Combo with Urinalysis Review questions and 3 others

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258 terms

the three glass method of urine collection is performed to assess

prostate infections

to obtain a clean catch urine specimen

Clean the external genitalia, void a few milliliters of urine into the toilet, and then collect midstream flow

In a urine sample that is being examined microscopically, the best way to differentiate yeast from RBCs is to:

Add a drop of dilute acetic acid to the urine sediment to lyse the rbcs

A low seminal fluid volume of 1.0 mL containing a sperm count of 5 million/mL would indicate the following?

Infertility

The active accumulation of fluid within body cavities caused by infection, malignancies, or inflammation damaging the vascular wall is known as a(n):

Effusion

What substance besides red blood cells and hemoglobin will react with the blood pad on the reagent test strip?

Myoglobin

The normal healthy reference intervals fo CSF total protein is approximately

20-50 mg/dL

The pigment responsible for normal urine color that present in the highest concentration is

urochrome

To determine if a specimen is urine, measure the concentrations of

urea and creatinine

A positive bilirubin results is noted on the reagent strip used for a routine urinalysis, and bilirubin crystals are noted on the microscopic examination. This would indicate:

Liver disease

Sperm motility that is ranked at a value of 3.0 indicates that the sperm are

Mobile with moderate linear progression

A positive chemical reagent strip test for blood with no red blood cells found in the sediment:

Indicates the presence of hemoglobin or myoglobin

A dark, amber-colored random urine sample can be cause by:

dehydration

The reagent strip method used to detect protein in urine is based on:

the protein error of indicators

A synovial fluid was received in the lab from a 25 year old man who had a recent hokey injury. In the days following the injury, he reported progressively increasing pain and swelling. The final lab report was as follows: Color Brownish green

septic inflammation

The finding of indigo-blue colored urine is indicative of a defect in the metabolism of:

Tryptophan

A woman with a history of miscarriages visits her OB for assessment of pregnancy. She sees the doctor ever few days to have her HCG level tested. The hCG levels begin at 5 IU/L and appear to double every 7 to 8 days. What is indicated by these results?

Normal pregnancy

A pink-orange acidic urine becomes turbid after it has been refrigerated. This is most likely caused by:

Amorphous urates

A CSF glucose concentration of 35 mg/dL would indicate which of the following:

Bacterial meningitis

The normal glomerular filtrate volume per minute is:

120 mL/min

Observations of urine color and clarity should be performed using:

A well-mixed uncentrifuged specimen

the nephritic syndrom frequently occurs as a complication of

systemic shock

Malabsorption of fats by the gastrointestinal system is called

steatorrhea

The number and type of casts found in urine sediment reflect:

The extent of renal tubular involvement in disease processes

The hormone responsible for maintenance of sodium balance through its action on the renal tubules is:

Aldosterone

A man with normal fluid intake excreted 1400 mL of urine in 24 hours. This urine volume can be best described as

Normal

Ketones in the urine are frequently associated with

Acidosis

A yellow-brown urine results from the excretion of :

Bilirubin

Which of the following terms is correctly matched with the definition of urine output?
A) Polyuria: lack of urine output
B) Anuria: decreased urine output at night
C) Oliguria: decreased urine output
D) Nocturia: increased urine output

Oliguria: decreased urine output

Urine that has a mousy order typically indicated:

Phenylketonuria

Normal crystals found in alkaline urine include

Triple phosphates, amorphous, ammonium biurate

Synovial fluid is collected by

arthrocentesis

The protein reagent pad on a urine reagent testing strip is specific for:

Albumin

The function of ADH is to:

Control water reabsorption by the tubules

An individual with hepatic cirrhosis has excess peritoneal fluid in his abdominal cavity between the two layers of mesothelial cells. This abnormal fluid buildup is referred to as a (n)

transudate

Most renal calculi contain:

calcium and oxlate

Regarding gastric fluid analysis, what does the term "achlorhydria" mean?

The physiologic failure of gastric fluid pH to fall below 3.5 or 1.0 pH unit with gastric stimulation

Melena is

a large amount of blood in a stool sample

The cavities of the body that hold abdominal organs, lungs, and the heart are lined by two membranes consisting of which of the following cell types?

Mesothelial cells

Diabetes insipidus is a disease characterized by:

Polydipsia, polyuria and urine with low specific gravity

Testing of a urine specimen must occur within how many hours after collection?

