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MTAP 1 > EE - AUBF > Flashcards

EE - AUBF Flashcards

1
Q

Why is the first-voided morning urine
specimen the most desirable specimen for
routine urinalysis?

A. Most dilute specimen of the day and
therefore any chemical compounds
present will not exceed the detectability
limits of the reagent strips
B. Least likely to be contaminated with
microorganisms because the bladder is
a sterile environment
C. Most likely to contain protein because
the patient has been in the orthostatic
position during the night
D. Most concentrated specimen of the
day and therefore it is more likely that
abnormalities will be detected

A

Most concentrated specimen of the
day and therefore it is more likely that
abnormalities will be detected

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2
Q

The physical characteristic of color
is assessed when a routine urinalysis
is performed. What substance is
normally found in urine that is principally
responsible for its yellow coloration?

A. Bilirubin
B. Melanin
C. Carotene
D. Urochrome

A

Urochrome

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3
Q

In certain malignant disorders, what
substance is found in the urine that turns
the urine dark brown or black on exposure
of the urine to air?

A. Urobilinogen
B. Indican
C. Melanin
D. Porphyrin

A

C. Melanin

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4
Q

What is the expected pH range of a freshly
voided urine specimen?

A. 3.5-8.0
B. 3.5-9.0
C. 4.0-8.5
D. 4.5-8.0

A

4.5-8.0

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5
Q

Urine specimens should be analyzed as
soon as possible after collection. If urine
specimens are allowed to stand at room
temperature for an excessive amount of
time, the urine pH will become alkaline
because of bacterial decomposition of

A. Protein
B. Urea
C. Creatinine
D. Ketones

A

Urea

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6
Q

Which term is defined as a urine volume
in excess of 2000 mL excreted over a
24-hour period?

A. Anuria
B. Oliguria
C. Polyuria
D. Hypersthenuria

A

C. Polyuria

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7
Q

The reagent test strips used for the
detection of protein in urine are most
reactive to?

A. Albumin
B. Hemoglobin
C. Alpha-globulins
D. Beta-globulins

A

A. Albumin

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8
Q

A urine specimen that exhibits yellow
foam on being shaken should be suspected
of having an increased concentration of

A. Protein
B. Hemoglobin
C. Bilirubin
D. Nitrite

A

C. Bilirubin

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9
Q

How should controls be run to ensure the
precision and accuracy of the reagent test
strips used for the chemical analysis of
urine?

A. Positive controls should be run on a
daily basis and negative controls when
opening a new bottle of test strips.
B. Positive and negative controls should
be run when the test strips’ expiration
date is passed.
C. Positive and negative controls should
be run on a daily basis.
D. Positive controls should be run on a
daily basis and negative controls on a
weekly basis.

A

C. Positive and negative controls should
be run on a daily basis.

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10
Q

The colorimetric reagent strip test for
protein is able to detect as little as 5-20 nig
of protein per deciliter. What may cause a
false-positive urine protein reading?

A. Uric acid concentration is greater than
0.5 g/day.
B. Vitamin C concentration is greater
than 0.5 g/day.
C. Glucose concentration is greater than
130mg/day.
D. pH is greater than 8.0.

A

D. pH is greater than 8.0.

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11
Q

“Isosthenuria” is a term applied to a series
of urine specimens from the same patient
that exhibit a

A. Specific gravity of exactly 1.000
B. Specific gravity less than 1.007
C. Specific gravity greater than 1.020
D. Fixed specific gravity of approximately 1.010

A

D. Fixed specific gravity of approximately 1.010

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12
Q

A urine specimen is tested by a reagent
strip test and the sulfosalicylic acid test to
determine whether protein is present. The
former yields a negative protein, whereas
the latter results in a reading of 2+
protein. Which of the following statements
best explains this difference?

A. The urine contained an excessive
amount of amorphous urates or
phosphates that caused the turbidity
seen with the sulfosalicylic acid test.
B. The urine pH was greater than 8,
exceeding the buffering capacity
of the reagent strip, thus causing
a false-negative reaction.
C. A protein other than albumin must be
present in the urine.
D. The reading time of the reagent strip
test was exceeded (the reading being
taken at 2 minutes), causing a false-negative reaction to be detected.

