Urinalysis and Body Fluids

Which of the following is the principle of the reagent strip test from pH? A. A double indicator reaction B. The protein error of indicators C. the diazo reaction D. A dye-binding reaction

A. A double indicator reaction

In an unpreserved urine specimen left at room temperature overnight, which of the following have increased? A. Bacteria and nitrite B. Specific gravity and bilirubin C. Glucose and ketones D. Urobilinogen and protein

A. Bacteria and nitrite

Urinary casts are formed in: A. Distal tubules and collecting ducts B. Distal tubules and loops of Henle C. Proximal and distal tubules D. Proximal tubules and loops of Henle

A. Distal tubules and collecting ducts

A falsely low result for urobilinogen may occur if the urine specimen is: A. Exposed to light B. Adjusted to a neutral pH C. Cooled to room temperature D. Collected in a nonsterile container

A. Exposed to light

Which of the following diseases is not related to tyrosine production or metabolism? A. Galactosuria B. Melanuria C. Phenylketonuria D. Alkaptonuria

A. Galactosuria

Pilocarpine iontophoresis refers to the specific process of: A. Inducing sweat B. Separating proteins in CSF C. Measuring ions in sweat D. Measuring pilocarpine in CSF

A. Inducing sweat

When a reagent strip is positive for bilirubin, it can be assumed that the bilirubin: A. Is conjugated B. Has passed through the small intestine C. Is attached to protein D. Is unconjugated

A. Is conjugated

A 62-year-old with hyperlipoproteinemia has a large amount of protein in his urine. Microscopic analysis yields moderate too many fatty, waxy, granular, and cellular casts. Many oval fat bodies are also noted. This is most consistent with: A. Nephrotic syndrome B. Viral infection C. Acute pyelonephritis D. Acute glomerulonephritis

A. Nephrotic syndrome

A patient with uncontrolled diabetes mellitus will most likely have: A. Pale urine with a high specific gravity B. Concentrated urine with a high specific gravity C. Pale urine with a low specific gravity D. Dark urine with a high specific gravity

A. Pale urine with a high specific gravity

What is true about Bence Jones proteins? A. The protein consists of kappa and lambda light chains. B. The protein is often found in the urine of patients with multiple sclerosis. C. The protein precipitates when urine is heated to 100°C and redissolves when cooled to 60°C. D. The protein can produce a positive reagent strip protein test.

A. The protein consists of kappa and lambda light chains.

Which of the following is not one of the four main functions of the kidney? A. To rid the body of excess protein B. To rid the body of waste products of metabolism C. To rid the body of foreign substance D. To maintain acid-base equilibrium

A. To rid the body of excess protein

Which of the following solutes are present in the largest molar amounts in urine? A. Urea, chloride, and sodium B. Urea, creatinine, and sodium C. Creatinine, uric acid, and ammonium d. Urea, uric acid, and ammonium

A. Urea, chloride, and sodium

Microscopic analysis of a urine specimen yields a moderate amount of red blood cells in spite of a negative result for occult blood using a reagent strip. The laboratorian should determine if this patient has taken: A. Vitamin C B. A diuretic C. High blood pressure medication D. Antibiotics

A. Vitamin C

A 2-year-old girl had a positive urine ketone. This would most likely be caused by: A. Vomiting B. Anemia C. Hypoglycemia D. Biliary tract obstruction

A. Vomiting

A white blood differential on a CSF of an adult showed a majority of neutrophils. What would this be suggestive of? A. bacterial meningitis B. viral meningitis C. fungal meningitis D. tubercular meningitis

A. bacterial meningitis

Increased CSF lactate is found in: A. bacterial meningitis B. Reye encephalopathy C. spina bifida D. multiple sclerosis

A. bacterial meningitis

Which of the following tests evaluate glomerular filtration? A. creatinine and inulin clearance B. urine and serum protein C. pH D. urine and serum osmolarity

A. creatinine and inulin clearance

A buildup of fluid in a body cavity is called a(an): A. effusion B. transudate C. exudate D. metastasis

A. effusion

Which of the following casts is most likely to be found in healthy individuals? A. hyaline B. red blood cell C. waxy D. white blood cell

A. hyaline

The presence of with of the following may result in a CSF specimen with an oily appearance? A. radiographic contrast media B. neutral triglycerides C. >500 WBC/uL D. 30 mg/dL total protein

A. radiographic contrast media

A clue cell a form of: A. squamous epithelial cell B. urothelial cell C. white blood cell D. renal tubular epithelial cell

A. squamous epithelial cell

Polarized light can often be used to differentiate between: A. uric acid crystals and cystine crystals B. hyaline and waxy casts C. squamous and transitional epithelial cells D. red and white blood cells

