Urinalysis & Body Fluids

178 Questions | Total Attempts: 441

SettingsSettingsSettings
Please wait...
Urinalysis & Body Fluids

Urinalysis is the process of checking the appearance, concentration and content of urine so as to detect a wide range of medical disorders like diabetes and kidney disease. What can you tell us about this, and other bodily fluids?


Questions and Answers
  • 1. 
    After receiving a 24 hour urine for quantitative total protein analysis, the technician must first:
    • A. 

      Subculture the urine for bacteria

    • B. 

      Add the appropriate preservative

    • C. 

      Screen for albumin using a dipstick

    • D. 

      Measure the total volume

  • 2. 
    False results in urobilinogen testing may occur if the urine specimen is:
    • A. 

      Exposed to light

    • B. 

      Adjusted to a neutral pH

    • C. 

      Cooled to room temperature

    • D. 

      Collected in a nonsterile container

  • 3. 
    A clean-catch urine is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hours later, the specimen is sent to the microbiology department for culture. The specimen should:
    • A. 

      Be centrifuged, and the supernatant cultured

    • B. 

      Be rejected due to time delay

    • C. 

      Not be cultured if no bacteria are seen

    • D. 

      Be processed for culture only if the nitrate is positive

  • 4. 
    Which of the following urine results is most apt to be changed by proloinged exposure to light?
    • A. 

      PH

    • B. 

      Protein

    • C. 

      Ketones

    • D. 

      Bilirubin

  • 5. 
    • A. 

      RBCs, leukocytes and casts agglutinate on standing for several hours at room temperature

    • B. 

      Urobilinogen increases and bilirubin decreases after prolonged exposure to light

    • C. 

      Bacterial contamination will cause alkalinization of the urine

    • D. 

      Ketones will increase due to bacterial and cellular metabolism

  • 6. 
    The following results were obtained one a urine speciment at 8:00 am: pH:                 5.5 protein:           2+ glucose:         3+ ketones:         3+ blood:             negative bilirubin:          positive nitrite:             positive If this urine speciment was stored uncapped at 5 degrees C without preservation and retested at 2pm, which of the following test results would be changed due to these storage conditions?
    • A. 

      Glucose

    • B. 

      Ketones

    • C. 

      Protein

    • D. 

      Nitrite

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

      At room temperature

    • B. 

      At 4-7 degrees C

    • C. 

      Frozen

    • D. 

      With a preservative additive

  • 8. 
    Which of the following would be affected by allowing a urine specimen to remain at room temperature for 3 hours before analysis?
    • A. 

      Occult blood

    • B. 

      Specific gravity

    • C. 

      PH

    • D. 

      Protein

  • 9. 
    A 24-hour urine from a man who had no evidence of kidney impairment was sent to the laboratory for hormone determination. The volume was 600 mL, but there was some question as to the completeness of the 24-hour collection. The next step would be to :
    • A. 

      Perform the hormone determination, since 600 mL is a normal 24-hour urine volume

    • B. 

      Check the creatinine level; if it is

    • C. 

      Report the hormone determination in mg/dL in case the specimen was incomplete

    • D. 

      Check the creatinine level; if it is >1g, do the procedure

  • 10. 
    Failure to observe RBC casts in a urine specimen can be caused by:
    • A. 

      Staining the specimen

    • B. 

      Centrifuging an unmixed specimen

    • C. 

      Mixing the sediment after decantation

    • D. 

      Examining the sediment first under low power

  • 11. 
    EGFR calculated by the MDRD formula takes into account the age, BUN, race, albumin and what else for its calculation?
    • A. 

      Urea

    • B. 

      Ammonia

    • C. 

      Creatinine

    • D. 

      Cystatin C

  • 12. 
    The creatinine clearance is reported in:
    • A. 

      Mg/dL

    • B. 

      Mg/24 hours

    • C. 

      ML/min

    • D. 

      ML/24 hours

  • 13. 
    Microalbumin can be measured by a random urine collection. An increase microalbumin is predictive of:
    • A. 

      Diabetes mellitus

    • B. 

      Nephropathy

    • C. 

      Hypertension

    • D. 

      Nephrotic syndrome

  • 14. 
    A patient with uncontrolled diabetes mellitus will most likely have:
    • A. 

      Pale urine with a high specific gravity

    • B. 

      Concentrated urine with a high specific gravity

    • C. 

      Pale urine with a low specific gravity

    • D. 

      Dark urine with a high specific gravity

  • 15. 
    While performing an analysis of a baby's urine, the technologist notices the specimen to have a "mousy" odor. Of the following substances that may be excreted in urine, the one that most characteristically produces this odor is:
    • A. 

      Phenylpyruvic acid

    • B. 

      Acetone

    • C. 

      Coliform bacilli

    • D. 

      Porphyrin

  • 16. 
    An ammonia-like odor is characteristically associated with urine from patients who:
    • A. 

      Are diabetic

    • B. 

      Have hepatitis

    • C. 

      Have an infection with Proteus sp

    • D. 

      Have a yeast infection

  • 17. 
    Urine that develops a port wine color after standing may contain:
    • A. 

      Melanin

    • B. 

      Porphyrins

    • C. 

      Bilirubin

    • D. 

      Urobilinogen

  • 18. 
    Acid urine that contains hemoglobin will darken on standing due to the formation of:
    • A. 

      Myoglobin

    • B. 

      Sulfhemoglobin

    • C. 

      Methemoglobin

    • D. 

      Red blood cells

  • 19. 
    Urine from a 50-year-old man was noted to turn dark red on standing. This change is caused by:
    • A. 

      Glucose

    • B. 

      Porphyrins

    • C. 

      Urochrome

    • D. 

      Creatinine

  • 20. 
    The clarity of a urine sample should be determined:
    • A. 

      Using glass tubes only; never plastic

    • B. 

      Following thorough mixing of the specimen

    • C. 

      After addition of sulfosalicylic acid

    • D. 

