MLT ASCP Practice Questions: Urinalysis & Body Fluids
False The method used on the reagent strip is specific for glucose. An additional test, such as Clinitest, should be used to check for other reducing substances.
(T/F) When the glucose result on a urine specimen from an infant is negative on the reagent strip, it can be assumed that the specimen is negative for other reducing substances such as galactose.
B; Nephrotic syndrome would best match the clinical symtpoms and laboratory findings. Nephrotic syndrome is caused by damage to the kidneys, especially the basement membrane of the glomerulus; which causes abnormal excretion of protein and red blood cells in the urine. Fats are also present in the urine in most cases. A foamy appearance of the urine is a key characteristic of this condition. Clinical symptoms include: Swelling Weight gain from fluid retention Poor appetite High blood pressure
A 41-year-old man is admitted to the hospital complaining of a decreased frequency of urination, a constant bloated feeling, weight gain, and mild edema of the ankles and eyes. Urinalysis results are as follows: Color: pale yellow Clarity: clear pH: 5.0 Sp. Gravity 1.010 Glucose: 2+ Ketones: negative Protein- 3+ Blood: moderate Bilirubin: negative Bacteria: negative Urobilinogen: normal Nitrate: negative **A large amount of white foam was noted. Microscopic Results: RBCs: 0-2 WBCs: 0-2 Casts: 2-5 hyaline, 0 - 3 fatty casts, 0 - 2 waxy casts Few transitional epithelial cells Few oval fat bodies Based on the urinalysis report above, the MOST probable diagnosis is: A. Acute pyelonephritis B. Nephrotic syndrome C. Acute glomerulonephritis D. Lipiduria of unknown etiology
C; The crystals that are seen in the urine are monohydrate calcium oxalate crystals. Oxalic acid, a byproduct of ethylene glycol metabolism, combines with calcium in the body to form monohydrate calcium oxalate crystals, as shown in the accompanying image.
A 62-year-old man drank an unknown liquid in a suicide attempt, and his urine contained crystals similar in shape to those shown in this image. This man MOST likely ingested: A. Methanol B. Isopropanol C. Ethylene glycol D. Ethanol E. Rubbing alcohol
C; A daily urine output which is over 2000 ml/24 hours is referred to as polyuria. Polyuria is associated with at least 2.5 liters of urine filtered per day, resulting in profuse urinary frequency and urination. Polyuria is a key characteristic of diabetes mellitus that is not under control.
A daily urine output which is over 2000 ml/24 hours is referred to as: A. anuria B. oliguria C. polyuria D. pyuria E. dysuria
A & C; When a urine sample shows a negative nitrite test, but bacteria are present upon microscopic examination, the false-negative result could be caused by two possibilities listed in the choices above: The bacteria that is present is not a nitrate-reducer OR the urine was in the bladder for an insufficient amount of time for nitrate to be reduced to nitrite.
A patient suspected of a urinary tract infection has a negative nitrite test, but bacteria are present upon microscopic examination. What may have caused this discrepant result? (Choose ALL correct answers) A. The bacteria present are not nitrate-reducers. B. The urine specimen may have been tested too soon after collection. C. The urine was not held in the bladder for a sufficient amount of time for nitrate to be reduced to nitrite. D. The urine was in the bladder for more than 4 hours.
B; Leukocyte esterase is an enzyme present in most granulocytic white blood cells (WBCs). When the number of granulocytes in the urine increases significantly (more than 0-2 per field), this screening test pad will become positive on the chemical reagent strip.
A positive leukocyte esterase test indicates the presence in a urine specimen of which of the following? A. Lymphocytes B. Granulocytes C. Erythrocytes D. All of the above
B; Acetic acid can be added to urine samples in order to lyse red blood cells and leave the remaining sediment in tact. This is useful when attempting to differentiate between red cells, yeast, or fat droplets. Once the red cells are lysed, polarized light can help to differentiate yeast from oil droplets, as oil or fat droplets will refract with a characteristic maltese cross shape.
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
C; Oliguria is defined as the production of a decreased amount of urine. This can be defined as a daily urine production of less than 400 mL.
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 E. caused by moderate dehydration
C; Acetest® can be used to test for ketones in urine, serum, and whole blood.
