AUBF QUIZ 1

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Macroscopic screening of urine specimens is used to:

Increase cost-effectiveness of urinalysis

Variations in the microscopic analysis of urine include all of the following except:

Identification of formed elements

All of the following can cause false-negative microscopic results except:

Using midstream clean-catch specimens

The two factors that determine relative centrifugal force are:

Diameter of rotor head and RPM

When using the glass-slide and cover-slip method,

which of the following might be missed if the cover slip

is overflowed?

Casts

Initial screening of the urine sediment is performed using an objective power of:

10×

Which of the following should be used to reduce light

intensity in bright-field microscopy?

Rheostat

Which of the following are reported as number per lpf?

Casts

The Sternheimer-Malbin stain is added to urine

sediments to do all of the following except:

Decrease precipitation of crystals

Nuclear detail can be enhanced by:

Both B and C

Which of the following lipids is/are stained by Sudan III?

Both B and C

Which of the following lipids is/are capable of polarizing

light?

Cholesterol

The purpose of the Hansel stain is to identify:

Eosinophils

Crenated RBCs are seen in urine that is:

Hypersthenuric

Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except:

Lysis of yeast cells by acetic acid

A finding of dysmorphic RBCs is indicative of:

Glomerular bleeding

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

Glitter cells

Sometimes mononuclear leukocytes are mistaken for:

Renal tubular cells

When pyuria is detected in a urine sediment, the slide

should be checked carefully for the presence of:

Bacteria

Transitional epithelial cells are sloughed from the:

Bladder

The largest cells in the urine sediment are:

Squamous epithelial cells

A squamous epithelial cell that is clinically significant

is the:

Clue cell

Forms of transitional epithelial cells include all of the

following except:

Convoluted

Increased transitional cells are indicative of:

Both A and B

A primary characteristic used to identify renal tubular

epithelial cells is:

Eccentrically located nucleus

After an episode of hemoglobinuria, RTE cells may

contain:

Hemosiderin granules

The predecessor of the oval fat body is the:

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

The finding of yeast cells in the urine is commonly

associated with:

Diabetes mellitus

The primary component of urinary mucus is:

Uromodulin

The majority of casts are formed in the:

Distal convoluted tubules

Cylindruria refers to the presence of:

All types of casts

A person submitting a urine specimen after a strenuous

exercise routine normally can have all of the following in the sediment except:

WBC casts

Before identifying an RBC cast, all of the following

should be observed:

All of the above

WBC casts are associated primarily with:

Pyelonephritis

The shape of the RTE cell associated with RTE casts is

primarily:

Round

When observing RTE casts, the cells are primarily:

Attached to the surface of a matrix

The presence of fatty casts is associated with:

All of the above

Nonpathogenic granular casts contain:

Cellular lysosomes

All of the following are true about waxy casts except they

Require staining to be visualized

Observation of broad casts represents:

Both A and C

All of the following contribute to urinary crystals

formation except:

Protein concentration

The most valuable initial aid for identifying crystals in a

urine specimen is:

pH

Crystals associated with severe liver disease include all

of the following except:

Cystine

All of the following crystals routinely polarize except:

Cystine

Casts and fibers usually can be differentiated using:

polarized light microscopy

Most glomerular disorders are caused by:

Immunologic disorders

Dysmorphic RBC casts would be a significant finding

with all of the following except:

Chronic pyelonephritis

Occasional episodes of macroscopic hematuria over periods of 20 or more years are seen in patients with:

IgA nephropathy

Antiglomerular basement membrane antibody is seen with:

Goodpasture syndrome

ANCA is diagnostic for:

GPA

Respiratory and renal symptoms are associated with all of the following except:

IgA nephropathy

The presence of fatty casts is associated with all of the following except:

Nephrogenic DI

The highest levels of proteinuria are seen with:

NS

Ischemia frequently produces:

Acute renal tubular necrosis

A disorder associated with polyuria and low specific gravity is:

Nephrogenic DI

An inherited disorder producing a generalized defect in

tubular reabsorption is:

Fanconi syndrome

A teenage boy who develops gout in his big toe and has a high serum uric acid should be monitored for:

Uromodulin-associated kidney disease

The only protein produced by the kidney is:

Uromodulin

The presence of RTE cells and casts is an indication of:

ATN

Differentiation between cystitis and pyelonephritis is aided by the presence of:

WBC Casts

The presence of WBCs and WBC casts with no bacteria is indicative of:

AIN

ESRD is characterized by all of the following except:

Hypersthenuria

Prerenal acute renal failure could be caused by:

Massive hemorrhage

The most common component of renal calculi is:

calcium oxalate

Urinalysis on a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed:

Microscopic hematuria

Which of the following dyes are used in Sternheimer–Malbin stain?

