CHAPTER 6: Chemical Examination of Urine Flashcards

1
Q

Leaving excess urine on the reagent strip after removing it from the specimen will:
A. Cause runover between reagent pads
B. Alter the color of the specimen
C. Cause reagents to leach from the pads
D. Not affect the chemical reactions

A

A. Cause runover between reagent pads

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2
Q

Failure to mix a specimen before inserting the reagent strip will primarily affect the:
A. Glucose reading
B. Blood reading
C. Leukocyte reading
D. Both B and C

A

D. Both B and C

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3
Q

Testing a refrigerated specimen that has not warmed to room temperature will adversely affect:
A. Enzymatic reactions
B. Dye-binding reactions
C. The sodium nitroprusside reaction
D. Diazo reactions

A

A. Enzymatic reactions

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4
Q

Thereagentstripreactionthatrequiresthelongest reaction time is the:
A. Bilirubin
B. pH
C. Leukocyte esterase
D. Glucose

A

C. Leukocyte esterase

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5
Q

Quality control of reagent strips is performed:
A. Using positive and negative controls
B. When results are questionable
C. Per laboratory policy
D. All of the above

A

D. All of the above

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6
Q

All of the following are important to protect the integrity of reagent strips except:
A. Removing the desiccant from the bottle
B. Storing in an opaque bottle
C. Storing at room temperature
D. Resealing the bottle after removing a strip

A

A. Removing the desiccant from the bottle

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7
Q

The principle of the reagent strip test for pH is the:
A. Protein error of indicators
B. Greiss reaction
C. Dissociation of a polyelectrolyte
D. Double indicator reaction

A

D. Double indicator reaction

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8
Q

A urine specimen with a pH of9.0:
A. Indicates metabolic acidosis
B. Should be re-collected
C. May contain calcium oxalate crystals
D. Is seen after drinking cranberry juice

A

B. Should be re-collected

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9
Q

In the laboratory, a primary consideration associated with pH is:
A. Identifying urinary crystals
B. Monitoring vegetarian diets
C. Determining specimen acceptability
D. Both A and C

A

D. Both A and C

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10
Q

Indicate the source of the following proteinurias by placing a 1 for prerenal, 2 for renal, or 3 for postrenal in front of the condition.
A. Microalbuminuria
B. Acute-phase reactants
C. Preeclampsia
D. Vaginal inflammation
E. Multiple myeloma
F. Orthostatic proteinuria
G. Prostatitis

A

A. Microalbuminuria - 2
B. Acute-phase reactants - 1
C. Preeclampsia - 2
D. Vaginal inflammation - 3
E. Multiple myeloma - 1
F. Orthostatic proteinuria - 2
G. Prostatitis - 3

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11
Q

The principle of the protein error of indicators reaction is that:
A. Protein keeps the pH of the urine constant
B. Albumin accepts hydrogen ions from the indicator
C. The indicator accepts hydrogen ions from albumin
D. Albumin changes the pH of the urine

A

B. Albumin accepts hydrogen ions from the indicator

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12
Q

All of the following will cause false-positive protein values on a reagent strip except:
A. Microalbuminuria
B. Highly buffered alkaline urines
C. Delay in removing the reagent strip from the specimen
D. Contamination by quaternary ammonium compounds

A

A. Microalbuminuria

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13
Q

A patient with a 2+ protein reading in the afternoon is asked to submit a first morning specimen. The second specimen has a negative protein reading. This patient is:
A. Positive for orthostatic proteinuria
B. Negative for orthostatic proteinuria
C. Positive for Bence Jones protein
D. Negative for clinical proteinuria

A

A. Positive for orthostatic proteinuria

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14
Q

Testing for microalbuminuria is valuable for early detection of kidney disease and monitoring patients with:
A. Hypertension
B. Diabetes mellitus
C. Cardiovascular disease risk
D. All of the above

A

D. All of the above

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15
Q

The primary chemical on the reagent strip in the Micral- Test for microalbumin binds to:
A. Protein
B. Antihuman albumin antibody
C. Conjugated enzyme
D. Galactoside