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
B; Normal adult urine volume is 800 to 1800 ml/24hours for males, and 600 to 1600 ml/24 hours for females.
An average adult would excrete approximately what volume of urine per 24 hours: A. 3000 ml B. 1500 ml C. 750 ml D. 250 ml
C; Urine in the bladder is normally sterile unless an infection is present.
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
B; Bence-Jones proteins are monoclonal light chains excreted in the urine, seen with multiple myeloma, and other neoplasms of lymphoid cells. Small amounts can be missed by urine dipsticks, which are more sensitive to albumin than globulins. They are best detected by urine protein electrophoresis, immunoelectrophoresis, or immunofixation. Large amounts cause renal tubular damage, resulting in myeloma kidney. Bence-Jones proteins have unusual heat solubility properties, in that they precipitate between 50- 60 degrees C and redisolve at 90 -100 degrees C. Historical detection methods often utilized this unusual property.
Bence-Jones proteinuria can be seen in all of the following conditions except: A. Amyloidosis B. Nephrotic syndrome C. Multiple myeloma D. Macroglobulinemia
B & D; Amorphous urates and calcium oxalate are the only crystals from the choices listed that can be found in acid urine. Amorphous phosphates and calcium carbonate are both found in alkaline urine.
Common crystals which can be found in ACID urine include: (Choose all that apply.) A. Amorphous phosphates B. Amorphous urates C. Calcium carbonate D. Calcium oxalate
A & D; Conditions such as starvation and diabetes mellitus can lead to an increase of ketones in the urine, giving the urine a "fruity", sweet type of odor.
Detection of a fruity odor in a fresh urine sample may be indicative of which of the following: A. Starvation B. Yeast infection C. Bacterial infection D. Diabetes mellitus
A-C; Bacterial contamination, urine that has remained at room temperature for an extended period of time, and the presence of alkaline medication are all factors which can cause false positives on the protein pad of a urine reagent strip.
False-positive tests for protein on a urine reagent strip may be caused by: (Choose ALL of the correct answers) A. Bacterial contamination B. Urine that has remained at room temperature for an extended period of time C. Alkaline medication D. Ascorbic acid
A; Urine specific gravity increases as ionic concentration increases. If there were no solutes present, the specific gravity of urine would be 1.000, which is the same as pure water. Since all urine has some solutes present, a urine SG of 1.000 is not really possible. The upper limit of the test pad on a chemical reagent strip, which is typically 1.035, indicates a concentrated urine, one with many solutes with a smaller amount of water.
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.
A; The production of a blue or purple color on the test pad of an Ictotest® be interpreted as positive for bilirubin.
How should the production of a blue or purple color on the test pad of an Ictotest® be interpreted? A. Positive for bilirubin B. Positive for ketones C. Negative for bilirubin D. Negative for ketones
C; These urate salts frequently appear in acid or neutral urine in a noncrystalline amorphous form. They have a yellowish-brown granular appearance. They may be seen in normal urine. They are soluble in dilute alkali, and can change to uric acid crystals in the presence of concentrated hydrochloric acid.
Identify the urine sediment elements present in this acidic urine: A. Cholesterol crystals B. Uric acid crystals C. Amorphous urate crystals D. Cystine crystals
D; Fine granular cases may represent degenerated cellular casts. They usually indicate renal parenchymal disease, or allograft rejection.
Identify the urine sediment elements present in this illustration: A. WBC casts B. Coarse granular casts C. Waxy casts D. Fine granular casts
B; Uric acid crystals are variably shaped: they occur as flat diamond (four-sized), rhombic, lemon-shaped, or rarely hexagonal shapes with a yellowish or yellowish brown coloration. They are present in acid urine. They are polarizable and show various colors when polarized. They may be present in normal urine.
Identify the urine sediment elements shown by the arrow: A. Cholesterol crystals B. Uric acid crystals C. Amorphous urate crystals D. Cystine crystals
D; Cystine crystals are characteristically seen as colorless hexagonal plates in acid urine. They may be confused with hexagonal uric acid crystals. They can be differentiated from uric acid by their solubility in dilute hydrochloric acid versus crystalline uric acid, which is not soluble in dilute hydrochloric acid. The cyanide-nitroprusside test can be used to confirm the presence of cystine in urine. Cystine crystals are not present in normal urine.
