WorksheetsCM-8
Total questions: 120
Worksheet time: 3600secs
Name
Class
Date
1.
The Harmonic Oscillation Densitometry (H.O.D.) method for specific gravity is based on which principle?
a)
A. Frequency of a sound wave entering a solution changes in proportion to the solution’s density
b)
B. Refraction of light through the sample determines solute concentration
c)
C. Ionization of polyelectrolytes releases hydrogen ions proportional to ionic concentration
d)
D. Buoyancy principle where urinometer displacement reflects density
2.
The Harmonic Oscillation Densitometry (H.O.D.) method is currently considered:
a)
Gold standard for specific gravity
b)
Obsolete
c)
Preferred over reagent strips
d)
Used only for protein determination
3.
Which automated urinalysis system used the H.O.D. principle for determining specific gravity?
a)
A. IRIS Diagnostics Workstation
b)
B. Miles “Clinitest” Analyzer
c)
C. Beckman Coulter AU Series
d)
D. Siemens Clinitek Advantus
4.
The IRIS Diagnostics System (Models 300 and 500) requires how much urine sample volume for testing?
a)
3 mL
b)
4 mL
c)
6 mL
d)
10 mL
5.
In the IRIS Diagnostics system, how is the 6 mL urine sample allocated?
a)
A. 4 mL for slideless microscopy and 2 mL for H.O.D. (specific gravity)
b)
B. 3 mL for chemical analysis and 3 mL for microscopy
c)
C. 5 mL for reagent strips and 1 mL for confirmatory tests
d)
D. 2 mL for microscopy and 4 mL for chemical reactions
6.
The IRIS system uses Harmonic Oscillation Densitometry for which test parameter?
a)
Protein concentration
b)
Specific gravity determination
c)
pH measurement
d)
Bilirubin estimation
7.
Acidity refers to the ________ of a solution, while alkalinity refers to its ________.
a)
A. Bitterness; sourness
b)
B. Sweetness; saltiness
c)
C. Sourness; bitterness
d)
D. Sourness; sweetness
8.
Why is urine pH determination important in routine urinalysis?
a)
A. It helps identify abnormal casts
b)
B. It helps identify crystals and detect unsatisfactory specimens
c)
C. It determines the amount of glucose in urine
d)
D. It screens for ketones
9.
What is the normal urine pH range for a random sample?
a)
A. 5.0 – 6.0
b)
B. 4.5 – 8.0
c)
C. 6.0 – 9.0
d)
D. 5.0 – 7.0
10.
The normal urine pH for a first morning specimen is:
a)
A. 4.0 – 5.0
b)
B. 5.0 – 6.0
c)
C. 6.0 – 7.5
d)
D. 7.0 – 8.0
11.
A urine specimen with a pH of ≥9.0 most likely indicates:
a)
A. A patient with metabolic acidosis
b)
B. A properly preserved specimen
c)
C. An unpreserved or old specimen
d)
D. A patient on a high-protein diet
12.
A blood pH below 6.8 or above 7.8 is:
a)
A. Indicative of compensated acidosis
b)
B. Not clinically significant
c)
C. Incompatible with life
d)
D. Caused by alkaline medication
13.
The principle behind the reagent strip method for urine pH is based on a:
a)
A. Polyelectrolyte ion exchange reaction
b)
B. Protein error of indicators
c)
C. Double indicator system
d)
D. Redox reaction
14.
The reagents used for urine pH testing in reagent strips are:
a)
A. Methyl red and bromthymol blue
b)
B. Phenolphthalein and methyl orange
c)
C. Bromcresol green and methyl orange
d)
D. Tetramethylbenzidine and glucose oxidase
15.
The reaction time for the pH reagent strip test is approximately:
a)
A. 30 seconds
b)
B. 45 seconds
c)
C. 60 seconds
d)
D. 90 seconds
16.
