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Urinalysis


Urinalysis Study Guide
  
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Substances that show a diurnal variation in their urinary excretion pattern are best evaluated using a) first morning specimen b) Midstream "clean catch" c) fractional collection d) timed collection
 
d) Timed Collection
Which of the following will NOT cause erroneous results in a 24-hr timed urine collection? a) when the collection starts & ends in the evening b) when 2 1st morning specimens are included in the collection c) when multiple collection containers aren't mixed together prior to specimen testing d) when a portion of the collection is removed before total volume measurement
 
A
A 25 y.o. woman complains of painful urination & is suspected of having a UTI. Which of the following specimens should be collected for a routine urinalysis & urine culture? a) fractional collection b) timed collection c) midstream "clean catch" d) random specimen
 
C
An unpreserved urine specimen collected at midnight is kept at room temp until the morning hospital shift. Which of the following changes will most likely occur? a) decrease in urine color & clarity b) decrease in pH & specific gravity c) decrease in glucose & ketones d) decrease in bacteria & nitrite
 
C
Which of the following is the most common form of urine preservation? a) boric acid b) sodium fluoride c) freezing d) refrigeration
 
D
If refrigeration is used to preserve a urine specimen, which of the following may occur? a) cellular or bacterial glycolysis will be enhanced b) formed elements will be destroyed c) amorphous crystals may precipitate d) bacteria will proliferate
 
C
Beginning w/ the glomerulus, number the following structures in the order the ultrafiltrate travels for processing & excretion in the kidney
 
1-11
bladder, calyces, collecting tubule, distal tubule, glomerulus, juxaglomerular apparatus, loop of Henle, proximal tubule, renal pelvis, ureter, urethra
 
10, 7, 6, 5, 1, 4, 3, 2, 8, 9, 11
How many nephrons are found in an average kidney? a0 13,000 b) 130,000 c) 1.3 million d) 13 million
 
C 1.3 million
Which component of the nephron is located exclusively in the renal medulla? a) the collecting tubule b) the distal tubule c) the loop of Henle d) the proximal tubule
 
C
The formation of the utlrafiltrate in the glomerulus is driven by the a) hydrostatic blood pressure b) oncotic pressure of the plasma proteins c) oncotic pressure of the solutes in the ultrafiltrate d) pressures exerted by the glomerular filtration barrier
 
A
The ability of a solute to cross the glomerular membrane is determined by its 1. molecular size 2. molecular radius 3. electrical charge 4. plasma conc. a) 1, 2, &3 b) 1 & 3 c) 4 d) all are correct
 
a) 1, 2, 3
The kidney plays an important role in the 1) excretion of waste products 2) regulation of H2O & electrolytes 3) maintenance of acid-base equilibrium 4) control of bp & fluid balance a) 1, 2, & 3 b) 1 & 3 c) 4 d) all are correct
 
D
During tubular transport, the movement of a solute against a gradient a) is called passive transport b) requires little to no energy c) involves specific cell membrane binding sites d) may occur paracellularly
 
C
When too much protein is presented to the renal tubules for reabsorption, it is excreted in the urine because: a) the renal threshold for protein has not been exceeded b) the maximal tubular reabsorptive capacity for protein has been exceeded c) protein isn't normally present in the ultrafiltrate & it can't be reabsorbed d) the glomerular membrane will allow only abnormal proteins to pass
 
B
ADH hormone regulates the reabsorption of a) H2O in the collecting tubules b) Na in the collecting tubules c) Na in the distal convoluted tubule d) H2O & Na in the loop of Henle
 
A
The final conc of the urine is determined w/in the a) collecting ducts b) distal convoluted tubules c) loops of Henle d) proximal convoluted tubules
 
A
Which of the following solutes are present in the largest molar amts in urine? a) urea, Cl & Na b) urea, creatinine, & Na, c) creatinine, uric acid & ammonium d) urea, uric acid & ammonium
 
A
Renal excretion is NOT involved in the elimination of a) electrolytes & H2O b) normal by-products of fat metabolisum c) soluble metabolic wastes (urea, creatinine) d) exogenous substances (drugs, x-ray contrast media)
 
B
The conc of which substances provides the best means of distinguishing urine from other body fluids a) creatinine & urea b) glucose & protein c) uric acid & ammonia d) H2O & electrolytes
 