Identify the urine sediment elements shown by the arrow: A. Cholesterol crystals B. Uric acid crystals C. Amorphous urate crystals D. Cystine crystals
C; Leucine crystals appear as oily, highly refractile, yellow to brown spheroids with radial concentric laminations. They are found in acid urine in patients with maple syrup urine disease.
Identify the urine sediment elements shown by the arrow: A. Cholesterol crystals B. Uric acid crystals C. Leucine crystals D. Cystine crystals
1. C 2. A 3. D 4. B Mucous threads may resemble hyaline casts. White cell casts are seen in renal infection or inflammation such as pyelonephritis. Granular casts are composed of plasma protein aggregates and cellular remnants. Waxy casts are refractile with squared-off ends, associated with chronic tubular injury.
Match the following casts with their associated conditions/descriptions. 1. Mucous threads may resemble these casts 2. Seen in renal infection or inflammation such as pyelonephritis 3. Composed of plasma protein aggregates and cellular remnants 4. Refractile casts with squared-off ends associated with chronic tubular injury A. White cell casts B. Waxy casts C. Hyaline casts D. Granular casts
Acidic pH: meat-filled diet high urine glucose Alakaline pH: metabolic alkalosis vegetarian diet In addition, a high urine pH may be due to: kidney failure, urinary tract infections, vomiting, etc. A low urine pH is also associated with diabetic ketoacidosis, diarrhea, starvation, etc.
Match the following factors with the expected urine pH type: 1. metabolic alkalosis 2. meat-filled diet 3. vegetarian diet 4. high urine glucose A. Alkaline pH B. Acidic pH
1. C 2. A 3. B 4. D
Match the following reagent strip tests to the disease or disorder that would most likely cause a positive test result. 1. Diabetes mellitus 2. Renal calculi 3. Hepatitis/cirrhosis 4. Urinary tract infection A. blood B. bilirubin C. ketones D. nitrite
1. B 2. A
Match the urine sediment or crystal to the correct description. 1. Amorphous Phosphates, Triple Phosphate,Ammonium biurate, Calcium Carbonate 2. Bilirubin, Cholesterol,Calcium Oxalates, Amorphous Urates A. Acidic urine B. Alkaline urine
A, B, & D; In nephrotic syndrome, increased proteinuria, decreased serum albumin, and edema are all expected findings. Nephrotic syndrome develops when the kidney glomeruli are damaged, which allows proteins in the blood, especially albumin, to leak into the urine. This causes an increased excretion of protein, or proteinuria. Hyperproteinemia is not associated with patient's suffering from nephrotic syndrome, as hyperproteinemia translates to increased serum protein levels. The opposite is true in cases of nephrotic syndrome.
Nephrotic syndrome is associated with which of the following clinical findings? Note: more than one answer choice is correct. A. Increased proteinuria B. Decreased serum albumin C. Hyperproteinemia D. Edema
A; Acute glomerulonephritis is closely associated with oliguria, and occasionally, anuria.
Oliguria is usually correlated with: A. Acute glomerulonephritis B. Diabetes mellitus C. Hepatitis D. Tubular damage
C; Approximately 80% of all water and salts are reabsorbed in the proximal convoluted tubules.
Reabsorption in the kidneys primarily occurs in: A. Glomerulus B. Acute glomerulonephritis C. Proximal convoluted tubule D. Loop of Henle
C; Semi-automated and automated urine chemical reagent strip readers remove subjectivity allowing for better reproducibility. This way, the laboratorians' results will be consistent while allowing for the interfacing of results into a laboratory information system.
Semi-automated and automated urine chemical reagent strip readers: A. increase the sensitivity of the urine dipsticks B. increase the specificity of the urine dipsticks C. remove subjectivity allowing for better reproducibility
A; The SSA reaction is used to detect protein in the urine. Unlike the protein test on the urine chemical reagent strip, the SSA reaction will detect albumin and globulins, and Bence-Jones proteins. This principle is based on the acidification of proteins which causes turbidity and can be measured based on protein concentration present.
Sulfosalicylic acid can be used to confirm the result of which of the following tests included on a urine chemical reagent strip? A. Protein B. Glucose C. Bilirubin D. Urobilinogen
False; These are leucine crystals.
