Chapter 7: Microscopic Examination

• 1. Macroscopic screening of urine specimen is used to:

  A Provide result as soon as possible

  B Predict the type of urinary cast present

  C Increase cost-effectiveness of urinalysis

  D Decrease the need for polarized

  C Increase cost-effectiveness of urinalysis
• 2. Variations in the microscopic analysis of urine include all

  of the following except:

  A.Preparation of the urine sediment

  B. Amount of sediment analyzed

  C. Method of reporting

  D. Identification of formed elements

  C. Method of reporting
• 3. All of the following can cause false-negative microscopic

  results except:

  A.Braking the centrifuge

  B. Failing to mix the specimen

  C. Diluting alkaline urine

  D. Using midstream clean-catch specimens

  D. Using midstream clean-catch specimens
• 4. The two factors that determine relative centrifugal force

  are:

  A.Radius of rotor head and RPM

  B. Radius of rotor head and time of centrifugation

  C. Diameter of rotor head and RPM

  D. RPM and time of centrifugation

  C. Diameter of rotor head and RPM
• 5. When using the glass-slide and cover-slip method,

  which of the following might be missed if the cover slip

  is overflowed?

  A.Casts

  B. RBCs

  C. WBCs

  D. Bacteria

  A.Casts
• 6. Initial screening of the urine sediment is performed using an objective power of:

  A 4x

  B 10x

  C 40x

  D 100x

  B 10x
• 7. Which of the following should be used to reduce light

  intensity in bright-field microscopy?

  A Centering screws

  B. Aperture diaphragm

  C. Rheostat

  D. Condenser aperture diaphragm

  C. Rheostat
• 8. Which of the following are reported as number per lpf?

  A.RBCs

  B. WBCs

  C. Crystals

  D. Casts

  D. Casts
• 9. The Sternheimer-Malbin stain is added to urine

  sediments to do all of the following except:

  A Increase visibility of sediment constituents

  B. Change the constituents’ refractive index

  C. Decrease precipitation of crystals

  D. Delineate constituent structures

  C. Decrease precipitation of crystals
• 10. Nuclear detail can be enhanced by:

  A Prussian blue

  B. Toluidine blue

  C. Acetic acid

  D. Both B and C

  D. Both B and C
• 11. Which of the following lipids is/are stained by Sudan III?

  A Cholesterol

  B. Neutral fats

  C. Triglycerides

  D. Both B and C

  D. Both B and C
• 12. Which of the following lipids is/are capable of polarizing

  light?

  A Cholesterol

  B. Neutral fats

  C. Triglycerides

  D. Both A and B

  A Cholesterol
• 13. The purpose of the Hansel stain is to identify:

  A Neutrophils

  B. Renal tubular cells

  C. Eosinophils

  D. Monocytes

  C. Eosinophils
• 14. Crenated RBCs are seen in urine that is:

  A Hyposthenuric

  B. Hypersthenuric

  C. Highly acidic

  D. Highly alkaline

  B. Hypersthenuric
• 15. Differentiation among RBCs, yeast, and oil droplets may

  be accomplished by all of the following except:

  A Observation of budding in yeast cells

  B. Increased refractility of oil droplets

  C. Lysis of yeast cells by acetic acid

  D. Lysis of RBCs by acetic acid

  C. Lysis of yeast cells by acetic acid
• 16. A finding of dysmorphic RBCs is indicative of:

  A Glomerular bleeding

  B. Renal calculi

  C. Traumatic injury

  D. Coagulation disorders

  A Glomerular bleeding
• 17. Leukocytes that stain pale blue with Sternheimer-Malbin

  stain and exhibit brownian movement are:

  A Indicative of pyelonephritis

  B. Basophils

  C. Mononuclear leukocytes

  D. Glitter cells

  D. Glitter cells
• 18. Sometimes mononuclear leukocytes are mistaken for:

  A Yeast cells

  B. Squamous epithelial cells

  C. Pollen grains

  D. Renal tubular cells

  D. Renal tubular cells
• 19. When pyuria is detected in a urine sediment, the slide

  should be checked carefully for the presence of:

