ASSESSMENT EXAM– ANALYSIS OF URINE AND BODY FLUIDS

1. In addition to ascorbate the glucose oxidase reaction may be inhibited by:

a. Acetoacetic acid c. Creatinine
b. Epsilon aminocaproic acid d. All of the above
2. A negative glucose oxidase test and a positive test for reducing sugars in urine indicates
a. True glycosuria
b. A false-negative glucose oxidase reaction
c. The presence of a nonglucose reducing sugar such as galactose
d. A trace quantity of glucose
3. Which of the following statements regarding the nitroprusside reaction for ketones is true?
a. The reaction is most sensitive to acetone
b. Nitroprusside reacts with acetone, acetoacetic acid (AAA), and beta hydroxybutyric acid
c. May be falsely positive in phenylketonuria
d. The reaction is not sensitive enough to detect serum ketones
4. Gerhardt’s test for acetoacetic acid is based upon:
a. Oxidation of AAA to acetone by peroxide
b. Boiling urine to convert AAA to acetone
c. Reduction of AAA to beta hydroxybutyric acid using ascorbic acid
d. Reaction of AAA with nitroferricyanide
5. Hemoglobin in urine can be differentiated from myoglobin using:
a. 80% ammonium sulfate to precipitate hemoglobin
b. sodium dithionite to reduce hemoglobin
c. o-Dianisidine instead of benzidine as the color indicator
d. microscopic exam
6. Which statement about the dry reagent strip blood test is true?
a. Test for blood are based upon its reaction with peroxidase
b. A blood reaction is often positive in the absence of visible red color
c. A nonhemolyzed trace is present when there are 1-2 RBCs/HPF.
d. Salicylates cause a false-positive reaction
7. All of the statements below regarding urine bilirubin tests are true except:
a. A positive test indicates either liver or hepatobiliary disease
b. The test detects only conjugated bilirubin
c. Standing urine may become falsely negative due to bacterial hydrolysis
d. High levels of ascorbate usually do not interfere
8. A urine sample is dark orange and turns brown after storage in the refrigerator overnight. The technologist requests a new
specimen and tests it immediately. Which test result would differ between the two specimens?
a. Ketone c. Urobilinogen
b. Leukocyte esterase d. Nitrite
9. All of the statements below regarding urine urobilinogen are true except:
a. Diurnal variation occurs, with highest levels seen in the afternoon
b. High levels occurring with a positive bile test indicate obstructive jaundice
c. Dry reagent strip tests do not detect decreased levels
d. An Ehrlich unit refers to urobilinogen in milligrams per unit time rather than volume
10. Which statement about the Watson-Schwartz test is true?
a. Urobilinogen is water soluble and gives a pink color in the upper layer
b. Urobilinogen is extracted in chloroform and gives a pink color in the lower layer
c. Porphobilinogen is extracted in n-butanol
d. Dietary indoles cannot be separated from PBG
11. The usual acidity of urine is due to
a. the excretion of amino acids c. the production of keto acids
b. the excretion of uric acid d. the reabsorption of bicarbonate
12. When a urine specimen is allowed to stand at room temperature, which one of the following does NOT occur?
a. disappearance of formed elements c. false positive glucose
b. elevation in pH d. false positive protein
13. At a temperature of 26degC, a urine specific gravity reads 1.014. If a temperature correction is employed, what would the
corrected specific gravity be?
