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AUBF STRASINGER > MIDTERMS > Flashcards

MIDTERMS Flashcards

1
Q

Most glomerular disorders are caused by:
A. Sudden drops in blood pressure
B. Immunologic disorders
C. Exposure to toxic substances
D. Bacterial infections

A

B. Immunologic disorders

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2
Q

. Dysmorphic RBC casts would be a significant finding
with all of the following except:
A. Goodpasture syndrome
B. AGN
C. Chronic pyelonephritis
D. Henoch-Schönlein purpura

A

C. Chronic pyelonephritis

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3
Q

Occasional episodes of macroscopic hematuria over periods of 20 or more years are seen in patients with:
A. Crescentic glomerulonephritis
B. IgA nephropathy
C. Nephrotic syndrome
D. GPA

A

B. IgA nephropathy

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4
Q

Antiglomerular basement membrane antibody is seen
with:
A. GPA
B. IgA nephropathy
C. Goodpasture syndrome
D. Diabetic nephropathy

A

C. Goodpasture syndrome

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5
Q

ANCA is diagnostic for:
A. IgA nephropathy
B. GPA
C. Henoch-Schönlein purpura
D. Goodpasture syndrome

A

B. GPA

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6
Q

Respiratory and renal symptoms are associated with all
of the following except:
A. IgA nephropathy
B. GPA
C. Henoch-Schönlein purpura
D. Goodpasture syndrome

A

A. IgA nephropathy

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7
Q

The presence of fatty casts is associated with all of the
following except:
A. Nephrotic syndrome
B. FSGS
C. Nephrogenic DI
D. MCD

A

C. Nephrogenic DI

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8
Q

The highest levels of proteinuria are seen with:
A. Alport syndrome
B. Diabetic nephropathy
C. IgA nephropathy
D. NS

A

D. NS

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9
Q

Ischemia frequently produces:
A. Acute renal tubular necrosis
B. MCD
C. Renal glycosuria
D. Goodpasture syndrome

A

A. Acute renal tubular necrosis

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10
Q

A disorder associated with polyuria and low specific
gravity is:
A. Renal glucosuria
B. MCD
C. Nephrogenic DI
D. FSGS

A

C. Nephrogenic DI

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11
Q

An inherited disorder producing a generalized defect in
tubular reabsorption is:
A. Alport syndrome
B. AIN
C. Fanconi syndrome
D. Renal glycosuria

A

C. Fanconi syndrome

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12
Q

A teenage boy who develops gout in his big toe and has
a high serum uric acid should be monitored for:
A. Fanconi syndrome
B. Renal calculi
C. Uromodulin-associated kidney disease
D. Chronic interstitial nephritis

A

C. Uromodulin-associated kidney disease

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13
Q

The only protein produced by the kidney is:
A. Albumin
B. Uromodulin
C. Uroprotein
D. Globulin

A

B. Uromodulin

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14
Q

The presence of RTE cells and casts is an indication of:
A. AIN
B. CGN
C. MCD
D. ATN

A

D. ATN

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15
Q

Differentiation between cystitis and pyelonephritis is
aided by the presence of:
A. WBC casts
B. RBC casts
C. Bacteria
D. Granular casts

A

A. WBC casts

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16
Q

The presence of WBCs and WBC casts with no bacteria
is indicative of:
A. Chronic pyelonephritis
B. ATN
C. AIN
D. Both B and C

A

C. AIN

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17
Q

ESRD is characterized by all of the following except:
A. Hypersthenuria
B. Isosthenuria
C. Azotemia
D. Electrolyte imbalance

A

A. Hypersthenuria

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18
Q

Prerenal acute renal failure could be caused by:
A. Massive hemorrhage
B. ATN
C. AIN
D. Malignant tumors

A

A. Massive hemorrhage

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19
Q

The most common component of renal calculi is:
A. Calcium oxalate
B. Magnesium ammonium phosphate
C. Cystine
D. Uric acid

A

A. Calcium oxalate

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20
Q

Urinalysis on a patient with severe back pain being
evaluated for renal calculi would be most beneficial if it
showed:
A. Heavy proteinuria
B. Low specific gravity
C. Uric acid crystals
D. Microscopic hematuria

