MIDTERMS Flashcards
Most glomerular disorders are caused by:
A. Sudden drops in blood pressure
B. Immunologic disorders
C. Exposure to toxic substances
D. Bacterial infections
B. Immunologic disorders
. 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
C. Chronic pyelonephritis
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
B. IgA nephropathy
Antiglomerular basement membrane antibody is seen
with:
A. GPA
B. IgA nephropathy
C. Goodpasture syndrome
D. Diabetic nephropathy
C. Goodpasture syndrome
ANCA is diagnostic for:
A. IgA nephropathy
B. GPA
C. Henoch-Schönlein purpura
D. Goodpasture syndrome
B. GPA
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. IgA nephropathy
The presence of fatty casts is associated with all of the
following except:
A. Nephrotic syndrome
B. FSGS
C. Nephrogenic DI
D. MCD
C. Nephrogenic DI
The highest levels of proteinuria are seen with:
A. Alport syndrome
B. Diabetic nephropathy
C. IgA nephropathy
D. NS
D. NS
Ischemia frequently produces:
A. Acute renal tubular necrosis
B. MCD
C. Renal glycosuria
D. Goodpasture syndrome
A. Acute renal tubular necrosis
A disorder associated with polyuria and low specific
gravity is:
A. Renal glucosuria
B. MCD
C. Nephrogenic DI
D. FSGS
C. Nephrogenic DI
An inherited disorder producing a generalized defect in
tubular reabsorption is:
A. Alport syndrome
B. AIN
C. Fanconi syndrome
D. Renal glycosuria
C. Fanconi syndrome
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
C. Uromodulin-associated kidney disease
The only protein produced by the kidney is:
A. Albumin
B. Uromodulin
C. Uroprotein
D. Globulin
B. Uromodulin
The presence of RTE cells and casts is an indication of:
A. AIN
B. CGN
C. MCD
D. ATN
D. ATN
Differentiation between cystitis and pyelonephritis is
aided by the presence of:
A. WBC casts
B. RBC casts
C. Bacteria
D. Granular casts
A. WBC casts
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
C. AIN
ESRD is characterized by all of the following except:
A. Hypersthenuria
B. Isosthenuria
C. Azotemia
D. Electrolyte imbalance
A. Hypersthenuria
Prerenal acute renal failure could be caused by:
A. Massive hemorrhage
B. ATN
C. AIN
D. Malignant tumors
A. Massive hemorrhage
The most common component of renal calculi is:
A. Calcium oxalate
B. Magnesium ammonium phosphate
C. Cystine
D. Uric acid
A. Calcium oxalate
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
D. Microscopic hematuria
Abnormal urine screening tests categorized as an overflow
disorder include all of the following except:
A. Alkaptonuria
B. Galactosemia
C. Melanuria
D. Cystinuria
C. Melanuria
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. Modifications of the diet
All of the following disorders can be detected by newborn
screening except:
A. Tyrosyluria
B. MSUD
C. Melanuria
D. Galactosemia
C. Melanuria
The best specimen for early newborn screening is a:
A. Timed urine specimen
B. Blood specimen
C. First morning urine specimen
D. Fecal specimen
B. Blood specimen
Which of the following disorders is not associated with
the phenylalanine–tyrosine pathway?
A. MSUD
B. Alkaptonuria
C. Albinism
D. Tyrosinemia
A. MSUD
The least serious form of tyrosylemia is:
A. Immature liver function
B. Type 1
C. Type 2
D. Type 3
A. Immature liver function
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
C. MSUD
An overflow disorder that could produce a false-positive
reaction with the Clinitest procedure is:
A. Cystinuria
B. Alkaptonuria
C. Indicanuria
D. Porphyrinuria
B. Alkaptonuria
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
D. Both A and C
Ketonuria in a newborn is an indication of:
A. MSUD
B. Isovaleric acidemia
C. Methylmalonic acidemia
D. All of the above
D. All of the above
Urine from a newborn with MSUD will have a
significant:
A. Pale color
B. Yellow precipitate
C. Milky appearance
D. Sweet odor
D. Sweet odor
Hartnup disease is a disorder associated with the
metabolism of:
A. Organic acids
B. Tryptophan
C. Cystine
D. Phenylalanine
B. Tryptophan
5-HIAA is a degradation product of:
A. Heme
B. Indole
C. Serotonin
D. Melanin
C. Serotonin
Elevated urinary levels of 5-HIAA are associated with:
A. Carcinoid tumors
B. Hartnup disease
C. Cystinuria
D. Platelet disorders
A. Carcinoid tumors
False-positive levels of 5-HIAA can be caused by a diet
high in:
A. Meat
B. Carbohydrates
C. Starch
D. Bananas
D. Bananas
IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS
IEM
Cystinosis
IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS
Inherited disorder of tubular reabsorption
Cystinuria
IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS
Fanconi syndrome
Cystinosis
IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS
Early renal calculi formation
Cystinuria
IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS
Cystine deposits in the cornea
Cystinosis
Blue diaper syndrome is associated with:
A. Lesch-Nyhan syndrome
B. Phenylketonuria
C. Cystinuria
D. Hartnup disease
D. Hartnup disease
Homocystinuria is caused by failure to metabolize:
A. Lysine
B. Methionine
C. Arginine
D. Cystine
B. Methionine
The Ehrlich reaction will detect only the presence of:
A. Uroporphyrin
B. Porphobilinogen
C. Coproporphyrin
D. Protoporphyrin
B. Porphobilinogen
Acetyl acetone is added to the urine before performing
the Ehrlich test when checking for:
A. Aminolevulinic acid
B. Porphobilinogen
C. Uroporphyrin
D. Coproporphyrin
B. Porphobilinogen
The classic urine color associated with porphyria is:
A. Dark yellow
B. Indigo blue
C. Pink
D. Port wine
D. Port wine
Which of the following specimens can be used for
porphyrin testing?
