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AUBF FINAL EXAM

Total questions: 116

Worksheet time: 1hrs 19mins

Name
Class
Date
1.

The primary chemical affected by the renin-angiotensin aldosterone system is:

a)

Chloride

b)

Sodium

c)

Potassium

d)

Hydrogen

2.

The fluid leaving the glomerulus has a specific gravity of:

a)

1.005

b)

1.010

c)

1.015

d)

1.020

3.

What are the variables included in the Cockgroft and Gault formula for creatinine clearance?

1. Age 3. Urine creatinine

2. Sex 4. Body weight

a)

1, 2 and 3

b)

1 and 3

c)

1, 2 and 4

d)

1, 2, 3 and 4

4.

The average total volume of urine produced by a normal adult every 24 hours is about

a)

750 mL

b)

1200 mL

c)

2000 mL

d)

2400 mL

5.

An abnormal decrease in urine production is called:

a)

Anuria

b)

Oliguria

c)

Polyuria

d)

Dysuria

6.

Cloudiness in a freshly-voided urine could indicate the presence of:

a)

Protein

b)

Sugar

c)

WBCs

d)

Any of these

7.

Which of these plasma substances is NOT normally filtered through the glomerulus in significant amounts

a)

Protein

b)

Glucose

c)

Creatinine

d)

Urea

8.

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

a)

Anuria

b)

Oliguria

c)

Polyuria

d)

Hypersthenuria

9.

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

a)

50-100 RBC/hpf

b)

85 mg/dL glucose

c)

3+ amorphous phosphates

d)

Moderate bacteria

10.

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

a)

Most dilute specimen of the day

b)

Less contamination by microorganisms

c)

It can detect orthostatic proteinuria

d)

Most concentrated specimen of the day

11.

Freshly voided normal urine is usually clear; however, if it is alkaline, a white turbidity may be present due to:

a)

Yeast cells

b)

Uroerythrin

c)

WBCs

d)

Amorphous phosphates

12.

A strong odor of cabbage in a urine specimen could indicate:

a)

Methionine malabsorption

b)

Trimethylaminuria

c)

Phenylketonuria

d)

Tyrosyluria

13.

A specimen with a strong ammonia odor and a heavy white precipitate when it arrives in the laboratory may require:

a)

Collection of a fresh specimen

b)

Centrifugation

c)

Dilution for specific gravity

d)

Testing under a hood

14.

A correlation exists between a specific gravity of 1.050 and a:

a)

2+ protein

b)

2+ glucose

c)

Radiographic dye infusion

d)

First morning specimen

15.

A yellow-brown specimen that produces a yellow foam when shaken can be suspected of containing:

a)

Carrots

b)

Hemoglobin

c)

Rhubarb

d)

Bilirubin

16.

A patient with a 1+ protein reading in the afternoon is asked to submit a first morning specimen. The second specimen also has a 1+ protein. This patient is

a)

Positive for orthostatic proteinuria

b)

Negative for orthostatic proteinuria

c)

Positive for Bence Jones proteinuria

d)

Negative for clinical proteinuria

17.

Urinalysis on a patient with severe back and abnominal pain is frequently performed to check for

a)

Bilirubinuria

b)

Proteinuria

c)

Hematuria

d)

Hemoglobinuria

18.

Reagent strip – specific gravity readings are affected by:

a)

Glucose

b)

Radiographic dye

c)

Alkaline urine

d)

All of the given choices

19.

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

a)

Bilirubin

b)

Leukocyte esterase

c)

pH

d)

Glucose

20.

The enzyme dipstick test for glucose has a sensitivity of:

a)

10 mg/dL

b)

50 mg/dL

c)

100 mg/dL

d)

200 mg/dL

21.

Which of the following is true of the detection of urinary glucose?

a)

Any reducing substance can give a false positive reaction w/ copper reduction test for glucose

b)

The copper reduction method is specific for glucose

c)

Glucose cannot appear in the urine in the absence of elevated plasma glucose

d)

Glucose cannot appear in the urine in the absence of elevated plasma glucose

22.