A

D. Microscopic hematuria

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21
Q

Abnormal urine screening tests categorized as an overflow
disorder include all of the following except:
A. Alkaptonuria
B. Galactosemia
C. Melanuria
D. Cystinuria

A

C. Melanuria

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22
Q

All states require newborn screening for PKU for early:
A. Modifications of the diet
B. Administration of antibiotics
C. Detection of diabetes
D. Initiation of gene therapy

A

A. Modifications of the diet

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23
Q

All of the following disorders can be detected by newborn
screening except:
A. Tyrosyluria
B. MSUD
C. Melanuria
D. Galactosemia

A

C. Melanuria

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24
Q

The best specimen for early newborn screening is a:
A. Timed urine specimen
B. Blood specimen
C. First morning urine specimen
D. Fecal specimen

A

B. Blood specimen

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25
Q

Which of the following disorders is not associated with
the phenylalanine–tyrosine pathway?
A. MSUD
B. Alkaptonuria
C. Albinism
D. Tyrosinemia

A

A. MSUD

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26
Q

The least serious form of tyrosylemia is:
A. Immature liver function
B. Type 1
C. Type 2
D. Type 3

A

A. Immature liver function

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27
Q

An overflow disorder of the phenylalanine–tyrosine
pathway that would produce a positive reaction with the
reagent strip test for ketones is:
A. Alkaptonuria
B. Melanuria
C. MSUD
D. Tyrosyluria

A

C. MSUD

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28
Q

An overflow disorder that could produce a false-positive
reaction with the Clinitest procedure is:
A. Cystinuria
B. Alkaptonuria
C. Indicanuria
D. Porphyrinuria

A

B. Alkaptonuria

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29
Q

A urine that turns black after sitting by the sink for
several hours could be indicative of:
A. Alkaptonuria
B. MSUD
C. Melanuria
D. Both A and C

A

D. Both A and C

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30
Q

Ketonuria in a newborn is an indication of:
A. MSUD
B. Isovaleric acidemia
C. Methylmalonic acidemia
D. All of the above

A

D. All of the above

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31
Q

Urine from a newborn with MSUD will have a
significant:
A. Pale color
B. Yellow precipitate
C. Milky appearance
D. Sweet odor

A

D. Sweet odor

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32
Q

Hartnup disease is a disorder associated with the
metabolism of:
A. Organic acids
B. Tryptophan
C. Cystine
D. Phenylalanine

A

B. Tryptophan

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33
Q

5-HIAA is a degradation product of:
A. Heme
B. Indole
C. Serotonin
D. Melanin

A

C. Serotonin

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34
Q

Elevated urinary levels of 5-HIAA are associated with:
A. Carcinoid tumors
B. Hartnup disease
C. Cystinuria
D. Platelet disorders

A

A. Carcinoid tumors

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35
Q

False-positive levels of 5-HIAA can be caused by a diet
high in:
A. Meat
B. Carbohydrates
C. Starch
D. Bananas

A

D. Bananas

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36
Q

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS

IEM

A

Cystinosis

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37
Q

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS

Inherited disorder of tubular reabsorption

A

Cystinuria

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38
Q

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS

Fanconi syndrome

A

Cystinosis

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39
Q

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS

Early renal calculi formation

A

Cystinuria

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40
Q

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS

Cystine deposits in the cornea

A

Cystinosis

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41
Q

Blue diaper syndrome is associated with:
A. Lesch-Nyhan syndrome
B. Phenylketonuria
C. Cystinuria
D. Hartnup disease

A

D. Hartnup disease

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42
Q

Homocystinuria is caused by failure to metabolize:
A. Lysine
B. Methionine
C. Arginine
D. Cystine

A

B. Methionine

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43
Q

The Ehrlich reaction will detect only the presence of:
A. Uroporphyrin
B. Porphobilinogen
C. Coproporphyrin
D. Protoporphyrin

A

B. Porphobilinogen

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44
Q

Acetyl acetone is added to the urine before performing
the Ehrlich test when checking for:
A. Aminolevulinic acid
B. Porphobilinogen
C. Uroporphyrin
D. Coproporphyrin