A. Urine
B. Blood
C. Feces
D. All of the above
D. All of the above
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
D. Aminolevulinic acid and protoporphyrin
Hurler, Hunter, and Sanfilippo syndromes are hereditary
disorders affecting the metabolism of:
A. Porphyrins
B. Purines
C. Mucopolysaccharides
D. Tryptophan
C. Mucopolysaccharides
Many uric acid crystals in a pediatric urine specimen
may indicate:
A. Hurler syndrome
B. Lesch-Nyhan disease
C. Melituria
D. Sanfilippo syndrome
B. Lesch-Nyhan disease
Deficiency of the GALT enzyme will produce a:
A. Positive Clinitest
B. Glycosuria
C. Galactosemia
D. Both A and C
D. Both A and C
identify the metabolic urine disorders with their classic
urine abnormalities
Mousy odor
PKU
identify the metabolic urine disorders with their classic
urine abnormalities
Blue color
Indicanuria
identify the metabolic urine disorders with their classic
urine abnormalities
Sulfur odor
Cystinuria
identify the metabolic urine disorders with their classic
urine abnormalities
Black color
Alkaptonuria
identify the metabolic urine disorders with their classic
urine abnormalities
Orange sand in
diaper
Lesch-Nyhan disease
identify the metabolic urine disorders with their classic
urine abnormalities
Sweaty feet odor
Isovaleric acidemia
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 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
Nuclear detail can be enhanced by:
A. Prussian blue
B. Toluidine blue
C. Acetic acid
D. Both B and C
D. Both B and C
Which of the following lipids is/are stained by Sudan III?
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both B and C
D. Both B and C
Which of the following lipids is/are capable of polarizing
light?
A. Cholesterol
B. Neutral fats
C. Triglycerides
D. Both A and B
A. Cholesterol
The purpose of the Hansel stain is to identify:
A. Neutrophils
B. Renal tubular cells
C. Eosinophils
D. Monocytes
C. Eosinophils
Crenated RBCs are seen in urine that is:
A. Hyposthenuric
B. Hypersthenuric
C. Highly acidic
D. Highly alkaline
B. Hypersthenuric
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
C. Lysis of yeast cells by acetic acid
A finding of dysmorphic RBCs is indicative of:
A. Glomerular bleeding
B. Renal calculi
C. Traumatic injury
D. Coagulation disorders
A. Glomerular bleeding
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
D. Glitter cells
Sometimes mononuclear leukocytes are mistaken for:
A. Yeast cells
B. Squamous epithelial cells
C. Pollen grains
D. Renal tubular cells
D. Renal tubular cells
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
B. Bacteria
Transitional epithelial cells are sloughed from the:
A. Collecting duct
B. Vagina
C. Bladder
D. Proximal convoluted tubule
C. Bladder
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. Squamous epithelial cells
A squamous epithelial cell that is clinically significant
is the:
A. Cuboidal cell
B. Clue cell
C. Caudate cell
D. Columnar cell
B. Clue cell
Forms of transitional epithelial cells include all of the
following except:
A. Spherical
B. Caudate
C. Convoluted
D. Polyhedral
C. Convoluted
Increased transitional cells are indicative of:
A. Catheterization
B. Malignancy
C. Pyelonephritis
D. Both A and B
D. Both A and B
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
D. Eccentrically located nucleus
After an episode of hemoglobinuria, RTE cells may
contain:
A. Bilirubin
B. Hemosiderin granules
C. Porphobilinogen
D. Myoglobin
B. Hemosiderin granules
The predecessor of the oval fat body is the:
A. Histiocyte
B. Urothelial cell
C. Monocyte
D. Renal tubular cell
D. Renal tubular cell
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. Contains cholesterol
The finding of yeast cells in the urine is commonly
associated with:
A. Cystitis
B. Diabetes mellitus
C. Pyelonephritis
D. Liver disorders
B. Diabetes mellitus
The primary component of urinary mucus is:
A. Bence Jones protein
B. Microalbumin
C. Uromodulin
D. Orthostatic protein
C. Uromodulin
The majority of casts are formed in the:
A. Proximal convoluted tubules
B. Ascending loop of Henle
C. Distal convoluted tubules
D. Collecting ducts
C. Distal convoluted tubules
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
D. All types of casts