      After the specimen cools to room temperature

  • 21. 
    Milky urine from a 24-year-old woman would most likely contain:
    • A. 

      Spermatozoa

    • B. 

      Many white blood cells

    • C. 

      Red blood cells

    • D. 

      Bilirubin

  • 22. 
    A brown-black urine would most likely contain:
    • A. 

      Bile pigment

    • B. 

      Porphyrins

    • C. 

      Melanin

    • D. 

      Blood cells

  • 23. 
    The yellow color of urine is primarily due to:
    • A. 

      Urochrome pigment

    • B. 

      Methemoglobin

    • C. 

      Bilirubin

    • D. 

      Homogenistic acid

  • 24. 
    Red urine may be due to:
    • A. 

      Bilirubin

    • B. 

      Excess urobilin

    • C. 

      Myoglobin

    • D. 

      Homogenistic acid

  • 25. 
    A urine specimen collected on an apparently healthy 25-year-old man shortly after he finished eating lunch was cloudy by showed some normal results on a multiple reagent strip analysis. The most likely cause of the turbidity is:
    • A. 

      Fat

    • B. 

      White blood cells

    • C. 

      Urates

    • D. 

      Phosphates

  • 26. 
    In which of the following metabolic diseases will urine turn dark brown to black upon standing?
    • A. 

      Phenylketonuria

    • B. 

      Alkaptonuria

    • C. 

      Maple syrup disease

    • D. 

      Aminoaciduria

  • 27. 
    Urine osmolality is related to:
    • A. 

      PH

    • B. 

      Filtration

    • C. 

      Specific gravity

    • D. 

      Volume

  • 28. 
    Urine specific gravity is an index of the ability of the kidney to:
    • A. 

      Filter the plasma

    • B. 

      Concentrate the urine

    • C. 

      Alter the hydrogen ion concentration

    • D. 

      Reabsorb sodium ions

  • 29. 
    Osmolality is the measure of:
    • A. 

      Dissolved particles, including ions

    • B. 

      Undissociated molecules only

    • C. 

      Total salt concentration

    • D. 

      Molecule size

  • 30. 
    A patient urine sample has an increased protein and a high specific gravity. Which of the following would be a more accurate measure of urine concentration?
    • A. 

      Osmolality

    • B. 

      Ketones

    • C. 

      Refractive index

    • D. 

      PH

  • 31. 
    To prepare a solution appropriate for quality control of the refractometer, a technician should use:
    • A. 

      Urea with a specific gravity of 1.040

    • B. 

      Water with a specific gravity of 1.005

    • C. 

      Sodium chloride with a specific gravity of 1.022

    • D. 

      Calcium chloride with an osmolarity of 460

  • 32. 
    A urine's specific gravity is directly proportional it its:
    • A. 

      Turbidity

    • B. 

      Dissolved solids

    • C. 

      Salt content

    • D. 

      Sugar content

  • 33. 
    Isosthenuria is associated with a specific gravity which is usually:
    • A. 

      Variable between 1.001 and 1.008

    • B. 

      Variable between 1.015 and 1.022

    • C. 

      Fixed around 1.010

    • D. 

      Fixed around 1.020

  • 34. 
    The fluid leaving the glomerulus normally has a specific gravity of:
    • A. 

      1.001

    • B. 

      1.010

    • C. 

      1.020

    • D. 

      1.030

  • 35. 
    An antidiuretic hormone deficiency is associated with a:
    • A. 

      Specific gravity around 1.031

    • B. 

      Low specific gravity

    • C. 

      High specific gravity

    • D. 

      Variable specific gravity

  • 36. 
    Use of a refractometer over a urinometer is preferred due to the fact that the refractometer uses:
    • A. 

      Large volume of urine and compensates for temperature

    • B. 

      Small volume of urine and compensates for glucose

    • C. 

      Small volume of urine and compensates for temperature

    • D. 

      Small volume of urine and compesates for protein

  • 37. 
    Calibration of refractometers is done by measuring the specific gravity of distilled water and:
    • A. 

      Protein

    • B. 

      Glucose

    • C. 

      Sodium chloride

    • D. 

      Urea

  • 38. 
    The method of choice for performing a specific gravity measurement of urine following administration of x-ray contrast dyes is:
    • A. 

      Reagent strip

    • B. 

      Refractometer

    • C. 

      Urinometer

    • D. 

      Densitometer

  • 39. 
    Which of the following urinary parameters are measured during the course of concentration and dilution tests to assess renal tubular function?
    • A. 

      Urea, nitrogen and creatinine

    • B. 

      Osmolality and specific gravity

    • C. 

      Sodium and chloride

    • D. 

      Sodium and omolality

  • 40. 
    Refractive index is a comparison of:
    • A. 

      Light velocity in solutions to light velocity in solids

    • B. 

      Light velocity in air to light velocity in solutions

    • C. 

      Light scattering by air to light scattering by solutions

    • D. 

      Light scattering by particles in solution

  • 41. 
    Which of the following can give a false-negative urine protein reading?
    • A. 

      Contamination with vaginal discharge

    • B. 

      Heavy mucus

    • C. 

      Presence of blood

    • D. 

      Very dilute urine

  • 42. 
    The pH of a urine specimen measures the:
    • A. 

      Free sodium ions

    • B. 

      Free hydrogen ions

    • C. 

      Total acid excretion

    • D. 

      Volatile acids

  • 43. 
    Upon standing at room temperature, a urine pH typically:
    • A. 

      Decreases

    • B. 

      Increases

    • C. 

      Remains the same

    • D. 

      Changes depending on bacterial concentration

  • 44. 
    Urine reagent strips should be stored in a(n):
    • A. 

      Refrigerator (4-7 degrees C)

    • B. 

      Incubator (37 degrees C)

    • C. 

      Cool dry area

    • D. 

      Open jar exposed to air

  • 45. 
    The principle of the reagent strip test for urine protein depends on:
    • A. 

