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WorksheetsAUBF MODULE 3 AND 4 QUIz
Total questions: 105
Worksheet time: 1hrs 17mins
The concentration of a normal urine specimen can be estimated by which of the following?
Color
Clarity
Foam
Odor
The normal yellow color of urine is produced by
Bilirubin
Hemoglobin
Urobilinogen
Urochrome
The presence of bilirubin in a urine specimen produces a:
Yellow foam when shaken
White foam when shaken
Cloudy specimen
Yellow-red specimen
A urine specimen containing melanin will appear
Pale pink
Dark yellow
Blue-green
Black
Specimens that contain hemoglobin can be visually distinguished from those that contain RBCs because
Hemoglobin produces a clear, yellow specimen
Hemoglobin produces a cloudy pink specimen
RBCs produce a cloudy red specimen
RBCs produce a clear red specimen
A patient with a viscous orange specimen may have been
Treated for a urinary tract infection
Taking vitamin B pills
Eating fresh carrots
Taking antidepressants
The presence of a pink precipitate in a refrigerated specimen is caused by:
Hemoglobin
Urobilin
Uroerythrin
Beets
Microscopic examination of a clear urine that produces a
white precipitate after refrigeration will show:
Amorphous urates
Porphyrin
Amorphous phosphate
Yeast
The color of urine containing porphyrins will be:
Yellow-brown
Green
Orange
Port wine
Which of the following specific gravities would be most
likely to correlate with a pale yellow urine?
1.005
1.010
1.020
1.030
A urine specific gravity measured by refractometer is
1.029, and the temperature of the urine is 14°C. The specific gravity should be reported as
1.023
1.027
1.029
1.032
The principle of refractive index is to compare:
Light velocity in solutions with light velocity in solids
Light velocity in air with light velocity in solutions
Light scattering by air with light scattering by solutions
Light scattering by particles in solution
A correlation exists between a specific gravity by refractometer of 1.050 and a
2+ glucose
2+ protein
First morning specimen
Radiographic dye infusion
A cloudy urine specimen turns black upon standing and
has a specific gravity of 1.012. The major concern about
this specimen would be:
Color
Turbidity
Specific gravity
All of the above
A specimen with a specific gravity of 1.035 would be considered
Isosthenuric
Hyposthenuric
Hypersthenuric
Not urine
A specimen with a specific gravity of 1.001 would be considered
Isosthenuric
Hyposthenuric
Hypersthenuric
Not urine
A strong odor of ammonia in a urine specimen could
indicate:
Ketones
Normalcy
Phenylketonuria
An old specimen
The microscopic of a clear red urine is reported as many
WBCs and epithelial cells. What does this suggest?
Urinary tract infection
Dilute random specimen
Hematuria
Possible mix-up of specimen and sediment
Which of the following would contribute the most to a
urine osmolality?
One osmole of glucose
One osmole of urea
One osmole of sodium chloride
All contribute equally
Which of the following colligative properties is not stated
correctly?
The boiling pointing is raised by solute
The freezing point is raised by solute
The vapor pressure is lowered by solute
The osmotic pressure is raised by solute
An osmole contains:
One gram molecular weight of solute dissolved in one liter of solvent
One gram molecular weight of solute dissolved in one kilogram of solvent
Two gram molecular weights of solute dissolved in one liter of solvent
Two gram molecular weights of solute dissolved in one kilogram of solvent
The unit of osmolality measured in the clinical laboratory
is the:
Osmole
Milliosmole
Molecular weight
Ionic charge
In the reagent strip specific gravity reaction the polyelectrolyte:
Combines with hydrogen ions in response to ion concentration
Releases hydrogen ions in response to ion concentration
Releases hydrogen ions in response to pH
Combines with sodium ions in response to pH
Which of the following will react in the reagent strip specific gravity test?