T/F: The crystals that are seen in this image are calcium oxalate.
True This is true; a cystine crystal is depicted in this image. Cystine crystals are present in acidic urine, are typically colorless, and have a characteristic hexagonal shape (also described as appearing similar to a benzene ring). These crystals are associated with cystinuria.
T/F; A cystine crystal is seen in this image.
False This is a fiber artifact.
T/F; The microscopic finding illustrated in this image is a hyaline cast.
True; This statement is true. Urine should be at room temperature prior to testing with the reagent strip method. Urine strip reactivity can increase with increased urine temperature, so the optimum temperature is 22-26o C, or room temperature.
T/F; Urine should be at room temperature prior to testing with the reagent strip method.
False The method used on the urine chemical reagent strip is specific for glucose. An additional test, such as Clinitest®, should be used to check for other reducing substances.
T/F; When the glucose result on a urine specimen from an infant is negative on the urine chemical reagent strip, it can be assumed that the specimen is negative for other reducing substances such as galactose.
B; These are yeast. They can be distinguished from red blood cell by observing budding of the yeast. Renal epithelial cells and white blood cells have nuclei. These cells do not have nuclei. Leukocytes are also present in this field.
The constituents that are indicated by the arrows in this image of a stained urine sediment are: A. Red blood cells B. Yeast C. Renal epithelial cells D. Leukocyte
C; The cells seen here are arachnoid cells which are found in the tissue surrounding the arachnoid space.
The image is a stained smear of cerebrospinal fluid. Which of the following statements is true about the cells shown at the right? The correct answer is highlighted below Their numbers are increased when the patient has leukemia. Their numbers are increased when the patient has multiple sclerosis. They line the arachnoid space. They are capable of engulfing red cells.
A & C; The indicator(s) used in the pH test region are methyl red and bromothymol blue. Typically on most chemical reagent strips for urine pH, with an increase in urinary pH, the indicators bromothymol blue and methyl red, changes from orange to green and blue.
The indicator(s) used in the pH test region of the chemical reagent strips for urine is/are: (Choose ALL correct answers) A. methyl red B. methyl blue C. bromothymol blue D. bromothymol red
A; Normal urine pH varies from 4.6 to 8.0. After meals, urine becomes more alkaline due to gastric acid secretion (alkaline tide). At night due to shallow breathing, it becomes more acid. A high meat diet results in a more acid urine than a vegetarian diet, due to excretion of phosphates and sulfates.
The normal range for urine pH is: A. 4.6 to 8.0 B. 5.0 to 6.0 C. 5.5-6.6 D. 7.35-7.45
D; The hydrostatic pressure in the capillaries of the glomerular tuft drives the filtrate across their semipermeable membrane. The normal glomerular filtrate is similar in composition to the plasma, with the exception that molecules with a molecular weight of greater than about 15,000 are not filtered.
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
B; The presence of white blood cells, especially in large quantities as in this case, is very indicative of urinary tract infections as the white cells are migrating to the urinary tract to fight the bacterial infection.
The sediment from a freshly collected urine specimen is examined microscopically. In addition to bacteria, what other finding from the list below would further indicate the presence of a urinary tract infection (UTI)? A. 0 - 2 cuboidal epithelial cells/high power field (HPF) B. > 100 white blood cells (WBCs)/ HPF C. 10 - 20 squamous epithelial cells/ HPF D. Rare hyaline cast/ low power field (LPF)
B; Glomerulonephritis is a type of kidney disease in which the glomerulus (filters waste and fluids from the blood) is damaged. Damage to the glomeruli causes blood and protein to be lost in the urine. Hence, the image shows the presence of red blood cells. Diabetes mellitus, yeast infections, and pyruria are not associated with red blood cells in the urine.
The technologist in the urinalysis department received a sample for a microscopic examination. The image to the right shows the microscopic urinalysis. Which of the following conditions below would most closely match this patient's microscopic urinalysis morphology? A. Diabetes mellitus B. Glomerulonephritis C. Yeast infection D. Pyuria
B; These are artifacts; perhaps oil droplets. If they were red blood cells (RBCs), we would have expected to see evidence of this in the chemical (urinalysis strip) analysis.
