Urina 2.1 Flashcards
(100 cards)
1
Q
Urochrome is a lipid-soluble pigment that
1. is excreted in urine, imparting the characteristic amber color.
2. may be deposited in subcutaneous fat tissue in renal failure.
3. darkens on exposure to light.
1 and 2
1 and 3
• 2 and 3
• 1, 2, and 3
A
1, 2, and 3
2
Q
Urine color is derived from which of the following?
Urobilin
) Urochrome
Uroerythrin
All of the above
A
All of the above
3
Q
Which factor contributes to urine color?
Added preservative
• Urine pH
• Collection method
Patient’s age
A
Urine pH
4
Q
Urine color may be indicative of which of the following?
1. Body hydration
2. Urine concentration
3. Pathologic disease
1 and 2
1 and 3
2 and 3
1, 2, and 3
A
1, 2, and 3
5
Q
A reddish-brown urine specimen is received in the laboratory. The technologist most likely will expect which reagent strip results?
Acidic pH, positive blood
Neutral pH, negative blood
• Alkaline pH, positive blood
Acidic pH, negative blood
A
• Alkaline pH, positive blood
6
Q
A fresh brown urine may indicate the presence of
urobilinogen.
bilirubin.
myoglobin.
melanin.
A
myoglobin.
7
Q
Oxidation of bilirubin to biliverdin in urine results in which of the following urine colors?
Blue
Green
Dark amber
Orange
A
Green
8
Q
The technologist receives a urine specimen from the OB floor and notes an orange-brown color.
She suspects
oxidation of urobilinogen.
degradation of RBCs.
• breakdown of bilirubin.
• contamination with amniotic fluid.
A
oxidation of urobilinogen.
9
Q
Oxidation of porphobilinogen to porphobilin causes the urine to take on a
greenish hue.
blue color.
pink color.•
brownish hue.
A
pink color.
10
Q
Upon dipping the chemical reagent strip into orange urine, the technologist notes that the entire reagent strip is orange. He suspects the presence of
metronidazole.
homogentisic acid.
amitriptyline.
• phenazopyridine.
A
phenazopyridine.
11
Q
While processing a urine specimen, the technologist notes yellow foam that does not dissipate upon standing. He suspects the presence of
bilirubin.
• protein and bilirubin.
•urochrome and protein.
biliverdin and urochrome.
A
• protein and bilirubin.
12
Q
While processing a urine specimen, the technologist notes yellow foam that does not dissipate upon standing. This requires the technologist to
report the presence of yellow foam.
perform confirmatory testing.
not report findings because they are normal.
make a notation that the presence of foam and color are not relevant.
A
perform confirmatory testing.
13
Q
Which urine color is not the result of drug metabolites?
Red
Blue-green
Brown
Red-purple
A
Red-purple
14
Q
Clarity in a freshly voided urine specimen from a healthy individual is
clear.
hazy.
slightly cloudy.
All are correct.
A
All are correct.
15
Q
The technologist pulls a urine specimen out of the refrigerator and notes a pink precipitate. She knows that she has a urine with a(n)
) alkaline pH and brick dust.
alkaline pH and uroerythin on uric acid crystals.
neutral pH and uric acid crystals.
acidic pH and amorphous urates.
A
acidic pH and amorphous urates.
16
Q
Clarity of urine provides a rapid quality check for which of the following?
Presence of protein
• Microscopic examination
Amorphous crystal precipitation
Time between collection and testing
A
Microscopic examination
17
Q
The presence of which substance is considered iatrogenic?
Fecal matter
Squamous epithelial cells
Radiographic dye
Sperm and prostate fluid
A
Radiographic dye
18
Q
All of the following can result in a turbid urine except
RBCS.
medication.
dehydration.
urochrome.
A
urochrome.
19
Q
Which substance found in urine is considered pathologic?
Spermatozoa
• Yeast
Powder
Squamous epithelial cells
A
• Yeast
20
Q
The urine of a patient who had been on a medical fast for the past several weeks may smell
sweet and fruity.
pungent and fetid.
ammonia-like.
I faintly aromatic.
A
sweet and fruity.
21
Q
Calibration of a refractometer requires the use of
1. distilled water.
2. sodium chloride solution.
3. bicarbonate buffer.
