UA Exam 2

Question 1

Reference range of creatinine.

Answer 1

0.6 – 1.2 mg/dL

Question 2

Reference range of BUN.

Answer 2

11 – 23 mg/dL.

Question 3

Reference range of serum osmolality.

Answer 3

275 – 300 mOsm.

Question 4

Reference range of renal glucose.

Answer 4

70 – 105 mg/dL.

Question 5

Which two test pads do we typically see positive in Diabetes Mellitus?

Answer 5

Glucose and ketones.

Question 6

History: A 25-year-old pregnant women comes to the ED with symptoms of lower back pain, urinary frequency, and a burning sensation when voiding. Her pregnancy has been normal up to this point. She is given a sterile container and asked to collect a mid-stream clean catch urine specimen. Routine urinalysis are as follows.

Which of the following structures seen microscopically do the most significant chemical results of this patient’s diagnosis correlate?

Answer 6

WBC casts? Bacteria?

Question 7

Which of the following is useful in the identification of early renal disease?

Answer 7

Microalbumin.

Question 8

Which of the following renal function tests is most effected by muscle mass?

Answer 8

Creatinine Clearance.

Question 9

Which conditions would likely cause an increase in ammonia levels?

Answer 9

Severe liver disease, Reye’s syndrome, hyperammonemia.

Question 10

What are the testing methods for microalbumin?

Answer 10

immunodip, micral test, multistix pro, and clinitek microalbumin.

Question 11

The p-aminohippuric acid (PAH) test is used to measure which of the following?

Answer 11

Renal plasma flow.

Question 12

Which of the following conditions promotes the formation of renal calculi?

Answer 12

Supersaturation of chemical salts, optimal pH, urinary stasis, nucleation/initial crystal formation.

Question 13

Indicate in what patient population is Type II Diabetes Mellitus most often seen.

Answer 13

Obese people >40 y/o.

Question 14

With is the most probable diagnosis for the patient?

Answer 14

Acute interstitial nephritis?

Question 15

What is the notable color of a urine that contains porphobilinogens?

Answer 15

Port-wine color.

Question 16

A urine that turns black after sitting on the counter for several hours could be indicative of which of the following? NOTE: nothing has been added to the urine.

Answer 16

Alkapronuria.

Question 17

Which of the following quantitative microalbumin results is associated with advanced kidney disease?

Answer 17

> 300 mg/L.

Question 18

What conditions are associated with diabetes insipidus?

Answer 18

Neurogenic or nephrogenic defects, water not reabsorbed by tubules, very low specific gravity, increased water consumption.

Question 19

What principle is the basis of the Clinitek 100 urine chemistry reader?

Answer 19

Photometry? Reflectance?

Question 20

Match the enzyme with the type of galactosuria it causes: Type I (GALT)

Answer 20

Galactose-1-phosphate uridylyltransferase.

Question 21

Match the enzyme with the type of galactosuria it causes: Type II (GALK).

Answer 21

Galactose Kinase.

Question 22

Match the enzyme with the type of galactosuria it causes: Type III (GALE).

Answer 22

Uridine diphosphate galactose-4-epimerase.

Question 23

Identify the two methodologies used for an automated microscopic analysis in urine.

Answer 23

Flowcell digital imaging and flow cytometry.

Question 24

In which of the following conditions will the presence of both tyrosine and leucine crystals be seen?

Answer 24

Type II Tyrosinemia.

Question 25

Which of the following analytes is seen elevated in someone who has azotemia?

Answer 25

Urea.

Question 26

Which of the following disorders is characterized by the inability to reabsorb cystine and causes cystine crystals to be formed?

Answer 26

Cystinuria? Ocular cystinosis?

Question 27

Select all of the following factors involved in calculating the estimated glomerular filtration rate (eGFR).

Answer 27

Hydrostatic pressure, oncotic pressure, capsular hydrostatic pressure (3 pressures indicate the net filtration pressure), surface area and permeability.

Question 28

Calculate the creatinine clearance for a patient of average size from the following data:

Answer 28

80 mL/min.

Question 29

All of the following are considered types of Cystinosis?

Answer 29

Types of Cystinosis: 3R-nephropathic cystinosis, intermediate cystinosis, and ocular cystinosis.

Question 30

Which of the following low molecular weight proteins can be tested for to determine tubular damage?

Answer 30

Albumin?

Question 31

Using the same case from question 3, which element(s) of the chemical exam is/are most significant in suggesting the source for the patient’s symptoms?

Answer 31

Nitrite and leukocyte esterase.

Question 32

Which of the following best describes the calculation of the glomerular filtration rate?

Answer 32

Takes net filtration rate, surface area, and permeability into account.

Question 33

All of the following are testing methods for microalbumin?

Answer 33

Testing methods: immunodip, micral test, multistix pro, and clinitek microalbumin.

Question 34

A rare autosomal recessive diseases that causes homogentisic acid to be excreted in the urine causes the urine to:

Answer 34

Alkaptonuria; have a very strong odor? Dark color?

Question 35

Which of the following best describes the normal reference interval for a GFR?

Answer 35

> 60.

Question 36

When determining the glomerular filtration rate which of the following determine the net filtration pressure?

Answer 36

Hydrostatic pressure, onconic pressure, and capsular hydrostatic pressure.

Question 37

Which of the following best describes why creatinine is a better substance than urea to use for a renal clearance testing?

Answer 37

It does not get reabsorbed from the tubules and is not affected by urine flow rate.

Question 38

After controlled fluid intake, the urine to serum osmolarity ratio should be at least:

Answer 38

3:1.

Question 39

Using the cause study from question 3, what on the microscopic examination helps to distinguish this diagnosis from other similar diseases?

Answer 39

Nitrite and WBC casts?

Question 40

In which of the following condition will the presence of both tyrosine and leucine crystals be seen?

Answer 40

Type II Tyrosinemia.