Urina 2.1

Question 1

Urochrome is a lipid-soluble pigment that
1. is excreted in urine, imparting the characteristic amber color.
2. may be deposited in subcutaneous fat tissue in renal failure.
3. darkens on exposure to light.
1 and 2
1 and 3
• 2 and 3
• 1, 2, and 3

Answer 1

1, 2, and 3

Question 2

Urine color is derived from which of the following?
Urobilin
) Urochrome
Uroerythrin
All of the above

Answer 2

All of the above

Question 3

Which factor contributes to urine color?
Added preservative
• Urine pH
• Collection method
Patient’s age

Answer 3

Urine pH

Question 4

Urine color may be indicative of which of the following?
1. Body hydration
2. Urine concentration
3. Pathologic disease
1 and 2
1 and 3
2 and 3
1, 2, and 3

Answer 4

1, 2, and 3

Question 5

A reddish-brown urine specimen is received in the laboratory. The technologist most likely will expect which reagent strip results?
Acidic pH, positive blood
Neutral pH, negative blood
• Alkaline pH, positive blood
Acidic pH, negative blood

Answer 5

• Alkaline pH, positive blood

Question 6

A fresh brown urine may indicate the presence of
urobilinogen.
bilirubin.
myoglobin.
melanin.

Answer 6

myoglobin.

Question 7

Oxidation of bilirubin to biliverdin in urine results in which of the following urine colors?
Blue
Green
Dark amber
Orange

Answer 7

Green

Question 8

The technologist receives a urine specimen from the OB floor and notes an orange-brown color.
She suspects
oxidation of urobilinogen.
degradation of RBCs.
• breakdown of bilirubin.
• contamination with amniotic fluid.

Answer 8

oxidation of urobilinogen.

Question 9

Oxidation of porphobilinogen to porphobilin causes the urine to take on a
greenish hue.
blue color.
pink color.•
brownish hue.

Answer 9

pink color.

Question 10

Upon dipping the chemical reagent strip into orange urine, the technologist notes that the entire reagent strip is orange. He suspects the presence of
metronidazole.
homogentisic acid.
amitriptyline.
• phenazopyridine.

Answer 10

phenazopyridine.

Question 11

While processing a urine specimen, the technologist notes yellow foam that does not dissipate upon standing. He suspects the presence of
bilirubin.
• protein and bilirubin.
•urochrome and protein.
biliverdin and urochrome.

Answer 11

• protein and bilirubin.

Question 12

While processing a urine specimen, the technologist notes yellow foam that does not dissipate upon standing. This requires the technologist to
report the presence of yellow foam.
perform confirmatory testing.
not report findings because they are normal.
make a notation that the presence of foam and color are not relevant.

Answer 12

perform confirmatory testing.

Question 13

Which urine color is not the result of drug metabolites?
Red
Blue-green
Brown
Red-purple

Answer 13

Red-purple

Question 14

Clarity in a freshly voided urine specimen from a healthy individual is
clear.
hazy.
slightly cloudy.
All are correct.

Answer 14

All are correct.

Question 15

The technologist pulls a urine specimen out of the refrigerator and notes a pink precipitate. She knows that she has a urine with a(n)
) alkaline pH and brick dust.
alkaline pH and uroerythin on uric acid crystals.
neutral pH and uric acid crystals.
acidic pH and amorphous urates.

Answer 15

acidic pH and amorphous urates.

Question 16

Clarity of urine provides a rapid quality check for which of the following?
Presence of protein
• Microscopic examination
Amorphous crystal precipitation
Time between collection and testing

Answer 16

Microscopic examination

Question 17

The presence of which substance is considered iatrogenic?
Fecal matter
Squamous epithelial cells
Radiographic dye
Sperm and prostate fluid

Answer 17

Radiographic dye

Question 18

All of the following can result in a turbid urine except
RBCS.
medication.
dehydration.
urochrome.

Answer 18

urochrome.

Question 19

Which substance found in urine is considered pathologic?
Spermatozoa
• Yeast
Powder
Squamous epithelial cells

Answer 19

• Yeast

Question 20

The urine of a patient who had been on a medical fast for the past several weeks may smell
sweet and fruity.
pungent and fetid.
ammonia-like.
I faintly aromatic.

