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WorksheetsMLT 1203 Clinical Microscopy Exam 2 Review Ch 6-10
Total questions: 72
Worksheet time: 12mins
Which would compromise the proper care of reagent strips?
Checking the expiration date
Storing in a clear container
Preventing exposure to toxic fumes
Storing with a desiccant
Reagent strip chemical tests may be inaccurate if the specimen is:
Mixed before delivery
Tested immediately after refrigeration
Tested immediately after it is voided
Collected by catheter
Quality control must be
Run at the beginning of each shift
Run only when a new bottle is opened
Run once a week
Run using distilled water
The principle of the reagent strip test for pH is:
A. A double indicator reaction
B. The protein error of indicators
C. The diazo reaction
D. A Greiss reaction
The normal range of urine pH is:
4.5 to 6.0
5.0 to 7.0
4.5 to 8.0
4.5 to 9.0
A urine specimen with a pH of 9.0 indicates that the patient should be:
Tested further for metabolic or respiratory alkalosis
Changed to a high meat diet to lower the pH
Placed on medication to lower the pH
Asked to collect a new specimen
Which of the following is a cause of prerenal proteinuria?
Prostatitis
Multiple myeloma
Preeclampsia
Diabetes mellitus
15. The protein section of the reagent strip is most sensitive to:
Albumin
Globulin
Hemoglobin
Myoglobin
To detect the presence of early renal disease, diabetic patients are tested for:
Bence Jones protein
Microalbuminuria
Orthostatic protein
Glucose and ketones
A possible cause of postrenal proteinuria is:
Prostatitis
Multiple myeloma
Glomerulonephritis
Posture
The principle of the reagent strip test for protein is the:
Acid precipitation of protein
Salting out of proteins
pH effect on bromothymol blue
Protein “error of indicators”
Which of the following best describes the chemical principle of the protein reagent strip?
Protein reacts with an immune complex on the pad, which results in a color change.
Protein causes a pH change on the reagent strip pad that results in a color change.
Protein accepts hydrogen ions from an indicator dye, which results in a color change.
Protein causes protons to be released from a polyelectrolyte, resulting in a color change.
Microalbumin tests are frequently used to screen patients with:
Fanconi’s syndrome
Porphyrinuria
Diabetes mellitus
Diabetes insipidus
The chemical reaction for the reagent strip reaction for glucose uses a:
Double sequential enzyme reaction
Sodium nitroprusside reaction
Diazonium salt reaction
Pyrrole amino acid ester reaction
Which of the following will not interfere with glucose detection in a urine specimen?
Galactose
Ascorbic acid
Bleach
Old specimen
While performing a Clinitest, you observe that the color changes rapidly from blue to orange and then back to blue. You should:
Report the test as negative, because the final reaction color is blue
Report the test as negative, because the brief orange color was contamination
Repeat the test using fewer drops of urine to check for “pass through”
Repeat the test using more drops of urine to prevent “pass through”
Which of the following is not a ketone produced in normal adult metabolism?
