204 terms

Urinalysis SQ Ch 1-6

Study Quetions from Urinalysis Book Ch 1-6
1. In the urinalysis laboratory the primary source in the chain of infection would be
A. Patients
B. Needlesticks
C. Specimens
D. Biohazardous waste
2. The best way to break the chain of infection is
A. Handwashing
B. Personal protective equipment
C. Aerosol prevention
D. Decontamination
3. Standard Precautions differ from Universal Precautions and body substance isolation by requiring
A. Wearing face shields and gloves whenever blood may be encountered
B. Wearing gloves when encountering any moist body fluid
C. Washing hands after removing gloves if visual contamination is present
D. Wearing gloves when exposed to moist body fluids and washing hands after glove removal
4. An employee who is accidentally exposed to a possible
blood-borne pathogen should immediately
A. Report to a supervisor
B. Plush the area with water
C. Clean the area with disinfectant
D. Receive HIV prophylaxis
5. Personnel in the urinalysis laboratory should wear lab coats that
A. Do not have buttons
B. Are fluid-resistant
C. Have short sleeves
D. Have full—length zippers
6. All of the following should be discarded in biohazardous waste containers except
A. Urine specimen containers
B. Towels used for decontamination
C. Disposable lab coats
D. Blood collection tubes
7. An employer who fails to provide sufficient gloves for the employees may be fined by the
8. An acceptable disinfectant for blood and body fluid decontamination is
A. Sodium hydroxide
B. Antimicrobial soap
C. Hydrogen peroxide
D. Sodium hypochlorite
9. Proper hand washing includes all of the following except
A. Using warm water
B. Rubbing to create a lather
C. Rinsing hands in a downward position
D. Turning on the water with a paper towel
10. Centrifuging an uncapped specimen may produce a biological hazard in the form of
A. Vectors
B. Sharps contamination
C. Aerosols
D. Specimen contamination
11. An employee who accidently spills acid on his arm should immediately
A. Neutralize the acid with a base
B. Hold the arn under running water for 15 minutes
C. Consult the MSDSs
D. Wrap the arm in gauze and go to the emergency room
12. When combining acid and water, ensure that
A. Acid is added to water
B. Water is added to acid
C. They are added simultaneously
D. Water is slowly added to acid
13. An employee can learn the carcinogenic potential of potassium chloride by consulting the
A. Chemical hygiene plan
B. Material safety data sheets
C. OSHA standards
D. Urinalysis procedure manual
14. Employees should not work with radioisotopes if they are
A. Wearing contact lenses
B. Allergic to iodine
C. Sensitive to latex
D. Pregnant
15. All of the following are safe to do when removing the source of an electric shock except
A. Pulling the person away from the instrument
B. Turning off the circuit breaker
C. Using a glass container to move the instrument
D. Unplugging the instrument
16. The acronym PASS refers to
A. Presence of vital chemicals
B. Operation of a fire extinguisher
C. Labeling of hazardous material
D. Presence of radioactive substances
17. The system used by firefighters when a fire occurs in the laboratory is
18. A class ABC fire extinguisher contains
A. Sand
B. Water
C. Dry chemicals
D. Acid
19. The first thing to d0 when a fire is discovered is to
A. Rescue persons in danger
B. Activate the alarm system
C. Close doors to other areas
D. Extinguish the fire if possible
20. If a red rash is observed after removing gloves, the employee
A. May be washing her hands too often
B. May have developed a latex allergy
C. Should apply cortisone cream
D. Should not rub the hands so vigorously
21. Pipetting by mouth is
lA. Acceptable for urine but not serum
B. Not acceptable without proper training
C. Acceptable for reagents but not specimens
D. Not acceptable in the laboratory
22. The NPFA classification symbol contains information on all of the following except
A. Fire hazards .
B. Biohazards
C. Reactivity
D. Health hazards
23. The classification of a lire that can be extinguished with water is
A. Class A .
B. Class B V
C. Class C
D. Class D
24. Employers are required to provide free immunization for
B. HTLV-] y
25. A possible physical hazard in the hospital is
A. Wearing closed-toed shoes
B. Not wearing jewelry
C. Having short hair
D. Running to answer the telephone
1. The type of nephron responsible for renal concentration is the
A. Cortical
B. juxtaglomerular
2. The function of the peritubular capillaries is
A. Reabsorption
B. Filtration
C. Secretion
D. Both A and C
3. Blood flows through the nephron in the following order
