Urinalysis and Body Fluids BOC questions

A random urine specimen collected shortly after the patient ate lunch appeared cloudy. Results of the reagent test strip were normal. The most likely cause of the sample’s turbidity is the presence of?

Amorphous phosphates

Measurement of urine specific gravity aids in the evaluation of the kidney’s ability to?

concentrate the urine

Osmolality is a measure of?

All dissolved particles, including ions

A urine sample has a high specific gravity by refractometry, but normal value when measured by reagent test strip. An increased presence of which of the following might explain the discrepancy between these measurements?

protein

A urine’s specific gravity by reagent test strip is directly proportional to its?

Ionic solutes

When using a refractometer to measure urine concentration, the laboratorian must correct for which of the following in their calculations?

Glucose

The method of choice for determining urine concentration following administration of x-ray contrast dye is?

Osmometry

A deficiency in arginine vasopressin (antidiuretic hormone ADH) is associated with?

Hyposthenuria

Which of the following urinary parameters may be measured to assess renal tubular function?

Specific gravity

Refractive index is a comparison of light

velocity in air to light velocity in solutions

The results in from a urine specimen collected at 8 AM were stored unrefrigerated and retested at 12 PM which of the following results would be decreased due to the storage conditions?

Glucose

Which of the following would be affected by allowing a urine specimen to remain at room temperature for 3 hours before analysis?

pH

The glucose test pad on a test strip may yield a false-positive result in the presence of?

Bleach

The occult blood test pas on a test strip may yield a false-positive result in the presence of?

Bleach

The pH of a urine specimen is related to its concentration of free?

Hydrogen ions

After standing at room temperature, a urine pH will typically increase due to bacterial production of?

Urease

Patients that take high doses of vitamin C may have a false-negative result for which of the following urine reagent test strip analytes?

Bilirubin

Which of the following reagents is embedded on the reagent test strip pad for ketones?

Sodium nitroprusside

Which of the following reagents is used to enhance the reaction of acetone with sodium nitroprusside in the tablet test for ketones?

Lactose

A reagent test strip pad impregnated with a stabilized diazonium salt, such as diazotized 2, 4-dichloroaniline, will yield a positive reaction in an acid medium with?

Bilirubin

Which of the following substances may interfere with the reagent test strip pad for leukocyte esterase and yields a false-negative result when present in high concentrations?

Protein

When employing the urine reagent strip method for protein, a false-positive result may occur in the presence of?

A highly alkaline urine

A urine specimen with an elevated urobilinogen concentration but a negative bilirubin result may indicate the patient has?

Hemolytic anemia

Microscopic analysis of a urine specimen yields a moderate amount of red blood cells in spite of a negative result for occult blood using a reagent strip. The presence of which of the following may explain this discrepancy?

VItamin C

The principle of the reagent test strip for micro albumin is based on?

An immunochemical reaction

Measurement of which of the following may be performed to account for the patient’s hydration status and renal function?

Creatinine

Development of a pink color on the absorbent mat surrounding an Ictotest tablet should be reported as?

Negative

A urine specimen analyzed for glucose by a glucose oxidase reagent test strip may yield a falsely low or negative value in the presence of?

Ascorbic acid

The occult blood pad of a reagent test strip yields an orange background with several green spots. This indicates the specimen is likely?

Intact RBC’s

The results of a urinalysis on a first morning specimen are shown in this table:

color dark yellow

clarity hazy

specific gravity 1.025

pH 8.5

urobilinogen 1.0

After viewing uric acid crystals in the centrifuged urine sediment, the laboratorian should question which of the results"?

pH

Reagent test strips pads for ketones primarily measure?

Acetoacetic acid

Microscopic examination of cellular elements in a urine sediment, such as RBC’s, WBC’s, bacteria, and epithelial cells, should be enumerated using?

High dry power (40x objective)

Oval fat bodies are?

Renal tubular epithelial cells that contain lipids

Microscopic examination of a urine sediment reveals the presence of ghost cells which would most likely be associated with?

specific gravity of 1.000

Glitter cells are a microscopic finding of?

White blood cells in hypotonic urine

Which of the following cells is most commonly associated with non-clean-catch specimen and/or vaginal contamination?