a. 1.010 b. 1.011 c. 1.016 d. 1.018
14. Precipitation tests for urine protein do NOT include which of the following?
a. acid and heat c. sulfosalicylic acid
b. dipstix d. trichloracetic acid
15. Which of the following does NOT apply to urine protein estimation by dipstick?
a. Bence-Jones protein interferes with measurement of albumin
b. Highly alkaline buffered urine can cause a false positive test
c. The principle of the test is the protein error of indicators
d. The test is more sensitive to albumin than to globulin
16. Which of the following is true of the detection of urinary glucose?
a. any reducing substance can give a false positive reaction with the copper reduction method for glucose
b. the copper reduction method is specific for glucose
c. glucose cannot appear in the urine in the absence of an elevated plasma glucose
d. ketonuria may produce a false negative dipstick test for glucose
17. Which of the following is the most definitive test for PKU?
a. blood level of phenylalanine c. measurement of liver enzymes
b. Guthrie tests on blood of a newborn d. Phenistix test on a freshly voided urine
18. The urine stick tests for occult blood depend on the fact that
a. hemoglobin can act as a peroxidase
b. hemoglobin can release an enzyme from the strip
c. hemoglobin in urine combines with oxygen on the strip to produce a blue color
d. red cells in urine are lysed by peroxide from the strip
19. Which of the following statements is true regarding the test for heme pigments in urine?
a. color in the inorganic phase identifies urobilinogen
b. color in the organic phase identifies porphobilinogen
c. Ehrlich’s reagent contains resorcinol and HCl
d. Prior removal of bilirubin is necessary
20. An unpreserved urine specimen was at room temperature for 4 hours in an unsterile container. Which one of the following sets
of actions can occur?
a. Bacteria decrease, ketones decrease, glucose decrease, pH decrease
b. Bacteria decrease, ketones increase, glucose decreases, pH increases
c. Bacteria increase, ketones decrease, glucose decreases, pH increases
d. Bacteria increase, ketones increase, glucose decreases, pH decreases
21. Which one of the following groups of crystals is normally found in the alkaline urine?
a. Uric acid, calcium oxalate, cystine
b. Cholesterol, bilirubin, calcium carbonate
c. Calcium oxalate, triple phosphate, leucine
d. Triple phosphate, ammonium biurate and calcium carbonate
22. A serous fluid that result from filtration of serum across a physically intact vascular wall, which is caused by a systemic
disease such as congestive heart failure is known as:
a. A transudate
b. An osmolite
c. An exudates
d. Synovial fluid
23. Three separate tubes of cerebrospinal fluid (CSF) are routinely collected in a lumbar puncture procedure. What type of
testing is performed on tube 3?
a. Microbiology
b. Immunology
c. Chemistry
d. Hematology
24. A cerebrospinal fluid (CSF) electrophoresis can be a good test to aid in obtaining a diagnosis of central nervous system
(CNS)-related disorders. If oligoclonal bands are found, their presence is associated with:
a. Multiple myeloma
b. Bacterial meningitis
c. Cerebral tumor
d. Multiple sclerosis
25. Zollinger-Ellison syndrome refers to which one of the following conditions?
a. a condition caused by the accumulation of uric acid in the synovial fluid of joints
b. the physiologic failure of gastric pH to fall lower than 3.5 with gastric stimulation
c. a neoplasm of the pancreas causing increased secretion of gastrin and gastric secretion of acid
d. a condition of chronic osmotic diarrhea caused by a genetic disaccharidase deficiency
26. The presence of stool white blood cells (WBCs) indicates which one of the following intestinal conditions?
a. Disaccharidase deficiency
b. Lactose intolerance
c. Colorectal cancer
d. Infectious or inflammatory bowel disease
27. A urine sample is found to have an abnormally high level of urobilinogen and normal bilirubin. This most likely indicates:
a. drug interference with the urobilinogen test
b. obstructive jaundice
c. hemolytic anemia
d. chemical interference causing a false negative bilirubin
28. Which of the following conditions is most likely to cause the hCG doubling time to be more rapid than normal and to
continue beyond week 12?
a. molar pregnancy
b. ectopic pregnancy
c. wrong gestation time estimate
d. twins
29. Which statement best describes the principle of the dry reagent strip test for specific gravity?
a. it is based on the protein error of indicator effect
b. dissolved solutes cause ionization of malic acid from a polyelectrolytes
c. inhibition of the diazo reaction caused by ionized solute results in green to blue color change
d. solutes react with sodium tetrafluoroborate diazonium forming a blue-green color
30. To best assess urine for the presence of microalbuminuria, the protein concentration should be reported as a ratio using
which other analyte as a reference?
a. Urea b. creatinine c. uric acid d. specific gravity
31. Which statement below regarding renal function is true?
a. Glomeruli are far more permeable to water and salt than other capillaries.
