Urinalysis and Body Fluids Certification Questions
A 2-year-old child had a positive urine ketone. This would most likely be caused by: A. vomiting B. anemia C. hypoglycemia D. biliary tract obstruction
A
A 21-year-old woman had glucose in her urine with a normal blood sugar. These findings are most consistent with: A. renal glycosuria B. diabetes insipidus C. diabetes mellitus D. alkaline tide
A
A 62-year-old patient with hyperlipoproteinemia has a large amount of protein in his urine. Microscopic analysis yields moderate to 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
A patient with uncontrolled diabetes mellitus will most likely have: A. pale urine with a high SG B. concentrated urine with a high SG C. pale urine with a low SG D. dark urine with a high SG
A
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
A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Addition of acetic acid results in turbidity and a clot. This indicates that: A. the fluid is synovial fluid B. plasma was obtained C. red blood cells caused a false positive reaction D. the specimen is not adequate
A
A reagent strip area impregnated with stabilized, diazotized 2,4-dichloroaniline will yield a positive reaction with: A. bilirubin B. hemoglobin C. ketones D. urobilinogen
A
A test area of a urine reagent strip is impregnated with only sodium nitroprusside. This section will react with: A. acetoacetic (diacetic) acid B. leukocyte esterase C. beta-hydroxybutyric acid D. ferric chloride
A
A turbid cerebrospinal fluid is most commonly caused by: A. increased white blood cells B. increased protein C. increased glucose D. increased bacterial organisms
A
A urine with an increased protein has a high specific gravity. Which of the following would be a more accurate measure of urine concentration? A. osmolality B. ketones C. refractive index D. pH
A
Antidiuretic hormone regulates the reabsorption of: A. water B. glucose C. potassium D. calcium
A
In addition to the sperm count in a fertility study, analysis of seminal fluid should also include: A. time of liquefaction, estimation of motility, morphology B. motility, morphology, test for alkaline phosphatase C. time of liquefaction, test for acid phosphatase, qualitative test for hemoglobin D. time of liquefaction, qualitative test for hemoglobin and motility
A
In most compound light microscopes, the ocular lens has a magnification of: A. 10x B. 40x C. 50x D. 100x
A
On bright-light microscopic examination of a urinary sediment, round refractile globules are noted in cells encapsulated within a hyaline matrix. A polarized-light microscopic examination of the urinary structure showed the globules to be birefringent in the shape of Maltese crosses. These urinary structures can be identified as: A. waxy casts associated with advanced tubular atrophy B. granular casts containing plasma protein aggregates C. crystal casts associated with obstruction due to tubular damage D. fatty casts containing lipid-laden renal tubular cells
A
Polyuria is usually correlated with: A. acute glomerulonephritis B. diabetes mellitus C. hepatitis D. tubular damage
A
Routine screening of urine samples for glycosuria is preformed primarily to detect: A. glucose B. galactose C. bilirubin D. ketones
A
The amber yellow color of urine is primarily due to: A. urochrome pigment B. methemoglobin C. bilirubin D. homogentisic acid
A
The principal mucin in synovial fluid is: A. hyaluronate B. albumin C. orosomucoid D. pepsin
A
To prepare the reagent used in confirmatory protein testing, a technician would: A. dissolve 3 g sulfosalicylic acid in 100 mL of water B. dissolve 5 g trichloracetic acid in 100 mL of water C. combine 3 mL of hydrochloric acid and 97 mL of water D. combine 5 mL of glacial acetic acid and 95 mL of water
A
To prepare the reagent used in confirmatory protein testing, a technician would: A. dissolve 3 g sulfosalicylic acid in 100 mL of water B. dissolve 5 g trichloracetic acid in 100 mL of water C. combine 3 mL of hydrochloric acid and 97 mL of water D. combine 5 mL of glacial acetic acid and 95 mL of water`
A
Urinary calculi most often consist of: A. calcium B. uric acid C. leucine D. cystine
A
Which of the following inorganic substances are excreted in the urine in the largest amount? A. urea and NaCl B. creatinine and NaCl C. creatinine and ammonia D. urea and glucose
A
Which of the following is an abnormal crystal described as a hexagonal plate? Urinalysis and Body Fluids 471 A. cystine B. tyrosine C. leucine D. cholesterol
A
Which of the following reagents is used to react with ketones in the urine? A. sodium nitroprusside B. acetoacetic acid C. acetone D. beta-hydroxybutyric acid
A
While performing a urinalysis, a technologist notices that the urine specimen has a fruity odor. This patient's urine most likely contains: A. acetone B. bilirubin C. coliform bacilli D. porphyrin
