Body Fluids Chapter 7: Microscopic exam of urine

What changes in urine sediment can take place over time if the urine is not examined as soon after collection as possible?

Overall degradation of cells and casts within the sample and bacteria, nitrite, and ph increasing. For example bacteria lyse, casts dissolve, crystals dissolve, crystals form, erythrocytes crenate, microorganism multiply.

Which of the following methods is NOT commonly performed in the microscopic examination
of urine sediment?

Differential interference contrast

How will erythrocytes appear in hypertonic urine?

Crenated or shrunk

What are glitter cells?

Swollen leukocytes, usually neutrophils due to Brownian motion of their granules.

Which of the following is NOT a prime condition for cast formation to take place?

Alkaline pH
what is:
-acidic pH
-urinary stasis aka decreased flow
-high solute concentration
-presence of abnormal ion

In what part of the nephron does cast formation not take place?

Proximal convoluted tubule

What is the basis for cast classification?

Based on their contents

The order of cast degradation is?

Cellular, Granular, Waxy

Crystals in the urine are not:

Confirmed by urine dipstick

Parasites seen in the urine are:

usually fecal or vaginal contaminants

In which of the following are oval fat bodies most commonly seen?

Nephrotic syndrome

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

RBCs of glomerular origin often appear dysmorphic

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 of the following statements regarding urinary casts is correct?

Broad casts are associated with severe renal tubular obstruction

A 5 mL urine specimen is submitted for routine urinalysis and analyzed immediately. The specific gravity of the sample is 1.012 and the pH is 6.5. The dry reagent strip test for blood is large positive (3+) and the microscopic examination shows 11-20 RBCs per HPF. The leukocyte esterase reaction is small positive (1+), and the microscopic examination shows 0-5 WBCs per HPF. What is the most likely cause of these results?

Insufficient volume causing results to be underestimated.

A reagent test strip pad for blood has been reported positive. Microscopic exam fails to yield RBCs. Which of the following can this patients condition be called?

Hemoglobinuria

Which of the following suspected conditions should a urine eosinophil count may be requested?

Acute interstitial nephritis

Which of the following cells is a clue cell a form of?

Vaginal epithelia cell

Which of the following conditions does the presence of RBC Casts correlate best?

Glomerulonephritis 

Which of the following can spherical transitional epithelial cells be confused?

Renal tubular epithelial cells

Which of these systemic diseases contribute to kidney damage and disease?

Diabetes mellitus, Systemic lupus erythematosus, Hypertension, Amyloidosis

WBC casts are more likely to be indicative of which of these?

Pyelonephritis

A 3 year old girl has edema that is noticeable in her eyelids, urinalysis and blood tests reveal:

elevated serum cholesterol

Renal failure would most likely not be associated with which of these:

urine with a high SG

This disease is one of the most common aminoaciduria with urine that has a mousy odor:

Phenylketonuria

Which of the following diseases results in the production and excretion of large amounts of homogentisic acid?

Alkaptonuria 

The ill effects of this condition involving metabolism of milk sugar can be lessened by dietary control if caught early enough in an infants life:

Galactosemia