      An enzyme reaction

    • B. 

      Protein error of indicators

    • C. 

      Copper reduction

    • D. 

      The toluidine reaction

  • 46. 
    The protein section of the urine reagent strip is most sensitive to:
    • A. 

      Albumin

    • B. 

      Mucoprotein

    • C. 

      Bence Jones protein

    • D. 

      Globulin

  • 47. 
    Routine screening of urine samples for glycosuria is performed primarity to detect:
    • A. 

      Glucose

    • B. 

      Galactose

    • C. 

      Bilirubin

    • D. 

      Ketones

  • 48. 
    Which of the following reagents is used to react with ketones in the urine?
    • A. 

      Sodium nitroprusside

    • B. 

      Acetoacetic acid

    • C. 

      Acetone

    • D. 

      Beta-hydroxybutyric acid

  • 49. 
    A test area of a urine reagent strip is impregnated with only sodium nitroprusside. This section will react with:
    • A. 

      Acetoacetic (diacetic) acid

    • B. 

      Leukocyte estrase

    • C. 

      Beta-hydroxybutyric acid

    • D. 

      Ferric chloride

  • 50. 
    A reagent strip area impregnated with stabilized, diazotized 2, 4-dichloroaniline will yield a positive reaction with:
    • A. 

      Bilirubin

    • B. 

      Hemoglobin

    • C. 

      Ketones

    • D. 

      Urobilinogen

  • 51. 
    Which of the following factors will not interfere with the reagent strip test for leukocytes?
    • A. 

      Ascorbic acid

    • B. 

      Formaldehyde

    • C. 

      Nitrite

    • D. 

      Urine protein level of 500mg/dL

  • 52. 
    Excess urine on the reagent test strip can turn a normal pH result into a falsely acidic pH when which of the following reagents runs into the pH pad?
    • A. 

      Tetrabromphenol blue

    • B. 

      Citrate buffer

    • C. 

      Glucose oxidase

    • D. 

      Alkaline copper sulfate

  • 53. 
    When employing the urine reagent strip method, a false-positive protein result may occur in the presence of:
    • A. 

      Large amounts of glucose

    • B. 

      X-ray contrast media

    • C. 

      Bence Jones protein

    • D. 

      Highly alkaline urine

  • 54. 
    A 17-year-old girl decided to go on a starvation diet. After 1 week of starving herself, what substance would most likely be found in her urine?
    • A. 

      Protein

    • B. 

      Ketones

    • C. 

      Glucose

    • D. 

      Blood

  • 55. 
    A 2-year-old child had a positive urine ketones. The would most likely be caused by:
    • A. 

      Vomiting

    • B. 

      Anemia

    • C. 

      Hypoglycemia

    • D. 

      Biliary tract obstruction

  • 56. 
    A patient's urinalysis revealed a positive bilirubin and a decreased urobilinogen level. These results are associated with:
    • A. 

      Hemolytic disease

    • B. 

      Biliary obstruction

    • C. 

      Hepatic disease

    • D. 

      Urinary tract infection

  • 57. 
    A urine specimen with an elevated urobilinogen and a negative bilirubin may indicate:
    • A. 

      Obstruction of the biliary tract

    • B. 

      Viral hepatitis

    • C. 

      Hemolytic jaundice

    • D. 

      Cirrhosis

  • 58. 
    Microscopic analysis of a urine specimen yields a moderate amount of red blood cells in spite of a negative result for occult blood using a reagent strip. The technologist should determine if this patient has taken:
    • A. 

      Vitamin C

    • B. 

      A diuretic

    • C. 

      High blood pressure medicine

    • D. 

      Antibiotics

  • 59. 
    The purpose for routinely screening diabetes mellitus patients for microalbuminuria is to monitor the development of:
    • A. 

      Urinary tract infection

    • B. 

      Renal disease

    • C. 

      Yeast infection

    • D. 

      Diabetes insipidus

  • 60. 
    The principle of the reagent strip test for microalbuminuria is:
    • A. 

      A diazo reaction

    • B. 

      The protein error of indicators

    • C. 

      A dye-dinding reaction

    • D. 

      The release of hydrogen ions to an indicator

  • 61. 
    The reason that an albumin:creatinine ratio can be run on random specimen is:
    • A. 

      Creatinine corrects for over or under body hydration

    • B. 

      A first morning specimen may be too concentrated

    • C. 

      Albumin corrects for over or under body hydration

    • D. 

      The reaction is sensitive to any level of albumin

  • 62. 
    To prepare the reagent used in confirmatory protein technician, a technician would:
    • A. 

      Dissolve 3g sulfosalicylic acid in 100mL of water

    • B. 

      Dissolve 5g trichloroacetic acid in 100mL of water

    • C. 

      Combine 3mL of hydrochloric acid in 97mL of water

    • D. 

      Combine 5mL of glacial acetic acid in 95mL of water

  • 63. 
    A positive result for bilirubin on a reagent strip should be followed up by:
    • A. 

      Notifying the physician

    • B. 

      Requesting a new specimen

    • C. 

      Performing an Ictotest

    • D. 

      Performing a urobilinogen test

  • 64. 
    Ammonium sulfate was added to red urine. The urine had a positive reaction for blood, but no RBC's were seen on microscopic examination. After centrifugation the supernatant fluid is red. The abnormal color is caued by:
    • A. 

      Pyridium

    • B. 

      Hemoglobin

    • C. 

      Porphyrins

    • D. 

      Myoglobin

  • 65. 
    A urine tested with Clinitest exhibits a passthrough reaction and is diluted by adding 2 drops of urine to 10 drops of water. This is a dilution of:
    • A. 

      1:4

    • B. 

      1:5

    • C. 

      1:6

    • D. 

      1:8

  • 66. 
    When performing a routine urinalysis, the technologist notes a 2+ protein result. He should:
    • A. 

      Request another specimen

    • B. 

      Confirm with the acid precipitation test

    • C. 