What are possible interferences in urine pH reagent strip readings?
a)
A. Old specimens and runover from adjacent pads
b)
B. Glucose and protein concentration
c)
C. Detergent residues and high temperature
d)
D. High specific gravity and bilirubin
17.
The pH reagent pad correlates with which of the following tests?
a)
A. Glucose, ketone, bilirubin
b)
B. Nitrite, leukocyte esterase, and microscopic examination
c)
C. Protein and specific gravity
d)
D. Urobilinogen and bilirubin
18.
The alkaline tide occurs:
a)
A. During fasting, due to increased ketone production
b)
B. After meals, due to withdrawal of H⁺ ions for HCl secretion
c)
C. During exercise, due to lactic acid accumulation
d)
D. After prolonged vomiting, due to bicarbonate loss
19.
The term alkaline tide refers to:
a)
A. Temporary rise in urine acidity after eating
b)
B. Temporary rise in urine alkalinity after eating
c)
C. Constant alkaline urine pH during fasting
d)
D. Acidic urine following carbohydrate ingestion
20.
Cranberry juice contains which acid that promotes the urinary excretion of hippuric acid?
a)
Citric acid
b)
Quinic acid
c)
Lactic acid
d)
Uric acid
21.
The production of hippuric acid in urine after ingestion of cranberry juice is beneficial because it:
a)
A. Neutralizes ketones
b)
B. Inhibits uric acid crystallization
c)
C. Exerts an antibacterial effect in the urinary tract
d)
D. Increases glucose excretion
22.
The most indicative test for renal disease in routine urinalysis is the detection of:
a)
Glucose
b)
Protein
c)
Ketones
d)
Bilirubin
23.
The presence of white foam when urine is shaken indicates:
a)
Glucosuria
b)
Proteinuria
c)
Bilirubinuria
d)
Hematuria
24.
The normal reference range for urinary protein is approximately:
a)
A. <10 mg/dL or <100–150 mg/day
b)
B. <50 mg/dL or <500 mg/day
c)
C. <1 g/day
d)
D. <10 g/day
25.
According to Strasinger, the normal daily urinary protein excretion should be:
a)
A. <150 mg/day
b)
B. <100 mg/day
c)
C. <10 mg/day
d)
D. <50 mg/day
26.
According to Henry, the normal daily urinary protein excretion should be:
a)
A. <150 mg/day
b)
B. <100 mg/day
c)
C. <10 mg/day
d)
D. <50 mg/day
27.
Mild or minimal proteinuria corresponds to urinary protein excretion of:
a)
<1 g/day
b)
1–3 g/day
c)
>3–4 g/day
d)
1–3 or 4 g/day
28.
Moderate proteinuria corresponds to urinary protein excretion of:
a)
<1 g/day
b)
1–3 g/day
c)
>3–4 g/day
d)
1–3 or 4 g/day
29.
Heavy or large proteinuria is defined as protein excretion of:
a)
<1 g/day
b)
1–3 g/day
c)
>3–4 g/day
d)
1–3 or 4 g/day
30.
The major serum protein found in urine is:
a)
Fibrinogen
b)
Albumin
c)
Globulin
d)
Myoglobin
31.
What percentage of plasma albumin normally enters the glomerular ultrafiltrate?
a)
A. <0.1%
b)
B. 1–2%
c)
C. 10%
d)
D. 50%
32.
How much of the filtered protein is normally reabsorbed in the renal tubules?
a)
A. 50–60%
b)
B. 70–80%
c)
C. 95–99%
d)
D. 100%
33.
The most abundant protein in normal urine is:
a)
A. Albumin
b)
B. Tamm-Horsfall protein (uromodulin)
c)
C. Serum microglobulin
d)
D. Immunoglobulin A
34.
The Tamm-Horsfall protein is produced by which part of the nephron?
a)
A. Glomerulus
b)
B. Proximal convoluted tubule
c)
C. Thick ascending limb of loop of Henle and distal convoluted tubule
d)
D. Collecting duct
35.