2

Glomerular basement membrane thickening occurs in membranous glomerulonephritis as a result of deposition of:

Immune complexes

Cellular casts degenerate into:

Granular casts

The type of cells that line the bladder are:

Transitional cells

Urine with fixed specific gravity equal to 1.010 is termed:

Isothenuric

To perform a microscopic examination of a urine sample for casts, the sediment is examined using a(n):

Low-power objective

A patient with pseudogout (degenerative arthritis) would be expected to have what kind of crystals in their synovial fluid?

calcium pyrophosphate dehydrate

Bacterial decomposition of urea produces urine that has an order or

Ammonia

The urinalysis reagent strip reaction that reacts specifically to the presence of increased numbers of certain bacteria in the urine is:

Nitrite

An examination for the presence of white blood cells in a stool sample is performed to:

aid in the differential diagnosis of diarrhea

The sulfosalicylic acid precipitation confirmatory test is useful in detecting:

proteins other than albumin

Which of the following is the most often associated with the formation of serous fluid transudate?

systemic disease

Which of the following laboratory results would point to a diagnosis of acute nephritic syndrome?
A) Increased serum protein, increased GFR, and hematuria
B) Increased WBCs in the urine, bacteria in the urine, decreased GFR, and proteinuria
C) Normal serum urea and creatinine, increased GFR, and massive proteinuria
D) Hematuria, sodium retention, decreased GFR, and proteinuria

Hematuria, sodium retention, decreased GFR and proteinuria

The functional unit of the kidney is the

nephron

If a physician orders a creatinine clearance on an individual, what is he or she attempting to determine?

glomerular filtration rate (GFR)

the major function of the loops of Henle in the kidney is to

adjust urine osmolality

Upon microscopic examination, a patient's urine exhibits many bacteria, white blood cells, and cellular casts composed of polymorphonuclear leukocytes. It is likely that this individual has

pyelonephritis

If a freshly voided morning urine specimen has a pH of 6.0 in the absence of any other systemic disease, what is the likely cause?

this pH is within the healthy reference interval for this specimen

Damage to the glomerulus would be suspected when the urine sediment contains

red blood cell casts

The portion of a nephron that is most important in maintaining plasma electrolyte balance is the

distal tubule

The most common glomerular disease worldwide is

IgA nephropathy

A man comes to his physician with generalized weakness and fatigue. Blood is collected and an elevated WBC count with lymphocytosis is noted. Serum protein is moderately decreased, but the urine reagent dipstick does not indicate proteinuria. Upon confirmatory testing with a precipitation test, the urine protein is 4+. Based on other symptoms, the physician suspects multiple myeloma. What might be the cause of the discrepancy in urine protein values?

reagent dipsticks respond mosstly to urine albumin and not other proteins

Which of the following would be affected by allowing a urine specimen to remain at room temperature for three hours before analysis?

pH

Which of the follow urine results is most apt to be changed by prolonged exposure to light?

bilirubin

The normal pH for a healthy adult's urine is:
A) 4.5
B) 5.0
C) 6.0
D) 8.0

4.5-8.0

Which of the following is the average volume of urine excreted by an adult in 24 hours?
A) 750 mL
B) 1000 mL
C) 1500 mL
D) 2000 mL

1500 mL

A urine's specific gravity is directly proportional to its:

dissolved solids

failure to mix a specimen prior to inserting the reagen strip wil primarily affect the

blood reading

Urine reagent strips should be stored in a(an):

cool dry air

A urine specimen comes to the laboratory 7 hours after it is obtained. It is acceptable for culture only if the specimen has been stored:

at 4-7C

All casts typically contain:

Tamm-Horsfall glycoprotein

An ammonia-like odor is characteristically associated with urine from patients who:

have an infection with Proteus spp.

When using the glass slide and coverslip method, which of the following might be missed if the coverslip is overflowed?