A
What is the definition of the osmolality of a solution? a) the density of solute particles per liter of solvent b) the mass of solute particles per kg of solvent c) the # of solute particles per kg of solvent d) the weight of solute particles per L of solvent
 
C
Serum osmolality remains relatively constant, whereas the urine osmolality ranges from a) 1/3 to 1/2 that of serum b) 1/3 to equal that of serum c) 1-3 times that of serum d) 3-5 times that of serum
 
C
Another name for excessive thirst is a) polydipsia b) polyuria c) hydrophilia d) hydrostasis
 
A
Osmolality is a measure of solute a) density b) mass c) # d) weight
 
C
Occasionally the specific gravity of a urine specimen exceeds that physiologically possible (greater than 1.040) Which of the following substances when found in the urine could account for such a high value? a) protein b) glucose c) contraste media d) more than one of the above
 
D
The excretion of large volumes of urine (greater than 3 L/day) is called a) glucosuria b) hyperuria c)polydipsia d) polyuria
 
D
The daily volume of urine excreted normally ranges from a) 100-500 ml/day b) 100-1800 ml/day c) 500-1800 ml/day d) 1000-3000 ml/day
 
C
All of the following conditions may produce nocturia EXCEPT a) anuria b) pregnancy c) chronic renal failure d) fluid intake at night
 
A
Which of the following is an endogenous substance used to measure glomerular filtration rate? a) urea b) insulin c) creatinine d) para-aminohippurate
 
C
Renal clearance is defined as a) volume of urine cleared of a substance per min b) volume of plasma cleared of a substance in a time interval c) volume of plasma flowing through the kidney per min d) volume of plasma containing the same amount of substance in 1 ml of urine
 
B
Creatinine is a good substance to use for a renal clearance test because it a) is exogenous b) is reabsorbed c) is affected by fluid intake d) has a constant plasma conc
 
D
Creatinine clearance results are 'normalized' using an individual's body surface area to account for variations in the individual's a) age b) sex c) dietary intake d) muscle mass
 
D
A 24-hr urine collection is preferred for the determination of creatinine clearance because of the diurnal variation in the : a) glomerular filtration rate b) plasma creatinine c) creatinine excretion d) urine excretion
 
A
The color of normal urine is due to the pigment: a) bilirubin b) urobilin c) uroerthrin d) urochrome
 
D
Which of the following urine characteristics provides the best rough indicator of urine conc & body hydration a) the urine's color b) the urine's clarity c) the urine's foam d) the urine's volume
 
A
Which of the following pigments will deposit on urate & uric acid crystals to form a precipitate described as "brick dust" a) bilirubin b) urobilin c) uroerythrin d) urochrome
 
C
Select the urine specimen that does NOT indicate the possible presence of blood or hgb a) a clear red urine b) a cloudy brown urine c) a clear brown urine d) a cloudy amber urine
 
D
Which of the following substances will change the color of both the urine & its foam? a) bilirubin b) hemoglobin c) myoglobin d) urobilin
 
A
The clarity of a well-mixed urine specimen that has visible particulate matter & through which newsprint can be seen but not read should be described as: a) cloudy b) flocculated c) slightly cloudy d) turbid
 
A
Classify each substance that can be present in urine as indicating a pathologic or nonpathologic condition
 
1. pathologic 2. nonpathologic
bacteria (fresh urine), bacteria (old urine), fat, powder, radiographic contrast media, RBCs, renal epi cells, spermatozoa, squamous epi cells, urate crystals, WBCs, yeast
 
1, 2, 1, 2, 2, 1, 1, 2, 2, 2, 1, 1
Which of the following urine specimens is considered normal? a) a freshly voided urine that is brown & clear b) a freshly voided urine that is yellow & cloudy c) a clear yellow urine specimen that changes color upon standing d) a clear yellow urine specimen that becomes cloudy upon refrigeration
 
D
A white precipitate in a normal alkaline urine is most likely caused by: a) amorphous phosphates b) amorphous urates c) uric acid crystals d) radiographic contrast media
 
A
Match the urine odor to the conditions or substance that can cause it diabetes mellitus normal urine old, improperly stored urine specimen adulteration starvation UTI
 
1 ammonia-like 2 bleach 3 faintly aromatic 4 pungent, fetid 5 sweet, fruity
Diabetes mellitus normal urine old, improperly stored urine specimen adulteration starvation UTI
 