A. Efferent arteriole, peritubular capillaries, vasa recta, afferent arteriole
B. Peritubular capillaries, afferent arteriole, vasa recta, efferent arteriole
C. Afferent arteriole, peritubular capillaries, vasa recta, efferent arteriole
D. Efferent arteriole, vasa recta, peritubular capillaries, afferent arteriole
4. Filtration of protein is prevented in the glomerulus by
A. Hydrostatic pressure
B. Oncotic pressure
C. Renin
D. Capillary pores
5. Renin is secreted by the nephron in response to
A. Low systemic blood pressure
B. High systemic blood pressure
C. Oncotic capillary pressure
D. Increased water retention
6. The primary chemical affected by the renin-angiotensin-aldosterone system is
A. Chloride
B. Sodium ~
C. Potassium
D. Hydrogen
7. Secretion of renin is stimulated by
A. juxtaglomerular cells
B. Angiotensin I and II
C. Macula densa cells
D. Circulating angiotensin-converting enzyme
8. The hormone aldosterone is responsible for
A. Hydrogen ion secretion
B. Potassium secretion
C. Chloride retention
D. Sodium retention
9. The fluid leaving the glomerulus has a specific gravity of
A. 1.005
B. 1.010
C. 1.015
D. 1.020
10. All of the following are reabsorbed by active transport in the tubules except
A. Urea
B. Glucose
C. Sodium
D. Chloride
11. Which of the tubules is impermeable to water
A. Proximal convoluted tubule
B. Descending loop of Henle
C. Ascending loop of Henle
D. Distal convoluted tubule
12. Glucose will appear in the urine when the
A. Blood level of glucose is 200 mg/dl.
B. Tm for glucose is reached
C. Renal threshold for glucose is exceeded
D. All of the above
13. The countercurrent mechanism takes place in the
A. juxtaglomerular nephrons
B. Proximal convoluted tubule
C. Cortical nephrons
D. Both A and C
14. ADH regulates the final urine concentration by controlling
A. Active reabsorption of sodium
B. Tubular permeability
C. Passive reabsorption of urea
D, Passive reabsorption of chloride
15. When the body is dehydrated
A. ADH production is decreased
B. ADH production is increased
C. Urine volume is increased
D. Both A and C
16. Bicarbonate ions filtered by the gloinerulus are returned to the blood
A. ln the proximal convoluted tubule
B. Combined with hydrogen ions
C. By tubular secretion
D. All of the above
17. lf ammonia is not produced by the distal convoluted tubule, the urine pH will be
A. Acidic
B. Basic
18. Place the appropriate letter in front of the following clearance substances
A. Exogenous
B. Endogenous
A: inulin
B: creatinine
B: cystatin C
A: 125 I-iothalmate
19. The largest source of error in creatinine clearance tests is
A. Secretion of creatinine
B. improperly timed urine specimens
C. Refrigeration of the urine _
D. Time of collecting blood sample _ A
20. Given the following infomation, calculate the creatinine clearance
24-hour urine volume: 1000 mL: serum creatinine:2.0 mg/dL: urine creatinine: 200 mg/dL
69 mil/min
21. Values for creatinine clearance tests on children arecorrected for
A. Body size
B. Urine volume
C. Activity level
D. Diet
22. Given the data serum creatinine
1.1 mg/dL: age:50 years, and weight: 72 kg, the estimated creatinine clearance using the Cockcroft-Gault formula is:
A. 46
B. 62
C. 82
D. 127
23. Variables that may be included in estimated creatinine clearance calculations include all of the following except
A. Serum creatinine
B. Urine creatinine
C. Age
D. Blood urea nitrogen
24. An advantage to using cystatin C to monitor GPR is
A. It does not require urine collection
B. It is not secreted by the tubules
C. It can be measured by immunoassay
D. All of the above
25. Solute dissolved in solvent will
A. Decrease vapor pressure
B. Lower the boiling point
C. Decrease the osmotic pressure
D. Lower the specific gravity
26. Substances that may interfere with measurement of urine and serum osmolarity include all of the following except
A. Ethanol
B. Lactic acid
C. Sodium
D. Lipids
27. The normal serum osmolarity is
A. 50-100 mOsm
B. 275-300 mOsm
C. 400-500 mOsm
D. 3 times the urine osmolarity
28. After controlled fluid intake, the urine-to-serum osmolarity ratio should be at least
A. 1:1
B. 2:1
C. 3:1
D. 4:1
29. Calculate the free water clearance from the following results
urine volume in 6 hours 720 mL urine osmolarity:
225 mOsm plasma osmolarity 300 mOsm
30. To provide an accurate measure of renal blood flow, a test substance should be completely
A. Filtered by the glomerulus
B. Reabsorbed by the tubules
C. Secreted when it reaches the distal convoluted
D. Cleared on each contact with functional renal tissue
31. Given the following data, calculate the effective renal plasma flow
urine volume ih 2 hours 240 ml. urine PAH
150 mg/dL plasma PAI•I 0.5 mg/dl.
