phlebotomy, urinalysis Lecture final Flashcards Preview

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Flashcards in phlebotomy, urinalysis Lecture final Deck (205):
1

A primary example of proteinuria due to increased serum protein levels is the excretion of Bence Jones proteins in persons who have:

1) urinary tract infection


2) defects in renal tubular secretion


3) multiple myeloma


4) hemolytic uremic syndrome

multiple myeloma

2

A reagent test strip for hemoglobin has been reported positive. Microscopic examination fails to yield red cells. This patient's condition can be called:

1) hematuria


2) hemoglobinuria


3) oliguria


4) hemosiderinuria

2) hemoglobinuria

3

A urine specimen is tested for protein by reagent strip and by the sulfosalicylic acid (SSA) test. The reagent strip is negative and the SSA test shows a positive 2+ reaction. What could be a cause of this discrepancy?

1) A protein other than albumin is present in the urine


2) The reagent strip is negative because the pH of the urine is 8.0


3) A large amount of amorphous urates in the urine caused the false-positive SSA result.


4) The time interval for reading the reagent strip pad was exceeded, causing a false-negative result.

1) A protein other than albumin is present in the urine

4

All of the following will yield a positive result for blood on the urine reagent test strip EXCEPT:

1) hematuria


2) hemoglobinuria


3) ascorbic acid


4) myoglobinuria

ascorbic acid

5

In a patient with chronic renal disease in whom the kidneys can no longer adjust urine concentration, the urine specific gravity would be:

1) 1.000


2) 1.010


3) 1.020


4) 1.030

1.010

6

Proper care of reagent strips includes all of the following EXCEPT:

1) checking the expiration date


2) storing in the refrigerator


3) preventing exposure to volatile fumes


4) storage with desiccant

storing in the refrigerator

7

Reagent strip chemical tests may be inaccurate if the specimen is:

1) mixed prior to testing


2) Tested immediately after refrigeration


3) Tested immediately after voiding


4) collected by catheter

Tested immediately after refrigeration

8

Reagent strips which contain nitroprusside react to measure all of the following EXCEPT:

1) acetone


2) ketones


3) beta-hydroxybutyric acid


4) acetoacetic acid

beta-hydroxybutyric acid

9

A breakdown product of hemoglobin is

1) glucose


2) nitrate


3) acetone


4) bilirubin

bilirubin

10

The confirmatory test for protein is:

1) SSA--sulfosalicylic acid test


2) Ictotest


3) Clinitest


4) copper reduction test

SSA--sulfosalicylic acid test

11

The microorganisms involved in most urinary tract infections are Gram Negative Bacilli and they usually give a positive chemstrip reaction for:

1) glucose


2) bilirubin


3) nitrite


4) ketones

nitrite

12

The principle of light reflectance using the refractometer is used to determine:

1) bilirubin


2) specific gravity


3) protein


4) pH

specific gravity

13

The protein section of the reagent strip test for urine protein depends on:

1) a enzyme reaction


2) protein error of indicators


3) copper reduction


4) the toluidine reaction

protein error of indicators

14

The test for reduction of copper is one of the earliest chemical tests performed on urine. This test relies on the ability of glucose to:

1) react with peroxidase to form an oxidized colored compound


2) change copper sulfate to cuprous oxide in the presence of heat


3) differentiate between urobilinogen and prophobilinogen


4) produce colors when reacted with para-dimethylaminobenzaldehyde

change copper sulfate to cuprous oxide in the presence of heat

15

Which of the following will be detected by the clinitest tablet:

1) reducing sugars


2) sodium nitroprusside


3) glucose oxidase


4) methyl red and bromothymol blue

reducing sugars

16

The Watson-Schwartz test is a confirmatory test for:

1) urobilinogen & porphobilinogen


2) bilirubin & ictotest


3) glucose & Ketones


4) protein & Glucose

urobilinogen & porphobilinogen

17

Which one of the following tests will be positive in all of these disorders: diabetes, starvation, vomiting, and anorexia?

1) blood


2) protein


3) ketones


4) bilirubin

ketones

18

Match the chemstrip Reagent strip with the "Principle of the chemical reagent test"
____ Bilirubin
____ Nitrite
____ Glucose
____ pH
____ Specific Gravity
____ Protein
____ Blood
____ Leukocyte Esterase
____ Ketones
____ Urobilinogen
1. pH change of polyelectrolyte
2. Error of Indicators
3. Glucose Oxidase
4. Sodium Nitroprusside
5. Peroxidase Activity
6. Diazo Salt
7. Erhlich's reaction
8. Griess Reaction
9. Granulocyte esterase
10. Double Indicator System

__6__ Bilirubin
__8__ Nitrite
__3__ Glucose
__10__ pH
__1__ Specific Gravity
__2__ Protein
__5__ Blood
__9__ Leukocyte Esterase
__4__ Ketones
__7__ Urobilinogen

19

What urine test can be done to help determine if a newborn is galactose intolerant?

1) ictotest


2) protein dipstick


3) SSA -- sulfosalicylic acid


4) clinitest

clinitest

20

The Acetest tablet has glycine added so that this ketone can be more easily detected.