Other normal urinary proteins include all except:
a)
A. Serum and tubular microglobulins
b)
B. Proteins from prostatic and vaginal secretions
c)
C. Hemoglobin
d)
D. Tamm-Horsfall protein
36.
Which of the following best explains why proteinuria is considered the most indicative of renal disease?
a)
A. It directly reflects glomerular or tubular dysfunction
b)
B. It only occurs in dehydration
c)
C. It correlates with bilirubin levels
d)
D. It is influenced by dietary protein intake
37.
Diabetes mellitus
a)
Causes of acid urine
b)
Causes of alkaline urine
38.
medications
a)
Causes of acid urine
b)
Causes of alkaline urine
39.
Acid-producing bacteria (E. coli)
a)
Causes of acid urine
b)
Causes of alkaline urine
40.
Diarrhea
a)
Causes of acid urine
b)
Causes of alkaline urine
41.
Dehydration
a)
Causes of acid urine
b)
Causes of alkaline urine
42.
Emphysema
a)
Causes of acid urine
b)
Causes of alkaline urine
43.
Cranberry juice
a)
Causes of acid urine
b)
Causes of alkaline urine
44.
High protein diet
a)
Causes of acid urine
b)
Causes of alkaline urine
45.
Starvation
a)
Causes of acid urine
b)
Causes of alkaline urine
46.
Renal tubular acidosis
a)
Causes of acid urine
b)
Causes of alkaline urine
47.
Vegetarian diet
a)
Causes of acid urine
b)
Causes of alkaline urine
48.
Presence of urease-producing bacteria
a)
Causes of acid urine
b)
Causes of alkaline urine
49.
Hyperventilation
a)
Causes of acid urine
b)
Causes of alkaline urine
50.
Old specimens
a)
Causes of acid urine
b)
Causes of alkaline urine
51.
Vomiting
a)
Causes of acid urine
b)
Causes of alkaline urine
52.
After meal
a)
Causes of acid urine
b)
Causes of alkaline urine
53.
Pre-renal or “overflow” proteinuria occurs when:
a)
Glomeruli become more permeable to albumin
b)
Excess plasma proteins enter the filtrate due to increased serum levels
c)
Tubular reabsorption of proteins is increased
d)
There is obstruction to urine flow
54.
Which of the following is not a cause of pre-renal proteinuria?
a)
Intravascular hemolysis
b)
Severe infection or inflammation
c)
Diabetic nephropathy
d)
Muscle injury
55.
Intravascular hemolysis causes pre-renal proteinuria due to increased plasma levels of:
a)
Myoglobin
b)
Hemoglobin
c)
Albumin
d)
Fibrinogen
56.
Muscle injury results in pre-renal proteinuria due to release of:
a)
Albumin
b)
Myoglobin
c)
Hemoglobin
d)
Immunoglobulins
57.
Severe infection and inflammation can cause overflow proteinuria due to increased:
a)
Acute-phase reactants (APRs)
b)
Antidiuretic hormone
c)
Hemoglobin degradation products
d)
Glomerular permeability
58.
Multiple myeloma causes pre-renal proteinuria due to excessive production of:
a)
Immunoglobulin heavy chains
b)
Immunoglobulin light chains
c)
Albumin
d)
β2-microglobulin
59.
The Bence-Jones protein (BJP) is composed of:
a)
Identical immunoglobulin heavy chains
b)
Identical immunoglobulin light chains
c)
Identical immunoglobulin constant chains
d)
Alpha and beta globulins
60.
Diagnostic confirmation of Bence-Jones proteinuria can be done by:
a)
Micral test
b)
Serum electrophoresis and immunofixation electrophoresis
c)
Reagent strip for albumin
d)
Clinitest
61.