b. The collecting tubule reabsorbs sodium and secretes potassium in response to aldosterone.
c. The collecting duct is permeable to water only in the presence of antidiuretic hormone (ADH)
d. All of the above
32. All of the statement below regarding the nephron are true except:
a. The ascending limb of the tubule is highly permeable to salt but not water
b. The stimulus for ADH release is low plasma osmolality
c. The descending limb of the tubule is highly permeable to water and urea but not salt
d. Renin is released in response to low arterial pressure within the kidney
33. All of the statements below regarding the kidneys are true except:
a. In salt deprivation the kidneys will conserve sodium at the expense of potassium.
b. Potassium is not excreted when serum concentration is below 3.5 mmol/L
c. The amount of phenolsulfonphthalein (PSP) dye excreted in urine after 15 minutes is determined by tubular secretion
d. Normal kidneys can reabsorb 100% of filtered sodium when serum levels are low.
34. Which of the following is inappropriate when collecting urine for bacteriological culture?
a. The container must be sterile
b. The midstream void technique must be used
c. The collected sample must be refrigerated if not plated immediately
d. The container should contain 10 mL of 6N HCl.
35. Which statement about sample collection for routine urinalysis is true?
a. Preservative tablets should be used for collecting random urine specimens.
b. Containers may be washed and reused, if rinsed in deionized water.
c. Samples may be stored at room temperature for up to 2 hours
d. Random samples are acceptable when renal disease is suspected
36. Which statement does NOT apply to white cells in the urine sediment?
a. a few white cells may be present in normal urine
b. an increase in white cells is associated with an inflammatory process
c. white cells in urine must be accompanied by proteinuria
d. unstained white cells in urine appear spherical and granular
37. The “Coffin lid” crystal is that of
a. ammonium biurate c. sodium urate
b. calcium oxalate d. triple phosphate
38. Which of the following is true of casts in urine?
a. the high power objective is employed in a search for these elements
b. some kind of stain is needed to make them at all visible
c. their refractive index makes them easily visible
d. they tend to accumulate near the edges of the coverslip
39. Which of the following is NOT true about oval fat bodies?
a. cholesterol esters break down into fatty globules in desquamated tubular epithelial cells
b. their fat content is related to the level of lipids in the plasma
c. they are associated with degenerative tubular disease
d. they are associated with the appearance of the “Maltese cross” formation under polarization
40. Which of the following statement is NOT true?
a. a “clean catch” urine is preferable, in most instances, to a specimen collected by catheterization
b. in a routine culture of urine, 102 microorganisms/ml urine is considered significant
c. the presence of bacteria in the uncentrifuged specimen of urine collected under controlled condition is associated with a
significant colony count on culture
d. the presence of bacteriuria can be recognized by a positive result on the nitrite portion of a dipstick
41. Which of the following is a true statement?
a. a high specific gravity of urine may result in lysis of red cells
b. hemoglobinuria is a more common finding than hematuria
c. a low pH of urine may result in the conversion of red cells to hemoglobin
d. true hemoglobinuria occurs after intravascular hemolysis
42. A doctor sent the laboratory a sample of a fluid he aspirated from the abdomen of one of his patients. To determine if the fluid
is urine, the clinical laboratory scientist should measure which one of the following groups of substances?
