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Exam 3 Flashcards

1
Q

1.The color of normal urine is due to the pigment
A. bilirubin.
B. urobilin.
C. uroerythrin.
D. urochrome.

A

D. urochrome.

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2
Q

2.A single substance can impart different colors to urine
depending on the

  1. amount of the substance present.
  2. storage conditions of the urine.
  3. pH of the urine.
  4. structural form of the substance.
    A. 1, 2, and 3 are correct.
    B. 1 and 3 are correct.
    C. 4 is correct.
    D. All are correct.
A

D. All are correct.

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3
Q
  1. Which of the following urine characteristics provides
    the best rough indicator of urine concentration and
    body hydration?
    A. Color
    B. Clarity
    C. Foam
    D. Volume
A

A. Color

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4
Q
  1. Which of the following pigments deposits on urate and uric acid crystals to form a precipitate described as “brick dust”?
    A. Bilirubin
    B. Urobilin
    C. Uroerythrin
    D. Urochrome
A

C. Uroerythrin

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5
Q

6.Which of the following criteria should one use to consistently evaluate urine color and clarity?

  1. Mix all specimens well.
  2. Use the same depth or volume of a specimen.
  3. Evaluate the specimens at the same temperature.
  4. View the specimens against a dark background
    with good lighting.
    A. 1, 2, and 3 are correct.
    B. 1 and 3 are correct.
    C. 4 is correct.
    D. All are correct
A

A. 1, 2, and 3 are correct.

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6
Q
  1. Select the urine specimen that does not indicate the
    possible presence of blood or hemoglobin.
    A. Clear, red urine
    B. Cloudy, brown urine
    C. Clear, brown urine
    D. Cloudy, amber urine
A

D. Cloudy, amber urine

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7
Q
  1. A urine that produces a large amount of white foam when
    mixed should be suspected to contain increased amounts of
    A. bilirubin.
    B. protein.
    C. urobilin.
    D. urobilinogen
A

B. protein.

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8
Q
  1. Which of the following substances can change the color of a urine and its foam?
    A. Bilirubin
    B. Hemoglobin
    C. Myoglobin
    D. Urobilin
A

A. Bilirubin

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9
Q
  1. The clarity of a well-mixed urine specimen that has visible particulate matter and through which newsprint can be seen but not read should be described as
    A. cloudy.
    B. flocculated.
    C. slightly cloudy.
    D. turbid.
A

A. cloudy.

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10
Q
  1. Classify each substance that can be present in urine
    as indicating a (1) pathologic or (2) nonpathologic
    condition.
    __ A. Bacteria (fresh urine)
    __ B. Bacteria (old urine)
    __ C. Fat
    __ D. Powder
    __ E. Radiographic contrast media
    __ F. Red blood cells
    __ G. Renal epithelial cells
    __ H. Spermatozoa
    __ I. Squamous epithelial cells
    __ J. Urate crystals
    __ K. White blood cells
A

A.1
B.2
C.1
D.2
E.2
F.1
G.1
H.2
I.2
J.2
k. 1
l.1

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11
Q
  1. Which of the following urine specimens is considered
    normal?
    A. A freshly voided urine that is brown and clear
    B. A freshly voided urine that is yellow and cloudy
    C. A clear yellow urine specimen that changes color upon standing
    D. A clear yellow urine specimen that becomes cloudy upon refrigeration
A

D. A clear yellow urine specimen that becomes cloudy upon refrigeration

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12
Q
  1. A white or beige precipitate in a “normal” alkaline urine
    most likely is caused by
    A. amorphous phosphates.
    B. amorphous urates.
    C. uric acid crystals.
    D. radiographic contrast media.
A

A. amorphous phosphates.

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13
Q
  1. Which of the following specific gravity values is
    physiologically impossible?
    A. 1.000
    B. 1.010
    C. 1.020
    D. 1.030
A