1) acetoacetate


2) Beta hydroxybutrate


3) acetone


4) n-acetylcysteine

acetone

21

The normal urine pH varies from:

1) 4.5 to 8.0


2) 5.0 to 9.0


3) 3.0 to 8.5


4) 5.0 to 7.0

4.5 to 8.0

22

A brown colored urine causing a positive test for blood could contain the following instead of hemoglobin:

1) microalbumin


2) bilirubin


3) myoglobin


4) haptoglobin

myoglobin

23

High plasma levels of protein that exceed the renal threshold of the kidney is called:

1) Overflow proteinuria


2) Tubular proteinuria


3) Postrenal proteinuria


4) Fanconi's syndrome

Overflow proteinuria

24

The pH of urine is usually acid but is alkaline during and after meals. This condition is called:

1) alkaline tide


2) glomerular proteinuria


3) bence-jones proteinuria


4) aminoaciduria

alkaline tide

25

Gram negative enteric bacteria like E. coli produce an enzyme that results in a positive nitrite test. The enzyme is:

1) nitrate reductase


2) pseudoperoxidase


3) hexokinase


4) glucose oxidase

nitrate reductase

26

The confirmatory test for bilirubin is:

1) SSA -- sulfosalicylic acid


2) Clinitest tablet


3) Acetest tablet


4) Ictotest tablet

Ictotest tablet

27

A confirmatory test for ketones is:

1) SSA -- sulfosalicylic acid


2) Clinitest tablet


3) Acetest tablet


4) Ictotest tablet

Acetest tablet

28

A confirmatory test for glucose is:

1) SSA -- sulfosalicylic acid


2) Clinitest tablet


3) Acetest tablet


4) Ictotest tablet

Clinitest tablet

29

The confirmatory test for glucose using copper reduction is called:

1) Ehrlich's reaction


2) Diazo reaction


3) peroxidase reaction


4) Benedict's test

Benedict's test

30

The following test would be positive with Bence-Jones proteins:

1) dipstick protein


2) SSA -- sulfosalicylic acid


3) Watson-Schwartz


4) Benedict's test

SSA -- sulfosalicylic acid

31

The pass-through phenomenon where high concentrations of a substance can cause a reversal of color development could be a problem with the following test:

1) SSA -- sulfosalicylic acid


2) Clinitest tablet


3) Acetest tablet


4) Ictotest tablet

Clinitest tablet

32

Which of the specimens listed below would be the best specimen for culture and sensitivity?

random specimen

24 hour specimen

fasting specimen

catheterized specimen

catheterized specimen

33

Which of the following is not a method to determine specific gravity of urine?

urinometer

refractometer

Ictotest

reagent strip (dipstick)

Ictotest

34

Which routine chemical test on urine is the most indicative of renal disease?

protein

pH

specific gravity

glucose

protein

35

Which of the following is the most specific test for detecting glucose?

reagent strip (dipstick)

clinitest

refractometer

osmolarity

reagent strip (dipstick)

36

Individuals who excrete protein in their urine when awake and active but do not excrete protein at night most likely have:

prerenal proteinuria

postrenal proteinuria

renal proteinuria

orthostatic proteinuria

orthostatic proteinuria

37

What is the name of the pigment that gives urine it's yellow color?

urochrome

38

List one disadvantage of using a urinometer to determine specific gravity of urine.

large volume;temperature correction

39

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

acetoacetic acid

ketoacetic acid

beta-hydroxybutyric acid

acetone

ketoacetic acid

40

The reagent strip reaction that requires the longest time to react is the:

bilirubin

pH

leukocyte esterase

glucose

leukocyte esterase

41

What is the most routinely used method for the preservation of urine specimens?

refrigeration

42

Counters and work areas should be cleaned using:
10% bleach
10% alcohol
hand sanitizer
10% soap and water

10% bleach

43

An employer who fails to provide sufficient gloves for the employees may be fined by the:
CDC
NFPA
OSHA
FDA

OSHA

44

An employee can learn the carcinogenic potential of potassium chloride by consulting the:
Lab Safety plan
Material Safety Data Sheet
OSHA standards
Procedure manual

Material Safety Data Sheet

45

The NPFA classification symbol contains information on all of the following except:
Fire hazards
Biohazards
Reactivity
Health hazards

fire hazards

46

Pipetting by mouth is:
Acceptable for urine but not serum.
Not acceptable without proper training.
Acceptable for reagents but not specimens.
Not acceptable in the laboratory.

Not acceptable in the laboratory.

47

Question 6 1 / 1 point
The type of isolation used when the patient is an immunocompromised patient is referred to as:
Protective isolation.
Airborne precautions
Contact precautions
Droplet precautions

Protective isolation.

