DAPHNE'S HW: STUDY QUESTIONS

CHAPTER 4

1) The concentration of a normal urine specimen can be estimated by which of the following?

A. Color

2) The normal yellow color of urine is produced by:

D. Urochrome

3) A yellow-brown specimen that produces a yellow foam when shaken can be suspected of containing

A. Bilirubin

4) A urine that turns black after standing may contain

D. All of the above (Homogentisic acid, Melanin & Methemoglobin)

5)Specimens that contain intact RBCs can be visually distinguihed by those that contain hemoglobin
because:

C. RBC produce a cloudy specimen

6)After eating beets purchased at the local farmers' market, Mrs. Williams notices that her urine is red,
but Mr. William's urine is remains yellow. The williamses should:

D. Not be concerned because only Mrs. Williams is genetically susceptible to producing red urine from
beets.

7) Specimens from patients receiving treatment for urineary tract infections frequently appear:

B. Viscous and Orange

8) Freshly voided normal urine is usually clear; however, if it is alkaline, a white turbidity may be present
due to:

A. Amorphous phosphates and carbonates

9)Microscopic examination of a clear urine that produces a pink precipitate after refrigeration will show:

A. Amorphous urates

10) Under what conditions will a port-wine urine color be observe in a urine specimen?

C. Urine contains porphyrins

11) Which of the following specific gravities would be most likely to correlate with a dark yellow urine?

D. 1.030

12) True or False: Urine specific gravity is equally influenced by the presence of glucose and sodium.

False

13) In what circumstance might a sediment be slightly warmed prior to microscopic examination?

B. To dissolve amorphous urates

14) A urine specific gravity measured by refractometer is 1.029, and the temperature of the urine is 14
degrees C. The specific gravity should be reported as:

B. 1.027

15) Refractive index compares:

Light velocity in air with light velocity in solutions.

16) Refractometers are calibrated using:

C. Distilled water and sodium chloride

17) A correlation exist between a specific gravity of 1.050 and a:

D. Radiographic dye infusion

18) An alkaline urine turns black upon standing, develops a cloudy white precipitate, and has a SG of
1.012. The major concern about this specimen would be:

A. Color

19) The reading of distilled water by the refractometer is 1.003. You should:

D. Adjust the set screw

20) A urine specimen with a specific gravity of 1.008 has been diluted 1:5, the actual specific gravity is:

B. 1.040

21) The method for determining a urine specific gravity that is based on the principle that the frequency
of a sound wave entering a solution changes in proportion to the density of the solution is:

Harmonic Oscillation Densitometry

22) A specimen with a specific gravity of 1.005 would be considered:

B. Hyposthenuric

23) True or False: Specific gravity is of more diagnostic value than osmolarity in evaluating renal
concentration ability.

False

24) A strong odor of ammonia in a urine specimen coul indicate:

D. Urinary tract infection

25) The microscopic of a cloudy amber urine is reported as rare WBCs and epithelial cells. What does
this suggest?

D. Possible mix up of specimen and sediment

26) A specimen with a strong ammonia odor and a heavy white precipitate when it arrives in the
laboratory may require:

A. Collection of a fresh specimen.

Chapter 5

1) Leaving a reagent strip in the specimen for too long will:

C. Cause reagents to leach from the pads

2) Failure to mix a specimen prior to inserting the reagent strip will primarily affect the:

B. Blood reading

3) Testing a refrigerated specimen that has not warmed to room temperature will adversely affect

A. Enzymatic reactions

4) The reagent strip reaction that requires the longest reaction time is the:

C. Leukocyte esterase

5) Qality control of the reagent strips is performed:

D. All of the above: Using positive and negative controls, when results are questionable, & at least once
every 24 hour

6) All of the following are important to protect the integrity of the reagent strips:

A. Removing the desiccant from the bottle

7) The principle of the reagent strip test for pH is the:

D. Double indicator reaction

8) A urine specimen with a pH of 9.0:

B. Should be recollected

9) In the laboratory, a primary consideration associated with pH is:

D. Both A & C : Identification of urinary crystals & Determination of specimen acceptability

10) Indicate the source of proteinuria by placing a 1 for prerenal, 2 for renal, or 3 for postrenal in front
of the condition.