A. 1.000

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14
Q

16.The refractive index of a solution is affected by the

  1. wavelength of light used.
  2. size and number of the solutes present.
  3. concentration of the solution.
  4. temperature of the solution.
    A. 1, 2, and 3 are correct.
    B. 1 and 3 are correct.
    C. 4 is correct.
    D. All are correct
A

D. All are correct

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15
Q

17.Advantages of the refractometry method for specific
gravity measurement include:

  1. It uses a small amount of sample.
  2. It is fast and easy to perform.
  3. It automatically compensates for temperature.
  4. It measures only ionic solutes.
    A. 1, 2, and 3 are correct.
    B. 1 and 3 are correct.
    C. 4 is correct.
    D. All are correct
A

A. 1,2, and 3 are correct

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16
Q
  1. The principle of the reagent strip method for measuring
    specific gravity is based on
    A. the pKa of a polyelectrolyte decreasing in proportion
    to the ionic concentration of the specimen.
    B. the pH of a polyelectrolyte decreasing in proportion
    to the ionic concentration of the specimen.
    C. the pKa of a polyelectrolyte increasing in proportion
    to the ionic concentration of the specimen.
    D. the pH of a polyelectrolyte increasing in proportion
    to the ionic concentration of the specimen.
A

A. the pKa of a polyelectrolyte decreasing in proportion
to the ionic concentration of the specimen.

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17
Q
  1. Ionic specific gravity (SGionic) measurements obtained using reagent strips provide useful clinical information because
    A. all of the urinary solutes present are measured.
    B. the quantity of nonionic solutes in urine relative to ionic solutes is significant.
    C. excretion of nonionic solutes (e.g., urea, glucose, protein) does not reflect renal dysfunction.
    D. the ability of the kidneys to concentrate urine is reflected in the reabsorption and secretion of ionic solutes
A

A. all of the urinary solutes present are measured.

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18
Q
  1. Which of the following solutes is measured when using
    the reagent strip specific gravity method?
    A. Albumin
    B. Glucose
    C. Sodium
    D. Radiographic media
A

C. Sodium

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19
Q
  1. To preserve the integrity of reagent strips, it is necessary that they are
    A. humidified adequately.
    B. stored in a refrigerator.
    C. stored in a tightly capped container.
    D. protected from the dark.
A

C. Stored in a tightly capped container

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20
Q
  1. Which of the following is not a source of erroneous results when reagent strips are used?
    A. Testing a refrigerated urine specimen
    B. Timing using a clock without a second hand
    C. Allowing excess urine to remain on the reagent strip
    D. Dipping the reagent strip briefly into the urine specimen
A

D. Dipping the reagent strip briefly into the urine specimen

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21
Q
  1. Which of the following is not checked by quality control materials?
    A. The technical skills of the personnel performing the test
    B. The integrity of the specimen, that is, that the specimen was collected and stored properly
    C. The test protocol, that is, that the procedure was performed according to written guidelines
    D. The functioning of the equipment used—for exampe
A

B. The integrity of the specimen, that is, that the specimen was collected and stored properly

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22
Q
  1. Quality control materials used to assess the performance of reagent strips and tablet tests must
    A. be purchased from a commercial manufacturer.
    B. yield the same results regardless of the commercial brand used.
    C. contain chemical constituents at realistic and critical detection levels.
    D. include constituents to assess the chemical and microscopic examinations
A

C. contain chemical constituents at realistic and critical
detection levels.

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23
Q

5.Using quality control materials, one should check reagent strip performance

  1. at least once daily.
  2. when a new bottle of strips or tablets is opened.
  3. when a new lot number of strips or tablets is placed into use
  4. once each shift by each laboratorian performing urinalysis testing.
    A. 1, 2, and 3 are correct.
    B. 1 and 3 are correct.
    C. 4 is correct.
    D. All are correct
A

A. 1,2, and 3 are correct

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24
Q
  1. Select the primary reason why tablet (e.g., Ictotest) and
    chemical tests (e.g., sulfosalicylic acid precipitation test)
    generally are performed.
    A. They confirm results suspected about the specimen.
    B. They are alternative testing methods for highly
    concentrated urines.
    C. Their specificity differs from that of the reagent strip
    test.
    D. They are more sensitive to the chemical constituents
    in urine
A