48

Which of the following is the most effective method of preventing disease transmission?
Handwashing
Proper waste disposal
Control of insects and rodents
All of the above

Handwashing

49

A code word which identifies a method to use when a fire is prosent is:
PASS
RACE
RUNN
NFPA

RACE

50

Which type of isolation requires the phlebotomist to wear Sterile PPE into the room?
Airborne
Contact
Droplet
Reverse

Reverse

51

Match the tube stopper color with the anticoagulant.
____ None
____ Potassium EDTA
____ ACD
____ Lithium Heparin
____ Sodium Citrate
1. Red
2. Lavender
3. Blue
4. Green
5. Yellow

__1__ None
__2__ Potassium EDTA
__5__ ACD
__4__ Lithium Heparin
__3__ Sodium Citrate

52

Reverse isolation is the same as:
protective isolation
enteric isolation
airborne precautions
contact precautions

protective isolation

53

Safe working conditions must be ensured by the employer and have been mandated by law by:
FDA
CDC
CLIA'88
OSHA

OSHA

54

Malpractice in blood collection is the same as:
professional negligence
battery
assault
integrity

professional negligence

55

Winged infusion sets (butterflies) are normally used for all but the following;
blood collection from children
blood collection from a hand vein
blood collection from the elderly
blood collection from all patients

blood collection from all patients

56

The number one safety rule when using needles is to:
Never recap a needle
Always dispose of the needle in a hard-sided cardboard container
use the proper gauge (size) for the type of blood collection
Secure the lid tightly on all needle disposal boxes when full

Never recap a needle

57

Which of the following needle sizes is the smallest?
20 gauge
21 gauge
22 gauge
23 gauge

23 gauge

58

The only tube that needs to be filled with blood to it's full capacity is the:
Red top
Blue top
Green top
Yellow top

Blue top

59

WHich anticoagulant is in the green top tube?
EDTA
Lithium Heparin
Sodium fluoride
Potassium oxalate

Lithium Heparin

60

Which laboratory department uses the lavender (purple) top tube?
Hematology
Chemistry
Blood Bank
Coagulation

Hematology

61

The law that requires that patient information be kept "confidential" is:
CDC
OSHA
CLIA'88
HIPAA

HIPAA

62

Which of the following agencies inspects and certifies laboratories so they can bill Medicare and Medicaid for laboratory testing?
CDC
JCAHO or CAP
OSHA
HIPAA

JCAHO or CAP

63

The tourniquet should never be left on longer than:
one minute
two minutes
three minutes
five minutes

one minute

64

Failure to act or perform duties according to standards of the profession is:
Assault
Battery
Litigation
Negligence

Negligence

65

A phlebotomist forgot her password for the laboratory computer and used a colleague's passowrd to enter the laboratory access files to check on a patient's blood work to be performed. What law has she violated?
OSHA
HIPAA
no law has been violated because she was checking on blood tests for a patient
CLIA'88

HIPAA

66

The intentional touching of another person without permission is considered to be:
Assault
Battery
Assault and Battery
Negligence

Battery

67

The measuring stick (Standard of Care) representing the conduct of the average health care worker is the:
community where the health care provider works.
community where the health care provider lives.
national community.
international community.

national community.

68

Question 27 1 / 1 point
PPE stands for the term:
Phlebotomy performed early
Palpated pericubital entry
Personal preventative extinguishers
Personl protective equipment

Personl protective equipment

69

The disinfectant used to clean counters and tabletops in the lab is:
10% sodium hypochlorite
10% sodium fluoride
10% sodium oxalate
20% bleach

10% sodium hypochlorite

70

Manufacturers of chemicals provide laboratories with information on those chemicals to promote safe handling. The information provided is called:
a written safety plan
Material Safety Data Sheets (MSDS)
a Fire Safety Plan
Job Safety Analysis

Material Safety Data Sheets (MSDS)

71

Handwashing should be performed:
after completing work before leaving the laboratory.
any time there is visible contamination on your gloves or present on counters.
before all activities that entail hand contact to mucous membranes (like applying makeup, contact lenses, etc)
All of the above

All of the above

72

The phlebotomist is collecting blood using four tubes. According to the order of draw, the lavender top tube should be collected:
first
second
third
fourth

fourth

73

When blood is allowed to clot, the liquid portion of the blood is called serum.
True
False

True

74

Which of the following has the highest percentage of needlestick injuries?
19-gauge needles
21-gauge needles
butterfly (winged infusion set) needles
BD Eclipse needles

butterfly (winged infusion set) needles

75

Which of the following is the anticoagulant of choice for coagulation studies?
sodium oxalate
sodium citrate
EDTA
potassium oxalate

sodium citrate

76

Match the tube color with the laboratory department that will perform the testing.
____ Microbiology
____ Chemistry
____ Hematology
____ Chemistry
____ Coagulation
1. Green
2. Lavender (purple)
3. Blue
4. Yellow
5. Red

__4__ Microbiology
__5__ Chemistry
__2__ Hematology
__1__ Chemistry
__3__ Coagulation

77

All of the following are causes for rejection of blood specimens except:
1) The specimen collected at the wrong time

2) Syncope (fainting)

3) hemolysis

4) Insufficient specimen

Syncope (fainting)

78

The term fasting usually means:
1) abstaining from water

2) abstaining from everything

3) abstaining from smoking

4) abstaining from food and drinks except water

abstaining from food and drinks except water

79

All of the following tests are affected by drawing blood from a non-fasting patient EXCEPT:
1) glucose