A. uric acid crystals and cystine crystals

A turbid CSF is most commonly caused by an increase in: A. white blood cells B. protein C. glucose D. bacterial organisms

A. white blood cells

In a patient with chronic renal disease, in whom the kidneys can no longer adjust urine concentration, the urine specific gravity would be: A. 1.000 B. 1.010 C. 1.020 D. 1.030

B. 1.010

The specific gravity of the glomerular filtrate is __________. A. 1.000 B. 1.010 C. 1.025 D. 1.040

B. 1.010

A CSF was hazy and the WBC was too high to perform undiluted. The technologist took 50 ul of sample and added 500 ul of saline. The cell count on the diluted sample was 200 WBC per ul. This result should be multiplied by: A. 10 B. 11 C. 1/10 D. 1/11

B. 11

In which of the following diseases will urine turn dark brown to black upon standing? A. Phenylketonuria B. Alkaptonuria C. Maple syrup disease D. Aminoaciduria

B. Alkaptonuria

A patient's urinalysis revealed a positive bilirubin and a decreased urobilinogen level. These results are associated with: A. Hemolytic disease B. Biliary obstruction C. Hepatic disease D. Urinary tract infection

B. Biliary obstruction

The preferred method of urine preservation in the laboratory is: A. Refrigeration B. Boric acid C. Sodium fluoride D. Chlorhexidine

B. Boric acid

In renal tubular acidosis, the pH of the urine is: A. Consistently acid B. Consistently alkaline C. Neutral D. Variable, no consistentcy

B. Consistently alkaline

What is the primary cause of acute interstitial nephritis? A. Infection B. Drug induced hypersensitivity reaction C. Birth defect D. Autoimmune disorder

B. Drug induced hypersensitivity reaction

The pH of a urine specimen is measured by the: A. Free sodium ions B. Free hydrogen ions C. Total acid excretion D. Volatile acids

B. Free hydrogen ions

Only 1 mL of CSF was collected. Which test should be performed first? A. manual cell count B. Gram stain and culture C. glucose D. total protein

B. Gram stain and culture

Most UTIs are caused by: A. yeast B. Gram-negative rods C. Gram-positive rods D. Gram-positive cocci

B. Gram-negative rods

False positives results can occur for fecal occult blood due to the ingestion of: A. Ascorbic acid B. Horseradish C. Acetaminophen D. Blueberries

B. Horseradish

Nephrotic syndrome is usually associated with all of the following findings, except: A. Proteinuria B. Hyperalbuminemia C. Edema D. Lipidemia

B. Hyperalbuminemia

Greater than 50% of the disease of the glomerulus are of _____________ origin. A. Infectious B. Immune C. Toxic D. Necrotic

B. Immune

A deficiency of arginine vasopressin (antidiuretic hormone) is associated with a: A. Urine specific gravity around 1.031 B. Low urine specific gravity C. High urine specific gravity D. Variable urine specific gravity

B. Low urine specific gravity

Which of the following specimens usually eliminates contamination of the urine with entities from the external genitalia and the distal urethra? A. First morning specimen B. Midstream "clean catch" specimen C. Random specimen D. 4-hour timed collection

B. Midstream "clean catch" specimen

Oval fat bodies can often be seen in what disease? A. Chronic glomerulonephritis B. Nephrotic syndrome C. Acute tubular nephrosis D. Renal failure of any cause

B. Nephrotic syndrome

Urine that develops a port wine color after standing may contain: A. Melanin B. Porphyrins C. Bilirubin D. Urobilinogen

B. Porphyrins

Which of the following is not a stage of chronic renal failure? A. Diminished renal reserve B. Renal inhibition C. Renal insufficiency D. Uremia

B. Renal inhibition

Triglycerides can be identified in body fluids by their ability to: A. Polarize light B. Stain with sudan III C. Sediment upon standing D. Glitter

B. Stain with sudan III

Which of the following cells is most likely to be seen in the urine sediment following catheterization? A. Squamous epithelial B. Transitional epithelial C. White blood cells D. Renal tubular epithelial

B. Transitional epithelial

The appearance of normal CSF is: A. pale yellow and clear B. colorless and clear C. opalescent D. xanthochromic

B. colorless and clear

The finding of large amount of uric acid crystals in a urine specimen from a 6-month-old boy: A. may actually be diaper fibers B. could indicate Lesch-Nyhan syndrome C. should not be reported D. may indicate improper feeding

B. could indicate Lesch-Nyhan syndrome

Light is strongly polarized by all of the following except: A. starch granules B. cystine crystals C. uric acid crystals D. fibers

B. cystine crystals

A urine's specific gravity is directly proportional to its: A. turbidity B. dissolved solids C. salt content D. sugar content

B. dissolved solids

In glomerular diseases, morphologic changes in the glomeruli include all of the following, except: A. cellular proliferation B. erythrocyte congestion C. leukocyte infiltration D. glomerular basement membrane thickening

