small                                   Rare RBC and granular casts

 

The student is upset with these results, but his instructor is not.

a.       Which opinion would you support?

b.       How could you prove your opinion?

c.       Explain the significance of each abnormal result.

RBC casts

Acute glomerulonephritis such as that seen following streptococcus infections can be suspected when the urinary sediment contains

nephrotic syndrome

The finding of oval fat bodies, fatty casts and marked increase in protein is indicative of

identification of crystals

Urinary pH is a valuable aid in

recheck the sediment

What action would you take with the following results?

                    Blood: negative

Appearance: hazy           Urobilinogen: 1.0 EU

SG: 1.013                          Nitrite: negative

pH: 8.0                              Leukocyte esterase: positive

protein: trace                   MICROSCOPIC:

glucose: negative                           4-8 WBC/hpf

ketones: negative                          20-25 RBC/hpf

bilirubin: negative

high pH, low SG

Ghost RBC’s most frequently occur with

pH 8.0, WBCs and uric acid crystals

Which of the following results should be repeated:

1. positive blood and protein

2. pH 5.0 with amorphous urates

3. positive blood, glucose, and ketones

4. pH 8.0, WBCs and uric acid crystals

uric acid

Urinary crystals that appear yellow to reddish-brown are

leucine, tyrosine

Crystals found in the urine that are associated with disease include:

reduced light under low power

Examination of the urine sediment for the presence of casts should be performed with:

waxy casts

Degeneration of granular casts produces

hematuria

Which of the following constituents present in urine sediment is a sensitive early indicator of renal disease

drug-induced interstitial nephritis

The presence of eosinophils in the urine is associated with

renal transplant rejection

 The presence of lymphocytes in the urine is associated with

renal

 

Of the following epithelial cell types, which provides strong evidence of active kidney disease or tubular injury when 15 or more cells are found using 10 high-power fields

proteinuria, high specific gravity, acid pH

 Which of the following conditions is most likely to result in cast formation:

1. proteinuria, high specific gravity, acid pH

2. proteinuria, low specific gravity, alkaline pH

absolutely freshly voided urine

The presence of uric acid crystals in the urine sediment is most significant in

uric acid and calcium oxalate

 

Most normal crystals seen in urine of an acid pH are made up of the chemical compounds

calcium oxalate

 

Which of the following is the most common chemical constituent found in renal or bladder stones?

cystine

Which of the following is associated with stone formation

protein

The presence of which of the following chemical constituents will help differentiate waxy casts and disposable diaper fibers

hyaline

Which of the following casts are the most frequently seen in urine sediments

amorphous urates

A pink color sediment “brick dust” observed in normal acid urine is due to

all of the above

 Broad casts are:

1. formed in the collecting ducts

2. considered renal failure casts

3. considered a poor prognosis for the patient

4. all the above

diabetic women with increased glucose

Yeast are typically found in