Clinical Microscopy Flashcards
Which of the following organizations publishes guidelines for writing procedures and policies in the urinalysis?
A. CDC
B. OSHA
C. CLSI
D. CLIA
C. CLSI
Exposure to toxic, carcinogenic, or caustic agents is what type of laboratory safety hazard?
A. Biological
B. Sharps
C. Chemical
D. Fire/explosive
C. Chemical
In the urinalysis laboratory, the primary source in the chain of infection would be:
A. Patients
B. Needlesticks
C. Specimens
D. Biohazardous waste
C. Specimens
The best way to break the chain of infection is:
A. Hand sanitizing
B. Personal protective equipment
C. Aerosol prevention
D. Decontamination
A. Hand sanitizing
The current routine infection control policy developed by CDC and followed in all health-care settings is:
A. Universal Precautions
B. Isolation Precautions
C. Blood and Body Fluid Precautions
D. Standard Precautions
D. Standard Precautions
An employee who is accidentally exposed to a possible bloodborne pathogen should immediately:
A. Report to a supervisor
B. Flush the area with water
C. Clean the area with disinfectant
D. Receive HIV prophylaxis
A. Report to a supervisor
Personnel in the urinalysis laboratory should wear laboratory coats that:
A. Do not have buttons
B. Are fluid-resistant
C. Have short sleeves
D. Have full-length zippers
B. Are fluid-resistant
All of the following should be discarded in biohazardous waste containers except:
A. Urine specimen containers
B. Towels used for decontamination
C. Disposable laboratory coats
D. Blood collection tubes
A. Urine specimen containers
An employer who fails to provide sufficient gloves for the employees may be fined by the:
A. CDC
B. NFPA
C. OSHA
D. FDA
C. OSHA
An acceptable disinfectant for decontamination of blood and body fluids is:
A. Sodium hydroxide
B. Antimicrobial soap
C. Hydrogen peroxide
D. Sodium hypochlorite
D. Sodium hypochlorite
Correct hand washing includes all of the following except:
A. Using warm water
B. Rubbing to create a lather
C. Rinsing hands in a downward position
D. Turning on the water with a paper towel
D. Turning on the water with a paper towel
Centrifuging an uncapped specimen may produce a biological hazard in the form of:
A. Vectors
B. Sharps contamination
C. Aerosols
D. Specimen contamination
C. Aerosols
An employee who accidentally spills acid on his arm should immediately:
A. Neutralize the acid with a base
B. Hold the arm under running water for 15 minutes
C. Consult the SDS
D. Wrap the arm in gauze and go to the emergency department
B. Hold the arm under running water for 15 minutes
When combining acid and water, ensure that:
A. Acid is added to water
B. Water is added to acid
C. They are added simultaneously
D. Water is slowly added to acid
A. Acid is added to water
An employee can learn the carcinogenic potential of potassium chloride by consulting the:
A. Chemical hygiene plan
B. Safety Data Sheet
C. OSHA standards
D. Urinalysis procedure manual
B. Safety Data Sheet
Employees should not work with radioisotopes if they are:
A. Wearing contact lenses
B. Allergic to iodine
C. Sensitive to latex
D. Pregnant
D. Pregnant
All of the following are safe to do when removing the source of an electric shock except:
A. Pulling the person away from the instrument
B. Turning off the circuit breaker
C. Using a glass container to move the instrument
D. Unplugging the instrument
A. Pulling the person away from the instrument
The acronym PASS refers to:
A. Presence of vital chemicals
B. Operation of a fire extinguisher
C. Labeling of hazardous material
D. Presence of radioactive substances
B. Operation of a fire extinguisher
The system used by firefighters to assess the risk potential when a fire occurs in the laboratory is:
A. SDS
B. RACE
C. NFPA
D. PASS
C. NFPA
A class ABC fire extinguisher contains:
A. Sand
B. Water
C. Dry chemicals
D. Acid
C. Dry chemicals
The first thing to do when a fire is discovered is to:
A. Rescue people in danger
B. Activate the alarm system
C. Close doors to other areas
D. Extinguish the fire if possible
A. Rescue people in danger
If a red rash is observed after removing gloves, the employee:
A. May be washing her hands too often
B. May have developed a latex allergy
C. Should apply cortisone cream
D. Should not rub her hands so vigorously
B. May have developed a latex allergy
Pipetting by mouth is:
A. Acceptable for urine but not serum