      Test for Bence Jones protein

    • D. 

      Report the result obtained without further testing

  • 67. 
    The confirmatory test for a positive protein result by the reagent strip method uses:
    • A. 

      Ehrlich reagent

    • B. 

      A diazo reaction

    • C. 

      Sulfosalicylic acid

    • D. 

      A copper reduction tablet

  • 68. 
    A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copper reduction test. If both results are positive, which of the following interpretations is correct?
    • A. 

      Galactose is present

    • B. 

      Glucose is present

    • C. 

      Lactose is not present

    • D. 

      Sucrose is not present

  • 69. 
    A woman in her ninth month of pregnancy has a urine sugar which is negative with the urine reagent strip, but gives a positive reaction with the copper reduction method. The sugar most likely responsible for these results is:
    • A. 

      Maltose

    • B. 

      Galactose

    • C. 

      Glucose

    • D. 

      Lactose

  • 70. 
    A urinalysis performed on a 2-week-old infant with diarrhea shows a negative reaction with the gluose oxidasse reagent strip. A copper reduction tablet test should be performed to check the urine sample for the presence of:
    • A. 

      Glucose

    • B. 

      Galactose

    • C. 

      Bilirubin

    • D. 

      Ketones

  • 71. 
    When using the sulfosalicylic acid test, false-positive protein results may occur in the presence of:
    • A. 

      Ketones

    • B. 

      Alkali

    • C. 

      Glucose

    • D. 

      Radiographic contrast media

  • 72. 
    Which of the following is the primary reagent in the copper reduction tablet?
    • A. 

      Sodium carbonate

    • B. 

      Copper sulfate

    • C. 

      Glucose oxidase

    • D. 

      Polymerized diazonium salt

  • 73. 
    In most compound light microscopes, the ocular lens has a magnification of:
    • A. 

      10x

    • B. 

      40x

    • C. 

      50x

    • D. 

      100x

  • 74. 
    The best way to lower the light intensity of the microscope is to:
    • A. 

      Lower the condenser

    • B. 

      Adjust the aperture diaphragm

    • C. 

      Lower the rheostat

    • D. 

      Raise the condenser

  • 75. 
    The advantage of using phase microscopy in urinalysis is to:
    • A. 

      Provide higher magnification

    • B. 

      Enhance constituents with a lower refractive index

    • C. 

      Allow constituents to stain more clearly

    • D. 

      Provide a larger field of view

  • 76. 
    The presence of leukocytes in urine is known as:
    • A. 

      Chyluria

    • B. 

      Hematuria

    • C. 

      Leukocytosis

    • D. 

      Pyuria

  • 77. 
    Oval fat bodies are:
    • A. 

      Squamous epithelial cells that contain lipids

    • B. 

      Renal tubular epithelial cells that contain lipids

    • C. 

      Free-floating fat droplets

    • D. 

      White blood cells with phagocytized lipids

  • 78. 
    A microscopic examination of urine sediment reveals ghost cells. These red blood cells are seen in urine with a:
    • A. 

      >2% glucose concentrations

    • B. 

      Specific gravity

    • C. 

      Large amounts of ketone bodies

    • D. 

      Neutral pH

  • 79. 
    Glitter cells are a microscopic finding of:
    • A. 

      Red blood cells in hypertonic urine

    • B. 

      Red blood cells in hypotonic urine

    • C. 

      White blood cells in hypertonic urine

    • D. 

      White blood cells in hypotonic urine

  • 80. 
    What cell is most commonly associated with vaginal contamination?
    • A. 

      White

    • B. 

      Transitional

    • C. 

      Squamous

    • D. 

      Glitter

  • 81. 
    A reagent strip test for blood has been reported positive. Microscopic examination fails to yield red blood cells. This patient's condition can be called:
    • A. 

      Hematuria

    • B. 

      Hemoglobinuria

    • C. 

      Oliguria

    • D. 

      Hemosiderinuria

  • 82. 
    Ghost red blood cells are seen in urine that is:
    • A. 

      Acidic and dilute

    • B. 

      Alkaline and dilute

    • C. 

      Acidic and concentrated

    • D. 

      Alkaline and concentrated

  • 83. 
    The possibility of detecting glitter cells is associated with urine that is:
    • A. 

      Acidic

    • B. 

      Dilute

    • C. 

      Alkaline

    • D. 

      Concentrated

  • 84. 
    An eosinophil count may be requested on urine from a patient with suspected:
    • A. 

      Acute glomerulonephritis

    • B. 

      Cystitis

    • C. 

      Renal lithiasis

    • D. 

      Acute interstitial nephritis

  • 85. 
    Clue cells are a form of:
    • A. 

      Squamous epithelial cell

    • B. 

      Urothelial cell

    • C. 

      White blood cell

    • D. 

      Renal tubular epithelial cell

  • 86. 
    Which of the following cells is most likely to be seen in the urine sediment following a catheterization procedure?
    • A. 

      Squamous epithelial cell

    • B. 

      Urothelial cell

    • C. 

      White blood cell

    • D. 

      Renal tubular epithelial cell

  • 87. 
    A patient admitted following an accident involving massive crush injuries has the following urinalysis results: color:                             red brown clarity:                            clear specific gravity:            1.011 pH:                                  6.0 protein:                           1+ blood:                             large glucose:                         negative ketones:                         negative nitrite:                              negative leukocytes:                    negative bilirubin:                         negative urobilinogen:                 negative Microscopic findings renal tubular epithelial:        5-10 renal tubular cast cells:       1-2 The discrepancy between the large amount of blood and the absence of RBC's on microscopy is caused by:
    • A. 

      Failure to mix the specimen before centrifuging

    • B. 

      Mistaking RBCs for RTE cells

    • C. 

      Contamination oxidizing detergents in the container

    • D. 

      The presence of myoglobin in the urine specimen

  • 88. 
    What is the most likely diagnosis given this microscopic finding?
    • A. 