2) Complete Blood Count

3) Triglycerides

4) Triglyceride

Complete Blood Count

80

List at least three items that must be on the label of a specimen

name, number, date, time, initials
Time and Date of collection, Patient's name and identification number, phlebotomist's initial

81

Match the test given, with the proper collection technique or handling.
____ Blood Alcohol/Drug Testing
____ Arterial Blood Gases
____ Bilirubin
____ Cold Agglutinins
____ Blood Cultures
____ Therapeutic Drug Monitoring
1. Specimen kept at 37.5 degrees C until testing
2. Specimen protected from light until testing
3. Chain of Custody
4. specimen is kept in crushed Ice until arrival in the laboratory
5. Collected using strict aseptic technique
6. Draw Peak and Trough levels

__3__ Blood Alcohol/Drug Testing
__4__ Arterial Blood Gases
__2__ Bilirubin
__1__ Cold Agglutinins
__5__ Blood Cultures
__6__ Therapeutic Drug Monitoring

82

The Triglycerides are not affected by a non-fasting patient.
1) true

2) false

false

83

Capillary blood is a mixture of arterial and venous blood.
1) true

2) False

true

84

The purpose of a volume collection log in the Nursery is to monitor blood loss to see if the baby is becoming anemic.
1) true

2) false

true

85

List four possible causes of specimen rejection.

unlabeled specimen, mislabeled specimen, incorrect volume, hemolyzed specimen, clotted anticoagulant tube, improper transport, wrong collection time, etc.

86

The liquid portion of blood from an anticoagulated tube is:
1) serum

2) plasma

plasma

87

Winged infusion sets (butterflies) are routinely used for all but one of the following:
1) collection from fragile veins

2) collection from hand veins

3) collection from small veins

4) collection of therapeutic drug tests

collection of therapeutic drug tests

88

The tourniquet should never be left on longer than:
1) one minute

2) three minutes

3) five minutes

4) two minutes

one minute

89

Which of the errors below could be a life-threatening mistake for the patient?
1) drawing a hemolyzed specimen

2) labeling a tube with the wrong patient name

3) leaving the tourniquet on too long.

4) failing to keep pressure on the needle puncture site.

labeling a tube with the wrong patient name

90

Which of the following needle sizes is the smallest?
1) 21 gauge

2) 18 gauge

3) 22 gauge

4) 23 gauge

23 gauge

91

A heelstick to collect blood from a newborn should always be in the middle of the heel. (True/False)
1) true

2) false

false

92

Failure to get blood may result from all but one of the following:
1) Needle in too far.

2) Bevel not up

3) Needle partially inserted.

4) Tourniquet on too tight.

Tourniquet on too tight.

93

If possible, the vein of choice is the:
1) cephalic

2) basilic

3) median cubital

4) radial

median cubital

94

Hemoconcentration of the collected specimen is a result of:
1) Not keeping the bevel up.

2) Going through the vein

3) Drawing tubes in the wrong order.

4) Leaving the tourniquet on too long.

Leaving the tourniquet on too long.

95

It is usually o.k. to draw blood above an IV site if the nurse turns off the IV for five to ten minutes first. (True/False)
1) True

2) False

FALSE

96

All but one of the following are patient conditions that might complicate drawing a patient's blood.
1) Edema

2) Syncope

3) Obesity

4) Low hemoglobin

Low hemoglobin

97

At what temperature should urine specimens be stored until testing?
Room temperature
37 degrees celsius
Refrigerator temperature
64 degrees celsius

Refrigerator temperature

98

You have made an administrative error on a logsheet in the laboratory. What is the best way to correct it?
Use white-out to cover the error, then write the correct informaiton on the whited out area.
Use a black magic marker to obliterate the incorrect result and then write the correct information on the next line of the log sheet.
Draw a line through the error, enter your initials, the date and time and then write the correct result above the incorrect result.
Tear off that page of the log sheet and transcribe all results to a new page.

Draw a line through the error, enter your initials, the date and time and then write the correct result above the incorrect result.

99

The best finger to use for a fingerstick is:
thumb
index finger
pinky
middle finger or ring finger

middle finger or ring finger

100

The most important part of the phlebotomy process is:
washing your hands before and after the procedure.
wearing gloves during the procedure.
correct identification of the patient.
explaining the procedure to the patient before beginning to collect the blood.

correct identification of the patient.

101

When performing a heelstick, the maximum puncture depth for a full term, normal birth weight baby is:
0.65 to 0.85 mm

3.0 mm
1.0 mm
2.0 mm

2.0 mm

102

List three types of patients who might be appropriate candidates for performing a fingerstick or heelstick instead of a venipuncture

children, elderly, newborns, obese, burns

103

Which of the following would be the preferred site for a capillary puncture (fingerstick) on an adult?
ring finger
pinkie finger
heel
thumb

ring finger

104

What is the preferred site for collecting arterial blood gas specimens?
brachial artery
femoral artery
ulnar artery
radial artery

radial artery

105

What test should a phlebotomist perform before collecting an arterial blood gas specimen?

allen's test

106

Which of the following tubes should always be drawn first when performing a venipuncture?
blood culture tube
lavender topped tube
blue topped tube
red topped tube

blood culture tube

107

A phlebotomist was preparing to collect blood for a fasting glucose from Ms. Gonzalez at 9:00 am. She asked Ms. Gonzalez if she had eaten anything this morning. Ms. Gonzalez replied that she had not eaten any food since seven o'clock the previous evening. What else should the phlebotomist ask before drawing the blood?