B. Not acceptable without proper training
C. Acceptable for reagents but not specimens
D. Not acceptable in the laboratory
D. Not acceptable in the laboratory
The NPFA classification symbol contains information on all of the following except:
A. Fire hazards
B. Biohazards
C. Reactivity
D. Health hazards
B. Biohazards
The GHS requires the following on a chemical label:
A. Biohazard symbol, warning sign, environmental impact
B. Hazard pictogram, signal words, hazard statement
C. Biological symbol, hazard pictogram, long-term effects
D. Signal words, hazard statement, biological symbol
B. Hazard pictogram, signal words, hazard statement
The classification of a fire that can be extinguished with water is:
A. Class A
B. Class B
C. Class C
D. Class D
A. Class A
Employers are required to provide free immunization for:
A. HIV
B. HTLV-1
C. HBV
D. HCV
C. HBV
A possible physical hazard in the hospital is:
A. Wearing closed-toed shoes
B. Not wearing jewelry
C. Having short hair
D. Running to answer the telephone
D. Running to answer the telephone
Quality management refers to:
A. Analysis of testing controls
B. Increased productivity
C. Precise control results
D. Quality of specimens and patient care
D. Quality of specimens and patient care
During laboratory accreditation inspections, procedure manuals are examined for the presence of:
A. Critical values
B. Procedure references
C. Procedures for specimen preservation
D. All of the above
D. All of the above
As the supervisor of the urinalysis laboratory, you have just adopted a new procedure. You should:
A. Put the package insert in the procedure manual
B. Put a complete, referenced procedure in the manual
C. Notify the microbiology department
D. Put a cost analysis study in the procedure manual
B. Put a complete, referenced procedure in the manual
Indicate whether each of the following would be considered a 1) preexamination, 2) examination, or
3) postexamination factor by placing the appropriate
number in the blank:
1. Reagent expiration date
2. Rejecting a contaminated specimen
3. Constructing a Levy-Jennings chart
4. Telephoning a positive Clinitest result on a newborn
5. Calibrating the centrifuge
6. Collecting a timed urine specimen
- 2
- 1
- 2
- 3
- 2
- 1
The testing of a specimen from an outside agency and the comparison of results with participating laboratories
is called:
A. External QC
B. Electronic QC
C. Internal QC
D. Proficiency testing
D. Proficiency testing
A color change indicating that a sufficient amount of a patient’s specimen or reagent is added correctly to the test system would be an example of:
A. External QC
B. Equivalent QC
C. Internal QC
D. Proficiency testing
C. Internal QC
What steps are taken when the results of reagent strip QC are outside the stated confidence limits?
A. Check the expiration date of the reagent strip
B. Run a new control
C. Open a new reagent strips container
D. All of the above
D. All of the above
When a new bottle of QC material is opened, what information is placed on the label?
A. The supervisor’s initials
B. The lot number
C. The date and the laboratory worker’s initials
D. The time the bottle was opened
C. The date and the laboratory worker’s initials
When a control is run, what information is documented?
A. The lot number
B. Expiration date of the control
C. The test results
D. All of the above
D. All of the above
The principle commonly used to measure the concentration of a particular analyte in the chemical examination of urine is:
A. Reflectance photometry
B. Digital imaging
C. Flow cytometry
D. Auto particle recognition
A. Reflectance photometry
In automated urinalysis, the specific gravity is measured by:
A. Light transmittance
B. Light scattering
C. Refractometry
D. Turbidity
C. Refractometry
All of the following are true concerning fully automated urine chemistry analyzers, except:
A. They are designed for a high-volume urinalysis laboratory.
B. The reagent strip is dipped into the well-mixed urine.
C. The urine tube moves through the instrument.
D. A sample probe aspirates the urine.
B. The reagent strip is dipped into the well-mixed urine.
The advantages of an automated urine microscopy analyzer over manual microscopy includes:
A. Cost-effective
B. Centrifugation not required
C. Standardized results
D. All of the above
D. All of the above
Which of the following is a complete urinalysis automated urinalysis system?
