Urinalysis - Test 2 - Units 3 & 4

Using quality control materials, reagent strip performance should be checked 1. at least daily 2. when a new bottle of strips or tablets is opened 3. when questionable results are obtained 4. once each shift by each Lab Tech performing urinalysis testing

1,2, and 3 are correct

The number of fields that should be examined when quantitating urinary sediment constituents is:

10

The Clinitest "pass-through" phenomenon refers to:

A positive urine that "passes-through" all positive indicators to read low or negative

List the three types of ketone bodies and indicate which is excreted in the largest amounts

Acetone, acetoacetic acid, beta-hydroxybutyric acid are the three ketone bodies. Beta-hydroxybutyrate is the most abundant, although acetoacetic acid is typically detected by reagent strips.

Match the reagent strip reaction with the analyte it is measuring.

An indicator (tetrabromphenol) releases H+ to the analyte being measured - Protein Measures the change in disassociation constant of a polyelectrolyte - Specific Gravity Utilizes a double indicator system, which includes methyl red and bromthymol blue - pH Pseudoperoxidase of analyte catalyzes reaction between hydrogen peroxide and the chromogen - Blood 2, 4-dichloroanline diazonium salt reacts with analyte to cause a color change - Bilirubin Analyte reacts with either Ehrlich's reagent or and Azo-dye to cause a color change -Urobilinogen Two step reaction where the peroxidase in the first step catalyzes the reaction between peroxide and and a chromogen - Glucose Analyte reacts with sodium nitroprusside in an alkaline medium - Ketones Based on the Griess Reaction - Nitrites Analyte comes in contact with an acid ester, which produces an aromatic compound that reacts with a diazonium salt -Leukocyte Esterase

A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copper reduction test. If both results are positive, which of the following interpretations is correct?

Glucose is present

What is the confirmatory test for a positive bilirubin result by the reagent strip method?

Ictotest©

Yeast can be easily confused with what type of cell?

RBC

Match the type of cast with the clinical significance

RBC - Glomerulonephritis Epithelial (RTE) - Renal tubular damage Bacterial - Pyelonephritis Waxy - Extreme urinary stasis Fatty - Nephrotic syndrome Hyaline - Strenuous exercise, dehydration Broad - Extreme urinary stasis

Which if the following substances if present in the urine will result in a negative Clinitest?

Sucrose

All casts typically contain:

Tamm-Horsfall glycoprotein

Which of the following proteins originates in the urinary tract?

Tamm-Horsfall protein

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 Blood sugar = 195 mg/dl Which of the following is the MOST likely explanation for the negative urine glucose finding?

The specimen is probably old and the bacteria and yeast have consumed the glucose.

What is another name for ammonium biurate?

Thorny apple

Which of the following casts are characteristically associated with acute pyelonephritis?

WBC

Several individual and clumps of cells are seen associated with UTIs. What are the cells?

WBCs

"Brick dust" would be found in urine of what pH?

acid

Abnormal crystals are found in urine at what pH range?

acid

The protein section of the urine reagent strip is MOST sensitive to:

albumin

For each urinary crystal listed indicate whether the crystal is categorized as normal or abnormal

ammonium biurate - normal calcium carbonate - normal leucine - abnormal cholesterol - abnormal uric acid - normal calcium phosphate - normal tyrosine - abnormal calcium oxalate - normal triple phosphate - normal cystine -abnormal

These urine crystals can come in several forms, some of which can be heated away after incubating the sample in a water bath. The result report of this microscopic examination would indicate

amorphous

Students may have difficulty differentiating between bacteria and:

amorphous phosphates

A positive nitrite test is associated with which of the following?

bacteria

Which of the following ketone bodies is excreted in the largest amount in ketonuria?

beta-hydroxybutyric acid

All of the following conditions can promote or effect crystal formation EXCEPT:

centrifugation

Urine reagent strips should be stored in a(n):

cool dry area

Which of the following is the primary reagent in the copper reduction tablet?

copper sulfate

Hexagon shaped crystal found in urine is

cystine

The purpose of scanning the perimeter of urine sediment placed under a conventional glass slide is to:

detect the presence of casts

A urinalysis performed on a 2-week-old infant with diarrhea shows a negative reaction with the glucose oxidase reagent strip. A copper reduction tablet should be performed to check the urine sample for the presence of:

galactose

Routine screening of urine samples for gycosuria is performed primarily to detect:

glucose

A reagent test strip for hemoglobin has been reported positive. Microscopic examination fails to yield red blood cells. The patient's condition can be called

hemoglobinuria

Ketones in urine are due to:

incomplete fat metabolism

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?

ketones

Which of the following blood cells will NOT be detected by the leukocyte esterase pad because it lacks esterases?

lymphocytes

Which if the following factors will NOT interfere with the reagent test strip for leukocytes?

nitrite

When reporting casts they are reported as:

number per low power field

On the reagent strip test for blood, any hemoglobin present in urine catalyzes the:

oxidation of the chromogen in the presence of hydrogen peroxide

Urobilinogen is formed from the:

reduction of bilirubin by intestinal bacteria

A 21-year-old woman had glucose in her urine with a normal blood sugar. These findings are most consistent with:

renal glycosuria

Oval fat bodies are defined as:

renal tubular epithelial cells that contain lipids

The primary advantage in using a commercial system for preparing the urine sediment is:

standardization

This image may be the result of the patient's or tech's use of powder. It is properly identified as:

starch crystals

A false negative result in urobilinogen testing may occur if the urine specimen is:

stored for a prolonged period

Hyaline casts are usually found:

under subdued light

Bilirubinuria may be associated with:

viral hepatitis

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 technologist should determine if this patient has taken:

vitamin C

Which of the following casts is most indicative of severe renal disease?

waxy

"Glitter cells" are a microscopic finding of:

white blood cells in hypotonic urine