The urine macroscopic (urinalysis test strip) results were completely normal and within range. Upon viewing the microscopic, the technologist noticed these circular elements. What could be the identification of these elements? A. Red blood cells (RBCs) B. Artifacts C. Yeast D. Transitional epithelial cells
C & D; Good laboratory practice states that to ensure that urinalysis instruments/procedures/reagents are functioning correctly, that positive and negative controls be run on a daily basis as well as when a new bottle is opened.
To ensure precision and accuracy of the reagent strip tests used for chemical analysis of urine, it is necessary that: A. only a positive control be run on a daily basis B. positive controls be run on a daily basis and negative controls be run when opening a new bottle of test strips C. positive and negative controls be run on a daily basis D. positive and negative controls be run when a new bottle of test strips is opened E. positive and negative controls are not required for urine strips
C; To screen for urinary tract infections leukocyte esterase should be coupled with nitrite. Urinary nitrites can help to detect the presence of gram-negative bacterial organisms that are the typical cause of urinary tract infections.
To screen for urinary tract infections, leukocyte esterase results should be evaluated along with the results from which of these other reagent strip tests? A. Urobilinogen B. Bilirubin C. Nitrite D. Glucose
True If tubes are left to sit too long, the red cells can lyse causing hemolysis in the tube which can appear similar to xanthochromia
True or false? To determine if xanthochromia is present in a cerebrospinal fluid sample, the sample must be centrifuged within one hour.
True Yeast is present on this slide. Several examples are indicated by the arrows.
True or false? Yeast is present in this slide.
C; Bilirubin is conjugated with glucuronic acid in the liver to become conjugated bilirubin, which is water-soluble.
Unconjugated bilirubin is conjugated in the liver with which of the following substances to become water soluble? A. Glycogen B. Glucose oxidase C. Glucuronic acid D. Glycine
A; Depending on the person's acid-base status, the pH of urine may range from 5.0 to 8. The kidneys maintain normal acid-base balance primarily through the reabsorption of sodium and the tubular secretion of hydrogen and ammonium ions. Urine becomes increasingly acidic as the amount of sodium and excess acid retained by the body increases. Alkaline urine, usually containing bicarbonate-carbonic acid buffer, is normally excreted when there is an excess of base or alkali in the body. Secretion of an acid or alkaline urine by the kidneys is one of the most important mechanisms the body uses to maintain a constant body pH.
Urine pH values can normally vary between: A. 5.0 to 8.0 B. 5.0 to 6.0 C. 7.0 to 8.0
False Amorphous urates would NOT be seen in alkaline urine.
Use the following urinalysis report to answer: The patient is a female and the urinalysis is completed within two hours of collection. Color - light yellow Appearance - slightly turbid Sp. Gravity - 1.009 pH - 8.0 Glucose - negative Protein - 1+ Blood - negative WBC - 5/HPF RBC - 1/HPF Epithelial - 0/HPF Casts - 2 hyaline/LPF Crystals - amorphous urates Bacteria - 2+ True or false? The results are abnormal but all results correlate.
A; A urine pH above 8.0 may indicate that a specimen has been held non-preserved too long, which allows multiplication of urea-splitting bacteria with resultant increase in pH.
What effect may bacterial contamination have on urine pH? A. The bacteria may make the pH more alkaline. B. The bacteria may make the pH more acidic. C. The bacteria would not affect urine pH.
C; The image below depicts a granular cast. Granular casts are usually indicative of renal disease. These casts are composed of a protein matrix with degraded cellular material.
What is the element indicated by the arrow in this image? A. Hyaline cast B. Waxy cast C. Granular cast
B; The crystals in the image below are composed of calcium oxalate. Calcium oxalate crystals have a refractile square envelope shape.
What is the identification of these crystals seen in a urine with an acid pH? A. Uric acid B. Calcium oxalate C. Triple phosphate D. Calcium carbonate
C; The nephron, the basic functional unit of the kidney, consists of a glomerulus, the proximal convoluted tubule, the loop of Henle, the distal convoluted tubule, and the excretory duct.
What is the primary functional unit of the kidney: A. Ureter B. Glomerulus C. Nephron D. Distal convoluted tubule
A-C; There are no blasts seen in this image. The lymphocytes seen here are mature, though from cytocentrifugation they can appear to have prominent nucleoli similar to blasts. The chromatin pattern of the nucleus in the lymphs shown is mature and clumped.