D. They are more sensitive to the chemical constituents
in urine.

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25
Q
  1. Urine pH normally ranges from
    A. 4.0 to 9.0.
    B. 4.5 to 7.0.
    C. 4.5 to 8.0.
    D. 5.0 to 6.0.
A

C. 4.5 to 8.0

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26
Q
  1. Urine pH can be modified by all of the following except
    A. diet.
    B. increased ingestion of water.
    C. ingestion of medications.
    D. urinary tract infections.
A

B. Increased ingestion of water

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27
Q
  1. Commercial reagent strips use which of the following
    reactions to determine urine pH?
    A. Azo coupling or diazotization reaction
    B. Double indicator combinations
    C. Double sequential enzyme reaction
    D. Proton release from a polyelectrolyte
A

B. Double indicator combinations

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28
Q
  1. All of the following can result in inaccurate urine pH measurements except
    A. large amounts of protein present in the urine.
    B. double-dipping of the reagent strip into the specimen.
    C. maintaining the specimen at room temperature for 4hours.
    D. allowing excess urine to remai
A

A. large amounts of protein present in the urine

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29
Q
  1. Normally, daily urine protein excretion does not exceed
    A. 150mg/day.
    B. 500mg/day.
    C. 1.5 g/day.
    D. 2.5 g/day
A

A. 150 mg/day

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30
Q
  1. Which of the following proteins originates in the
    urinary tract?
    A. Albumin
    B. Bence Jones protein
    C. β2-Microglobulin
    D. Uromodulin
A

D. Uromodulin

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31
Q
  1. Which of the following statements about Bence Jones
    protein is correct?
    A. The protein consists of κ and λ light chains.
    B. The protein is often found in the urine of patients
    with multiple sclerosis.
    C. The protein precipitates when urine is heated to
    100°C and redissolves when cooled to 60°C.
    D. The protein can p
A

A. The protein consists of κ and λ light chains.

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32
Q
  1. Which of the following statements best describes the chemical principle of the protein reagent strip test?
    A. The protein reacts with an immunocomplex on the
    pad, which results in a color change.
    B. The protein causes a pH change on the reagent strip pad, which results in a color change.
    C. The protein accepts hydrogen ions from the indicator dye, which results in a color change.
    D. The protein causes protons to be released from a
A

C. The protein accepts hydrogen ions from the indicator dye, which results in a color change

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33
Q
  1. Which of the following aids in the differentiation of
    hemoglobinuria and hematuria?
    A. Urine pH
    B. Urine color
    C. Leukocyte esterase test
    D. Microscopic examination
A

D. Microscopic examination

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34
Q

17.Select the correct statement(s).
1. Myoglobin and hemoglobin are reabsorbed readily by renal tubular cells.
2. Hemosiderin, a soluble storage form of iron, is found in aqueous solutions.
3. When haptoglobin is saturated, free hemoglobin passes through the glomerular filtration barrier.
4. Hemosiderin is found in the urine during a hemolytic episode.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct

A

B. 1 and 3 are correct

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35
Q
  1. Which statement about hemoglobin and myoglobin is true?
    A. They are heme-containing proteins involved in oxygen transport.
    B. Their presence is suspected when urine and serum appear red.
    C. Their presence in serum is associated with high creatine kinase values.
    D. They precipitate out of solution when the urine is 80% saturated with ammonium sulfate
A

A. They are heme-containing proteins involved in oxygen transport

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36
Q
  1. On the reagent strip test for blood, any heme moiety (e.g., hemoglobin, myoglobin) present in urine catalyzes
    A. oxidation of the chromogen and hydrogen peroxide.
    B. reduction of the chromogen in the presence of hydrogen peroxide.
    C. reduction of the pseudoperoxidase while the chromogen undergoes a color change.
    D. oxidation of the chromogen while hydrogen peroxide is reduced.
A