B. erythrocyte congestion

A laboratorian is having trouble differentiating between red blood cells, oil droplets, and yeast on a urine microscopy. Adding acetic acid would: A. lyse the yeast cells B. lyse the red blood cells C. dissolve the oil droplets D. clump the yeast cells

B. lyse the red blood cells

A xanthochromic CSF specimen is centrifuged resulting in a pink-colored supernatant. this indicated the presence of: A. red blood cells B. oxyhemoglobin C. bilirubin D. methemoglobin

B. oxyhemoglobin

When identifying crystals, which test strip result is most important? A. protein B. pH C. specific gravity D. nitrite

B. pH

Which of the following would be most affected by allowing a urine sample to sit at room temperature three hours before analysis? A. Occult blood B. pH C. Specific gravity D. Protein

B. pH

An increased IgG index on a CSF specimen indicates: A. antibody response to bacteria B. synthesis of IgG in the CNS C. brain tumor D. breach of the blood-brain barrier

B. synthesis of IgG in the CNS

Urine pH usually ranges from: A. 4.0 to 9.0 B. 4.5 to 7.0 C. 4.5 to 8.0 D. 5.0 to 6.0

C. 4.5 to 8.0

A specimen with a negative nitrate reaction and a positive leukocytes reaction that has WBCs, WBC casts, but no bacteria in the sediment will be seen in cases of: A. Cystitis B. Pyelonephritis C. Acute interstitial nephritis D. Acute glomerulonephritis

C. Acute interstitial nephritis

What type of microscopy is used for routine urinalysis? A. Phase contrast B. Interference contrast C. Bright field D. Polarization

C. Bright field

An unpreserved urine specimen collected at midnight is kept at room temperature until the morning hospital shift. Which of the following changes will most likely occur? A. Decrease in urine color and clarity B. Decrease in pH and specific gravity C. Decrease in glucose and ketones D. Decrease in bacteria and nitrite

C. Decrease in glucose and ketones

Anti-glomerular basement antibody is seen with: A. Wegener's granulomatosis B. IgA nephropathy C. Goodpasture's syndrome D. Diabetic nephropathy

C. Goodpasture's syndrome

An ammonia-like odor is characteristically associated with urine from patients who: A. Are diabetic B. Have hepatitis C. Have an infection with Proteus spp D. Have a yeast infection

C. Have an infection with Proteus spp

Failure of the nephron to produce ammonia from glutamine will result in urine with a: A. Low specific gravity B. Positive nitrite C. High pH D. Positive Protein

C. High pH

Which of the following tests is confirmatory for most Amino Acid Disorders? A. Cyanide Nitroprusside B. Bacterial Inhibition C. Liquid Chromatography or Mass Spectrometry D. Watson-Schwartz Test

C. Liquid Chromatography or Mass Spectrometry

pH determinations are clinically relevant for which of the following? A. Cerebrospinal fluid B. Pericardial fluid C. Pleural fluid D. Synovial fluid

C. Pleural fluid

A patient with severe back pain comes to the emergency room. The urine has a 1+ reagent strip reading for blood and a specific gravity of 1.030. This can aid in confirming a diagnosis of _________. A. Pyelonephritis B. Appendicitis C. Renal calculi D. Multiple myeloma

C. Renal calculi

The location of epithelial cells in the urinary tract in descending order is: A. Squamous, transitional, renal tubular B. Transitional, renal tubular, squamous C. Renal tubular, transitional, squamous D. Squamous, renal tubular, transitional

C. Renal tubular, transitional, squamous

Myoglobinuria may be caused by: A. Decreased glomerular filtration B. Incompatible blood transfusions C. Strenuous exercise D. Biliary obstruction

C. Strenuous exercise

Pyelonephritis can be differentiated from cystitis by the presence of: A. Eosinophils B. Hyaline Casts C. White Blood Cells D. Bacteriuria

C. White Blood Cells

Acute renal failure can be caused by all of the following, except: A. hemorrhage B. acute tubular necrosis C. acute pyelonephritis D. urinary tract obstruction

C. acute pyelonephritis

A white precipitate in a urine specimen with a pH of 7.5 would most probably be caused by: A. amorphous urates B. WBCs C. amorphous phosphates D. bacteria

C. amorphous phosphates

Which positive test result is indicative of yeast being present? A. nitrite B. protein C. glucose D. blood

C. glucose

Porphyrins are intermediates in the biosynthetic pathway of: A. alpha ketoisocaporic acid B. tryptophan C. heme D. mucopolysaccharides

C. heme

Creatinine clearance is reported in: A. mg/dL B. mg/24 hours C. mL/min D. mL/24 hours