A
While performing an analysis of a baby's urine, the technologist notices the specimen to have a "mousy" odor. Of the following substances that may be excreted in urine, the one that MOST characteristically produces this odor is: A. phenylpyruvic acid B. acetone C. coliform bacilli D. porphyrin
A
A 17-year-old girl decided to go on a starvation diet. After 1 week of starving herself, what substance would most likely be found in her urine? A. protein B. ketones C. glucose D. blood
B
A 42-year-old man is admitted to the emergency room with multiple abrasions, several broken bones, a fractured pelvis, and a crushed femur. The following urinalysis results are obtained: Clarity - Hazy Color - Red-brown Specific gravity - 1.026 pH - 6.0 Protein - 300 mg/dL Glucose - Negative Ketones - Negative Blood - 4+ Bilirubin - Negative Nitrite - Negative Urobilinogen - 0.1 EU/dL Microscopic: Hemoglobin granular casts 3-5 What is the MOST likely explanation for the discrepancy between the 4+ blood result, hemoglobin granular casts, and the complete absence of red cells on the microscopic? A. There is a false-positive reaction for blood on the urine strip due to the large amount of protein. B. The blood portion of the urine reagent strip is more sensitive to hemoglobin than intact red cells. C. Red blood cells have been lysed due to the pH and the specific gravity. D. The hemoglobin granular casts which were reported may actually be white blood cell casts.
B
A 59-year-old man is evaluated for back pain. Urine studies (urinalysis by multiple reagent strip) include: Urinalysis Specific gravity - 1.017 pH - 6.5 Protein - Negative Glucose - Negative Blood - Negative Microscopic - Rare epithelial cells Urine protein electrophoresis: Monoclonal spike in gamma globulin region Which of the following statements best explains these results? A. The urine protein is falsely negative due to the specific gravity. B. The urine protein is falsely negative because the method is not sensitive for Bence Jones protein. C. The microscopic examination is falsely negative due to the specific gravity. D. The electrophoresis is incorrect and should be repeated.
B
A centrifuge head has a diameter of 60 cm and spins at 3000 rpm. What is the maximum achievable g force (g = 0.00001 x radius in cm x rpm2)? A. 1.8g B. 2700g C. 27,000g D. 90,000g
B
A clean-catch urine sample is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and the specimen is then sent to microbiology for culture. The specimen should: A. be centrifuged and the supernatant cultured B. be rejected due to possible contamination from routine urinalysis C. not be cultured if no bacteria are seen D. be immediately processed for culture regardless of urinalysis results
B
A component seen during a microscopic urinalysis stains positively with Sudan III stain but does not polarize. This most likely is a: A. cholesterol ester B. neutral fat C. lipid D. leucine
B
A micropipet graduated to the tip and calibrated to contain should: A. be drained B. be rinsed C. not be blown out D. not be rinsed
B
A milky colored urine from a 24-year-old woman would most likely contain: A. spermatozoa B. many white blood cells C. red blood cells D. bilirubin
B
A patient has glucosuria, hyperglycemia, and polyuria. These findings would be associated with: A. renal glucosuria B. diabetes mellitus C. emotional stress D. eating a heavy meal
B
A patient with renal tubular acidosis would most likely excrete a urine with a: A. low pH B. high pH C. neutral pH D. variable pH
B
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
A reagent strip test for hemoglobin has been reported positive. Microscopic examination fails to yield red blood cells. This patient's condition can be called: A. hematuria B. hemoglobinuria C. oliguria D. hemosiderinuria
B
A technologist is having trouble differentiating between red blood cells, oil droplets, and yeast cells on a urine microscopy. Acetic acid should be added to the sediment to: A. lyse the yeast cells B. lyse the red blood cells C. dissolve the oil droplets D. crenate the red blood cells
B
A urine specimen comes to the laboratory 7 hours after it is obtained. It is acceptable for culture only if the specimen has been stored: A. at room temperature B. at 4°C-7°C C. frozen D. with a preservative additive
B
A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copp reduction test. If both results are positive, which of the following interpretations is corre A. Galactose is present B. Glucose is present C. Lactose is not present D. sucrose is not present
B
A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copp reduction test. If both results are positive, which of the following interpretations is corre A. Galactose is present. B. Glucose is present. C. Lactose is not present. D. Sucrose is not present.