5 3 1 1&2 5 1&4
Which of the following specific gravity values is physiologically impossible? a) 1.000 b) 1.010 c) 1.020 d) 1.030
 
A
The principle of the rgt strip method for measuring specific gravity is based on: a) the pKa of a polyelectrolyte decreasing in proportion to the ionic conc of the specimen b) the pH of a polyelectrolyte decreasing in proportion to the ionic conc of the specimen c) the pKa of a polyelectrolyte increasing in proportion to the ionic conc of the specimen d) the pH of a polyelectrolyte increasing in proportion to the ionic conc of the specimen
 
A
Which of the following will NOT influence the volume of urine produced? a) diarrhea b) exercise c) caffeine ingestion d) carbohydrate ingestion
 
D
To preserve the integrity of rgt strips, it is necessary that they are: a) humidified adequately b) stored in a refrigerator c) stored in a tightly capped container d) protected from the dark
 
C
Using QC materials, rgt strip performance should be checked: 1. at least once daily 2. when a new bottle of strips or tablets is opened 3. when a new lot # of strips or tablets is placed into use 4. once each shift by each tech performing urinalysis testing a) 1, 2, 3 b) 1 & 3 c) 4 d) all are correct
 
A
Which of the following is NOT checked by QC materials? a) the technical skills of the personnel performing the test b) the integrity of the specimen (that the specimen was properly collected & stored) c) the test protocol (that the procedure was performed according to written guidelines) d) the functioning of the equipment used (the refractometer, the rgt strip readers)
 
B
Which of the following is NOT a source of erroneous results when using rgt strips? a) testing a refrigerated urine specimen b) timing using a clock w/out a second hand c) allowing excess urine to remain on the rgt strip d) dipping the rgt strip briefly into the urine specimen
 
D
Urine pH normally ranges from : a) 4.0-9.0 b) 4.5-7.0 c) 4.5-8.0 d) 5.0-6.0
 
C
Urine pH can be modified by all of the following EXCEPT: a) diet b) increased ingestion of H2O c) ingestion of medications d) UTIs
 
B
The "double indicator system" employed by commercial rgt strips to determine urine pH uses which two indicator dyes? a) methyl orange & bromphenol blue b) methyl red & bromthymol blue c) phenol red & thymol blue d) phenolphthalein & litmus
 
B
Which of the following aids in the differentiation of hemoglobinuria & hematuria? a) urine pH b) urine color c) leukocyte esterase test d) microscopic examination
 
D
On the rgt strip test for blood, any hgb present in the urine catalyzes the : a) oxidation of both the chromogen & the hydrogen peroxide b) oxidation of the chromogen in the presence of hydrogen peroxide c) reduction of the pseudoperoxide while the chromogen undergoes a color change d) reduction of the chromogen while the hydrogen peroxide becomes oxidized
 
D
Which of the following WBCs will NOT be detected by the leukocyte esterase pad on the rgt stip, because it lacks esterases? a) eosinophils b) lymphocytes c) monocytes d) neutrophils
 
B
A microscopic exam of a urine sediment revealed an avg of 2-5 WBCs per HPF, whereas the leukocyte esterase test by rgt strip was neg. Which of the following best accounts for this discrepancy? a) the urine is contaminated w/ vaginal fluid b) many WBCs are lysed & their esterase has been inactivated c) ascorbic acid is interfering w/ the rxn on the rgt stip d) the amt of esterase present is below the sensitivity of the rgt strip test
 
D
Which of the following statements describes the chemical principle involved on the leukocyte esterase pad of rgt strips? a) leukocyte esterase reacts w/ a diazonium salt on the rgt pad to form an azodye b) an ester & a diazonium salt combine to form an azodye in the presence of leukocyte esterase c) an aromatic compound on the rgt pad combines w/ leukocyte esterase to form an azodye d) leukocyte esterase hydrolyzes an ester on the rgt pad, then an azo-coupling rxn results in the formation of an azodye
 
D
Which of the following conditions most likely account for a neg nitrite result on the rgt strip despite the presence of Lg amts of bacteria 1. the bacteria present did not have enough time to convert nitrate to nitrite 2. the bacteria present are not capable of convertin nitrate to nitrite 3. the pt is not ingesting adequate amounts of nitrate in the diet 4. the urine is very dilute & the level of nitrite present is below the sensitivity of the test a) 1, 2, & 3 b) 1 & 3 c) 4 d) all are correct
 