a. Urea, creatinine, sodium and chloride
b. Glucose, protein, blood and nitrates
c. Urochrome, urobilin, bilirubin and urobilinogen
d. Glucose, protein, urea and chloride
43. The specific gravity of urine is best described by which one of the following statements?
a. It reflects the ability of the kidney to concentrate and dilute urine
b. It is a measure of the number of solute particles per unit of solvent
c. It is a measure of the weight of a substance compared with an equal volume of saline
d. It is equal to the amount of dissolved substances in plasma
44. A urine specimen is too concentrated to read on the refractometer scale. It is diluted by taking one drop of the specimen by
adding it to three drops of distilled water. The diluted sample now reads 1.012 on the refractometer scale. The specific gravity of
the sample should be reported as:
a. 1.012 c. 1.036
b. 1.048 d. 3.036
45. All of the statements below about urine color are true except:
a. Normal color is due to dietary products and water-soluble bile pigments
b. Urine may turn dark on standing if high levels of urobilinogen are present
c. Deep yellow urine with yellow foam may contain bilirubin
d. Abnormal color is consistently caused by metabolic disease
46. A urine that contains porphyrins might cause any of the following except:
a. A positive Watson-Schwartz test
b. A positive Schlessinger’s test
c. Pink fluorescence when illuminated with an ultraviolet lamp (360 nm)
d. A false-positive dry reagent strip test for blood
47. Which of the following is inappropriate when collecting a 24-hour urine for VMA?
a. Urine in the bladder is voided and discarded at the start of the tests
b. At 24 hours any urine in the bladder is voided and added to the collection
c. All urine should be collected in a single container that is kept refrigerated
d. HCl is added to the container after the 24-hour urine volume is measured
48. Urine production of less than 400 mL per day is:
a. Consistent with normal renal function and water balance c. Termed isosthenuria
b. Defined as oliguria d. Associated with diabetes mellitus
49. What is the principle of the colorimetric reagent strip determination of specific gravity in urine?
a. Ionic strength alters the pKa of a polyelectrolyte.
b. Sodium and other cations are chelated by a ligand that changes color
c. Anions displace a pH indicator from a mordant, making it water soluble
d. Ionized solutes catalyze oxidation of an azo dye
50. Which statement below regarding urine pH is true?
a. High-protein diets promote an alkaline urine pH
b. pH tends to decrease as urine is stored
c. Contamination should be suspected if urine pH is less than 4.5
d. Bacteriuria is most often associated with a low urine pH.
51. Results of turbidimetric and dry reagent strip tests for protein in urine may differ because:
a. Colorimetric tests are more likely to detect globulins
b. Colorimetric tests may be falsely positive in highly buffered alkaline urine
c. Colorimetric tests are far more sensitive than turbidimetric tests
d. Drug interference is more common with colorimetric tests
52. Daily loss of protein in urine normally does not exceed:
a. 30mg b. 50 mg c. 100 mg d. 150 mg
53. All of the statements below about microalbuminuria are true except:
a. Testing may detect early renal involvement in diabetes mellitus
b. Microalbuminuria refers to urinary albumin levels less than 5 mg/dL
c. Tests will be positive in orthostatic albuminuria
d. Testing should be part of the routine urinalysis
54. All of the statements below about reagent strip protein tests are true except:
a. They are based on the protein error of indicator effect
b. The reagent strip pad must be buffered to maintain constant pH
c. Results may be negative in the presence of hematuria or hemoglobinuria
d. They will detect renal tubular proteinuria
55. Which statement about the dry reagent strip test for leukocytes is true?
a. The test detects only intact WBCs
b. The reaction is based upon the hydrolysis of substrate by WBC esterases
c. Several antibiotics may give a false-positive reaction
d. The test is sensitive to 2-3 WBCs/HPF
56. A urine sediment shows the presence of 100mg/dL of protein and 5 to 10 hyaline casts/lpf. All other findings are within
normal limits, and the patient appears healthy. This suggests:
a. acute or chronic glomerulonephritis in the late stages of disease
b. tubular nephrosis resulting from autoimmune disease
c. cylindruria induced by drugs, exercise or running
d. nephrotic syndrome
57. A urinalysis is performed, and dry reagent strip reactions show a small blood reaction and glucose reaction. Microscopic
analysis reveals large numbers of RBCs and quantitative measurement of glucose gives a result of 100mg/dL. These results
could have been caused by:
a. prolonged storage of the sample at room temperature
b. too great a time lapse between the dipstick and other tests
c. the presence of large amounts of salicylate acid in the sample
d. the presence of yeast mistaken for RBCs
58. The microscopic examination of sediment shows small oval cells, but blood and leukocyte esterase tests are negative. The urine
pH is 8.0 and specific gravity is 1.015. A drop of sediment is suspended in WBC counting fluid (2% acetic acid) and the cells
remain. They are most likely:
a. lymphocytes
b. yeasts
c. PMNs
d. RBCs
59. Given the following data, calculate
the IgG index: CSF IgG = 18mg/dL
CSF albumin = 25mg/dL
Serum IgG = 1200mg/dL
Serum albumin = 3.2g/dL
a. 0.37
b. 0.52
c. 0.72
d. 1.92
60. When examining a urinary sediment under 400x magnification, the technologist noted many RBCs to have cytoplasmic
blebs and an irregular distribution of the hemoglobin. This phenomenon is most often caused by:
a. intravascular hemolytic anemia
b. glomerular disease
c. hypotonic or alkaline urine
d. severe dehydration
61. A urine sample has a specific gravity of 1.005 and pH of 8.0. The blood test is a moderate positive, but RBCs are absent from
the microscopic examination. Which statement best explains these results?