  A RBCs

  B. Bacteria

  C. Hyaline casts

  D. Mucus

  B. Bacteria
• 20. Transitional epithelial cells are sloughed from the:

  A Collecting duct

  B. Vagina

  C. Bladder

  D. Proximal convoluted tubule

  C. Bladder
• 21. The largest cells in the urine sediment are:

  A Squamous epithelial cells

  B. Urothelial epithelial cells

  C. Cuboidal epithelial cells

  D. Columnar epithelial cells

  A Squamous epithelial cells
• 22. A squamous epithelial cell that is clinically significant

  is the:

  A Cuboidal cell

  B. Clue cell

  C. Caudate cell

  D. Columnar cell

  B. Clue cell
• 23. Forms of transitional epithelial cells include all of the

  following except:

  A Spherical

  B. Caudate

  C. Convoluted

  D. Polyhedral

  C. Convoluted
• 24. Increased transitional cells are indicative of:

  A Catheterization

  B. Malignancy

  C. Pyelonephritis

  D. Both A and B

  D. Both A and B
• 25. A primary characteristic used to identify renal tubular

  epithelial cells is:

  A Elongated structure

  B. Centrally located nucleus

  C. Spherical appearance

  D. Eccentrically located nucleus

  D. Eccentrically located nucleus
• 26. After an episode of hemoglobinuria, RTE cells may

  contain:

  A Bilirubin

  B. Hemosiderin granules

  C. Porphobilinogen

  D. Myoglobin

  B. Hemosiderin granules
• 27. The predecessor of the oval fat body is the:

  A Histiocyte

  B. Urothelial cell

  C. Monocyte

  D. Renal tubular cell

  D. Renal tubular cell
• 28. 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:

  A Contains cholesterol

  B. Is not an oval fat body

  C. Contains neutral fats

  D. Is contaminated with immersion oil

  A Contains cholesterol
• 29. The finding of yeast cells in the urine is commonly

  associated with:

  A Cystitis

  B. Diabetes mellitus

  C. Pyelonephritis

  D. Liver disorders

  B. Diabetes mellitus
• 30. The primary component of urinary mucus is:

  A Bence Jones protein

  B. Microalbumin

  C. Uromodulin

  D. Orthostatic protein

  C. Uromodulin
• 31. The majority of casts are formed in the:

  A Proximal convoluted tubules

  B. Ascending loop of Henle

  C. Distal convoluted tubules

  D. Collecting ducts

  C. Distal convoluted tubules
• 32. Cylindruria refers to the presence of:

  A Cylindrical renal tubular cells

  B. Mucus-resembling casts

  C. Hyaline and waxy casts

  D. All types of casts

  D. All types of casts
• 33. A person submitting a urine specimen after a strenuous

  exercise routine normally can have all of the following in

  the sediment except:

  A Hyaline casts

  B. Granular casts

  C. RBC casts

  D. WBC casts

  D. WBC casts
• 34. Before identifying an RBC cast, all of the following

  should be observed:

  A Free-floating RBCs

  B. Intact RBCs in the cast matrix

  C. A positive reagent strip blood reaction

  D. All of the above

  D. All of the above
• 35. WBC casts are associated primarily with:

  A Pyelonephritis

  B. Cystitis

  C. Glomerulonephritis

  D. Viral infections

  A Pyelonephritis
• 36. The shape of the RTE cell associated with RTE casts is

  primarily:

  A Elongated

  B. Cuboidal

  C. Round

  D. Columnar

  C. Round
• 37. When observing RTE casts, the cells are primarily:

  A Embedded in a clear matrix

  B. Embedded in a granular matrix

  C. Attached to the surface of a matrix

  D. Stained by components of the urine filtrate

  C. Attached to the surface of a matrix
• 38. The presence of fatty casts is associated with:

  A Nephrotic syndrome

  B. Crush injuries

  C. Diabetes mellitus

  D. All of the above

  D. All of the above
• 39. Nonpathogenic granular casts contain:

  A Cellular lysosomes

  B. Degenerated cells

  C. Protein aggregates

  D. Gram-positive cocci

  A Cellular lysosomes
• 40. All of the following are true about waxy casts except they:

  A Represent extreme urine stasis

  B. May have a brittle consistency

  C. Require staining to be visualized

  D. Contain degenerated granules

  C. Require staining to be visualized