D
The chemical principle of the nitrite rgt pad is based on the: a) pseudoperoxidase activity of nitrite b) diazotization of nitrite following by an azo-coupling rxn c) azo-coupling action of nitrite w/ a diazonium salt to form an azodye d) hydrolysis of an ester by nitrite combine w/ an azo-coupling rxn
 
B
Which of the following substances can result in false positive nitrite results? a) ascorbic acid b) vaginal contamination c) strong reducing agents d) improper specimen storage
 
D
Which of the following statements about Bence Jones protein is correct? a) it consists of kappa & lambda light chains b) it is often found in the urine of pts w/ MS c) it precipitates when the urine is heated to 100C & redissolves when cooled to 60C d) it can produce a pos rgt strip protein test & a neg sulfosalicylic acid precipitation (SSA) test
 
A
Which of the following best describes the chemical principle of the protein rgt strip test? a) the protein reacts w/ an immunocomplex on the pad, which results in a color change b) the protein causes a pH change on the rgt strip pad, which results in a color change c) the protein accepts hydrogen ions from the indicator dye, which results in a color change d) the protein causes protons to be released from a polyelectrolyte, which results in a color change
 
C
The glucose rgt strip test is more sensitive & specific for glucose than the Clinitest method because it detects: a) other reducing substances & higher concs of glucose b) no other substances & higher concs of glucose c) other reducing substances & lower concs of glucose d) no other substances & lower concs of glucose
 
D
The "pass-through" phenomenon observed w/ the Clinitest method when Lg amts of glucose are present in the urine is due to: a) the "carmelization" of the sugar present b) the reduction of copper sulfate to green-brown cupric complexes c) the depletion of the substrate (not enough copper sulfate present initially) d) the re-oxidation of the cuprous oxide formed to cupric oxide & other cupric complexes
 
D
The glucose specificity of the "double sequential enzyme rxn" employed on rgt strip tests is due to the use of: a) gluconic acid b) glucose oxidase c) hydrogen peroxide d) peroxidase
 
B
Which of the following ketones are NOT detected by the rgt strip or tablet (Acetest) test? a) acetone b) acetoacetate c) beta-hydroxybutrate d) none of the above
 
C
The ketone rgt steip & tablet tests are based on the reactivity of ketones w/: a) ferric chloride b) ferric nitrate c) nitroglycerin d) nitroprusside
 
D
Which of the following statements about bilirubin is true? a) conjugated bilirubin is H2O insoluble b) bilirubin is a degradation product of heme catabolism c) unconjugated bilirubin readily passes through the glomerular membrane d) the liver conjugates bilirubin w/ albumin to form conjugated bilirubin
 
B
Urobliniogen is formed from the: a) conjugation of bilirubin in the liver b) reduction of conjugated bilirubin in the bile c) reduction of bilirubin by intestinal bacteria d) oxidation of urobilin by anaerobic intestinal bacteria
 
C
The classic Ehrlich's rxn is based on the rxn of urobilinogen w/: a) diazotized dichloroaniline b) p-aminobenzoic acid c) p-dichlorobenzene diazonium salt d) p-dimethylaminobenzaldehyde
 
D
Which of the following rgt strips can be affected by ascorbic acid, resulting in falsely low or false neg results? 1 blood 2 bilirubin 3 glucose 4 nitrite a) 1, 2, & 3 b) 1 & 3 c) 4 d) all are correct
 
D
When urine sediment is viewed, stains & various microscopic techniques are used to: 1 enhance the observation of fine detail 2 confirm the ID of suspected components 3 differentiate formed elements that look alike 4 facilitate the visualization of low-refractile components a) 1, 2, & 3 b) 1 & 3 c) 4 d) all of the above
 
D
When a tech performs the micro exam of urine sediment, which of the following are enumerated using low-power magnification? a) bacteria b) casts c) RBCs d) none of the above
 
B
A urine sediment could have which of the following formed elements & still be considered "normal"? a) 0-2 hyaline casts b) 5-10 RBCs c) moderate bacteria d) a few yeast
 
A
Which urinary sediment component can resemble RBCs? 1 yeast 2 air bubbles 3 oil droplets 4 calcium oxalate crystals a) 1, 2, & 3 b) 1 & 3 c) 4 d) all is correct
 