A

C. A protein other than albumin must be
present in the urine.

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13
Q

Which of the following is the major
organic substance found in urine?

A. Sodium
B. Potassium
C. Glucose
D. Urea

A

D. Urea

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14
Q

Each of the following is included in the
quality assurance program for a urinalysis
laboratory. Which one represents a
preanalytical component of testing?

A. Setting collection guidelines for
24-hour urines
B. Setting a maintenance schedule for
microscopes
C. Reporting units to be used for crystals
D. Requiring acceptable results for
control specimens before any patient
results are reported out

A

A. Setting collection guidelines for
24-hour urines

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15
Q

The presence of ketone bodies in urine
specimens may be detected by use of a
reagent strip impregnated with sodium
nitroprusside. This strip test is sensitive
to the presence of?

A. Acetoacetic acid and betahydroxybutyric acid
B. Acetoacetic acid and acetone
C. Diacetic acid and beta-hydroxybutyric
acid
D. Beta-hydroxybutyric acid and acetone

A

B. Acetoacetic acid and acetone

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16
Q

A routine urinalysis is performed on a
young child suffering from diarrhea. The
reagent test strip is negative for glucose
but positive for ketones. These results may
be explained by which of the following
statements?

A. The child has Type 1 diabetes mellitus.
B. The child is suffering from lactic
acidosis, and the lactic acid has falsely
reacted with the impregnated reagent
area for ketones.
C. The child is suffering from increased
catabolism of fat because of decreased
intestinal absorption.
D. The reagent area for ketones was read
after the maximum reading time
allowed.

A

C. The child is suffering from increased
catabolism of fat because of decreased
intestinal absorption.

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17
Q

The principle of the colorimetric reagent
strip test for hemoglobin is based on the
peroxidase activity of hemoglobin in
catalyzing the oxidation of a dye with
peroxide to form a colored compound.
This method may yield false-positive
results for the presence of hemoglobin
when the urine specimen contains

A. Ascorbic acid
B. Tetracycline
C. Myoglobin
D. Nitrite

A

C. Myoglobin

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18
Q

A reagent test strip impregnated with
a diazonium salt such as diazotized
2,4-dichloroaniline may be used to
determine which analyte?

A. Glucose
B. Ketone
C. Hemoglobin
D. Bilirubin

A

D. Bilirubin

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19
Q

Which of the following will contribute to a
specimen’s specific gravity if it is present
in a person’s urine?

A. 50-100 RBC/hpf
B. 85 mg/dL glucose
C. 3+ amorphous phosphates
D. Moderate bacteria

A

B. 85 mg/dL glucose

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20
Q

With infections of the urinary system,
white blood cells are frequently seen in
the urine sediment. What type of white
blood cell is seen the most frequently in
urine sediment?

A. Eosinophil
B. Lymphocyte
C. Monocyte
D. Neutrophil

A

D. Neutrophil

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21
Q

A random urine is collected from a patient
and the results obtained are as follows:
urine albumin =16 mg/dL and urine
creatinine = 140 mg/dL. These findings
are consistent with?

A. Microalbuminuria
B. Macroalbuminuria
C. Nephrotic syndrome
D. Obstructive jaundice

A

A. Microalbuminuria

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22
Q

To detect more easily the presence of casts
in urine sediments, which microscopic
method can be used?

A. Fluorescent microscopy
B. Phase-contrast microscopy
C. Polarized microscopy
D. Brightfield microscopy

A

B. Phase-contrast microscopy

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23
Q

Which substance found in urinary
sediment is more easily distinguished
by use of polarized microscopy?

A. Lipids
B. Casts
C. Red blood cells
D. Ketone bodies

A

A. Lipids

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24
Q

“Glitter cell” is a term used to describe
a specific type of

A. Ketone body
B. Oval fat body
C. Fatty droplet
D. Neutrophil

A

D. Neutrophil

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25
Q

The final phase of degeneration that
granular casts undergo is represented
by which of the following casts?

