Urinalysis/BF Internship study questions

which of the following specific gravity values is physiologically impossible? a 1.000 b. 1.010 c. 1.020 d. 1.030

a 1.000

A urine sediment could have which of the following formed elements and still be considered "normal"? a. 0-2 hyaline casts b. 5-10 RBCs c. moderate bacteria d, a few yeast

a. 0-2 hyaline casts

The ability of a solute to cross the glomerular membrane isdetermined by its: 1. molecular size 2. molecular radius 3. electrical charge 4. plasma concentration a. 1,2, and 3 are correct b. 1 and 3 are correct c. 4 is correct d. all are correct

a. 1, 2, 3 are correct

Using quality control materials, reagent strip performance should be checked: 1. at least once daily 2. when a new bottle of strips or tablets is opened 3. when a new lot number of strips or tablets is placed into use 4. once each shift by each technician performing urinalysis testing a. 1,2, and 3 are correct b. 1 and 3 are correct c. 4 is correct d. all are correct

a. 1,2, and 3 are correct

Which urinary sediment component can resemble RBCs? 1. yeast 2. air bubbles 3. oil droplets 4. calcium oxalate crystals a. 1,2, and 3 are correct b. I and 3 are correct c. 4 is correct d. all are correct

a. 1,2, and 3 are correct

Which of the following frequently occurs following a bacterial infection of the skin or throat? a. acute glomerulonephritis b. chronic glomerulonephritis c. membranous glomerulonephritis d. rapidly progressive glomerulonephritis

a. acute glomerulonephritis

A white precipitate in a normal alkaline urine is most likely caused by: a. amorphous phosphates b. amorphous urates c. uric acidcrystaIs d. radiographic contrast media

a. amorphous phosphates

All of the following conditions may produce nocturia EXCEPT: a. anuria b. pregnancy c. chronic renal failure d. fluid intake at night

a. anuria

Which of the following crystals, when found in the urine sediment, most likely indicates an abnormal metabolic condition? a. bilirubin b. sulfonamide c. triple phosphate d. uric acid

a. bilirubin

Which of the following substances will change the color of both the urine and its foam? a. bilirubin . b. hemoglobin c. myoglobin d. Urobilin

a. bilirubin

Approximately 75% of the renal calculi that form in patients contain: a. calcium b. cystine c. oxalate d, uric acid

a. calcium

The clarity of a well-mixed urine specimen that has visible particulate matter and through which newsprint can be seen but not read should be described as: a. cloudy b. flocculated c. slightly cloudy d. turbid

a. cloudy

The final concentration ofthe urine is determined within the: a. collecting ducts b. distal convoluted tubules c. loops of Henle d. proximal convoluted tubules

a. collecting ducts

The concentration of which substances provides the best means of distinguishing urine from other body fluids? a. creatinine and urea b. glucose and protein c. uric acid and ammonia d. water and electrolytes

a. creatinine and urea

Which of the following is considered a "lower" urinary tract infection? a. cystitis b. glomerulonephritis c. pyelitis d. pyelonephritis

a. cystitis

Urinary casts are formed in the: a. distal and collecting ducts b. distal tubules and the loops of Henle c. proximal and distal tubules d. proximal tubules and the loops of Henle

a. distal and collecting ducts

Which of the following when found in the urine sediment from a female patient is NOT considered a vaginal contaminant? a. fat b. clue cells c. spermatozoa d. trichomonads

a. fat

A 24-hour urine collection is preferred for the determination of creatinine clearance because of the diurnal variation in the: a. glomerular filtration rate b. plasma creatinine c. creatinine excretion d. urine excretion

a. glomerular filtration rate

Which of the following statements about renal disease is true? a. glomerular renal diseases are usually immune mediated b. vascular disorders induce renal disease by increasing renal perfusion c. all structural components of the kidney are equally susceptible to disease d. tubulointerstitial renal diseases usually result from antibody-antigen and complement interactions

a. glomerular renal diseases are usually immune mediated

The formation of the ultrafiltrate in the glomerulus is driven by the: a. hydrostatic blood pressure b. oncotic pressure of the plasma proteins c. oncotic pressure Ofthe solutes in the ultrafiltrate d, pressures exerted by the glomerular filtration barrier

a. hydrostatic blood pressure

Which of the following statements about Bence Jones protein is correct? a. it consists of kappa and lambda light chains b. it is often found in the urine of patients with multiple sclerosis c. it precipitates when the urine id heated to lOOC and redissolves when cooled to 60C d. it can produce a positive reagent strip protein test and a negative sulfosalicylic acid precipitation (SSA) test.

a. it consists of kappa and lambda light chains

Which of the following is NOT a distinguishing characteristic of yeast in the urine sediment? a. motility b. budding forms c. hyphae formation d. colorless ovoid forms

a. motility

Another name for excessive thirst is: a. polydipsia b. polyuria c. hydrophilia d. hydrostasis

a. polydipsia

Which of the following does NOT contribute to the size, shape, or length of a urinary cast? a. the concentration of protein in the cast's core matrix . b. the configuration of the tubules in which the cast is formed c. the diameter of the tubular lumen in which the cast is formed d. the duration of time the cast is allowed to form in the tubule

a. the concentration of protein in the cast's core matrix .