Acetone
Phenylketones
Acetoacetic acid
Beta-hydroxybutyric acid
Reagent strip reactions for ketones react primarily with:
Acetone
Acetoacetic acid
Beta-hydroxybutyric acid
Phenylacetone
Excessive fat metabolism is indicated by the urinary presence of:
Cholesterol
Glucose
Ketones
Protein
Sodium nitroprusside and an alkaline buffer are used to test for:
Bilirubin
Ketones
Glucose
Protein
Reagent strip reactions for blood are based on the:
Peroxidase activity of hemoglobin
Oxidation of hemoglobin peroxidase
Reaction of hemoglobin with bromothymol blue
Reduction of a chromogen by hemoglobin
Myoglobinuria may be caused by:
A. A “crushing” injury
B. Incompatible blood transfusions
C. Chronic renal disease
D. Biliary obstruction
The chemical principle of the reagent strip test for bilirubin is that bilirubin:
Causes a color change when it binds to a buffered pH indicator
Combines with a diazonium salt to form a colored complex
Is oxidized to biliverdin
Causes a pH change detected by the reagent pad indicator
Ascorbic acid interferes with the reactions for bilirubin and nitrite by:
Reducing the oxidized chromogen
Binding with the diazonium salt
Neutralizing the buffer
Oxidizing the aromatic amine
Urobilinogen is formed from the:
Conjugation of bilirubin in the liver
Reduction of conjugated bilirubin in the bile
Reduction of bilirubin by intestinal bacteria
Oxidation of urobilin by intestinal bacteria
Tests for nitrite tend to be positive:
When gram-positive bacteria are present
When the urine sits in the bladder for less than 2 hours
When gram-negative bacteria are present
When a renal transplant rejection occurs
The reagent strip test for nitrite is based on the:
Reduction of urea
Reaction of nitrite with the cell wall of gram-negative bacteria
Reduction of nitrate in urine to nitrite by bacteria
Reaction of bacterial nitrite with an aromatic amine to produce a pH change
Reagent strip reactions for white blood cells are based on the detection of:
Bacterial peroxidase activity
Esterase activity
Reduction of indoxyl blue
Binding of a diazonium salt
A false-negative LE reaction may be caused by:
The presence of eosinophils and basophils
Increased bacteria
Lysed leukocytes
Failure to wait 2 minutes to read the reaction
In review of the following results, what do the results most likely suggest?
The results most likely suggest a significant correlation.
The results most likely suggest no relationship.
The results most likely suggest a measurement error.
The results most likely suggest a random occurrence.
Given the following urinalysis results: Clarity: Clear Specific gravity: 1.028 pH: 5.0 Glucose: Negative Ketones: Large Bilirubin: Negative Urobilinogen: 0.2 Nitrite: Negative Leukocyte esterase: Negative Which of the following is most likely?
A. A child with uncontrolled diarrhea and vomiting
B. An uncontrolled diabetic patient
C. An adult maintaining adequate fluid intake
D. A woman with a urinary tract infection
What do the urine results suggest? Color: Yellow Clarity: Cloudy Specific gravity: 1.019 pH: 8.0 Protein: Trace Glucose: Negative Ketones: Negative Bilirubin: Negative Blood: Negative Urobilinogen: 0.1 EU Nitrite: Positive Leukocyte esterase: Positive
Diabetes mellitus
Unsatisfactory specimen
Urinary tract infection
Normal female specimen
The urinalysis result most closely associated with renal disease is a positive:
Bilirubin
Glucose
Nitrite
Protein
The recommended centrifugation setting for preparation of the urine sediment is:
400 RPM for 10 minutes
1,000 RPM for 5 minutes
400 RCF for 5 minutes
1,000 RCF for 10 minutes
The purpose of scanning the perimeter of urine sediment placed under a conventional glass slide is to:
Identify types of casts
Detect renal tubular epithelial cells
Evaluate the overall sediment composition
Detect the presence of casts
Which of the following are reported as the quantity per low-power field?
Casts
Red blood cells
White blood cells
Bacteria
Substances found in the urinary sediment that can be confirmed using polarized light are:
WBCs
Yeast
Ketone bodies
Lipids
Identification of oval fat bodies can be verified using:
Bright-field microscopy
Phase contrast
Polarized light
Interference-contrast microscopy
Using a bright-field microscope, the final magnification of a high-power field is:
10×
40×
400×
1,000×
To increase the probability of detecting urine sediment constituents that have a low refractive index, clinical laboratories often use:
Phase-contrast microscopy
Polarizing microscopy
Interference-contrast microscopy
Bright-field microscopy
The presence of crenated RBCs in the urine sediment is associated with:
Trauma
Hypersthenuria
Hyposthenuria
Urinary tract infection
Glitter cell is a term used to describe a specific type of:
Ketone body
Renal tubular epithelial cell
Neutrophil
Oval fat body
An increase in urinary WBCs is called:
Pyelonephritis
Cystitis
Urethritis
Pyuria
Urine sediments containing increased WBCs should be observed closely for the presence of:
Hyaline casts
Granular casts
Eosinophils are found in the urine in cases of:
Nephrotic syndrome
Cystitis
Acute interstitial nephritis
Renal lithiasis
The type of cells that line the bladder and ureters are called:
Squamous
Renal tubular
Transitional
Basal
In ascending order, the location of epithelial cells in the urinary tract is:
Squamous, transitional, renal tubular
Transitional, renal tubular, squamous
Renal tubular, transitional, squamous
Squamous, renal tubular, urothelial
Which of the following cells found in increased numbers in the urine sediment is only indicative of nephron damage?
