Urinalysis Exam 1 (part 2)

1) Which of the following crystals is associated with ethylene glycol ingestion? A. Uric acid B. Calcium oxalate monohydrate C. Triple phosphate D. Calcium oxalate dihydrate

Calcium oxalate monohydrate

1) Nonpathogenic or "normal" crystals found in acidic urine include: A. Calcium oxalate, uric acid, amorphous urates B. Calcium oxalate, uric acid, sulfonamides C. Uric acid, amorphous urates, triple phosphate D. Uric acid, calcium carbonate, bilirubin

Calcium oxalate, uric acid, amorphous urates

1) Granular casts present in the urine following strenuous exercise can: A. Represent disintegration of cellular casts B. Contain cellular lysosomes C. Be pathogenic for renal disease D. Represent a prerenal condition

Contain cellular lysosomes

364) True/False When changing magnification using a parfocal microscope, focusing is performed using the coarse adjustment knob.

false

366) True/False The finding of increased urinary WBCs is not significant unless increased bacteria are also present.

false

368) True/False A structure resembling a cast but having a tapered end should not be reported as a cast.

false

369) True/False WBC casts should always be accompanied by significant bacteriuria.

false

371) True/False Trichomonas vaginalis is not found in urine from male patients.

false

1) The only type of cast capable of polarization is the: A. Waxy cast B. Hyaline cast C. Fatty cast D. Granular cast

fatty cast

1) Schistosoma haematobium would most likely be found in the urine from a: A. Foreign-service employee B. Marathon runner C. Diabetic patient D. Health-care worker

foreign-service employee

1) The organisms attached to a clue cell are: A. Gardnerella vaginalis B. Trichomonas vaginalis C. Escherichia coli D. Candida albicans

gardnerella vaginalis

1) Dilute alkaline urine should be examined carefully for the presence of: A. Yeast B. Renal tubular epithelial cells C. Ghost RBCs D. Fatty casts

ghost rbcs

1) 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

glitter cells

1) The presence of hypochromic, irregularly shaped RBCs in the urine sediment can indicate: A. A coagulation disorder B. Menstrual contamination C. Urinary tract infection D. Glomerular bleeding

glomerular bleeding

1) All of the following may be seen in the urine following strenuous exercise except: A. Protein B. Glucose C. Hyaline casts D. Granular casts

glucose

1) Stain eosinophils. A. Sudan III B. Hansel stain C. Prussian blue D. Toluidine blue

hansel stains

1) Ghost RBCs most frequently occur with a urine specimen that exhibits the following: A. High pH, high specific gravity B. High pH, low specific gravity C. Low pH, high specific gravity D. Low pH, low specific gravity

high ph, low spg

1) Specimens containing mucus may be erroneously reported as containing: A. Bacteria B. Yeast C. Hyaline casts D. Oval fat bodies

hyaline casts

1) The presence of crenated RBCs in the urine sediment is associated with: A. Rrauma B. Hypersthenuria C. Hyposthenuria D. Urinary tract infection

hypersthenuria

1) Formation of crystals due to medications is most frequently caused by A. Inadequate hydration B. Incorrect timing of medication doses C. Medication overdoses D. Use of expired antibiotics

inadequate hydration

1) 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

lysis of yeast cells by acetic acid

1) Glitter cell is a term used to describe a specific type of: A. Ketone body B. Renal tubular epithelial cell C. Neutrophil D. Oval fat body

neutrophil

377) Concerned or not concerned? Triple phosphate and ammonium biurate crystals in a specimen with a pH of 8.0

not concerned

378) Concerned or not concerned? Candida albicans and leukocytes in a specimen with a negative nitrite test

not concerned

380) Concerned or not concerned? Many budding yeasts in a clear, red specimen from a bedridden, diabetic patient

not concerned

1) To differentiate a bacterial cast from a granular cast, a clinical laboratory scientist could: A. Perform a Gram stain B. Use polarizing microscopy C. Perform a Hansel stain D. Add acetic acid to the sediment