What types of cells are present in this field of a cytocentrifuged CSF sample? A. red cells B. lymphocytes C. neutrophils D. blasts
D; When a urine specimen cannot be cultured immediately it may be stored at 4° C for up to 24 hours. After 24 hours of refrigeration, the culture results may not be accurate as some bacteria may not survive the extended time/temperature conditions.
When a urine specimen cannot be cultured immediately it may be: A. Stored at room temperature for up to 8 hours B. Stored in freezer for up to 24 hours C. Stored in the incubator for up to 8 hours D. Stored at 4° C for up to 24 hours
B; When three tubes of CSF are collected, the first tube is used for chemical and/or serological analysis, the second tube is used to prevent contamination of the bacterial culture by skin germs or flora. The last tube (#3) should always be used for hematology studies in order to minimize the effect of any peripheral blood contamination which may have occurred during the insertion of the spinal needle.
When three tubes of cerebrospinal fluid are received in the laboratory they should be distributed to the various laboratory sections as follows: A. #1 Hematology, #2 Chemistry, #3 Microbiology B. #1 Chemistry, #2 Microbiology, #3 Hematology C. #1 Microbiology, #2 Hematology, #3 Chemistry D. #1 Chemistry, #2 Hematology, #3 Microbiology
A & C; Casts are cylindrical bodies formed either in the distal convoluted tubules or the collecting ducts of the kidney. The matrix of all casts is thought to be Tamm-Horsfall protein, a glycoprotein secreted by the distal loop of Henle and the distal tubule. This protein entraps cells and granular material of tubular origin. After formation, casts are loosened from the tubules and discharged into the urine. Casts, if present, are visible in freshly voided urine.
Which of the following are characteristics of casts? (Choose all that apply.) A. They are cylindrical bodies. B. They are formed in the urethra. C. They contain Tamm-Horsfall mucoprotein. D. They are present only in stale urine.
B; Renal tubular epithelial cells may be found rarely in healthy patients, but in increased numbers, can indicate destruction of the kidney's tubules (nephrons). These cells are small and round. Conditions associated with the presence of these cells include: allograft rejection, viral infection, and other less common conditions.
Which of the following cells when found upon microscopic examination of the urine would be most indicative of kidney disease: A. WBCs and bacteria B. Tubular epithelial cells C. Squamous epithelial cells D. RBCs
B & D; The characteristics of cerebrospinal fluid are present if blood is due to SAH are: Blood is evenly distributed in all tubes AND Supernatant is pink when centrifuged within one hour. These characteristics help to differentiate between true hemorrhages and traumatic taps.
Which of the following characteristics of cerebrospinal fluid are present if blood is due to subarachnoid hemorrhage (SAH)? A. Sample clots on standing. B. Blood is evenly distributed in all tubes. C. Supernatant is clear when centrifuged within one hour. D. Supernatant is pink when centrifuged within one hour.
C; The Fructose test is not employed for routine seminal fluid analysis, but may be performed as a special functional test.
Which of the following is not a routine component of semen analysis: A. pH B. Motility C. Fructose level D. Morphology
B; Osmolality can be measured by freezing point depression, but not specific gravity as specified in this question. The other methods are used to measure specific gravity in urine samples.
Which of the following is not a standard method for measuring the specific gravity of urine: A. Urine reagent strips B. Freezing point depression C. Refractometry D. Hydrometry
B; Osmolality is dependent on the number of particles of solute in a unit of solution and is often measured by freezing point depression. Specific gravity is usually directly related to osmolality, but is more easily measured. It provides a rough measure of the urine concentrating power of the kidney.
Which of the following is not a standard method for measuring the specific gravity of urine? A. SP reagent strips B. Osmolality C. Refractometry D. Hydrometry
B; Acetest® does not detect beta-hydroxybutyric acid. Since sodium nitroprusside (one of the main ingredients in the Acetest tablet) does not react with beta-hydroxybutyrate, this compound is not measured by Acetest. It is important to remember this fact, since a negative Acetest tablet does not completely rule out a ketoacidosis diagnosis.