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
D. WBC casts
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
D. All of the above
WBC casts are associated primarily with:
A. Pyelonephritis
B. Cystitis
C. Glomerulonephritis
D. Viral infections
A. Pyelonephritis
The shape of the RTE cell associated with RTE casts is
primarily:
A. Elongated
B. Cuboidal
C. Round
D. Columnar
C. Round
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
C. Attached to the surface of a matrix
The presence of fatty casts is associated with:
A. Nephrotic syndrome
B. Crush injuries
C. Diabetes mellitus
D. All of the above
D. All of the above
Nonpathogenic granular casts contain:
A. Cellular lysosomes
B. Degenerated cells
C. Protein aggregates
D. Gram-positive cocci
A. Cellular lysosomes
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
C. Require staining to be visualized
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
D. Both A and C
All of the following contribute to urinary crystals
formation except:
A. Protein concentration
B. pH
C. Solute concentration
D. Temperature
A. Protein concentration
The most valuable initial aid for identifying crystals in a
urine specimen is:
A. pH
B. Solubility
C. Staining
D. Polarized microscopy
A. pH
Crystals associated with severe liver disease include all
of the following except:
A. Bilirubin
B. Leucine
C. Cystine
D. Tyrosine
C. Cystine
All of the following crystals routinely polarize except:
A. Uric acid
B. Cholesterol
C. Radiographic dye
D. Cystine
D. Cystine
Casts and fibers usually can be differentiated using:
A. Solubility characteristics
B. Patient history
C. Polarized light
D. Fluorescent light
C. Polarized light
Identify the following crystals seen in acidic urine with
their description/identifying characteristics
Pink sediment
Amorphous urates
Identify the following crystals seen in acidic urine with
their description/identifying characteristics
Ovoid
Calcium oxalate monohydrate
Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:
“Coffin lids”
Triple phosphate
Identify the following crystals seen in acidic urine with
their description/identifying characteristics
Envelopes
Calcium oxalate dihydrate
Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:
White precipitate
Amorphous phosphate
Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:
Thin prisms
Calcium phosphate
Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:
Thorny apple
Ammonium biurate
Identify the following crystals seen in alkaline urine with
their description/identifying characteristics:
Dumbbell shape
Calcium carbonate
Identify the following abnormal crystals with their
description/identifying characteristics:
Hexagonal plates
Cystine
Identify the following abnormal crystals with their
description/identifying characteristics:
Fine needles seen in
liver disease
Tyrosine
Identify the following abnormal crystals with their
description/identifying characteristics:
Notched corners
Cholesterol
Identify the following abnormal crystals with their
description/identifying characteristics:
Concentric circles,
radial striations
Leucine
Identify the following abnormal crystals with their
description/identifying characteristics:
Bundles after
refrigeration
Ampicillin
Identify the following abnormal crystals with their
description/identifying characteristics:
Flat plates, high specific gravity
Radiographic dye
Identify the following abnormal crystals with their
description/identifying characteristics:
Bright yellow clumps
Bilirubin
Identify the following types of microscopy with their
descriptions:
Low-refractive-index objects may be overlooked
Bright-field
Identify the following types of microscopy with their
descriptions:
Forms halo of light around
object
Phase
Identify the following types of microscopy with their
descriptions:
Objects split light into two
beams
Polarized
Identify the following types of microscopy with their
descriptions:
Indirect light is reflected off
the object
Dark-field
Identify the following types of microscopy with their
descriptions:
Detects specific wavelengths of light emitted
from objects
Fluorescent
Identify the following types of microscopy with their
descriptions:
Three-dimensional images
Interference contrast