A. Fine
B. Coarse
C. Cellular
D. Waxy

A

D. Waxy

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26
Q

A 40-year-old female patient with a history
of kidney infection is seen by her physician
because she has felt lethargic for a few
weeks. She has decreased frequency of
urination and a bloated feeling. Physical
examination shows periorbital swelling
and general edema, including a swollen
abdomen. Significant urinalysis results
show the following: color = yellow;
appearance = cloudy/frothy; specific
gravity = 1.022;pH = 7.0; protein =
4+; 0-3 WBC/hpf; 0-1 RBC/hpf; 0-2
renal epithelial cells/hpf; 10-20 hyaline
casts/lpf; 0-1 granular casts/lpf; 0-1 fatty
casts/lpf; occasional oval fat bodies. Her
serum chemistries show significantly
decreased albumin, increased urea
nitrogen, and increased creatinine. These
findings suggest which condition?

A. Multiple myeloma
B. Glomerulonephritis
C. Nephrotic syndrome
D. Chronic renal failure

A

C. Nephrotic syndrome

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27
Q

A 47-year-old female patient with
controlled type 2 diabetes mellitus
complains of urinary frequency and
burning. She provides a first-morning,
clean-catch specimen. Results show
color = yellow; appearance = cloudy;
pH = 6.5; a representative microscopic
high-power field is shown in Color
Plate 46B. Which of the following is true
for this patient?

A. The number of bacteria seen would
result in a positive nitrite.
B. The major formed elements are white
blood cells and yeast.
C. The type and number of epithelial
cells suggest incorrect sample
collection.
D. The red blood cells would be sufficient
to give a positive blood result on the
reagent strip.

A

B. The major formed elements are white
blood cells and yeast.

28
Q

Alkaptonuria, a rare hereditary disease, is
characterized by the urinary excretion of?

A. Alkaptone
B. Phenylalanine
C. 5-Hydroxyindole acetic acid
D. Homogentisic acid

A

D. Homogentisic acid

29
Q

A 22-year-old female clinical laboratory
student performs a urinalysis on her own
urine as part of a lab class. Significant
results include: color = yellow;
appearance = cloudy; pH = 7.5;
nitrite = positive; leukocyte
esterase - 2+; 25^0 WBC/hpf;
0-3 RBC/hpf; 2-5 squamous epithelial
cells/hpf; moderate bacteria. All other
chemistries and microscopic results
were normal. These findings suggest?

A. Glomerulonephritis
B. Upper urinary tract infection
C. Lower urinary tract infection
D. Nephrolithiasis

A

C. Lower urinary tract infection

30
Q

Metastatic carcinoid tumors arising from
the enterochromaffin cells of the gastrointestinal tract are characterized by
increased excretion of urinary?

A. Serotonin
B. 5-Hydroxytryptophan
C. Homogentisic acid
D. 5-Hydroxyindole acetic acid

A

D. 5-Hydroxyindole acetic acid

31
Q

Some clinical conditions are characterized
by unique urinalysis result patterns.
Which of the following shows such a
relationship?

A. Nephrotic syndrome: positive protein
on reagent strip, negative protein with
sulfosalicylic acid
B. Intensive dieting: increased ketones,
negative glucose
C. Multiple myeloma: positive protein
by both reagent strip and sulfosalicylic
acid
D. Cystitis: positive nitrite and protein

A

B. Intensive dieting: increased ketones,
negative glucose

32
Q

Nitrite in a urine specimen suggests the
presence of?

A. White blood cells
B. Red blood cells
C. Bacteria
D. Yeasts

A

C. Bacteria

33
Q

If a fasting plasma glucose level of 100
mg/dL is obtained on an individual, what
is the expected fasting cerebrospinal fluid
(CSF) glucose level in mg/dL?