B
A urine's specific gravity is directly proportional to its: A. turbidity B. dissolved solids C. salt content D.sugar content
B
An antidiuretic hormone deficiency is associated with a: A. specific gravity around 1.031 B. low specific gravity C. high specific gravity D. variable specific gravity
B
In which of the following metabolic diseases will urine turn dark brown to black upon standing? A. phenylketonuria B. alkaptonuria C. maple syrup disease D. aminoaciduria
B
Ketones in urine are due to: A. complete utilization of fatty acids B. incomplete fat metabolism C. high carbohydrate diets D. renal tubular dysfunction
B
Refractive index is a comparison of: A. light velocity in solutions with light velocity in solids B. light velocity in air with light velocity in solutions C. light scattering by air with light scattering by solutions D. light scattering by particles in solution
B
The clarity of a urine sample should be determined: A. using glass tubes only, never plastic B. following thorough mixing of the specimen C. after addition of sulfosalicylic acid D. after the specimen cools to room temperature
B
The following lab values were obtained on a body fluid sample: Protein - 3 g/dL Albumin - 2.1 g/dL Hyaluronate - 0.4 g/dL Glucose - 80mg/dL Lactate - 10mg/dL The sample is: A. pleural fluid B. synovial fluid C. urine D. cerebrospinal fluid
B
The following results were obtained on a urine specimen at 8 AM: pH - 5.5 Protein - 2+ Glucose - 3+ Ketones - 3+ Blood - Negative Bilirubin - Positive Nitrite - Positive If this urine specimen was stored uncapped at 5°C without preservation and retested at 2 PM, which of the following test results would be changed due to these storage conditions? A. glucose B. ketones C. protein D. nitrite
B
The knob between the eyepieces on a binocular microscope is used to: A. correct for optical differences between the right and left eyes B. adjust for distances between one's eyes C. change the magnification of the oculars D. improve the equivalent focus of the microscope
B
The principle of the reagent strip test for urine protein depends on: A. an enzyme reaction B. protein error of indicators C. copper reduciton D. the toluidine reaction
B
Urine specific gravity is an index of the ability of the kidney to: A. filter the plasma B. concentrate the urine C. alter the hydrogen ion concentration D. reabsorb sodium ions
B
Urine that develops a port wine color after standing may contain: A. melanin B. porphyrins C. bilirubin D. urobilinogen
B
Which of the following urinary parameters are measured during the course of concentration and dilution tests to assess renal tubular function? A. urea, nitrogen, and creatinine B. osmolality and specific gravity C. sodium and chloride D. sodium and osmolality
B
While performing a urinalysis, a technologist notices that the urine specimen has a fruity odor. This patient's urine most likely contains: A. acetone B. bilirubin C. coliform bacilli D. porphyrin
B
A 24-year-old obese diabetic woman had the following blood and urine test results from specimens obtained at the same time: pH = 7.5 Protein =30 mg/dL Glucose = negative Ketones = 15 mg/dL Bilirubin = negative Blood = negative Nitrite = negative Urobilinogen = 1 EU/dL Specific gravity = 1.008 Microscopic: Epithelial cells = 3-5 Bacteria = many Yeast = many Amorphous = moderate Blood sugar = 195 mg/dL Which of the following is the MOST likely explanation for the negative urine glucose finding? A. There is a false-negative glucose due to oxidizing contaminants. B. There is a false-negative glucose due to the alkaline pH. C. The specimen is probably old and the bacteria and yeast have consumed the glucose. D. Glucose would not be present in the urine specimen since the blood sugar was normal.