Answer 20

sweet and fruity.

Question 21

Calibration of a refractometer requires the use of
1. distilled water.
2. sodium chloride solution.
3. bicarbonate buffer.
1 and 2
1 and 3
2 and 3
1, 2, and 3

Answer 21

1 and 2

Question 22

All of the following are true about the refractive index as a measure of specific gravity except
it is a measurement of the mass of solutes per volume of solution.
it is a ratio of light refraction in two different media.
it is a comparison of the velocity of light passing through air into solution.
it is an indirect measure based on the refractive index of light.

Answer 22

it is a measurement of the mass of solutes per volume of solution.

Question 23

The refractive index of a solution is affected by all of the following except
concentration of the solution.
temperature of the solution.
• light scattering by particles in the solution.
wavelength of light used

Answer 23

light scattering by particles in the solution.

Question 24

Reagent strip SG indirectly estimates urine density on the basis of
colligative properties.
charged solutes.
nonionic particles.
large-molecular-weight molecules.

Answer 24

charged solutes.

Question 25

The colligative properties of a sample depend on the
number of solute particles.
particle size.
ionic charge.
temperature of the sample.

Answer 25

number of solute particles.

Question 26

Measures of freezing point depression can be used to calculate all of the following except
depression of the vapor pressure.
osmolality.
elevation of the osmotic pressure. elevation of the boiling point.

Answer 26

osmolality.

Question 27

Isosthenuria is a term used to describe
•
a fixed specific gravity of 1.010.
the balance of ionic and nonionic particles in urine.
temperature plateaus in freezing point osmometry.
a dilute, clear urine.

Answer 27

a fixed specific gravity of 1.010

Question 28

The technologist is busy trying to cover several departments, because she is the lone technologist on the third shift. She receives several routine urinalysis specimens, STAT blood work for chemistry and hematology, and a STAT cross-match; in addition, the emergency department is hopping. How will the technologist prioritize her workload?
Put the urine specimens in the refrigerator for later analysis.
• Evaluate the color and clarity of the specimens and then refrigerate.
Leave the specimens at room temperature until later.
Call for recollection of specimens after things settle down.

Answer 28

Evaluate the color and clarity of the specimens and then refrigerate.

Question 29

Several urine specimens come into the laboratory around lunchtime. The technologist checks the times on the specimens and notes that she can go to lunch and get back in time to perform the UA without having to refrigerate the specimens.Upon her return, she finds that one of the specimens is now black.
The pH test result is 8.0, so the technologist
checks the specimen for myoglobin. orders a test for homogentisic acid.
checks the patient’s medications.
calls the floor for a new specimen.

Answer 29

orders a test for homogentisic acid.

Question 30

Which of the following drug-color pairings is incorrect?
Levodopa-red then brown, alkaline
Methyldopa-red to brown
Nitrofurantoin-orange-red
) Rifampin-bright orange-red

Answer 30

Nitrofurantoin-orange-red

Question 31

Which of the following statements regarding uroerythin is true?
1. Pink urine pigment
2. Indicates presence of RBCs in urine
3. Produces precipitate described as brick dust
4. Most evident when deposited on hippurate crystals
1,4
1, 2
1, 3
3,4

Answer 31

1,3

Question 32

Which of the following is incorrectly paired with urine pigment color?
* Consumption of high carotene foods-amber
Crush injury-brown
Pseudomonas infection-blue-green
Alkaptonuria-brown to black on standing

Answer 32

Consumption of high carotene foods-amber

Question 33

Which of the following urine substances and color of urine foam is correct?
* Myglogin-brown foam
Hemoglobin-pink foam
Urochrome-pale yellow foam
None is correct

Answer 33

None is correct

Question 34

Which of the following descriptions would identify a urine specimen as being cloudy?
Newsprint cannot be seen when viewed through urine tube.
Visible particles present; newsprint can be read when view through urine tube.
* Significant particulate matter; newsprint blurred when viewed through urine tube.
Flocculation present; newsprint hazy but can be read through urine tube.

