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C Afferent arteriole, peritubular capillaries, vasa recta, efferent arteriole 4. D Capillary pores 5. A Low systemic blood pressure 6. B Sodium 7. C Macula densa cells 8. D Sodium retention 9. B 1.010 10. A . Urea 11. C Ascending loop of Henle 12. D All of the above A. Blood level of glucose is 200 mg/dL B. Tm for glucose is reached C. Renal threshold for glucose is exceeded 13. A Juxtaglomerular nephrons 14. B Tubular permeability 15. B ADH production is increased 16. D All of the above A. In the proximal convoluted tubule B. Combined with hydrogen ions C. By tubular secretion 17. B.Basic 18. A. Exogenous B. Endogenous A – Inulin, B – Cre atinine, B – Cystatin C, A – 125 I-iothalmate 19. B. Improperly timed urine specimens 20. 69 mL/min 21. A Body size 22. C 82 23. B Urine creatinine 24. D. All of the above A. It does not require urine collection B. It is not secreted by the tubules C. It can be measured by immunoassay 25. A Decrease vapor pressure 26. C Sodium 27. B 275–300 mOsm 28. C 3:1 29. +0.5 30. D Cleared on each contact with functional renal tissue
31. 600 mL/min 32. C Inability to produce an acidic urine due to impaired production of ammonia 33. B Arterial pH
Chapter 2 1. a. 160 to 180 mg/dL b. Renal tubular reabsorption is impaired. 2. a. Juxtaglomerular apparatus Macula densa -> -> Angiotensinogen ->Renin ->Angiotensin I -> Angiotensin II. b. Vasodilation and constriction, increased sodium reabsorption, increased aldosterone and ADH production. c. Production of renin decreases, and this reduces the actions of the renin-angiotensinaldosterone system. 3. a. Calculate the approximate creatinine clearance with Cockcroft-Gault formula. b. Yes, the calculated creatinine clearance is 80 mL/min, (normal). c. Yes, the measured creatinine clearance is 86 mL/min, (normal). 4. a. Serum from the midnight specimen is not being separated from the clot and refrigerated in a timely manner. b. Yes, lactic acid affects both cryoscopic and vapor pressure osmolarity readings. c. If the laboratory is using a cryoscopic osmometer, results will be affected by alcohol ingestion; vapor pressure results would not be affected and could be used as a comparison. 5. a. Diabetes insipidus. b. Decreased production of ADH. c. Lack of tubular response to ADH. Chapter 3 1. C Urea, chloride, and water 2. B Urea and creatinine 3. A 200–400 mL 4. B Diabetes mellitus 5. True 6. C Attach the label to the container 7. C The specimen and accompanying requisition did 8. C 1 and 2 only 9. D Refrigeration 10. C Increased bacteria, decreased red blood cells, decreased casts 11. C Refrigeration 12. A Boric acid and thymol 13. A Boric acid 14. False 15. B First morning specimen 16. B Timed specimens
17. C . Random 18. C . First morning specimen 19. A Anuri 20. B Polyuria 21. D Midstream clean-catch Chapter 3 1. a. No, the specimen should be analyzed and the volume reported. Persons with decreased glomerular filtration rates may also exhibit oliguria. b. Failure to collect a complete specimen will result in a low clearance rate not related to renal function. 2. a. The specimen is a dilute random specimen that has remained more than 2 hours at room temperature prior to being tested. b. Collect a 2-hour postprandial specimen. 3. a. A prostatic infection cannot be determined because the patient has a urinary tract infection. b. White blood cells present after prostate massage only need to be compared with one premassage specimen. c. A prostate infection is present. 4. a. The specimen temperature was measured. b. The temperature was too low. c. The specimen analyzed did not belong to the defendant. d. By maintaining a thoroughly documented COC form. Chapter 4 1. A Color 2. D Urochrome 3. A Bilirubin 4. D All of the above A. Homogentisic acid B. Melanin C. Methemoglobin 5. C RBCs produce a cloudy specimen 6. D Not be concerned because only Mrs. Williams is genetically susceptible to producing red urine from beets 7. B . Viscous and orange 8. A Amorphous phosphates and carbonates 9. A Amorphous urates 10. C Urine contains porphyrins 11. D 1.030 12. False 13. B . To dissolve amorphous urates 14. B 1.027 15. B Light velocity in air with light velocity in solutions 16. C Distilled water and sodium chloride
17. D Radiographic dye infusion 18. A . Color 19. D Adjust the set screw 20. B . 1.040 21. B Harmonic oscillation densitometry 22. B Hyposthenuric 23. False 24. D Urinary tract infection 25. D Possible mix-up of specimen and sediment 26. A Collection of a fresh specimen Chapter 4 1. a. No, because red blood cells would produce a hazy cloudy specimen. b. Hemoglobin from intravascular hemolysis and myoglobin from muscle-tissue damage. c. Yes, the red blood cells may have hemolyzed. d. Dietary intake, exercise, and medications. 2. a. Yes, the specimen may contain melanin or homogentisic acid. b. Homogentisic acid. c. Melanin. d. Breakdown of red blood cells followed by oxidation of hemoglobin to methemoglobin. 3. a. Radiographic dye. b. 1.060 c. Add 3 mL of water to 1 mL of urine and mix. d. Reagent strip 4. a. Beets b. Yes, beets produce a red color in alkaline urine, and the fresh specimen may have an acid pH, or she has not recently eaten beets. 5. a. Support: the specimen may be old and bilirubin has oxidized to biliverdin and glycolysis may have occurred. b. Disagree: The specimen is concentrated and the white foam is from protein that will be detected by reagent strip. c. Support: The specimen may be old. d. Disagree: The specimen can be accurately analyzed by reagent strip.
