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WorksheetsMEDL 279 Urinalysis Review
Total questions: 98
Worksheet time: 49mins
What is the major functional unit of the kidney?
Glomerulus
Nephron
Tubule
Urea
Approximately how many nephrons are there per kidney?
100,000
500,000
1 million
10 million
The glomerulus is composed of a coil of ______ vessels.
capillary
artery
vein
lymphatic
Which of the following substances are filtered by the glomerulus?
All answers are correct
Urea
Water
Glucose
What is the normal average urine volume per day?
500-800 mL
1200-1500 mL
2000-2500 mL
3000-3500 mL
Polyuria is defined as urine output greater than ______ mL/day.
2500
1000
1500
3500
Oliguria is defined as urine output less than ______ mL/day.
500
1000
200
1500
Anuria means ______ cessation of urine output.
complete
partial
intermittent
frequent
Which of the following is a metabolic waste product produced in the liver from protein breakdown?
Uric acid
Urea
Creatinine
Chloride
Which inorganic solid is the primary constituent in urine?
Urea
Creatinine
Chloride
Glucose
Which hormone is produced by the adrenal cortex and increases the rate of Na+ reabsorption?
Aldosterone
Arginine Vasopressin (ADH)
Erythropoietin (EPO)
Insulin
Fill in the blank: Arginine Vasopressin (ADH) is produced by the ________ and is responsible for the reabsorption of water from the distal tubules.
Posterior Pituitary Gland
Anterior Pituitary Gland
Adrenal Cortex
Thyroid Gland
Which hormone stimulates the production of RBCs?
Aldosterone
Arginine Vasopressin (ADH)
Erythropoietin (EPO)
Insulin
Which urine collection method is the most common specimen type and is easiest to collect?
First Morning
Random
Catheterization
Pediatric
Fill in the blank: The first voided specimen upon wakening is called the ________ specimen.
First Morning
Random
Midstream Clean Catch
24-hour
Which urine collection method is the specimen of choice for bacterial culture?
Random
First Morning
Midstream Clean Catch
Pediatric
What is the main advantage of suprapubic aspiration as a urine collection method?
Easiest to collect
Avoids external contamination, optimum for bacterial culture
Most common specimen type
Bag checked every 15min
Fill in the blank: In catheterization, a catheter is inserted directly into the bladder via the ________.
urethra
esophagus
trachea
rectum
Which urine collection method involves collecting urine over a 24-hour period and discarding the first specimen?
24-hour Urine
Random Urine Collection
Clean-catch Midstream Collection
First Morning Specimen
What is the recommended time frame to analyze urine specimens after collection?
Within 1 hour
Within 2 hours
Within 4 hours
Within 24 hours
Which of the following increases due to bacterial growth in urine specimens?
Glucose
Nitrite
Ketones
Bilirubin
What is the preservation method of choice for urine specimens for up to 24 hours?
Refrigeration
Freezing
Adding formalin
Boiling
Which odor is associated with Maple syrup urine disease?
Fruity
Ammonia
Mousy
Maple syrup
Normal urine is clear.
True
False
What gives urine its color?
Urochrome
Hemoglobin
Chlorophyll
Melanin
Normal urine is slightly acid with a pH of _____
pH 6.0
pH 8.0
pH 4.0
pH 9.5
After removal from the refrigerator, what should be done before testing a urine specimen?
Let sample return to room temp before testing
Add preservatives to the sample
Shake the sample vigorously
Test immediately while cold
What is the normal specific gravity (SG) range for urine?
1.000-1.010
1.002-1.035
1.040-1.050
1.035-1.045
Which of the following is the best single indicator of renal abnormality?
Glucose
Proteinuria
Ketones
Bilirubin
If the specific gravity (SG) is higher than 1.035, how should the urine be diluted for measurement?
Dilute the urine 1:2 with distilled water and multiply the last two digits of the result by 2.
Dilute the urine 1:5 with saline and multiply the result by 5.
Dilute the urine 1:10 with tap water and multiply the result by 10.
Do not dilute the urine and record the value as is.
Which of the following can cause a false positive result in the dipstick protein test?
Highly acidic urine
Highly alkaline urine
Low specific gravity
Low protein concentration
What is the color change observed when the dye's spectrum is shifted in the dipstick protein test?
The color changes from yellow to green.
The color changes from blue to red.
The color changes from green to orange.
The color changes from red to yellow.
Which method is more sensitive to albumin than globulin in urine protein testing?
Dipstick method
Sulfosalicylic acid test
Biuret method
Heat coagulation test
What is microalbuminuria detected by?
Sensitive albumin tests (level too low to be detected by reagent strip)
Urine glucose test
Serum creatinine measurement
Blood pressure monitoring
Periodic monitoring of microalbuminuria benefits patients with which conditions?
Diabetes, hypertension, and peripheral vascular disease
Asthma, eczema, and allergic rhinitis
Osteoarthritis, osteoporosis, and gout
Migraine, epilepsy, and Parkinson's disease
What is the renal threshold for glucose analyzed by dipstick in diabetes?