Answer 34

• Significant particulate matter; newsprint blurred when viewed through urine tube.

Question 35

A patient has a urine glucose of 2 g/dL. Specific gravity by refractometry reads 1.035 and is reported out as
1.029.
1.031.
1.033.
1.035.

Answer 35

1.031.

Question 36

The integrity of reagent strips is best assessed by
a. using automated instrumentation.
b. running control materials.
c. keeping the lid tightly closed on the bottle.
d. checking for a color change on the pads.

Answer 36

running control materials.

Question 37

While performing UAs, the technologist ran controls and began testing the specimens. He ran out of reagent strips and needed one more to complete the run. He opened a new bottle and
a. continued testing on the remaining specimens.
b. ran controls on the new bottle and then continued the run.
c. aborted the run and started all over with the first specimen.
d. checked for discoloration before continuing the run.

Answer 37

ran controls on the new bottle and then continued the run.

Question 38

Interlaboratory testing provides additional quality control checks on all of the following except
a. QC material.
b. laboratorian skill.
c. chemical analysis.
d. microscopic analysis.

Answer 38

QC material.

Question 39

All of the following are improper uses of the reagent strip, which will produce erroneous results, except
a. inadequate removal of excess urine from the strip.
b. blotting the edge of the reagent strip after dipping it in the urine.
c. prolonged dipping of the strip in urine.
d. reading the results after all test pads have reached full development.

Answer 39

blotting the edge of the reagent strip after dipping it in the urine.

Question 40

The technologist dips a reagent strip into a urine specimen and then reads it manually, following the manufacturer’s specifications. After performing the microscopic examination, he notes that the dipstick color on the edge of the reaction pad for ketones is darker than when he had first read it. The technologist
Select one:
a. reports the original result and discards the strip and other disposable items.
b. changes the original result of negative to 2+ and verifies the report.
c. takes a new reagent strip and retests the specimen.
d. asks another technologist to look at the strip for verification.

Answer 40

reports the original result and discards the strip and other disposable items.

Question 41

The technologist is logging urine color and clarity for four specimens he had running on the Clinitek. He notes an abnormal orange color for specimen #3. All test pads for specimen #3 are positive. Upon microscopic examination, the technologist reports a negative result for all cellular and crystal elements. Specimens #1 and #4 test negative for all constituents, and no microscopic examinations are performed. Specimen #2 tests positive for nitrites and leukocytes only; that microscopic examination reveals WBCs and bacteria. The next course of action the technologist should take is
a. finalize all reports and results and send them to the appropriate departments.
b. rerun all specimens, using reagent strips with a new lot number.
c. manually retest specimen #3.
d. spin down specimen #3 and rerun it on the Clinitek.

Answer 41

manually retest specimen #3.

Question 42

End-stage renal failure has which of the following characteristics?

1. Isosthenuria
2. Nocturia
3. Fixed specific gravity (SG) of 1.010
   Select one:
   a. 1 and 2
   b. 1 and 3
   c. 2 and 3
   d. 1, 2, and 3

Answer 42

1, 2, and 3

Question 43

The reagent strip test pad for specific gravity produces a color change by measuring the
a. release of protons by ionic solutes, resulting in a decreased pH.
b. ratio of ionic and nonionic solutes, resulting in polar bonds.
c. number of solute molecules in relation to solvent.
d. binding of protons by ionic solutes in solution.

Answer 43

release of protons by ionic solutes, resulting in a decreased pH.

Question 44

The kidneys play a major role in acid-base balance by
Select one:
a. adjusting the pH of the blood as it flows through the glomerulus.
b. reabsorbing buffers from the ultrafiltrate.
c. selectively excreting acid or alkali.
d. filtering out excess hydrogen and hydroxyl ions.

Answer 44

selectively excreting acid or alkali.

Question 45

Upon review of the urinalysis printout, the technologist notes a urine pH of 9.0 on one specimen. The other test results were negative, except for nitrites, which tested positive. The next step is
Select one:
a. double-check the time of collection, transport, and storage.
b. review the other results and, if normal, finalize the report.
c. use pH test paper to confirm the pH result.
d. rerun the reagent strip to confirm all results.