D. oxidation of the chromogen while hydrogen peroxide
is reduced.

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37
Q
  1. Which of the following blood cells will not be detected
    by the leukocyte esterase pad because it lacks esterases?
    A. Eosinophils
    B. Lymphocytes
    C. Monocytes
    D. Neutrophils
A

B. Lymphocytes

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38
Q
  1. Microscopic examination of a urine sediment revealed
    an average of 2 to 5 white blood cells per high-power
    field, whereas the leukocyte esterase test by reagent strip
    was negative. Which of the following statements best
    accounts for this discrepancy?
    A. The urine is contaminated with vaginal fluid.
    B. Many white blood cells are lysed, and their esterase
    has been inactivated.
    C. Ascorbic acid is interfering with the reaction on the
    reagent strip.
    D. The amount of esterase present is below the
    sensitivity of the reagent strip test.
A

D. . The amount of esterase present is below the
sensitivity of the reagent strip test.

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39
Q
  1. Which of the following statements describes the chemical principle involved in the leukocyte esterase
    pad of commercial reagent strips?
    A. Leukocyte esterase reacts with a diazonium salt on the reagent pad to form an azo dye.
    B. An ester and a diazonium salt combine to form an azo dye in the presence of leukocyte esterase.
    C. An aromatic compound on the reagent pad combines with leukocyte esterase to form an azo dye.
    D. Leukocyte esterase hydrolyzes an ester on the reagent pad; then an azo coupling reaction results in the formation of an azo dye.
A

D. Leukocyte esterase hydrolyzes an ester on the reagent pad; then an azo coupling reaction results in the formation of an azo dye.

40
Q

23.Which of the following conditions most likely accounts for a negative nitrite result on the reagent strip despite the presence of large quantities of bacteria?
1. The bacteria present did not have enough time to convert nitrate to nitrite.
2. The bacteria present are not capable of converting nitrate to nitrite.
3. The patient is not ingesting adequate amounts of nitrate in the diet.
4. The urine is dilute and the level of nitrite present is below the sensitivity of the test.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct

A

D. All are correct.

41
Q
  1. The chemical principle of the nitrite reagent pad is based on the
    A. pseudoperoxidase activity of nitrite.
    B. diazotization of nitrite followed by an azo coupling reaction.
    C. azo coupling action of nitrite with a diazonium salt to form an azo dye.
    D. hydrolysis of an ester by nitrite combined with an azo coupling reaction.
A

B. diazotization of nitrite followed by an azo coupling reaction.

42
Q
  1. Which of the following substances or actions can produce false-positive nitrite results?
    A. Ascorbic acid
    B. Vaginal contamination
    C. Strong reducing agents
    D. Improper specimen storage
A

D. Improper specimen storage

43
Q
  1. A urine specimen is tested for glucose by a reagent strip
    and by the Clinitest method. The reagent strip result is
    100mg/dL, and the Clinitest result is 500mg/dL. Which of the following statements would best account for this discrepancy?
    A. The Clinitest tablets have expired or were stored improperly.
    B. A large amount of ascorbic acid is present in the specimen.
    C. A strong oxidizing agent (e.g., bleach) is contaminating the specimen.
    D. The reagent strip is exhibiting the pass-through phenomenon, which results in a falsely low value.
A

B. A large amount of ascorbic acid is present in the
specimen

44
Q
  1. Which of the following substances if present in the urine results in a negative Clinitest?
    A. Fructose
    B. Lactose
    C. Galactose
    D. Sucrose
A

D. Sucrose

45
Q
  1. The glucose reagent strip test is more sensitive and specific for glucose than the Clinitest method because it detects
    A. other reducing substances and higher concentrations of glucose.
    B. no other substances and higher concentrations of glucose.
    C. other reducing substances and lower concentrations of glucose.
    D. no other substances and lower concentrations of glucose
A

D. no other substances and lower concentrations of
glucose

46
Q
  1. Which of the following statements about glucose is false?
    A. Glucose readily passes the glomerular filtration barrier.
    B. Glucose is reabsorbed passively in the proximal tubule.
    C. Glucosuria occurs when plasma glucose levels exceed 160 to 180mg/dL.
    D. High plasma glucose concentrations are associated with damage to the glomerular filtration barrier.
A