A. 25
B. 50
C. 65
D. 100

A

C. 65

34
Q

A 35-year-old man has just experienced
severe crush injuries sustained in a car
accident. He has a broken pelvis and right
femur and has numerous abrasions and
contusions. A random urinalysis specimen
shows a brown color and clear appearance.
pH is 6.0, protein is 1 + , and blood is 3+.
There is, however, only 0-1 RBC/hpf,
along with 0-3 WBC/hpf. Casts found
include hyaline (0-2/lpf) and granular
(0-1/Ipf). Other urine results are normal.
Which of the following is true about this
patient?

A. The positive blood result is from a
hemolytic anemia.
B. The bilirubin result should have also
been positive for this patient.
C. Rhabdomyolysis may be a cause for
the discrepant chemical/microscopic
blood findings.
D. The bone crushing led to the increased
protein result.

A

C. Rhabdomyolysis may be a cause for
the discrepant chemical/microscopic
blood findings.

35
Q

A 67-year-old male has routine testing
done and shows an estimated glomerular
filtration rate (eGFR) of 42 mL/min/1.73 m2.
Which of the following is true for this
patient?

A. This test requires a 24-hour urine
collection.
B. The patient does not have chronic
kidney damage, based on these results.
C. Similar results would be obtained
using the Cockgroft-Gault formula.
D. The patient is in Stage 3 chronic
kidney damage.

A

D. The patient is in Stage 3 chronic
kidney damage.

36
Q

Which is true about the formed element
shown in Color Plate 47 *?

A. May be found in normal alkaline urine
B. Associated with renal pathology
C. Characteristic of glomerulonephritis
D. Associated with lung pathology

A

A. May be found in normal alkaline urine

37
Q

The major formed element in the highpower field shown in Color Plate 48 *
is most likely a?

A. Granular cast
B. Hyaline cast
C. Waxy cast
D. Fiber artifact

A

D. Fiber artifact

38
Q

Which of the following is true about the
final concentrating of urine in the kidney?

A. The distal convoluted tubule, through
active transport, reabsorbs water.
B. Water is reabsorbed under the direct
influence of angiotensin II.
C. Vasopressin controls the collecting
duct reabsorption of water.
D. Water reabsorption is influenced by
urine filtrate levels of potassium.

A

C. Vasopressin controls the collecting
duct reabsorption of water.

39
Q

If a urine specimen is left standing at room
temperature for several hours, which of
the following changes may occur?

A. Multiplication of bacteria
B. An increase in the glucose concentration
C. Production of an acid urine
D. Deterioration of any albumin present

A

A. Multiplication of bacteria

40
Q

The formed element shown in Color
Plate 49B would usually be found in the
patient’s urine along with which soluble
biochemicals?

A. Phenylalanine and tyrosine
B. Ornithine and arginine
C. Isoleucine and leucine
D. Acetoacetic acid and (3-hydroxybutyric acid

A

B. Ornithine and arginine

41
Q

A 13-year-old ice skater is having her
routine physical before the school year.
Her first morning urinalysis results
include color = straw; appearance =
hazy; pH = 6.0; protein = trace; a
representative microscopic high-power
field is shown in Color Plate 50B. All
other chemical results were normal. The
major formed elements are and
suggest.

A. Hyaline casts and waxy casts;
nephrotic syndrome
B. Mucus and fibers; no pathology
C. Granular casts and red blood cells;
glomerulonephritis
D. Hyaline casts and mucus; normal
sediment

A

D. Hyaline casts and mucus; normal
sediment

42
Q

Phenylketonuria may be characterized
by which of the following statements?

A. It may cause brain damage if
untreated.
B. It is caused by the absence of the
enzyme, phenylalanine oxidase.
C. Phenylpyruvic acid excess appears
in the blood.
D. Excess tyrosine accumulates in the
blood.

A

A. It may cause brain damage if
untreated.

43
Q

What condition is suggested by the
number of the formed element that
predominates in the high-power field
of Color Plate 51?

A. Glomerulonephritis
B. Improperly collected specimen
C. Pyelonephritis
D. Normal sample

A

D. Normal sample

44
Q

Xanthochromia of cerebrospinal fluid
(CSF) samples may be due to increased
levels of which of the following?