Which of the reagents below is used to detect urobilinogen in urine?

a)

p-Dinitrobenzene

b)

p-Aminosalicylate

c)

p-Dichloroaniline

d)

p-Dimethylaminobenzaldehyde

23.

All of the statements below regarding urine bilirubin tests are true EXCEPT

a)

A positive test indicates either liver or hepatobiliary disease

b)

The test detects only conjugated bilirubin

c)

High levels of ascorbate usually do not interfere

d)

Standing urine may become falsely negative due to bacterial hydrolysis

24.

A positive test for blood in urine can occur in the following EXCEPT:

a)

Extravascular hemolytic anemia

b)

Crush injury

c)

Malignancy of the kidney or urinary system

d)

Renal calculi

25.

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

a)

Sodium

b)

Glucose

c)

Chloride

d)

Urea

26.

A reagent test strip impregnated with an aromatic amine such as p-arsanilic acid or sulfanilamide may be used to detect which analyte?

a)

Bilirubin

b)

Blood

c)

Nitrite

d)

Urobilinogen

27.

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

a)

3.5-8.0

b)

3.5-9.0

c)

4.0-8.5

d)

4.5-8.0

28.

False positive levels of 5-HIAA can be caused by a diet high in:

a)

Bananas

b)

Tomatoes

c)

Pineapples

d)

All of the given choices

29.

Blue diaper syndrome is associated with:

a)

Lesch-Nyhan syndrome

b)

Hartnup disease

c)

Alkaptonuria

d)

Dubin-Johnson syndrome

30.

Hurler, Hunter and Sanfilippo syndrome are hereditary disorders affecting metabolism of:

a)

Tryptophan

b)

Purines

c)

Mucopolysaccharides

d)

Porphyrins

31.

Uroporphyrinogen decarboxylase deficiency is associated with which of the following?

a)

Acute intermittent porphyria (AIN)

b)

Hereditary coproporphyria (HCP)

c)

Congenital erythropoietic porphyria (CEP)

d)

Porphyria cutanea tarda (PCT)

32.

Urinary screening tests for mucopolysaccharides:

1. Acid albumin 3. Cyanide-Nitroprusside

2. CTAB 4. Nitroso-naphthol

a)

1 and 2

b)

2 only

c)

1, 2 and 3

d)

3 and 4

33.

He discovered phenylketonuria from a mentally retarded child with a peculiar mousy odor to his urine:

a)

Ivan Folling

b)

Garrod

c)

Cotugno

d)

Frederik Dekkers

34.

A clinically significant epithelial cell is the:

a)

Cuboidal cell

b)

Clue cell

c)

Caudate cell

d)

Squamous epithelial cell

35.

When using the glass slide and coverslip method, which of the following might be missed if the coverslip is overflowed?

a)

RBCs

b)

WBCs

c)

Casts

d)

Bacteria

36.

Which of the following should be used to reduce light intensity in bright-field microscopy?

a)

Centering screws

b)

Aperture diaphragm

c)

Rheostat

d)

Condenser aperture diaphragm

37.

The finding of dysmorphic RBCs is indicative of:

a)

Renal calculi

b)

Traumatic injury

c)

Glomerular bleeding

d)

Coagulation disorders

38.

The primary component of urinary mucus is:

a)

Albumin

b)

Uromodulin

c)

Goblet cells

d)

Beta2-microglobulin

39.

The purpose of the Hansel stain is to identify:

a)

Neutrophils

b)

Monocyte

c)

Renal tubular cells

d)

Eosinophils

40.

What is the normal value for urinary eosinophils?

a)

>10%

b)

<1%

c)

>1%

d)

<10%

41.

A disorder characterized by the disruption of the electrical charges that produce the tightly fitting podocyte barrier resulting in massive loss of proteins and lipids:

a)

Alport syndrome

b)

Nephrotic syndrome

c)

IgA nephropathy

d)

Lipid nephrosis

42.