C. mL/min

In synovial fluid, the most characteristic microscopic finding in gout is: A. calcium pyrophosphate crystals B. cartilage debris C. monosodium urate crystals D. hemosiderin-laden macrophages

C. monosodium urate crystals

The finding of hemosiderin laden macrophages in a CSF sample indicates: A. bacterial infection B. viral infection C. previous hemorrhage D. traumatic tap

C. previous hemorrhage

The presence of unusually broad, granular or waxy, casts in urinary sediment is usually indicative of: A. calculi B. cystitis C. significant urinary stasis D. orthostatic proteinuria

C. significant urinary stasis

All of the following diseases can result in severe mental retardation if not detected and treated in the infant, except: A. Phenylketonuria B. Maple syrup urine disease C. Galactosuria D. Alkaptonuria

D. Alkaptonuria

Decreased CSF protein can be found in: A. meningitis B. hemorrhage C. multiple sclerosis D. CSF leakage

D. CSF leakage

Ketonuria can be caused by: A. Ability to use carbohydrates B. Adequate intake of carbohydrates C. Decreased metabolism of carbohydrates D. Excessive loss of carbohydrates

D. Excessive loss of carbohydrates

Which of the following aids in the differentiation of hemoglobinuria and hematuria? A. Urine pH B. Urine color C. Leukocyte esterase test D. Microscopic examination

D. Microscopic examination

Which of the following is a finding in end-stage renal disease? A. Renal calculi B. Pyuria C. Proteinuria D. Ketonuria

D. Proteinuria

The presence of leukocytes in urine is known as: A. Chyluria B. Hematuria C. Leukocytosis D. Pyruria

D. Pyruria

Glucosuria not accompanied by hyperglycemia is seen in patients with: A. Hormonal disorders B. Gestational diabetes C. Diabetes mellitus D. Renal disease

D. Renal disease

In which part of the kidney does concentration of urine mostly take place? A. The glomeruli and bowman's capsules B. The loop of henle C. The proximal convoluted tubules D. The distal convoluted tubules and the collecting duct

D. The distal convoluted tubules and the collecting duct

Which of the following proteins originates in the urinary tract? A. Albumin B. Bence Jones protein C. Beta-2-Microglobulin D. Uromodulin

D. Uromodulin

An eosinophil count may be requested on urine from a patient with suspected: A. acute glomerulonephritis B. cystitis C. renal lithiasis D. acute interstitial nephritis

D. acute interstitial nephritis

Pleural fluid from a patient with congestive heart failure would be expected to: A. contain bacteria B. have a high protein content C. be purulent D. appear clear and pale yellow

D. appear clear and pale yellow

The best method of urine preservation for a specimen for routine urinalysis that will not be received into a lab for analysis until 36 hours after collection is: A. refrigeration B. formalin C. boric acid D. chlorhexidine

D. chlorhexidine

A sweat chloride >60 meq/L is indicative of: A. multiple sclerosis B. muscular dystrophy C. respiratory distress syndrome D. cystic fibrosis

D. cystic fibrosis

The test for which of the following results should be repeated? A. Positive blood and protein B. pH 7.0 with ammonium biurate crystals C. Positive nitrite and leukocyte esterase D. pH 5.0, WBCs, and triple phosphate crystals

D. pH 5.0, WBCs, and triple phosphate crystals

The metabolic disorder that will give the urine a mousy/musty smell is: A. porphyrinuria B. maple syrup urine disease C. tyrosyluria D. phenylketonuria

D. phenylketonuria

To avoid falsely elevated CSF cell counts: A. used an aliquot from the first tube collected B. use only those specimens showing no turbidity C. centrifuge all specimens before counting D. select an aliquot from the last tube collected

D. select an aliquot from the last tube collected

All casts are typically composed of: A. albumin B. globulin C. immunoglobulins G and M D. uromodulin

D. uromodulin

Degeneration of granular casts produce: A. hyaline casts B. broad casts C. fatty casts D. waxy casts

D. waxy casts

TRUE OR FALSE: Urine pH decreases in an unpreserved urine specimen as it ages.

FALSE

TRUE OR FALSE: the presence of Candida albicans in the urine can result in a positive urinary nitrite.

FALSE

TRUE OR FALSE: An oval fat body is usually a renal tubular epithlial cell that has lipid droplets in it.

TRUE

TRUE OR FALSE: Glucose decreases in an unpreserved urine specimen as it ages

TRUE

TRUE OR FALSE: Polycystic kidney disease is an inherited disorder which causes grape-like clusters of fluid-filled cysts which rupture periodically -- eventually causing chronic renal failure.

TRUE

TRUE OR FALSE: Renal tubular epithelial cells and casts are unique to the kidneys.

TRUE

TRUE OR FALSE: The presence of nitrite in a freshly void specimen is diagnostic for a UTI.

TRUE