a. the RBCs have lysed c. a false positive blood test result is present
b. the blood test is more sensitive than microscopic analysis d. the iris diaphragm of the microscope is too far open
62. A random urine sample, specific gravity 1.008 gave a negative test for nitrite. Microscopic examination of the sediment
revealed 20 WBCs per high power field and 2+ bacteria. What is the most likely explanation of these results?
a. improper sample storage
b. ascorbic acid inhibition of the nitrite test
c. insufficient incubation time in the urinary bladder
d. suppression of the nitrite reaction caused by low specific gravity
63. All of the statements below regarding epithelial cells in the urinary system are true except:
a. Caudate transitional cells are derived from the distal tubules.
b. Transitional cells may originate from the upper ureter, bladder, and pelvis
c. Cells from the proximal tubules are often columnar and have a brush border
d. Squamous epithelium line the vagina, urethra, and lower two thirds of the ureters
64. Which of the statements regarding examination of unstained sediment is true?
a. Renal cells can be differentiated reliably from WBCs
b. Large numbers of transitional cells often are seen after catheterization
c. Neoplastic cells from the bladder are not seen in urinary sediment
d. RBCs are easily differentiated from nonbudding yeast
65. All of the following statements regarding cells found in urinary sediment are true except:
a. Transitional cells swell and become spherical in hypotonic urine
b. Renal tubular cells are often polyhedral and have a large round nucleus.
c. Trichomonads have no nucleus and prominent anterior flagella
d. Clumps of bacteria are frequently mistaken for granular casts
66. Which of the statements below regarding red blood cells in the urinary sediment is true?
a. RBCs will be lysed in dilute acetic acid but yeast and WBCs will not
b. RBCs often have a granular appearance in hypertonic urine
c. RBCs of glomerular origin often appear dysmorphic
d. All of the above
67. All of the following statements regarding urinary casts are true except:
a. Many hyaline casts may appear in sediment after jogging or exercise.
b. An occasional granular cast may be seen in a normal sediment
c. Casts can be seen in significant numbers even when protein tests are negative
d. Hyaline casts will dissolve readily in alkaline urine
68. All of the following conditions promote the formation of casts in the urine except:
a. Chronic production of acidic urine
b. Excessive leakage of protein by the glomeruli
c. Slow flow of filtrate associated with reduced glomerular filtration
d. Low urine specific gravity
69. All of the statements below regarding urinary casts are true except:
a. Granular casts may be formed by degeneration of cellular casts
b. The term for casts in urine is cylindruria
c. A cylindroid is a cast that is tapered to a tail at one end
d. Cylindroids are associated with severe renal obstruction
70. All of the statements below regarding urinary casts are true except:
a. Blood casts and RBC casts have the same significance
b. Coarse and fine granular casts have the same significance
c. Waxy and hyaline casts have the same significance
d. Fatty casts are often seen along with oval fat bodies
71. All of the following statements regarding the urinary sediment are true except:
a. PMNs can be differentiated from renal cells by peroxidase staining
b. Fat droplets of fatty casts will stain orange-red with Sudan III
c. Fatty casts will show a Maltese cross effect by polarizing microscopy
d. Sediment stained with potassium ferrocyanide detects bilirubin granules
72. All of the statements below about creatinine clearance are true except:
a. Clearance will be overestimated when filtrate flow is less than 1.5 mL/min.