Chapter 5 1. C Cause reagents to leach from the pads 2. B Blood reading 3. A Enzymatic reactions 4. C Leukocyte esterase 5. D . All of the above
A. Using positive and negative controls B. When results are questionable C. At least once every 24 hours 6. A Removing the desiccant from the bottle 7. D Double indicator reaction 8. B Should be recollected 9. D Both A and C
A. Identification of urinary crystals C. Determination of specimen acceptability 10. 1 for prerenal, 2 for renal, or 3 for postrenal A. _2___Microalbuminuria B. _1___Acute phase reactants C. _2___Pre-eclampsia D. _3___Vaginal inflammation E. _1___Multiple myeloma F. _2___Orthostatic proteinuria G. _3___Prostatitis 11. B Albumin accepts hydrogen ions from the indicator 12. A . Proteins other than albumin 13. B Negative for orthostatic proteinuria 14. D All of the above A. Hypertension B. Diabetes mellitus C. Cardiovascular disease risk 15. C Two blue bands are formed on the strip 16. C Bound antibody migrates further than unbound antibody 17. A Binding of albumin to sulphonphtalein dye 18. C Pseudoperoxidase reaction 19. B Correct for hydration in random specimens 20. B Renal disease 21. C Double sequential enzyme reaction 22. A Detergent contamination 23. B Nonglucose reducing substances 24. C Check for newborn galactosuria 25. B. Ketoacetic acid 26. A Glucose 27. D Sodium nitroprusside 28. A Bacterial infections 29. C Hematuria 30. 1. Hemoglobinuria 2. Myoglobinuria A. _1___Associated with transfusion reactions B. _2___Clear, red urine and pale yellow plasma C. _1___Clear, red urine and red plasma D. _2___Associated with rhabdomylosis E. _1___Precipitated by ammonium sulfate F. _2___Not precipitated by ammonium sulfate G. _1___Produced hemosiderin granules in urinary sediments H. _2___Associated with acute renal failure
31. B. Peroxidase activity of heme 32. A. Hematuria 33. correct order by placing numbers 1–4
A. _2__Conjugated bilirubin B. _3__Urobilinogen and stercobiligen C. _4__Urobilin D. _1__Unconjugated bilirubin
34. A. Diazo reaction 35. D. Biliary obstruction 36. C. Specimen exposure to light 37. A. Bilirubin remains on the surface of the mat 38. C. p-dimethylaminobenzaldehyde 39. D. Both A and C
A. Positive reactions with porphobilinogen C. Positive reactions with Ehrlich reactive substances 40. B. Porphobilinogen 41. C. Porphobilinogen 42. A. Greiss reaction 43. B. Gram-negative bacteria) 44. D. Specimen older than 2 hours 45. C. Lymphocytes 46. B. Nitrite 47. C. Diazo reaction 48. C. Polyelectrolyte 49. C. Yellow 50. C. Alkaline urine
Chapter 5 1. a. The patient’s blood glucose level exceeds the renal threshold for glucose, causing glucosuria. b. Diabetes mellitus. c. Diabetic nephropathy. d. Periodic testing for microalbuminuria followed by better stabilization of the blood glucose levels. e. Tubular dysfunction 2. a. Yellow foam b. Ictotest c. Possible biliary-duct obstruction preventing conjugated bilirubin from entering the intestine. d. Icteric e. Specimens must be protected from light. 3. a. Hemoglobinuria b. Increased bilirubin presented to the liver results in increased bilirubin entering the intestine for conversion to urobilinogen. c. The circulating bilirubin is unconjugated. d. Perform a Watson-Schwartz test; retest the specimen using a Chemstrip. 4. a. Negative chemical reactions for blood and nitrite. Ascorbic acid interference for both reactions. Random specimen or further reduction of nitrite could cause the negative nitrite. b. Glucose, bilirubin, LE. Ascorbic acid is a strong reducing agent that interferes with the oxidation reaction in the glucose test. Ascorbic acid combines with the diazo reagent in the bilirubina and LE tests lowering the sensitivity. c. The dark yellow color may be caused by beta-carotene instead of specimen concentration.
d. Non-nitrate–reducing microorganisms; lack of dietary nitrate; antibiotic administration. 5. a. To check for possible exercise-induced abnormal results. b. Negative protein and blood, possible changes in color and specific gravity. c. Renal 6. a. No, the specimen is clear. b. Myoglobinuria c. Muscle damage from the accident (rhabdomyolysis). d. Yes, myoglobin is toxic to the renal tubules. 7. a. Laboratory personnel are not tightly capping the reagent strip containers in a timely manner. b. Personnel performing the manual reagent strip test are not waiting 2 minutes to read the LE reaction. c. The student is not mixing the specimen.
*all answers as stated in the book* Answers seemed correct with exception to number 30 of chapter 5 where the answers did not align with the questions. All other seem correct to my best guess and ability.
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