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?
The active accumulation of fluid within body cavities caused by infection, malignancies, or inflammation damaging the vascular wall is known as a(n):
What substance besides red blood cells and hemoglobin will react with the blood pad on the reagent test strip?
The pigment responsible for normal urine color that present in the highest concentration is
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:
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
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
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?
A pink-orange acidic urine becomes turbid after it has been refrigerated. This is most likely caused by:
Observations of urine color and clarity should be performed using:
A well-mixed uncentrifuged specimen
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:
A man with normal fluid intake excreted 1400 mL of urine in 24 hours. This urine volume can be best described as
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
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)
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
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?
Diabetes insipidus is a disease characterized by:
Polydipsia, polyuria and urine with low specific gravity
Glomerular basement membrane thickening occurs in membranous glomerulonephritis as a result of deposition of:
To perform a microscopic examination of a urine sample for casts, the sediment is examined using a(n):
A patient with pseudogout (degenerative arthritis) would be expected to have what kind of crystals in their synovial fluid?
calcium pyrophosphate dehydrate
The urinalysis reagent strip reaction that reacts specifically to the presence of increased numbers of certain bacteria in the urine is:
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?
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
If a physician orders a creatinine clearance on an individual, what is he or she attempting to determine?
glomerular filtration rate (GFR)
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
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
The portion of a nephron that is most important in maintaining plasma electrolyte balance is the
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?
Which of the follow urine results is most apt to be changed by prolonged exposure to light?
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
failure to mix a specimen prior to inserting the reagen strip wil primarily affect the
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:
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?
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:
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
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
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
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
The American Cancer Society recommends that ____ fecal specimen(s) from ____ consecutive specimen(s) be collected for colorectal screening.
Semen specimens should be kept ____ before microscopic examination for motility.
at body temperature
A urine specimen is left on the urinalysis counter for 4 hours before being tested. Ketones would be
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
the renal threshold is best described as the
concentration at which substance in the blood spills into the urine
A urine specimen is left on the urinalysis counter for 4 hours before being tested. RBCs and WBCs would be
to establish and maintain a quality control program in a laboratory with regards to procedures, each specific test should be
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)
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
a urine specimen is left on the urinalysis counter for more than 4 hours before being tested glucose would be
a urine specimen is left on the urinalysis counter for 4 hours before being tested. pH would be
Not permitting trash and combustible material to pile up, good housekeeping and keeping your work place neat and orderly can help prevent
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
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
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.
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
Color and it's significance:
Brown Black-Dark yellow-red-green
Dark yellow-concentrated specimen
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
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
a urine specimen is left on the urinalysis counter for 4 hours before being tested. Nitrite would be
the purpose of scanning the perimeter of urine sediment placed under a conventional glass slide is to
detect the presence of casts
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)
Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except
lysis of yeast cells by acetic acid (If the yeast cannot be differentiated on the basis of budding, 2% acetic acid can be added. RBCs will lyse; yeast will not. The oil droplets will have very defined refractile edges)
The type of protein that precipitates at 60F and dissolves at 100F is a/an
abnormal globulin associated with multiple myeloma (Bence Jones protein can be found in multiple myeloma. In multiple myeloma, the serum contains a high levels of immunoglobulin light chains or Bence Jones protein. Bence Jones protein can be detected by the heat soluble. Other proteins when heated will coagulate and remain coagulated. Bence Jones protein however will coagulate or precipitate at 60 degrees and will dissolve at 100 degrees. Serum electrophoresis should be done as a confirmatory test)
The location of epithelial cells in the urinary tract in ascending order is
squamous, transitional, renal tubular (The squamous epithelial cells are found in the urethra. Transitional can be found in the bladder and renal tubular in the kidneys)
The SSA test should be performed on
urine that has been centrifuged (The SSA test for protein is more sensitive the reagent strips and will detect other protein besides albumin. To perform the SSA a aliquot of 3% Sulfosalicylic acid is added to an equal amount of urine. The tube is mixed and graded from 1+-4+ based on the amount of precipitate. If a un centrifuged urine is used the turbidity from other element could interfere in this reading)
Sediment constituents that are used to differentiate between upper and lower urinary tract infections are
WBC casts (White blood cell cast are associated with pyelonephritis and infection. Since cast are only formed in the kidney, white blood cell cast pinpoint the location of the white blood cells and the infection to the kidneys. The white blood cells in the cast can be differentiated from red blood cells because they are larger and have multinuclei and granules in the cytoplasma. down)
To detect the presence of casts, the sediment is examined using
reduced light under low power (The casts will be reported out in number of cast per low power field. However high powered is used to differentiate the different types of casts)
Th presence of increased renal tubular epithelial cell casts is most indicative of
acute tubular necrosis
motility by which of the following si most noticeable during the urine sediment examination
A 1+ reagent strip reaction and a 4+ Clinitest reaction could indicate the presence of
glucose and other reducing substances
Which of the following cells found in increased numbers in the urine sediment is only indicative of nephron damage
renal tubular cells
A medical technology student consistently obtains lower RBC counts than the instructor. A possible reason for this might be
failure to recognize crenated cells, focusing in the wrong plane, failure to centrifuge a mixed specimen
A false-positive test for 5-HIAA may result if the patient
does not receive appropriate diet instructions
A disease that causes large amounts of branched-chain amino acids to be excreted in the urine is
maple syrup urine disease
The pseudoperoxidase reaction is the principle for the reagent strip test(s) for
both blood and creatinine
What can produce a negative nitrite test in the presence of significant bacteriuria?