160-180 mg/dL
80-100 mg/dL
200-220 mg/dL
300-320 mg/dL
Which enzyme is the principle for glucose dipstick tests?
Glucose oxidase
Amylase
Urease
Lactase
Which of the following can cause a false positive in the dipstick test for glucose?
Ascorbic acid
Oxidizing agents (bleach)
Fructose
Galactose
The principle of the Clinitest tablet is based on which chemical reaction?
Benedict's copper reduction test (CuSO4 + NaOH + reducing substance = Cu2O)
Biuret reaction (protein + CuSO4 in alkaline medium = violet color)
Jaffe reaction (creatinine + picric acid in alkaline medium = orange-red complex)
Salkowski reaction (cholesterol + sulfuric acid = red color)
Which sugars can give false positive results in the Clinitest tablet?
Galactose, lactose, fructose, maltose, and pentose
Sucrose, starch, cellulose, and glycogen
Glucose, ribose, and deoxyribose only
Mannose, raffinose, and trehalose
What is the principle of ketone detection by dipstick and tablets?
Sodium nitroprusside + ketone = purple color
Benedict's reagent + ketone = blue color
Fehling's solution + ketone = red color
Biuret reagent + ketone = green color
Which test is specific for diacetic acid in urine analysis?
Dipstick
Acetest tablets
Both A and B
None of the above
What can cause a false positive result in urine analysis due to interference?
Highly pigmented urine
Levodopa metabolites
Both A and B
None of the above
What is the principle of the 2-step enzymatic procedure for blood detection in urine?
Peroxide on strip + blood = O2
O2 + Oxidase = color change
Both A and B
None of the above
Which agents can interfere and cause false positive results in blood detection in urine?
Bleach
Other oxidizing agents
Both A and B
None of the above
Hematuria is associated with which of the following?
Systemic bleeding disorders
Renal diseases
Cystitis, calculi, and strenuous exercise
All of the above
What is the principle of the bilirubin test in urine analysis?
Diazo reaction: diazonium salt + bilirubin = bluish purple color
Peroxide reaction
Acetest reaction
None of the above
Which of the following can cause false negatives in the bilirubin test?
Ascorbic acid
Nitrite
Both A and B
None of the above
Bilirubinuria is associated with ______ and liver damage.
bile duct obstruction
pancreatic insufficiency
renal failure
gallstone dissolution
What is the normal value of urobilinogen in urine?
0.5 mg/dL or less
1 mg/dL or less
2 mg/dL or less
5 mg/dL or less
Nitrite reacts with amine reagent at acidic pH to form which type of compound?
Pyrrole compound
Diazoniun compound
Ester compound
Urobilinogen
Which compound reacts with 3-hydroxy-1,2,3,4 tetrahydrobenz (h)-quinoline to produce a pink color?
Nitrite
Leukocyte esterase
Urobilinogen
Bilirubin
Which of the following is NOT a cause of false negative nitrite test?
A) Lack of dietary nitrate
B) Urine not in the bladder long enough
C) Bacteria are present but not nitrate reducers
D) Excessive protein in urine
E) Ascorbic acid on some older strips
Any shade of pink in the nitrite test is considered to represent a clinically significant amount of _________
bacteria
glucose
protein
ketones
Leukocyte esterase splits an ester to form a pyrrole compound which reacts with a diazo reagent to produce a ________ color.
purple
green
yellow
red
Positive reactions in the leukocyte esterase test indicate the presence of ________ (pyuria).
leukocytes
erythrocytes
proteins
glucose
Normal urine sediment includes which of the following?
0-2 RBC/hpf
0-5 WBC/hpf
0-2 hyaline casts/lpf
Slight mucus
All of the above
Abnormal urine sediment: RBCs may indicate ________ damage or menstrual contamination.
glomerular
tubular
vascular
interstitial
WBCs in abnormal urine sediment may indicate ________ or infection (pyuria).
inflammation
dehydration
allergy
malnutrition
Casts in urine sediment are cylindrical forms having ________ sides and are formed in the lumen of the distal convoluted tubule and collecting duct.
parallel
curved
irregular
tapered
What is the major constituent of casts in urine?
Albumin
Uromodulin (Tamm Horsfall protein)
Hemoglobin
Myoglobin
Which of the following is NOT a factor that influences cast formation?
Low pH
High output
High solute concentration
High protein
Fill in the blank: The most frequently seen type of cast is _________.
Hyaline
Granular
Waxy
Fatty
Which type of cast is primarily composed of uromodulin protein?
RBC cast
WBC cast
Hyaline cast
Granular cast
RBC casts in urine are diagnostic of which condition?
Intrinsic renal disease
Pyelonephritis
Chronic renal disease
Renal failure
WBC casts in urine are associated with which condition?
Glomerular dysfunction
Pyelonephritis
Renal failure
Chronic renal disease
Which type of cast indicates prolonged urinary stasis and is considered a sign of renal failure?
Hyaline cast
Waxy cast
Granular cast
Broad cast
Broad casts form in which part of the nephron?
