ANALYSIS OF URINE AND OTHER BODILY FLUIDS

PRACTICE QUESTIONS
Yume Gail S. Batumbakal
NAME:_______________________________________ SCORE:______________

IDENTIFICATION

1. The normal threshold for sodium is approximately? 110-130 mg/dL

2. Following the invention of the microscope in the 17 th century, a method for
quantitating the urine sediment was developed by ______. Thomas Addis
3. Antidiuretic hormone regulates the reabsorption of water from the _____. Collecting duct
4. The hormone that stimulates sodium reabsorption in the proximal convoluted
tubule is ____. Renin
5. The renal corpuscles of juxtamedullary nephrons are located in the _____. Renal cortex
6. The general evaluation of the urine sediment and the enumeration of casts are
performed using a total magnification of ____. 100x
7. Convert 2,500 rpm to RCF (g) given a centrifuge rotational radius of 7.15 cm.
Round off answer to the nearest whole number and do not anymore include the
unit. 500
8. A urine specimen diluted with a ratio of 1:3 has a specific gravity reading of 1.020.
What would be the actual value? 1.060
9. Reagent strip test for protein employs what principle? Protein-error of indicators
10. What is the principle employed by automated analyzers in measuring urine
specific gravity? Refractometry
11. What is the principle commonly used to measure the concentration of a particular
analyte in the chemical examination of urine? Reflectance photometry
12. What is the most commonly used microscope in the clinical microscopy
laboratory? Bright field microscope
13. What is the renal threshold for glucose? 160-180 mg/dL
14. What is the shape of triple phosphate crystals? Coffin lid
15. The only form of bilirubin that can be detected in urine is ____. Conjugated bilirubin
16. What reagent is used in the reagent strip test pad for ketones? Sodium nitroprusside
17. What test reaction is employed in the reagent strip test pad for Nitrite? Greiss reaction
18. What stain is used to confirm the presence of hemosiderin granules in renal
tubular epithelial cells? Peri's Prussian blue
19. What is the shape of the monohydrate form of calcium oxalate? Dumbbell
20. A WBC count was performed on a slightly hazy CSF. Using the recommended
dilution for slightly hazy specimens, calculate the WBC count if 75 cells were
counted in 10 large Neubauer squares. 750
21. A metabolic disorder involving the phenylalanine-tyrosine pathway results from Alkaptonuria
failure to inherit the gene that codes for the enzyme homogentisic acid oxidase?
22. It is the most well-known of the aminoacidurias. Phenylketonuria
23. Confirmatory test for unilateral kidney disease. Indigo carmine test
24. Metabolic disorder referred to as the “blue diaper syndrome” Hartnup disease
25. A positive result for guaiac fecal occult blood testing will produce what color? Blue
26. A black tarry stool is indicative of? Upper GI bleeding
27. It is also known as lipid nephrosis. Minimal Change Disease
28. It is also known as Berger disease. IgA Nephropathy
29. How many grams of feces are normally excreted in a 24-hour period? 100-200
30. In what part of the digestive tract do pancreatic enzymes and bile salts contribute
to digestion? Small intestine
31. The most appropriate stain for demonstrating the inclusions within siderophages.
Methylene blue
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
32. The procedure carried out to detect intra-abdominal bleeding following blunt
trauma injury is: Methylene blue
33. The aspiration procedure that may result in a grossly bloody fluid due to
accidental puncture and misuse of anticoagulants is: Methylene blue
34. Stools from persons with steatorrhea will contain excess amounts of: Fat
35. A carbohydrate-deficient isoform of transferrin found only in CSF. Tau protein
36. Metabolic disorder associated with a characteristic “sweaty feet” odor of urine. Isovaleric
37. The aspiration procedure to extract pleural fluid is referred to as: acidemia
Thoracentesis
MULTIPLE CHOICE

38. The most abundant inorganic component of urine is primarily reabsorbed

from the:
a. DCT; active transport
b. Thin DLH; passive transport
c. Thick ALH; passive transport
d. Thick ALH; active transport
39. Which of the following are likely to be found in the container in three-glass
collection technique?
a. Urethral washing, bladder elements, and kidney elements
b. Few urethral elements, bladderelements, and kidney elements
c. Prostatic fluid, seminal fluid, and urethral elements
d. Prostatic fluid, bladder elements, and kidney elements
40. Th renin-angiotensin-aldosterone system is responsible for which of the
following actions? MULTIPLE ANSWERS
a. Stimulation of vasopressin secretion
b. Stimulation of aldosterone release
c. Sodium reabsorption in the PCT
d. Vasoconstriction of the afferentarteriole
41. What disorder results from this defect?
a. Diabetes insipidus
b. Lactic acidosis
c. Nephrotic syndrome
d. Renal tubular acidosis