      Glomerulonephritis

    • B. 

      Pyelonephritis

    • C. 

      Nephrotic syndrome

    • D. 

      Cystitis

  • 89. 
    Identify the formed element in this photomicrograph:
    • A. 

      RBC

    • B. 

      WBC

    • C. 

      Epithelial cell

    • D. 

      Yeast

  • 90. 
    All casts typically contain:
    • A. 

      Albumin

    • B. 

      Globulin

    • C. 

      Immunoglobulins G and M

    • D. 

      Tamm-Horsfall glycoprotein

  • 91. 
    Hyaline casts are usually found:
    • A. 

      In the center of the coverslip

    • B. 

      Under subdued light

    • C. 

      Under very bright light

    • D. 

      In the supernatant

  • 92. 
    Which of the following casts is most likely to be found in healthy people?
    • A. 

      Hyaline

    • B. 

      Red blood cell

    • C. 

      Waxy

    • D. 

      White blood cell

  • 93. 
    Which of the following casts is most indicative of end stage renal disease?
    • A. 

      Hemoglobin

    • B. 

      Granular

    • C. 

      Cellular

    • D. 

      Waxy

  • 94. 
    A technologist performed a STAT microscopic urinalysis and reported the following: WBC:                   10-13 RBC:                     2-6 hyaline casts:     5-7 bacteria                1+ The centrifuge tube was not discarded and the urine sediment was reevaluated microscopically 5 hours after the above results were reported. A second technologist reported the same results, except 2+ bacteria and no hyaline casts were found. The most probable explanation for the second technologist's findings is:
    • A. 

      Sediment was not agitated before preparing the microscope slide

    • B. 

      Casts dissolve due to decrease in urine pH

    • C. 

      Casts dissolve due to increase in urine pH

    • D. 

      Casts were never present in this specimen

  • 95. 
    Which of the following aids in differentiating a spherical transitional cell from a round renal tubular cell?
    • A. 

      Spherical transitional cell is larger

    • B. 

      Eccentrically-placed nucleus in the renal tubular cell

    • C. 

      Eccentrically-placed nucleus in teh spherical transitional cell

    • D. 

      Round renal tubular cell is larger

  • 96. 
    The urine microscopic constituents that best differentiate between cystitis and pyelonephritis are:
    • A. 

      WBC's

    • B. 

      Bacteria

    • C. 

      RBC's

    • D. 

      WBC casts

  • 97. 
    Epithelial cell casts are most indicative of:
    • A. 

      Glomerulonephritis

    • B. 

      Nephrotic syndrome

    • C. 

      Tubular necrosis

    • D. 

      Pyelonephritis

  • 98. 
    Granular casts found in the urine of a football player admitted to the hospital with a broken leg occurring during the game can be the result of:
    • A. 

      Excessive bruising

    • B. 

      Strenous exercise

    • C. 

      Excess power drink ingestion

    • D. 

      Bone fracture

  • 99. 
    Which of the following casts most frequently appears to have a brittle consistency?
    • A. 

      Hyaline

    • B. 

      Granular

    • C. 

      Waxy

    • D. 

      Fatty

  • 100. 
    To distinguish between a clump of WBC's and a WBC cast, it is important to observe:
    • A. 

      The presence of free-floating WBCs

    • B. 

      A positive leukocyte reaction

    • C. 

      A positive nitrite reaction

    • D. 

      The presence of a cast matrix

  • 101. 
    Spherical urothelial cells may be confused with:
    • A. 

      Oval fat bodies

    • B. 

      Renal tubular epithelial cells

    • C. 

      Glitter cells

    • D. 

      Lymphocytes

  • 102. 
    Prior to reporting a red blood cell cast, it is important to observe:
    • A. 

      Free-floating RBCs

    • B. 

      Hyaline casts

    • C. 

      Granular casts

    • D. 

      Increased white blood cells

  • 103. 
    In a specimen with a large amount of bilirubin, which of the following sediment constituents would be most noticeable bile-stained?
    • A. 

      Squamous epithelial cells

    • B. 

      White blood cell casts

    • C. 

      Cystine crystals

    • D. 

      Renal tubular epithelial cell casts

  • 104. 
    What is the most likely diagnosis given this microscopic finding?
    • A. 

      Glomerulonephritis

    • B. 

      Pyelonephritis

    • C. 

      Nephrotic syndrome

    • D. 

      Cystitis

  • 105. 
    A white precipitate in a urine specimen with a pH of 7.5 would most probably be caused by:
    • A. 

      Amorphous urates

    • B. 

      WBC's

    • C. 

      Amorphous phosphates

    • D. 

      Bacteria

  • 106. 
    Whic of the following is an abnormal crystal described as a hexagonal plate?
    • A. 

      Cystine

    • B. 

      Tyrosine

    • C. 

      Leucine

    • D. 

      Cholesterol

  • 107. 
    The primary component of most urinary calculi is:
    • A. 

      Calcium

    • B. 

      Uric acid

    • C. 

      Leucine

    • D. 

      Cystine

  • 108. 
    After warming, a cloudy urine clears. This is due to the presence of:
    • A. 

      Urates

    • B. 

      Phosphates

    • C. 

      WBC's

    • D. 

      Bacteria

  • 109. 
    Tiny, colorless, dumb bell shaped crystals were found in an alkaline urine sediment. They most likely are:
    • A. 

      Calcium oxalate

    • B. 

      Calcium carbonate

    • C. 

      Calcium phosphate

    • D. 

      Amorphous phosphate

  • 110. 
    Which of the following crystals may be found in acidic urine?
    • A. 

      Calcium carbonate

    • B. 

      Calcium oxalate

    • C. 

      Calcium phosphate

    • D. 

      Triple phosphate

  • 111. 
    Using polarized light microscopy, which of the following urinary elements are birefringent?
    • A. 

      Cholesterol

    • B. 

      Triglycerides

    • C. 

      Fatty acids

    • D. 