A. AUTION ELEVEN AE 4022
B. Clinitek Atlas
C. iQ200 Automated Urine Microscopy
D. Clinitek AUWi Pro System
D. Clinitek AUWi Pro System
What two technologies are used for urine sediment analysis?
A. Light scattering and refractometry
B. Light scattering and flow cytometry
C. Flow cytometry and digital imaging
D. Digital imaging and refractometry
C. Flow cytometry and digital imaging
Which automated urine particle counter combines urine flow cytometry with digital image analysis?
A. UN-2000
B. iRICELL
C. UF-1000i
D. iQ 200
A. UN-2000
Which of the following urine sediment particles cannot be autovalidated but will be flagged and must be reviewed by laboratory personnel?
A. RBCs
B. WBCs
C. RTEs
D. Squamous epithelial cells
C. RTEs
Which of the automated body fluid analyzers does not need to dilute or pretreat body fluids before analysis?
A. ADVIA 2120i
B. XN Series
C. iQ 200
D. None of the above
B. XN Series
What is a disadvantage of counting body fluid cells using an automated instrument versus a Neubauer hemocytometer?
A. Less labor-intensive and time-consuming
B. More precise
C. Unable to count low WBC numbers and malignant cells
D. Able to perform a WBC differential
C. Unable to count low WBC numbers and malignant cells
The primary inorganic substance found in urine is:
A. Sodium
B. Phosphate
C. Chloride
D. Calcium
C. Chloride
An unidentified fluid is received in the laboratory with a request to determine whether the fluid is urine or another body fluid. Using routine laboratory tests, which substances
would determine that the fluid is most probably urine?
A. Glucose and ketones
B. Urea and creatinine
C. Uric acid and amino acids
D. Protein and amino acids
B. Urea and creatinine
The average daily output of urine is:
A. 200 mL
B. 500 mL
C. 1200 mL
D. 2500 mL
C. 1200 mL
A patient presenting with polyuria, nocturia, polydipsia, and a low urine specific gravity is exhibiting symptoms of:
A. Diabetes insipidus
B. Diabetes mellitus
C. Urinary tract infection
D. Uremia
A. Diabetes insipidus
A patient with oliguria might progress to having:
A. Nocturia
B. Polyuria
C. Polydipsia
D. Anuria
D. Anuria
All of the following are characteristics of recommended urine containers except:
A. A flat bottom
B. A capacity of 50 mL
C. A snap-on lid
D. Are disposable
C. A snap-on lid
Labels for urine containers are:
A. Attached to the container
B. Attached to the lid
C. Placed on the container before collection
D. Not detachable
C. Placed on the container before collection
A urine specimen may be rejected by the laboratory for all of the following reasons except the fact that the:
A. Requisition form states the specimen is catheterized
B. Specimen contains toilet paper
C. Label and requisition form do not match
D. Outside of the container has contamination from fecal material
A. Requisition form states the specimen is catheterized
A cloudy specimen received in the laboratory may have been preserved using:
A. Boric acid
B. Chloroform
C. Refrigeration
D. Formalin
C. Refrigeration
For general screening, the specimen collected most frequently is a:
A. Random one
B. First morning
C. Midstream clean-catch
D. Timed
A. Random one
The primary advantage of a first morning specimen over a random specimen is that it:
A. Is less contaminated
B. Is more concentrated
C. Is less concentrated
D. Has a higher volume
B. Is more concentrated
If a routine urinalysis and a culture are requested on a catheterized specimen, then:
A. Two separate containers must be collected
B. The routine urinalysis is performed first
C. The patient must be recatheterized
D. The culture is performed first
D. The culture is performed first
If a patient fails to discard the first specimen when collecting a timed specimen, then the:
A. Specimen must be re-collected
B. Results will be falsely elevated
C. Results will be falsely decreased
D. Both A and B
D. Both A and B
The primary cause of unsatisfactory results in an unpreserved routine specimen not tested for 8 hours is:
A. Bacterial growth
B. Glycolysis
C. Decreased pH
D. Chemical oxidation
A. Bacterial growth
Prolonged exposure of a preserved urine specimen to light will cause:
A. Decreased glucose
B. Increased cells and casts
C. Decreased bilirubin
D. Increased bacteria
C. Decreased bilirubin
Which of the following would be least affected in a specimen that has remained unpreserved at room temperature for more than 2 hours?