32. Renal tubular acidosis can be caused by the
A. Production of excessively acidic urine due to increased Hltration of hydrogen ions
B. Production of excessively acidic urine due to increased secretion of hydrogen ions
C. Inability to produce an acidic urine due to impaired production of ammonia
D. Inability to produce an acidic urine due to increased production of ammonia
33. Tests performed to detect renal tubular acidosis after administering an ammonium chloride load include all of the following except
A. Urine ammonia
B. Arterial pH
C. Urine pH
D. Titratable acicity
1. The primary chemical constituents of normal urine are
A. Protein, sodium, and water
B. Urea, water, and protein
C. Urea, chloride, and water
D. Urea, bilirubin, and glucose
2. An unidentified fluid is received in the laboratory with a request to determine if the fluid is urine or another body fluid. Using routine laboratory tests, what test would determine that the fluid is most probably urine
A. Glucose and ketones
B. Urea and creatinine
C. Uric acid and amino acids
D. Protein and amino acids
3. A person exhibiting oliguria would have a daily urine volume of
A. 200-400 mL '
B. 600-1000 mL
C. 1000-1500 mL
D. Over 1500 mL
4. A patient presenting with polyuria, nocturia, polydipsia, and a high urine specific gravity is exhibiting symptoms of what disorder
A. Diabetes insipidus
B. Diabetes mellitus A
C. Urinary tract infection
D. Uremia
5. True or False
Disposable containers with a capacity of 50 mL are recommended for the collection of specimens for routine urinalysis.
6. The correct method for labeling urine specimen containers is to
A. Attach the label to the lid
B. Attach the label to the bottom
C. Attach the label to the container
D. Use only a wax pencil for labeling
7. A urine specimen for routine urinalysis would be rejected by the laboratory because
A. The specimen had been refrigerated
B. More than 50 mL was in the container
C. The specimen and accompanying requisition donot match
D. The label was placed on the side of the container
8. An unpreserved specimen collected at 8 a.m. and remaining at room temperature until the afternoon shift arrives can be expected to have
I. Decreased glucose and ketones
2. Increased bacteria and nitrite
3. Decreased pH and turbidity
4. Increased cellular elements
A. I, 2, and 3
B. I, 2, and 4
C. I and 2 only
D. 4 only
9. A specimen containing precipitated amorphous urates may have been preserved using
A. Boric acid ,
B. Chloroform
C. Forrnalin
D. Refrigeration
10. What three changes will affect the results of the microscopic examination of urine if it is not tested within 2 hours
A. Decreased bacteria, decreased red blood cells, decreased casts
B. Increased bacteria, increased red blood cells, increased casts
C. Increased bacteria, decreased red blood cells, decreased casts
D. Decreased bacteria, increased red blood cells, increased casts
11. What is the method of choice for preservation of routine urinalysis samples
A. Boric acid
B. Formalin
C. Refrigeration
D. Sodium fluoride
12. For best preservation of urinary sediments, the preservatives of choice are
A. Boric acid and thymol •
B. Fonnalin and sodium fluoride
C. Toluene and freezing
D. Chloroform and refngeration
13. What chemical can be used to preserve a specimen for a culture and a routine urinalysis
A. Boric acid
B. Formalin
C. Sodium fluoride
D. Thymol
'True or False: A properly labeled urine specimen for routine urinalysis delivered to the laboratory in a gray—top blood collection tube can be tested.