A
How do increased numbers of leukocytes usually get into the urine? a) through a renal bleed b) by passive movement through pores int he vascular epithelium c) by active ameboid movement through the tissues & epithelium d) through damage to the integrity of normal vascular barrier
 
C
Urinary casts are formed in the: a) distal & collecting ducts b) distal tubules & the loops of Henle c) proximal & distal tubules d) proximal tubules & the loops of Henle
 
A
Urinary casts are formed w/ a core matrix of: a) albumin b) Bence Jones protein c) Tamm-Horsfall protein d) transferrin
 
C
Which of the following does NOT contribute to the size, shape, or length of a urinary cast? a) the conc of protein in the cast's core matrix b) the configuration of the tubules in which the cast is formed c) the diameter of the tubular lumen in which the cast is formed d) the duration of time the cast is allowed to form in the tubule
 
A
Which of the following urinary casts are diagnostic of glomerular or renal tubular damage? a) bacterial casts b) RBC casts c) renal tubular cell casts d) WBC casts
 
B
Which of the following does NOT affect the formation of urinary crystals in the nephrons? a) the pH of the urine b) the diameter of the tubular lumen c) the flow of the urine through the tubules d) the conc of solutes in the ultrafiltrate
 
B
The formation of urinary crystals is assoc w/ a specific urine pH. Match the urine pH that facilitates crystalline formation to the crystal type. More tahn one # can be used. ammonium biurate, amorphous urates, amorphous phosphates, calcium oxalate, cholesterol, cystine, radiographic contrast media, sulfonamides, triple phosphate, tyrosine, uric acid
 
1 acid 2 neutral 3 alkaline
ammonium biurate amorphous urates amorphous phosphate calcium oxalate cholesterol cystine radiographic contrast media sulfonamides triple phosphate tyrosine uric acid
 
3 1 & 2 2 & 3 1 & 2 1 1 1 1 3 & 2 1 1
Match the crystal composition to the microscopic description that best describes it Microscopic description: colorless "coffin lid" form colorless hexagonal plates colorless "envelope" form colorless rectangular plates w/ notched corners yellow-brown "thorny apple" form colorless to yellow; diamond or lemon-shaped; flat or rosettes yellow-brown sheaves of wheat
 
Crystal composition 1. ammonium biurate 2. amorphous urates 3. amorphous phosphates 4. calcium oxalate 5. cholesterol 6. cystine 7. sulfonamide 8. triple phosphate 9. uric acid
colorless "coffin lid" form colorless hexagonal plates colorless "envelope" form colorless rectangular plates w/ notched corners yellow-brown "thorny apple" form colorless to yellow; diamond or lemon-shaped; flat or rosettes yellow-brown sheaves of wheat
 
8. triple phosphate 6. cystine 4. calcium oxalate 5. cholesterol 1. ammonium biurate 9. uric acid 7. sulfonamide
Which of the following crystals, when found in the urine sediment, most likely indicates an abnormal metabolic condition? a) bilirubin b) sulfonamide c) triple phosphate d) uric acid
 
A
Mucous threads can be difficult to differentiate from: a) pigmented casts b) hyaline casts c) waxy casts d) none of the above
 
B
Which of the following is NOT a distinguishing characteristic of yeast in the urine sediment? a) motility b) budding forms c) hyphae formation d) colorless ovoid forms
 
A
The following are initial results obtained during a routine urinalysis. Which reults should be investigated further? a) neg protein; 0-2 hyaline casts b) urine pH 6.0; calcium oxalate crystals c) cloudy yellow urine; specific gravity 1.050 d) amber urine w/ yellow foam; neg bilirubin by rgt strip; pos Ictotest
 
C
Which of the following when found in the urine sediment from a female pt is NOT considered a vaginal contaminant? a) fat b) clue cells c) spermatozoa d) trichomonads
 
A
Which of the following statements about renal disease is true? a) glomerular renal diseases are usually immune mediated b) vascular disorders induce renal disease by increasing renal perfusion c) all structural components of the kidney are equally susceptible to disease d) tubulointerstitial renal diseases usually result from antibody-antigen & complement interactions
 
A
Clinical features that are characteristic of glomerular damage include all of the following EXCEPT: a) edema b) hematuria c) proteinuria d) polyuria
 
D
Which of the following frequently occurs following a bacterial infection of the skin or throat? a) acute glomerulonephritis b) chronic glomerulonephritis c) membranous glomerulonephritis d) rapidly progressive glomerulonephritis
 