A

B. Antihuman albumin antibody

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16
Q

All of the following are true for the ImmunoDip test for microalbumin except:
A. Unbound antibody migrates farther than bound antibody
B. Blue latex particles are coated with antihuman albumin antibody
C. Bound antibody migrates farther than unbound antibody
D. It utilizes an immunochromographic principle

A

A. Unbound antibody migrates farther than bound antibody

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17
Q

The principle of the protein-high pad on the Multistix Pro reagent strip is the:
A. Diazo reaction
B. Enzymatic dye-binding reaction
C. Protein error of indicators
D. Microalbumin-Micral-Test

A

C. Protein error of indicators

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18
Q

Which of the following is not tested on the Multistix Pro reagent strip?
A. Urobilinogen
B. Specific gravity
C. Creatinine
D. Protein-high

A

A. Urobilinogen

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19
Q

The principle of the protein-low reagent pad on the Multistix Pro is the:
A. Binding of albumin to sulphonphthalein dye
B. Immunological binding of albumin to antibody
C. Reverse protein error of indicators reaction
D. Enzymatic reaction between albumin and dye

A

A. Binding of albumin to sulphonphthalein dye

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20
Q

The principle of the creatinine microalbumin reagent strips is:
A. Double indicator reaction
B. Diazo reaction
C. Pseudoperoxidase reaction
D. Reduction of a chromogen

A

C. Pseudoperoxidase reaction

21
Q

The purpose of performing an is to:
reagent pad on the: albumin:creatinine ratio
A. Estimate the glomerular filtration rate
B. Correct for hydration in random specimens
C. Avoid interference for alkaline urines
D. Correct for abnormally colored urines

A

A. Estimate the glomerular filtration rate

22
Q

A patient with a normal blood glucose and a positive urine glucose should be further checked for:
A. Diabetes mellitus
B. Renal disease
C. Gestational diabetes
D. Pancreatitis

A

B. Renal disease

23
Q

The principle of the reagent strip tests for glucose is the:
A. Peroxidase activity of glucose
B. Glucose oxidase reaction
C. Double sequential enzyme reaction
D. Dye-binding of glucose and chromogen

A

C. Double sequential enzyme reaction

24
Q

All of the following may produce false-negative glucose reactions except:
A. Detergent contamination
B. Ascorbic acid
C. Unpreserved specimens
D. Low urine temperature

A

A. Detergent contamination

25
Q

The primary reason for performing a Clinitest is to:
A. Check for high ascorbic acid levels
B. Confirm a positive reagent strip glucose
C. Check for newborn galactosuria
D. Confirm a negative glucose reading

A

C. Check for newborn galactosuria

26
Q

The three intermediate products of fat metabolism
include all of the following except:
A. Acetoacetic acid
B. Ketoacetic acid
C. β-hydroxybutyric acid
D. Acetone

A

B. Ketoacetic acid

27
Q

The most significant reagent strip test that is associated with a positive ketone result is:
A. Glucose
B. Protein
C. pH
D. Specific gravity

A

A. Glucose

28
Q

The primary reagent in the reagent strip test for ketones is:
A. Glycine
B. Lactose
C. Sodium hydroxide
D. Sodium nitroprusside

A

D. Sodium nitroprusside

29
Q

Ketonuria may be caused by all of the following except:
A. Bacterial infections
B. Diabetic acidosis
C. Starvation
D. Vomiting

A

A. Bacterial infections

30
Q

Urinalysis is frequently performed on a patient with severe back and abdominal pain to check for:
A. Glucosuria
B. Proteinuria
C. Hematuria
D. Hemoglobinuria

A

C. Hematuria

31
Q

Place the appropriate number or numbers in front of each of the following statements. Use both numbers for an answer if needed.
1. Hemoglobinuria
2. Myoglobinuria

A. Associated with transfusion reactions
B. Clear red urine and pale yellow plasma
C. Clear red urine and red plasma
D. Associated with rhabdomyolysis
E. Produces hemosiderin granules in urinary sediments
F. Associated with acute renal failure

A

A. Associated with transfusion reactions - 1
B. Clear red urine and pale yellow plasma - 2
C. Clear red urine and red plasma - 1
D. Associated with rhabdomyolysis - 2
E. Produces hemosiderin granules in urinary sediments - 1
F. Associated with acute renal failure - 2