Answer 45

double-check the time of collection, transport, and storage.

Question 46

A 75-year-old man has excruciating flank pain on the left side. The doctor suspects a kidney stone. UA findings of blood and calcium oxalate crystals, along with a CT scan, confirm the diagnosis. The physician treats the patient and advises him to
Select one:
a. drink cranberry juice.
b. eat a vegetarian diet.
c. include more protein at each meal.
d. increase his carbohydrate intake.

Answer 46

eat a vegetarian diet.

Question 47

A 16-year-old boy is brought to the ED unconscious and unresponsive. His blood alcohol level is 3 times the normal limit. His friends report that the last time they saw him conscious was 8 hours ago, around 5 AM. Later that morning, they saw him on the floor in the family room, but they thought he was just sleeping and left him alone. In the afternoon, unable to rouse him, they called 911. The patient is catheterized, and the urine color is brown. The physician is concerned that the urine contains
Select one:
a. hemoglobin.
b. RBCs.
c. myoglobin.
d. porphyrin.

Answer 47

myoglobin

Question 48

The UA results for the patient in question 12 are positive for blood, but no RBCs are seen on the microscopic examination. The next step is to perform a(n)
Select one:
a. Prussian blue staining test.
b. immunoassay and/or high-performance chromatography.
c. Watson-Schwartz test.
d. hemolyticdifferentiation test.

Answer 48

immunoassay and/or high-performance chromatography.

Question 49

In light of the answers to questions 12 and 13, which of the following is the most likely cause of this patient’s condition?
a. Hemolytic episode
b. Hemosiderin excretion
c. Nontraumatic rhabdomyolysis
d. Kidney disease

Answer 49

Nontraumatic rhabdomyolysis

Question 50

The reagent pad for blood detection is impregnated with
Select one:
a. methyl red and bromothymol blue.
b. tetramethylbenzidine and peroxide.
c. ester and diazonium salt.
d. copper sulfate and tetramethylbenzidine and peroxide.

Answer 50

tetramethylbenzidine and peroxide.

Question 51

Whenever the reagent pad shows a negative result for blood and the microscopic examination reveals RBCs, the technologist should suspect the presence of
Select one:
a. ascorbic acid.
b. peroxide.
c. hemosiderin.
d. porphyrin.

Answer 51

ascorbic acid.

Question 52

A 23-year-old female patient comes in for a urinalysis on a midstream clean catch specimen. The results are as follows:
a. The results are accurate and do not indicate a urinary tract infection.
b. The results are inaccurate and indicate improper collection of the midstream clean catch specimen.
c. The results are accurate and indicate that the patient is being treated with an alkaline medication.
d. The results are inaccurate, because a discrepancy exists between the chemical and microscopic results.

Answer 52

The results are inaccurate, because a discrepancy exists between the chemical and microscopic results.

Question 53

The technologist performs a microscopic examination on urine sediment from a 35-year-old female. The findings for this specimen are
Select one:
a. the specimen was not well mixed, resulting in a negative LE result.
b. vaginal contamination of the specimen masked the LE result.
c. an insufficient amount of leukocyte esterase was produced.
d. the specific gravity was too high, causing a false-negative LE result.

Answer 53

an insufficient amount of leukocyte esterase was produced.

Question 54

The technologist notes the discrepancy between the chemical examination findings for LE and blood (i.e., negative) and the microscopic examination findings (i.e., presence of WBCs and RBCs). Which of the following may explain the discrepancy?
UA results on a 28-year-old female are as follows:
a. Specific gravity, glucose, and protein
b. Glucose and protein
c. Specific gravity
d. Protein

Answer 54

Specific gravity

Question 55

The first morning UA results on a 60-year-old male suspected of having a bladder infection are
Which of the following is likely to be questionable?
Select one:
a. Nitrite and leukocyte esterase
b. Specific gravity and blood
c. Specific gravity, nitrite, and leukocyte esterase
d. Specific gravity, nitrite, leukocyte esterase, and blood

Answer 55

Specific gravity, nitrite, leukocyte esterase, and blood

Question 56

Postural (orthostatic) proteinuria requires
Select one:
a. a random urine specimen.
b. a timed urine specimen.
c. a first morning urine specimen.
d. two urine specimens.