When heating a urine specimen containing Bence-Jones protein:
a)
A. It precipitates at 100°C
b)
B. It remains clear at 40°C
c)
C. It precipitates between 40°C and 60°C and dissolves at 100°C
d)
D. It dissolves between 40°C and 60°C and precipitates at 100°C
62.
To eliminate interference from other precipitated proteins in the Bence-Jones test, the specimen should be:
a)
A. Centrifuged at 60°C
b)
B. Filtered at 100°C and observed for turbidity as it cools to 40–60°C
c)
C. Filtered at 40–60°C and observed for turbidity as it cools to 100°C
d)
D. Treated with sulfosalicylic acid
63.
A classic example of glomerular proteinuria is:
a)
Myoglobinuria
b)
Diabetic nephropathy
c)
Pyelonephritis
d)
Hematuria
64.
Persistent microalbuminuria is an early indicator of:
a)
Myoglobinuria
b)
Diabetic nephropathy
c)
Pyelonephritis
d)
Hematuria
65.
The albumin excretion rate (AER) is expressed in:
a)
mg/dL
b)
mmol
c)
µg/min
d)
mg/min/kg
66.
The albumin excretion rate (AER) can also be expressed using:
a)
mg/dL
b)
mmol
c)
mg/min/kg
d)
mg/24 hours
67.
Normal AER value:
a)
0–10 µg/min
b)
0–20 µg/min
c)
20–200 µg/min
d)
>200 µg/min
68.
Microalbuminuria corresponds to an albumin excretion rate of:
a)
0–10 µg/min
b)
0–20 µg/min
c)
20–200 µg/min
d)
>200 µg/min
69.
Clinical albuminuria corresponds to an albumin excretion rate of:
a)
0–10 µg/min
b)
0–20 µg/min
c)
20–200 µg/min
d)
>200 µg/min
70.
Microalbuminuria corresponds to an albumin excretion rate of:
a)
20–100 mg/24 hours
b)
10–200 mg/24 hours
c)
30–400 mg/24 hours
d)
30–300 mg/24 hours
71.
The Micral test for microalbuminuria is based on which principle?
a)
Enzyme-linked immunosorbent assay
b)
Enzyme immunoassay
c)
Immunochromatography
d)
Dye-binding method
72.
The Micral test employs an antibody-enzyme conjugate that binds to albumin. Which enzyme is used?
a)
Peroxidase
b)
β-galactosidase
c)
Glucose oxidase
d)
Alkaline phosphatase
73.
In the Micral test, which chromogen produces the visible color change?
a)
Tetramethylbenzidine
b)
Chlorophenol red galactoside
c)
Bromthymol blue
d)
Phenol red
74.
Positive reaction in Micral test
a)
White
b)
Purple
c)
Yellow
d)
Red
e)
Blue
75.
Negative reaction in Micral test
a)
White
b)
Purple
c)
Yellow
d)
Red
e)
Blue
76.
The Micral test for microalbuminuria uses a gold-labeled antibody and detects albumin concentrations in what range?
a)
0–5 mg/dL
b)
0–10 mg/dL
c)
10–50 mg/dL
d)
50–100 mg/dL
77.
What condition may cause a false-negative Micral test result?
a)
Proteinuria
b)
Dilute urine
c)
Alkaline urine
d)
Acidic urine
e)
Hemoglobinuria
78.
The Immunodip test for microalbuminuria is based on what principle?
a)
Immunofluorescence
b)
Immunochromatography
c)
Immunoturbidimetry
d)
Enzyme immunoassay
79.
The reagent used in the Immunodip test includes:
a)
Antibody-coated blue latex particles
b)
Gold-labeled antibody and β-galactosidase
c)
Copper sulfate and tetramethylbenzidine
d)
Bromcresol green dye
80.
The sensitivity range of the Immunodip test is:
a)
0–10 mg/dL
b)
1.2–8.0 mg/dL
c)
10–150 mg/L
d)
10–300 mg/dL
81.