C
A positive result for bilirubin on a reagent strip should be followed up by: A. notifying the physician B. requesting a new specimen C. performing an IctotestTM D. performing a urobilinogen
C
A urine tested with Clinitest exhibits a pass through reaction and is diluted by adding 2 drops of urine to 10 drops water. This is a dilution of: A. 1 to 4 B. 1 to 5 C. 1 to 6 D. 1 to 8
C
An abdominal fluid is submitted from surgery. The physician wants to determine if this fluid could be urine. The technologist should: A. perform a culture B. smell the fluid C. test for urea, creatinine, sodium and chloride D. test for protein, glucose and pH
C
An acid urine that contains hemoglobin will darken on standing due to the formation of: A. myoglobin B. sulthemoglobin C. methemoglobin D. red blood cells
C
An ammonia-like odor is characteristically associated with urine from patients who: A. are diabetic B. have hepatitis C. have an infection with Proteus sp D. have a yeast infection
C
Bilirubinuria may be associated with: A. strenuous exercise B. increased destruction of platelets C. viral hepatitis D. hemolytic anemia
C
Broad waxy casts are LEAST likely to be associated with: A. advanced tubular atrophy B. end-stage renal disease C. fatty degeneration tubular disease D. formation in a pathologically dilated tubule
C
Glycosuria may be due to: A. hypoglycemia B. increased renal threshold C. renal tubular dysfunction D. increased glomerular filtration rate
C
Normal urine primarily consists of: A. water, protein, and sodium B. water, urea, and protein C. water, urea, and sodium chloride D. water, urea, and bilirubin
C
Red colored urine may be due to: A. bilirubin B. excess urobilin C. myoglobin D. homogentisic acid
C
Small round objects found in a urine sediment that dissolve after addition of dilute acetic acid and do not polarize most likely are: A. air bubbles B. calcium oxalate C. RBCs D. yeast cells
C
The confirmatory test for a positive protein result by the reagent strip method uses: A. Ehrlich's reagent B. a diazo reaction C. sulfosalicylic acid D. a copper reduction tablet
C
The following urinalysis results were obtained from an 18-year-old woman in labor: pH - 6.5 Protein - 30 mg/dL Glucose - 250 mg/dL Ketones - Negative Bilirubin - Small (color slightly abnormal) Blood - Negative Nitrite - Negative Urobilinogen - 0.1 EU/dL Specific gravity - 1.025 Copper reduction test - 1.0 g/dL Sulfosalicylic acid test for protein - 30 mg/dL Which of the following is the MOST likely explanation for the patient's positive copper reduction test? A. only glucose is present B. only lactose is present C. glucose and possibly other reducing substances/sugars are present D. results are false positive due to the presence of protein
C
The normal pH value for a healthy adult's urine is: A. 4.5 B. 5.0 C. 6.0 D. 8.0
C
The primary constituent of hyaline casts is: A. fat B. cells C. protein D. mucus
C
The type of urinary test that is most characteristically associated with glomerular injury is a(n): A. epithelial cell B. white cell C. red cell D. fatty
C
To prepare a solution appropriate for quality control of the refractometer, a technician should use: A. urea with a specific gravity of 1.040 B. water with a specific gravity of 1.005 C. sodium chloride with a specific gravity of 1.022 D. calcium chloride with an osmolarity of 460
C
Urine osmolality is related to: A. pH B. filtration C. specific gravity D. volume
C
Urine reagent strips should be stored in a(n): A. refrigerator (4°C-7°C) B. incubator (37°C) C. cool dry area D. open jar exposed to air
C
Urine samples should be examined within 1 hour of voiding because: A. red blood cells, leukocytes, and casts agglutinate after standing for several hours at room temperature B. urobilinogen increases and bilirubin decreases after prolonged exposure to light C. bacterial contamination will cause alkalinization of the urine D. ketones will increase due to bacterial and cellular metabolism
C
Use of a refractometer over a urinometer is preferred due to the fact that the refractometer uses a: A. large volume of urine and compensates for temperature B. small volume of urine and compensates for glucose C. small volume of urine and compensates for temperature D. small volume of urine and compensates for protein
C
What cell is MOST commonly associated with vaginal contamination? A. white B. transitional C. squamous D. glitter
C
Which of the following is the best guide to consistent centrifugation? A. potentiometer setting B. armature settings C. tachometer readings D. rheostat readings
C
Which of the following would be affected by allowing a urine specimen to remain at room temperature for three hours before analysis? A. occult blood B. specific gravity C. pH D. protein
C