A

B. Porphobilinogen

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45
Q

The classic urine color associated with porphyria is:
A. Dark yellow
B. Indigo blue
C. Pink
D. Port wine

A

D. Port wine

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46
Q

Which of the following specimens can be used for
porphyrin testing?
A. Urine
B. Blood
C. Feces
D. All of the above

A

D. All of the above

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47
Q

The two stages of heme formation affected by lead
poisoning are:
A. Porphobilinogen and uroporphyrin
B. Aminolevulinic acid and porphobilinogen
C. Coproporphyrin and protoporphyrin
D. Aminolevulinic acid and protoporphyrin

A

D. Aminolevulinic acid and protoporphyrin

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48
Q

Hurler, Hunter, and Sanfilippo syndromes are hereditary
disorders affecting the metabolism of:
A. Porphyrins
B. Purines
C. Mucopolysaccharides
D. Tryptophan

A

C. Mucopolysaccharides

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49
Q

Many uric acid crystals in a pediatric urine specimen
may indicate:
A. Hurler syndrome
B. Lesch-Nyhan disease
C. Melituria
D. Sanfilippo syndrome

A

B. Lesch-Nyhan disease

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50
Q

Deficiency of the GALT enzyme will produce a:
A. Positive Clinitest
B. Glycosuria
C. Galactosemia
D. Both A and C

A

D. Both A and C

51
Q

identify the metabolic urine disorders with their classic
urine abnormalities

Mousy odor

A

PKU

52
Q

identify the metabolic urine disorders with their classic
urine abnormalities

Blue color

A

Indicanuria

53
Q

identify the metabolic urine disorders with their classic
urine abnormalities

Sulfur odor

A

Cystinuria

54
Q

identify the metabolic urine disorders with their classic
urine abnormalities

Black color

A

Alkaptonuria

55
Q

identify the metabolic urine disorders with their classic
urine abnormalities

Orange sand in
diaper

A

Lesch-Nyhan disease

56
Q

identify the metabolic urine disorders with their classic
urine abnormalities

Sweaty feet odor

A

Isovaleric acidemia

57
Q

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

A

C. Increase cost-effectiveness of urinalysis

58
Q

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

A

D. Identification of formed elements

59
Q

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

A

D. Using midstream clean-catch specimens

60
Q

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

A

C. Diameter of rotor head and RPM

61
Q

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

A. Casts

62
Q

Initial screening of the urine sediment is performed using
an objective power of:
A. 4×
B. 10×
C. 40×
D. 100×

A

B. 10×

63
Q

Which of the following are reported as number per lpf?
A. RBCs
B. WBCs
C. Crystals
D. Casts

A

D. Casts

64
Q

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

A

C. Decrease precipitation of crystals

65
Q

Nuclear detail can be enhanced by:
A. Prussian blue
B. Toluidine blue
C. Acetic acid
D. Both B and C

A

D. Both B and C

66
Q

Which of the following lipids is/are stained by Sudan III?
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both B and C

A

D. Both B and C

67
Q

Which of the following lipids is/are capable of polarizing
light?
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both A and B

A

A. Cholesterol

68
Q

The purpose of the Hansel stain is to identify:
A. Neutrophils
B. Renal tubular cells
C. Eosinophils
D. Monocytes

A

C. Eosinophils

69
Q

Crenated RBCs are seen in urine that is:
A. Hyposthenuric
B. Hypersthenuric
C. Highly acidic
D. Highly alkaline

A

B. Hypersthenuric

70
Q

Differentiation among RBCs, yeast, and oil droplets may
be accomplished by all of the following except:
A. Observation of budding in yeast cells
B. Increased refractility of oil droplets
C. Lysis of yeast cells by acetic acid
D. Lysis of RBCs by acetic acid

A

C. Lysis of yeast cells by acetic acid

71
Q

A finding of dysmorphic RBCs is indicative of:
A. Glomerular bleeding
B. Renal calculi
C. Traumatic injury
D. Coagulation disorders