The sensitivity range of the Albumin:Creatinine ratio test for albumin is:
a)
0–10 mg/dL
b)
1.2–8.0 mg/dL
c)
10–150 mg/L
d)
10–300 mg/dL
82.
The sensitivity range of the Albumin:Creatinine ratio test for creatinine is:
a)
0–10 mg/dL
b)
1.2–8.0 mg/dL
c)
10–150 mg/L
d)
10–300 mg/dL
83.
Which medication may cause a false-positive creatinine result in the Albumin:Creatinine ratio test?
a)
Cimetidine
b)
Furosemide
c)
Chlorampenicol
d)
Bacitracin
84.
Which condition may cause invalid results in the Albumin:Creatinine ratio test?
a)
A. Visibly bloody or abnormally colored urine
b)
B. High urine glucose
c)
C. Acidic urine
d)
D. Prolonged storage at 4°C
85.
false-negative Immunodip test result for microalbuminuria can occur when:
a)
A. The specimen is dilute
b)
B. The urine has Bence Jones Protein
c)
C. The strip is expired
d)
D. The urine contains radiographic dye
86.
The Albumin:Creatinine ratio (Clinitest microalbumin / Multistix-Pro) test corrects for what patient variable?
a)
Blood pH
b)
Hydration status
c)
Sodium excretion
d)
Glucose concentration
87.
The principle of the Albumin:Creatinine ratio test is:
a)
Immunoturbidimetry
b)
Immunochromotography
c)
Enzyme-linked immunosorbent assay
d)
Enzyme immunoassay
e)
Sensitive albumin test related to creatinine concentration
88.
The reagent for albumin detection in the Albumin:Creatinine ratio test is:
a)
Diiodo-dihydroxydinitrophenyl tetrabromosulfonphthalein
b)
2,4-dichloroaniline diazonium salt
c)
p-arsanilic acid, tetrahydrobenzo(h)-quinolin-3-ol
d)
Diisopropylbenzene dihydroperoxide tetramethylbenzidine
89.
The reagent for creatinine detection in the Albumin:Creatinine ratio test includes:
a)
A. Copper sulfate, tetramethylbenzidine, and diisopropylbenzenedihydroperoxide
b)
B. Gold-labeled antibody and β-galactosidase
c)
C. Antibody-coated latex particles
d)
D. Alkaline picrate
90.
BJP precipitates at
a)
40 to 60 degree Celsius
b)
20 degree Celsius
c)
100 degree Celsius
d)
40 degree Celsius
91.
BJP dissolves at
a)
40 to 60 degree Celsius
b)
20 degree Celsius
c)
100 degree Celsius
d)
40 degree Celsius
92.
Interference due to other precipitated proteins can be removed by filtering the specimen at
a)
40 to 60 degree Celsius
b)
20 degree Celsius
c)
100 degree Celsius
d)
40 degree Celsius
93.
Interference due to other precipitated proteins can be removed by observing the specimen for turbidity as it cools between
a)
40 to 60 degree Celsius
b)
20 degree Celsius
c)
100 degree Celsius
d)
40 degree Celsius
94.
A strip emplying antibody-enzyme conjugate that binds albumin
a)
Micral test
b)
Immunodip test
c)
Clinitest microalbumin strips
95.
Sensitive albumin test related to creatinine ratio
a)
Micral test
b)
Immunodip test
c)
Clinitest microalbumin strips
96.
Principle: enzyme immunoassay
a)
Micral test
b)
Immunodip test
c)
Clinitest microalbumin strips
97.
Principle: immunochromographics
a)
Micral test
b)
Immunodip test
c)
Clinitest microalbumin strips
98.
Orthostatic (postural or cyclic) proteinuria is characterized by the presence of protein in the urine:
a)
A. Only when lying down
b)
B. Only when standing
c)
C. Both when standing and lying down
d)
D. Only after meals
99.