A. 2 (Renal) - Microalbuminuria

B. 1 (Pre-renal) - Acute phase reactants

C. 2 (Renal) - Pre-eclampsia

D. 3 (Post-renal) - Vaginal inflammation

E. 1 (Pre-renal) - Multiple myeloma

F. 2 (Renal) - Orthostatic proteinuria

G. 3 (Post-renal) - Prostatitis

11) The principle of the protein error of indicators reaction is that:

B. Albumin accepts hydrogen ions from the indicator

12) All of the following will cause false-positive protein reagent strip values except

A. Proteins other than albumin

13) A patient with a +1 protein reading in the afternoon is asked to submit a first morning specimen. The
second specimen also has a +1 protein. This patient is:

B. Negative for orthostatic proteinuria

14) Testing for microalbuminuria is valuable for monitoring patients with:

D. All of the above: Hypertension, Diabetes mellitus, Cardiovascular disease risk

15) All of the following are true for the Micral-test for microalbumin except:

C. Two blue bands are formed on the strip

16) All of the following are true for the Immunidip test for microalbumin except:

C. Bound antigen migrates further than unbound antibody

17) The principle of the protein-low reagent pad on the Multistix Pro is the:

A. Binding of albumin to sulphonphtalein dye

18) The principle of the creatinine reagent pad on microalbumin reagent strips is the:

C. Pseudoperoxidase reaction

19) The purpose of performing an albumin:creatinine ratio is to:

B. Correct for hydration in random specimens

20) A patient with a normal blood glucose and a positive urine glucose should be further checked for:

B. Renal disease

21) The principle of the reagent strip tests for glucose is the

C. Double sequential enzyme reaction

22) All of the following may produce false negative glucose reaction except:

A. Detergent contamination

23) A positive clinitest and a negative reagent strip glucose are indicative o

B. Nonglucose reducing substances

24) The primary reason for performing a clinitest is to:

C. Check for newborn galactosuria

25) The three intermediate products of fat metabolism include all of the following except:

B. Ketoacetic acid

26) The most significant reagent strip test that is associated with a positive ketone result is:

A. Glucose

27) The primary reagent in the reagent strip test for ketones is:

D. Sodium nitroprusside

28) Ketonuria may be caused by all the following except:

A. Bacteria infections

29) Urinalysis on a patient with severe back and abdominal pain is frequently performed to check for:

c. Hematuria

30)

31) The principle of the reagent strip reactions for blood are based on the:

B. Peroxidase activity of hemoglobin

32) A speckled pattern on the blood pad of the reagent strip indicates

A. Hematuria

33) List the following products of hemoglobin degradation In the correct order by placing numbers 1-4 in
front of them:

1. Unconjugated billirubin

2. Conjugated bilirubin

3. Unobilinogen and stercobiligen

4. Urobilin

34) The principle of the reagent strip test for bilirubin is the

A. Diazo reaction

35) An elevated urine bilirubin with a normal urobilinogen is indicative of

D. Biliary obstruction

36) The primary cause of false negative bilirubin reaction is

C. Specimen exposed to light

37) The purpose of the special mat supplied with the icottest tablet is

A. Bilirubin remains on the surface of the mat

38) The reagent in the Multistix reactions for urobilinogen is:

C. P-dimethylaminobenzaldehyde

39) The primary problem with urobilinogen tests using Ehrlich reagent is: (2)

D. Positive reactions with porphobilinogen and positive reactions with Ehrlich reactive substances

40) In the Watson Schwartz differentiation test, the substance not extracted into butanol is

B. Porphobilinogen

41) The Hoesch test is used to monitor or screen patients for the presence of:

C. Porphobilinogen

42) The reagent strip test for nitrite used the:

A. Greiss reaction

43) All of the following can cause a negative nitrite reading except:

B. Gram negative bacteria

44) A positive nitrite test and a negative leukocyte esterase test is an indication of a:
D. Specimen older than 2 hours

45) All of the following can be detected by the leukocyte esterase reaction except:

D. Basophils

46) Screening tests for urinary infection combine the leukocyte esterase test with the test for:

B. Nitrite

47) The principle of the leukocyte esterase reagent strip test uses a (reaction type)

B. Diazo reaction

48) The principle of the reagent strip test for specific gravity uses the dissociation constant of a

