13 RENAL PHYSIOLOGY AND URINALYSIS Flashcards

1
Q

The parts or a part of a routine urinalysis are (is):
a. Physical
b. Chemical
c. Microscopic
d. All the above

A

d. All the above

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2
Q

The formation of urine begins in the:
a. Nephron
b. Glomerulus
c. Ureter
d. Bladder

A

b. Glomerulus

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3
Q

What is the principal end product of protein metabolism in the urine?
a. Uric acid
b. Creatinine
c. Glucose
d. Urea

A

d. Urea

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4
Q

Which of the following is true about the first morning urine specimen?
a. It contains high levels of analytes and cellular elements.
b. It is preferred for culture and sensitivity testing.
c. It is used for substances affected by diurnal variation.
d. It is the most common type of specimen collected.

A

a. It contains high levels of analytes and cellular elements.

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5
Q

After collection with no gross alterations, how long can urine can be refrigerated?
a. 2 to 4 hours
b. 4 to 6 hours
c. 6 to 8 hours
d. 8 to 10 hours

A

c. 6 to 8 hours

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6
Q

Which of the following is the preservative that allows urine to be kept at room temperature with results comparable to refrigeration?
a. Hydrochloric acid
b. Boric acid
c. Toluene
d. All the above

A

d. All the above

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7
Q

Anuria is:
a. Any increase in urine volume, even temporary
b. Complete absence of urine formation
c. Consistent elimination of 2000mL urine per 24 hours
d. Excretion of 500mL urine per 24 hours

A

b. Complete absence of urine formation

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8
Q

Anuria is:
a. Any increase in urine volume, even temporary
b. Complete absence of urine formation
c. Consistent elimination of 2000mL urine per 24 hours
d. Excretion of 500mL urine per 24 hours

A

a. Any increase in urine volume, even temporary

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9
Q

Polyuria is:
a. Any increase in urine volume, even temporary
b. Complete absence of urine formation
c. Consistent elimination of 2000mL urine per 24 hours
d. Excretion of 500mL urine per 24 hours

A

c. Consistent elimination of 2000mL urine per 24 hours

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10
Q

A urine specimen with a strong ammonia odor is most often the result of:
a. Breakdown of urea by bacteria
b. The presence of higher quantities of acetone
c. Ingestion of certain foodstuffs
d. Urinary tract infection in an older specimen

A

a. Breakdown of urea by bacteria

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11
Q

If the kidney has completely lost the ability to concentrate or dilute urine, the specific gravity will remain at:
a. 1.000
b. 1.005
c. 1.010
d. 1.035

A

c. 1.010

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12
Q

When urine decomposes, the pH:
a. Becomes more alkaline
b. Becomes more acidic
c. Does not change
d. Causes crystals associated with acidic urine to form

A

a. Becomes more alkaline

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13
Q

Urine pH is:
a. An indicator of proteinuria
b. Helpful in the identification of some types of crystals in the urine
c. Unaffected by diet
d. Unchanged for each individual

A

b. Helpful in the identification of some types of crystals in the urine

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14
Q

Detection of which of the following urine constituents is most helpful in the detection and diagnosis of renal disease?
a. Blood
b. Leukocyte esterase
c. Nitrite
d. Protein

A

d. Protein

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15
Q

Which of the following is correct regarding the presence of albumin in urine?
a. It is associated with γ-globulinopathies such as multiple myeloma.
b. It may be seen in urine as the result of intravascular hemolysis.
c. Molecule is generally too large to be filtered through the glomerulus.
d. It is the protein most often associated with glomerular damage.

A

d. It is the protein most often associated with glomerular damage.

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16
Q

Which of the following is correct regarding the presence of globulin in urine?
a. It is associated with γ-globulinopathies such as multiple myeloma.
b. It may be seen in urine as the result of intravascular hemolysis.
c. Molecule is generally too large to be filtered through the glomerulus.
d. It is the protein most often associated with glomerular damage

A

c. Molecule is generally too large to be filtered through the glomerulus.

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17
Q

Which of the following is correct regarding light-chain immunoglobulins (Bence Jones protein)?
a. It is associated with γ-globulinopathies such as multiple myeloma.
b. It may be seen in urine as the result of intravascular hemolysis.
c. Molecule is generally too large to be filtered through the glomerulus.
d. It is the protein most often associated with glomerular damage.

A

a. It is associated with γ-globulinopathies such as multiple myeloma.

18
Q

The reagent strip test for protein is more sensitive to which of the following than to other proteins?
a. Albumin
b. Hemoglobin
c. Light-chain immunoglobulins
d. Both a and b

A

a. Albumin

19
Q

Which of the following is not detected by the reagent strip test for blood?
a. Hemoglobin
b. Hemosiderin
c. Myoglobin
d. Red blood cells

A

b. Hemosiderin

20
Q

Reagent strip tests that depend on the release of oxygen and subsequent oxidation of a chromogen, resulting in a color change, are subject to false negative reactions because of the presence of:
a. Ascorbic acid (<25mg/dL)
b. Azo-containing drugs or compounds
c. Chlorine bleach
d. Low specific gravity

A

a. Ascorbic acid (<25mg/dL)

21
Q

Dipstick tests for nitrite tend to be:
a. Positive when large numbers of gram-positive bacteria are present
b. Positive when large numbers of gram-negative bacteria are present
c. Negative in the presence of a urinary tract infection
d. Falsely positive in the presence of a urinary tract infection