perform a gram stain

1) Which of the following results should have testing repeated? A. Positive blood and protein B. pH 7.0 with uric acid crystals C. Positive bilirubin and urobilinogen D. pH 8.0, WBCs, and triple phosphate crystals

ph 7.0 with uric acid crystals

1) Under POLARIZED light, all of the following will exhibit the MALTESE cross formation except: A. Starch granules B. Oval fat bodies C. Pollen grains D. Fatty casts

pollen grains

1) Stain hemosiderin granules. A. Hansel stain B. Prussian blue C. Toluidine blue D. Sternheimer-Malbin

prussian blue

1) An increase in urinary WBCs is called: A. Pyelonephritis B. Cystitis C. Urethritis D. Pyuria

pyuria

1) The urinary sediment constituent most closely associated with bleeding within the nephron is the: A. RBC B. RBC cast C. WBC cast D. Hyaline cast

rbc cast

1) The finding of increased hyaline and granular casts in the urine of an otherwise healthy person may be the result of: A. Fecal contamination B. Recent strenuous exercise C. Early urinary tract infection D. Analyzing an old specimen

recent strenuous exercise

1) Urine sediment artifacts frequently differ from true sediment constituents by their: A. Location in the specimen B. Appearance C. Refractility D. Number present

refractility

1) Waxy casts are most easily differentiated from hyaline casts by their: A. Color B. Size C. Granules D. Refractivity

refractivity

1) A patient with severe back pain and 15 to 20 RBCs/hpf in the urine sediment may have: A. Renal calculi B. Acute glomerulonephritis C. Nephrotic syndrome D. Osteomyelitis

renal calculi

1) Which of the following cells found in increased numbers in the urine sediment is only indicative of nephron damage? A. Erythrocytes B. WBCs C. Squamous epithelial cells D. Renal tubular cells

renal tubular cells

1) Oval fat bodies are: A. Squamous epithelial cells that contain lipids B. Renal tubular epithelial cells that contain lipids C. WBCs that have phagocytized lipids D. People who fail to work out regularly

renal tubular epithelial cells that contain lipids

1) Clue cells are derived from: A. Renal tubular epithelial cells B. Trichomonas vaginalis C. Histiocytes D. Squamous epithelial cells

squamous epithelial cells

1) Collection of a midstream clean-catch specimen will alleviate contamination by: A. Renal tubular epithelial cells B. RBCs C. Transitional epithelial cells D. Squamous epithelial cells

squamous epithelial cells

1) Initial microscopic focusing on the urinary sediment is frequently performed by referencing: A. Mucus B. Squamous epithelial cells C. RBCs D. Hyaline casts

squamous epithelial cells

1) In ascending order, the location of epithelial cells in the urinary tract is: A. Squamous, transitional, renal tubular B. Transitional, renal tubular, squamous C. Renal tubular, transitional, squamous D. Squamous, renal tubular, urothelial

squamous, transitional, renal tubular

1) Enhance nuclear detail. A. Sudan III B. Hansel stain C. Prussian blue D. Toluidine blue

toluidine blue

1) The type of cells that line the bladder and ureters are called: A. Squamous B. Renal tubular C. Transitional D. Basal

transitional

1) Motility by which of the following is most noticeable during the urine sediment examination? A. Spermatozoa B. Candida albicans C. Trichomonas vaginalis D. Escherichia coli

trichonomonas vaginalis

365) True/False In the urinalysis laboratory, a bright-field microscope can be converted to a polarizing microscope.

true

367) True/False Renal tubular epithelial cells from the distal convoluted tubule are smaller than those from the proximal convoluted tubule.

true

370) True/False To be considered significant, yeast cells in the urine sediment should be accompanied by leukocytes.

