Urinalysis & Other Body Fluids MLT Practice
How many white blood cells (WBCs) would be considered normal for adult cerebrospinal fluid? A). Any number of WBCs is considered abnormal B). 0-5 WBCs/µL C). 6-10 WBCs/µL D). Up to 30 WBCs/µL
0-5 WBCs/µL
For BEST results, if not tested immediately, a semen sample should remain at which of the following temperatures following collection? A). 4 ºC B). Room temperature C). 37 ºC D). -40 ºC
37 ºC
Which of the following ketones is NOT detected in the Acetest® tablet method? A). Acetone B). Beta-hydroxybutyric acid C). Acetoacetic acid D). Beta-hydroxybutyric acid and acetone
Beta-hydroxybutyric acid
Fecal urobilinogen level may be markedly decreased because of: A). Hemolysis B). Decreased intestinal reabsorption of urobilinogen C). Increased serum bilirubin D). Biliary obstruction
Biliary obstruction
A patient whose diagnosis is hepatitis may have which of the following test positive on urine test strip? A). Ketone B). Blood C). Bilirubin D). Nitrite
Bilirubin
Which of the following substances can cause a false positive result for blood on the urine chemical reagent strip? A). Ascorbic acid B). Bleach in the collecting bottle C). High levels of nitrite D). High specific gravity
Bleach in the collecting bottle
What urine contaminant could cause a falsely elevated level of urinary albumin, thus giving the false interpretation of kidney damage? A). Blood from menstruation B). Feces from urine collections during bowel movement C). Incomplete cleansing of the genitalia with a disinfectant prep pad D). Diluting the urine sample with water
Blood from menstruation
Sulfosalicylic acid (SSA) can be used to confirm the result of which of the following tests included on a urine chemical reagent strip? A). Glucose B). Bilirubin C). Protein D). Urobilinogen
Protein
Sulfosalicylic acid (SSA) can be used to confirm the result of which of the following tests included on a urine reagent strip? A). Glucose B). Bilirubin C). Urobilinogen D). Protein
Protein
The kidneys perform all of the following functions EXCEPT: A). Reabsorption of waste products B). Water and electrolyte balance C). Hormone production D). Acid-base balance
Reabsorption of waste products
Which of the following cells would be increased if the cerebrospinal fluid (CSF) of a patient suspected of having multiple sclerosis? A). Neutrophils B). Lymphocytes C). Macrophages D). Monocytes
Lymphocytes
What is the urinary system composed of? A). Kidney, ureter, urinary bladder, and urethra. B). Two kidneys, two urethras, one urinary bladder, and one ureter. C). Two kidneys, two ureters, one urinary bladder, and one urethra. D). Two kidneys, one ureter, one bladder, and one urethra.
Two kidneys, two ureters, one urinary bladder, and one urethra.
Which two of the following crystalline elements are found in acid urine: A). Cystine and calcium carbonate B). Triple phosphate and calcium carbonate C). Calcium phosphate and uric acid D). Tyrosine and cystine
Tyrosine and cystine
Which of the following methods would be used to confirm the presence of Bence-Jones protein in the urine: A). Urine protein electrophoresis or immunoelectrophoresis B). Benedict qualitative test C). Ictotest D). Watson-Schwartz test
Urine protein electrophoresis or immunoelectrophoresis
Which of the following may cause a false-positive protein reading on a urinalysis dipstick? A). Urine pH is between 5.0 and 6.0. B). Specimen has been refrigerated. C). Urine specimen is highly pigmented. D). Urine specimen with a low specific gravity.
Urine specimen is highly pigmented.
What is the role of albuminuria testing? A). Monitor diabetic patient carbohydrate management. B). Detect serum albumin levels in early renal disease. C). Detect small urinary concentrations of albumin before there is irreparable renal damage. D). Diagnose renal failure in a type 1 diabetic patient.
Detect small urinary concentrations of albumin before there is irreparable renal damage.