Glucose
Radiographic dye
Protein
Chloride
The type of nephron responsible for renal concentration
is the
Cortical
Juxtaglomerular
The function of the peritubular capillaries is:
Reabsorption
Filtration
Secretion
Both reabsorption and filtration
Blood flows through the nephron in the following order:
Efferent arteriole, peritubular capillaries, vasa recta, afferent arteriole
Peritubular capillaries, afferent arteriole, vasa recta, efferent arteriole
Afferent arteriole, peritubular capillaries, vasa recta, efferent arteriole
Efferent arteriole, vasa recta, peritubular capillaries, afferent arteriole
Filtration of protein is prevented in the glomerulus by:
Hydrostatic pressure
Oncotic pressure
Renin
The glomerular filtration barrier
The renin-angiotensin-aldosterone system is responsible for all of the following except:
Vasoconstriction of the afferent arteriole
Vasoconstriction of the efferent arteriole
Reabsorbing sodium
Releasing aldosterone
The primary chemical affected by the renin angiotensin-aldosterone system is:
Chloride
Sodium
Potassium
Hydrogen
Secretion of renin is stimulated by
Juxtaglomerular cells
Angiotensin I and II
Macula densa cells
Circulating angiotensin-converting enzyme
The hormone aldosterone is responsible for
Hydrogen ion secretion
Potassium secretion
Chloride retention
Sodium retention
The fluid leaving the glomerulus has a specific gravity of:
1.005
1.010
1.015
1.020
For active transport to occur, a chemical:
Must combine with a carrier protein to create electrochemical energy
Must be filtered through the proximal convoluted
tubule
Must be in higher concentration in the filtrate than in the blood
Must be in higher concentration in the blood than in the filtrate
Which of the tubules is impermeable to water?
Proximal convoluted tubule
Descending loop of Henle
Ascending loop of Henle
Distal convoluted tubule
Glucose will appear in the urine when the:
. Blood level of glucose is 200 mg/dL
Tm for glucose is reached
Renal threshold for glucose is exceeded
All of the above
Concentration of the tubular filtrate by the countercurrent mechanism depends on all of the following except
High salt concentration in the medulla
Water-impermeable walls of the ascending loop of Henle
Reabsorption of sodium and chloride from the ascending loop of Henle
Reabsorption of water in the descending loop of Henle
ADH regulates the final urine concentration by controlling:
Active reabsorption of sodium
Tubular permeability
Passive reabsorption of urea
Passive reabsorption of chloride
Decreased production of ADH:
Produces a low urine volume
Produces a high urine volume
Increases ammonia excretion
Affects active transport of sodium
Bicarbonate ions filtered by the glomerulus are returned
to the blood
In the proximal convoluted tubule
Combined with hydrogen ions
By tubular secretion
All of the above
If ammonia is not produced by the distal convoluted
tubule, the urine pH will be:
Acidic
Basic
The largest source of error in creatinine clearance tests is
Secretion of creatinine
Improperly timed urine specimens
Refrigeration of the urine
Time of collecting blood sample
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 or secreted by the tubules
Performing a clearance test using radionucleotides
Eliminates the need to collect urine only
Does not require an infusion
Provides visualization of the filtration only
Eliminates the need to collect urine and provides visualization of the filtration
Variables that are included in the MDRD-IDSM estimated creatinine clearance calculations include all of the following except:
Serum creatinine
Weight
Age
Gender
An advantage to using cystatin C to monitor GFR is that:
It does not require urine collection
It is not secreted by the tubules
It can be measured by immunoassay
All of the above
Solute dissolved in solvent will:
Raise the vapor pressure
Lower the boiling point
Decrease the osmotic pressure
Lower the freezing point
Substances that may interfere with freezing point measurement of urine and serum osmolarity include all of the following except:
Ethyl alcohol
Lactic acid
Sodium
Lipids
Clinical osmometers use NaCl as a reference solution because
1 g molecular weight of NaCl will lower the freezing point 1.86oC
NaCl is readily frozen
NaCl is partially ionized similar to the composition of urine
1 g equivalent weight of NaCl will raise the freezing point 1.86oC
The normal serum osmolarity is:
50 to 100 mOsm
275 to 300 mOsm
400 to 500 mOsm
3 times the urine osmolarity
After controlled fluid intake, the urine-to-serum osmolarity ratio should be at least:
1:1
2:1
3:1
4:1
To provide an accurate measure of renal blood flow, a test substance should be completely
Filtered by the glomerulus
Reabsorbed by the tubules
Secreted when it reaches the distal convoluted tubule
Cleared on each contact with functional renal tissue
Renal tubular acidosis can be caused by the:
Production of excessively acidic urine due to increased filtration of hydrogen ions
Production of excessively acidic urine due to increased secretion of hydrogen ions
Inability to produce an acidic urine due to impaired production of ammonia
Inability to produce an acidic urine due to increased production of ammonia
Tests performed to detect renal tubular acidosis after administering an ammonium chloride load include all of the following except
Urine ammonia
Arterial pH
Urine pH
Titratable acidity
How many nephrons are found in an average kidney?
13,000-15,000
130,000-150,000
1.3 million-1.5 million
13 million-15 million
Which component of the nephron is located exclusively in the renal medulla?