      Neutral fats

  • 112. 
    Which of the following crystals appear as fine, silky needles?
    • A. 

      Cholesterol

    • B. 

      Leucine

    • C. 

      Hemosiderin

    • D. 

      Tyrosine

  • 113. 
    Which of the following crystals is seen in an amber urine with a positive bilirubin?
    • A. 

      Ammonium biurate

    • B. 

      Cystine

    • C. 

      Tyrosine

    • D. 

      Uric acid

  • 114. 
    Following ingestion of ethylene glycol (antifreeze) numerous crystals are found in the urine. The shape of these crystals is:
    • A. 

      Flat with notched corners

    • B. 

      Oval/dumbell

    • C. 

      Coffin-lid

    • D. 

      Rosettes/rhomboid

  • 115. 
    Cholesterol crystals will most likely be observed in urine that contains:
    • A. 

      3+ glucose

    • B. 

      4+ protein

    • C. 

      WBC casts

    • D. 

      Triple phosphate crystals

  • 116. 
    The finding of a large amount of uric acid crystals in a urine specimen from a 6-month-old boy:
    • A. 

      May actually be diaper fibers

    • B. 

      Could indicate Lesch-Nyhan syndrome

    • C. 

      Should not be reported

    • D. 

      May indicate improper feeding

  • 117. 
    The following crystal is found in:
    • A. 

      Acid pH and is nonpathologic

    • B. 

      Alkaline pH and is nonpathologic

    • C. 

      Acid pH and is pathologic

    • D. 

      Alkaline pH and is pathologic

  • 118. 
    Identify this crystal:
    • A. 

      Uric acid

    • B. 

      Calcium phosphate

    • C. 

      Calcium carbonate

    • D. 

      Triple phosphate acid

  • 119. 
    Alkaline urine showed this microscopic finding:
    • A. 

      Dilute with saline

    • B. 

      Request a new sample

    • C. 

      Culture for bacteria

    • D. 

      Dissolve with acetic acid

  • 120. 
    Polarized light can often be used to differentiate between:
    • A. 

      Fibers and mucus clumps

    • B. 

      Hyaline and waxy casts

    • C. 

      Squamous and transitional epithelial cells

    • D. 

      Red blood cells and white blood cells

  • 121. 
    Which of the following contaminants has a dimpled center and will polarize?
    • A. 

      Starch

    • B. 

      Oil droplets

    • C. 

      Air bubbles

    • D. 

      Pollen grains

  • 122. 
    The presence of this element in urine indicates the presence of:
    • A. 

      A UTI

    • B. 

      Powder

    • C. 

      Carbohydrate deficiency

    • D. 

      High urine amylase

  • 123. 
    Identify the formed element in this photomicrograph:
    • A. 

      Cloth fiber

    • B. 

      Hyaline cast

    • C. 

      Granular cast

    • D. 

      Waxy cast

  • 124. 
    A technologist is having trouble differentiating between red blood cells, oil droples and yeast cells on a urine microscopy. Acetic acid should be added to the sediment to:
    • A. 

      Lyse the yeast cells

    • B. 

      Lyse the red blood cells

    • C. 

      Dissolve the oil droplets

    • D. 

      Crenate the red blood cells

  • 125. 
    A urine specimen is tested and has the following results: Reagent strip glucose 3+ protein 1+ Microscopic findings >100 WBCs/hpf many yeast cells This is indicative of:
    • A. 

      Diabetes mellitus

    • B. 

      Contamination

    • C. 

      Pyelonephritis

    • D. 

      Diabetes insipidus

  • 126. 
    When identifying urine crystals, which reagent strip result is most important?
    • A. 

      Protein

    • B. 

      PH

    • C. 

      Specific gravity

    • D. 

      Nitrite

  • 127. 
    Bacteria are considered significant in the urine sediment when the:
    • A. 

      Nitrite is positive

    • B. 

      Protein is positive

    • C. 

      Specimen is cloudy

    • D. 

      Leukocytes is positive

  • 128. 
    Which of the following exhibits rapid motility in urine sediment?
    • A. 

      Spermatozoa

    • B. 

      Trichomonas vaginalis

    • C. 

      Gardnerella vaginalis

    • D. 

      Enterobius vermicularis

  • 129. 
    Which of the following positive chemical reaction is most closely associated with the presence of yeast in urine sediment?
    • A. 

      Nitrite

    • B. 

      Protein

    • C. 

      Glucose

    • D. 

      Blood

  • 130. 
    What of the following is consistent with this urine microscopic finding?
    • A. 

      Ketone

    • B. 

      Glucose

    • C. 

      Specific gravity

    • D. 

      Nitrate

  • 131. 
    A 21-year-old woman had glucose in her urine with a normal blood sugar. These findings are most consistent with:
    • A. 

      Renal glyosuria

    • B. 

      Diabetes insipidus

    • C. 

      Diabetes mellitus

    • D. 

      Alkaline tide

  • 132. 
    A 59-year-old man is evaluated for back pain. Urine studies show: Reagent strip: specific gravity 1.017 pH 6.5 protein negative glucose negative blood negative microscopic findings: rare epithelial cells urine protein electrophoresis: monoclonal spike in gamma globulin region Which of the following statements best explains these results?
    • A. 

      Urine protein is falsely negative due to the specific gravity

    • B. 

      Urine protein is falsely negative because the method is not sensitive for Bence Jones protein

    • C. 

      Microscopic examination is falsely negative due to specific gravity

    • D. 

      Electrophoresis is incorrect and should be repeated

  • 133. 
    The results of a urinalysis on a first morning specimen are:
    • specific gravity 1.024
    • pH 8.5
    • protein, negative
    • glucose, negative
    • microscopic, uric acid crystals
    The next step is to repeat the:
    • A. 

      Microscopic examination

    • B. 

      Protein and glucose

    • C. 

      Specific gravity

    • D. 