If she had anything to drink

108

A female patient has had a mastectomy on her right side and has an IV in the antecubital space in her left arm. What site would you use to collect the blood?

Left hand

109

What is the preferred time limit for a patient to refrain from consuming food and drink before collecting fasting blood specimens?
8 - 12 hours
6 - 8 hours
24 hours
4 - 8 hours

8 - 12 hours

110

Antidiuretic hormone regulates the reabsorption of:
1) Water in the collecting tubules

2) sodium in the collecting tubules

3) sodium in the distal convoluted tubule

4) water and sodium in the ascending loop of Henle

Water in the collecting tubules

111

Utrafiltrate refers to which of the following:
1) The functioning unit at the proximal end of a renal tubule

2) Glomerular filtrate at a specific gravity of 1.010

3) Urine with a specific gravity greater than 1.035

4) Urine with a specific gravity less than 1.010

Glomerular filtrate at a specific gravity of 1.010

112

Increased production of Vasopressin (antidiuretic hormone):
1) produces a low volume of urine

2) produces a high volume of urine

3) increased ammonia excretion

4) affects proximal convoluted tubule transport

produces a low volume of urine

113

All of the following are considered normal functions of the kidney except:
regulating body hydration
elimination of nitrogenous wastes
regulating electrolyte balance
elimination of serum proteins

elimination of serum proteins

114

The approximate number of nephrons contained in each kidney is:
100,000
500,000
1,000,000
5,000,000

1,000,000

115

The total renal blood flow is approximately:
40 ml/min
120 ml/min
500 ml/min
1200 ml/min

1200 ml/min

116

The glomerular filtrate is described as a:
plasma filtrate containing glucose and protein
protein-free ultrafiltrate of plasma
selective filtrate of plasma containing urea
plasma filtrate without glucose and urea

protein-free ultrafiltrate of plasma

117

Increased production of aldosterone causes:
decreased plasma sodium levels
decreased glomerular blood pressure
increased plasma sodium levels
increased urine volume

increased plasma sodium levels

118

The primary substance effected by the renin-angiotensin-aldosterone system is:
glucose
potassium
chloride
sodium

sodium

119

The enzyme renin is produced by the kidney:
to increase excretion of urea
in response to changes in blood pressure and plasma sodium levels
when too much sodium is reabsorbed.
to regulate secretion of hydrogen ions

in response to changes in blood pressure and plasma sodium levels

120

Water is passively reabsorbed in all parts of the nephron except the:
proximal convoluted tubule
descending loop of Henle
ascending loop of Henle
collecting duct

ascending loop of Henle

121

Aldosterone regulates sodium reabsorption in the:
proximal convoluted tubule
descending loop of Henle
ascending loop of Henle
distal tubule

distal tubule

122

Vasopressin is another term for:
anti-diuretic hormone (ADH)
renin
aldosterone
angiotensin

anti-diuretic hormone (ADH)

123

Clearance tests used to determine the glomerular filtration rate must measure substances that are:
not filtered by the glomerulus.
completely reabsorbed by the proximal convoluted tubule.
secreted in the distal convoluted tubule.
neither reabsorbed nor secreted by the tubules.

neither reabsorbed nor secreted by the tubules.

124

Results for glomerular filtration tests are reported in:
milliliters per minute
milliliters per 24 hours
milliliters per deciliter
milliequivalents per liter

milliliters per minute

125

All of the following are endogenous clearance test substances except:
urea
creatinine
inulin
beta2 microglobulin

creatinine

126

The most routinely used laboratory method for measuring the glomerular filtration rate is the:
inulin clearance
urea clearance
creatinine clearance
beta2 microglobulin clearance

creatinine clearance

127

The body surface of the average size person in square meters is:
0.60
1.73
2.10
3.50

1.73

128

An additional calculation that may be required in the creatinine clearance is a correction for:
body size
fasting status
basal metabolic rate
tubular reabsorption rate

body size

129

Calculate the creatinine clearance for a patient of average size from the following data: Urine volume equals 720 ml for 12 hours; Urine creatinine equals 120 mg/dL; Serum creatinine equals 1.5 mg/dL, the patient is average body size.
60 ml/min
80 ml/min
100 ml/min
120 ml/min

80 ml/min

130

Measurement of urine osmolarity is a more accurate measure of renal concentrating ability than specific gravity because:
osmolarity is measured by instrumentation
specific gravity is not influenced by urea and glucose molecules
osmolarity is influenced only by the number of particles in solution
specific gravity measures only urea and glucose molecules

osmolarity is influenced only by the number of particles in solution

131

Afferent and efferent arterioles have the ability to vary in size.
True
False

True

132

Using the following values, calculate the creatinine clearance. Urine volume - 2400 ml/24 hours; Urine creatinine - 60 mg/dL; Serum creatinine - 0.8 mg/dL, average body size.
60 ml/min
75 ml/min
112 ml/min
125 ml/min

125 ml/min

133

The kidney performs the following processes except:
filtration
absorption (reabsorption)
secretion
adhesion

adhesion

134

The glomerulus performs filtration through the following mechanisms except:
endothelial cells
basement membrane
podocytes
active transport of proteins

active transport of proteins

135

The presence of protein in the urine without any blood being present in the urine is an indicator that:
something is wrong in the distal convoluted tubule.
something is wrong in the collecting ducts.
something is wrong in the proximal convoluted tubule.
something is wrong in the ascending loop of Henle

something is wrong in the collecting ducts.