A. Urobilinogen
B. Ketones
C. Protein
D. Nitrite
C. Protein
Bacterial growth in an unpreserved specimen will:
A. Decrease clarity
B. Increase bilirubin
C. Decrease pH
D. Increase glucose
A. Decrease clarity
The most sterile specimen collected is a:
A. Catheterized
B. Midstream clean-catch
C. Three-glass
D. Suprapubic aspiration
D. Suprapubic aspiration
Which of the following would not be given to a patient before the collection of a midstream clean-catch
specimen?
A. Sterile container
B. Iodine cleanser
C. Antiseptic towelette
D. Instructions
B. Iodine cleanser
Urine specimen collection for drug testing requires the collector to do all of the following except:
A. Inspect the specimen color
B. Perform reagent strip testing
C. Read the specimen temperature
D. Fill out a chain-of-custody form
B. Perform reagent strip testing
The type of nephron responsible for renal concentration is the:
A. Cortical
B. Juxtaglomerular
C. Efferent
D. Afferent
B. Juxtaglomerular
The function of the peritubular capillaries is:
A. Reabsorption
B. Filtration
C. Secretion
D. Both A and C
D. Both A and C
Blood flows through the nephron in the following order:
A. Efferent arteriole, peritubular capillaries, vasa recta, afferent arteriole
B. Peritubular capillaries, afferent arteriole, vasa recta, efferent arteriole
C. Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta
D. Efferent arteriole, vasa recta, peritubular capillaries, afferent arteriole
C. Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta
Filtration of protein is prevented in the glomerulus by:
A. Hydrostatic pressure
B. Oncotic pressure
C. Renin
D. The glomerular filtration barrier
D. The glomerular filtration barrier
The renin–angiotensin–aldosterone system is responsible
for all of the following except:
A. Vasoconstriction of the afferent arteriole
B. Vasoconstriction of the efferent arteriole
C. Reabsorbing sodium
D. Releasing aldosterone
A. Vasoconstriction of the afferent arteriole
The primary chemical affected by the renin–angiotensin–aldosterone system is:
A. Chloride
B. Sodium
C. Potassium
D. Hydrogen
B. Sodium
Secretion of renin is stimulated by:
A. Juxtaglomerular cells
B. Angiotensin I and II
C. Macula densa cells
D. Circulating angiotensin-converting enzyme
C. Macula densa cells
The hormone aldosterone is responsible for:
A. Hydrogen ion secretion
B. Potassium secretion
C. Chloride retention
D. Sodium retention
D. Sodium retention
The fluid leaving the glomerulus has a specific gravity of:
A. 1.005
B. 1.010
C. 1.015
D. 1.020
B. 1.010
For active transport to occur, a chemical must:
A. Combine with a carrier protein to create electrochemical energy
B. Be filtered through the proximal convoluted tubule
C. Be in higher concentration in the filtrate than in the blood
D. Be in higher concentration in the blood than in the filtrate
A. Combine with a carrier protein to create electrochemical energy
Which of the tubules is impermeable to water?