Visicoureteral reflux or the reflux of urine from the bladder back into the ureters may result to:

a)

Acute glomerulonephritis

b)

Cystitis

c)

Acute pyelonephritis

d)

Acute interstitial nephritis

43.

The presence of renal tubular epithelial cells and casts is an indication of

a)

Acute interstitial nephritis

b)

Chronic glomerulonephritis

c)

Minimal change disease

d)

Acute tubular necrosis

44.

End-stage renal disease is characterized by all of the following EXCEPT:

a)

Electrolyte imbalance

b)

Azotemia

c)

Hypersthenuria

d)

Isosthenuria

45.

Broad and waxy casts are most likely associated with:

a)

Nephrotic syndrome

b)

Acute renal failure

c)

Chronic renal failure

d)

Focal segmental glomerulosclerosis

46.

It is described as a genetic disorder showing lamellated and thinning of glomerular basement membrane:

a)

Goodpasture syndrome

b)

Alport syndrome

c)

Nephrotic syndrome

d)

Wegener’s granulomatosis

47.

Casts are formed primarily in which portion of the kidney?

a)

Distal convoluted tubule

b)

Glomerulus

c)

Loop of Henle

d)

Proximal convoluted tubule

48.

A parasite associated with a positive leukocyte esterase is:

a)

Enterobius vermicularis

b)

Trichomonas vaginalis

c)

Schistosoma haematobium

d)

Candida albicans

49.

The hormone characteristically present in the blood of pregnant women and which, when its concentration in the blood reaches a certain point, also appears in the urine is:

a)

Estradiol

b)

Aldosterone

c)

Progesterone

d)

hCG

50.

HCG is produced by which of the following?

a)

Cytotrophoblast cells

b)

Argentaffin cells

c)

Endocervical glandular cells

d)

Type II pneumocytes

51.

The most common composition of renal calculi is:

a)

Calcium oxalate

b)

Magnesium ammonium phosphate

c)

Cystine

d)

Uric acid

52.

A renal calculi described as yellowish to brownish red in color with a moderately hard consistency is

a)

Cystine

b)

Phosphate

c)

Calcium oxalate

d)

Uric acid

53.

A renal calculi described as pale and friable is

a)

Cystine

b)

Phosphate

c)

Calcium oxalate

d)

Uric acid

54.

A stool specimen collected from an infant with diarrhea has a pH of 5.0. This result correlates with a:

a)

Positive APT test

b)

Negative trypsin test

c)

Positive Clinitest

d)

Negative occult blood test

55.

What is the gold standard for fecal fat determination?

a)

Van de Kamer titration

b)

Van den Berg reaction

c)

APT test

d)

D-Xylose test

56.

Which of the following pairings of stool appearance and cause does not match?

a)

Pale, frothy: steatorrhea

b)

Black, tarry: blood

c)

Yellow-gray: bile duct obstruction

d)

Yellow-green: barium sulfate

57.

All of the following statements about CSF are true EXCEPT:

a)

CSF is formed by ultrafiltration of plasma through the choroid plexus

b)

CSF circulates in the subarachnoid space and ventricles of the brain

c)

The chemical composition of CSF is similar to plasma

d)

Reabsorption of CSF occurs via vessels in the sagittal sinus

58.

All of the following are indication of CSF traumatic tap EXCEPT:

a)

Clearing of fluid as it is aspirated

b)

A clear supernatant after centrifugation

c)

Xanthochromia

d)

Presence of a clot in the sample

59.

The term used to denote a high WBC count in the CSF is

a)

Empysema

b)

Neutrophilia

c)

Pleocytosis

d)

Lymphocytosis

60.

The limulus lysate test on CSF is a sensitive assay for:

a)

Viral meningitis

b)

Cryptococcal meningitis

c)

Gram positive bacterial exotoxin

d)

Gram negative bacterial endotoxin

61.

A normal CSF glucose and lactate level is associated with which type of meningitis?

a)

Viral meningitis

b)

Bacterial meningitis

c)

Fungal meningitis

d)

Tubercular meningitis

62.