production of nitrogen from the presence of many bacteria
The recommended diluting fluid for synovial fluid cell counts is
saline (WBC counts are most commonly done on a synovial fluid. If a fluid is very viscous hyaluronidase may need to be added. This will reduce the viscosity of the sample and allow the count to be performed. Many traditional WBC counting methods used acetic acid as a diluent but this would cause clot formation in a synovial fluid. To prevent this saline is used as a diluent)
conditions the produce elevated CSF protein include all of the following except
fluid leakage (multiple sclerosis, hemorrhage, meningitis)
examination of a CSF shows 1000 WBCs, of which 75% are lymphocytes and 25% are monocytes this finding is consistent with
A yellow color in semen specimen may be caused by all of the following except
preservation at room temperature
wet preparations for the detection of fecal neutrophils are stained with
Methylene blue ( Methylene blue is used for wet preps and Wright stain is used for fixed specimens)
When performing microscopic examination of a stool for muscle fibers, the structures that are counted
have vertical and horizontal striations
chemical analysis of CSF shows that the fluid contains
plasma chemicals in the concentrations different from those in the plasma
Which one does not match:
A) Normal: clear, pale yellow
B) Traumatic tap: blood streaks
C) Crystals: milky
D) Sepsis: Uniform blood
Sepsis: Uniform blood
where is synovial fluid found?
Synovial fluid surrounds all joints, acts as a lubricant and supplies nourishment to cartilage
(It is NOT found only in the knee)
To determine the WBC count on a cloudy CSF specimen that contains both RBCs and WBCs, it is necessary to
dilute the specimen using glacial acetic acid
Semen analysis on postvasectomy patients should be performed
until two consecutive monthly specimens show no sperm
The presence of xanthochromia and an increased D-dimer test in the CSF is indicative of
a cerebral hemorrhage
Which of the following pairings of stool appearance and cause does not match?
A) Pale, frothy: steatorrhea
B) Yellow-gray: bile duct obstruction
C) Black, tarry: blood
D) Yellow-green: barium sulfate
Yellow-green barium sulfate
The primary cause of decreased CSF glucose in bacterial meningitis is
alteration of blood-brain glucose transport
Before and during collection of a sample for quantitative fecal fats, a patient should
consume 100 g of fat per day.
A CSF specimen, in which there is uneven distribution of blood among the three tubes and clots are detected, is an indication of
A pleural fluid delivered to the laboratory in ice would be accompanied by a requisition to test for
Using a 1:20 dilution and the 5 RBC counting squares of the Neubauer counting chamber, an average of 54 sperm is counted. The sperm concentration is
The functions of the cerebrospinal fluid include all of the following except
A) protection of neurologic tissue from trauma.
B) removal of metabolic waste products.
C) transmission of neurologic impulses.
D) nutritional enrichment of nervous tissue
transmission of neurologic impulses.
Hemolytic disease of the newborn endangers the fetus by
destroying fetal RBCs (the fetus will suffer from anemia)
If CSF tubes numbered 2 and 3 cannot be analyzed within 1 hour, the correct procedure is to
refrigerate tube 3 and leave tube 2 at room temperature.
To determine if a questionable specimen is semen, the specimen should be tested for
What is most often associated with the formation of a transudate?
Congestive heart failure (Transudates result from excessive filtration of blood serum across a physically intact vascular wall due to disruption of reabsorption. This occurs in systematic diseases that alter the hydrostatic pressure of the capillaries and include congestive heart failure, hepatic cirrhosis or nephritic syndrome)
To determine if an unknown fluid is synovial fluid, the fluid can be tested
by adding acetic acid and observing clot formation
A turbid synovial fluid with yellow-green color is indicates
infection (Specimens that are septic or caused by an infection can produce a specimen that is white, gray, yellow of green. The majority of infectious agents in septic arthritis are bacterial but can also be fungal or viral)
An amniocentesis is performed on a woman whose last two pregnancies have resulted in stillbirths due to hemolytic disease of the newborn. A screening test performed at the hospital is positive for bilirubin, and the specimen is sent to a reference laboratory for a bilirubin scan. Doctors are concerned when the report comes back negative, and they question if the
specimen was exposed to light
deposition of immune complexes, formed in conjunction with group A strep infection, on the glomerular membrane
attachment of cytotoxic antibody formed during viral respiratory infections to glomerular and alveolar basement membranes
disruption of the electrical charges that produce the tightly fitting podocytes barrier results in a massive protein and lipid loss
minimal change syndrome
disruption of podocytes occurring primarily in children following alleric reactions and immunizations
marked decrease in renal function resulting from the glomerular damage precipitated by other renal disorders
ANCA binds to neutrophils in cascular walls producing damage to small vessels in the lungs and glomerulus
infection of the renal tubules and interstitum related to inference of urine flow to the bladder reflux of urine from the bladder and untreated cystitis