A. Proximal convoluted tubule
B. Descending loop of Henle
C. Ascending loop of Henle
D. Distal convoluted tubule
C. Ascending loop of Henle
Glucose will appear in the urine when the:
A. Blood level of glucose is 200 mg/dL
B. Tm for glucose is reached
C. Renal threshold for glucose is exceeded
D. All of the above
D. All of the above
Concentration of the tubular filtrate by the countercurrent mechanism depends on all of the following except:
A. High salt concentration in the medulla
B. Water-impermeable walls of the ascending loop of Henle
C. Reabsorption of sodium and chloride from the ascending loop of Henle
D. Reabsorption of water in the descending loop of Henle
D. Reabsorption of water in the descending loop of Henle
ADH regulates the final urine concentration by controlling:
A. Active reabsorption of sodium
B. Tubular permeability
C. Passive reabsorption of urea
D. Passive reabsorption of chloride
B. Tubular permeability
Decreased production of ADH:
A. Produces a low volume of urine
B. Produces a high volume of urine
C. Increases excretion of ammonia
D. Affects active transport of sodium
B. Produces a high volume of urine
Bicarbonate ions filtered by the glomerulus are returned to the blood:
A. In the proximal convoluted tubule
B. Combined with hydrogen ions
C. By tubular secretion
D. All of the above
D. All of the above
If ammonia is not produced by the distal convoluted tubule, the urine pH will be:
A. Acidic
B. Basic
C. Hypothenuric
D. Hypersthenuric
B. Basic
Place the appropriate letter in front of the following clearance substances:
A. Exogenous
B. Endogenous
1. beta2-microglobulin
2. creatinine
3. cystatin C
4. 125 I-iothalmate
- B
- B
- B
- A
The largest source of error in creatinine clearance tests is:
A. Secretion of creatinine
B. Improperly timed urine specimens
C. Refrigeration of the urine
D. Time of collecting blood specimen
B. Improperly timed urine specimens
Clearance tests used to determine the glomerular filtration rate must measure substances that are:
A. Not filtered by the glomerulus
B. Completely reabsorbed by the proximal convoluted tubule
C. Secreted in the distal convoluted tubule
D. Neither reabsorbed nor secreted by the tubules
D. Neither reabsorbed nor secreted by the tubules
Performing a clearance test using radionucleotides:
A. Eliminates the need to collect urine
B. Does not require an infusion
C. Provides visualization of the filtration
D. Both A and C
D. Both A and C
Given the following information, calculate the creatinine
clearance:
24-hour urine volume = 1000 mL; serum creatinine = 2.0 mg/dL;
urine creatinine = 200 mg/dL
200 mg/dl x 1000mL /
2.0 mg/dL x 1440 mg
3.= 69 mL/min
Variables that are included in the MDRD-IDSM estimated calculations of creatinine clearance include all
of the following except:
A. Serum creatinine
B. Weight
C. Age
D. Gender
B. Weight
An advantage to using cystatin C to monitor GFR is that:
A. It does not require urine collection
B. It is not secreted by the tubules
C. It can be measured by immunoassay
D. All of the above
D. All of the above
Solute dissolved in solvent will:
A. Raise the vapor pressure
B. Lower the boiling point
C. Decrease the osmotic pressure
D. Lower the freezing point
D. Lower the freezing point
Substances that may interfere with freezing-point measurement of urine and serum osmolarity include all
of the following except:
A. Ethanol
B. Lactic acid
C. Sodium
D. Lipids
C. Sodium
Clinical osmometers use NaCl as a reference solution because:
A. 1 g molecular weight of NaCl will lower the freezing point 1.86°C
B. NaCl is readily frozen
C. NaCl is partially ionized, similar to the composition of urine
D. 1 g equivalent weight of NaCl will raise the freezing point 1.86°C
C. NaCl is partially ionized, similar to the composition of urine
The normal serum osmolarity is:
A. 50 to 100 mOsm
B. 275 to 300 mOsm
C. 400 to 500 mOsm
D. 3 times the urine osmolarity
B. 275 to 300 mOsm
After controlled fluid intake, the urine-to-serum osmolarity ratio should be at least:
A. 1:1
B. 2:1
C. 3:1
D. 4:1
A. 1:1
To provide an accurate measure of renal blood flow, a test substance should be completely:
A. Filtered by the glomerulus
B. Reabsorbed by the tubules
C. Secreted when it reaches the distal convoluted tubule
D. Cleared on each contact with functional renal tissue
D. Cleared on each contact with functional renal tissue
Renal tubular acidosis can be caused by the:
A. Production of excessively acidic urine due to increased filtration of hydrogen ions
B. Production of excessively acidic urine due to increased secretion of hydrogen ions
C. Inability to produce an acidic urine due to impaired production of ammonia
D. Inability to produce an acidic urine due to increased production of ammonia
C. Inability to produce an acidic urine due to impaired production of ammonia
Tests performed to detect renal tubular acidosis after administering an ammonium chloride load include all of
the following except:
A. Urine ammonia
B. Arterial pH
C. Urine pH
D. Titratable acidity
B. Arterial pH
The concentration of a normal urine specimen can be estimated by which of the following?