136

What is the maximal reabsorptive capacity (renal threshhold) for glucose?

160-180 mg/dL

Describe two mechanisms for excreting hydrogen ions.
The hydrogen ions can attach to phosphate or ammonia to be secreted.

137

The buffering capacity of the blood depends on the reabsorption by the kidney of which ions?
Sodium ions
Chloride ions
Hydrogen ions
Bicarbonate ions

Bicarbonate ions

138

List three substances that are actively transported back into the plasma

glucose
amino acids
sodium

139

Which arteriole allows blood to enter the capillaries of the nephron?

afferent arteriole (Afferent)

140

The hormone aldosterone is responsible for:
hydrogen ion secretion
potassium secretion
chloride retention
sodium retention

sodium retention

141

When the body is dehydrated:
ADH production is increased
ADH production is decreased
Urine volume is increased
Both A and C

ADH production is increased

142

What is another name for Anti-diuretic hormone?
Aldosterone
Renin
Angiotensinogen
Vasopressin

Vasopressin

143

What are the two major functions of tubular secretion?

eliminating waste that did not get filtered by the glomurelus
maintaining the acid-base concentration in the blood

144

When a solute is added to a solvent, it changes the colligiative properties of the solvent. Which of the following is not a colligiative property?
boiling point
freezing point
barometric pressure
vapor pressure

barometric pressure

145

Which test provides the more representative measure of renal concentrating ability?
osmolarity
specific gravity
urine volume
glomerular filtration rate

osmolarity

146

Which colligiative property of solutions is most commonly measured when testing osmolarity?
freezing point depression
boiling point depression
osmotic pressure
barometric pressure

freezing point depression

147

How does the arterioles respond to low blood pressure to the kidney?
Enlarges afferent arteriole, restricts efferent arteriole.
Enlarges efferent arteriole, restricts afferent arteriole
Produces renin to release angiotensin I
Causes angiotensin II to produce aldosterone

Enlarges afferent arteriole, restricts efferent arteriole.

148

What is the unit of measure for glomerular filtration rate?
milliosmoles
milligrams per deciliter
milliliters per hour
milliliters per minute

milliliters per minute

149

List two advantages of using creatinine clearance for determining glomerular filtration rate.

it is already in the circulation and does not have to be injected, endogenous substance
it is maintained at regular rate in the plasma

150

The recommended centrifugation for preparing a urine sediment is:
400 RPM for 10 minutes
1000 RPM for 5 minutes
400 RCF for 5 minutes
1000 RCF for 10 minutes

400 RPM for 10 minutes

151

The number of fields that should be examined when quantitating urinary sediment constituents is:
2
5
10
20

10

152

All of the following are reported as the quantity per high-power field (40x ocular) EXCEPT:
casts
red blood cells
white blood cells
bacteria

casts

153

Oval fat bodies are:
squamous epithelial cells that contain lipids
renal tubular epithelial cells that contain lipids
WBCs that have phagocytized lipids
people who fail to work out regularly

renal tubular epithelial cells that contain lipids

154

The type of cells that line the bladder and ureters are:
parabasal
renal tubular
transitional
basal

transitional

155

An increase in urinary WBCs is called:
pyelonephritis
cystitis
urethritis
pyuria

pyuria

156

The major constituent of casts is:
lipoprotein
Tamm-Horsfall protein
Bence-Jones protein
fibrinogen

Tamm-Horsfall protein

157

The finding of increased hyaline and granular casts in the urine of an otherwise healthy person may be the result of:
fecal contamination
recent strenuous exercise
early urinary tract infection
analyzing an old specimen

recent strenuous exercise

158

Normal crystals found in acidic urine include:
calcium oxalate, uric acid, amorphous urates
calcium oxalate, uric acid, sulfonamides
uric acid, amorphous urates, triple phosphate
uric acid, calcium oxalate, bilirubin

calcium oxalate, uric acid, amorphous urates

159

Normal crystals found in alkaline urine include:
calcium oxalate, uric acid, amorphous urates
calcium oxalate, uric acid, sulfonamides
uric acid, amorphous urates, calcium carbonate
triple phosphate, calcium carbonate, ammonium biurate

triple phosphate, calcium carbonate, ammonium biurate

160

Crystals that are found in urine that are associated with liver disease include:
calcium oxalate and uric acid
leucine and tyrosine
amorphous phosphates and calcium carbonate
triple phosphate and ammonium biurate

leucine and tyrosine

161

A urine specimen refrigerated overnight is cloudy and has a pH of 6.0. The cloudiness (turbidity) is probably due to:
amorphous phosphates
amorphous urates
triple phosphate crystals
calcium oxalate crystals

amorphous urates

162

An acid urine that has a pink sediment usually contains:
amorphous urates
amorphous phosphates
uric acid crystals
calcium carbonate

amorphous urates

163

Amorphous phosphates appear as white sediment after centrifugation of the urine specimen.
True
False