15. What is the specimen of choice for routine urinalysis
A. Fasting specimen
B. First morning specimen
C. Random specimen
D. 24—Hour specimen
16. Quantitative urine tests are performed on
A. First morning specimens
B. Timed specimens •
C. Midstsream clean-catch specimens
D. Suprapubic aspirations
17. Three types of urine specimens that would be acceptable for culture to diagnose a bladder infection include all of the following except
A. Catheterized
B. Midstream clean-catch
C. Random •t
D. Suprapubic aspiration
18. A negative urine pregnancy test performed on a random specimen may need to be repeated using a
A. Clean-catch specimen
B. Fasting specimen
C. First morning specimen
D. 24-Hour specimen
19. Cessation of urine flow is termed
A. Anuria
B. Azoternia
C. Diuresis
D. Dysuria
20. Persons taking diuretics can be expected to produce
A. Oliguria
B. Polyuria
C. Proteinuria
D. Pyuria
21. What type of urine specimen should be collected from a patient who complains of painful urination and the physician has ordered a routine urinalysis and urine culture
A. Random
B. First morning
C. Fasting
D. Midstream clean-catch
1. The concentration of a normal urine specimen can be estimated by which of the following
A. Color
B. Clarity
C. Foam
D. Odor
2. The normal yellow color of urine is produced by
A. Bilirubin
B. Hemoglobin
C. Urobilinogen
D. Urochrome
3. A yellow—brown specimen that produces a yellow foam when shaken can be suspected of containing
A. Bilirubin
B. Carrots
C. Hemoglobin
D. Rhubarb
4. A urine that turns black after standing may contain
A. Homogentisic acid
B. Melanin
C. Methemoglobin
D. All of the above ~
5. Specimens that contain intact RBCs can be visually distinguished from those that contain hemoglobin because
A. Hemoglobin produces a much brighter red color
B. Hemoglobin produces a cloudy pink specimen
C. RBCs produce a cloudy specimen
D. RBCs are quickly converted to hemoglobin
6. After eating beets purchased at the local farmers' market, Mrs. Williams notices that her urine is red, but Mr. Williams urine remains yellow The Williamses should
A. Be concerned because red urine always indicates
the presence of blood
B. Not be concerned because all women produce red
urine after eating beets
C. Be concerned because both of them should have
red urine if beets are the cause
D. Not be concerned because only Mrs. Williams is
genetically susceptible to producing red urine
from beets
7. Specimens from patients receiving treatment for urinary tract infections frequently appear
A. Clear and red
B. Viscous and orange '
C. Dilute and pale yellow
D. Cloudy and red
8. Freshly voided normal urine is usually clear
however, if it is alkaline, a white turbidity may be present due to:
A. Amorphous phosphates and carbonates
B. Uroerythrin
D. Yeast
9. Microscopic examination of a clear urine that produces a pink precipitate after refrigeration will show
A. Amorphous urates
B. Porphyrins
C. Red blood cells
D. Triple phosphate crystals
10. Under what conditions will a port-wine urine color be observed in a urine specimen
A. The patient has eaten Clorets.
B. Melanin is present.
C. Urine contains porphyrins.
D. The patient has a Pseudomonas infection.
11. Which of the following specific gravities would be most likely to correlate with a dark yellow urine
A. 1.005
B. 1.010
C. 1.020
D. l.030
12. True or False
Urine specific gravity is equally influenced by the presence of glucose and sodium.
13. In what circumstance might sediment be slightly warmed prior to microscopic examination
A. To hemolyze RBCs
B. To dissolve amorphous urates
C. To increase the specific gravity
D. To correct for temperature in determining the it A
cific gravity
14. A urine specific gravity measured by refractometer 1.029, and the temperature of the urine is 14°C. The specific gravity should be reported as
A. 1.023
B. 1.027
C. 1.029
D. 1.032
15. Refractive index compares
A. Light velocity in solutions with light velocity in solids
B. Light velocity in air with light velocity in solutml
C. Light scattenng by air with light scattering by Solutions
D. Light scattering by particles in solution
16. Refractometers are calibrated using
A. Distilled water and protein
B. Distilled water and blood
C. Distilled water and sodium chloride
D. Distilled water and urea »
17. A correlation exists between a specific gravity of 1.050 and at
A. 2+ glucose V
B. 2+ protein T
C. First morning specimen
D. Radiographic dye infusion
18. An alkaline urine turns black upon standing, develops a cloudy white precipitate, and has a specific gravity of 1.012. The major concern about this specimen would be