Which of the following conditions is associated with a positive ketone test on the urine test strip? A). Renal calculi B). Diabetes mellitus C). Hepatitis/cirrhosis D). Urinary tract infection
Diabetes mellitus
A urine specimen is received in the laboratory late in the afternoon. The specimen was collected early in the morning and was accidentally left in bright sunlight and at room temperature on a counter in the outpatient clinic. The test order is for urine bilirubin screening. Which of the following could occur as a result of the storage conditions? A). False-positive test result B). No adverse effect from the storage conditions C). False-negative test result D). It can not be determined based on the information provided.
False-negative test result
Sudan III will confirm the presence of: A). Parasites B). Sperm C). Mucus D). Fat
Fat
Which of the following artifacts may be mistaken for casts? A). Fibers B). Air bubbles C). Coverslip scratches D). Talc particles
Fibers
Which of the following conditions is most likely when an oligoclonal band is seen in CSF electrophoresis without a corresponding serum peak? A). Lymphoproliferative disorder B). Viral meningitis C). Multiple sclerosis D). Traumatic lumbar puncture
Multiple sclerosis
Acetest® can be used to test for ketones in: A). Urine B). Urine and serum C). Urine, serum, and whole blood D. Urine, serum, whole blood, and CSF
Urine, serum, and whole blood
Which of the following reagent strip tests is based on the Ehrlich-aldehyde reaction? A). Urobilinogen B). Specific gravity C). Glucose D). pH
Urobilinogen
Which of the following urine chemical reagent strip tests is based on the Ehrlich-aldehyde reaction? A). pH B). Protein C). Glucose D). Urobilinogen
Urobilinogen
What is the lower reference limit for semen volume according to the World Health Organization, WHO Laboratory Manual for the Examination and Processing of Human Semen, 5th edition? A). 0.5 mL B). 1.5 mL C). 3.5 mL D). 4.5 mL
1.5 mL
If the spinal fluid is slightly hazy, what is the best dilution? A). 1:200 B). 1:10 C). 1:20 D). 1:100
1:10
When performing a chemical examination of urine, a routine reagent strip test for protein is based on the principle of: A). Precipitation by acid B). Protein-error-of-indicators C). Copper reduction D). Ictotest tablets
Protein-error-of-indicators
All of the following specimen collection methods should be used if urine cultures are also required, EXCEPT? A). Routinely voided B). "Clean catch" C). Catheterized D). Suprapubic aspiration
Routinely voided
The ketone component that is measured by the nitroprusside reaction is: A). Beta-hydroxybutyric acid B). Acetoacetic acid C). Acetone D). C-Reactive Protein
Acetoacetic acid
Oliguria is usually correlated with: A). Acute glomerulonephritis B). Diabetes mellitus C). Hepatitis D). Tubular damage
Acute glomerulonephritis
A microscopic examination of a normal urine pH 8.0 shows 2+ yellow-brown thorny spheres which are MOST probably: A). Ammonium biurate crystals B). Waxy casts C). Amorphous urate crystals D). Crenated red cells
Ammonium biurate crystals
Common crystals which can be found in ACID urine include: A). Amorphous phosphates and amorphous urates B). Amorphous urates and calcium oxalate C). Calcium carbonate and calcium oxalate D). Calcium oxalate and amorphous phosphates
Amorphous urates and calcium oxalate
Which of the following is the recommended method for preparing a cerebrospinal fluid (CSF) sample for a differential count? A). Cytocentrifugation B). Concentration of cells by traditional centrifugation C). Manual smear methods D). Use of hemocytometer
Cytocentrifugation
Detection of a fruity odor in a fresh urine sample may be indicative of all of the following EXCEPT: A). Starvation B). Malabsorption C). Diabetes mellitus D). Bacterial infection
Bacterial infection
"Xanthochromic" CSF means that the color of the CSF can be any of the following EXCEPT: A). Pale orange B). Pale pink C). Yellow D). Blue
Blue
Prominent vacuolation involving the cytoplasm of abnormal lymphoblast-like cells seen in the peritoneal body fluid preparation, is a distinctive feature of which disease? A). Hodgkin Lymphoma B). Burkitt Lymphoma C). Hairy Cell Leukemia D). Chronic Lymphocytic Leukemia