The most common cause of male infertility is

a)

Mumps

b)

Klinefelter’s syndrome

c)

Varicocele

d)

Malignancy

63.

Which of the following stains is used to determine sperm viability?

a)

Eosin

b)

Hematoxylin

c)

Papanicolau

d)

Methylene blue

64.

Seminal fluid viscosity graded as 4 is described as:

a)

Watery

b)

Fair

c)

Friable

d)

Gel-like

65.

Which test for FLM is least affected by contamination with hemoglobin and meconium

a)

Amniostat-FLM

b)

Foam stability

c)

Lamellar body count

d)

L/S ratio

66.

How are specimens for FLM testing delivered to and stored in the laboratory

a)

Delivered on ice and refrigerated or frozen

b)

Immediately centrifuged

c)

Kept at room temperature

d)

Protected from light

67.

The presence of a fetal neural tube disorder may be detected by:

a)

Increased amniotic fluid bilirubin

b)

Increased maternal serum alpha-fetoprotein

c)

Decreased amniotic fluid phosphatidyl glycerol

d)

Decreased maternal serum acetylcholinesterase

68.

What type of tube for gastric fluid collection is inserted through the mouth

a)

Rehfuss tube

b)

Levine tube

c)

Diagnex tube

d)

None of these

69.

A gastric disorder characterized by achlorhydria due to the presence of anti-parietal cell antibodies

a)

Zollinger-Ellison disease

b)

Helicobacter pylori infection

c)

Pernicious anemia

d)

Cystic fibrosis

70.

All of the following may be associated with bronchial asthma EXCEPT:

a)

Creola bodies

b)

Curschmann’s spirals

c)

Charcot-Leyden crystals

d)

Pneumoliths

71.

A sputum that is rusty-colored and filled with pus is associated with:

a)

Congestive heart failure

b)

Lobar pneumonia

c)

Tuberculosis

d)

Anthracosis

72.

CYFRA 21-1 is a tumor marker for:

a)

Uterine cancer

b)

Colon cancer

c)

Lung cancer

d)

Breast cancer

73.

This is a sensitive test for the detection of intra-abdominal bleeding:

a)

Peritoneal lavage

b)

Bronchioalveolar lavage

c)

Thoracic lavage

d)

Pericardial lavage

74.

Which of the following is the preferred urine specimen for cytology studies?

a)

Catheterized

b)

First morning

c)

Suprapubic aspiration

d)

Three-glass collection

75.

All of the following changes occur in unpreserved urine EXCEPT:

1. Decreased glucose

2. Increased pH

3. Increased ketones

4. Increased clarity

5. Incr. urobilinogen

6. Increased bacteria

a)

3, 4 and 5

b)

1, 2 and 6

c)

1, 3 and 5

d)

1, 2, 3, 4, 5 and 6

76.

Which of the following matches regarding specimen collection is/are incorrect?

1. Arthrocentesis – synovial fluid

2. Amniocentesis – amniotic fluid

3. Thoracentesis – Ascitic fluid

4. Pericardiocentesis – Pleural fluid

a)

1 and 2

b)

3 and 4

c)

1 and 3

d)

2 and 4

77.

It refers to the ability of a microscopic lens to distinguish two small objects that are a specific distance apart:

a)

Parfocal

b)

Birefringence

c)

Illumination

d)

Resolution

78.

Which type of microscopy is used to aid in identification of cholesterol in oval fat bodies, fatty casts and crystals?

a)

Polarizing

b)

Phase-contrast

c)

Interference-contrast

d)

Dark-field

79.

Given the following, identify the preanalytical errors:

1. Patient misidentification

2. Poor handwriting

3. Reagent deterioration

4. Insufficient urine volume

5. Delayed transport of urine to lab

6. Instrument malfunction

a)

1, 4 and 5

b)

2, 3 and 6

c)

1, 2 and 3

d)

4, 5 and 6

80.