A. Color
B. Turbidity
C. Specific gravity
D. All of the above .
19. The reading of distilled water by the refractometer is 1.003. You should
A. Subtract 1.003 from each specimen reading j
B. Add 1.003 to each specimen reading
C. Use a new refractometer
D. Adjust the set screw
20. A unne specimen with a specinc gravity of 1.008 has been diluted 1
5. The actual specihc gravity is:
A. 1.008 .
B. 1.040
21. The method for determining a urine specific gravity that is based on the principle that the frequency of a sound wave entering a solution changes in proportion to the density of the solution is
A. Colorimetric
B. Harmonic oscillation densitometry
C. Refractometry
D. Urinometry
22. A specimen with a specific gravity of 1.005 would be considered
A. lsosthenuric
B. Hyposthenuric
C. Hypersthenuric
D. Not urine
23. True or False
Specific gravity is of more diagnostic value than osmolarity in evaluating renal concentration ability
24. A strong odor of ammonia in a urine specimen could indicate
A. Ketones
B. Normal
C. Phenylketonuria
D. Urinary tract infection ~
25. The microscopic of a cloudy amber urine is reported as rare WBCs and epithelial cells. What does this suggest
A. Urinary tract infection
B. Dilute random specimen
C. Precipitated amorphous urates
D. Possible mix-up of specimen and sediment »
26. A specimen with a strong ammonia odor and a heavy white precipitate when it arrives in the laboratory may require
A. Collection of a fresh specimen
B. Centrifugation
C. Dilution for specific gravity
D. Testing under a hood
1. Leaving a reagent strip in the specimen for too long will
A. Cause runover between reagent pads
B. Alter the color of the specimen
C. Cause reagents to leach from the pads
D. Not affect the chemical reactions
2. Failure to mix a specimen prior to inserting the reagent strip will primarily affect the
A. Glucose reading
B. Blood reading
C. Nitrite reading
D. Ph reading
3. Testing a refrigerated specimen that has not warmed to room temperature will adversely affect
A. Enzymatic reactions
B. Dye-binding reactions
C. The sodium nitroprusside reaction
D. Diazo reactions
4. The reagent strip reaction that requires the longest reaction time is the
A. Bilirubin
B. pH
C. Leukocyte esterase »
D. Glucose
5. Quality control of reagent strips is performed
A. Using positive and negative controls
B. When results are questionable
C. At least once every 24 hours
D. All of the above
6. All of the following are important to protect the integrity of reagent strips except
A. Removing the desiccant from the bottle ~
B. Storing in an opaque bottle
C. Storing at room temperature
D. Resealing the bottle after removing a strip
7. The principle of the reagent strip test for pH is the
A. Protein error of indicators
B. Greiss reaction
C. Dissociation of a polyelectrolyte
D. Double indicator reaction ••
8. A urine specimen with a pl•l of 9.0
A. ls indicative of metabolic acidosis
B. Should be recollected t
C. May contain calcium oxalate crystals
D. ls seen after drinking cranberry juice
9. In the laboratory a primary consideration associated with pH is
A. Identification of urinary crystals
B. Monitoring of vegetarian diets
C. Determination of specimen acceptability
D. Both A and C
10. Indicate the source of the following proteinuiias by placing a 1 for prerenal, 2 for renal, or 3 for postrenal in front of the condition
A. ___Microalbuminuria 2. Renal
B. ___Acute phase reactants 1.Prerenal
C. ___Pre-eclampsia 2. Renal
D. ___Vaginal inflammation 3. Postrenal
E. ____Multiple myeloma 1. Prerenal
F. ___Orthostatic Proteinuria 2. Renal
G. ___Prostatitis 3. Postrenal

11. The principle of the protein error of indicators reaction is that:
A. Protein changes the pH of the urine
B. Albumin accepts hydrogen ions from the indicator!
C. The indicator accepts ions for albumin