Collecting tubule
Distal tubule
Loop of Henle
Proximal tubule
Which of the following is not a vascular characteristic of the kidney
The afferent arteriole has a narrower lumen than the efferent arteriole
The arteries are primarily end arteries, supplying specific areas of tissue, and they do not interconnect
The arterioles subdivide into a capillary network, rejoin as an arteriole, and subdivide into a second capillary bed
The vasa recta vessels deep in the renal medulla form the beginning of the venous renal circulation
Formation of the ultrafiltrate in the glomerulus is driven by the
hydrostatic blood pressure.
oncotic pressure of the plasma proteins.
osmotic pressure of the solutes in the ultrafiltrate
pressures exerted by the glomerular filtration barrier
Which of the following is a characteristic of renin, an enzyme secreted by specialized cells of the juxtaglomerular apparatus?
Renin stimulates the diffusion of urea into the renal interstitium.
Renin inhibits the reabsorption of sodium and water in the nephron.
Renin regulates the osmotic reabsorption of water by the collecting tubules.
Renin causes the formation of angiotensin and the secretion of aldosterone
The glomerular filtration barrier is composed of the
capillary endothelium, basement membrane, and podocytes
mesangium, basement membrane, and shield of negativity
capillary endothelium, mesangium, and juxtaglomerular apparatus
basement membrane, podocytes, and juxtaglomerular apparatus
The ability of a solute to cross the glomerular filtration barrier is determined by its
1. molecular size.
2. molecular radius.
3. electrical charge.
4. plasma concentration
1, 2, and 3 are correct
1 and 3 are correct
4 is correct.
All are correct
The epithelium characterized by a brush border owing to numerous microvilli is found in the
collecting tubules
distal tubules.
loops of Henle
proximal tubules
The kidneys play an important role in the
1. excretion of waste products.
2. regulation of water and electrolytes.
3. maintenance of acid-base equilibrium.
4. control of blood pressure and fluid balance
1, 2, and 3 are correct
1 and 3 are correct.
4 is correct
All are correct
What percent of the original ultrafiltrate formed in the urinary space actually is excreted as urine?
1%
10%
25%
33%
What differentiates tubular reabsorption from tubular secretion in the nephron?
The direction of movement of the substance being absorbed or secreted is different
Reabsorption is an active transport process, whereas secretion is a passive transport process
Cell membrane–binding sites are different for the reabsorption and secretion of a solute
The location of the epithelium in the nephron determines which process occurs
During tubular transport, the movement of a solute against a gradient
is called passive transport
requires little to no energy
involves specific cell membrane–binding sites
may occur paracellularly, that is, between cells through intercellular spaces.
Substances bound to plasma proteins in the blood can be eliminated in the urine by
glomerular secretion.
glomerular filtration.
tubular secretion
tubular reabsorption.
Which statement characterizes the ability of the renal system to regulate blood pH?
The renal system has a slow response with complete correction of the pH to normal
The renal system has a fast response with complete correction of the pH to normal.
The renal system has a slow response with only partial correction of the pH toward normal.
The renal system has a fast response with only partial correction of the pH toward normal
The kidneys excrete excess alkali (base) in the urine as
ammonium ions
ammonium salts
sodium bicarbonate.
titratable acids
Which of the following substances is secreted into the tubular lumen to eliminate hydrogen ions?
Ammonia (NH3)
Ammonium ions (NH4+ )
Disodium phosphate (Na2HPO4)
Monosodium phosphate (NaH2PO4)
The renal threshold level for glucose is 160 to 180 mg/dL. This corresponds to the
rate of glucose reabsorption by the renal tubules.
concentration of glucose in the tubular lumen fluid
plasma concentration above which tubular reabsorption of glucose occur
plasma concentration above which glucose is excreted in the urine
When too much protein is presented to the renal tubules for reabsorption, it is excreted in the urine because
the renal threshold for protein has not been exceeded
the maximal tubular reabsorptive capacity for protein has been exceeded
protein is not normally present in the ultrafiltrate and cannot be reabsorbed.
the glomerular filtration barrier allows only abnormal proteins to pass.
More than 66% of filtered water, sodium, and chloride and 100% of filtered glucose, amino acids, and proteins are reabsorbed in the
collecting tubules
distal tubules
loops of Henle.
proximal tubules.
Water reabsorption occurs throughout the nephron except in the
cortical collecting tubule
proximal convoluted tubule
ascending limb of the loops of Henle.
descending limb of the loops of Henle
The process solely responsible for water reabsorption throughout the nephron is
osmosis
the urea cycle
the countercurrent exchange mechanism.
the countercurrent multiplier mechanism
Antidiuretic hormone regulates the reabsorption of
water in the collecting tubules
sodium in the collecting tubules
sodium in the distal convoluted tubule
water and sodium in the loop of Henle.