Given the following, identify the preanalytical errors:

1. Patient misidentification

2. Poor handwriting

3. Reagent deterioration

4. Insufficient urine volume

5. Delayed transport of urine to lab

6. Instrument malfunction

a)

1, 4 and 5

b)

2, 3 and 6

c)

1, 2 and 3

d)

4, 5 and 6

81.

Which statement regarding renal function is true?

a)

Glomeruli are far more permeable to H2O and salt than other capillaries

b)

The collecting tubule reabsorbs sodium and secretes potassium in response to antidiuretic hormone (ADH

c)

The collecting tubule is permeable to H2O only in the presence of aldosterone

d)

The thick ascending limb is highly permeable to H2O and urea

82.

Which statement about sample collection for routine urinalysis is true?

a)

Preservative tablets should be used for collecting random urine specimens

b)

Containers may be washed and reused if rinsed in deionized H2O

c)

Samples may be stored at room temperature for up to 2 hours

d)

First morning voided samples are not acceptable when renal disease is suspected

83.

A brown or black pigment in urine can be caused by:

a)

Gantrisin (Pyridium)

b)

Phenolsulfonphthalein

c)

Rifampin

d)

Melanin

84.

Which of the following contributes to SG, but not to osmolality?

a)

Protein

b)

Salt

c)

Urea

d)

Glucose

85.

In renal tubular acidosis, the pH of urine is:

a)

Consistently acid

b)

Consistently alkaline

c)

Neutral

d)

Variable, depending upon diet

86.

The normal daily urine output for an adult is

approximately:

a)

0.2–0.5 L

b)

0.6–1.6 L

c)

2.7–3.0 L

d)

3.2–3.5 L

87.

The normal renal threshold for glucose is:

a)

70–85 mg/dL

b)

100–115 mg/dL

c)

130–145 mg/dL

d)

165–180 mg/dL

88.

Class C fires are usually caused by

a)

Wood, paper, clothing

b)

Chemicals

c)

Metals

d)

Electrical

e)

Grease, oils and fats

89.

The primary chemical constituents of normal

urine are:

a)

Protein, sodium, and water

b)

Urea, water, and protein

c)

Urea, chloride, and water

d)

Urea, bilirubin, and glucose

90.

A patient presenting with polyuria, nocturia, polydipsia,

and a high urine specific gravity is exhibiting

symptoms of what disorder?

a)

Diabetes insipidus

b)

Diabetes mellitus

c)

Urinary tract infection

d)

Uremia

91.

The physical characteristic of color is assessed when a routine urinalysis is performed. What substance is

normally found in urine that is principally responsible for its yellow coloration?

a)

Bilirubin

b)

Melanin

c)

Carotene

d)

Urochrome

92.

Patients with diabetes insipidus tend to

produce urine _____________________ in volume with

_______________specific gravity.

a)

Increased; decreased

b)

Increased; increased

c)

Decreased; decreased

d)

Decreased; increased

93.

During active transport, sodium is reabsorbed at?

a)

PCT

b)

DCT

c)

DLH

d)

ALH

e)

CD

94.

This colligative property was the first principle incorporated into clinical osmometers.

a)

Freezing point

b)

Boiling point

c)

Vapor Pressure

d)

Osmotic Pressure

95.

Which of the following statements regarding WBCs in urinary sediment is true?

a)

"Glitter cells” seen in the urinary sediment are a sign of renal disease

b)

Bacteriuria in the absence of WBCs indicates lower urinary tract infection (UTI)

c)

WBCs other than PMNs are not found in urinary sediment

d)

WBC casts indicate that pyuria is of renal, rather than lower urinary, origin

96.

Which of the following statements regarding RBCs in the urinary sediment is true?

a)

Yeast cells will lyse in dilute acetic acid but RBCs will not

b)

RBCs are often swollen in hypertonic urine

c)

RBCs of glomerular origin often appear dysmorphic

d)

Yeast cells will tumble when the cover glass is touched but RBCs will not

97.