A. Chloride
B. Protein
C. Glucose
D. Magnesium

A

B. Protein

45
Q

Which of the following will be characterized by an increased number of the urinary
component seen in Color Plate 52?

A. Acute glomerulonephritis
B. Biliary tract obstruction
C. Contamination from vaginal discharge
D. Nephrotic syndrome

A

A. Acute glomerulonephritis

46
Q

To determine amniotic fluid contamination
with maternal urine, which of the
following measurements could be used?

A. Creatinine concentration
B. Delta absorbance at 410 nm
C. Albumin/globulin ratio
D. Lactate dehydrogenase

A

A. Creatinine concentration

47
Q

With the development of fetal lung
maturity, which of the following phospholipid concentrations in amniotic fluid
significantly and consistently increases?

A. Sphingomyelin
B. Phosphatidyl ethanolamine
C. Phosphatidyl inositol
D. Phosphatidyl choline

A

D. Phosphatidyl choline

48
Q

A patient has been diagnosed with an
upper gastrointestinal bleed. Which of the
following would be characteristic for this
condition?

A. Brown stool with streaks of bright red
B. Stool with lack of brown color
(“clay-colored”)
C. Stool with a much darker brown/black
color
D. Yellow stool with increased mucus

A

C. Stool with a much darker brown/black
color

49
Q

A pleural effusion is found to have 3000
white blood cells per microliter and 5 g/dL
total protein. From this it can be determined that the patient’s effusion is?

A. A transudate
B. An exudate
C. Noninflammatory
D. Hemorrhagic

A

B. An exudate

50
Q

Patients with diabetes insipidus tend to
produce urine in _________ volume with ___________
specific gravity.

A. Increased; decreased
B. Increased; increased
C. Decreased; decreased
D. Decreased; increased

A

A. Increased; decreased

51
Q

The estimation of hyaluronic acid
concentration by measurement of
viscosity is useful in evaluating which
type of fluid?

A. Spinal
B. Peritoneal
C. Pleural
D. Synovial

A

D. Synovial

52
Q

Which of the following is characteristic of
an exudate effusion?

A. Leukocyte count >1000/uL
B. Clear appearance
C. Protein concentration <3.0 g/dL
D. Absence of fibrinogen

A

A. Leukocyte count >1000/uL

53
Q

Which of the following systems utilizes
polyelectrolytes to determine the specific
gravity of urine?

A. Refractometer
B. Osmometer
C. TS meter
D. Reagent strip

A

D. Reagent strip

54
Q

Which methods may be used to quantify
protein in both cerebrospinal fluid and
urine specimens?

A. Trichloroacetic acid and bromcresol
green
B. Ponceau S and Coomassie brilliant
blue
C. Bromcresol green and Coomassie
brilliant blue
D. Coomassie brilliant blue and
trichloroacetic acid

A

D. Coomassie brilliant blue and
trichloroacetic acid

55
Q

Which of the following characteristics is
true of the primary urinary components
shown in Color Plate 53?

A. Consist of uromodulin protein
B. Presence always indicates a disease
process
C. Can be observed with polarized
microscopy
D. Appear yellowish in brightfield
microscopy

A

A. Consist of uromodulin protein

56
Q

A characteristic of substances normally
found dissolved in the urine is that they
are all?

A. Water soluble
B. Inorganic
C. Organic
D. Waste products

A

A. Water soluble

57
Q

Which of the following statements applies
to the proper collection and handling of
CSF?

A. The second tube collected should be
used for chemistry analyses.
B. The third tube collected should be
used for bacteriologic studies.
C. CSF collected in the evening should
be refrigerated and assays performed
only by day-shift personnel.
D. With low-volume specimens, a culture
is performed first, before cell counts
are done.

A

D. With low-volume specimens, a culture
is performed first, before cell counts
are done.

58
Q

Which of the following characteristics is
true for the urinary components shown in
Color Plate 54?