A. Color
B. Clarity
C. Foam
D. Odor
A. Color
The normal yellow color of urine is produced by:
A. Bilirubin
B. Hemoglobin
C. Urobilinogen
D. Urochrome
D. Urochrome
The presence of bilirubin in a urine specimen produces a:
A. Yellow foam when shaken
B. White foam when shaken
C. Cloudy specimen
D. Yellow-red specimen
A. Yellow foam when shaken
A urine specimen containing melanin will appear:
A. Pale pink
B. Dark yellow
C. Blue-green
D. Black
D. Black
Specimens that contain hemoglobin can be visually distinguished from those that contain RBCs because:
A. Hemoglobin produces a clear yellow specimen
B. Hemoglobin produces a cloudy pink specimen
C. RBCs produce a cloudy red specimen
D. RBCs produce a clear red specimen
C. RBCs produce a cloudy red specimen
A patient with a viscous orange specimen may have been:
A. Treated for a urinary tract infection
B. Taking vitamin B pills
C. Eating fresh carrots
D. Taking antidepressants
A. Treated for a urinary tract infection
The presence of a pink precipitate in a refrigerated specimen is caused by:
A. Hemoglobin
B. Urobilin
C. Uroerythrin
D. Beets
C. Uroerythrin
Microscopic examination of a clear urine that produces a white precipitate after refrigeration will show:
A. Amorphous urates
B. Porphyrins
C. Amorphous phosphates
D. Yeast
C. Amorphous phosphates
The color of urine containing porphyrins will be:
A. Yellow-brown
B. Green
C. Orange
D. Port wine
D. Port wine
Which of the following specific gravities would be most likely to correlate with a urine that is pale yellow?
A. 1.005
B. 1.010
C. 1.020
D. 1.030
A. 1.005
A urine specific gravity measured by a refractometer is 1.029, and the temperature of the urine is 14°C. The
specific gravity should be reported as:
A. 1.023
B. 1.027
C. 1.029
D. 1.032
C. 1.029
The principle of refractive index is to compare:
A. Light velocity in solutions with light velocity in solids
B. Light velocity in air with light velocity in solutions
C. Light scattering by air with light scattering by solutions
D. Light scattering by particles in solution
B. Light velocity in air with light velocity in solutions
A correlation exists between a specific gravity by a refractometer of 1.050 and a:
A. 2+ glucose
B. 2+ protein
C. First morning specimen
D. Radiographic dye infusion
D. Radiographic dye infusion
A cloudy urine specimen turns black upon standing and has a specific gravity of 1.012. The major concern about this specimen would be:
A. Color
B. Turbidity
C. Specific gravity
D. All of the above
A. Color
A specimen with a specific gravity of 1.035 would be considered:
A. Isosthenuric
B. Hyposthenuric
C. Hypersthenuric
D. Not urine
C. Hypersthenuric
A specimen with a specific gravity of 1.001 would be considered:
A. Hyposthenuric
B. Not urine
C. Hypersthenuric
D. Isosthenuric
B. Not urine
A strong odor of ammonia in a urine specimen could indicate:
A. Ketones
B. Normalcy
C. Phenylketonuria
D. An old specimen
D. An old specimen
The microscopic examination of a clear red urine is reported as many WBCs and epithelial cells. What does
this suggest?
A. Urinary tract infection
B. Dilute random specimen
C. Hematuria
D. Possible mix-up of specimen and sediment
D. Possible mix-up of specimen and sediment
Which of the following would contribute the most to a urine osmolality?
A. One osmole of glucose
B. One osmole of urea
C. One osmole of sodium chloride
D. All contribute equally
C. One osmole of sodium chloride
Which of the following colligative properties is not stated correctly?