Proximal tubule
Loop of Henle
Collecting ducts
Distal tubule
Crystals in urine are formed by the precipitation of urine solutes subjected to changes in ________, temperature, and concentration.
pH
volume
pressure
color
Which of the following is a normal crystal found in acid urine?
Amorphous urate
Calcium oxalate
Cystine
Struvite
What shape is calcium oxalate crystal?
Enveloped shaped
Needle shaped
Hexagonal shaped
Dumbbell shaped
Calcium oxalate crystals may be seen in ______ poisoning.
antifreeze
paracetamol
aspirin
lead
Which of the following is a type of crystal found in alkaline urine?
Amorphous phosphate
Bilirubin
Cystine
Tyrosine
Triple phosphates in urine are described as having a ______ lid appearance.
coffin
glass
box
bottle
Which abnormal crystal is described as colorless hexagonal plates?
Bilirubin
Cystine
Cholesterol
Leucine
Cholesterol crystals in urine are described as ______ plates with notched corners.
rectangular
hexagonal
oval
circular
Leucine crystals are yellow brown spheres with ______ circles or radial striations.
concentric
eccentric
parallel
spiral
Bacteria in urine are most commonly present as ______ shaped.
rod
spherical
spiral
comma
Yeast in urine most often represents a ______ infection and must correlate with clinical findings.
vaginal
urinary tract
respiratory
skin
Which of the following produces large intracellular inclusions in RTE cells?
Rubella
CMV
Lead poisoning
Herpes
What is the hormone used as a marker for confirming pregnancy in pregnancy testing?
Human chorionic gonadotropin (hCG)
Progesterone
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
At what time can hCG be detected earliest for pregnancy testing?
1-2 days
8-10 days
2-3 weeks
4-5 weeks
Which specimen is preferred for pregnancy testing?
Random urine specimen
First morning specimen
Afternoon specimen
Evening specimen
Which of the following is NOT a test for glomerular filtration?
Clearance tests
B2-Microglobulin
Cystatin C
Hemoglobin
What is the most commonly used clearance test to assess GFR?
Creatinine Clearance Test
Urea Clearance Test
Inulin Clearance Test
PAH Clearance Test
(U x V / P) This equation allows the technician to figure?
Creatinine Clearance
Glomerular Filtration Rate
Blood Urea Nitrogen
Serum Albumin
What is the normal creatinine clearance value for adults?
120 ml/min
60 ml/min
200 ml/min
30 ml/min
Which marker is useful for renal tubular function and increases in plasma concentration when GFR is reduced?
Creatinine
B2-Microglobulin
Cystatin C
Hemoglobin
What is a disadvantage of using Cystatin C for GFR detection?
Higher cost than creatinine clearance
It is less sensitive than creatinine
It is not affected by age or sex
It is only useful in pediatric patients
What are the microscopic findings for Acute Glomerulonephritis?
Gross hematuria, Smoky turbidity, RBC casts, Waxy
Fatty casts, Oval fat bodies, Maltese cross
Eosinophiluria, White blood cell casts, Pyuria
Hyaline casts, Broad casts, Granular casts
What are the microscopic findings for Chronic Glomerulonephritis?
Hematuria, all types of casts, but only Occ to few RBC casts
Proteinuria, fatty casts, and oval fat bodies
Eosinophiluria and white cell casts
Granular casts and hyaline casts only
What are the microscopic findings for Acute pyelonephritis?
Turbid, Pos Nitrite, Pos Leukocyte esterase, WBC casts, Bacteria
Clear, Neg Nitrite, Neg Leukocyte esterase, RBC casts, No bacteria
Turbid, Pos Glucose, Pos Protein, Eosinophils, No bacteria
Clear, Pos Ketones, Neg Leukocyte esterase, Hyaline casts, No bacteria
What are the microscopic findings for Chronic pyelonephritis?
Pos Nitrite, Pos Leukocyte Esterase, All types of casts, but Occ to few WBC Casts
Red blood cell casts, heavy proteinuria, and oval fat bodies
Large numbers of eosinophils and granular casts
Abundant uric acid crystals and calcium oxalate stones
What are the microscopic findings for Nephrotic Syndrome?
May see free fat droplets, fatty casts, oval fat bodies
Presence of red blood cell casts
Granulomatous inflammation with caseating necrosis
Glomerular crescents in Bowman's space
What are the microscopic findings for Cystitis/Lower UTI?
Bacteria: WBC's
Red blood cells only
Epithelial cells predominance
Crystals and casts
The innermost portion of the kidney.
renal capsule
renal cortex
renal medulla
renal pyramids
How can urine clarity be described when it contains many particles?
Clear
Cloudy
Colored
Transparent
How does the kidney respond to a high intake of fluid in terms of urine production, and what mechanisms are involved in this response?
Decreases urine production by increasing ADH secretion
Increases urine production by decreasing ADH secretion
Increases urine production by increasing ADH secretion
Decreases urine production by decreasing ADH secretion