A

A. Glomerular bleeding

72
Q

Leukocytes that stain pale blue with Sternheimer-Malbin
stain and exhibit brownian movement are:
A. Indicative of pyelonephritis
B. Basophils
C. Mononuclear leukocytes
D. Glitter cells

A

D. Glitter cells

73
Q

Sometimes mononuclear leukocytes are mistaken for:
A. Yeast cells
B. Squamous epithelial cells
C. Pollen grains
D. Renal tubular cells

A

D. Renal tubular cells

74
Q

When pyuria is detected in a urine sediment, the slide
should be checked carefully for the presence of:
A. RBCs
B. Bacteria
C. Hyaline casts
D. Mucus

A

B. Bacteria

75
Q

Transitional epithelial cells are sloughed from the:
A. Collecting duct
B. Vagina
C. Bladder
D. Proximal convoluted tubule

A

C. Bladder

76
Q

The largest cells in the urine sediment are:
A. Squamous epithelial cells
B. Urothelial epithelial cells
C. Cuboidal epithelial cells
D. Columnar epithelial cells

A

A. Squamous epithelial cells

77
Q

A squamous epithelial cell that is clinically significant
is the:
A. Cuboidal cell
B. Clue cell
C. Caudate cell
D. Columnar cell

A

B. Clue cell

78
Q

Forms of transitional epithelial cells include all of the
following except:
A. Spherical
B. Caudate
C. Convoluted
D. Polyhedral

A

C. Convoluted

79
Q

Increased transitional cells are indicative of:
A. Catheterization
B. Malignancy
C. Pyelonephritis
D. Both A and B

A

D. Both A and B

80
Q

A primary characteristic used to identify renal tubular
epithelial cells is:
A. Elongated structure
B. Centrally located nucleus
C. Spherical appearance
D. Eccentrically located nucleus

A

D. Eccentrically located nucleus

81
Q

After an episode of hemoglobinuria, RTE cells may
contain:
A. Bilirubin
B. Hemosiderin granules
C. Porphobilinogen
D. Myoglobin

A

B. Hemosiderin granules

82
Q

The predecessor of the oval fat body is the:
A. Histiocyte
B. Urothelial cell
C. Monocyte
D. Renal tubular cell

A

D. Renal tubular cell

83
Q

A structure believed to be an oval fat body produced a
Maltese cross formation under polarized light but does
not stain with Sudan III. The structure:
A. Contains cholesterol
B. Is not an oval fat body
C. Contains neutral fats
D. Is contaminated with immersion oil

A

A. Contains cholesterol

84
Q

The finding of yeast cells in the urine is commonly
associated with:
A. Cystitis
B. Diabetes mellitus
C. Pyelonephritis
D. Liver disorders

A

B. Diabetes mellitus

85
Q

The primary component of urinary mucus is:
A. Bence Jones protein
B. Microalbumin
C. Uromodulin
D. Orthostatic protein

A

C. Uromodulin

86
Q

The majority of casts are formed in the:
A. Proximal convoluted tubules
B. Ascending loop of Henle
C. Distal convoluted tubules
D. Collecting ducts

A

C. Distal convoluted tubules

87
Q

Cylindruria refers to the presence of:
A. Cylindrical renal tubular cells
B. Mucus-resembling casts
C. Hyaline and waxy casts
D. All types of casts

A

D. All types of casts

88
Q

A person submitting a urine specimen after a strenuous
exercise routine normally can have all of the following in
the sediment except:
A. Hyaline casts
B. Granular casts
C. RBC casts
D. WBC casts

A

D. WBC casts

89
Q

Before identifying an RBC cast, all of the following
should be observed:
A. Free-floating RBCs
B. Intact RBCs in the cast matrix
C. A positive reagent strip blood reaction
D. All of the above

A

D. All of the above

90
Q

WBC casts are associated primarily with:
A. Pyelonephritis
B. Cystitis
C. Glomerulonephritis
D. Viral infections

A

A. Pyelonephritis

91
Q

The shape of the RTE cell associated with RTE casts is
primarily:
A. Elongated
B. Cuboidal
C. Round
D. Columnar

A

C. Round

92
Q

When observing RTE casts, the cells are primarily:
A. Embedded in a clear matrix
B. Embedded in a granular matrix
C. Attached to the surface of a matrix
D. Stained by components of the urine filtrate