B. Glucose is reabsorbed passively in the proximal
tubule.

47
Q
  1. The pass-through phenomenon observed with the Clinitest method when large amounts of glucose are present in the urine is due to
    A. “caramelization” of the sugar present.
    B. reduction of copper sulfate to green-brown cupric complexes.
    C. depletion of the substrate, that is, not enough copper sulfate is present initially.
    D. reoxidation of the cuprous oxide formed to cupric oxide and other cupric complexes
A

D. reoxidation of the cuprous oxide formed to cupric
oxide and other cupric complexes.

48
Q
  1. The glucose specificity of the double sequential enzyme reaction used on reagent strip tests is due to the use of
    A. gluconic acid.
    B. glucose oxidase.
    C. hydrogen peroxide.
    D. peroxidase
A

B. glucose oxidase.

49
Q
  1. Which of the following ketones is not detected by the reagent strip or tablet test?
    A. Acetone
    B. Acetoacetate
    C. Acetone and acetoacetate
    D. β-Hydroxybutyrate
A

D. β-Hydroxybutyrate

50
Q
  1. Which of the following can cause false-positive ketone results?
    A. A large amount of ascorbic acid in urine
    B. Improper storage of the urine specimen
    C. Drugs containing free sulfhydryl groups
    D. A large amount of glucose (glucosuria)
A

C. Drugs containing free sulfhydryl groups

51
Q
  1. Which of the following will not cause ketonemia and ketonuria?
    A. An inability to use carbohydrates
    B. Inadequate intake of carbohydrates
    C. Increased metabolism of carbohydrates
    D. Excessive loss of carbohydrates
A

C. Increased metabolism of carbohydrates

52
Q
  1. The ketone reagent strip and tablet tests are based on the reactivity of ketones with
    A. ferric chloride.
    B. ferric nitrate.
    C. nitroglycerin.
    D. nitroprusside.
A

D. nitroprusside.

53
Q
  1. Which of the following statements about bilirubin is true?
    A. Conjugated bilirubin is water insoluble.
    B. Bilirubin is a degradation product of heme catabolism.
    C. Unconjugated bilirubin readily passes through the glomerular filtration barrier.
    D. The liver conjugates bilirubin with albumin to form conjugated bilirubin.
A

B. Bilirubin is a degradation product of heme catabolism.

54
Q
  1. The bilirubin reagent strip and tablet tests are based on
    A. Ehrlich’s aldehyde reaction.
    B. the oxidation of bilirubin to biliverdin.
    C. the reduction of bilirubin to azobilirubin.
    D. the coupling of bilirubin with a diazonium salt
A

D. the coupling of bilirubin with a diazonium salt

55
Q
  1. Which of the following are characteristic urine findings
    from a patient with hemolytic jaundice?
    A. A positive test for bilirubin and an increased amount of urobilinogen
    B. A positive test for bilirubin and a decreased amount of urobilinogen
    C. A negative test for bilirubin and an increased amount of urobilinogen
    D. A negative test for bilirubin and a decreased amount of urobilinogen
A

C. A negative test for bilirubin and an increased amount of urobilinogen

56
Q
  1. Which of the following results shows characteristic urine findings from a patient with an obstruction of the bile duct?
    A. A positive test for bilirubin and an increased amount of urobilinogen
    B. A positive test for bilirubin and a decreased amount of urobilinogen
    C. A negative test for bilirubin and an increased amount of urobilinogen
    D. A negative test for bilirubin and a decreased amount of urobilinogen
A

B. A positive test for bilirubin and a decreased amount of urobilinogen

57
Q
  1. Which of the following conditions can result in falsepositive bilirubin results?
    A. Elevated concentrations of nitrite
    B. Improper storage of the specimen
    C. Ingestion of ascorbic acid
    D. Ingestion of certain medications
A