1 and 2
1 and 3
2 and 3
1, 2, and 3
A
1 and 2
22
Q
All of the following are true about the refractive index as a measure of specific gravity except
it is a measurement of the mass of solutes per volume of solution.
it is a ratio of light refraction in two different media.
it is a comparison of the velocity of light passing through air into solution.
it is an indirect measure based on the refractive index of light.
A
it is a measurement of the mass of solutes per volume of solution.
23
Q
The refractive index of a solution is affected by all of the following except
concentration of the solution.
temperature of the solution.
• light scattering by particles in the solution.
wavelength of light used
A
light scattering by particles in the solution.
24
Q
Reagent strip SG indirectly estimates urine density on the basis of
colligative properties.
charged solutes.
nonionic particles.
large-molecular-weight molecules.
A
charged solutes.
25
The colligative properties of a sample depend on the
number of solute particles.
particle size.
ionic charge.
temperature of the sample.
number of solute particles.
26
Measures of freezing point depression can be used to calculate all of the following except
depression of the vapor pressure.
osmolality.
elevation of the osmotic pressure. elevation of the boiling point.
osmolality.
27
Isosthenuria is a term used to describe
•
a fixed specific gravity of 1.010.
the balance of ionic and nonionic particles in urine.
temperature plateaus in freezing point osmometry.
a dilute, clear urine.
a fixed specific gravity of 1.010
28
The technologist is busy trying to cover several departments, because she is the lone technologist on the third shift. She receives several routine urinalysis specimens, STAT blood work for chemistry and hematology, and a STAT cross-match; in addition, the emergency department is hopping. How will the technologist prioritize her workload?
Put the urine specimens in the refrigerator for later analysis.
• Evaluate the color and clarity of the specimens and then refrigerate.
Leave the specimens at room temperature until later.
Call for recollection of specimens after things settle down.
Evaluate the color and clarity of the specimens and then refrigerate.
29
Several urine specimens come into the laboratory around lunchtime. The technologist checks the times on the specimens and notes that she can go to lunch and get back in time to perform the UA without having to refrigerate the specimens.Upon her return, she finds that one of the specimens is now black.
The pH test result is 8.0, so the technologist
checks the specimen for myoglobin. orders a test for homogentisic acid.
checks the patient's medications.
calls the floor for a new specimen.
orders a test for homogentisic acid.
30
Which of the following drug-color pairings is incorrect?
Levodopa-red then brown, alkaline
Methyldopa-red to brown
Nitrofurantoin-orange-red
) Rifampin-bright orange-red
Nitrofurantoin-orange-red
31
Which of the following statements regarding uroerythin is true?
1. Pink urine pigment
2. Indicates presence of RBCs in urine
3. Produces precipitate described as brick dust
4. Most evident when deposited on hippurate crystals
1,4
1, 2
1, 3
3,4
1,3
32
Which of the following is incorrectly paired with urine pigment color?
* Consumption of high carotene foods-amber
Crush injury-brown
Pseudomonas infection-blue-green
Alkaptonuria-brown to black on standing
Consumption of high carotene foods-amber
33
Which of the following urine substances and color of urine foam is correct?
* Myglogin-brown foam
Hemoglobin-pink foam
Urochrome-pale yellow foam
None is correct
None is correct
34
Which of the following descriptions would identify a urine specimen as being cloudy?
Newsprint cannot be seen when viewed through urine tube.
Visible particles present; newsprint can be read when view through urine tube.
* Significant particulate matter; newsprint blurred when viewed through urine tube.
Flocculation present; newsprint hazy but can be read through urine tube.
* Significant particulate matter; newsprint blurred when viewed through urine tube.
35
A patient has a urine glucose of 2 g/dL. Specific gravity by refractometry reads 1.035 and is reported out as
1.029.
1.031.
1.033.
1.035.
1.031.
36
The integrity of reagent strips is best assessed by
a. using automated instrumentation.
b. running control materials.
c. keeping the lid tightly closed on the bottle.
d. checking for a color change on the pads.
running control materials.
37
While performing UAs, the technologist ran controls and began testing the specimens. He ran out of reagent strips and needed one more to complete the run. He opened a new bottle and
a. continued testing on the remaining specimens.
b. ran controls on the new bottle and then continued the run.
c. aborted the run and started all over with the first specimen.
d. checked for discoloration before continuing the run.
ran controls on the new bottle and then continued the run.
38
Interlaboratory testing provides additional quality control checks on all of the following except
a. QC material.
b. laboratorian skill.
c. chemical analysis.
d. microscopic analysis.