The principle of the reagent strip method for measuring specific gravity is base on: a. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen b. the pH of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen c. the pKa of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen d. the pH of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen

a. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen

Which of the following urine characteristics provides the best rough indicator of urine concentration and body hydration: a. the urine's color b. the urine's clarity c. the urine's foam d. the urine's volume

a. the urine's color

Which of the following solutes are present in the largest molar amounts in urine? a. urea, chloride, and sodium b. urea, creatinine, and sodium c. creatinine, uric acid, and ammonium d. urea, uric acid, and ammonium

a. urea, chloride, and sodium

Antidiuretic hormone (ADH) regulates the reabsorption of: a. water in the collecting tubules b. sodium in the collecting tubules c. sodium in the distal convoluted tubule d. water and sodium in the loop of Henle

a. water in the collecting tubules

which of the following will not cause erroneous results in a 24-hour timed urine collection? a: when the collection starts and ends in the evening b: when two first morning specimens are included in the collection c: when multiple collection containers are not mixed together prior to specimen testing d: when a portion of the collection is removed before the total volume measurement

a: when the collection starts and ends in the evening

Which of the following statements about bilirubin is true? a. conjugated bilirubin is water insoluble b. bilirubin is a degradation product of heme catabolism c. unconjugated bilirubin readily passes through the glomerular membrane d. the liver conjugates bilirubin with albumin to form conjugated bilirubin

b. bilirubin is a degradation product of heme catabolism

When a technician performs the microscopic examination of urine sediment, which of the following are enumerated using low-power magnification? a. bacteria b. casts c. red blood cells d. none of the above

b. casts

Which of the following formed elements found in urine sediment is most indicative of an "upper" urinary tract infection? a. bacteria b. casts c. erythrocytes d. leukocytes

b. casts

Which of the following disorders is characterized by the urinary excretion of large amounts of arginine, cystine, lysine, and ornithine? a. cystinosis b. cystinuria c. lysinuria d tyrosinuria

b. cystinuria

The chemical principle of the nitrite reagent pad is based on the: a. pseudoperoxidase activity of Iiitrite b. diazotization of nitrite followed by an azo-coupling reaction c. azo-coupling action of nitrite with a diazonium salt to form an azodye d. hydrolysis of an ester by nitrite combined with an azo-coupling reaction

b. diazotization of nitrite followed by an azo-coupling reaction

The glucose specificity of the "double sequential enzyme reaction" employed on reagent strip tests is due to the use of: A. gluconic acid b. glucose oxidase c. hydrogen peroxide d. peroxidase

b. glucose oxidase

Most urinary tract infections are due to: a. yeast b. gram-negative rods c. gram-positive rods d gram-positive cocci

b. gram-negative rods

Mucous threads can be difficult to differentiate from: a. pigmented casts b. hyaline casts c. waxy casts d. none of the above

b. hyaline casts

Urine pH can be modified by all of the following EXCEPT: a. diet b increased ingestion of water c. ingestion of medications d urinary tract infections

b. increased ingestion of water

Which of the following blood cells will NOT be detected by the leukocyte esterase pad on the reagent strip, because it lacks esterases? a. eosinophils b. lymphocytes c. monocytes d neutrophils

b. lymphocytes

The "double indicator system" employed by commercial reagent strips to determine urine pH uses which two indicator dyes? a. methyl orange and bromphenol blue b. methyl red and bromthymol blue c. phenol red and thymol blue d phenolphthalein and litmus

b. methyl red and bromthymol blue

Renal excretion is NOT involved in the elimination of: a. electrolytes and water b. normal by-products of fat metabolism c. soluble metabolic wastes (i.e., urea, creatinine) d. exogenous substances (e.g., drugs, x-ray contrast media)

b. normal by-products of fat metabolism

Which of the following urinary casts are diagnostic of glomerular or renal tubular damage? a. bacterial casts b. red blood cell casts c. renal tubular cell casts d white blood cell casts