Casts

The largest cells in the urine sediment are:

Squamous epithelial cells

Increased transitional cells are indicative of:

Catheterization and Malignancy

A primary characteristic used to identify renal tubular epithelial cells is:

Eccentrically located nucleus

A person submitted a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment except:

WBC casts

WBC casts are primarily associated with:

Pyelonephritis

Explain the correlation between the patient's blood and urine glucose results. A patient taken to the emergency room following an episode of syncope has a fasting blood glucose level of 450 mg/dL. Results of the routine urinalysis are as follows:COLOR: Pale yellow KETONES: NegativeCLARITY: Clear BLOOD: NegativeSP. GRAVITY: 1.020 BILIRUBIN: NegativePH: 5.0 UROBILINOGEN: NegativePROTEIN: 1+ NITRITE: NegativeGLUCOSE: 250 mg/dL LEUKOCYTES: Negative

The renal threshold for glucose is exceeded

All of the following are reasons for a negative nitrite test in the presence of increasedbacteria except:

Presence of gram-negative bacteria

The urinalysis supervisor notices that an unusually large number of reagent strips arebecoming discolored before the expiration date has been reached.

The bottle is not being recapped

A physician's office is consistently reporting positive nitrite test results with negative LE test results

The LE is read before the required reaction time

A student's results for reagent strip blood and LE are consistently lower than those of the laboratory staff.

the student is not mixing the sample prior to testing

A macroscopically turbid cerebrospinal fluid may indicate:

Increased white blood cell count

If cerebrospinal fluid has a xanthochromic appearance, it can indicate bleeding:

between 12 hours and 2 to 4 weeks

When a leukocyte differential smear made from a cerebrospinal fluid specimen with an elevated leukocyte count reveals an increase in polymorphonuclear cells, it may be indicative of _____ infection

Bacterial

Cerebrospinal fluid specimens should be delivered to the laboratory:

Immediately

Serous fluids:

Are contained within the closed cavities of the body and are an ultrafiltrates of plasma

Serous fluid for laboratory examination should be collected in a(n):

Sterile container, EDTA tube for cell counts, aspectic enviroment

Synovial fluids should be collected:

into an anticoagulated tube, into an non-anticoagulate tube, using a sterile needle and syringe

Fecal occult blood testing tests for:

Whole blood in the stool

The value of the fecal occult blood test is that it could determine the cause of or aid in detecting:

hypochromic anemia, ulcerative disease, and neoplasic diseases

False-positive fecal occult blood results can be caused by ingestion of:

red meat and horseradish

A false-negative fecal occult blood can be caused by:

vitamin C `

The American Cancer Society recommends that ____ fecal specimen(s) from ____ consecutive specimen(s) be collected for colorectal screening.

2,3

Semen specimens should be kept ____ before microscopic examination for motility.

at body temperature

Excessive urination during the night

nocturia

Marked increase in urine flow

polyuria

A marked decrease in urine flow

oliguria

complete stoppage of urine flow

anuria

A urine specimen is left on the urinalysis counter for 4 hours before being tested. Ketones would be

decreased

the fluid leaving the glomerulus has a specific gravity of

1.010 (pH of 7.4)

What substance are and are not reabsorbed in the ascending Loop of Henle

The ascending will reabsorb Na+ and Cl- and not water

what is the significance of a positive urine glucose result and a normal blood glucose

Renal tubular damage

The extent to which a measurement agrees with the true value of the analyte being measures is known as

accuracy

The normal color of urine is produce by

urochrome

the renal threshold is best described as the

concentration at which substance in the blood spills into the urine

What is the functional unit of the kidney

nephron (1-1.5 million in each kidney)

A urine specimen is left on the urinalysis counter for 4 hours before being tested. RBCs and WBCs would be

decreased

The primary site of reabsorption of glomerular filtrate is the

proximal convoluted tubule

to establish and maintain a quality control program in a laboratory with regards to procedures, each specific test should be

standardized

A specimen with a specific gravity of 1.005 would be considered

hyposthenuric (1.010-Isosthenuric, above 1.010 hypersthenuric, diluted urine below 1.010 is considered hyposthenuric)

Collected by passing a sterile tube into the bladder

catheterized specimen

Used to determine prostatic infection

three-glass collection

second voided specimen urine specimen collected after fasting

fasting specimen

specimen collected in a sterile container after cleansing the glans penis or urinary meatus

midstream clean catch specimen

Which of the following: Hydrometry, Urine reagent strips, freezing point depression, refractometry is not a standard method for measuring the specific gravity of urine

freezing point depression

A urine specimen is left on the urinalysis counter for 4 hours before being tested. Bilirubin would be

decreased

what requires a chain of custody

urine drug screen

a urine specimen is left on the urinalysis counter for more than 4 hours before being tested glucose would be

decreased

Normal urine is primarily composed of

water, urea, and sodium chloride

a urine specimen is left on the urinalysis counter for 4 hours before being tested. pH would be