Burkitt Lymphoma
All of the following normal urine crystals are most often found in a urine that has a pH > 7 EXCEPT: A). Calcium oxalate B). Triple phosphate C). Ammonium biurate D). Calcium carbonate
Calcium oxalate
Which of the following would be the most characteristic finding in synovial fluid in a case of pseudogout? A). Monosodium urate crystals B). Calcium pyrophosphate crystals C). Macrophage infiltration D). Mixed RBC/WBC infiltration
Calcium pyrophosphate crystals
The Clinitest® reaction is based on which of the following principles? A). Ortho-toluidine oxidation B). Diazotization of sugars C). Enzyme reaction D). Copper reduction
Copper reduction
A urine production of less than 400 mL/day is: A). Consistent with normal renal function and water balance B). Termed isosthenuria C). Defined as oliguria D). Associated with diabetes mellitus
Defined as oliguria
Examples of conditions resulting in benign proteinuria include: A). Multiple myeloma and dehydration B). Dehydration and orthostatic proteinuria C). Lupus erythematosus and multiple myeloma D). Orthostatic proteinuria and lupus erythematosus
Dehydration and orthostatic proteinuria
Ovoid in shape with one side flattened. The embryo is separated from the shell by a clear space: A). Sperm B). Schistosoma haematobium ova C). Trichomonas vaginalis D). Enterobius vermicularis ova
Enterobius vermicularis ova
Significantly increased levels of ketones are typically detected in the urine with all of the following conditions, EXCEPT? A). Diabetic acidosis B). Excessive carbohydrate loss C). Starvation D). Following a low-impact exercise routine
Following a low-impact exercise routine
All of the following are standard methods for measuring the specific gravity of urine, EXCEPT: A). Urine reagent strips B). Freezing point depression C). Refractometry D). Harmonic oscillation densitometry
Freezing point depression
Which of the following conditions will cause a positive reagent strip blood result due to hematuria? A). Hemolytic anemia B). Glomerulonephritis C). Dehydration D). Severe burns
Glomerulonephritis
Which of the following methods would be employed to collect sweat for chloride analysis: A). Electrophoresis B). Counter electrophoresis C). Isoelectric focusing D). Iontophoresis
Iontophoresis
The glucose result on a urine specimen from an infant is negative on the urine chemical reagent strip, what is the next step? A). It can be reported that the specimen is negative for other reducing substances such as galactose. B). It must be followed by the Acetest® tablet test to check for other reducing substances. C). There is nothing else to do, report the result as negative for glucose. D). It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances.
It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances.
All of the statements below about synovial fluid are true EXCEPT: A). Arthrocentesis is performed as a means to evaluate arthritis and other joint disorders B). Joint fluid resembles plasma in viscosity C). Joint fluid has approximately the same glucose as plasma D). Synovial fluid is present only in movable joints
Joint fluid resembles plasma in viscosity
Which of the following sites is used most often for CSF collection? A). Ventricles B). L3-L4 C). L1-L2 D). Suboccipital
L3-L4
If CSF tubes numbered #1, #2 and #3 CANNOT be analyzed within one hour, the correct procedure for the microbiology sample tube is to: A). Refrigerate it B). Leave it at room temperature C). Freeze it D). Incubate in a 56 degree water bath
Leave it at room temperature
With the development of fetal lung maturity, which of the following phospholipid concentrations in amniotic fluid increases? A). Sphingomyelin B). Phosphatidyl ethanolamine C). Phosphatidylinositol D). Lecithin
Lecithin
All of the following crystals are found in normal urine, EXCEPT? A). Triple phosphate B). Ammonium biurate C). Calcium oxalate D). Leucine
Leucine