Squamous epithelial cells

Which of the following elements is most likely to be seen in a urine sediment as a result of catheterization?

transitional epithelial cells

Examination for casts should be performed?

using subdued lighting and low power (10x objective) magnification

Which of the following casts is most indicative of renal failure/end stage renal disease?

Waxy

Shortly after collection of a random urine sample, the laboratorain performed a microscopic urinalysis and reported the results show in the table:

WBC 10-13

RBC 2-6

Hyaline casts 5-7

Bacteria 1+

The urine sediment is reevaluated by a trainee 2 hours later and similar values were reported for WBC, RBC, and bacteria, but they found no hyaline casts. The most probable explanation for this discrepancy is that the casts dissolved due to?

Increase in urine pH

Which of the following aids in differentiating a spherical transitional cells from a round renal tubular cell?

Spherical transitional cell nuclei are eccentric

Renal tubular epithelial cell casts are most indicative of?

Tubular necrosis

Hyaline casts found in the urine of a football player admitted to the hospital following a concussion are most likely the result of?

Dehydration and urinary stasis

Which of the following casts most frequently appears to have broken or serrated edges?

Waxy

To distinguish between a clump of WBCs and a WBC cast, it is important to observe?

Presence of a cast matrix

Which of the following crystals may be found in an acidic urine?

Calcium oxalate

Using polarized light microscopy, which of the following urinary elements is birefringent?

Cholesterol

Cholesterol crystals will most likely be observed in urine with a?

protein of 4+

The crystal seen in the photomicrograph would be categorized as?

Triple phosphate

An alkaline crystal that is considered non pathologic

Polarized light might be used to differentiate between?

Uric acid and cystinine crystals

If the total volume of urine excreted in a 24 hour period by an adult patient is 300 mL, their condition would be termed?

Oliguria

A physician wants to determine if an abdominal fluid collected during surgery is urine. Which of the following analyses would normally be present in the urine of an apparently healthy patient?

Creatinine

Arginine vasopressin (antidiruretic hormone ADH) regulates the reabsorption of?

Water

Which of the following components would be present in the filtrate as a result of glomerular damage?

RBC’s

Polyuria is often associated with?

diabetes mellitus

Ketonuria is associated with increased metabolism of?

Lipids

Hepatic disorders may result in the presence of which of the following types of urinary crystals?

Hepatobiliary obstruction

A patient with renal tubular acidosis would most likely excrete a urine with a?

High pH

Glycosuria may be due to?

renal tubular dysfunction

A random urine sample collected from a 45-year old male patient following a transfusion reaction yields the laboratory results in this table:

color red

clarity hazy

specific gravity 1.010

blood large

pH 7.5

urobilinogen 0.2

RBC 2-5

casts 2-4 hyaline

epithelial cells 3-5 renal tubular

These results may indicate the patient has?

Acute tubular necrosis

Failure of the nephron to produce ammonia from glutamine will results in urine with a?

high pH

A random urine sample with an increased micro albumin concentration is prdictive of?

nephropathy

A 21-year-old patient had glucose in their urine and a low fasting blood glucose. These findings are most consistent with?

Renal glycosuria

A specimen with a negative nitrite reaction and a positive leukocyte esterase reaction that has WBC, WBC casts, but no bacteria in the sediment may be seen in cases of?

Acute interstitial nephritis

Ascites is collected by?

paracentesis

CSF should normally appear clear and ?

Colorless

Which of the following stains is commonly used to evaluate sperm viability?

Eosin-nigrosin

A green-colored amniotic fluid is received in the laboratory for testing. The color of the specimen indicates the presence of?

Meconium

Which of the following results would be considered abnormal for seminal fluid?

liquefaction time >60 minutes

The mucin clot test for synovial fluid is performed by adding which of the following to an aliquot of the sample?

Glacial acetic acid

THe laboratory values shown in this table were obtained on an unlabeled body fluid sample:

protein 3

albumin 2.1

hyaluronate 0.4

glucose 80

lactate 10

Based on these results, this sample is most likely?

synovial fluid

A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Additon of acetic acid results in turbidity and a clot. This indicates the fluid?

is synovial fluid

False-negative results can occur for a guaiac-based fecal occult blood test due to the ingestion of?

Ascorbic acid

Which of the following compounds is used as a chromogen in fecal occult blood tests?

Guaiac

Normal CSF contains all fo the following proteins except?

Fibrinogen

An increased CSF IgG index indicates?

increased intrathecal IgG synthesis