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Final Exam Review for UA

Exams 1,2,3 ONLY!
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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)
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)
Phenylketonuria is caused by
lack of the enzyme phenylalanine hydroxylase
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)
Phenylketonuria produces what kind of scent?
mousy
The recommended centrifugation for preparing the urine sediment is
400 RCF for 5 minutes
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)
Acute renal failure may be classified by
post renal, pre-renal and renal
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
Cystinosis produces what kind of scent
a sulfur odor is associated with Cysinosis
Urobilinogen is formed from the
reduction of bilirubin by intestinal bacteria
the protein section of the reagent strip is most sensitive to
albumin
a spotted reaction on the reagent strip reaction for blood indicates
hematuria
the cells most frequently associated with urinary tract infections are
neutrophils
motility by which of the following si most noticeable during the urine sediment examination
Trichomonas vaginalis
A 1+ reagent strip reaction and a 4+ Clinitest reaction could indicate the presence of
glucose and other reducing substances
Porphyrins are intermediary compounds in the formation of
heme
Infection of the bladder is termed
cystitis
the reagent strip reaction that should be read last is the
Leukocyte esterase
The substance producing the brown color in feces is
urobilin
Normal crystals found acidic urine include
calcium oxalate, uric acid, amorphous urates
pediatric urine specimens are additionally tested for the presence of
galactose using Clinitest
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
Inhibition of bacterial growth in the Guthrie test should be interpreted as
negative for PKU
the major constituent of casts is
Tamm-Horsfall protein
Excessive fat metabolism is indicated by the presence in the urine of
ketones
The normal range of pH is
4.5-8.0
Identification of crystals is based on shape and
urine pH and crystal size
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)
The normal sperm concentration is
20-160 million/mL
the function of serous fluid is to
provide lubrication for the serous membranes
a dark green amniotic fluid is associated with
meconium
conditions the produce elevated CSF protein include all of the following except
fluid leakage (multiple sclerosis, hemorrhage, meningitis)
crystals found in the synovial fluid during attacks of gout are
monosodium urate
examination of a CSF shows 1000 WBCs, of which 75% are lymphocytes and 25% are monocytes this finding is consistent with
viral meningitis
exudate fluids usually result from
inflammation of the serous membrane
The pathological accumulation of fluid in a body cavity is termed a/an
effusion
a milky-appearing synovial fluid is associated with the presence of
monsodium urate crystals
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
Stools from persons with steatorrhea contain excess amounts of
fat
normal semen should liquefy
within 1 hour
Amniotic fluid tests for fetal maturity include
L/S ratio and microviscosity
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
The term occult blood describes blood that
is not visibly apparent in the stool specimen
the normal CSF glucose is
60-70% of the blood glucose
before analysis semen specimens should be
allowed to liquefy
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)
A xanthochromic CSF specimen will appear
yellow and clear
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 third tube of CSF collected from a lumbar puncture should be used for
hematology tests
The presence of xanthochromia and an increased D-dimer test in the CSF is indicative of
a cerebral hemorrhage
Peritoneal fluid is collected by a procedure called
paracentesis
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
the normal brown color of the feces is produced by
urobilin
spermatogenesis takes place in the
seminiferous tubules
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
traumatic tap
A pleural fluid delivered to the laboratory in ice would be accompanied by a requisition to test for
pH
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
54,000,000/mL
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.
Tests for the detection of occult blood rely on the
pseudoperoxidase activity of hemoglobin
To determine if a questionable specimen is semen, the specimen should be tested for
acid phosphatase.
Crystals frequently seen with chronic inflammation are
cholesterol
Hemolytic disease of the newborn is caused by
maternal antibodies.
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)
A milky, green-tinged pleural fluid
stains weakly with Sudan III
The recommended specimen for quantitative fecal testing is a
72-hour specimen
The foam, or shake, test is a screening test for amniotic fluid
surfactants
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