A patient presents to his family doctor with respiratory issues. He has a history of being a heavy smoker for more than 20 years, so the physician orders a BAL cell count with differential. Which of the following cells would most closely correlate with the patient's medical history? A). Macrophages with phagocytized red blood cells B). Macrophages with phagocytized bacteria C). Macrophages without any inclusions D). Macrophages with purple/black inclusions
Macrophages with purple/black inclusions
What are the MAIN functions of the distal convoluted tubules? A). Maintain water-electrolyte and acid-base balances B). Balance hydrogen ions and keep the body pH at 6.8 C). Control aldosterone production and ammonia reabsorption D). Excrete various antibiotics and uric acid
Maintain water-electrolyte and acid-base balances
Urine test strip positive for blood may indicate all, EXCEPT: A). Hematuria B). Hemoglobinuria C). Myoglobinuria D). Meat diet
Meat diet
Appear as single or clumped threads with low refractive index: A). Mucus B). Fiber C). Cylindroid D). Hyaline cast
Mucus
Which of the following cells are considered abnormal and clinically significant on a CSF differential? A). Ependymal B). Myeloblast C). Pia arachnoid mesothelial D). Choroidal cells
Myeloblast
What is the primary functional unit of the kidney? A). Ureter B). Nephron C). Glomerulus D). Distal convoluted tubule
Nephron
Which is the best method for examination of synovial crystals? A). Phase contrast B). Darkfield microscopy C). Brightfield microscopy D). Polarized light
Polarized light
Reabsorption in the kidneys primarily occurs in: A). Glomerulus B). Proximal convoluted tubule C). Bowman's capsule D). Loop of Henle
Proximal convoluted tubule
In order to avoid falsely elevated spinal fluid cell counts one should: A). Use an aliquot only 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
Select an aliquot from the last tube collected
Normal fecal specimens contain all of the following, EXCEPT: A). Shigella spp. B). Escherichia coli C). Electrolytes D). Urobilin
Shigella spp.
How does ion concentration in the urine relate to specific gravity? A). Specific gravity increases as ionic concentration increases. B). Specific gravity decreases as ionic concentration increases. C). There is no relationship between SG and ionic concentration. D). Specific gravity stays the same regardless of the ionic concentration.
Specific gravity increases as ionic concentration increases.
A patient has been diagnosed with an upper gastrointestinal bleed. Which of the following would be characteristic for this condition? A). Red stool B). Pale yellow, white, or gray stool C). Stool much darker brown or black color D). Mucous or blood-streaked mucus stool
Stool much darker brown or black color
Which of the following test procedures is used to diagnose cystic fibrosis? A). Fecal occult blood test B). Throat swab C). Sweat chloride test D). Breath analysis
Sweat chloride test
The function of the cerebrospinal fluid includes all of the following EXCEPT: A). Nutritional enrichment of nervous tissue B). Transmittance of neurologic impulses C). Removal of metabolic waste products D). Protection of neurologic tissue from trauma
Transmittance of neurologic impulses
All of the following are directly involved in the production of semen EXCEPT? A). Prostate B). Pituitary gland C). Seminal vesicles D). Bulbourethral gland
Pituitary gland
A test that can be used as a confirmatory test for urobilinogen is: A). Acetest® B). Ictotest® C). Watson-Schwartz Test D). Clinitest
Watson-Schwartz Test
A urine specimen which was collected in a dark container, stored in the dark, has a pH of 7.5, and whose sample aliquot is wrapped in foil, is most likely being sent for: A). Aldosterone B). Porphyrins C). Catecholamines D). Metanephrines
Porphyrins
A cell count is ordered on a CSF sample that is bloody. Which of the following procedures would improve count accuracy? A). Use Spinal Diluting Fluid, a mixture of acetic acid and crystal violet. B). Use an automated hematology cell counter. C). Dilute the sample to minimize the number of red blood cells in the squares being counted. D). Use of electronic cell counter.
Dilute the sample to minimize the number of red blood cells in the squares being counted.