Answer 56

two urine specimens.

Question 57

Fanconi’s syndrome is a proximal tubular dysfunction that produces which of the following urine findings?
Select one:
a. Aminoaciduria
b. Proteinuria and glycosuria
c. Phosphaturia, proteinuria, and glycosuria
d. Aminoaciduria, proteinuria, phosphaturia, and glycosuria

Answer 57

Aminoaciduria, proteinuria, phosphaturia, and glycosuria

Question 58

Protein error of indicators in the protein reagent test pad may result in false-positive readings
Select one:
a. in highly buffered or alkaline urine (≥9.0).
b. in the presence of proteins other than albumin.
c. if the patient is taking phenazopyridine.
d. if an alkaline pH is adjusted down to 5.0.

Answer 58

in highly buffered or alkaline urine (≥9.0).

Question 59

The UA of a 70-year-old male who takes an alkaline medication reveals 3+ protein on the reagent test strip and a pH of 9.0. The technologist should
Select one:
a. perform the sulfosalicylic acid test and report out both results.
b. adjust the urine pH to 5.0 and retest using a reagent strip.
c. note on the report that the protein result is falsely elevated because of the high pH.
d. report the protein result, because protein error of indicators adjusts for a high pH.

Answer 59

adjust the urine pH to 5.0 and retest using a reagent strip.

Question 60

The reagent strip for protein can detect which protein(s)?

a. Myoglobin
b. Hemoglobin
c. Albumin
d. All of the above

Answer 60

Albumin

Question 61

Diabetic patients must routinely have their urine checked to monitor their renal status. For this purpose, the technologist performs which test?
Select one:
a. 24-hour urine protein test
b. Reagent strip for protein test
c. Microalbumin reagent strip test
d. Sulfosalicylic acid test for protein

Answer 61

Microalbumin reagent strip test

Question 62

An 80-year-old female with diabetes presents to the ED with heart failure. You might expect to see which of the following conditions confirmed by blood glucose and UA testing?
Select one:
a. Hyperglycemia and no glucosuria
b. Normal blood glucose and normal glucosuria
c. Normal blood glucose and hypoglucosuria
d. Hypoglycemia and glucosuria

Answer 62

Hyperglycemia and no glucosuria

Question 63

The technologist receives the following results on a urine specimen from a 1-month-old patient. What additional testing, if any, is required?
a. Ictotest
b. Clinitest
c. SSA test
d. No additional testing is needed.

Answer 63

Clinitest

Question 64

The technologist performs a UA and a copper reduction test on a 19-month-old child. The reagent strip shows a positive result for glucose; the copper reduction test also produces a positive result. Which of the following is most likely present in the urine?
Select one:
a. Galactose
b. Glucose
c. Lactose
d. Homogentisic acid

Answer 64

Glucose

Question 65

The technologist records these results on a UA and Clinitest: glucose 4+ on reagent strip and negative for Clinitest. The most likely explanation is
Select one:
a. the patient has no other reducing substances.
b. the patient is taking high doses of ascorbic acid.
c. the renal threshold level has been reached for glucose.
d. the Clinitest result indicates that the pass-through effect has occurred.

Answer 65

the Clinitest result indicates that the pass-through effect has occurred.

Question 66

Mr. Smith, a regular client at the laboratory, comes in for a UA. The technologist comments that she hasn’t seen Mr. Smith in quite a while. He tells her that he has been at the University Hospital, undergoing chemotherapy for cancer. He says that he has had a rough time and has lost a lot of weight, but he feels much better thanks to a new medication, MESNA. His appetite is back, and he has been eating regularly. When she tests Mr. Smith’s urine, the technologist notes that the ketone pad immediately turns purple. Results from the Clinitek show 4+ ketones. She suspects a false-positive result caused by
Select one:
a. weight loss
b. cancer
c. free sulfhydryl groups
d. an improper read time

Answer 66

free sulfhydryl groups.