The final concentration of the urine is determined within the
collecting ducts
distal convoluted tubules
loops of Henle.
proximal convoluted tubules
Which of the following solutes are present in the largest molar amounts in urine?
Urea, chloride, and sodium
Urea, creatinine, and sodium
Creatinine, uric acid, and ammonium
Urea, uric acid, and ammonium
The concentration of which substances provides the best means of distinguishing urine from other body fluids?
Creatinine and urea
Glucose and protein
Uric acid and ammonia
Water and electrolytes
What is the definition of the osmolality of a solution?
The density of solute particles per liter of solvent
The mass of solute particles per kilogram of solvent
The number of solute particles per kilogram of solvent
The weight of solute particles per liter of solvent
The excretion of large volumes of urine (>3 L/day) is called
glucosuria.
hyperuria.
polydipsia.
polyuria.
The daily volume of urine excreted normally ranges from
100 to 500 mL/day
100 to 1800 mL/day
500 to 1800 mL/day
1000 to 3000 mL/day
Which of the following groups would be expected to have the greatest 24-hour excretion of creatinine?
Infants
Children
Women
Men
Which of the following groups would be expected to have the greatest 24-hour excretion of creatinine?
Infants
Children
Women
Men
A 24-hour urine collection is preferred for determination of creatinine clearance because of diurnal variation in the
glomerular filtration rate.
plasma creatinine.
creatinine excretion.
urine excretion.
Which of the following is an endogenous substance used to measure glomerular filtration rate?
Urea
Creatinine
Inulin
p-aminohippurate
A fluid deprivation test is used to
determine renal plasma flow.
investigate the cause of oliguria
assess renal concentrating ability
measure the glomerular filtration rate
A single substance can impart different colors to
urine depending on the
1. amount of the substance present.
2. storage conditions of the urine.
3. pH of the urine.
4. structural form of the substance
1, 2, and 3 are correct
1 and 3 are correct.
4 is correct
All are correct
Which of the following urine characteristics provides the best rough indicator of urine concentration and body hydration?
Color
Clarity
Foam
Volume
Which of the following pigments deposits on urate and uric acid crystals to form a precipitate described as “brick dust”?
Bilirubin
Urobilin
Uroerythrin
Urochrome
Select the urine specimen that does not indicate the possible presence of blood or hemoglobin
Clear, red urine
Cloudy, brown urine
Clear, brown urine
Cloudy, amber urine
Select the urine specimen that does not indicate the possible presence of blood or hemoglobin
Clear, red urine
Cloudy, brown urine
Clear, brown urine
Cloudy, amber urine
A urine that produces a large amount of white foam when mixed should be suspected to contain increased amounts of
bilirubin
protein
urobilin
urobilinogen
A urine that produces a large amount of white foam when mixed should be suspected to contain increased amounts of
bilirubin
protein
urobilin
urobilinogen
Which of the following substances can change the
color of a urine and its foam?
Bilirubin
Hemoglobin
Myoglobin
Urobilin
Which of the following substances can change the
color of a urine and its foam?
Bilirubin
Hemoglobin
Myoglobin
Urobilin
The clarity of a well-mixed urine specimen that has visible particulate matter and through which news print can be seen but not read should be described as
cloudy
flocculated
slightly cloudy
turbid
Which of the following methods is an indirect
measure of specific gravity?
1. Reagent strip
2. Urinometry
3. Refractometry
4. Harmonic oscillation densitometry
1, 2, and 3 are correct
1 and 3 are correct
4 is correct
All are correct
The principle of the reagent strip method for measuring specific gravity is based on
the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen
the pH of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen
the pKa of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen
he pH of a polyelectrolyte increasing in proportion to the ionic concentration of the
Which of the following will not influence the volume
of urine produced?
Diarrhea
Exercise
Caffeine ingestion
Carbohydrate ingestion
Which of the following will not influence the volume
of urine produced?
Diarrhea
Exercise
Caffeine ingestion
Carbohydrate ingestion
Which of the following specific gravity values is physiologically impossible?
1.000
1.010
1.020
1.030
Match the urine odor to the condition given: Diabetes mellitus
Ammonia-like
Bleach
Faintly aromatic
Pungent, fetid
Sweet, fruity
Match the urine odor to the condition given: Starvation
Ammonia-like
Bleach
Faintly aromatic
Pungent, fetid
Sweet, fruity
Match the urine odor to the condition given: Normal urine
Ammonia-like
Bleach
Faintly aromatic
Pungent, fetid
Sweet, fruity