D. Ingestion of certain medications

58
Q
  1. Urobilinogen is formed from the
    A. conjugation of bilirubin in the liver.
    B. reduction of conjugated bilirubin in bile.
    C. reduction of bilirubin by intestinal bacteria.
    D. oxidation of urobilin by anaerobic intestinal bacteria
A

C. reduction of bilirubin by intestinal bacteria

59
Q
  1. Which of the following statements about urobilinogen is true?
    A. Urobilinogen is not normally present in urine.
    B. Urobilinogen excretion usually is decreased after a meal.
    C. Urobilinogen excretion is an indicator of renal function.
    D. Urobilinogen is labile and readily photo-oxidizes to urobilin.
A

D. Urobilinogen is labile and readily photo-oxidizes to
urobilin.

60
Q
  1. The classic Ehrlich’s reaction is based on the reaction of
    urobilinogen with
    A. diazotized dichloroaniline.
    B. p-aminobenzoic acid.
    C. p-dichlorobenzene diazonium salt.
    D. p-dimethylaminobenzaldehyde.
A

D. p-dimethylaminobenzaldehyde

61
Q
  1. Which of the available chemical principles is most specific for the detection of urobilinogen?
    A. Ictotest
    B. Ehrlich’s reaction
    C. Azo coupling reaction
    D. Double sequential enzyme reaction
A

C. Azo coupling reaction

62
Q

45.Which of the following reagent strip tests can be affected by ascorbic acid, resulting in falsely low or false negative results?
1. Blood
2. Bilirubin
3. Glucose
4. Nitrite
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

A

D. All are correct

63
Q
  1. Which of the following best describes the mechanism of ascorbic acid interference?
    A. Ascorbic acid inhibits oxidation of the chromogen.
    B. Ascorbic acid inactivates a reactant, promoting color development.
    C. Ascorbic acid removes a reactant from the intended reaction sequence.
    D. Ascorbic acid interacts with the reactants, producing a color that masks the results.
A

C. Ascorbic acid removes a reactant from the intended
reaction sequence.

64
Q
  1. Which of the following are not standardized when commercial systems are used for the processing and microscopic examination of urine sediment?
    A. Microscopic variables, such as the number of focal planes
    B. The concentration and volume of the urine sediment prepared
    C. The volume of the urine sediment dispensed for microscopic viewing
    D. Identification and enumeration of formed elements in the urine sediment
A

D. Identification and enumeration of formed elements in the urine sediment

65
Q

2.When urine sediment is viewed, stains and various microscopic techniques are used to
1. enhance the observation of fine detail.
2. confirm the identity of suspected components.
3. differentiate formed elements that look alike.
4. facilitate the visualization of low-refractile components.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

A

D. All are correct.

66
Q
  1. The microscopic identification of hemosiderin is enhanced when the urine sediment is stained with
    A. Gram stain.
    B. Hansel stain.
    C. Prussian blue stain.
    D. Sudan III stain
A

C. Prussian blue stain

67
Q
  1. When the laboratorian performs the microscopic examination of urine sediment, which of the following are
    enumerated using low-power magnification?
    A. Bacteria
    B. Casts
    C. Red blood cells
    D. Renal tubular cells
A

B. Casts

68
Q
  1. A urine sediment could have which of the following formed elements and still be considered “normal”?
    A. Two or fewer hyaline casts
    B. Five to 10 red blood cells
    C. A few bacteria
    D. A few yeast cells
A

A. Two or fewer hyaline casts

69
Q
  1. Which of the following statements about red blood cells in urine is true?
    A. Red blood cells crenate in hypotonic urine.
    B. Red blood cell remnants are called “ghost cells.”
    C. Alkaline and hypotonic urine promotes red blood cell disintegration.
    D. Dysmorphic red blood cells often are associated with renal tubular disease
A