A. Never should appear in a freshly
collected sample
B. Can also resemble cysteine crystals
C. Appear insoluble in alkaline urine
D. Presence indicates an inborn error of
metabolism

A

B. Can also resemble cysteine crystals

59
Q

A patient sends the following question to
an online consumer health Web site: “I am
a 22-year-old female who experienced
increasing headaches, thirst, and decreasing energy. I was studying in the library
when I felt lightheaded and passed out.
I was taken to a hospital emergency
department and they told me that my
serum Acetest® was 40 mg/dL and urine
glucose was 500 mg/dL. What does this
mean?” How would you reply?

A. Your lab results pattern suggests
diabetes mellitus.
B. You probably have been crash dieting
recently.
C. The two results do not fit any disease
pattern.
D. The tests need to be repeated because
they could not possibly occur together.

A

A. Your lab results pattern suggests
diabetes mellitus.

60
Q

Which urinalysis reagent strip test will
never be reported out as “negative”?

A. Protein
B. Urobilinogen
C. Bilirubin
D. Nitrite

A

B. Urobilinogen

61
Q

The following urinalysis results were
obtained on a 40-year-old white male
whose skin appeared yellowish during the
clinical examination. Color and clarity—
dark brown, clear; protein—negative;
glucose—negative; blood—negative;
ketones—negative; bilirubin— moderate;
urobilinogen—0.2 mg/dL. These results
are clinically significant in which of the
following conditions?

A. Bile duct obstruction
B. Cirrhosis
C. Hepatitis
D. Hemolytic anemia

A

A. Bile duct obstruction

62
Q

Compared to the fecal occult blood test,
which of the following is a disadvantage
of performing a DNA-based test to detect
colon cancer?

A. The DNA test is more invasive.
B. The DNA test is less sensitive.
C. The DNA test is more expensive.
D. Additional diet restrictions are needed
for the DNA test.

A

C. The DNA test is more expensive.

63
Q

Which of the following may be associated
with morphologic examination of
spermatozoa?

A. Evaluation should include assessment
of 1000 spermatozoa.
B. A small number of sperm should have
normal morphologic characteristics.
C. Papanicolaou stain may be used.
D. Presence of red or white cells and
epithelial cells need not be noted.

A

C. Papanicolaou stain may be used.

64
Q

Which condition is characterized by
increased levels of immunoglobulins in
the cerebrospinal fluid, originating from
within the central nervous system and not
from the general blood circulation?

A. Gout
B. Erythroblastosis fetalis
C. Multiple myeloma
D. Multiple sclerosis

A

D. Multiple sclerosis

65
Q

Which of the following statements
pertains to screening methods used to
determine pregnancy?

A. Immunoassays will use reagent
anti-hCG to react with patient hCG.
B. A random urine specimen is the
preferred specimen for pregnancy
screening tests.
C. Internal controls provided within the
kit will assess if the patient’s specimen
was collected correctly.
D. External quality control is not needed
with these methods.

A

A. Immunoassays will use reagent
anti-hCG to react with patient hCG.

66
Q

The following urinalysis biochemical
results were obtained from a 4-month-old
infant who experienced vomiting and
diarrhea after milk ingestion and failed to
gain weight: pH—6; protein—negative;
glucose—negative; ketone—negative;
bilirubin—negative; Clinitest®—2+.
These results are clinically significant in
which of the following disorders?

A. Diabetes mellitus
B. Ketosis
C. Starvation
D. Galactosemia

A

D. Galactosemia

67
Q

Which of the following is a true statement?

A. Renal tubular cells originate from the
renal pelvis.
B. Red blood cells in acid urine (pH 4.5)
will usually be crenated because of the
acidity.
C. Bacteria introduced into a urine
specimen at the time of the collection
will have no immediate effect on the
level of nitrite in the specimen.
D. Pilocarpine iontophoresis is the
method of choice for the collection of
pericardial fluid.

A

C. Bacteria introduced into a urine
specimen at the time of the collection
will have no immediate effect on the
level of nitrite in the specimen.

MTAP 1 (7 decks)

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