True

164

Match the following crystals seen in alkaline urine with their description/identifying characteristic.
____ Dumbbell shape
____ Coffin lid
____ White precipitate
____ Thin prisms with pointed ends
____ thorny apple
1. Amorphous phosphate
2. Triple phosphate
3. Ammonium biurate
4. Calcium phosphate
5. Calcium carbonate

__5__ Dumbbell shape
__2__ Coffin lid
__1__ White precipitate
__4__ Thin prisms with pointed ends
__3__ thorny apple

165

Match the following abnormal crystals with their description/identifying characteristic.
____ Notched corners
____ Hexagon
____ Concentric circles and radial striations
____ Fine needles seen in liver disease
____ Bright yellow clumps
1. Cystine
2. Cholesterol
3. Tyrosine
4. Leucine
5. Bilirubin

__2__ Notched corners
__1__ Hexagon
__4__ Concentric circles and radial striations
__3__ Fine needles seen in liver disease
__5__ Bright yellow clumps

166

Which urinary cast is frequently associated with pyelonephritis and is a primary marker for distinguishing pyelonephritis from lower urinary tract infection (cystitis).
waxy cast
granular cast
red blood cell cast
white blood cell cast

white blood cell cast

167

Which of the following disorders frequently occurs following a bacterial infection of the skin or throat?
Acute glomerulonephritis
Chronic glomerulonephritis
Membranous glomerulonephritis
Rapidly progressive glomerulonephritis

Acute glomerulonephritis

168

Chronic renal failure often develops in each of the following diseases except:
amyloidosis
diabetes mellitus
diabetes insipidus
systemic lupus erythematosis

amyloidosis

169

Infection in the urinary tract below the kidney (bladder infection) is termed:
pyelonephritis
glomerulonephritis
nephritis
cystitis

cystitis

170

The most common cause of end-stage renal disease (renal failure) is:
acute glomerulonephritis
diabetic nephropathy
minimal change disease
Alport syndrome

diabetic nephropathy

171

The buildup of crescentic formations on the glomerular capillaries is characteristic of:
Goodpasture syndrome
Rapidly progressive glomerulonephritis
Wegner's granulomatosis
IgA nephropathy

Rapidly progressive glomerulonephritis

172

Diseases affecting the glomerulus are primarily caused by:
trauma
diabetes
immune complexes
toxic chemicals

immune complexes

173

Goodpasture syndrome and Wegener's granulomatosis and several other glomerular diseases are associated with the presence of which of the following in the urine sediment?
Hyaline casts
Red blood cell casts
Waxy casts
White blood cell casts

Red blood cell casts

174

A patient with symptoms of hemoptysis and hematuria should be tested for:
antiglomerular basement membrane antibody
antistreptolysin O antibody
antineutrophilic cytoplasmic antibody
both A and C

both A and C

175

Which of the following antibodies causes Goodpasture Syndrome?
antiglomerular basement membrane antibody
antistreptolysin O antibody
antineutrophilic cytoplasmic antibody
antinuclear antibody

antiglomerular basement membrane antibody

176

Which of the following antibodies causes Wegner's granulomatosis?
antiglomerular basement membrane antibody
antistreptolysin O antibody
antineutrophilic cytoplasmic antibody
antinuclear antibody

antineutrophilic cytoplasmic antibody

177

Heavy proteinuria (>3.5 gm/day) is most characteristic of:
acute glomerulonephritis
acute interstitial nephritis
pyelonephritis
nephrotic syndrome

nephrotic syndrome

178

The pronounced edema associated with the nephrotic syndrome is related to the:
lipidemia
hypoalbuminemia
decreased glomerular filtration rate
lipiduria

hypoalbuminemia

179

Oval fat bodies and fatty casts are characteristic urine sediment constituents in patients with:
chronic glomerulonephritis
acute interstitial nephritis
nephrotic syndrome
Wegner's granulomatosis

nephrotic syndrome

180

Which of the following renal disorders may be inherited?
Nephrotic syndrome
Acute interstitial nephritis
Acute tubular necrosis
Fanconi syndrome

