Exam #2 Multiple Choice

RTEs from the collecting duct are typically what shape? a. Cuboidal b. Round c. Oval d. Columnar

a. Cuboidal

Urinary casts most commonly form under which of the following conditions? a. Dehydration, increased acidity, increased SG b. Renal stasis, increased pH, decreased SG c. Increased uromodulin, renal stasis, and increased pH d. Dehydration, increased alkalinity, renal stasis

a. Dehydration, increased acidity, increased SG

Which of the following would the stain toluene blue best be used to do? a. Differentiate WBCs and renal tubular epithelial cells b. Distinguish RBCs from WBCs, yeast, oil, and crystals c. Identify yellow-brown granules of hemosiderin in cells and casts d. Identify bacterial casts

a. Differentiate WBCs and renal tubular epithelial cells

Glitter cells most often appear in what kind of urine? a. In a dilute urine from patients with lower UTIs b. In an alkaline urine from patients with lower UTIs c. In an alkaline urine with a specific gravity of 1.035 d. In an acidic urine with a specific gravity 1.035

a. In a dilute urine from patients with lower UTIs

Which of the following is NOT true about mucus? a. It is a glycoprotein detected by the reagent strip b. It appears as shadowy strings in the background c. It is best viewed under a phase contrast microscope d. it can be increased under conditions of stress and exercise

a. It is a glycoprotein detected by the reagent strip

Prussian blue stain does which of the following? a. Stains structures containing iron b. Differentiates gram-positive and gram-negative bacteria c. Triglycerides and neutral fats d. Enhances nuclear detail

a. Stains structures containing iron

Which of the following urinary crystals forms a gas when acetic acid is added? a. calcium carbonate b. ammonium bitrate c. triple phosphate d. calcium phosphate

a. calcium carbonate

Which of the following normal urinary crystals is soluble in dilute in HCl? a. calcium oxalate dihydrate b. uric acid c. triple phosphate d. amorphous phosphates

a. calcium oxalate dihydrate

You have a urine with specific gravity of 1.005. What types of RBCs would you look for in the urine sediment? a. swollen and ghost b. crenated and ghost c. swollen and glitter d. crenated and glitter

a. swollen and ghost

Which of the following normal crystals are both found in acidic urine? a. uric acid and calcium oxalate b. uric acid and triple phosphate c. calcium phosphate and calcium carbonate d. ammonium bitrate and urates

a. uric acid and calcium oxalate

Which of the following is the most common volume of urine to centrifuge in preparation of urine sediment? a. 4 mLs b. 12 mLs c. 20 mLs d. 400 mLs

b. 12 mLs

Urinary casts most commonly form where? a. Proximal convoluted tubule and collecting duct b. Distal convoluted tubule and collecting duct c. Distal convoluted tubule and loop of Henle d. Collecting duct and ureter

b. Distal convoluted tubule and collecting duct

Renal tubular damage most likely results in what type of casts in urine? a. Granular b. Epithelial c. RBC d. Hyaline

b. Epithelial

Patients with uncontrolled diabetes mellitus are prone to having what kind of urinary sediment cast? a. Broad b. Fatty c. Waxy d. Bacterial

b. Fatty

You have the following results on a urinalysis: pH: 7.0, SG - 1.020, neg glucose, neg ketone, trace protein, neg nitrite, pos LE, neg blood, neg bilirubin, and normal urobilinogen. Under the microscope you see granular cells approximately 14um in diameter each with a segmented nucleus and as well as smaller individual cocci. There are no casts visible. What is the most likely patient condition? a. Upper UTI (pyelonephritis) b. Lower UTI (cystitis) c. Inflammation of he urinary tract d. Yeast infection

b. Lower UTI (cystitis)

Which of the following patients is in renal failure? a. SG- 1.025, pH 7.5, volume 300 mLs/day, fatty & granular casts b. SG- 1.010 pH 7.5, volume 300 mLs/day, waxy & broad casts c. SG- 1.010, pH 5.5, volume 600 mLs/day, RBC & granular casts d. SG- 1.025, pH 5.5, volume 600 mLs/day, granular & epithelial casts

b. SG- 1.010 pH 7.5, volume 300 mLs/day, waxy & broad casts

Which of the following has the highest cytoplasm to nuclear ratio? a. WBC b. Squamous epithelial c. Transitional cell d. Renal tubular epithelial cell

b. Squamous epithelial

You have the following urinalysis result on a female long distance runner: pH - 5.0, SG - 1.030, neg glucose, trace ketones, trace protein, neg nitrite, neg LE, neg blood, neg bilirubin and normal urobilinogen. The patient has not been previously identified as being diabetic. Under the microscope you see ovoid shaped elements. What conclusion do you make? a. The sample has bacterial contamination b. The sample was not collected by the MSCC method c. The patient is probably diabetic d. The patient has a urinary tract yeast infection

b. The sample was not collected by the MSCC method

White blood cells enter the kidney by what means? a. Through the glomerulus b. Through the tissues c. By Brownian movement d. By osmosis

b. Through the tissues

Which of the following may be spherical, polyhedral, or caudate with a centrally located nucleus? a. Squamous epithelial b. Transitional epithelial c. Clue cell d. Oval Fat Body (OFB)