b. Creatinine is filtered 100% by the glomeruli
c. Creatinine is partially reabsorbed by the renal tubules
d. Creatinine clearance is dependent upon lean body mass
73. A patient’s creatinine clearance is 75 mL/minute. This indicates:
a. Normal glomerular filtration rate
b. The patient is uremic and will be hyperkalemic
c. Renal tubular dysfunction
d. Reduced glomerular filtration without uremia
74. All of the statements below regarding creatinine clearance are true except:
a. Serum creatinine levels are independent of diet.
b. Results are slightly higher than inulin clearance owing to tubular secretion
c. Creatinine clearance is an accurate expression of glomerular filtration
d. Creatinine clearance may be normal when serum creatinine is increased
75. Which statement regarding BUN is true?
a. Urea is 100% filtered by the glomeruli
b. Blood urea levels are independent of diet
c. Urea is not significantly reabsorbed by the tubules
d. Urine excretion is a specific measure of glomerular function
76. Given the date below, calculate the creatinine clearance
Serum creatinine 1.5 mg/dL; urine creatinine 115 mg/dL;
Urine volume 1.5 mL/min; body surface area 1.73 m2
a. 47 mL/min b. 97 mL/min c. 100 mL/min d. 115 mL/min
77. All of the statements below regarding WBCs in urinary sediment are true except:
a. “Glitter cells” are WBCs often associated with infection
b. Bacteriuria in the absence of WBCs indicates lower urinary tract infection
c. Large WBCs showing Brownian movement can be caused by hypotonic urine
d. WBC casts indicate that pyuria is of renal rather than lower urinary tract origin
78. Which description of sediment staining with Sternheimer-Malbin is correct?
a. Transitional epithelium: cytoplasm pale blue, nucleus dark blue
b. Renal epithelium: cytoplasm orange-purple, nucleus dark purple
c. Glitter cells: cytoplasm light blue, nucleus pale blue
d. All of these
79. All of the following procedures regarding the urine sediment are correct except:
a. A 12-mL aliquot of well-mixed urine is used whenever possible
b. Urine is centrifuged in a conical tube at 450 X g for 5 minutes
c. Routine biochemical tests should be performed on supernatant
d. Less than 0.5 mL of supernatant should be used to reconstitute sediment
80. Which statement about renal calculi is true?
a. Calcium oxalate and calcium phosphate account for about three fourths of all stones
b. Uric acid stones cannot be seen by x-ray and occur in chronic acid urine
c. Triple phosphate stones are found in the renal pelvis as “staghorn” calculi
d. All of the above

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81. All of the following statements about cerebrospinal fluid (CSF) are true except:
a. CSF is formed by ultrafiltration of plasma through the choroid plexus
b. CSF circulates in the subarachnoid space and ventricles of the brain
c. The chemical composition of CSF is similar to plasma
d. Reabsorption of CSF occurs via vessels in the sagittal sinus
82. Which statement below regarding CSF is true?
a. Normal values for monocytes are higher for infants than adults

b. Absolute neutrophilia is not significant if the total WBC count is less than 25/μL
c. The first aliquot of CSF should be sent to the microbiology laboratory
d. Neutrophils comprise the majority of WBCs in normal CSF
83. All of the following results are consistent with fungal meningitis except:
a. Low CSF glucose c. Absolute lymphocytosis and a differential showing mixed cellularity
b. High CSF protein d. High CSF lactate
84. All of the following statements regarding CSF are true except:
a. Oligoclonal bands in CSF occur in more than 90% of cases of active multiple sclerosis
b. An IgG-albumin index greater than 1.0 is strong evidence of CSF infection or multiple sclerosis