Question 67

Which condition produces a negative urine bilirubin result but also an increased urobilinogen result?
Select one:
a. Transfusion reaction
b. Hepatitis
c. Common bile duct tumor
d. Liver tumor

Answer 67

Transfusion reaction

Question 68

The technologist performs an admission UA on a urine specimen that is beer brown in color and that was obtained from a homeless 25-year-old male hospitalized with hepatitis. The results are:
The technologist had not expected to see a negative bilirubin result based on the physical examination results. Based on the chemical UA results, the most likely explanation is

Answer 68

the bilirubin result is a false negative caused by the presence of nitrite.

Question 69

A quantitative assessment of the urobilinogen level is performed on which type of urine specimen?
a. 24-hour collection, because of diurnal variation
b. 2-hour collection obtained between 2 and 4 PM
c. 12-hour collection that started at 7 AM
d. Random specimen, because excretion is constant

Answer 69

2-hour collection obtained between 2 and 4 PM

Question 70

The following UA results were obtained on a specimen from a sexually active 20-year-old college student who was admitted to the hospital with anxiety, abdominal pain, muscle pain, tingling, numbness, weakness, excessive sweating, and slight disorientation.
The patient reported the onset of symptoms over the past few days and stated that she had not really eaten much of anything for a couple of days. She also reported that her urine had turned red. The next course of action would be to perform which test?
Select one:
a. Watson-Schwartz test
b. Microalbumin test
c. Homogentisic acid test
d. Sulfosalicylic acid test

Answer 70

Watson-Schwartz test

Question 71

All of the following statements about urine specimen volume are true except
A. The recommended volume for urinalysis is 12 mL for accurate results.
B. A pediatric volume of 6 mL requires doubling of sediment examination results.
C. Urine volumes less than 3 mL must be rejected as QNS (quantity not sufficient).
D. Variations in volume require notation in the specimen report.

Answer 71

urine volumes less than 3 mL must be rejected as QNS (quantity not sufficient).

Question 72

Which urine specimen should be rejected?
A. 1 mL specimen from a newborn
B. 4 mL specimen from an adult with a renal condition
C. 12 mL specimen with a small amount of fecal matter
D. 20 mL specimen from a catheterization bag

Answer 72

12-mL specimen with a small amount of fecal matter

Question 73

Centrifugation requirements for urine sediment preparation are
A. 300 g for 15 minutes
B. 350 g for 10 minutes
C. 400 g for 3 minutes
D. 450 g for 5 minutes

Answer 73

450 g for 5 minutes.

Question 74

The stain most commonly used to enhance visualization of urine sediment is
A. Hansel stain
B. Sudan III
C. Prussian blue
D. Sternheimer-Malbin

Answer 74

Sternheimer-Malbin.

Question 75

The microscopy technique that provides more detailed visualization of translucent or low-refractile components and living cells is
A. Polarizing microscopy
B. Brightfield microscopy
C. Phase-contrast microscopy
D. Interference contrast microscopy

Answer 75

phase-contrast microscopy.

Question 76

In a hypotonic urine, RBCs have what type of appearance?
A. Crenated
B. Ghost cell
C. Acanthocyte
D. Biconcave

Answer 76

Ghost cell

Question 77

The technologist evaluates the following urinalysis results and notes a discrepancy between the reagent test and the microscopic examination for blood:
A. High specific gravity
B. Strong oxidizing agents
C. Ascorbic acid
D. Microbial peroxidases

Answer 77

ascorbic acid.

Question 78

The technologist is having a difficult time identifying cellular elements that look like RBCs but for which the reagent test pad was negative, as was the test for ascorbic acid. The technologist decides to add a drop of Sternheimer-Malbin stain, which will differentiate

1. calcium oxalate crystals from yeast.
2. yeast from RBCs.
3. RBCs from calcium oxalate crystals.