D. Albumin changes the pH of the urine
12. All of the following will cause false-positive protein reagent strip values except
A. Proteins other than albumin
B. Highly buffered alkaline urines
C. Delay in removing the reagent strip from the specimen
D. Contamination by quartenary ammonium compounds
13. A patient with a 1+ protein reading in the afternoon is asked to submit a first morning specimen. The second specimen also has a 1 + protein. This patient is
A. Positive for orthostatic proteinuria
B. Negative for orthostatic proteinuria
C, Positive for Bence jones protein
D. Negative for clinical proteinuria
14. Testing for microalbuminuria is valuable for monitoring patients with
A. Hypertension
B. Diabetes mellitus
C. Cardiovascular disease risk
D. All of the above
15. All of the following are true for the Micral-Test for microalbumin except
A. It is run on first morning specimens
B. It contains an antibody-enzyme conjugate
C. Two blue bands are formed on the strip
D. Unbound antibody attaches to immobilized Albumin
16. All of the following are true for the lmmunodip test for microalbumin except
A. Unbound antibody migrates farther than bound antibody
B. Blue latex particles are coated with antibody
C. Bound antibody migrates further than unbound antibody —
D. It utilizes an immumochromographic principle
17. The principle of the protein-low reagent pad on the Multistix Pro is the
A. Binding of albumin to sulphonphtalein dye
B. Immunologic binding of albumin to antibody
C. Reverse protein error of indicators reaction
D. Enzymatic reaction between albumin and dye
18. The principle of the creatinine reagent pad on microalbumin reagent strips is the
A. Double indicator reaction
B. Diazo reaction
C. Pseudoperoxidase reaction "
D. Reduction of a chromogen
19. The purpose of performing an albuminzcreatinine ratio is to
A. Estimate the glomerular filtration rate
B. Correct for hydration in random specimens —•~•
C. Avoid interference for alkaline urines
D. Correct for abnonnally colored urines
20. A patient with a normal blood glucose and a positive urine glucose should be further checked for
A. Diabetes mellitus
B. Renal disease ~
C. Gestational diabetes
D. Pancreatitis
21. The principle of the reagent strip tests for glucose is the
A. Peroxidase activity of glucose
B. Glucose oxidase reaction
C. Double sequential enzyme reaction r`
D. Dye—binding of glucose and chromogen
22. All of the following may produce false-negative glucose reactions except
A. Detergent contamination
B. Ascorbic acid
C. Unpreserved specimens
D. Low urine temperature
23. A positive Clinitest and a negative reagent strip glucose are indicative of
A. Low levels of glucose
B. Nonglucose reducing substances
C. High levels of glucose
D. Both A and B
24. The primary reason for performing a Clinitest is to
A. Check for high ascorbic acid levels
B. Confirm a positive reagent strip glucose
C. Check for newborn galactosuria
D. Confirm a negative glucose reading
25. The three intermediate products of fat metabolism include all of the following except
A. Acetoacetic acid
B. Ketoacetic acid
C. Beta-hydroxybutyric acid
D. Acetone
26. The most significant reagent strip test that is associated with a positive ketone result is
A. Glucose
B. Protein
C. pH
D. Specific gravity
27. The primary reagent in the reagent strip test for ketones is
A. Glycine
B. Lactose
C. Sodium hydroxide
D. Sodium nitroprusside
28. Ketonuria may be caused by all of the following except
A. Bacterial infections
B. Diabetic acidosis
C. Starvation
D. Vomiting
29. Urinalysis on a patient with severe back and abdominal pain is frequently perfonned to check for
A. Glucosuria
B. Proteinuria
C. Hematuria ~»
D. Hemoglobinuria
30. Place the appropriate number or numbers in front of each of the following statements. Use both numbers for an answer if needed