A
Chronic renal failure often develops in each of the following diseases EXCEPT: a) amyloidosis b) diabetes mellitus c) diabetes insipidus d) systemic lupus erythematosus
 
C
Which of the following characterizes nephrotic syndrome 1 proteinuria 2 edema 3 hypoalbuminemia 4 hyperlipidemia a) 1, 2, & 3 b) 1 & 3 c) 4 d) all are correct
 
D
Which of the following disorders is characterized by the urinary excretion of Lg amts of arginine, cystine, lysine & ornithine? a) cystinosis b) cystinuria c) lysinuria d) tyrosinuria
 
B
Which of the following is considered a lower UTI? a) cystitis b) glomerulonephritis c) pyelitis d) pyelonephritis
 
A
Most UTIs are due to: a) yeast b) gram neg rods c) gram pos rods d) gram pos cocci
 
B
Which of the following formed elements found in urine sediment is most indicative of an upper UTI? a) bacteria b) casts c) erythrocytes d) leukocytes
 
B
Yeast is considered part of the normal flora in each of the following locations EXCEPT in the: a) GI tract b) oral cavity c) urinary tract d) vagina
 
C
Isosthenuria, significant proteinuria, & numerous casts of all types describes the urinalysis findings from a pt w/ a) acute renal failure b) acute tubular necrosis c) chronic renal failure d) renal tubular acidosis
 
C
Approximately 75% of the renal calculi that form in pts contain: a) calcium b) cystine c) oxalate d) uric acid
 
A
The formation of renal calculi is enhanced by: a) an increase in urine flow b) the body's natural acid-alkaline tide c) increases in protein in the urine ultrafiltrate d) increases in chemical salts in the urine ultrafiltrate
 
D
Which of the following hereditary diseases results in the accumulation & excretion of Lg amts of homogentisic acid? a) alkaptonuria b) melanuria c) phenylketonuria d) tyrosinuria
 
A
Which of the following diseases can result in severe mental retardation if not detected & treated in the infant? 1 phenylketonuria 2 maple syrup urine disease 3 galactosuria 4 alkaptonuria a) 1, 2, & 3 b) 1 & 3 c) 4 d) all are correct
 
A
Which of the following is NOT a characteristic of diabetes insipidus? a) polyuria b) polydipsia c) increased production of ADH d) urine w/ a low specific gravity
 
C
Porphyria is characterized by: a) increased heme degradation b) increased heme formation c) decreased globin synthesis d) decreased iron catabolism
 
B
Which of the following substances is NOT a component of normal feces? a) bacteria b) blood c) electrolytes d) water
 
B
All of the following will result in watery or diarrheal stools EXCEPT: a) decreased intestinal motility b) the inhibition of water reabsorption c) inadequate time allowed for water reabsorption d) an excessive volume of fluid presented for reabsorption
 
A
Which of the following conditions is characterized by the excretion of greasy, pale, foul-smelling feces? a) steatorrhea b) osmotic diarrhea c) secretory diarrhea d) intestinal hypermotility
 
A
Which of the following tests is required in order to diagnose steatorrhea? a) fecal fat b) fecal carbohydrates c) fecal occult blood d) fecal osmolality
 
A
Which of the following statements regarding feces is true? a) the normal color of feces is primarily due to urobilinogens b) the amt of feces produced in 24 hrs correlates poorly w/ food intake c) the normal odor of the feces is usually due to metabolic by-products of intestinal protozoa d) the consistency of the feces is primarily determined by the amt of fluid intake
 
B
Fecal specimens are often tested for all of the following EXCEPT: a) fat b) blood c) bilirubin d) carbohydrates
 
C
Which of the following is responsible for the characteristic color of normal feces? a) bilirubin b) hemoglobin c) urobilins d) urobilinogen
 
C
Which of the following statements regarding fecal tests is true? a) a fecal fat determination IDs the cause of steatorrhea b) a fecal leukocyte determination aids in differentiating the cause of diarrhea c) a fecal Clinitest IDs the enzyme deficiency that prevents sugar digestion d) a fecal blood screen aids in differentiating bacterial from parasitic infestations
 
B
Mass screening in adults for occult blood in the feces is primarily performed to detect: a) ulcers b) hemorrhoids c) colorectal cancer d) esophageal varices
 