true

1) Urinary crystals that appear yellow to reddish-brown are: A. Calcium oxalate B. Triple phosphate C. Cholesterol D. Uric acid

uric acid

1) Cystine crystals are often confused with: A. Cholesterol crystals B. Leucine crystals C. Uric acid crystals D. Triple phosphate crystals

uric acid crystals

1) All of the following affect the formation of crystals except: A. Urine specific gravity B. Urine pH C. Urinary casts D. Urine temperature

urinary casts

1) The primary factor that favors the formation of urinary casts is: A. Urinary stasis B. High pH C. Positive blood D. Low specific gravity

urinary stasis

1) Waxy casts can be found in the urine sediment: A. In patients with renal failure B. Of an alkaline urine C. Whenever abnormal protein is present D. When urine is not correctly preserved

In patients with renal failure

1) To distinguish a cellular cast from a clump of cells, the clinical laboratory scientist should: A. Check for dysmorphic cells B. Look carefully for a cast matrix C. Determine if free-standing cells are present D. Examine the sediment using polarizing microscopy

Look carefully for a cast matrix

1) Stain oval fat bodies. A. Sudan III B. Hansel stain C. Prussian blue D. Sternheimer-Malbin

Sudan III

1) Calcium carbonate crystals can be distinguished from bacteria by: A. Warming the sediment B. Refrigerating the specimen C. Checking the pH of the specimen D. Adding acetic acid

adding acetic acid

1) All of the following crystals can be found in acid urine except: A. Cholesterol B. Tyrosine C. Cystine D. Ammonium biurate

ammonium biurate

1) In an unpreserved and old urine specimen, there could be difficulty differentiating between bacteria and: A. Yeast B. Mucus C. Amorphous phosphates D. Pollen grains

amorphous phosphates

1) A urine specimen refrigerated overnight is cloudy and has a pH of 6. The turbidity is probably due to: A. Amorphous phosphates B. Amorphous urates C. Triple phosphate crystals D. Calcium oxalate crystals

amorphous urates

1) Identification of urinary crystals is based on shape and: A. Urine pH and crystal solubility B. Urine protein and crystal size C. Urine bilirubin and glucose D. Urine pH and crystal size

urine ph and crystal solubility

1) Information that aids in the identification of crystals includes all of the following except: A. Urine temperature B. Urine pH C. Crystal solubility D. Crystal birefringence

urine temperature

1) The major constituent of urinary casts is: A. Lipoprotein B. Bence Jones protein C. Uromodulin protein D. Amino acids

uromodulin protein

1) Hyaline casts may degenerate into: A. Granular casts B. Fatty casts C. Broad casts D. Waxy casts

waxy casts

1) All of the following are associated with severe urinary stasis except: A. Granular casts B. Waxy casts C. WBC casts D. Broad casts

wbc casts

1) Sediment constituents that are used to differentiate between upper and lower urinary tract infections are: A. WBCs B. WBC clumps C. RBCs and WBCs D. WBC casts

wbc casts

1) The significance of seeing bacteria in the urine sediment is increased when: A. RBCs and casts are present B. The patient has an elevated temperature C. The specimen is cloudy D. WBCs are present

wbcs are present

1) Which of the following cells can both be found in both a vaginal wet prep and in urine sediment? A. Yeast cell and clue cell B. Transitional and renal epithelial cell C. Clue cell and squamous cell D. Renal and squamous cells

yeast cell and clue cell

1) Urine sediments containing increased WBCs should be observed closely for the presence of: A. Hyaline casts B. Granular casts C. Bacteria D. Urothelial cells

bacteria

1) Yeast may appear in the urine sediment in all of the following forms except: A. Mycelial B. Biconcave C. Oval D. Budding ovals

biconcave

1) The finding of renal tubular epithelial cells containing yellow-brown granules correlates with a positive reagent strip test for: A. Blood B. Bilirubin C. Glucose D. Nitrite

blood

379) Concerned or not concerned? 2-3 granular casts/lpf in a refrigerated specimen containing many amorphous crystals

concerned

1) Urothelial cells routinely occur in all of the following shapes except: A. Spherical B. Cylindroid C. Polyhedral D. Caudate

cylindroid

363) True/False To adjust the intensity of light in a bright-field microscope, the condenser should be raised or lowered.