Which of the following ketones is NOT detected in the Acetest® tablet method? A. Acetone B. Beta-hydroxybutyric acid C. Acetoacetic acid
B; The following factors promote the formation of casts in the kidney: Larger than normal amounts of plasma proteins entering the tubules Decreased pH Decreased urinary flow rate Increased urine concentration
Which of the following macroscopic findings is MOST consistent with the microscopic finding of casts? A. Specific gravity of 1.005 B. Positive protein C. Alkaline pH D. Clear urine
A; Bence Jones protein is a protein that is excreted by persons with multiple myeloma, a myeloproliferative disorder of the immunoglobulin-producing plasma cells. The protein, which is markedly elevated in blood serum, is filtered through the kidneys in quantities that exceed the tubular reabsorption capacity. Consequently, it is excreted in the urine. All suspected cases shoud have protein and immunoelectrophoresis performed on both serum and urine.
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
D; The urobilinogen reagent strip tests is based on the Ehrlich- aldehyde reaction. In this test, a pink-red color forms in proportion to the amount of urobilinogen present.
Which of the following reagent strip tests is based on the Ehrlich- aldehyde reaction. A. pH B. protein C. glucose D. urobilinogen E. specific gravity
A & C; There are two correct statements listed in the answer choices which accurately describe specific gravity measurements by the reagent strip method. These statements are: The reagent strip method is based on the relationship between ionic concentration and specific gravity. AND The reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen.
Which of the following statements are TRUE for specific gravity measured by the reagent strip method? (Select ALL that apply) A. The reagent strip method is based on the relationship between ionic concentration and specific gravity. B. The reagent strip method is based on the fact that light is refracted in proportion to the amount of total solids dissolved in the urine. C. The reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen. D. An alkaline pH would not affect the specific gravity result using a reagent strip method.
A & B; Compare strip to color chart to check for correlating color and handling strips at the end away from the test area are the two correct answers. It is not suggested to remove the cap of the test strip bottle and leave it off until testing is completed, as moisture from the air can alter the test pads on the chemical reagent strips.
Which of the following statements are TRUE regarding storing and handling of chemical reagent strips if you are using a manual method (visually reading the reagent strip)? A. Compare strip to color chart to check for correlating color. B. Handle strips at end away from test area. C. Remove cap of test strip bottle and leave it off until testing is completed.
A & C; Out of the options listed, the correct answers are to store reagent strips at the temperature recommended by the manufacturer of the strips and to remove only enough strips for immediate use. It is never recommended to touch any of the reagent pad areas or to leave the reagent strip bottle uncovered, as both can lead to inaccurate results and faulty reagent strip analysis.
Which of the following statements are true regarding the storage and handling of urinalysis chemical reagent strips? (Choose ALL correct answers) A. Store reagent strips at the temperature recommended by the manufacturer. B. Touching the reagent areas of the strip will not interfere with test results. C. Remove only enough strips for immediate use. D. The bottle of reagent strips can remain uncovered once it has been opened.
B; Creatinine is filtered by the glomerulus and is not reabsorbed; therefore it can be used to estimate the GFR (glomerular filtration rate).
Which of the following tests would be used in the assessment of glomerular filtration: A. 24 hour urine protein B. Creatinine clearance C. PSP test D. Urea
D; The presence of lymphocytes will not produce a positive leukocyte esterase test since lymphocytes do not contain leukocyte esterase.
Which of the following white blood cells would NOT produce a positive leukocyte esterase test on the urine chemical reagent strip? A. Neutrophils B. Eosinophils C. Basophils D. Lymphocytes
C; Urea is actually increased during bouts of dehydration.
Which one of the following statements about urea is false: A. It accounts for 75% of nonprotein nitrogen excreted B. It is elevated in a variety of glomerular, tubular, interstitial, and vascular renal diseases C. It is decreased in dehydration D. The reference range for normal individuals is 7 to 18 mg/dl when expressed as blood urea nitrogen
A & D; Crystals and sediment found in acid urine include: cystine, leucine, calcium oxalate, sodium urate, sulfonamide, tyrosine, uric acid, and amorphous urates.
Which two of the following crystalline elements are found in acid urine: A. Cystine B. Triple phosphate C. Calcium phosphate D. Tyrosine