32
Q

The principle of the reagent strip test for blood is based on the:
A. Binding of heme and a chromogenic dye
B. Peroxidase activity of heme
C. Reaction of peroxide and chromogen
D. Diazo activity of heme

A

B. Peroxidase activity of heme

33
Q

A speckled pattern on the blood pad of the reagent strip indicates:
A. Hematuria
B. Hemoglobinuria
C. Myoglobinuria
D. All of the above

A

A. Hematuria

34
Q

List the following products of hemoglobin degradation in the correct order of metabolism by placing numbers 1 to 4 in the blank, where 1 indicates the beginning and 4 indicates the end product.
A. Conjugated bilirubin
B. Urobilinogen and stercobilinogen
C. Urobilin
D. Unconjugated bilirubin

A

A. Conjugated bilirubin - 1
B. Urobilinogen and stercobilinogen - 3
C. Urobilin - 4
D. Unconjugated bilirubin - 2

35
Q

The principle of the reagent strip test for bilirubin is the:
A. Diazo reaction
B. Ehrlich reaction
C. Greiss reaction
D. Peroxidase reaction

A

A. Diazo reaction

36
Q

An elevated urine bilirubin with a normal urobilinogen is indicative of:
A. Cirrhosis of the liver
B. Hemolytic disease
C. Hepatitis
D. Biliary obstruction

A

D. Biliary obstruction

37
Q

The primary cause of a false-negative bilirubin reaction is:
A. Highly pigmented urine
B. Specimen contamination
C. Specimen exposure to light
D. Excess conjugated bilirubin

A

C. Specimen exposure to light

38
Q

The purpose of the special mat supplied with the Ictotest tablets is that:
A. Bilirubin remains on the surface of the mat
B. It contains the dye needed to produce color
C. It removes interfering substances
D. Bilirubin is absorbed into the mat

A

A. Bilirubin remains on the surface of the mat

39
Q

The reagent in the Multistix reaction for urobilinogen is:
A. A diazonium salt
B. Tetramethylbenzidine
C. p-Dimethylaminobenzaldehyde
D. Hoesch reagent

A

C. p-Dimethylaminobenzaldehyde

40
Q

The primary problem with urobilinogen tests using Ehrlich reagent is:
A. Positive reactions with porphobilinogen
B. Lack of specificity
C. Positive reactions with Ehrlich reactive substances
D. All of the above

A

D. All of the above

41
Q

The reagent strip test for nitrite uses the:
A. Greiss reaction
B. Ehrlich reaction
C. Peroxidase reaction
D. Pseudoperoxidase reaction

A

A. Greiss reaction

42
Q

All of the following can cause a negative nitrite reading except:
A. Gram-positive bacteria
B. Gram-negative bacteria
C. Random urine specimens
D. Heavy bacterial infections

A

B. Gram-negative bacteria

43
Q

A positive nitrite test and a negative leukocyte esterase test is an indication of a:
A. Dilute random specimen
B. Specimen with lysed leukocytes
C. Vaginal yeast infection
D. Specimen older than 2 hours

A

D. Specimen older than 2 hours

44
Q

All of the following can be detected by the leukocyte esterase reaction except:
A. Neutrophils
B. Eosinophils
C. Lymphocytes
D. Basophils

A

C. Lymphocytes

45
Q

Screening tests for urinary infection combine the leukocyte esterase test with the test for:
A. pH
B. Nitrite
C. Protein
D. Blood

A

B. Nitrite

46
Q

The principle of the leukocyte esterase reagent strip test uses a:
A. Peroxidase reaction
B. Double indicator reaction
C. Diazo reaction
D. Dye-binding technique

A

C. Diazo reaction

47
Q

The principle of the reagent strip test for specific gravity uses the dissociation constant of a(n):
A. Diazonium salt
B. Indicator dye
C. Polyelectrolyte
D. Enzyme substrate

A

C. Polyelectrolyte

48
Q

A specific gravity of 1.005 would produce the reagent
strip color:
A. Blue
B. Green
C. Yellow
D. Red

A

A. Blue

49
Q

Specific gravity readings on a reagent strip are affected by:
A. Glucose
B. Radiographic dye
C. Alkaline urine
D. All of the above

A

C. Alkaline urine