C. Alkaline and hypotonic urine promotes red blood cell
disintegration.

70
Q
  1. Hemoglobin is a protein and will
    A. does not react in the protein reagent strip test.
    B. interfere with the protein reagent strip test, producing erroneous results.
    C. always contribute to the protein reagent strip result, regardless of the amount of hemoglobin present.
    D. contribute to the protein reagent strip result only when large concentrations of hemoglobin are present.
A

D. contribute to the protein reagent strip result only when large concentrations of hemoglobin are present

71
Q

8.Which urinary sediment component(s) when observed microscopically can resemble red blood cells?
1. Yeasts
2. Air bubbles
3. Oil droplets
4. Calcium oxalate monohydrate crystals
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

A

D. All are correct

72
Q
  1. Which of the following is not a characteristic of neutrophils found in the urine sediment?
    A. They are approximately 10 to 14 μm in diameter.
    B. They form “ghost cells” in hypotonic urine.
    C. They shrink in hypertonic urine but do not crenate.
    D. As they disintegrate, vacuoles and blebs form and their nuclei fuse.
A

B. They form “ghost cells” in hypotonic urine

73
Q
  1. How do increased numbers of leukocytes usually get into the urine?
    A. Through a renal bleed
    B. By passive movement through pores in the vascular epithelium
    C. By active ameboid movement through tissues and epithelium
    D. Through damage to the integrity of the normal vascular barrier
A

C. By active ameboid movement through tissues and
epithelium

74
Q
  1. Which statement regarding lymphocytes found in urine
    sediment is correct?
    A. They are not normally present in the urine.
    B. They produce a positive leukocyte esterase test.
    C. Their number is increased in patients with drug hypersensitivity.
    D. Their number is increased in patients experiencing kidney transplant rejection
A

D. Their number is increased in patients experiencing kidney transplant rejection

75
Q
  1. Which of the following urinary tract structures is not lined with transitional epithelium?
    A. Bladder
    B. Nephrons
    C. Renal pelves
    D. Ureters
A

B. Nephrons

76
Q

14.Which of the following can be observed in the urine sediment as an intact fragment or sheet of cells?
1. Collecting tubular epithelium
2. Distal tubular epithelium
3. Transitional epithelium
4. Proximal tubular epithelium
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

A

B. 1 and 3 are correct.

77
Q
  1. Urinary casts are formed in
    A. the distal and collecting tubules.
    B. the distal tubules and the loops of Henle.
    C. the proximal and distal tubules.
    D. the proximal tubules and the loops of Henle.
A

A. the distal and collecting tubules

78
Q
  1. Urinary casts are formed with a core matrix of
    A. albumin.
    B. Bence Jones protein.
    C. transferrin.
    D. uromodulin
A

D. uromodulin

79
Q
  1. Which of the following does not contribute to the size,shape, or length of a urinary cast?
    A. The concentration of protein in the core matrix of the cast
    B. The configuration of the tubule in which the cast is formed
    C. The diameter of the tubular lumen in which the cast is formed
    D. The duration of time the cast is allowed to form in the tubule
A

A. The concentration of protein in the core matrix of the cast

80
Q
  1. All of the following enhance urinary cast formation except
    A. an alkaline pH.
    B. urinary stasis.
    C. an increase in the solute concentration of the ultrafiltrate.
    D. an increase in the quantity of plasma proteins in the
    ultrafiltrate
A

A. an alkaline pH.

81
Q
  1. When the laboratorian is using brightfield microscopy, a urinary cast that appears homogeneous with well-defined edges, blunt ends, and cracks is most likely a
    A. fatty cast.
    B. granular cast.
    C. hyaline cast.
    D. waxy cast
A

D. waxy cast

82
Q
  1. All of the following can be found incorporated into a cast matrix except
    A. bacteria.
    B. crystals.
    C. transitional epithelial cells.
    D. white blood cells
A

C. transitional epithelial cells.

83
Q
  1. Which of the following urinary casts are diagnostic of glomerular or renal tubular damage?
    A. Bacterial casts
    B. Red blood cell casts
    C. Renal tubular cell casts
    D. White blood cell casts
A