b. red blood cell casts

Which of the following does NOT affect the fonnation of urinary crystals in the nephtons? a. the pH of the urine b. the diameter of the tubular lumen c. the flow of the urine through the tubules d. the concentration of solutes in the ultrafiltrate

b. the diameter of the tubular lumen

Which of the following is NOTchecked by quality control materials? a. the technical skills of the personnel performing the test b. the integrity of the specimen, i.e., that the specimen was properly collected and stored c. the test protocol, i.e., that the procedure was-performed according to written guidelines d. the functioning of the equipment used, e.g., the refractometer, the reagent strip readers

b. the integrity of the specimen, i.e., that the specimen was properly collected and stored

When too much protein is presented to the renal tubules for reabsorption, it is excreted in the urine because: a. the renal threshold for protein has not been exceeded b. the maximal tubular reabsorptive capacity for protein has been exceeded c. protein is not normally present in the ultrafiltrate and it cannot be reabsorbed d. the glomerular membrane will allow only abnormal proteins to pass

b. the maximal tubular reabsorptive capacity for protein has been exceeded

Renal clearance is defined as: a. volume of urine cleared of a substance per minute b. volume of plasma cleared of a substance in a time interval c. volume of plasma flowing through the kidney per minute d. volume of plasma containing the same amount of substance in 1 m1 of urine

b. volume of plasma cleared of a substance in a time interval

Serum osmolality remains relatively constant, whereas the urine osmolality ranges from: a. 113to 112that of serum b. 113to equal that of serum c. 1-3 times that of serum d. 3-5 times that of serum

c. 1-3 times that of serum

How many nephrons are found in an average kidney? a. 13,000 b. 130,000 , c. 1.3 million d. 13 million

c. 1.3 million

Urine pH normally ranges form: a. 4.0-9.0 b. 4.5-7.0 c. 4.5-8.0 d. 5.0-6.0

c. 4.5-8.0

The daily volume of urine excreted normally ranges from: a. 100-500 mlIday b. 100-1800 mlIday c. 500-1800 mlIday d. 1000-3000 mlIday

c. 500-1800 mlIday

Urinary casts are formed with a core matrix of: a. albumin b. Bence Jones protein c. Tamm-Horsfall protein d transferrin

c. Tamm-Horsfall protein

If refrigeration is used to preserve a urine specimen, which ofthe following may occur? a. cellular or bacterial glycolysis will be enhanced b. formed elements will be destroyed c. amorphous crystals may precipitate d. bacteria will proliferate

c. amorphous crystals

Which of the following ketones are NOT detected by the reagent strip or tablet (Acetest) test? a. acetone b. acetoacetate c. beta-hydroxybutyrate d. none ofthe above

c. beta-hydroxybutyrate

How do increased numbers ofleukocytes usually get into the urine? a. through a renal bleed b. by passive movement through pores in the vascular epithelium c. by active ameboid movement through the tissues and epithelium d. through damage to the integrity of normal vascular barrier

c. by active ameboid movement through the tissues and epithelium

Isosthenuria, significant proteinuria, and numerous casts of all types describes the urinalysis findings from a patient with: a. acute renal failure b. acute tubular necrosis c. chronic renal failure d. renal tubular acidosis

c. chronic renal failure

The following are initial results obtained during a routine urinalysis. Which results should be investigated further? a. negative protein; 0-2 hyaline casts b. urine pH 6.0; calcium oxalate crystals c. cloudy yellow urine; specific gravity 1.050 d. amber urine with yellow foam; negative bilirubin by reagent strip; positive Ictotest

c. cloudy yellow urine; specific gravity 1.050

Which of the following is an endogenous substance used to measure glomerular filtration rate? a. urea b. inulin c. creatinine d. para-aminohippurate

c. creatinine

An unpreserved urine specimen collected at midnight is kept at room temperature until the morning hospital shift. Which of the following changes will most likely occur? a. decrease in urine color and clarity b. decrease in pH and specific gravity c. decrease in glucose and ketones d. decrease in bacteria and nitrite

c. decrease in glucose and ketones

Chronic renal failure often develops in each of the following diseases EXCEPT: a. amyloidosis b. diabetes mellitus c. diabetes insipidus d. systemic lupus erythematosus

c. diabetes insipidus

During tubular transport, the movement of a solute against a gradient: a. is called passive transport b. requires little to no energy c. involves specific cell membrane binding sites d. may occur paracellularly, i.e., between cells through intercellular spaces