c. High CSF glucose is caused by hyperglycemia or hemorrhage
d. High CSF lactate is suggestive of Reye’s syndrome
85. Which of the following is an inappropriate?

a. A differential is done only if the total WBC count is greater than 10/μL
b. A differential should be done on a stained CSF concentrate
c. A minimum of 30 WBCs should be differentiated
d. A Wright-stained slide should be examined rather than a chamber differential
86. Highly alkaline urine sediment may have:
a. amorphous phosphates c. amorphous casts
b. amorphous urates d. uric acid crystals
87. Elevated or abnormal levels of protein in the urine may indicate:
a. renal disease c. acidosis
b. transfusion reaction d. obstructive jaundice
88. Leukocytes in the urine:
1. contain nuclei 3. insoluble in acetic acid
2. are larger than renal epithelial cells 4. larger than erythrocytes
a. 1,3, and 4 only b. 1,2, and 4 only c. 1 and 4 only d. 2 only
89. Urine from patients with diabetes mellitus has:
a. decreased volume and decreased specific gravity
b. decreased volume and increased specific gravity
c. increased volume and decreased specific gravity
d. increased volume and increased specific gravity
90. An unpreserved specimen collected at 8:00 AM and remaining at room temperature until the afternoon sluft arrives can be
expected to have:
1. decreased glucose and ketones 3. decreased pH and turbidity
2. increased bacteria and nitrite 4. decreased cellular elements
a. 1,2, and 3 b. 1,2, and 4 c. 1 and 2 only d. 4 only
91. John White donates one of his two healthy kidneys to his twin brother. His glomerular filtration rate can be expected to:
a. decrease by 50% c. decrease gradually over 1 year
b. increase by 50% d. remain essentially unchanged
92. Proper care of dipsticks used for urine chemical tests includes all of the following EXCEPT:
a. checking the expiration date c. preventing exposure from a volatile fumes
b. storing the refrigerator d. storing with dessicant
93. To produce pH readings at intervals between 5 and 9, dipsticks must use a:
a. broad-range indicator
b. narrow-range, broad spectrum indicator
c. combination of two low-range and two high range indicators
d. double-indicator system
94. Bence-Jones protein excreted in the urine in cases of multiple myeloma has a unique characteristic of:
a. reacting with dispticks and not sulfosalicylic acid
b. precipitating with acetic acid and heat and not with sulfosalicylic acid

c. precipitating when heated at 60 °C and dissolving at 100 °C

d. precipitating when heated at 100 °C and dissolving when cooled at 60 °C

95. Benzidine, which is commonly used in the laboratory for testing for hemoglobin such as plasma hemoglobin and occult
blood, is listed as a:
a. volatile substance c. carcinogenic hazardous compound
b. flammable solvent d. corrosive compound
96. Radioisotopes such as 125 I and 131 I are radioactive compounds frequently used in the radioimmunoassay laboratory
testing. If either is ingested, the radioactive compound may be broken down in the body, and the radioactive iodine is
absorbed and concentrated in the:
a. parathryroid gland b. thyroid gland c. liver d. kidney
97. Which observation is LEAST useful in distinguishing a hemorrhagic fluid from a traumatic tap?
a. Clearing of fluid as it is aspirated c. The formation of a clot
b. Presence of xanthochromia d. Diminished RBC count in successive aliquots
98. A cloudy synovial fluid demonstrating poor viscosity with decreased glucose levels and a WBC count of 180,000 (90%
neutrophils) is most likely from a patient with which process?
a. Crystal-induced c. Noninflammatory
b. Hemorrhagic d. Septic or inflammatory
99. All of the statements below regarding cells in CSF are true except:
a. Macrophages may be seen in a normal CSF
b. Large numbers of macrophages are often seen after subarachnoid hemorrhage
c. Eosinophilia in CSF often occurs in parasitic and fungal infections
d. Monocytosis in CSF is usually associated with allergic reactions to drugs
100. Which statement about CSF protein is true?
a. An abnormal serum protein electrophoretic pattern does not affect the CSF pattern
b. Normal CSF total protein in newborns may be one half of adult levels
c. CSF IgG is increased in panencephalitis, malignancy, and neurosyphilis
d. Antibodies to Treponema pallidum disappear after successful antibiotic therapy