42. The volume of urine excreted in a 24 hour period by an adult patient was 300 mL.
This condition is:
a. Due to osmotic diuresis inpatients with glucosuria
b. Consistent with normal renalfunction and water balance
c. Associated with urinary tract obstruction by calculi
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
d. Termed isosthenuria

43. Failure of the nephron to produce ammonia from glutamine will result inurine
with a:
a. Pale yellow color
b. Low specific gravity
c. Acidic pH
d. High pH
44. Which tube contains additive that interfere with drug and hormone
analysis?

a. A
b. B
c. C

45. In which segment is sodium passively reabsorbed?

a. L
b. I
c. A
d. K
e. H

46. Which structure senses changes in blood pressure and plasma sodium
concentration?
a. B
b. F
c. D
d. E
e. C

47. Which of the following is least affected in an improperly stored urine?

a. pH
b. Bilirubin
c. Protein
d. Glucose
48. Urine specimens should be examined within 2 hours of voiding because:
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
a. Ketones will increase due tobacterial and cellular metabolism
b. Bacterial contamination will cause alkalinization of the specimen.
c. RBCs, leukocytes, and castsagglutinate on standing for several
hours at room temperature
d. Urobilinogen increases andbilirubin decreases after prolonged
exposure to light

49. Which portion serves as control forkidney and bladder infections?

a. C
b. B
c. D
d. A

50. In an unwitnessed drug specimen collection, a blueing dye may be addedto

the .
a. Specimen container before collection
b. Soap dispenser
c. Specimen container aftercollection
d. Toilet water reservoir
51. Which statement regarding renalfunction is true?
a. The distal convoluted tubule reabsorbs sodium and secretes potassium in
response to antidiuretic hormone.
b. The collecting duct is permeable to water only in the presence of
aldosterone
c. The descending limb of the loop of Henle is impermeable to urea but highly
permeable to salt
d. The ascending limb of the loop of Henle is highly permeable to salt but not
water
52. Which of the following reagent strip tests is/are inhibited by sodium fluoride?
a. Leukocyte esterase
b. Blood
c. Glucose
d. Copper reduction
53. The RAAS component produced by the lungs functions to activate?
a. Angiotensin II
b. Angiotensinogen
c. Renin
d. Angiotensin I
54. Which of the following drug temperatures would be considered out of range?
a. 33.5
b. 30
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
c. 35
d. 37
55. Choose the incorrect pair between condition and urinalysis finding.
a. Urinary tract infection – increased WBC and bacterial count
b. Intake of ACE inhibitors – low sodium
c. Nephrotic syndrome – microalbuminuria
d. Absence of ADH production – low specific gravity
56. Which of the following correctly describe the commercially available gray top
urine collection?
a. Must be filled to minimum fill line to be acceptable
b. Preservative is sodium propionate, ethyl paraben, and chlorhexidine
c. Sample is stable at room temperature for 72 hours
d. Prevent bacterial infection
57. Which of the following are reported per low power field?
1. Non-squamous epithelial cells
2. Mucus threads
3. Hyaline casts
a. 1 and 3
b. 2 and 3
c. 1 and 2
d. 1, 2, and 3
58. A speckled pattern on the reagent strip pad for blood indicates the presence of
_____.
a. Lysed RBCs
b. Intact RBCs
c. Myoglobin
d. Pus cells
59. If a urine specimen collected at 8:00 am from a type 1 diabetic patient was stored
uncapped at 5 degrees C without preservation and retested at 2:00 pm, which of
the following test results would be most significantly affected due to these
storage conditions?
a. Ketones
b. Glucose
c. Nitrite
d. Protein
60. Given the following UA results, select the most appropriate course of action:
Reagent strip test: Microscopic findings:
pH = 8.0 RBCs = 0-2/hpf
Protein = trace WBCs = many/hpf
Glucose = neg Bacteria = many/hpf
Blood = neg Crystals = few Calcium carbonate/hpf
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
Nitrite = neg
a. Recheck pH because calcium carbonate does not occur at alkaline pH
b. Request for a new specimen because urine was contaminated in vitro
c. Report all results except bacteria because the nitrite test was negative
d. No indication of error; results indicate urinary tract infection
61. Trace the path of blood flow into and out ofthe nephrons:
1 peritubular capillaries
2 afferent arteriole
3 vasa recta
4 efferent arteriole
5 glomerulus
a. 2, 5, 4, 1, 3
b. 4. 5. 1. 3. 2
c. 2, 4, 1, 3, 4
d. 4, 5, 2, 1, 3
62. Which of the following substances are actively reabsorbed as the filtrate
passes through the proximal convoluted tubule?
1 sodium
2 cystine
3 glucose
4 urea
a. 1, 2, 3, and 4
b. 1 and 3
c. 2 and 4
d. 1, 2, and 3
63. In cases of orthostatic proteinuria, the first morning urine yields a protein
result.
a. Negative
b. 2+
c. 3+
d. 1+
64. All of the following solutions can be used tocalibrate refractometer, EXCEPT:
a. 9% sucrose
b. 3% sodium chloride
c. Potassium sulfate
d. 5% sodium chloride