l. Hemoglobinuria
2. Myoglobinuiia
A. Associated with transfusion reactions l. Hemoglobinuria
B. Clear, red urine and pale yellow plasma 2. Myoglobinuiia
C. Clear, red urine and red plasma l. Hemoglobinuria
D. Associated with rhabdomylosis 2. Myoglobinuiia
E. Precipitated by ammonium sulfate l. Hemoglobinuria
F. Not precipitated by ammonium sulfate 2. Myoglobinuiia
G. Produced hemosiderin granules in urinary sediments l. Hemoglobinuria
H. Associated with acute renal failure l. Hemoglobinuria 2. Myoglobinuiia
31. The principle of the reagent strip test for blood is based on the
A. Binding of heme and a chromogenic dye
B. Peroxidase activity of heme
C. Reaction of peroxide and chromogen
D. Diazo activity of heme
32. A speckled pattern on the blood pad of the reagent strip indicates
A. Hematuria
B. Hemoglobinuria
C. Myoglobinuria
D. All of the above
33. List the following products of hemoglobin degradation in the corrct order by placing numbers 1-4 in front of them
2 A. Conjugated bilirubin
3 B. Urobilinogen and stercobiligen
4 C. Urobilin
1 D. Unconjugated bilirubin
34. The principle of the reagent strip test for bilirubin is the
A. Diazo reaction •
B. Ehrlich reaction
C. Greiss reaction
D. Peroxidase reaction
35. An elevated urine bilirubin with a normal urobilinogen is indicative of
A. Cirrhosis of the liver
B. Hemolytic disease
C. Hepatitis
D. Biliary obstruction
36. The primary cause of a false-negative bilirubin reaction is
A. Highly pigmented urine
B. Specimen contamination
C. Specimen exposure to light T
D. Excess conjugated bilirubin
37. The purpose of the special mal supplied with the lctotest tablets is that
A. Bilirubin remains on the surface of the mat. T
B. It contains the dye needed to produce color.
C. lt removes interfering substances.
D. Bilirubin is absorbed into the mat.
38. The reagent in the Multistix reaction for urobilinogen is
A. A diazonium salt
B. Tetramethylbenzidine
C. p-dimethylaminobenzaldehyde ••
D. Hoesch reagent
39. The primary problem with urobilinogen tests using Ehrlich reagent is
A. Positive reactions with porphobilinogen
B. Lack of sensitivity
C. Positive reactions with Ehrlich reactive substances
D. Both A and C »-~
40. In the Watson-Schwartz differentiation test, the substance(s) not extracted into butanol is/are
A. Urobilinogen
B. Porphobilinogen
C. Ehrlich reactive substances
D. All of the above
41. The Hoesch test is used to monitor or screen patient for the presence of
A. Urobilinogen
B. Nitrite
C. Porphobilinogen tr
D. Leukocyte esterase
42. The reagent strip test for nitrite used the
A. Greiss reaction ''''
B. Hoesch reaction
C. Peroxidase reaction
D. Pseudoperoxidase reaction
43. All of the following can cause a negative nitrite reading except
A. Gram-positive bacteria
B. Gram-negative bacteria r
C. Random urine specimens
D. Heavy bacterial infections
44. A positive nitrite test and a negative leukocyte esterase test is an indication of a
A. Dilute random specimen
B. Specimen with lyzed leukocytes
C. Vaginal yeast infection
D. Specimen older than 2 hours ••'
45. All of the following can be detected by the leukocyte esterase reaction except
A. Neutrophils
B. Eosinophils
C. Lymphocytes A
D. Basophils
46. Screening tests for urinary infection combine the leukocyte esterase test with the test for
A. pH
B. Nitrite -r
C. Protein
D. Blood
47. The principle of the leukocyte esterase reagent strip test uses a
A. Peroxidase reaction
B. Double indicator reaction »
C. Diazo reaction ~
D. Dye—binding technique
48. The principle of the reagent strip test for specific gravity uses the dissociation constant of a/an
A. Diazonium salt
B. Indicator dye
C. Polyelectrolyte
D. Enzyme substrate
49. A specific gravity of 1.030 would produce the reagent strip color
A. Blue
B. Green
C. Yellow
D. Red
50. Reagent strip—speciflc gravity readings are affected by
A. Glucose
B. Radiographic dye
C. Alkaline urine
D. All of the above
1. Macroscopic screening of urine specimens is used to
A. Provide results as soon as possible
B. Predict the type of urinary casts present
C. Increase cost—effectiveness of urinalysis
D. Decrease the need for polarized microscopy
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
3. All of the following can cause false-negative microscopic results except
A. Braking the centrifuge
B. Failing to mix the specimen
C. Dilute alkaline urine
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
5. When using the glass slide and coverslip method, which of the following might be missed if the coverslip is overflowed
A. Casts
D. Bacteria
6. Initial screening of the urine sediment is performed using an objective power of
A. 4><
B. lO><
C. 40><
D. 100><
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
8. Which of the following are reported as number per LPF
C. Crystals
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
10. Nuclear detail can be enhanced by
A. Prussian blue
B. Toluidine blue
C. Acetic acid
D. Both B and C
11. Which of the following lipids is/are stained by Sudan lll
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both B and C
12. W'hich of the following lipids is/are capable of polarizing light
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both A and B
13. The purpose of the Hansel stain is to identify
A. Neutrophils
B. Renal tubular cells
C. Eosinophils
D. Monocytes
14. Crenated RBCs are seen in urine that is
A, Hyposthenuric
B. Hypersthenuric
C. Highly acidic
D. Highly alkaline
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
