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Clinical Microscopy Flashcards

6 cards from real ASCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. In a urinalysis, what does a positive reagent strip (dipstick) result for leukocyte esterase indicate?

    Answer: The presence of white blood cells (neutrophils) or their breakdown products

    Leukocyte esterase is an enzyme found in neutrophil granules. A positive dipstick result indicates WBCs (pyuria) or lysed neutrophils. It is a screening test for urinary tract infection but requires microscopic confirmation.

  2. Which urinary casts are characteristic of acute tubular necrosis (ATN)?

    Answer: Granular (muddy brown) casts

    Granular muddy brown casts in urine are characteristic of acute tubular necrosis. They form from degenerating tubular epithelial cells and cellular debris in the renal tubular lumen, creating the coarsely granular appearance.

  3. Which stain is used to identify fat/lipid in urine sediment?

    Answer: Oil Red O or Sudan III stain

    Oil Red O (and Sudan III/IV) are lipophilic dyes that stain neutral fats (triglycerides and cholesterol esters) orange-red. They are used to confirm lipiduria (oval fat bodies, fatty casts) in nephrotic syndrome or tubular injury.

  4. A WBC cast in urine sediment is most indicative of:

    Answer: Pyelonephritis or acute interstitial nephritis

    WBC (leukocyte) casts indicate that inflammation is occurring within the renal tubules and parenchyma, characteristic of pyelonephritis (bacterial) or acute interstitial nephritis (drug-induced or autoimmune). They must be distinguished from clumped WBCs not in cast matrix.

  5. Spermatozoa seen on a urine microscopy report in a female patient most likely indicates:

    Answer: Specimen contamination from recent sexual intercourse or vesico-vaginal communication

    Spermatozoa in female urine almost always represent contamination from recent sexual intercourse (retrograde into bladder, vaginal contamination of midstream specimen, or very rarely from vesico-vaginal fistula). They have no diagnostic significance for urinary tract disease.

  6. A patient's CSF appears xanthochromic (yellow). What does this finding most commonly indicate?

    Answer: Subarachnoid hemorrhage (SAH) that occurred hours to days before the procedure

    Xanthochromia (yellow discoloration of CSF) results from hemoglobin breakdown products (oxyhemoglobin within 2 hours; bilirubin by 10–12 hours) after subarachnoid hemorrhage. It peaks at 48 hours and persists for 2–4 weeks — distinguishing SAH from traumatic tap.