QC material.
39
All of the following are improper uses of the reagent strip, which will produce erroneous results, except
a. inadequate removal of excess urine from the strip.
b. blotting the edge of the reagent strip after dipping it in the urine.
c. prolonged dipping of the strip in urine.
d. reading the results after all test pads have reached full development.
blotting the edge of the reagent strip after dipping it in the urine.
40
The technologist dips a reagent strip into a urine specimen and then reads it manually, following the manufacturer’s specifications. After performing the microscopic examination, he notes that the dipstick color on the edge of the reaction pad for ketones is darker than when he had first read it. The technologist
Select one:
a. reports the original result and discards the strip and other disposable items.
b. changes the original result of negative to 2+ and verifies the report.
c. takes a new reagent strip and retests the specimen.
d. asks another technologist to look at the strip for verification.
reports the original result and discards the strip and other disposable items.
41
The technologist is logging urine color and clarity for four specimens he had running on the Clinitek. He notes an abnormal orange color for specimen #3. All test pads for specimen #3 are positive. Upon microscopic examination, the technologist reports a negative result for all cellular and crystal elements. Specimens #1 and #4 test negative for all constituents, and no microscopic examinations are performed. Specimen #2 tests positive for nitrites and leukocytes only; that microscopic examination reveals WBCs and bacteria. The next course of action the technologist should take is
a. finalize all reports and results and send them to the appropriate departments.
b. rerun all specimens, using reagent strips with a new lot number.
c. manually retest specimen #3.
d. spin down specimen #3 and rerun it on the Clinitek.
manually retest specimen #3.
42
End-stage renal failure has which of the following characteristics?
1. Isosthenuria
2. Nocturia
3. Fixed specific gravity (SG) of 1.010
Select one:
a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 1, 2, and 3
1, 2, and 3
43
The reagent strip test pad for specific gravity produces a color change by measuring the
a. release of protons by ionic solutes, resulting in a decreased pH.
b. ratio of ionic and nonionic solutes, resulting in polar bonds.
c. number of solute molecules in relation to solvent.
d. binding of protons by ionic solutes in solution.
release of protons by ionic solutes, resulting in a decreased pH.
44
The kidneys play a major role in acid-base balance by
Select one:
a. adjusting the pH of the blood as it flows through the glomerulus.
b. reabsorbing buffers from the ultrafiltrate.
c. selectively excreting acid or alkali.
d. filtering out excess hydrogen and hydroxyl ions.
selectively excreting acid or alkali.
45
Upon review of the urinalysis printout, the technologist notes a urine pH of 9.0 on one specimen. The other test results were negative, except for nitrites, which tested positive. The next step is
Select one:
a. double-check the time of collection, transport, and storage.
b. review the other results and, if normal, finalize the report.
c. use pH test paper to confirm the pH result.
d. rerun the reagent strip to confirm all results.
double-check the time of collection, transport, and storage.
46
A 75-year-old man has excruciating flank pain on the left side. The doctor suspects a kidney stone. UA findings of blood and calcium oxalate crystals, along with a CT scan, confirm the diagnosis. The physician treats the patient and advises him to
Select one:
a. drink cranberry juice.
b. eat a vegetarian diet.
c. include more protein at each meal.
d. increase his carbohydrate intake.
eat a vegetarian diet.
47
A 16-year-old boy is brought to the ED unconscious and unresponsive. His blood alcohol level is 3 times the normal limit. His friends report that the last time they saw him conscious was 8 hours ago, around 5 AM. Later that morning, they saw him on the floor in the family room, but they thought he was just sleeping and left him alone. In the afternoon, unable to rouse him, they called 911. The patient is catheterized, and the urine color is brown. The physician is concerned that the urine contains
Select one:
a. hemoglobin.
b. RBCs.
c. myoglobin.
d. porphyrin.
myoglobin
48
The UA results for the patient in question 12 are positive for blood, but no RBCs are seen on the microscopic examination. The next step is to perform a(n)
Select one:
a. Prussian blue staining test.
b. immunoassay and/or high-performance chromatography.
c. Watson-Schwartz test.
d. hemolyticdifferentiation test.
immunoassay and/or high-performance chromatography.