B. Red blood cell casts

84
Q
  1. Which of the following characteristics best differentiates waxy casts from fibers that may contaminate urine sediment?
    A. Waxy casts do not polarize light; fibers do.
    B. Waxy casts are more refractile than fibers.
    C. Waxy casts have rounded ends; fibers do not.
    D. Waxy casts are thicker at their margins; fibers are thicker in the middle.
A

A. Waxy casts do not polarize light; fibers do

85
Q
  1. Which of the following crystals, when found in the urine sediment, most likely indicates an abnormal metabolic condition?
    A. Bilirubin
    B. Sulfonamides
    C. Triple phosphate
    D. Uric acid
A

A. bilirubin

86
Q
  1. Which of the following does not affect the formation of
    urinary crystals within nephrons?
    A. The pH of the ultrafiltrate
    B. The diameter of the tubular lumen
    C. The flow of urine through the tubules
    D. The concentration of solutes in the ultrafiltrate
A

B. The diameter of the tubular lumen

87
Q

27.During the microscopic examination of a urine sediment, cystine crystals are found. The laboratorian should perform which of the following before reporting the presence of these crystals?
1. Perform a confirmatory chemical test
2. Ensure that the urine specimen has an acid pH
3. Assess the number of crystals per high-power field
4. Check the current medications that the patient is taking
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

A

A. 1, 2, and 3 are correct

88
Q
  1. Which of the following statements regarding the microscopic examination of urine sediment is false?
    A. If large numbers of leukocytes are present microscopically, then bacteria are present.
    B. If urinary fat is present microscopically, then the
    chemical test for protein should be positive.
    C. If large numbers of casts are present microscopically, then the chemical test for protein should be
    positive.
    D. If large numbers of red blood cells are present microscopically, then the chemical test for blood should be
    positive.
A

A. If large numbers of leukocytes are present microscopically, then bacteria are present.

89
Q
  1. When using brightfield microscopy, mucus threads can be difficult to differentiate from
    A. cloth fibers.
    B. hyaline casts.
    C. pigmented casts.
    D. waxy casts
A

B. hyaline casts

90
Q
  1. Which of the following is not a distinguishing characteristic of yeast in the urine sediment?
    A. Motility
    B. Budding forms
    C. Hyphae formation
    D. Colorless ovoid forms
A

A. Motility

91
Q
  1. Fat can be found in the urine sediment in all of the following forms except
    A. within casts.
    B. within cells.
    C. as free-floating droplets.
    D. within hemosiderin granules
A

D. within hemosiderin granules

92
Q
  1. Which of the following statements regarding the characteristics of urinary fat is true?
    A. Cholesterol droplets stain with Sudan III stain.
    B. Triglyceride (neutral fat) stains with oil red O stain.
    C. Cholesterol droplets do not form a Maltese cross pattern under polarized light.
    D. Triglycerides (neutral fat) are anisotropic and form a
    Maltese cross pattern under polarized light.
A

B. Triglyceride (neutral fat) stains with oil red O stain.

93
Q
  1. The following are initial results obtained during a routine
    urinalysis. Which results should be investigated further?
    A. Negative protein; 2 to 5 waxy casts
    B. Cloudy brown urine; 2 to 5 red blood cells
    C. Urine pH 7.5; ammonium biurate crystals
    D. Clear, colorless urine; specific gravity 1.010
A

A. Negative protein; 2 to 5 waxy casts

94
Q
  1. The following are initial results obtained during a routine
    urinalysis. Which results should be investigated further?
    A. Negative protein; 0 to 2 hyaline casts
    B. Urine pH 6.0; calcium oxalate crystals
    C. Cloudy yellow urine; specific gravity 1.050
    D. Amber urine with yellow foam; negative bilirubin by
    reagent strip; positive Ictotest
A

C. Cloudy yellow urine; specific gravity 1.050

95
Q
  1. Which of the following when found in the urine sediment from a female patient is not considered a vaginal
    contaminant?
    A. Fat
    B. Clue cells
    C. Spermatozoa
    D. Trichomonad
A

A. Fat

UA (5 decks)

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