c. involves specific cell membrane binding sites

A 25-year old woman complains of painful urination and is suspected of having a UTI. Which of the following specimens should be collected for a routine urinalysis and urine culture?a. fractional collection b. timed collection c. midstream "clean catch" specimen d. random specimen

c. midstream "clean catch" specimen

Osmolality is a measure of solute: a. density b. mass c. number d. weight

c. number

Urobilinogen is formed from the: a. conjugation of bilirubin in the liver b. reduction of conjugated bilirubin in the bile c. reduction of bilirubin by intestinal bacteria d. oxidation of urobilin by anaerobic. intestinal.bacteria

c. reduction of bilirubin by intestinal bacteria

To preserve the integrity of reagent strips, it is necessary that they are: a. humidified adequately b. stored in a refrigerator c. stored in a tightly capped container d. protected from the dark

c. stored in a tightly capped container

which component of the nephron is located exclusively in the renal medulla? a. the collecting tubule b. the distal tubule c. the loop of henle d. the proximal tubule

c. the loop of henle

What is the definition of the "osmolality" of a solution? a. the density of solute particles per liter of solvent b. the mass of solute particles per kilogram of solvent c. the number of solute particles per kilogram of solvent d. the weight of solute particles per liter of solvent

c. the number of solute particles per kilogram of solvent

Which of the following best describes the chemical principle of the protein reagent strip test? a. the protein reacts with an immunocomplex on the pad, which results in a color change b. the protein causes a pH change on the reagent strip pad, which results in a color change c. the protein accepts hydrogen ions from the indicator dye, which results in a color change d. the protein causes protons to be released from a polyelectrolyte, which results in a color change

c. the protein accepts hydrogen ions from the indicator dye, which results in a color change

Yeast is considered part of the normal flora in each of the following locations EXCEPT in the: a. GI tract b. oral cavity c. urinary tract d vagina

c. urinary tract

Which of the following pigments will deposit on urate and uric acid crystals to form a precipitate described as "brick dust"? a. bilirubin b. urobilin c. uroerythrin d. urochrome

c. uroerythrin

Which of the following is NOT a source of erroneous results when using reagent strips? a. testing a refrigerated urine specimen b. timing using a clock without a second hand c. allowing excess urine to remain on the reagent strip d dipping the reagent strip briefly into the urine specimen

d dipping the reagent strip briefly into the urine specimen

Which of the following urine specimens is considered normal? a. a freshly voided urine that is brown and clear b. a freshly voided urine that is yellow and cloudy c. a clear yellow urine specimen that changes color upon standing d. a clear yellow urine specimen that becomes cloudy upon refrigeration

d. a clear yellow urine specimen that becomes cloudy upon refrigeration

Select the urine specimen that does NOT indicate the possible presence of blood or hemoglobin: a. a clear red urine b. a cloudy brown urine c. a clear brown urine d. a cloudy amber urine

d. a cloudy amber urine

The kidney plays an important role in the: I. excretion of waste products 2. regulation of water 'and electrolytes , 3. maintenance of acid-base equilibrium 4. control of blood pressure and fluid balance a. 1,2, and 3 are correct b. I and 3 are correct c. 4 is correct d. all are correct

d. all are correct

When urine sediment is viewed, stains and various microscopic techniques are used to: 1. enhance the observation of fine detail 2. confirm the identity of suspected components 3. differentiate formed elements that look alike 4. facilitate the visualization of low-refractile components a. 1, 2, and 3 are correct b. 1 and 3 are correct c. 4 is correct d. all are correct

d. all are correct

Which of the following characterizes nephrotic syndrome 1. proteinuria 2. edema 3. hypoalbuminemia 4. hyperlipidemia a. 1, 2, and 3 are correct b. 1 and 3 are correct c. 4 is correct d. all are correct

d. all are correct

Which of the following conditions most likely account for a negative nitrite result on the reagent strip despite the presence of large amounts of bacteria? I. the bacteria present did not have enough time to convert nitrate to nitrite 2. the bacteria present are not capable of converting nitrate to nitrite 3. the patient is not ingesting adequate amounts of nitrate in the diet . 4. the urine is very dilute and the level of nitrite present is below the sensitivity of the test a. 1,2, and 3 are correct b. I and 3 are correct c. 4 is correct d. all are correct

d. all are correct

Which of the following reagent strip tests can be affected by ascorbic acid, resulting in falsely low or false negative results? 1. blood 2. bilirubin 3. glucose 4. nitrite a. 1,2, and 3 are correct b. 1 and 3 are correct c. 4 is correct . d. all are correct

d. all are correct

Which of the following will NOT influence the volume of urine produced? a. diarrhea b. exercise c. caffeine ingestion d. carbohydrate ingestion

d. carbohydrate ingestion

The classic Ehrlich's reaction.is based onthe.reaction of urobilinogen with: a. diazotized dichloroaniline b. p-aminobenzoic acid c. p-dichlorobenzene diazonium salt d. dimethyUuninobenzaldehyde .

d. dimethyUuninobenzaldehyde .