49
In light of the answers to questions 12 and 13, which of the following is the most likely cause of this patient’s condition?
a. Hemolytic episode
b. Hemosiderin excretion
c. Nontraumatic rhabdomyolysis
d. Kidney disease
Nontraumatic rhabdomyolysis
50
The reagent pad for blood detection is impregnated with
Select one:
a. methyl red and bromothymol blue.
b. tetramethylbenzidine and peroxide.
c. ester and diazonium salt.
d. copper sulfate and tetramethylbenzidine and peroxide.
tetramethylbenzidine and peroxide.
51
Whenever the reagent pad shows a negative result for blood and the microscopic examination reveals RBCs, the technologist should suspect the presence of
Select one:
a. ascorbic acid.
b. peroxide.
c. hemosiderin.
d. porphyrin.
ascorbic acid.
52
A 23-year-old female patient comes in for a urinalysis on a midstream clean catch specimen. The results are as follows:
a. The results are accurate and do not indicate a urinary tract infection.
b. The results are inaccurate and indicate improper collection of the midstream clean catch specimen.
c. The results are accurate and indicate that the patient is being treated with an alkaline medication.
d. The results are inaccurate, because a discrepancy exists between the chemical and microscopic results.
The results are inaccurate, because a discrepancy exists between the chemical and microscopic results.
53
The technologist performs a microscopic examination on urine sediment from a 35-year-old female. The findings for this specimen are
Select one:
a. the specimen was not well mixed, resulting in a negative LE result.
b. vaginal contamination of the specimen masked the LE result.
c. an insufficient amount of leukocyte esterase was produced.
d. the specific gravity was too high, causing a false-negative LE result.
an insufficient amount of leukocyte esterase was produced.
54
The technologist notes the discrepancy between the chemical examination findings for LE and blood (i.e., negative) and the microscopic examination findings (i.e., presence of WBCs and RBCs). Which of the following may explain the discrepancy?
UA results on a 28-year-old female are as follows:
a. Specific gravity, glucose, and protein
b. Glucose and protein
c. Specific gravity
d. Protein
Specific gravity
55
The first morning UA results on a 60-year-old male suspected of having a bladder infection are
Which of the following is likely to be questionable?
Select one:
a. Nitrite and leukocyte esterase
b. Specific gravity and blood
c. Specific gravity, nitrite, and leukocyte esterase
d. Specific gravity, nitrite, leukocyte esterase, and blood
Specific gravity, nitrite, leukocyte esterase, and blood
56
Postural (orthostatic) proteinuria requires
Select one:
a. a random urine specimen.
b. a timed urine specimen.
c. a first morning urine specimen.
d. two urine specimens.
two urine specimens.
57
Fanconi’s syndrome is a proximal tubular dysfunction that produces which of the following urine findings?
Select one:
a. Aminoaciduria
b. Proteinuria and glycosuria
c. Phosphaturia, proteinuria, and glycosuria
d. Aminoaciduria, proteinuria, phosphaturia, and glycosuria
Aminoaciduria, proteinuria, phosphaturia, and glycosuria
58
Protein error of indicators in the protein reagent test pad may result in false-positive readings
Select one:
a. in highly buffered or alkaline urine (≥9.0).
b. in the presence of proteins other than albumin.
c. if the patient is taking phenazopyridine.
d. if an alkaline pH is adjusted down to 5.0.
in highly buffered or alkaline urine (≥9.0).
59
The UA of a 70-year-old male who takes an alkaline medication reveals 3+ protein on the reagent test strip and a pH of 9.0. The technologist should
Select one:
a. perform the sulfosalicylic acid test and report out both results.
b. adjust the urine pH to 5.0 and retest using a reagent strip.
c. note on the report that the protein result is falsely elevated because of the high pH.
d. report the protein result, because protein error of indicators adjusts for a high pH.
adjust the urine pH to 5.0 and retest using a reagent strip.
60
The reagent strip for protein can detect which protein(s)?
a. Myoglobin
b. Hemoglobin
c. Albumin
d. All of the above
Albumin
61
Diabetic patients must routinely have their urine checked to monitor their renal status. For this purpose, the technologist performs which test?
Select one:
a. 24-hour urine protein test
b. Reagent strip for protein test
c. Microalbumin reagent strip test
d. Sulfosalicylic acid test for protein
Microalbumin reagent strip test
62
An 80-year-old female with diabetes presents to the ED with heart failure. You might expect to see which of the following conditions confirmed by blood glucose and UA testing?