A

C. Attached to the surface of a matrix

93
Q

The presence of fatty casts is associated with:
A. Nephrotic syndrome
B. Crush injuries
C. Diabetes mellitus
D. All of the above

A

D. All of the above

94
Q

Nonpathogenic granular casts contain:
A. Cellular lysosomes
B. Degenerated cells
C. Protein aggregates
D. Gram-positive cocci

A

A. Cellular lysosomes

95
Q

All of the following are true about waxy casts except they:
A. Represent extreme urine stasis
B. May have a brittle consistency
C. Require staining to be visualized
D. Contain degenerated granules

A

C. Require staining to be visualized

96
Q

Observation of broad casts represents:
A. Destruction of tubular walls
B. Dehydration and high fever
C. Formation in the collecting ducts
D. Both A and C

A

D. Both A and C

97
Q

All of the following contribute to urinary crystals
formation except:
A. Protein concentration
B. pH
C. Solute concentration
D. Temperature

A

A. Protein concentration

98
Q

The most valuable initial aid for identifying crystals in a
urine specimen is:
A. pH
B. Solubility
C. Staining
D. Polarized microscopy

A

A. pH

99
Q

Crystals associated with severe liver disease include all
of the following except:
A. Bilirubin
B. Leucine
C. Cystine
D. Tyrosine

A

C. Cystine

100
Q

All of the following crystals routinely polarize except:
A. Uric acid
B. Cholesterol
C. Radiographic dye
D. Cystine

A

D. Cystine

101
Q

Casts and fibers usually can be differentiated using:
A. Solubility characteristics
B. Patient history
C. Polarized light
D. Fluorescent light

A

C. Polarized light

102
Q

Identify the following crystals seen in acidic urine with
their description/identifying characteristics

Pink sediment

A

Amorphous urates

103
Q

Identify the following crystals seen in acidic urine with
their description/identifying characteristics

Ovoid

A

Calcium oxalate monohydrate

104
Q

Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:

“Coffin lids”

A

Triple phosphate

105
Q

Identify the following crystals seen in acidic urine with
their description/identifying characteristics

Envelopes

A

Calcium oxalate dihydrate

106
Q
A
107
Q

Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:

White precipitate

A

Amorphous phosphate

108
Q

Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:

Thin prisms

A

Calcium phosphate

109
Q

Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:

Thorny apple

A

Ammonium biurate

110
Q

Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:

Dumbbell shape

A

Calcium carbonate

111
Q

Identify the following abnormal crystals with their
description/identifying characteristics:

Hexagonal plates

A

Cystine

112
Q

Identify the following abnormal crystals with their
description/identifying characteristics:

Fine needles seen in
liver disease

A

Tyrosine

113
Q

Identify the following abnormal crystals with their
description/identifying characteristics:

Notched corners

A

Cholesterol

114
Q

Identify the following abnormal crystals with their
description/identifying characteristics:

Concentric circles,
radial striations

A

Leucine

115
Q

Identify the following abnormal crystals with their
description/identifying characteristics:

Bundles after
refrigeration

A

Ampicillin

116
Q

Identify the following abnormal crystals with their
description/identifying characteristics:

Flat plates, high specific gravity

A

Radiographic dye

117
Q

Identify the following abnormal crystals with their
description/identifying characteristics:

Bright yellow clumps

A

Bilirubin

118
Q

Identify the following types of microscopy with their
descriptions:

Low-refractive-index objects may be overlooked

A

Bright-field

119
Q

Identify the following types of microscopy with their
descriptions:

Forms halo of light around
object

A

Phase

120
Q

Identify the following types of microscopy with their
descriptions:

Objects split light into two
beams

A

Polarized

121
Q

Identify the following types of microscopy with their
descriptions:

Indirect light is reflected off
the object

A

Dark-field

122
Q

Identify the following types of microscopy with their
descriptions:

Detects specific wavelengths of light emitted
from objects

A

Fluorescent

123
Q

Identify the following types of microscopy with their
descriptions:

Three-dimensional images

A

Interference contrast

AUBF STRASINGER (5 decks)

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