65. Which of the following causes a false negative result in the reagent strip test of
protein?
a. Highly buffed alkaline urine
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
b. High specific gravity
c. Proteins other than albumin
d. Highly pigmented urine
66. Spotted/speckled blue in the blood reagent pad would indicate the presence
of ____ in urine.
a. Hematuria
b. Porphyrin
c. Hemoglobinuria
d. Myoglobinuria
67. Distinguish which set of urine output at night and specific gravity can denote
the condition of nocturia:
a. >500 mL with the S.G. of 1.018
b. <400 mL with the S.G of 1.010
c. >400 mL with the S.G of 1.010
d. <500 mL with the S.G of 1.018
68. Identify which of the following urine sediments are pathologic causes of
turbidity: MULTIPLE ANSWERS
a. Nonsquamous epithelial cells
b. Squamous epithelial cells
c. Abnormal crystals
d. Amorphous crystals
69. Which of the following conditions willproduce a sweet smelling urine?
a. All of these
b. Diabetes mellitus
c. Diarrhea
d. Vomiting
70. In the urine clarity reporting, refers tourine that has many particulates in
which when looked through a newsprint, the text becomes blurred.
a. Cloudy
b. Turbid
c. Hazy
d. Milky
71. Which of these is the proper method for disposing of urine specimens?
a. Diluting with sodium hypochlorite
b. Pouring it down the sink followed by copious amounts of water
c. Throwing the specimen in a biohazard bag
d. Autoclaving the specimen
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
72. Quality assessment, as part of the five-Q framework of total quality
management, involves and monitors which of the following?
a. Statistical control procedures such as Westgard multi-rules and Levey-
Jennings charts
b. Identification of the causes of problems in the laboratory and the
solutions to these problems
c. Laboratory performance such as turnaround times, specimen, and
patient ID procedures, and test usage
d. General policies and procedures such as manuals and employee
handbooks
73. Methanol, like any other chemical, poses hazards to clinical laboratory
scientists. Using the image below, which of the following statements are
inaccurate about the hazards of methanol?
I. The chemical can cause significant irriation
II. Its flashpoint is below 100 deg Fahrenheit
III. It is a stable chemical compound
IV. It poses moderate health hazard
a. II and IV only
b. I and III only
c. I and II only
d. III and IV only
74. Which of the following pairs of pH andurine crystals is mismatched?
a. pH 6.0, Uric acid
b. pH 5.5, Amorphous phosphate
c. pH 7.5, Calcium carbonate
d. pH 7.0, Ammonium biurate
75. Which of the following pairs of indicators are used in the reagent strip test
pad for pH?
a. Neutral red and Bromothymol blue
b. Methyl red and Bromophenol blue
c. Methyl red and Bromothymol blue
d. Neutral red and bromophenol blue
76. Presence of dysmorphic red blood cells and RBC casts with a positive
protein test is indicative of:
a. Glomerulonephritis
b. Menstrual period
c. Amyloidosis
d. Cystitis
77. What must be done if the pH of the urine that was submitted by the patient is
9.0?
a. Ask the patient to recollect sample
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
b. Add special notes on result form of the urinalysis and release the result.
c. Rerun the chemical analysis
d. Release the result
78. Which cast is seen most frequently in urine sediments?
a. Waxy cast
b. Broad cast
c. Granular cast
d. Hyaline cast
79. Consumption of cranberry juice canproduce a urine that is:
a. Isosthenuric
b. Acidic
c. Alkaline
d. Hyposthenuric
80. The following are normal crystals inAlkaline urine EXCEPT:
a. Triple phosphate
b. Calcium oxalate
c. Ammonium biurate
d. Calcium carbonate
81. Neutrophils in diluted urine samples will:
a. Lyse
b. Swell
c. No change
d. Crenate
82. What is the color and shape of bilirubincrystals?
a. Colorless, clump needles
b. Yellow, spherical shaped
c. Yellow, clumped needles
d. Brown, hexagonal plates
83. What is the highest magnification that canbe used when performing routine
microscopic urine analysis?
a. 1000x
b. 40x
c. 400x
d. 100x
84. These are renal tubular epithelial cells thatabsorbed lipid:
a. Ghost cells
b. Oval fat bodies
c. Clue cells
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
d. Bubble cells
85. Which of the following are consistent with a diagnosis of multiple sclerosis?
MULTIPLE ANSWERS
a. IgG index of 1.2
b. High CK-BB level
c. Increased MBP
d. Oligoclonal bands in serum IFE
86. Wet and cytocentrifuge preparations of synovial fluid are observed under:
a. All of these
b. B. Polarized microscopy
c. A. Bright field microscopy
d. Both A and B
e. C. Compensated polarized light microscopy
87. Which of the following is associated with eosinophilic pleocytosis?
a. Coccidioidomycosis
b. Viral meningitis
c. Bacterial meningitis
d. Multiple sclerosis
88. Which of the following types of tyrosyluria is caused by deficiency of the enzyme
tyrosine aminotransferase?
a. Type 2
b. Type 3
c. Type 1
89. Which CSF finding is most consistentwith bacterial meningitis?