C
Which of the following dietary substances can cause a false neg fecal occult blood slide test? a) fish b) red meat c) ascorbic acid d) fruits & veggies
 
C
Which of the following is the indicator of choice in fecal occult blood slide tests? a) guaiac b) benzidine c) orthotoluidine d) tetramethylbenzidine
 
A
Which of the following conditions can result in the excretion of small amts of occult blood in the feces? 1 hemorrhoids 2 bleeding gums 3 peptic ulcers 4 intake of iron supplements a) 1, 2, & 3 b) 1 & 3 c) 4 d) all are correct
 
D
Which of the following statements regarding the test for fetal hgb in the feces (the Apt test) is true? a) any adult hgb present should be resistant to alkali Tx b) the Apt test is used to differentiate various hemoglobinopathies in the newborn c) hgb degraded to hematin usually produces a pos test result d) a pink color following alkali Tx indicates the presence of fetal hgb
 
D
Seminal fluid analysis is routinely performed to evaluate which of the following? a) prostate cancer b) postvasectomy status c) penile implant status d) premature ejaculation
 
B
Which of the following is a requirement when collecting seminal fluid specimens? a) the pt should abstain from sex for at least 2 days following the collection b) only complete collections of the entire ejaculate are acceptable for analysis c) a single seminal fluid specimen is sufficient for the evaluation of male infertility d) seminal fluid specimens must be evaluated w/in 3 hrs following collection
 
B
Which of the following will adversely affect the quality of a seminal fluid specimen? a) the use of silastic concoms b) the time of day the collection is obtained c) the collection of the specimen in a glass container d) the storage of the specimen at refrigerator specimens
 
D
Which of the following statements regarding seminal fluid is true? a) seminal fluid usually coagulates w/in 30 mins after ejaculation b) it is abnormal for seminal fluid to liquefy before 60 mins c) following liquefaction, the viscosity of normal seminal fluid is similar to that of water d) flowing liquefaction, the presence of particulate matter is highly indicative of bacterial infection
 
C
Which of the following statements regarding the evaluation of spermatozoa motility is NOT true? a) spermatozoa motility is most often subjectively graded b) spermatozoa motility is adversely affected by temp c) spermatozoa motility appraises both speed & forward progression d) spermatozoa motility should be evaluated initially & at 2 hrs after collection
 
D
Which of the following statements regarding sperm conc is true? a) sperm conc w/in a single individual is usually consistent b) sperm conc is dependent solely on the period of abstinence c) sperm conc in a normal ejaculate ranges from 20-250 million/ml d) sperm conc is more important than sperm motility for fertility
 
C
The conc of which of the following substances can be used to positively ID a fluid as seminal fluid? a) acid phosphatase b) citric acid c) fructose d) zinc
 
A
Which of the following is NOT a fxn of the amniotic fluid that surrounds the developing fetus? a) it provides protection of the fetus b) it enables the movement of the fetus c) it is a medium for exchange of O2 d) it is a source of H2O & solute exchange
 
C
Amniocentesis is usually performed at 15-18 wks gestation to determine which of the following? a) fetal distress b) fetal maturity c) genetic disorders d) infections in the amniotic fluid
 
C
Through which of the following mechanisms does solute & H2O exchange occur between the fetus & the amniotic fluid? 1 fetal swallowing of teh amniotic fluid 2 transudation across the fetal skin 3 fetal urination into the amniotic fluid 4 respiration of amniotic fluid into the fetal pulmonary system a) 1, 2, & 3 b) 1 & 3 c) 4 d) all of the above
 
D
Amniotic fluid is immediately protected from light to preserve which of the following substances? a) bilirubin b) fetal cells c) meconium d) phospholipids
 
A
Which of the following is NOT a test to evaluate the surfactants present in the fetal pulmonary system? a) bilirubin b) lecithin/sphingomyelin ratio c) phosphatidylglycerol detection d) foam stability index
 
A
Which of the following causes erythroblastosis fetalis? a) immaturity of the fetal liver b) decreased amts of amniotic fluid c) inadequate fetal pulmonary surfactants d) maternal immunization by fetal antigens
 
D
CSF is produced primarily from: a) secretions by the choroid plexus b) diffusion from plasma into the CNS c) ultrafiltration of plasma in the ventricles of the brain d) excretion from ependymal cells lining the brain & spinal cord
 