The exocrine functions of the kidneys include which of the following? A). Regulation of hormone production B). Elimination of metabolic waste products C). Maintenance of blood pressure D). Production of red blood cells
Elimination of metabolic waste products
A reagent strip test for hemoglobin has been reported positive. Microscopic examination fails to yield red blood cells. This patient's urine condition can be called: A). Hematuria B). Hemoglobinuria C). Oliguria D). Hemosiderinuria
Hemoglobinuria
False-positive tests for protein on a urine reagent strip may be caused by the following conditions, EXCEPT: A). Blood presence in the specimen B). High amounts of bilirubin C). High protein diet D). Alkaline medication
High protein diet
Which of the following may associated with acidic urinary pH? A). Metabolic alkalosis B). Renal tubular acidosis C). Vegetarian diet D). High urine glucose
High urine glucose
Which of the following casts might be found in the urine of a healthy individual after strenuous exercise? A). Epithelial cell casts and granular casts B). Hyaline casts and granular casts C). Granular casts waxy casts D). Waxy casts and hyaline casts
Hyaline casts and granular casts
The viscosity of synovial fluid is due to synoviocyte secretion of mucopolysaccharide, which contains: A). Acid phosphatase B). Phosphatidyl glycerol C). Hyaluronic acid D). Lecithin
Hyaluronic acid
The primary mechanism responsible for glomerular filtration is: A). Osmotic gradient B). Concentration of blood components C). Rate of blood flow through the kidneys D). Hydrostatic differential in glomerular tufts
Hydrostatic differential in glomerular tufts
Nephrotic syndrome is associated with all of the following clinical findings, except: A). Increased proteinuria B). Decreased serum albumin C). Hyperproteinemia D). Edema
Hyperproteinemia
Which of the following methods may be employed to definitively identify Bence-Jones proteins? A). Immunoelectrophoresis B). Sulfosalicyclic acid precipitation C). Heat precipitation at 40-60oC D). Urine dipstick
Immunoelectrophoresis
Found in acid to neutral pH urine specimens and are yellow in color. Concentric circles and the radial striations are noted microscopically: A). Cystine crystals B). Cholesterol crystals C). Leucine crystals D). Bilirubin crystals
Leucine crystals
All of the following white blood cells would produce a positive leukocyte esterase test on the urine chemical reagent strip, EXCEPT? A). Lymphocytes B). Basophils C). Eosinophils D). Neutrophils
Lymphocytes
All of the following white blood cells would produce a positive leukocyte esterase test, EXCEPT? A). Neutrophils B). Eosinophils C). Lymphocytes D). Basophils
Lymphocytes
Normal adult CSF may have 0-5 white blood cells (WBCs)/µL. Which of the following cell types account for 60-100% of these WBCs? A). Neutrophils B). Lymphocytes C). Monocytes D). Eosinophils
Lymphocytes
Which of the following may be seen in a CSF sample of a patient that has a subarachnoid (intracranial) hemorrhage (SAH)? A). Macrophages containing hemosiderin B). Uneven distribution of blood in CSF tubes collected C). Clot is present in CSF sample D). Supernatant of CSF sample does not have xanthochromia
Macrophages containing hemosiderin
Bence-Jones proteinuria can be seen in all of the following conditions EXCEPT: A). Amyloidosis B). Multiple myeloma C). Macroglobulinemia D). Nephrotic syndrome
Nephrotic syndrome
Which of the following would be the most appropriate method to confirm a positive protein from a urine dipstick: A). Immunoelectropheresis B). Heat precipitation C). Sulfosalicylic acid precipitation D). Protein electrophoresis
Sulfosalicylic acid precipitation
Which of the following is true of glucose levels in the CSF of an otherwise healthy individual? A). There is no glucose in the CSF of a healthy person. B). The CSF glucose should be about 20 to 30% of the plasma glucose level. C). The CSF glucose should be about 60 to 70% of the plasma glucose level. D). The CSF glucose should be the same as the plasma glucose level.
The CSF glucose should be about 60 to 70% of the plasma glucose level.
What effect may bacterial contamination have on urine pH? A). The bacteria may make the pH more acidic. B). The bacteria may make the pH more alkaline. C). The bacteria would not affect urine pH. D). The bacteria will keep the pH neutral.
The bacteria may make the pH more alkaline.
A urine specimen was collected at 6:00 a.m. and remained at room temperature until it was received in the laboratory at 3:30 p.m. How may the pH of the specimen be affected by the extended time at room temperature if bacteria are present in the specimen? A). The pH may become more acidic. B). The pH may become more alkaline. C). The pH will become neutral. D). The pH would probably not be affected.
The pH may become more alkaline.
Which of the following statements is TRUE for specific gravity measured by the urine chemical reagent strip method? A). High concentrations of protein in urine do not increase the readings when using the urine chemical reagent strip. B). An alkaline pH would not affect the specific gravity result using a reagent strip method. C). The urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen. D). The urine chemical reagent strip method is based on the fact that light is refracted in proportion to the amount of total solids dissolved in the urine.
The urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen.