Fanconi syndrome

181

Pyelonephritis can be distinguished from cystitis by:
performing a cystoscopy
the presence of white blood cell casts
performing blood cultures
the presence of bacteriuria

the presence of white blood cell casts

182

The presence of renal tubular epithelial cell casts is most indicative of:
nephrotic syndrome
Fanconi syndrome
acute tubular necrosis
acute pyelonephritis

acute tubular necrosis

183

The most serious tubularinterstitial disorder is:
acute interstitial nephritis
acute pyelonephritis
chronic pyelonephritis
cystitis

chronic pyelonephritis

184

Most renal calculi (kidney stones) are composed of:
ammonium phosphate
magnesium
uric acid
calcium oxalate

calcium oxalate

185

Lithotripsy (lithiasis) is performed to:
prevent the formation of renal calculi
determine the composition of renal calculi
remove renal calculi
identify the presence of renal calculi

remove renal calculi

186

A disorder associated with polyuria and low specific gravity is:
renal glucosuria
cystitis
diabetes insipidus
focal segmental glomerulonephritis

diabetes insipidus

187

The antibody causing acute poststreptococcal glomeuronephritis is:
antibody to basement membrane
antibody to cytoplasm of neutrophils
antibody to M protein
antibody to nuclear material of a person's own cells

antibody to M protein

188

Oval fat bodies are associated with:
acute poststreptococcal glomeulonephritis
goodpasture's syndrome
Berger's disease
nephrotic syndrome

nephrotic syndrome

189

Which two renal diseases affect both the kidneys and lungs?
Goodpasture and Wegner
Goodpasture and nephrotic syndrome
Goodpasture and diabetic nephropathy
Goodpasture and Henoch-Shonlein

Goodpasture and Wegner

190

Which of the following causes diabetic nephropathy?
antibody to basement membrane
antibody to cytoplasm of neutrophils
IgA deposits
gycosylated proteins

gycosylated proteins

191

Low blood flow to the kidney can result in:
Goodpasture's syndrome
Actue Tubular Necrosis
Alport's syndrome
Minimal Change Disease

Actue Tubular Necrosis

192


Most all glomerular disorders are of "immune" origin. Immune origin means:
Deposition of antibody-antigen complexes
Reaction to exposure to toxins or hazardous chemicals
Deposition of non-specific proteins from inflammatory reactions
Deposition of glycosylated proteins

Deposition of antibody-antigen complexes

193

Which of the following renal diseases is associated with heroin abuse?
Minimal Change Disease
Alport's syndrome
Focal Segmental glomerulonephritis
Membranous glomerulonephritis

Focal Segmental glomerulonephritis

194

Which of the following renal disorders is characterized by raised, red patches (purpura) on the skin and usually occurs in children following respiratory illness?
Goodpasture's syndrome
Alport's syndrome
Berger's disease
Henoch-Schonlein

Henoch-Schonlein

195

Which of the following renal diseases is charaterized by high lipid levels, pronounced edema, and low serum protein?
Nephrotic syndrome
Wegner's granulomatosis
Membranous glomerulonephritis
Berger's disease

Nephrotic syndrome

196

Which renal disease has changes to podocytes and occurs primarily in children after allergic reactions or immunization. Patients exhibit a mild hematuria but their BUN and creatinine levels are normal.
Goodpasture's syndrome
Acute poststreptococcal glomerulonephritis
Minimal Change Disease
Berger's disease

Minimal Change Disease

197

Patches of RTE cells and RTE casts in a patient's urine along with waxy and broad casts would indicate:
Goodpasture's syndrome
Acute tubular necrosis
Alport's syndrome
Nephrotic syndrome

Acute tubular necrosis

198

WBC casts in a patient's urine would indicate:
Nephrotic syndrome
Acute tubular necrosis
Acute glomerulonephritis
Pyelonephritis

Pyelonephritis

199

Polyuria, nocturia and urine with low specific gravity are characteristic of:
Diabetes insipidus
Diabetes mellitus
Berger's disease
Cystitis

Diabetes insipidus

200

Which glomerulonephritis might result as a complication from SLE, Sjogren's disease, syphilis, hepatitis B infection, gold or mercury poisoning or malignancy?
Henoch-Schonlein
Berger's disease
Membranous glomerulonephritis
Focal segmental glomerulonephritis

Membranous glomerulonephritis

201

Hemoptysis is a term that describes:
fainting
passing blood in the urine
removal of senescent red blood cells by the spleen
expectoration of blood (spitting or coughing up blood)

expectoration of blood (spitting or coughing up blood)

202

Which of the following terms describes blood in the urine?
hemoptysis
hematuria
hemolysis
hemoglobinemia

hematuria

203

Question 37 0 / 1 point
Which of the following diseases most commonly occurs in children following mucosal infection?
Berger's disease
Membranous glomerulonephritis
Wegner's granulomatosis
Alport's syndrome

Berger's disease

204

A routinely active 4-year old boy becomes increasingly less active after receiving preschool immunizations. His pediatrician observes noticeable puffiness around the eyes. A blood test shows normal BUN and creatinine results and markedly decreased total protein and albumin values. His microscopic urinalysis results show 10-15 RBCs/hpf, 0-5 WBCs/hpf, 0-1 hyaline casts/lpf, 0-2 granular casts/lpf. What disorder does the patient history and urinalysis results suggest?
Berger's disease
acute poststreptococcal glomerulonephritis
Focal segmental glomerulonephritis
Minimal change disease

Minimal change disease

205

A patient with severe back pain and microscopic hematuria is scheduled for lithotripsy. What is causing the pain and hematuria?
Berger's disease
Renal calculi
Cystitis
Pyelonephritis

Renal calculi