A. The boiling point is raised by solute
B. The freezing point is raised by solute
C. The vapor pressure is lowered by solute
D. The osmotic pressure is raised by solute
B. The freezing point is raised by solute
An osmole contains:
A. One gram molecular weight of solute dissolved in 1 liter of solvent
B. One gram molecular weight of solute dissolved in 1 kilogram of solvent
C. Two gram molecular weights of solute dissolved in 1 liter of solvent
D. Two gram molecular weights of solute dissolved in 1 kilogram of solvent
B. One gram molecular weight of solute dissolved in 1 kilogram of solvent
The unit of osmolality measured in the clinical laboratory is the:
A. Osmole
B. Milliosmole
C. Molecular weight
D. Ionic charge
A. Osmole
In the reagent strip specific gravity reaction, the polyelectrolyte:
A. Combines with hydrogen ions in response to ion concentration
B. Releases hydrogen ions in response to ion concentration
C. Releases hydrogen ions in response to pH
D. Combines with sodium ions in response to pH
B. Releases hydrogen ions in response to ion concentration
Which of the following will react in the reagent strip specific gravity test?
A. Glucose
B. Radiographic dye
C. Protein
D. Chloride
D. Chloride
page 14 no. 1
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. Cause runover between reagent pads
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
D. Both B and C
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. Enzymatic reactions
The reagent strip reaction that requires the longest reaction time is the:
A. Bilirubin
B. pH
C. Leukocyte esterase
D. Glucose
C. Leukocyte esterase
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
D. All of the above
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. Removing the desiccant from the bottle
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
D. Double indicator reaction
A urine specimen with a pH of 9.0:
A. Indicates metabolic acidosis
B. Should be re-collected
C. May contain calcium oxalate crystals
D. Is seen after drinking cranberry juice
B. Should be re-collected
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
D. Both A and C
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. 2
b. 1
c. 2
d. 3
e. 1
f. 2
g. 3
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
B. Albumin accepts hydrogen ions from the indicator
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. Microalbuminuria
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. Positive for orthostatic proteinuria
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
D. All of the above
The primary chemical on the reagent strip in the MicralTest for microalbumin binds to:
A. Protein
B. Antihuman albumin antibody
C. Conjugated enzyme
D. Galactoside
B. Antihuman albumin antibody
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. Unbound antibody migrates farther than bound antibody
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
C. Protein error of indicators
Which of the following is not tested on the Multistix Pro reagent strip?
A. Urobilinogen
B. Specific gravity
C. Creatinine
D. Protein-high
A. Urobilinogen
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. Binding of albumin to sulphonphthalein dye
The principle of the creatinine reagent pad on microalbumin reagent strips is the:
A. Double indicator reaction
B. Diazo reaction
C. Pseudoperoxidase reaction
D. Reduction of a chromogen
C. Pseudoperoxidase reaction
The purpose of performing an albumin:creatinine ratio is to:
A. Estimate the glomerular filtration rate
B. Correct for hydration in random specimens
C. Avoid interference for alkaline urines
D. Correct for abnormally colored urines
A. Estimate the glomerular filtration rate
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
B. Renal disease
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
C. Double sequential enzyme reaction
All of the following may produce false-negative
glucose reactions except:
A. Detergent contamination
B. Ascorbic acid
C. Unpreserved specimensD. Low urine temperature
A. Detergent contamination
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
C. Check for newborn galactosuria
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
B. Ketoacetic acid
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. Glucose
The primary reagent in the reagent strip test for ketones is:
A. Glycine
B. Lactose
C. Sodium hydroxide
D. Sodium nitroprusside
D. Sodium nitroprusside
Ketonuria may be caused by all of the following except:
A. Bacterial infections
B. Diabetic acidosis
C. Starvation
D. Vomiting