Select one:
a. Hyperglycemia and no glucosuria
b. Normal blood glucose and normal glucosuria
c. Normal blood glucose and hypoglucosuria
d. Hypoglycemia and glucosuria
Hyperglycemia and no glucosuria
63
The technologist receives the following results on a urine specimen from a 1-month-old patient. What additional testing, if any, is required?
a. Ictotest
b. Clinitest
c. SSA test
d. No additional testing is needed.
Clinitest
64
The technologist performs a UA and a copper reduction test on a 19-month-old child. The reagent strip shows a positive result for glucose; the copper reduction test also produces a positive result. Which of the following is most likely present in the urine?
Select one:
a. Galactose
b. Glucose
c. Lactose
d. Homogentisic acid
Glucose
65
The technologist records these results on a UA and Clinitest: glucose 4+ on reagent strip and negative for Clinitest. The most likely explanation is
Select one:
a. the patient has no other reducing substances.
b. the patient is taking high doses of ascorbic acid.
c. the renal threshold level has been reached for glucose.
d. the Clinitest result indicates that the pass-through effect has occurred.
the Clinitest result indicates that the pass-through effect has occurred.
66
Mr. Smith, a regular client at the laboratory, comes in for a UA. The technologist comments that she hasn’t seen Mr. Smith in quite a while. He tells her that he has been at the University Hospital, undergoing chemotherapy for cancer. He says that he has had a rough time and has lost a lot of weight, but he feels much better thanks to a new medication, MESNA. His appetite is back, and he has been eating regularly. When she tests Mr. Smith’s urine, the technologist notes that the ketone pad immediately turns purple. Results from the Clinitek show 4+ ketones. She suspects a false-positive result caused by
Select one:
a. weight loss
b. cancer
c. free sulfhydryl groups
d. an improper read time
free sulfhydryl groups.
67
Which condition produces a negative urine bilirubin result but also an increased urobilinogen result?
Select one:
a. Transfusion reaction
b. Hepatitis
c. Common bile duct tumor
d. Liver tumor
Transfusion reaction
68
The technologist performs an admission UA on a urine specimen that is beer brown in color and that was obtained from a homeless 25-year-old male hospitalized with hepatitis. The results are:
The technologist had not expected to see a negative bilirubin result based on the physical examination results. Based on the chemical UA results, the most likely explanation is
the bilirubin result is a false negative caused by the presence of nitrite.
69
A quantitative assessment of the urobilinogen level is performed on which type of urine specimen?
a. 24-hour collection, because of diurnal variation
b. 2-hour collection obtained between 2 and 4 PM
c. 12-hour collection that started at 7 AM
d. Random specimen, because excretion is constant
2-hour collection obtained between 2 and 4 PM
70
The following UA results were obtained on a specimen from a sexually active 20-year-old college student who was admitted to the hospital with anxiety, abdominal pain, muscle pain, tingling, numbness, weakness, excessive sweating, and slight disorientation.
The patient reported the onset of symptoms over the past few days and stated that she had not really eaten much of anything for a couple of days. She also reported that her urine had turned red. The next course of action would be to perform which test?
Select one:
a. Watson-Schwartz test
b. Microalbumin test
c. Homogentisic acid test
d. Sulfosalicylic acid test
Watson-Schwartz test
71
All of the following statements about urine specimen volume are true except
A. The recommended volume for urinalysis is 12 mL for accurate results.
B. A pediatric volume of 6 mL requires doubling of sediment examination results.
C. Urine volumes less than 3 mL must be rejected as QNS (quantity not sufficient).
D. Variations in volume require notation in the specimen report.
urine volumes less than 3 mL must be rejected as QNS (quantity not sufficient).
72
Which urine specimen should be rejected?
A. 1 mL specimen from a newborn
B. 4 mL specimen from an adult with a renal condition
C. 12 mL specimen with a small amount of fecal matter
D. 20 mL specimen from a catheterization bag
12-mL specimen with a small amount of fecal matter
73
Centrifugation requirements for urine sediment preparation are
A. 300 g for 15 minutes
B. 350 g for 10 minutes
C. 400 g for 3 minutes
D. 450 g for 5 minutes
450 g for 5 minutes.
74
The stain most commonly used to enhance visualization of urine sediment is
A. Hansel stain
B. Sudan III
C. Prussian blue
D. Sternheimer-Malbin
Sternheimer-Malbin.