A. Calcium oxalate crystals from yeast
B. Yeast from RBCs
C. RBCs from calcium oxalate crystals
D. A and B
E. B and C

Answer 78

2 and 3

Question 79

The laboratory receives a random urine specimen obtained from a 17-year-old female teenager, who needs the UA as part of her sports physical examination. The test results are
A. Glomerulonephritis
B. Urinary tract infection
C. Menstrual contamination
D. Allergic drug reaction

Answer 79

Menstrual contamination

Question 80

A 32-year-old woman presents to the ED with fever, oliguria, hematuria, and a rash. She reports that she has a sinus infection and is currently taking penicillin. The physician suspects that the patient has acute interstitial nephritis (AIN); she therefore orders which tests to be performed on the patient’s urine specimen?
A. Eosinophil count using Hansel stain
B. Total WBC count using acetic acid
C. Lymphocyte count using Giemsa stain
D. RBC count on 10 random fields

Answer 80

Eosinophil count using Hansel stain

Question 81

A 45-year-old patient who received a kidney transplant 2 months ago presents to the ED with a temperature of 100 °F, chills, aches, headache, dizziness, oliguria, and a weight gain of 6 pounds since yesterday. The technologist notes that the predominant WBC in the microscopic examination is
A. Eosinophils
B. Neutrophils
C. Glitter cells
D. Lymphocytes

Answer 81

lymphocytes

Question 82

A technologist performing a microscopic examination on a urine sediment is trying to determine whether he is looking at a large white cell or a renal tubular cell. He reports two to four renal tubular cells based on which criterion?
A. The cell is spherical.
B. The cell has refractile inclusions.
C. The cell is polygonal with one flat edge.
D. The cell has a flagstone appearance.

Answer 82

The cell is polygonal with one flat edge.

Question 83

Cells found in urine sediment that contain highly refractile droplets are
A. Glitter cells
B. Ghost cells
C. Oval fat bodies
D. Clue cells

Answer 83

oval fat bodies.

Question 84

The presence of which type of cell indicates vaginal contamination in a random urine specimen or an improperly collected midstream clean catch urine specimen?
A. Clue cell
B. Glitter cell
C. Columnar cell
D. Squamous cell

Answer 84

Squamous cell

Question 85

An 80-year-old woman is admitted to the hospital with disorientation, a temperature of 102 °F, cough, congestion, and a preliminary diagnosis of pneumonia. She is catheterized, and a urine specimen is sent down for UA. The technologist notes sheets of transitional epithelial cells in the urine sediment. The presence of these cells is most likely due to
A. An iatrogenic process
B. Transitional cell carcinoma
C. Renal tubular disease
D. Normal desquamation

Answer 85

an iatrogenic process.

Question 86

Healthy individuals may have which of the following in their urine, as a normal finding, after strenuous exercise?
A. WBC and RBC casts
B. Hyaline and finely granular casts
C. RBC and waxy casts
D. Nonpathologic pseudocasts

Answer 86

Hyaline and finely granular casts

Question 87

Which type of cast indicates significant urinary stasis and a poor prognosis?
A. Broad, waxy casts
B. Coarsely granular casts
C. Hyaline casts
D. Bilirubin casts

Answer 87

Broad, waxy casts

Question 88

A finding of increased numbers of casts and/or the presence of abnormal casts must be accompanied by a finding of
A. Leukocyturia
B. Hematuria
C. Proteinuria
D. A and B
E. A, B, and C

Answer 88

proteinuria

Question 89

A 45-year-old woman is seen in the clinic for her annual physical examination. Her general health is good, she is taking no medications, and she notes no physical complaints other than that her weight is creeping up and she has little time for exercise. A new technologist, fresh out of college, performs the UA. She then asks another technologist to double-check her results, because the chemical analysis does not correlate with the microscopic examination. A repeat UA confirms the chemical analysis results. A repeat microscopic examination is performed as well
No casts were reported on the repeat microscopic examination, so the original report of 20 to 30 hyaline casts most likely was due to
A. Misidentified mucous threads
B. Strenuous physical exercise
C. Urinary tubular stasis
D. Collecting duct fragments

Answer 89

misidentified mucous threads.