A

b. Positive when large numbers of gram-negative bacteria are present

22
Q

Reagent strip tests for urinary leukocyte esterase are most useful in the detection of:
a. Immunosuppression
b. Malignancy
c. Renal transplant rejection
d. Urinary tract infection

A

d. Urinary tract infection

23
Q

Reagent strip tests for urinary leukocyte esterase are most useful when results are evaluated together with the results for the reagent strip test for:
a. Blood
b. Nitrite
c. Protein
d. Specific gravity

A

b. Nitrite

24
Q

A positive reagent strip test for glucose is most often associated with which of the following conditions?
a. Anorexia nervosa
b. Diabetes insipidus
c. Diabetes mellitus
d. Starvation

A

c. Diabetes mellitus

25
Q

Which of the following is true about hematuria?
a. Sensitive early indicator of renal disease
b. Distorted or misshapen red cells that may indicate glomerular damage
c. Presence associated with dilute or hypotonic urine
d. Indicates a high level of protein

A

a. Sensitive early indicator of renal disease

26
Q

Normal urinary sediment can exhibit a:
a. Few leukocytes
b. Moderate number of squamous epithelia
c. Rare hyaline case
d. All the above

A

d. All the above

27
Q

Which of the following is true about a microscopic finding of dysmorphic red cells?
a. Sensitive early indicator of renal disease
b. Distorted or misshapen red cells that may indicate glomerular damage
c. Presence associated with dilute or hypotonic urine
d. Indicates a high level of protein

A

b. Distorted or misshapen red cells that may indicate glomerular damage

28
Q

Which of the following is true about a microscopic finding of shadow or swollen red cells?
a. Sensitive early indicator of renal disease
b. Distorted or misshapen red cells that may indicate glomerular damage
c. Presence associated with dilute or hypotonic urine
d. Indicates a high level of protein

A

c. Presence associated with dilute or hypotonic urine

29
Q

Which is suggested by the presence of neutrophils (PMNs) in a urine microscopic analysis?
a. Indicates active kidney disease or tubular injury
b. May be seen with infection and after urethral catheterization
c. Type of leukocyte most often seen in urine; indicates inflammation somewhere in the urogenital tract
d. Associated with the nephrotic syndrome

A

c. Type of leukocyte most often seen in urine; indicates inflammation somewhere in the urogenital tract

30
Q

Which is suggested by the presence of oval fat bodies in a urine microscopic analysis?
a. Indicates active kidney disease or tubular injury
b. May be seen with infection and after urethral catheterization
c. Type of leukocyte most often seen in urine; indicates inflammation somewhere in the urogenital tract
d. Associated with the nephrotic syndrome

A

d. Associated with the nephrotic syndrome

31
Q

Which is suggested by the presence of renal epithelial cells in a urine microscopic analysis?
a. Indicates destruction of renal tubules
b. May be seen with infection and after urethral catheterization
c. Type of leukocyte most often seen in urine; indicates inflammation somewhere in the urogenital tract
d. Associated with the nephrotic syndrome

A

a. Indicates destruction of renal tubules

32
Q

Which is suggested by the presence of transitional epithelial cells in a urine microscopic analysis?
a. Indicates active kidney disease or tubular injury
b. May be seen with infection and after urethral catheterization
c. Type of leukocyte most often seen in urine; indicates inflammation somewhere in the urogenital tract
d. Associated with the nephrotic syndrome

A

b. May be seen with infection and after urethral catheterization

33
Q

The presence of which of the following types of casts has the least clinical significance?
a. Fatty
b. Granular
c. Hyaline
d. Red or white cell

A

c. Hyaline

34
Q

The presence of epithelial cell casts indicates:
a. Acute glomerulonephritis
b. Acute pyelonephritis
c. Chronic renal disease or renal failure
d. Nephrotoxic poisoning

A

d. Nephrotoxic poisoning

35
Q

The presence of fatty casts indicates:
a. Acute glomerulonephritis
b. Acute pyelonephritis
c. Chronic renal disease or renal failure
d. Diabetes type 1 with renal degeneration

A

d. Diabetes type 1 with renal degeneration

36
Q

The presence of hyaline indicates:
a. Acute glomerulonephritis
b. Acute pyelonephritis
c. Diabetic nephropathy
d. Strenuous exercise

A

d. Strenuous exercise

37
Q

The presence of red blood cell casts indicates:
a. Acute glomerulonephritis
b. Acute pyelonephritis
c. Chronic renal disease or renal failure
d. Nephrotoxic poisoning

A

a. Acute glomerulonephritis

38
Q

The presence of waxy casts indicates:
a. Acute glomerulonephritis
b. Acute pyelonephritis
c. Chronic renal disease
d. Nephrotoxic poisoning

A

c. Chronic renal disease

39
Q

The presence of white blood cell casts indicates:
a. Acute glomerulonephritis
b. Pyelonephritis
c. Chronic renal disease or renal failure
d. Nephrotoxic poisoning

A

b. Pyelonephritis

40
Q

Which of the following is true about hemosiderin?
a. It is seen as free granules in cells or casts several days after an acute hemolytic episode.
b. Most of its abnormal crystals are seen in urine of an alkaline pH.
c. Most or its birefringent crystals are seen in urine.
d. It is made of calcium oxalate– or calcium-containing compounds

A

a. It is seen as free granules in cells or casts several days after an acute hemolytic episode.

41
Q

Uric acid crystals in the urine sediment indicate that the patient probably has:
a. Gout
b. Rheumatoid arthritis
c. Urinary tract infection
d. Acute glomerulonephritis

A

a. Gout