75
The microscopy technique that provides more detailed visualization of translucent or low-refractile components and living cells is
A. Polarizing microscopy
B. Brightfield microscopy
C. Phase-contrast microscopy
D. Interference contrast microscopy
phase-contrast microscopy.
76
In a hypotonic urine, RBCs have what type of appearance?
A. Crenated
B. Ghost cell
C. Acanthocyte
D. Biconcave
Ghost cell
77
The technologist evaluates the following urinalysis results and notes a discrepancy between the reagent test and the microscopic examination for blood:
A. High specific gravity
B. Strong oxidizing agents
C. Ascorbic acid
D. Microbial peroxidases
ascorbic acid.
78
The technologist is having a difficult time identifying cellular elements that look like RBCs but for which the reagent test pad was negative, as was the test for ascorbic acid. The technologist decides to add a drop of Sternheimer-Malbin stain, which will differentiate
1. calcium oxalate crystals from yeast.
2. yeast from RBCs.
3. RBCs from calcium oxalate crystals.
A. Calcium oxalate crystals from yeast
B. Yeast from RBCs
C. RBCs from calcium oxalate crystals
D. A and B
E. B and C
2 and 3
79
The laboratory receives a random urine specimen obtained from a 17-year-old female teenager, who needs the UA as part of her sports physical examination. The test results are
A. Glomerulonephritis
B. Urinary tract infection
C. Menstrual contamination
D. Allergic drug reaction
Menstrual contamination
80
A 32-year-old woman presents to the ED with fever, oliguria, hematuria, and a rash. She reports that she has a sinus infection and is currently taking penicillin. The physician suspects that the patient has acute interstitial nephritis (AIN); she therefore orders which tests to be performed on the patient’s urine specimen?
A. Eosinophil count using Hansel stain
B. Total WBC count using acetic acid
C. Lymphocyte count using Giemsa stain
D. RBC count on 10 random fields
Eosinophil count using Hansel stain
81
A 45-year-old patient who received a kidney transplant 2 months ago presents to the ED with a temperature of 100 °F, chills, aches, headache, dizziness, oliguria, and a weight gain of 6 pounds since yesterday. The technologist notes that the predominant WBC in the microscopic examination is
A. Eosinophils
B. Neutrophils
C. Glitter cells
D. Lymphocytes
lymphocytes
82
A technologist performing a microscopic examination on a urine sediment is trying to determine whether he is looking at a large white cell or a renal tubular cell. He reports two to four renal tubular cells based on which criterion?
A. The cell is spherical.
B. The cell has refractile inclusions.
C. The cell is polygonal with one flat edge.
D. The cell has a flagstone appearance.
The cell is polygonal with one flat edge.
83
Cells found in urine sediment that contain highly refractile droplets are
A. Glitter cells
B. Ghost cells
C. Oval fat bodies
D. Clue cells
oval fat bodies.
84
The presence of which type of cell indicates vaginal contamination in a random urine specimen or an improperly collected midstream clean catch urine specimen?
A. Clue cell
B. Glitter cell
C. Columnar cell
D. Squamous cell
Squamous cell
85
An 80-year-old woman is admitted to the hospital with disorientation, a temperature of 102 °F, cough, congestion, and a preliminary diagnosis of pneumonia. She is catheterized, and a urine specimen is sent down for UA. The technologist notes sheets of transitional epithelial cells in the urine sediment. The presence of these cells is most likely due to
A. An iatrogenic process
B. Transitional cell carcinoma
C. Renal tubular disease
D. Normal desquamation
an iatrogenic process.
86
Healthy individuals may have which of the following in their urine, as a normal finding, after strenuous exercise?
A. WBC and RBC casts
B. Hyaline and finely granular casts
C. RBC and waxy casts
D. Nonpathologic pseudocasts
Hyaline and finely granular casts
87
Which type of cast indicates significant urinary stasis and a poor prognosis?