b. Transitional epithelial

Which of the following best describes a renal tubular epithelial cell? a. highly refractive and stains with Oil red b. With an eccentric nucleus and possibly bilirubin or hemosiderin-laden c. Abundant irregular cytoplasm with prominent nuclei d. Folded ones may resemble casts

b. With an eccentric nucleus and possibly bilirubin or hemosiderin-laden

What three urinary crystals are associated with liver disease? a. cystine, leucine, tyrosine b. leucine, tyrosine, bilirubin c. tyrosine, bilirubin, cystine d. bilirubin, cystine, cholesterol

b. leucine, tyrosine, bilirubin

Which of the following is the most common centrifuge time and force in a clinical centrifuge for the preparation of urine sediment? a. 20 minutes at 14 RCF b. 15 minutes at 100 RCF c. 5 minutes at 400 RCF d. 5 minutes at 200 RCF

c. 5 minutes at 400 RCF

What is the size and shape of RBCs in isotonic urine? a. About 10-14 um in diameter and dysmorphic b. About 10-14 um in diameter and biconcave disc shaped c. About 7-8 um in diameter and biconcave disc shaped d. About 7-8 um in diameter and crenated

c. About 7-8 um in diameter and biconcave disc shaped

What are the uses of a polarizing microscope? a. Allows visualization of naturally fluorescent microorganisms b. Aids in the identification of Treponema palladum c. Aids in the identification of cholesterol, fatty casts and crystals d. Enhances visualization of elements with low refractive indices

c. Aids in the identification of cholesterol, fatty casts and crystals

Spermatozoa in urine are best identified how? a. By their motility b. By their pear shape and flagella c. By their oval head and long thin tail d. By the sex of the patient

c. By their oval head and long thin tail

You have the following urinalysis results: pH 5.5, SG - 1.010, pos. glucose, pos. ketone, trace protein, pos. nitrite, pos. LE, pos. blood, neg. bilirubin, normal urobilinogen. In the sediment under the microscope you see RBCs and another cell that is very granular but you are unable to see a nucleus. The cell you are most likely to see is what kind of cell? a. Yeast b. RTE cell c. Disintegrating WBC d. Glitter cell

c. Disintegrating WBC

You have an elderly patient currently in a nursing home. Their urinary sediment contains hyaline, granular and RBC casts. What is the most likely explanation? a. Pyelonephritis b. Strenuous exercise c. Glomerulonephritis d. Renal tubular damage

c. Glomerulonephritis

The size difference between RBCs and WBCs would be less noticeable in what kind of urine? a. Acidic b. Alkaline c. Hypertonic d. Hypotonic

c. Hypertonic

What is a telescoped urinary sediment? a. One where you use a telescope instead of a microscope b. One where you see all kinds of epithelial cells c. One where you see all kinds of casts d. One where you see all kinds of crystals

c. One where you see all kinds of casts

You have a patient with viral hepatitis B. What cell might you most likely encounter in their urine? a. Squamous epithelial b. Transitional epithelial c. Renal Tubular epithelial d. Oval Fat body

c. Renal Tubular epithelial

You have a urine sediment with many dirty brown casts. What do they most likely contain? a. disintegrating cells b. lysosomes due to increased metabolism c. methemoglobin d. hemosiderin

c. methemoglobin

Eosinophils in a urine may indicate what condition? a. Transplant rejection b. Damage to the glomerulus c. Toxins and viruses damaging the RTEs d. Acute interstitial nephritis induced by antibiotics

d. Acute interstitial nephritis induced by antibiotics

Broad casts typically are formed where? a. Bloated bladder b. Dilated ureter c. Dilated distal convoluted tubule d. Dilated collecting duct

d. Dilated collecting duct

What is the advantage of phase contrast microscope over a bright-field microscope? a. It produces a three-dimensional microscopy-image b. Aids in the identification of Treponema palladum c. Used for routine urinalysis d. Enhances visualization of hyaline casts and mucus

d. Enhances visualization of hyaline casts and mucus

You have a patient with nephrotic syndrome. What cell might you most likely encounter in their urine? a. WBCs b. "bubble" cells c. Renal tubular epithelial d. Oval fat body

d. Oval fat body

A clue cell indicates what? a. The patient has a lower UTI b. The patient has an upper UTI c. The patent has a prostate infection d. The patient has a vaginal infection

d. The patient has a vaginal infection

Which of the following urinary crystals is indicative of ethylene glycol poisoning? a. calcium carbonate b. calcium phosphate c. calcium oxalate dihydrate d. calcium oxalate monohydrate

d. calcium oxalate monohydrate

What do dysmorphic RBCs in a urine sediment indicate? a. centrifugation was too hard b. sample is hypotonic c. damage to RTEs d. damage to the glomerulus

d. damage to the glomerulus

Which of the following is a list of ALL of the urinary chemical dipstick results that warrant a microscopic examination but none of the ones that do not? a. pos urobilinogen, bilirubin, & ketone b. pos LE, nitrite, blood, protein c. pos glucose, ketone, blood, LE, nitrite d. pos glucose, blood, protein, nitrite, LE

d. pos glucose, blood, protein, nitrite, LE