C. Polyelectrolyte

49) A specific gravity of 1.030 would produce the reagent strip color:

C. Yellow

50) Reagent strip specific gravity readings are affected by:

C. Alkaline urine

Chapter 6

1) Macroscopic screening of urine specimens is used to:

A. Increase cost effectiveness of urinalysis

2) Variations in the microscopic analysis of urine include all of the following except:

D. Identification of formed elements

3) All of the following can cause false- negative micro-scopic results except:

D. Using midstream clean and catch specimen

4) The two factors that determine relative centrifugal force are:

C. Diameter of rotor head and rpm

5) When using the glass slide and coverslip method, which of the following might be missed if the
coverslip is overflowed?

A. Casts

6) Initial screening of the urine sediment is performed using an objective power of:

b. 10x

7) Which of the following should be used to reduce light intensity in bright- field microscopy?

C. Rheostat

8) Which of the following are reported as number per LPF?

D. Casts

9) The Sternheimer- Malbin stain is added to urine sediments to do all of the following except:

C. Decrease precipatation of crystals

10) Nuclear detail can be enhanced by:

B. Toluidine blue & Acetic acid

11) Which of the following lipids is are stained by Sudan III?

D. Neutral fats & Triglycerides

12) Which of the following lipids is are capable of polarizing light?

A. Cholestrol

13) The purpose of the Hansel stain is to identify:

C. Eosinophils

14) Crenated RBCs are seen in urine that is:

B. Hypersthenuric

15) Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following
except:

c. Lysis of yeast cells by acetic acid

16) The finding of dysmorphic RBCs is indicative of:

A. Glomerular bleeding

17) Leukocytes that stain pale blue with Sternheimer- Malbin stain and exhibit brownian movement are:

D. Glitter cells

18) Mononuclear leukocytes are sometimes mistaken for:

D. Renal tubular cells

19) When pyuria is detected in a sediment, the slide should be carefully checked for the presence of:

B. Bacteria

20) Transitional epithelial cells are sloughed from the:

C. Bladder

21) The largest cells in the urine sediment are:

A. Squamous epithelial cells

22) A clinically significant squamous epithelial cell is the:

B. Clue cell

23) Forms of transitional epithelial cells include all of the following except:

C. Convoluted

24) Increased transitional cells are indicative of:

D. Catheterization and Malignancy

25) A primary characteristic used to identify renal tubular epithelial cells is:

D. Eccentrically located nucleus

26) Following an episode of hemoglobinuria, RTE cells may contain:

B. Hemosiderin granules
27) The predecessor of the oval fat body is the:

D. Renal tubular cell

28) A structure believed to be an oval fat body produced a Maltese cross formation under polarized light
but does not stain with sudan III. The structure:

A. Contains cholesterol

29) The finding of yeast cells in the urine is commonly associated with:

B. Diabetes mellitus

30) The primary component of urinary mucus is:

C. Tamm-horsfall protein

31) The majority of casts are formed in the:

C. Distal convoluted tubules

32) Cylindroiduria refers to the presence of:

D. All types of Casts

33) A person submitting a urine specimen following a strenuous exercise routine can normally have all of
the following in the sediment except:

D. WBC casts

34) Prior to identifying an RBC cast, all of the following should be observed except:

B. Intact RBCs in the cast

35) WBC casts are primarily associated with:

A. Pyelonephritis

36) The shape of the RTE cell associated with renal tubular epithelial casts is primarily:

C. Round

37) When observing RTE casts, the cells are primarily:

C. Attached to the surface of a matrix

38) The presence of fatty casts is associated with:

D. All of the above: Nephrotic syndrome, Crush injuries, Diabetes Mellitus

39) Nonpathogenic granular casts contain:

A. Cellular lysosomes

40) All of the following are true about waxy casts except they:

C. Require sating to be visualized

41) The observation of broad casts represents:

D. Destruction of tubular walls and Formation in the collecting ducts

42) All of the following contribute to the formation of urinary crystals except:

A. Protein concentration

43) The most valuable initial aid for the identification of crystals in a urine specimen is:
A. pH

44) Crystals associated with severe liver disease include all of the following except:

C. Cystine

45) All of the following crystals routinely polarize except:

D. Cystine

46) Differentiation between casts and fibers can usually be made using:

C. Polarized light

47)

48)

49)

50)