      PH and microscopic examination

  • 134. 
    The following urinalysis results were obtained from an 18-year-old woman in labor: pH 6.5 Protein 30mg/dL Glucose 250mg/dL Ketones Negative Bilirubin Small Blood Negative Nitrite Negative Urobilinogen 0.1 EU/dL Specific Gravity 1.025 Copper reduction test 1.0 g/dL Which of the following is the most likely explanation for the patient's positive copper reduction test?
    • A. 

      Only glucose is present

    • B. 

      Only lactose is present

    • C. 

      Glucose and possibly other reducting substances/sugars are present

    • D. 

      Results are false positive due to the presence of protein

  • 135. 
    The following urine results were obtained on a 25-year-old female: pH 7.0 Color Yellow Appearance Cloudy Protein 1+ Glucose Negative Blood Small Specific gravity 1.015 Microscopic Bacteria Many WBC Casts 0-3/lpf WBC 30-40/hpf The results are most compatible with:
    • A. 

      Glomerulonephritis

    • B. 

      Renal calculus

    • C. 

      Cystitis

    • D. 

      Pyelonephritis

  • 136. 
    A urinalysis performed on a 27-year-old woman yields the following results: Specific gravity 1.008 Protein 2+ Glucose Negative Ketones Negative Bilirubin Negative Blood 3+ Nitrite Negative Leukocytes Positive Urobilinogen 0.1 EU/dL Microscopic findings WBC/hpf 10-15 RBC/hpf 30-55 Casts/lpf Hyaline 5-7 RBC 2-5 Granular 2-3 Uric acid crystals Moderate These findings are most consistent with:
    • A. 

      Yeast infection

    • B. 

      Pyelonephritis

    • C. 

      Bacterial cystitis

    • D. 

      Glomerulonephritis

  • 137. 
    A 62-year-old patient with hyperlipoproteinemia has a large amount of protein in his urine. Microscopic anaylsis yields moderate to many fatty, waxy, granular and cellular casts. Many oval fat bodies are also noted. This is most consistent with:
    • A. 

      Nephrotic syndrome

    • B. 

      Viral infection

    • C. 

      Acute pyelonephritis

    • D. 

      Acute glomerulonephritis

  • 138. 
    X
    • A. 

      X

    • B. 

      X

    • C. 

      X

    • D. 

      X

  • 139. 
    X
    • A. 

      X

    • B. 

      X

    • C. 

      X

    • D. 

      X

  • 140. 
    A specimen with a negative nitrate reaction and a positive leukocytes reaction that has WBC's, WBC casts, and no bacteria in the sediment will be seen in cases of:
    • A. 

      Cystitis

    • B. 

      Pyelonephritis

    • C. 

      Acute interstitial nephritis

    • D. 

      Acute glomerulonephritis

  • 141. 
    X
    • A. 

      X

    • B. 

      X

    • C. 

      X

    • D. 

      X

  • 142. 
    X
    • A. 

      X

    • B. 

      X

    • C. 

      X

    • D. 

      X

  • 143. 
    The sediment of a urine specimen with a reagent strip glucose of 250 mg/dL and a pH of 5.5 is ideal for the presence of:
    • A. 

      Cystine crystals

    • B. 

      Trichomonas vaginalis

    • C. 

      Canidida albicans

    • D. 

      Thorny apple crystals

  • 144. 
    X
    • A. 

      X

    • B. 

      X

    • C. 

      X

    • D. 

      X

  • 145. 
    The normal renal threshold for glucose in the adult is approximately:
    • A. 

      50 mg/dL

    • B. 

      100 mg/dL

    • C. 

      160 mg/dL

    • D. 

      300 mg/dL

  • 146. 
    The volume of urine excreted in a 24-hour period by an adult patient was 500 mL. This condition would be termed:
    • A. 

      Anuria

    • B. 

      Oliguria

    • C. 

      Polyuria

    • D. 

      Dysuria

  • 147. 
    A patient has glucosuria, hyperglycemia and polyuria. These findings are most consistent with:
    • A. 

      Renal glucosuria

    • B. 

      Diabetes mellitus

    • C. 

      Emotional stress

    • D. 

      Eating a heavy meal

  • 148. 
    The normal glomerular filtration rate is:
    • A. 

      1 mL/min

    • B. 

      120 mL/min

    • C. 

      660 mL/min

    • D. 

      1,200 mL/min

  • 149. 
    Normal urine primarily consists of:
    • A. 

      Water, protein and sodium

    • B. 

      Water, urea and protein

    • C. 

      Water, urea and sodium chloride

    • D. 

      Water, urea and bilirubin

  • 150. 
    An abdominal fluid is submitted from surgery. The physician wants to determine if this fluid could be urine. The technologist should:
    • A. 

      Perform a culture

    • B. 

      Smell the fluid

    • C. 

      Test for urea and creatinine

    • D. 

      Test for protein, glucose and pH

  • 151. 
    Antidiuretic hormone regulates the reabsorption of:
    • A. 

      Water

    • B. 

      Glucose

    • C. 

      Potassium

    • D. 

      Calcium

  • 152. 
    Which of the following components are present in serum but not present in the glomerular filtrate?
    • A. 

      Glucose

    • B. 

      Amino acids

    • C. 

      Urea

    • D. 

      Large molecular weight proteins

  • 153. 
    Polyuria is usually correlated with:
    • A. 

      Acute glomerulonephritis

    • B. 

      Diabetes mellitus

    • C. 

      Hepatitis

    • D. 

      Tubular damage

  • 154. 
    Cessation of urine flow is defined as:
    • A. 

      Azotemia

    • B. 

      Dysuria

    • C. 

      Diuresis

    • D. 

      Anuria

  • 155. 
    The reason for performing a Clinitest on a newborn's urine is to check for:
    • A. 

      Fructose

    • B. 

      Galactose

    • C. 

      Glucose

    • D. 

      Lactose

  • 156. 
    Ketones in the urine are due to:
    • A. 

