CHEM 08 - UA and Body Fluids

The primary constituent of hyaline casts is:

A)  albumin
B)  Tamm Horsfall protein
C)  immunoglobulin light chains
D)  mucus

Isosthenuria is the inability of the kidney to alter the specific gravity of the glomerular filtrate. Such a urine sample would be associated with a specific gravity:

A)  fixed at around 1.020
B)  between 1.020 and 1.030
C)  fixed at around 1.010
D)  between 1.010 and 1.020

The colorimetric reagent strip test for protein is most sensitive towards:

A)  Globulins
B)  Albumin
C)  Tamm Horsfall protein
D)  Dipeptides
E)  Free light chains

The first morning urine specimen is the optimum specimen for routine urinalysis because

A)  it is not altered by diet or medication.
B)  the specimen can be collected at a consistent time.
C)  it is the most concentrated.
D)  it is the freshest specimen.

A positive test for bilirubin on a reagent strip should be confirmed by:

A)  requesting a new specimen.
B)  performing an Ictotest
C)  performing a microscopic exam.
D)  performing a urobilinogen.

The diluting and concentrating ability of the kidneys may be measured by performing which of the following urine tests?

A)  Urine creatinine
B)  24 hour urine volume
C)  Urine specific gravity
D)  Urine sodium

On microscopic examination of a urinary sediment, round refractile globules are noted in cells encapsulated within a hyaline matrix. A polarized light microscopic exam of the urinary structure showed the globules to be birefringent in the shape of Maltese crosses. These urinary structures can be identified as:

A)  crystal casts associated with calculi
B)  white cell casts with phagocytosed fat globules
C)  waxy casts with advanced tubular atrophy
D)  fatty casts containing lipidladenrenal tubular cells

Which of the following casts is indicative of more severe renal disease?

A)  waxy
B)  cellular
C)  granular
D)  hyaline

White blood cell casts are most likely to indicate disease of the:

A)  urethra
B)  bladder
C)  genital tract
D)  kidney

Which of the following reagent strip tests can be affected by ascorbic acid, resulting in falsely low or negative results?

A)  blood
B) blood and glucose
C)  bilirubin
D)  nitrite
E)  glucose
F)  all are affected

The glucose specificity of the double sequential enzyme reaction used on reagent strip tests is due to the use of

A)  gluconic acid.
B)  peroxidase.
C)  hexokinase.
D)  glucose oxidase.

Select the best answer for the body in this image.




A)  oval fat bodies
B)  triglyceride droplets
C)  glitter cells
D)  disintegrating white cells

(T/F) Trichomonads in the urine should only be positively identified if they are motile, since they can be easily confused with white blood cells.
True False

A: Triple phosphate

The principle of the colorimetric reagent strip test for hemoglobin is based on the peroxidase activity of hemoglobin in catalyzing the oxidation of a dye with peroxide to form a colored compound. This method may yield false negative results for the presence of hemoglobin when the urine specimen contains:

A)  Myoglobin
B)  Ascorbic acid
C)  Tetracycline
D)  Nitrate

(T/F) The term oliguria refers to excessive urine output.
True False

Recurrent arthritis caused by crystalized urates in joint tissue and synovial fluid is called

A)  gout.
B)  rheumatoid arthritis.
C)  hyperuricemia.
D)  Lesch Nyhan disease.

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

A)  Increased lymphatic circulation
B)  Increased plasma oncotic pressure
C)  Increased capillary permeability
D)  Increased plasma protein

Which of the following conditions would more likely be associated with the formation of a transudate?

A)  Pancreatitis
B)  Metastatic neoplasm
C)  Congestive heart failure
D)  Pneumonia

(T/F) Glucose levels in CSF are roughly 60% of serum glucose levels.
True False

The following uric acid related crystals are more likely to be found in acidic urine EXCEPT

A)  monosodium urate.
B)  uric acid.
C)  amorphous urates.
D)  ammonium biurate.

A normal urinalysis except for specific gravity of 1.049 would most likely represent

A)  hypoaldosteronism.
B)  SIADH.
C)  dehydration.
D)  radiographic dye.

(T/F) A patient with an acute hemolytic process would likely have negative urine bilirubin and increased urine urobilinogen.
True False

(T/F) A patient with cholestatic jaundice would likely show increased urine bilirubin and normal urine urobilinogen.
True False

A urine specimen kept at room temperature overnight in a specimen pickup box would most likely show what changes in the following

+pH
+blood (dipstick)
+rbcs (microscopic)
+glucose
+bacteria

-increase
-decrease
-no change

The property of matter which depends upon the polarization and direction of light is

A)  specific gravity.
B)  fluorescence polarization.
C)  refractive index.
D)  birefringence.

Fetal fibronectin is a marker to assess

A)  premature labor.
B)  fetal lung maturity.
C)  gestational age.
D)  erythroblastosis fetalis.

All of the following are tests that assess fetal lung maturity EXCEPT

A)  L/S ratio.
B)  phosphatidylglycerol.
C)  Lamellar body count.
D)  delta OD 450.

Match the testing that should be performed on the CSF tube number (#1 collected first)

+Cell count and differential
+CSF protein
+Gram Stain

(T/F) The test for CSF total protein most commonly uses the biuret reaction with a larger sample volume than for serum.
True False

The delta OD 450 test is used to

A)  evaluate fetal lung maturity by measuring light scatter of amniotic fluid lamellar bodies
B)  evaluate potential hemolytic disease of the newborn by determining amniotic fluid bilirubin
C)  evaluate potential hemolytic disease of the newborn by determining amniotic fluid hemoglobin
D)  evaluate fetal lung maturity by measuring absorbance of amniotic fluid lamellar bodies

For each descriptor on the left, which is more likely, exudate or transudate?

+Caused by increased hydrostatic pressure
+More likely to include white blood cells
+Peritoneal infection
+Total protein (fluid) = 2.2 gm/dL

Which of the following crystal types is LEAST likely to be observed in alkaline urine?

A)  calcium carbonate
B)  triple phosphate
C)  calcium oxalate
D)  calcium phosphate

The single most diagnostic finding in acute glomerular disease is

A)  albuminuria.
B)  dysmorphic rbcs.
C)  proteinuria >3.0 gm/24 hrs.
D)  increased urine rbcs.

The "bumpy" objects present in this image are




A)  wbcs
B)  crenated rbcs
C)  ragweed pollen
D)  hemolyzed rbcs (rbc ghosts)

The object defined by the arrows is a




A)  waxy cast.
B)  cellular cast.
C)  granular cast.
D)  mucus.
E)  hyaline cast.

A)  bacterial rods.
B)  yeast.
C)  bacterial rods.
D)  mucus threads.

A)  waxy cast.
B)  granular cast.
C)  lipid cast.
D)  hyaline cast.

Detection of oligoclonal bands in CSF is used for diagnosis of

A)  subarachnoid hemorrhage.
B)  CNS bacterial infection.
C)  CNS viral infection.
D)  multiple sclerosis.

A urinalysis shows a negative nitrite, but many bacteria observed on microscopic exam. Which conditions might explain this discrepancy?

Place the following cast types in order as they progress from early to late development.

+Waxy
+Hyaline
+Granular
+Cellular

-1
-2
-3
-4
-Not in the progression

The most common method of measuring sweat chloride is:

A)  atomic absorption
B)  colorimetric
C)  ISE
D)  chloride meter
E)  ICP MS