16. The finding of dysmorphic RBCs is indicative of
A. Glomerular bleeding
B. Renal calculi
C. Traumatic injury
D. Coagulation disorders
17. Leukocytes that stain pale blue with 5ternheimer-Malbin stain and exhibit brownian movement are
A. Indicative of pyelonephiitis
B. Basophils
C. Mononuclear leukocytes »
D. Glitter cells
18. Mononuclear leukocytes are sometimes mistaken for
A. Yeast cells
B. Squamous epithelial cells
C. Pollen grains
D. Renal tubular cells
19. When pyuria is detected in a sediment, the slide should be carefully checked for the presence of
B. Bacteria
C. Hyaline casts
D. Mucus
20. Transitional epithelial cells are sloughed from the
A. Collecting duct
B. Vagina
C. Bladder
D. Proximal convoluted tubule
21. The largest cells in the urine sediment are
A. Squamous epithlial cells
B. Urothelial epithelial cells
C. Cuboidal epithelial cells
D. Columnar epithelial cells
22. A clinically significant squamous epithelial cell is the
A. Cuboidal cell
B. Clue cell
C. Caudate cell
D. Columnar cell
23. Forms of transitional epithelial cells include all of the following except
A. Spherical
B. Caudate
C. Convoluted
D. Polyhedral
24. Increased transitional cells are indicative of
A. Catheterization
B. Malignancy
C. Pyelonephritis
D. Both A and B
25. A primary characteristic used to identify renal tubular epithelial cells is
A. Elongatecl structure
B. Centrally located nucleus
C. Spherical appearance
D. Eccentrically located nucleus
26. Following an episode of hemoglobinuria, RTE cells may contain
A. Bilirubin
B. Hemosiderin granules
C. Porphobilinogen
D. Myoglobin
27. The predecessor of the oval fat body is the
A. Histiocyte
B. Urothelial cell
C. Monocyte
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 lll. The structure
A. Contains cholesterol
B. ls not an oval fat body
C. Contains neutral fats
D. ls contaminated with immersion oil
29. The finding of yeast cells in the urine is commonly associated with
A. Cystitis
B. Diabetes mellitus
C. Pyelonephritis
D. Liver disorders
30. The primary component of urinary mucus is
A. Bence jones protein
B. Microalbumin
C. Tamm—horsfall protein
D. Orthostatic protein
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
32. Cylindroiduiia refers to the presence of
A. Cylindrical renal tubular cells •
B. Mucus resembling casts
C. Hyaline and waxy casts
D. All types of casts
33. A person submitting a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment except
A. Hyaline casts
B. Granular casts
C. RBC casts
D. WBC casts
34. Prior to identifying an RBC cast, all of the following should be observed except
A. Free-floating RBCs
B. lntact RBCs in the cast
C. Presence of a cast matrix
D. A positive reagent strip blood reaction
35. WBC casts are primarily associated with
A. Pyelonephritis
B. Cystitis
C. Glomerulonephritis
D. Viral infections
36. The shape of the RTE cell associated with renal tubular epithelial casts is primarily
A. Elongated
B. Cuboidal
C. Round
D. Columnar
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
38. The presence of fatty casts is associated with
A. Nephrotic syndrome
B. Crush injuries
C. Diabetes mellitus
D. All of the above
39. Nonpathogenic granular Casts contain
A. Cellular lysosomes
B. Degenerated cells
C. Protein aggregates
D. Gram—positive cocci
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
41. The observation of broad casts represents
A. Destruction of tubular walls
B. Dehydraton and high fever
C. Formation in the collecting ducts
D. Both A and C
42. All of the following contribute to the formation of urinary crystals except
A. Protein concentration
B. ph
C. Solute concentration
D. Temperature
43. The most valuable initial aid for the identification of crystals in a urine specimen is
A. ph
B. Solubility
C. Staining
D. Polarized microscopy
44. Crystals associated with severe liver disease include all of the following except
A. Bilirubin
B. Leucine
C. Cystine
D. Brrosine Y
45. All of the following crystals routinely polarize except
A. Uric acid
B. Cholesterol
C. Radiographic dye
D. Cystine
46. Differentiation between casts and fibers can usually be made using
A. Solubility characteristics
B. Patient history
C. Polarized light
D. Fluorescent light
47. Match the following crystals seen in acidic urine with their description/identifying characteristics
Amorphous urates 4. Pink sediment
Uric acid 3. Yellow-brown, whetstone
Calcium oxalate monhydrate 5. Ovoid
Calcium oxalate dihydrate 1. Envelopes
48. Match the following crystals seen in alkaline urine with their description/identifying characteristics
Triple phosphate 3. "Coffin lids"
Amorphous phosphate 5. White precipitate
Calcium phosphate 2. Thin prisms
Ammonium biurate 6. Thorny apple
Calcium carbonate 4. Dumbbell shape
49. Match the following abnormal crystals with their description/identifying characteristics
Cystine 4. Hexagonal plates
Tyrosine 8. Fine needles seen in liver Disease
Cholesterol 7. Notched corners
Leucine 6. Concentric circles, radial striations
Ampicillin 1. Bundles following refrigeration
Radiographic dye 5. Flat plates, high specific gravity
Bilirubin 3. Bright yellow clumps
50. Match the following types of microscopy with their descriptions
Bright-field 3. Low refractive index objects may be overlooked
Phase 5. Forms halo of light around object
Polarized 2. Objects split light into two beams
Dark-field 1. indirect light is reflected off the object
Fluorescent 7. Detects specific wavelengths of light emitted from objects
lnterference contrast 4. Three-dimensional images