      Complete utilization of fatty acids

    • B. 

      Incomplete fat metabolism

    • C. 

      High carbohydrate diets

    • D. 

      Renal tubular dysfunction

  • 157. 
    Reagent strip tests for ketones measure primarily:
    • A. 

      Acetone

    • B. 

      Acetoacetic acid

    • C. 

      Cholesterol

    • D. 

      Beta-hydroxybutyric acid

  • 158. 
    Bilirubinuria may be associated with:
    • A. 

      Strenous exercise

    • B. 

      Increased destruction of platelets

    • C. 

      Viral hepatitis

    • D. 

      Hemolytic anemia

  • 159. 
    Myoglobinuria is most likely to be noted in urine specimens from patients with which of the following disorders?
    • A. 

      Hemolytic anemia

    • B. 

      Lower urinary tract infection

    • C. 

      Myocardial infarction

    • D. 

      Paroxysmal nocturnal hemoglobinuria

  • 160. 
    A patient with renal tubular acidosis would most likely excrete a urine with a:
    • A. 

      Low pH

    • B. 

      High pH

    • C. 

      Neutral pH

    • D. 

      Variable pH

  • 161. 
    Glycosuria may be due to:
    • A. 

      Hypoglyceia

    • B. 

      Increased renal threshold

    • C. 

      Renal tubular dysfunction

    • D. 

      Increased glomerular filtration rate

  • 162. 
    The area of the nephron that is impermeable to water is the:
    • A. 

      Proximal convoluted tubule

    • B. 

      Descending loop of Henle

    • C. 

      Ascending loop of Henle

    • D. 

      Distal convoluted tubule

  • 163. 
    The urinary tract structures responsible for renal concentration are the:
    • A. 

      Renal pelvis

    • B. 

      Cortical nephrons

    • C. 

      Renal papillae

    • D. 

      Juxtamedullary nephrons

  • 164. 
    The most accurate test to determine renal concentration in:
    • A. 

      Osmolarity

    • B. 

      Glomerular filtration rate

    • C. 

      Specific gravity

    • D. 

      Tubular reabsorption rate

  • 165. 
    Failure of the nephron to produce ammonia will result in a urine with a:
    • A. 

      Low specific gravity

    • B. 

      Positive nitrite

    • C. 

      High pH

    • D. 

      Positive protein

  • 166. 
    To avoid falsely elevated spinal fluid cell counts:
    • A. 

      Use an aliquot from the first tube collected

    • B. 

      Use only those specimens showing no turbidity

    • C. 

      Centrifuge all specimens before counting

    • D. 

      Select an aliquot from the last tube collected

  • 167. 
    A turbid cerebrospinal fluid is most commonly caused by increased:
    • A. 

      White blood cells

    • B. 

      Protein

    • C. 

      Glucose

    • D. 

      Bacterial organisms

  • 168. 
    The normal concentration of proteins in the cerebrospinal fluid, relative to serum protein, is:
    • A. 

    • B. 

      5%-10%

    • C. 

      25%-30%

    • D. 

      50%-60%

  • 169. 
    To prepare the reagent used for mucin clot determination of synovial fluid, water is mixed with:
    • A. 

      Hydrochloric acid

    • B. 

      Sodium hydroxide

    • C. 

      Trichloroacetic acid

    • D. 

      Glacial acetic acid

  • 170. 
    In addition to the sperm count in a fertility study, analysis of seminal fluid should also include:
    • A. 

      Time of liquefaction, estimation of motility, morphology

    • B. 

      Motility, morphology, test for alkaline phosphatase

    • C. 

      Time of liquefaction, test for acid phosphatase, qualitative test for hemoglobin

    • D. 

      Time of liquefaction, qualitative test for hemoglobin and motility

  • 171. 
    The following lab values were obtained on a body fluid sample: Protein: 3 g/dL Albumin: 2.1 g/dL Hyaluronate: 0.4 g/dL Glucose: 80 mg/dL Lactate: 10 mg/dL The sample is:
    • A. 

      Pleural fluid

    • B. 

      Synovial fluid

    • C. 

      Urine

    • D. 

      Cerebrospinal fluid

  • 172. 
    A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Addition of acetic acid results in turbidity and a clot. This indicates that:
    • A. 

      The fluid is synovial fluid

    • B. 

      Plasma was obtained

    • C. 

      Red blood cells caused a false-positive reaction

    • D. 

      The specimen is not adequate

  • 173. 
    Synovial fluid is analyzed with a polarizing microscope. Strongly birefringent needles are seen. This most likely indicates:
    • A. 

      Monosodium urate crystals

    • B. 

      Calcium pyrophosphate crystals

    • C. 

      Corticosteroid crystals

    • D. 

      Talc crystals

  • 174. 
    A sperm count is diluted 1:20 and 50 sperm are counted in 2 large squares of the neubauer counting chamber. The sperm count in mLs is:
    • A. 

      5,000

    • B. 

      50,000

    • C. 

      500,000

    • D. 

      5,000,000

  • 175. 
    The principal mucin in synovial fluid is:
    • A. 

      Hyaluronate

    • B. 

      Albumin

    • C. 

      Orosomucoid

    • D. 

      Pepsin

  • 176. 
    The synovial fluid easily forms small drops from the aspirating syringe. The viscosity is:
    • A. 

      Normal

    • B. 

      Increased

    • C. 

      Associated with inflammation

    • D. 

      Associated with hypothyroidism

  • 177. 
    Pleural transudate differe from pleural exudates in that transudates have:
    • A. 

      Protein values >4 g/dL

    • B. 

      Specific gravity values of >1.020

    • C. 

      LD values of >200 IU

    • D. 

      Relatively low cell counts

  • 178. 
    Pleural fluid from a patient with congestive heart failure would be expected to:
    • A. 

      Contain bacteria

    • B. 

      Have a high protein content

    • C. 

      Be purulent

    • D. 

      Appear clear and pale yellow