Orthostatic proteinuria occurs due to:
a)
Increased glomerular permeability from infection
b)
Increased pressure on the renal veins while standing
c)
Increased renal tubular secretion of proteins
d)
Decreased renal blood flow when lying down
100.
In orthostatic proteinuria, increased venous pressure leads to:
a)
Decreased renal blood flow and protein retention
b)
Renal congestion and glomerular changes
c)
Tubular necrosis
d)
Protein denaturation
101.
To confirm orthostatic proteinuria, urine must be collected:
a)
A. Randomly at any time of day
b)
B. Before bed and immediately after lying down
c)
C. Immediately upon arising and again 2 hours after standing
d)
D. After fasting for 12 hours
102.
The first morning urine in orthostatic proteinuria typically shows:
a)
Heavy proteinuria
b)
Trace proteinuria
c)
No proteinuria
d)
Increased specific gravity
103.
The second urine specimen (2 hours after standing) in orthostatic proteinuria typically shows:
a)
Absence of protein
b)
Presence of protein
c)
Glucosuria
d)
Increased urea
104.
Which of the following is not a cause of persistent proteinuria?
a)
Nephrotic syndrome
b)
Pre-eclampsia
c)
Strenuous exercise
d)
Orthostatic posture
105.
The condition characterized by generalized edema, heavy proteinuria, and lipiduria is:
a)
Pyelonephritis
b)
Nephrotic syndrome
c)
Fanconi’s syndrome
d)
Post-renal proteinuria
106.
Tubular proteinuria was originally discovered among workers exposed to:
a)
Mercury
b)
Cadmium dust
c)
Lead
d)
Arsenic
107.
The key mechanism in tubular proteinuria is:
a)
A. Increased glomerular permeability
b)
B. Decreased reabsorption of filtered proteins by renal tubules
c)
C. Overproduction of abnormal plasma proteins
d)
D. Decreased glomerular filtration rate
108.
In tubular proteinuria, which protein is normally filtered but no longer reabsorbed?
a)
Globulin
b)
Albumin
c)
Bence Jones protein
d)
Tamm-Horsfall protein
109.
Fanconi’s syndrome is an example of which category of proteinuria?
a)
Pre-renal
b)
Glomerular
c)
Tubular
d)
Post-renal
110.
Causes of tubular proteinuria include all except:
a)
Viral infections
b)
Heavy metal exposure
c)
Severe dehydration
d)
Fanconi’s syndrome
111.
Post-renal proteinuria originates from:
a)
Glomerular inflammation
b)
Tubular dysfunction
c)
Lower urinary tract inflammation or injury
d)
Systemic overproduction of proteins
112.
Which of the following may cause post-renal proteinuria?
a)
Nephrotic syndrome
b)
Multiple myeloma
c)
Menstrual contamination
d)
Fanconi’s syndrome
113.
Proteinuria resulting from urinary tract infection or trauma is classified as:
a)
Pre-renal proteinuria
b)
Glomerular proteinuria
c)
Tubular proteinuria
d)
Post-renal proteinuria
114.
First morning urine protein in Orthostatic proteinuria
a)
Positive
b)
Negative
115.
First morning urine protein in Clinical proteinuria
a)
Positive
b)
Negative
116.
2 hours after standing protein in Clinical proteinuria
a)
Positive
b)
Negative
117.
2 hours after standing protein in Orthostatic proteinuria
a)
Positive
b)
Negative
118.
Which of the following may cause Orthostatic proteinuria?
a)
Infectious mononucleosis
b)
Pre-eclampsia
c)
Lower UTI
d)
Fanconi syndrome
119.
Cadet proteinuria
a)
Orthostatic Proteinuria
b)
Tubular proteinuria
c)
Post-renal proteinuria
d)
Pre-renal proteinuria
120.
Postural proteinuria
a)
Orthostatic Proteinuria
b)
Tubular proteinuria
c)
Post-renal proteinuria
d)
Pre-renal proteinuria
100 %