Erythrocytes
WBCs
Squamous epithelial cells
Renal tubular cells
Collection of a midstream clean-catch specimen will alleviate contamination by:
Renal tubular epithelial cells
RBCs
Transitional epithelial cells
Squamous epithelial cells
Which of the following cells can be found in both a vaginal wet prep and in urine sediment?
Yeast cell and clue cell
Transitional and renal epithelial cell
Clue cell and hyaline casts
Renal and squamous cells
The primary factor that favors the formation of urinary casts is:
Urinary stasis
High pH
Positive blood
Low specific gravity
The major constituent of urinary casts is:
Lipoprotein
Bence Jones protein
Uromodulin protein
Amino acids
Sediment constituents that are used to differentiate between upper and lower urinary tract infections are:
WBCs
Bacteria
RBCs and WBCs
WBC casts
Waxy casts can be found in the urine sediment:
In patients with renal failure
Of an alkaline urine
Whenever abnormal protein is present
When urine is not correctly preserved
the:
RBC
RBC cast
WBC cast
Hyaline cast
To distinguish a cellular cast from a clump of cells, the clinical laboratory scientist should:
Check for dysmorphic cells
Look carefully for a cast matrix
Determine whether free-standing cells are present
Examine the sediment using polarizing microscopy
Nonpathogenic or “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 carbonate, bilirubin
Which of the following crystals can usually be found in an alkaline urine?
Cholesterol
Tyrosine
Cystine
Ammonium biurate
Abnormal crystals are most frequently seen in urine that is:
Acid
Neutral
Alkaline
Collected for 24 hours
Crystals found in the urine that are associated with pathogenic disease include:
Calcium oxalate and uric acid
Leucine and tyrosine
Heavy amorphous phosphates
Triple phosphate and ammonium biurate
Which of the following crystals is associated with ethylene glycol (Antifreeze) ingestion?
Uric acid
Calcium oxalate monohydrate
Triple phosphate
Calcium oxalate dihydrate
Which crystal appears to have notched corners?
Ammonium biurate
Cholesterol
Diseases affecting the glomerulus are primarily caused by:
Trauma
Diabetes
Immunological disorders
Toxic chemicals
Which does not cause damage to the glomerulus?
Increased filtration of electrolytes
Deposition of immune complexes
Deposition of amyloid materials
Cellular infiltration
The presence of which of the following crystals can be associated with nephrotic syndrome?
Cholesterol
Tyrosine
Cystine
Ampicillin
Oval fat bodies and fatty casts are characteristic urine sediment constituents in patients with:
Chronic glomerulonephritis
Acute interstitial nephritis
Nephrotic syndrome
Wegener’s granulomatosis
Which inherited renal disorder manifests itself in the development of gout in teenage years?
Fanconi syndrome
Diabetes mellitus
Uromodulin-associated kidney disease
Chronic glomerulonephritis
Which of the following renal disorders is most likely to be inherited?
Nephrotic syndrome
Acute interstitial nephritis
Acute tubular necrosis
Fanconi syndrome
The presence of increased renal tubular epithelial cell casts is most indicative of:
Nephrotic syndrome
Fanconi syndrome
Acute tubular necrosis
Acute pyelonephritis
Infection of the bladder is termed:
Pyelitis
Nephritis
Cystitis
Bacteriuria
Cystitis can be differentiated from pyelonephritis by:
Performing a cystoscopy
The presence of white blood cell casts
Performing blood cultures
The presence of bacteriuria
The finding of bacterial casts can be associated with:
Acute pyelonephritis
Acute interstitial nephritis
Cystitis
Acute glomerulonephritis