A
CSF is found between the: a) arachnoid & dura mater b) arachnoid & pia mater c) pia mater & dura mater d) pia mater & choroid plexus
 
B
During a lumber puncture procedure, the 1st collected tube of CSF removed should be used for: a) chemistry tests b) cytology studies c) hematology tests d) microbiology studies
 
A
All of the following can cause xanthochromia in CSF EXCEPT: a) high conc of protein b) high conc of bilirubin c) increased #s of leukocytes d) erythrocytes from a traumatic tap
 
C
In CSF, which of the following indicates a traumatic puncture? a) the presence of erythrophagocytic cells in the CSF b) hemosiderin granules w/in macrophages in the CSF sediment c) an uneven distribution of blood in the CSF collection tubes d) a xanthochromic supernatant following CSF centrifugation
 
C
How many leukocytes are normal present in the CSF obtained from an adult? a) 0-5 cells/ul b) 0-10 cells/ul c) 0-20 cells/ul d) 0-30 cells/ul
 
A
Which of the following cells may be present in small #s in normal CSF? a) erythrocytes b) lymphocytes c) macrophages d) plasma cells
 
B
Which of the following cell types predominate in CSF during a classic case of viral meningitis? a) lymphocytes b) macrophages c) monocytes d) neutrophils
 
D
Which of the following cell types predominate in CSF during a classic case of viral meningitis? a) lymphocytes b) macrophages c) monocytes d) neutrophils
 
D
When choroid plexus cells & ependymal cells are present in CSF, they: a) are clinically significant b) represent the demyelination of nerve tissue c) closely resemble clusters of malignant cells d) indicate breakdown of the blood-brain barrier
 
C
Which of the following will NOT result in an increased CSF total protein? a) a traumatic tap b) alterations in the blood-brain barrier c) trauma to the CNS, resulting in fluid loss d) decreased reabsorption of CSF into the peripheral blood
 
C
Which of the following procedures frequently provides a rapid presumptive diagnosis of bacterial meningitis? a) a blood culture b) a CSF culture c) a CSF gram stain d) immunologic tests for microbial antigens
 
C
India ink preps & microbial antigen tests on CSF can aid in the diagnosis of: a) bacterial meningitis b) fungal meningitis c) tuberculosis meningitis d) viral meningitis
 
B
Which of the following is a fxn of synovial fluid? 1. providing lubrication for a joint 2. assisting in the structural support of a joint 3. transporting nutrients to articular cartilage 4. synthesizing hyaluronate & degradative enzymes a) 1, 2, & 3 b) 1 & 3 c) 4 d) all are correct
 
B
Which of the following is NOT normally present in synovial fluid? a) fibrinogen b) neutrophils c) protein d) uric acid
 
A
A synovial fluid specimen has a high cell count & requires dilution to be counted. Which of the following diluents should be used? a) normal saline b) dilute acetic acid, 2% c) dilute methanol 1% d) phosphate buffer solution 0.050 mol/L
 
A
Which of the following crystals is characteristically seen in pts w/ gout? a) cholesterol crystals b) hydroxyapatite crystals c) monosodium urate monohydrate crystals d) calcium pyrophosphate dihydrate crystals
 
C
Which of the following mechanisms is responsible for the formation of serous fluid in body cavities? a) ultrafiltration of the circulating blood plasma b) selective absorption of the fluid from the lymphatic system c) diuresis of solutes & H2O across a conc gradient d) active secretion by mesothelial cells taht line the serous membrane
 
A
The pathologic accumulation of fluid in a body cavity is called: a) an abscess b) an effusion c) pleocytosis d) paracentesis
 
B
Thoracentesis refers specifically to the removal of fluid from the: a) abdominal cavity b) pericardial cavity c) peritoneal cavity d) pleural cavity
 
D
Which of the following parameters best IDs a fluid as a transudate or an exudate? a) its color & clarity b) its leukocyte & differential counts c) its total protein & specific gravity measurements d) its total protein ratio & lactate dehydrogenase ratio
 
D
Each of the following will increase the chances of obtaining a pos stain or culture when performing microbiologic studies on infectious serous fluid EXCEPT: a) using a Lg volume of serous fluid for inoculum b) storing serous fluid specimens at refrigerator temps c) using an anticoagulant in the serous fluid collection d) concentrating the serous fluid before preparing the smears for staining
 
B

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