Which condition promotes the formation of casts in the urine?

a)

Chronic production of alkaline urine

b)

Polyuria

c)

Reduced filtrate formation

d)

Low urine SG

98.

The mucoprotein that forms the matrix of a hyaline cast is called:

a)

Bence–Jones protein

b)

β-Microglobulin

c)

Tamm–Horsfall protein

d)

Arginine-rich glycoprotein

99.

Which of the following statements regarding urinary casts is correct?

a)

Fine granular casts are more significant than coarse granular casts

b)

Cylindruria is always clinically significant

c)

The appearance of cylindroids signals the onset of end-stage renal disease

d)

Broad casts are associated with severe renal tubular obstruction

100.

Urine sediment characterized by pyuria with bacterial and WBC casts indicates:

a)

Nephrotic syndrome

b)

Pyelonephritis

c)

Polycystic kidney disease

d)

Cystitis

101.

Whewellite and weddellite kidney stones are composed of:

a)

Magnesium ammonium phosphate

b)

Calcium oxalate

c)

Calcium phosphate

d)

Calcium carbonate

102.

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

a)

Alkaptone

b)

Phenylalanine

c)

5-Hydroxyindole acetic acid

d)

Homogentisic acid

103.

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

a)

Serotonin

b)

5-Hydroxytryptophan

c)

Homogentisic acid

d)

5-Hydroxyindole acetic acid

104.

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

a)

Protein

b)

Urobilinogen

c)

Bilirubin

d)

Nitrite

105.

In reporting SSA turbidity, distinct turbidity is seen with no granulation:

a)

1+

b)

2+

c)

3+

d)

4+

106.

Ascorbic acid causes false negative reactions in the following urine reagent strip except?

a)

Blood

b)

Bilirubin

c)

Leukocytes

d)

pH

107.

Ascending sequence of casts:

a)

Waxy-hyaline-coarsely granular-finely granular-cellular

b)

Coarsely granular-finely granular-hyaline-waxy-cellular

c)

Hyaline-cellular-coarsely granular-finely granular-waxy

d)

Cellular-hyaline-finely granular-coarsely granular-waxy

108.

Which of the following reagents is used to react with ketones in the urine?

a)

sodium nitroprusside

b)

acetoacetic acid

c)

acetone

d)

beta-hydroxybutyric acid

109.

A reagent strip area impregnated with stabilized, diazotized 2, 4 dichloroaniline will yield a positive reaction with:

a)

bilirubin

b)

hemoglobin

c)

ketones

d)

urobilinogen

110.

Lactose intolerance caused by the lack of sufficient lactase primarily presents with

a)

steatorrhea

b)

osmotic diarrhea

c)

secretory diarrhea

d)

intestinal hypermotility

111.

Which of the following components is not normally present in synovial fluid?

a)

Fibrinogen

b)

Neutrophils

c)

Protein

d)

Uric acid

112.

Which of the following is not a function of the amniotic fluid surrounding a developing fetus?

a)

Amniotic fluid provides protection of the fetus.

b)

Amniotic fluid enables fetal movement.

c)

Amniotic fluid is a medium for oxygen exchange.

d)

Amniotic fluid is a source of water and solute exchange.

113.

A ΔA450 value that falls into zone III indicates that the fetus is experiencing

a)

no hemolysis

b)

mild hemolysis

c)

moderate hemolysis

d)

severe hemolysis

114.

Which of the following conditions enhances the formation of serous fluid in a body cavity?

a)

Increased lymphatic absorption

b)

Increased capillary permeability

c)

Increased plasma oncotic pressure

d)

Decreased capillary hydrostatic pressure

115.

Which of the following parameters best identifies a fluid as a transudate or an exudate

a)

Color and clarity

b)

Leukocyte and differential counts

c)

Total protein and specific gravity measurements

d)

Total protein ratio and lactate dehydrogenase ratio

116.

Another name for a peritoneal effusion is:

a)

Peritonitis

b)

Lavage

c)

Ascites

d)

Cirrhosis