Increased

Not permitting trash and combustible material to pile up, good housekeeping and keeping your work place neat and orderly can help prevent

fires

What substances are and are not reabsorbed in the descending Loop of Henle

the decending will absorb water and not Na+ and Cl-

Fred Damon is at the lab to pick up a collection container for a 24 hour urine collection. What collection instructions would you give to Fred? Make sure you include storage requirements

Fred should Wake up in the morning and empty is bladder.
He should collect ALL urine for the next 24 hours
The next morning at the same time he should collect the last urine
During the collection Fred should keep the sample refrigerated

To extinguish a Class B fire you can use

an ABC fire extinguisher

When shaken, a urine specimen has yellow foam; what is most likely present?

protein and bilirubin

Complete the following creatinine clearance:
24 hour urine volume= 798 mL
Urine Creatinine= 120 mg/dL
Serum Creatinine= 2.3 mg/dL

Creatinine Clearance = (120 X 798)/(2.3 X1440)
Creatinine Clearance= 28.9 ml/Min

A urine specimen is left on the urinalysis counter for 4 hours before being tested. Bacteria would be

Increased

Safety regulations in the clinical laboratory fall under which government agency

OSHA

You receive a urine for a urine drug screen that has a specific gravity of 1.000. What should you do? Make sure you include other tests that may be helpful?

This specimen is most likely not urine and should be rejected. Other test that would be helpful in confirming this would be creatinine and BUN. The urine temperature would also help determine if this was a true specimen.

What is the preferred method for urine preservation

refrigeration

Which of the following statements about Standard Precautions is correct?
A) Standard Precautions only applies to body fluids that may contain blood.
B) Standard Precautions applies only to blood.
C) Standard Precautions mean that all blood and body fluids should be handled as if they were infectious and capable of transmitting disease.
D) Standard Precautions do not apply to pleural fluid or semen.

Standard Precautions mean that all blood and body fluids should be handled as if they were infectious and capable of transmitting disease.

A urine specimen is left on the ruinalysis counter for 4 hours before being tested clarity would be

increased

Color and it's significance:
Brown Black-Dark yellow-red-green

Brown black-melanin
Dark yellow-concentrated specimen
Red-myoglobin
Green-pseudomonas infection

A urine concentration test was performed on a patient after a food and water deprivation period with the following findings:
After 14 hours Urine Osmolality = 850 mOsm/Kg
After 16 hours Urine Osmolality = 850 mOsm/Kg
What do these results indicate?

this represents loss of tubular function and concentrating ability

Freshly voided normal urine is usually clear; however, if it is alkaline, a white turbidity may be present due to

amorphous phosphates

what is the normal ratio of urine to plasma osmolality with controlled fluid intake

3:1

A patient has a sudden drop in blood pressure. The sequence of reactions in the RAAS is

renin, angiotensinogen, angiotensin I, angiotensin II, aldosterone.

What substances are not allowed to filter through the glomerulus in significant amounts?

Protein and cells

what can be used to confirm that a body fluid is urine

creatinine

a urine specimen is left on the urinalysis counter for 4 hours before being tested. Nitrite would be

increased

The principle of the reagent strip test for pH is

double indicator reaction

the purpose of scanning the perimeter of urine sediment placed under a conventional glass slide is to

detect the presence of casts

most renal calculi are composed of

calcium

the principle of the reagent strip test for protein is the

protein error of indicators

Oval fat bodies and fatty casts are characteristic urine sediment constituents in patients with

acute interstitial nephritis (When present in a urine specimen, these cells are accompanied by increased amounts of protein and cast formation. Oval fat bodies are often associated with nephritic syndrome)

Reagent strip chemical tests may be inaccurate if the specimen is

tested immediately after refrigeration

The presence of crenated RBCs in the urine sediment is associated with

hypersthenuria (Crenated RBCs are a sign of a hypertonic urine. The high specific gravity causes the water to leave the cells. Hypertonic urine can be seen in dehydrated patients or early morning specimens)

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