a. Sample 1
b. Sample 2
c. Sample 3
d. Sample 4
90. Which of the following statements describe the protein content of
cerebrospinal fluid? MULTIPLE ANSWERS
a. <1% of plasma protein level when the BBB is intact
b. Normally ranges from 15 to 45 g/dL
c. Causes yellow xanthochromia when the level exceeds 150 mg/dL
d. Major fractions include albumin, prealbumin, and a1-antitrypsin
91. A fecal osmolal gap of <50 mOsm/kg is consistent with:
a. Secretory diarrhea
 ANALYSIS OF URINE AND OTHER BODILY FLUIDS
PRACTICE QUESTIONS
b. Osmotic diarrhea
92. A serum-ascites albumin gradient of <1.1 is suggestive of a/an:
a. Transudate
b. Exudate

TRUE OR FALSE

T 93. Osmolality can be used as a specific parameter to determine urine concentration

as it measures only the number of particles present.
F 94. When collected, synovial fluid in room temperature normally clots due to the
polymerization of hyaluronic acid.
F 95. In microscopic examination of the feces for undigested striated muscle fibers, a
count of greater than 5 per slide considered abnormal.
T 96. The volume of fluid collected largely depends on the size of the joint where it was
collected.
T 97. In a microscopic stool examination, as few as 3 neutrophils per high power field
can be indicative of an invasive condition.
T 98. The observation of a web-like pellicle in a refrigerated CSF specimen must be
correlated with increased ADA level.
T 99. A WBC count of >1000 uL is suggestive of an exudate effusion.
T 100. Diabetic nephropathy is currently the most common cause of end-stage
renal disease.
T 101. The term “occult” blood describes blood that is not visibly apparent in the
stool specimen.
T 102. For microscopic examination synovial, clear fluids can be subjected to cell
counts even without dilution.
T 103. Synovial fluid does not only reduces friction but also functions to dreduce
the shock produced during joint movement.
F 104. A normal synovial fluid is pale yellow or clear and less viscous.
F 105. A pleural fluid serum cholesterol ratio of <0.3 is suggestive of a transudate
effusion.
T 106. Synovial fluid is also known as joint fluid.
F 107. Patients must avoid eating red meat before the start of sample collection in
testing for muscle fibers.
T 108. In serological testing, synovial fluid usually is used for confirmatory
measures in cases that are difficult to diagnose.
T 109. Synovial fluid results from ultra filtration and secretion by the cells lining
the synovial cavity.
T 110. Routine bacterial cultures for synovial fluid always include an enrichment
medium for fastidious organisms.
T 111. An RBC count of >100,000 uL is a suggestive of an exudative effusion.