A. Broad, waxy casts
B. Coarsely granular casts
C. Hyaline casts
D. Bilirubin casts
Broad, waxy casts
88
A finding of increased numbers of casts and/or the presence of abnormal casts must be accompanied by a finding of
A. Leukocyturia
B. Hematuria
C. Proteinuria
D. A and B
E. A, B, and C
proteinuria
89
A 45-year-old woman is seen in the clinic for her annual physical examination. Her general health is good, she is taking no medications, and she notes no physical complaints other than that her weight is creeping up and she has little time for exercise. A new technologist, fresh out of college, performs the UA. She then asks another technologist to double-check her results, because the chemical analysis does not correlate with the microscopic examination. A repeat UA confirms the chemical analysis results. A repeat microscopic examination is performed as well
No casts were reported on the repeat microscopic examination, so the original report of 20 to 30 hyaline casts most likely was due to
A. Misidentified mucous threads
B. Strenuous physical exercise
C. Urinary tubular stasis
D. Collecting duct fragments
misidentified mucous threads.
90
A 50-year-old woman is admitted to the hospital. She states that she has not been feeling well for the past week and that she started running a fever several days ago. Examination and testing reveal bacterial endocarditis and renal insufficiency. The UA results are
Based on these results, what is the most likely renal diagnosis secondary to bacterial endocarditis?
A. Glomerulonephritis
B. Urinary tract infection
C. Renal tubular disease
D. Pyelonephritis
Glomerulonephritis
91
As the technologist is scanning for casts, she notes several hyaline-looking casts with a few yellowish cells that appear to be embedded in the matrix. She also notes several muddy brown casts. After closer inspection, the technologist reports out which of the following?
A. Bilirubin cast
B. Renal epithelial cast
C. RBC cast
D. WBC cast
RBC cast
92
A 45-year-old man with polycystic disease is admitted to the hospital. The technologist scans for casts and notes very large, colorless, hyaline-like casts that appear to have sharp, well-defined edges, some lateral fissures, and uneven ends. She checks the UA chemical analysis
A. Cotton fibers
B. Broad, waxy casts
C. Mucous threads
D. Degenerate casts
broad, waxy casts.
93
A 36-year-old female presents to the ED with shaking, chills, fever, and nausea, as well as abdominal, flank, and low and mid-back pain. A CAT scan and UA are ordered, along with other blood work. The CAT scan shows numerous kidney stones in the renal pelvis. The UA results reveal pathologic
The patient is most likely suffering from which of the following?
1. Kidney stone
2. Urinary tract infection
3. Pyelonephritis
4. Renal failure
5. Glomerulonephritis
A. Only 1 is correct
B. 3 is correct
C. 1, 3 and 5 are correct
D. 1, 2 and 5 are correct
E. 1, 4 and 5 are correct
3 is correct
94
A urine crystal that is not considered clinically significant is
A. Cystine
B. Cholesterol
C. Tyrosine
D. Leucine
cholesterol
95
Which type of crystal is found in acetic urine?
A. Calcium oxalate
B. Amorphous phosphates
C. Triple phosphates
D. Ammonium biurate
Calcium oxalate
96
Iatrogenic crystals include which of the following?
A. Tyrosine
B. Leucine
C. Cystine
D. Sulfonamides
E. A, B, and C
Sulfonamides
97
The presence of ammonium biurate crystals in a fresh urine specimen must be investigated to determine whether
1. the patient has a metabolic condition arising from a genetic defect.
2. the urine was improperly stored before delivery to the laboratory.
3. the crystals are the result of iatrogenically induced alkalinization.
A. The patient has a metabolic condition arising from a genetic defect.
B. The urine was improperly stored before delivery to the laboratory.
C. The crystals are the result of iatrogenically induced alkalinization.
D. A and B
E. B and C
2 and 3
98
The technologist reports the following results on a routine UA for an 89-year-old female being given her annual physical examination
The patient collected a CCMS specimen on-site at 2 PM, and the urine was tested at 3 PM. The results indicate which of the following?
A. Urinary tract infection with possible kidney involvement
B. Improper collection of the midstream clean catch specimen
C. Improper storage of the specimen between the time of collection and testing
D. False-negative reagent strip results because of overhydration of the patient
Improper collection of the midstream clean catch specimen
99
While performing the microscopic examination of the urine of a 20-year-old college student, the technologist notes flagellar movement on several large cells with undulating membranes. She reports
A. Enterobius vermicularis
B. Schistosoma haematobium
C. Trichomonas vaginalis
D. Torulopsis glabrata
Trichomonas vaginalis.
100
While examining a microscopic sediment specimen, the technologist sees one to three squamous epithelial cells that appear soft and finely granular with shaggy edges. He reports
A. Amorphous urates
B. 1 to 3 epithelial cells
C. Clue cells
D. Bacterial vaginosis
clue cells.