A. Bacterial infections
Urinalysis is frequently performed on a patient with severe back and abdominal pain to check for:
A. Glucosuria
B. Proteinuria
C. Hematuria
D. Hemoglobinuria
C. Hematuria
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 wit rhabdomyolysis
E. ____ Produces hemosiderin granules in urinary sediments
F. ____ Associated with acute renal failure
a. 1
b.2
c.1
d.2
e.1
f. 2
The principle of the reagent strip test for blood is based on the: (pg. 10)
A. Binding of heme and a chromogenic dye
B. Peroxidase activity of heme
C. Reaction of peroxide and chromogen
D. Diazo activity of heme
B. Peroxidase activity of heme
A speckled pattern on the blood pad of the reagent strip indicates:
A. Hematuria
B. Hemoglobinuria
C. Myoglobinuria
D. All of the above
A. Hematuria
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. 1
b. 3
c. 4
d. 2
The principle of the reagent strip test for bilirubin is the:
A. Diazo reaction
B. Ehrlich reaction
C. Greiss reaction
D. Peroxidase reaction
A. Diazo reaction
An elevated urine bilirubin with a normal urobilinogen is indicative of:
A. Cirrhosis of the liver
B. Hemolytic disease
C. Hepatitis
D. Biliary obstruction
D. Biliary obstruction
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
C. Specimen exposure to light
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. Bilirubin remains on the surface of the mat
The reagent in the Multistix reaction for urobilinogen is:
A. A diazonium salt
B. Tetramethylbenzidine
C. p-Dimethylaminobenzaldehyde
D. Hoesch reagent
C. p-Dimethylaminobenzaldehyde
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
C. Positive reactions with Ehrlich reactive substances
The reagent strip test for nitrite uses the:
A. Greiss reaction
B. Ehrlich reaction
C. Peroxidase reaction
D. Pseudoperoxidase reaction
A. Greiss reaction
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
B. Gram-negative bacteria
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
D. Specimen older than 2 hours
All of the following can be detected by the leukocyte esterase reaction except:
A. Neutrophils
B. Eosinophils
C. Lymphocytes
D. Basophils
C. Lymphocytes
Screening tests for urinary infection combine the leukocyte esterase test with the test for:
A. pH
B. Nitrite
C. Protein
D. Blood
B. Nitrite
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
C. Diazo reaction
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
C. Polyelectrolyte
A specific gravity of 1.005 would produce the reagent strip color:
A. Blue
B. Green
C. Yellow
D. Red
A. Blue
Specific gravity readings on a reagent strip are affected by:
A. Glucose
B. Radiographic dye
C. Alkaline urine
D. All of the above
C. Alkaline urine
Macroscopic screening of urine specimens is used to:
A. Provide results as soon as possible
B. Predict the type of urinary casts present
C. Increase cost-effectiveness of urinalysis
D. Decrease the need for polarized microscopy
C. Increase cost-effectiveness of urinalysis
Variations in the microscopic analysis of urine include all of the following except:
A. Preparation of the urine sediment
B. Amount of sediment analyzed
C. Method of reporting
D. Identification of formed elements
D. Identification of formed elements
All of the following can cause false-negative microscopic results except:
A. Braking the centrifuge
B. Failing to mix the specimen
C. Diluting alkaline urine
D. Using midstream clean-catch specimens
D. Using midstream clean-catch specimens
The two factors that determine relative centrifugal force are:
A. Radius of rotor head and RPM
B. Radius of rotor head and time of centrifugation
C. Diameter of rotor head and RPM
D. RPM and time of centrifugation
C. Diameter of rotor head and RPM
When using the glass-slide and cover-slip method, which of the following might be missed if the cover slip is overflowed?
A. Casts
B. RBCs
C. WBCs
D. Bacteria
A. Casts
Initial screening of the urine sediment is performed using an objective power of:
A. 4×
B. 10×
C. 40×
D. 100×
B. 10×
Which of the following should be used to reduce light intensity in bright-field microscopy?
A. Centering screws
B. Aperture diaphragm
C. Rheostat
D. Condenser aperture diaphragm
C. Rheostat
Which of the following are reported as number per lpf?
A. RBCs
B. WBCs
C. Crystals
D. Casts
D. Casts
The Sternheimer-Malbin stain is added to urine sediments to do all of the following except:
A. Increase visibility of sediment constituents
B. Change the constituents’ refractive index
C. Decrease precipitation of crystals
D. Delineate constituent structures
C. Decrease precipitation of crystals