Question 90

A 50-year-old woman is admitted to the hospital. She states that she has not been feeling well for the past week and that she started running a fever several days ago. Examination and testing reveal bacterial endocarditis and renal insufficiency. The UA results are
Based on these results, what is the most likely renal diagnosis secondary to bacterial endocarditis?
A. Glomerulonephritis
B. Urinary tract infection
C. Renal tubular disease
D. Pyelonephritis

Answer 90

Glomerulonephritis

Question 91

As the technologist is scanning for casts, she notes several hyaline-looking casts with a few yellowish cells that appear to be embedded in the matrix. She also notes several muddy brown casts. After closer inspection, the technologist reports out which of the following?
A. Bilirubin cast
B. Renal epithelial cast
C. RBC cast
D. WBC cast

Answer 91

RBC cast

Question 92

A 45-year-old man with polycystic disease is admitted to the hospital. The technologist scans for casts and notes very large, colorless, hyaline-like casts that appear to have sharp, well-defined edges, some lateral fissures, and uneven ends. She checks the UA chemical analysis
A. Cotton fibers
B. Broad, waxy casts
C. Mucous threads
D. Degenerate casts

Answer 92

broad, waxy casts.

Question 93

A 36-year-old female presents to the ED with shaking, chills, fever, and nausea, as well as abdominal, flank, and low and mid-back pain. A CAT scan and UA are ordered, along with other blood work. The CAT scan shows numerous kidney stones in the renal pelvis. The UA results reveal pathologic
The patient is most likely suffering from which of the following?

1. Kidney stone
2. Urinary tract infection
3. Pyelonephritis
4. Renal failure
5. Glomerulonephritis

A. Only 1 is correct
B. 3 is correct
C. 1, 3 and 5 are correct
D. 1, 2 and 5 are correct
E. 1, 4 and 5 are correct

Answer 93

3 is correct

Question 94

A urine crystal that is not considered clinically significant is
A. Cystine
B. Cholesterol
C. Tyrosine
D. Leucine

Answer 94

cholesterol

Question 95

Which type of crystal is found in acetic urine?
A. Calcium oxalate
B. Amorphous phosphates
C. Triple phosphates
D. Ammonium biurate

Answer 95

Calcium oxalate

Question 96

Iatrogenic crystals include which of the following?
A. Tyrosine
B. Leucine
C. Cystine
D. Sulfonamides
E. A, B, and C

Answer 96

Sulfonamides

Question 97

The presence of ammonium biurate crystals in a fresh urine specimen must be investigated to determine whether

1. the patient has a metabolic condition arising from a genetic defect.
2. the urine was improperly stored before delivery to the laboratory.
3. the crystals are the result of iatrogenically induced alkalinization.

A. The patient has a metabolic condition arising from a genetic defect.
B. The urine was improperly stored before delivery to the laboratory.
C. The crystals are the result of iatrogenically induced alkalinization.
D. A and B
E. B and C

Answer 97

2 and 3

Question 98

The technologist reports the following results on a routine UA for an 89-year-old female being given her annual physical examination
The patient collected a CCMS specimen on-site at 2 PM, and the urine was tested at 3 PM. The results indicate which of the following?
A. Urinary tract infection with possible kidney involvement
B. Improper collection of the midstream clean catch specimen
C. Improper storage of the specimen between the time of collection and testing
D. False-negative reagent strip results because of overhydration of the patient

Answer 98

Improper collection of the midstream clean catch specimen

Question 99

While performing the microscopic examination of the urine of a 20-year-old college student, the technologist notes flagellar movement on several large cells with undulating membranes. She reports
A. Enterobius vermicularis
B. Schistosoma haematobium
C. Trichomonas vaginalis
D. Torulopsis glabrata

Answer 99

Trichomonas vaginalis.

Question 100

While examining a microscopic sediment specimen, the technologist sees one to three squamous epithelial cells that appear soft and finely granular with shaggy edges. He reports
A. Amorphous urates
B. 1 to 3 epithelial cells
C. Clue cells
D. Bacterial vaginosis

Answer 100

clue cells.