A 24-hour urine from a man who had no evidence of kidney impairment was sent to the laboratory for hormone determination. The volume was 600 mL, but there was some question as to the completeness of the 24-hour collection. The next step would be to: A. perform the hormone determination, since 600 mL is a normal urine 24-hour volume B. check the creatinine level; if it is less than 1 g do the procedure C. report the hormone determination in milligrams per deciliter in case the specimen was incomplete D. check the creatinine level; if it is greater than 1 g do the procedure
D
A sperm count is diluted 1:20 and 50 sperm are counted in two large squares of the Neubauer counting chamber. The sperm count in mLs is: A. 5000 B. 50,000 C. 500,000 D. 5,000,000
D
A urinalysis performed on a 27-year-old woman yields the following results: Specific gravity = 1.008 pH = 5.0 Protein =2+ Glucose = negative Ketones = negative Bilirubin = negative Blood =3+ Nitrite = negative Leukocytes = positive Urobilinogen = 0.1 EU/dL Microscopic: WBC/HPF = 20-30 RBCIHPF = 30-55 CastsILPF Hyaline = 5-7 Epithelial = 1-3 Coarse granular = 2-3 Waxy = 1-3 Uric acid crystals = moderate Uris acid crystals = moderate The above data are consistent with: A. nephrotic syndrome B. gout C. biliary obstruction D. chronic renal disease
D
A urine specimen collected from an apparently healthy 25-year-old man shortly after he finished eating lunch was cloudy but showed normal results on a multiple reagent strip analysis. The most likely cause of the turbidity is: A. fat B. white blood cells C. urates D. phosphates
D
A woman in her ninth month of pregnancy has a urine sugar that is negative with the urine reagent strip but gives a positive reaction with the copper reduction method. The sugar most likely responsible for these results is: A. maltose B. galactose C. glucose D. lactose
D
After receiving a 24-hour urine sample for quantitative total protein analysis, the technician must first: A. subculture the urine for bacteria B. add the appropriate preservitive C. screen for albumin D. measure the total volume
D
Ammonium sulfate was added to red urine. The urine had a positive reaction tor blood, but no RBCs were seen on microscopic examination. After centrifugation the supernatant fluid is red. The abnormal color is caused by: A. Pyridium B. hemoglobin C. porphyrins D. myoglobin
D
Patients with diabetes mellitus have urine with: A. decreased volume and decreased specific gravity B. decreased volume and increased specific gravity C. increased volume and decreased specific gravity D. increased volume and increased specific gravity
D
Pleural transudates differ from pleural exudates in that transudates have: A. protein values of> 4 g/100 mL B. specific gravity values of> 1.020 C. LD values of> 200 U/L D. relatively low cell counts
D
Round refractile globules noted on bright-light microscopy of a urinary sediment were birefringent with polarized-light and appeared as perfect Maltese crosses. These globules are most likely: A. neutral fats B. starch C. triglycerides D. cholesterol
D
The following urine results were obtained on a 25-year-old female: Color = amber Appearance = cloudy Specific gravity = 1.015 WBC casts = few pH = 5.0 Protein = 1+ Glucose = negative Blood = small Microscopic: Bacteria = many WBC casts = few WBC/HPF = 30-40 These results are most compatible with: A. glomerulonephritis B. renal calculus C. vaginitis D. pyelonephritis
D
The presence of leukocytes in urine is known as: A. chyluria B. hematuria C. leukocytosis D. pyuria
D
The results of a urinalysis on a first-morning specimen are: Specific gravity - 1.024 pH - 8.5 Protein - Negative Glucose - Negative Microscopic - Uric acid crystals The next step is to repeat the: A. microscopic examination B. protein and glucose C. specific gravity D. pH and microscopic examination
D
The sequence of light through a microscope is: A. condenser, stage, objective B. iris diaphragm, condenser, ocular C. stage, condenser, iris, objective, ocular D. diaphragm, condenser, objective, ocular
D
To avoid falsely elevated spinal fluid cell counts: A. use 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
Waxy casts are most easily differentiated from hyaline casts by their: A. color B. size C. granules D. refractivity
D
When employing the urine reagent strip method, a false-positive protein result may occur in the presence of: A. large amounts of glucose B. x-ray contrast media C. Bence Jones protein D. highly alkaline urine
D
Which of the following casts is most indicative of severe renal disease? A. hemoglobin B. granular C. cellular D. waxy
D
Which of the following components is/are present in serum but NOT present in the glomerular filtrate? A. glucose B. amino acids C. urea D. large molecular weight proteins
D
White blood cell casts are most likely to indicate disease of the: A. bladder B. ureter C. urethra D. kidney
D