false

1) Eosinophils are found in the urine in cases of: A. Nephrotic syndrome B. Cystitis C. Acute interstitial nephritis D. Renal lithiasis

acute interstitial nephritis

373) Match the description (A-E) for the following urine crystals (1-3): 1. Ammonium biurate 2. Calcium carbonate 3. Triple phosphate A. Thorny apple B. Coffin lid C. Notched corners D. Hexagonal E. Dumbbell

1. A 2. E 3. B

1) Choose the correct microscope part (1-5) needed to perform the following functions (A-E) 1. Focus light on the specimen 2. Hold the objectives 3. Increase objective resolution 4. Control light intensity 5. Regulate interpupillary distance A. Condenser B. Oculars C. Diopter adjustment knob D. Rheostat E. Nose piece

1. A 2. E 3. B 4. D 5. C

374) Match the following urine crystals (1-5) with their description (A-E): 1. Ammonium biurate 2. Calcium carbonate 3. Triple phosphate 4. Cystine 5. Cholesterol A. Thorny apple B. Coffin lid C. Notched corners D. Hexagonal E. Dumbbell

1. Ammonium biurate A 2. Calcium carbonate E 3. Triple phosphate B 4. Cystine D 5. Cholesterol C

1) Nonpathogenic or "normal" crystals found in alkaline urine include: A. Calcium oxalate, uric acid, amorphous urates B. Calcium oxalate, uric acid, sulfonamides C. Uric acid, amorphous urates, calcium carbonate D. Triple phosphate, calcium carbonate, ammonium biurate

Triple phosphate, calcium carbonate, ammonium biurate

1) To dissolve amorphous urates, you could: A. Warm the specimen to body temperature B. Add concentrated sodium hydroxide C. Add dilute hydrochloric acid D. Add dilute acetic acid

Warm the specimen to body temperature

1) Which of the following differentiates a waxy cast from a fiber most effectively? A. Waxy casts do not polarize light, and fibers do. B. Waxy casts are more refractile than fibers. C. Waxy casts have rounded ends, and fibers do not. D. Waxy casts are thicker on the edge, and fibers are thicker in the center.

Waxy casts do not polarize light, and fibers do.

1) Abnormal crystals are most frequently seen in a urine that is: A. Acid B. Neutral C. Alkaline D. Collected for 24 hours

acid

1) Which of the following crystals occurs in two very distinct forms? A. Ammonium biurate B. Calcium oxalate C. Leucine D. Cholesterol

calcium oxalate

1) Which of the following is most likely to be found in the urine of a diabetic patient? A. Trichomonas vaginalis B. Escherichia coli C. Staphylococcus saprophyticus D. Candida albicans

candida albicans

1) Which of the following elements would most likely be found in an acidic concentrated urine that contains protein? A. Ghost RBCs B. Casts C. Bacteria D. Triple phosphate crystals

casts

1) Spherical transitional epithelial cells can be differentiated from renal tubular epithelial cells by observing the: A. Centrally located nucleus in renal tubular cells B. Granular cytoplasm in renal tubular cells C. Centrally located nucleus in transitional cells D. Granular cytoplasm in transitional cells

centrally located nucleus in transitional cells

375) State if a urinalysis supervisor would be concerned or not concerned about the following results: Enterobius vermicularis and waxy casts in a cloudy specimen from a pediatric patient

concerned

376) Concerned or not concerned? RBC casts in a specimen with a negative reagent strip test for blood

concerned

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

distal and collecting tubules

1) The type of cast most closely associated with tubular damage is the: A. WBC cast B. Epithelial cell cast C. RBC cast D. Fatty cast

epithelial cell cast

1) Broad casts may form as a result of: A. Extreme urinary stasis B. Strenuous exercise C. Increase in loss of amino acids D. Dehydration

extreme urinary stasis