Crystal violet and safranin

Which of the following statements regarding WBCs in urinary sediment is true?

WBC casts indicate that pyuria is of renal, rather than lower urinary, origin

Which description of sediment with Sternheimer–Malbin stain is correct?

Transitional epithelium: cytoplasm pale blue, nucleus dark blue

SITUATION:

A 5-mL urine specimen is submitted for routine urinalysis and analyzed immediately.

The SG of the sample is 1.012

pH is 6.5.

The dry reagent strip test for blood is a large positive (3+)

Microscopic examination shows 11–20 RBCs per HPF. The leukocyte esterase reaction is a small positive (1+), and the microscopic examination shows 0–5 WBCs per HPF.

What is the most likely cause of these results?

Insufficient volume is causing microscopic results to be underestimated

Which of the following statements regarding epithelial cells in the urinary system is correct?

Transitional cells originate from the upper urethra, ureters, bladder, or renal pelvis

Which of the statements regarding examination of unstained sediment is true?

Large numbers of transitional cells are often seen after catheterization

Which of the following statements regarding cells found in urinary sediment is true?

Renal tubular cells are often polyhedral and have an eccentric round nucleus

Which of the following statements regarding RBCs in the urinary sediment is true?

RBCs of glomerular origin often appear dysmorphic

Renal tubular epithelial cells are shed into the urine in largest numbers in which condition?

Cytomegalovirus (CMV) infection of the kidney

The ova of which parasite may be found in the urinary sediment?

Schistosoma hematobium

Oval fat bodies are often seen in:

Nephrotic syndrome

All of the following statements regarding urinary casts are true except:

Casts can be seen in significant numbers even when protein tests are negative

Which condition promotes the formation of casts in the urine?

Reduced filtrate formation

The mucoprotein that forms the matrix of a hyaline cast is called:

Tamm–Horsfall protein

“Pseudocasts” are often caused by:

Amorphous urates

Which of the following statements regarding urinary casts is correct?

Broad casts are associated with severe renal tubular obstruction

A sediment with moderate hematuria and RBC casts most likely results from:

Acute glomerulonephritis

Urine sediment characterized by pyuria with bacterial and WBC casts indicates:

Pyelonephritis

Which type of casts signals the presence of chronic renal failure?

Waxy casts

SITUATION:

Urinalysis of a sample from a patient suspected of having a transfusion reaction reveals small yellow-brown crystals in the microscopic examination. Dry reagent strip tests are normal with the exception of a positive blood reaction (moderate) and trace positive protein. The pH of the urine is 6.5.

What test should be performed to positively identify the crystals?

Prussian blue stain

When examining urinary sediment, which of the following is considered an abnormal finding?

0–1 renal cell casts per LPF

SITUATION:

A urine sample with a pH of 6.0 produces an abundance of pink sediment after centrifugation that appears as densely packed yellow- to reddish-brown granules under the microscope.

The crystals are so dense that no other formed elements can be evaluated.

What is the best course of action?

Suspend the sediment in prewarmed saline, then repeat centrifugation

How can hexagonal uric acid crystals be distinguished from cystine crystals?

Cystine gives a positive nitroprusside test after reduction with sodium cyanide

The presence of tyrosine and leucine crystals together in a urine sediment usually indicates:

Chronic liver disease

Which of the following crystals is considered nonpathological?

Bilirubin

At which pH are ammonium biurate crystals usually found in urine?

Alkaline urine only

Which of the following crystals is seen commonly in alkaline and neutral urine?

Uric acid

Which crystal appears in urine as a long, thin hexagonal plate, and is linked to ingestion of large amounts of benzoic acid?

Hippuric acid

Small yellow needles are seen in the sediment of a urine sample with a pH of 6.0. Which of the following crystals can be ruled out?

Cholesterol crystals

Oval fat bodies are derived from:

Renal tubular epithelium

Oval fat bodies are often associated with:

Lipoid nephrosis

Urine of constant SG ranging from 1.008 to 1.010 most likely indicates:

Renal tubular failure

Which of the following characterizes prerenal failure, and helps to differentiate it from acute renal failure caused by renal disease?

BUN:creatinine ratio of 20:1 or higher

Which of the following conditions characterizes chronic glomerulonephritis and helps to differentiate it from acute glomerulonephritis?

Polyuria