Which of the following crystals would most likely be found in normal ALKALINE urine? A). Amorphous urates B). Triple phosphate C). Uric acid D). Calcium oxalate
Triple phosphate
Appear smooth and homogeneous, and highly refractile. They are present in patients with severe renal failure, and can be due to allograft rejection: A). Granular cast B). Waxy cast C). Renal tubular epithelial cast D). Hyaline cast
Waxy cast
Which of the following casts is characteristically associated with acute pyelonephritis? A). Red cell B). Fatty C). White cell D). Waxy
White cell
In a patient with acute glomerulonephritis you would expect to find all of the following in the urine EXCEPT: A). Protein B). RBCs C). Yeast D). RBC casts
Yeast
A patient that is on a vegetarian diet will most likely have a(n): A). pH is not affected by diet B). Acid pH C). Alkaline pH D). Neutral pH
Alkaline pH
Bacterial contamination of a urine specimen from a normal healthy individual could originate from all of the following except: A). Contaminated urine container B). Vagina C). Bladder D). Vulva
Bladder
The primary site of reabsorption of glomerular filtrate is the: A). Loop of Henle B). Distal convoluted tubule C). Proximal convoluted tubule D). Collecting duct
Proximal convoluted tubule
A patient reported to her doctor that her stools have been ribbon-like over the last few weeks. What is most likely the cause of the patient's stool appearance? A). Diarrhea B). Constipation C). Inflammation of the intestinal wall D). Bowel obstruction
Bowel obstruction
What type of white blood cell is seen MOST frequently in urine sediment with infections of the urinary system? A). Eosinophil B). Lymphocyte C). Monocyte D). Neutrophil
Neutrophil
A 21-year-old visited her doctor. She mentioned dysuria, frequency and urgency of urination to her doctor. Which of the following urinalysis reagent strips tests would you expect to be positive for this patient based on her symptoms? A). Nitrites B). Blood C). Bilirubin D). Ketones
Nitrites
All of the following are methods employed for measuring the specific gravity of urine, EXCEPT? A). Refractometry B). Hydrometry C). Osmolality D). Urine reagent strips
Osmolality
Bence-Jones proteinuria is associated with all of the following conditions EXCEPT: A). Macroglobulinemia B). Pernicious anemia C). Multiple myeloma D). Amyloidosis
Pernicious anemia
Fetal lung maturity can be determined from amniotic fluid because the surfactant is PRIMARILY composed of: A). Protein B). Cholesterol C). Glycerol D). Phosphatidylcholine and other phospholipids
Phosphatidylcholine and other phospholipids
Effusion fluids are classified as transudates or exudates. According to Light's criteria, all of the following is applicable to an exudate EXCEPT? A). Pleural fluid/serum protein ratio >0.5 B). Pleural fluid/serum lactate dehydrogenase (LDH) ratio >0.6 C). Serum-ascites albumin gradient (SAGG) <1.1 g/dL D). Pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum
Pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum
When preparing a slide for morphologic examination, what is the reason for adding a drop of albumin to the cerebrospinal fluid (CSF) sample prior to cytocentrifugation? A). Enhance staining of the elements. B). Preserve the integrity of the cells. C). Increases the fluid volume so that cells will form a monolayer on the slide. D). Dilute the sample
Preserve the integrity of the cells.
Which of the following tests require a 72-hour stool (fecal) collection? A). Quantitative fecal fat B). Ova and Parasite (O&P) C). Stool culture D). Occult blood
Quantitative fecal fat
A urine concentration test was performed on a patient after fluid deprivation period with the following findings: After 12 hours Urine Osmolality = 850 mOsm/Kg After 16 hours Urine Osmolality = 850 mOsm/Kg A). This represents normal kidney function. B). This represents a loss of tubular function and concentrating ability. C). This represents a laboratory error, as these results are not medically possible. D). These results represent end-stage renal disease.
This represents normal kidney function.
Cerebrospinal fluid (CSF) specimens are usually collected by lumbar puncture and placed in numbered tubes starting with the first tube collected. If four tubes are collected, which tube would be used for a cell count and differential? A). Tube #1 B). Tube #2 C). Tube #3 D). Tube #4
Tube #3