Creatinine is a good substance to use for a renal clearance test because it: a. is exogenous b. is reabsorbed c. is affected by fluid intake d. has a constant plasma concentration

d. has a constant plasma concentration

Which of the following substances can result in false positive nitrite results? a. ascorbic acid b. vaginal contamination c. strong reducing agents d. improper specimen storage

d. improper specimen storage

Which of the following statements describes the chemical principle involved on the leukocyte esterase pad of reagent strips? a. leukocyte esterase reacts with a diazonium salt on the reagent pad to form an azodye b. an ester and a diazonium salt combine to form an azodye in the presence of leukocyte esterase c. an aromatic compound on the reagent pad combines with leukocyte esterase to form an azodye d. leukocyte esterase hydrolyzes an ester on the reagent pad, then an azo-coupling reaction results in the formation of an azodye

d. leukocyte esterase hydrolyzes an ester on the reagent pad, then an azo-coupling reaction results in the formation of an azodye

Which of the following aids in the differentiation of hemoglobinuria and hematuria? a. urine pH b. urine color c. A leukocyte esterase test d. microscopic examination

d. microscopic examination

Occasionally the specific gravity of a urine specimen exceeds that physiologically possible (i.e., greater than 1.040). Which of the following substances when found in the urine could-account for such a high value? a. protein b. glucose c. contrast media d. more than one of the above

d. more than one of the above

Creatinine clearance results are "normalized" using an individual's body surface area to account for variations in the individual's: a. age b. sex c. dietary intake d. muscle mass

d. muscle mass

. The ketone reagent strip and tablet tests are based on the reactivity of ketones with: a. ferric chloride b. ferric nitrate c. nitroglycerin d. nitroprusside

d. nitroprusside

The glucose reagent strip test is more sensitive and specific for glucose than the Clinitest method because it detects: a. other reducing substances and higher concentrations of glucose b. no other substances and higher concentrations of glucose c. other reducing substances and lower concentrations of glucose d. no other substances and lower concentrations of glucose

d. no other substances and lower concentrations of glucose

Clinical. features that are characteristic of glomerular damage include all of the following EXCEPT: a. edema b. hematuria c. proteinuria d. polyuria

d. polyuria

The excretion of large volumes of urine (greater than 3 liters/day) is called: a. glucosuria b. hyperuria c. polydipsia d. polyuria

d. polyuria

On the reagent strip test for blood, any hemoglobin present in the urine catalyzes the: a. oxidation of both the chromogen and the hydrogen peroxide b. oxidation of the chromogen in the presence of hydrogen peroxide c. reduction of the pseudoperoxidase while the chromogen undergoes a color change d. reduction of the chromogen while the hydrogen peroxide becomes oxidized

d. reduction of the chromogen while the hydrogen peroxide becomes oxidized

Which of the following is the most common form of urine preservation? a. boric acid b. sodium fluoride c. freezing d. refrigeration

d. refrigeration

A microscopic exatnination of a urine sediment revealed an average of two to five WBCs per highpower field, whereas the leukocyte esterase test by reagent strip was negative. Which of the following best accounts for this discrepancy? a. the urine is contaminated-with-vaginal-fluid b. many WBCs are lysed and their esterase has been-inactivated c. ascorbic acid is interfering with the reaction on the reagent strip d. the amount of- esterase present is below the sensitivity of the reagent strip test

d. the amount of- esterase present is below the sensitivity of the reagent strip test

The "pass-through" phenomenon observed with the Clinitest method when large amounts of glucose are present in the urine is due to: a. the "carmelization" of the sugar present b.the reduction of copper sulfate to green-brown cupric complexes c. the depletion of the substrate, i.e., not enough copper sulfate present initially d. the re-oxidation of the cuprous oxide formed to cupric oxide and other cupric complexes

d. the re-oxidation of the cuprous oxide formed to cupric oxide and other cupric complexes

The color of normal urine is due to the pigment: a. bilirubin b. urobilin c. uroerythrin d. urochrome

d. urochrome

substances that show diurnal variation in their urinary excretion pattern are best evaluated using a: a:first morning specimen b: midstream "clean catch" specimen c. fractional collection d: timed collection

d: timed collection