Urinanalysis & Body Fluids Flashcards
Urinanalysis #2
While performing an analysis of a baby’s urine, the laboratorian notices the specimen has a “mousy” odor. Of the following substances that may be excreted in urine, the one that most characteristically produces this odor is:
* Phenylpyruvic acid
* Acetone
* Coliform bacilli
* Porphyrin
Phenylpyruvic acid
Urinanalysis #8
A bright orange urine from a 24-year-old patient with cystitis likely contains:
* Bilirubin
* Pyridium
* Rifampin
* Ammonia
Pyridium
Urinanalysis #17
A urine sample has a high specific gravity by refractometry, but normal value when measured by reagent test strip. An increased presence of which of the following might explain the discrepancy between these measurements?
* Protein
* Sodium
* Hydrogen
* Ketones
Protein
Urinanalysis #27
Refractive index is a comparison of light:
* velocity in solutions to light velocity in solids
* velocity in air to light velocity in solutions
* scattering by air to light scattering by solutions
* scattering in particles by in solutions
Velocity in air to light velocity in solutions
Urinanalysis #30
A random urine sample from a patient with diabetes insipidus is most likely to appear:
* Pale yellow
* Yellow
* Dark yellow
* Dark brown
Pale yellow
Urinanalysis #35
Which of the following urine results is most likely to be affected by prolonged light exposure?
* pH
* Protein
* Ketones
* Bilirubin
Bilirubin
Urinanalysis #39
Which of the following confirmatory tests has historically been used to semi-quantitatively determine the presence of urinary ketones?
* SSA
* Ictotest
* Acetest
* Clinitest
Acetest
Acetest tablets have historically been used to semi-quantitatively confirm the presence of ketones, including acetoacetate and acetone, in serum, urine, and other body fluids.
Urinanalysis #48
Which of the following reagents is embedded on the reagent test strip pad for ketones?
* P-arsanilic acid
* Acetoacetic acid
* Ehrlich reagent
* Sodium nitroprusside
Sodium nitroprusside
The reagent test strip pad for ketones is embedded with sodium nitroprusside and a buffer. If present, acetoacetic acid will react with the sodium nitroprusside in an alkaline medium to produce a purple color.
Urinanalysis #53
When employing the urine reagent test strip method for protein, a false-positive result may occur in the presence of:
* Large amounts of glucose
* X-ray contrast media
* Bence Jones proteins
* A highly alkaline urine
A highly alkaline urine
Urinanalysis #54
Which of the following substances would most likely be found in the urine of a patient with anorexia nervosa?
* Protein
* Ketones
* Glucose
* Bilirubin
Ketones
Ketones are the byproducts of lipid metabolism. Patients that cannot metabolize carbohydrates effectively or do not have an adequate intake of carbohydrates, as may occur with anorexia nervosa, will metabolize available lipids as an energy source instead.
Urinanalysis #62
Which of the following tablet tests has historically been used to rule out a false-positive bilirubin result achieved bby reagent test strip?
* Acetest
* Clinitest
* Ictotest
* Guaiac test
Ictotest
Urinanalysis #71
The occult blood pad of a reagent test strip yields an orange background with several green spots. This indicates the specimen likely contains:
* Myoglobin
* Intact RBCs
* Hemoglobin
* Ascorbic acid
Intact RBCs
Urinanalysis #73
A patient seen at an urgent care facility for lower back pain and a fever has the urinanalysis results shown in this table:
Test — Result
* Color — dark yellow
* Clarity — cloudy
* Glucose — negative
* Bilirubin — negative
* Ketones — negative
* Specific Gravity — 1.010
* Blood — small
* pH —- 6.0
* Protein — 30 mg/dL
* Urobilinogen — 0.2 mg/dL
* Nitrite — negative
* Leukocyte Esterase — moderate
Microscopic examination shows the presence of 15-20 RBC/HPF, 30-40 WBC/HPF, 3+ bacteria, and 2-3 renal tubular epithelial cells/HPF. The discrepancy between the “negative” result for nitrite on the reagent test strip and the presence of bacteria on the microscopy may be best explained by:
* failure to mix the specimen before centrifuging
* failure to test the sample within 1 hour of collection
* presence of an oxidizing detergent in the specimen container
* the presence of a non-nitrate-reducing organism
The presence of a non-nitrate-reducing organism
Urinanalysis #79
Reagent test strip pads for ketones primarily measure:
* Acetone
* Cholesterol
* Acetoacetic acid
* Beta-hydroxybutyric acid
Acetoacetic acid
Urinanalysis #84
Glitter cells are a microscopic finding of:
* Red blood cells in hypertonic solution
* Red blood cells in hypotonic solution
* White blood cells in hypertonic solution
* White blood cells in hypotonic solution
White blood cells in a hypotonic solution
*When present in an alkaline or hypotonic urine (low specific gravity), white blood cells will absorb water causing them to swell. Granules inside the swollen cells exhibit brownian movement, which gives the appearance that the cell is glittering and so these cells are referred to as “glitter cells”.
Urinanalysis #89
Which of the following elements is most likely to be seen in a urine sediment as a result of catheterization?
* Hyaline casts
* Oval fat bodies
* Transitional epithelial cells
* Renal tubular epithelial cells
Transitional epithellial cells
Transitional epithelial, or urothelial, cells line the renal pelvis, calyces, ureters, bladder, and proximal portion of the male urethra. These can be dislodged from the walls of the bladder as a result of catherization and appear in the urine sediment singly, in pairs, or in clumps.
Urinanalysis #93
Examination for casts should be performed;
* After adding glacial acetic acid to the sediment
* Under high dry power (40x obj.) with bright light
* After adding Sternheimer-Malbin stain to the supernatant
* Using subdued lighting and low power (10x obj.) magnification
Using subdued lighting and low power (10x obj.) magnification
Urinanalysis #97
Which of the following aids in differentiating a spherical transitional cell from a round renal tubular cell?
* Round renal tubular cells are larger
* Spherical transitional cells are larger
* Renal tubular cell nuclei are eccentric
* Spherical transitional cell nuclei are eccentric
Renal tubular cell nuclei are eccentric
Transitional epithelial (urothelial) cells are 20-30 µm and appear in several forms, including spherical, polyhedral, and caudate, but all forms have centrally-located nuclei. Renal epithelial cells vary in size (14-60 µm) and shape (columnar, round, oval, cuboidal) depending on where they originate in the renal tubules, but all typically have eccentric nuclei.
Urinanalysis #100
Hyaline casts found in the urine of a football player admitted to the hospital following a concussion are most likely the result of:
* Dehydration and urinary stasis
* Trauma to the blood-brain barrier
* Significant trauma to the kidneys
* Excessive ingestion of electrolytes
Dehydration and urinary stasis
The formation of hyaline casts is common following strenuous exercise, periods of dehydration, and situations in which decreased urinary flow occurs.
Urinanalysis #107
A white precipitate in a refridgerated urine specimen with pH of 7.5 would most likely be:
* Uric acid crystals
* Amorphous urates
* Amorphous phosphates
* Triple phosphate crystals
Amorphous phosphates
Urinanalysis #108
Which of the following is an abnormal crystal described as a hexagonal plate?
* Cystine
* Tyrosine
* Leucine
* Cholesterol
Cystine
Urinanalysis #112
Which of the following crystals may be found in acidic urine?
* Ammonium biurate
* Calcium phosphate
* Calcium oxalate
* Triple phosphate
Calcium oxalate
Calcium oxalate crystals are most commonly found in acidic or neutral urines. Ammonium biurate, calcium phosphate, and triple phosphate are seen in alkaline urines.