101. Which of the statements below regarding routine microbiological examination of CSF is true?
a. A gram stain should always be performed on a sediment of CSF
b. The gram stain is positive in greater than 70% of cases of acute meningitis
c. India ink and acid fast stains are indicated if monocytosis is present in CSF
d. All of the above
102. Which statement about LD is CSF is true?
a. LD is greatly elevated in bacterial but not viral meningitis
b. LD-5 predominates in bacterial meningitis but LD-1 is highest in normal CSF
c. CSF LD is increased in malignancy, hemorrhage, lymphoma, and leukemia
d. All of the above
103. All of the statements below regarding serous fluids are true except:
a. The normal volume of pleural fluid is 30-50 mL.
b. Mesothelial cells, PMNs, lymphocytes, and macrophages may be in normal fluids
c. X-ray is not sensitive to serous fluid accumulation of less than 300 mL.
d. Malignancy is a common cause of serous fluid accumulation
104. All of the following statements about serous fluids are true except:
a. An effusion is an abnormal accumulation of a serous fluid
b. Thoracentesis refers to collection of pericardial fluid
c. Ascites refers specifically to peritoneal fluid
d. The term “chest fluid” usually refers to pleural fluid
105. All of the following statements about serous fluids are true except:
a. Exudates are turbid and often clot; transudates are clear and do not clot
b. Pleural exudates have a total protein greater than 3.0 g/dL
c. The fluid:serum LD ratio is approximately 1:4 for exudates
d. The specific gravity of exudates is greater than 1.015
106. All of the statements below regarding serous fluids are true except:
a. Pleural and peritoneal fluid amylase may be increased in pancreatitis
b. Pancreatitis can cause an exudative pleural fluid
c. Glucose levels in serous fluids are normally 10-20 mg/dL less than plasma
d. Very low pleural fluid glucose is often seen in rheumatoid arthritis
107. All of the statements below regarding pleural fluid pH are true except:
a. Pleural fluid pH below 6.3 is seen in esophageal rupture
b. A pleural fluid pH below 7.3 is considered low
c. Low pH occurs in rheumatic and septic fluids
d. High pH along with high glucose occurs in exudates caused by lung abscess
 108. All of the statements below regarding peritoneal (ascites) fluid are true except:
a. Lavage of the peritoneum revealing visible blood indicates abnormal bleeding
b. Patients with acute pancreatitis have a high LD level in peritoneal fluid
c. High ALP in ascites fluid is associated with cancer and bowel perforation
d. A green color in peritoneal fluid is associated with gallbladder leakage
109. All of the statements below regarding the synovial fluid WBC count are true except:

a. The WBC count is normally less than 200/μL

b. A WBC count in excess of 5,000/μL is diagnostic of septic arthritis

c. The WBC count is elevated in rheumatoid arthritis, hemorrhagic arthritis, and gout
d. Lymphocytes in excess of 15% are seen in rheumatoid arthritis
110. All of the following are correct procedures for examining joint fluid except:
a. The specimen should be collected in sodium oxalate
b. A wet prep should be examined immediately for crystals
c. Crystals inside cells should be noted as intracellular in the report
d. Polarizing microscopy using a red compensator is required
111. All of the statements below regarding synovial fluid are true except:
a. Formation of a mucin clot with 2% acetic acid is useful in confirming synovial fluid
b. Neisseria gonorrhoeae causes three out of four septic arthritis cases between ages 16-50 years
c. A traumatic tap will produce streaks of blood in the fluid
d. Normal fluid forms a 2-3 cm string when pulled from the end of the syringe
112. Which of the statements regarding pleural fluid cellularity is true?
a. Eosinophilia points to a diagnosis of tuberculosis
b. Greater than 50% PMNs indicates acute infection
c. Lymphocytes comprise more than 50% of WBCs in normal fluids
d. All of the above
113. All of the statements below about synovial fluid are true except:
a. Arthrocentesis is performed only to evaluate arthritis
b. Synovial fluid is present only in movable joints
c. Joint fluid resembles plasma in viscosity
d. Joint fluid has approximately the same glucose as plasma
114. What type of cell is a “ragocyte”?
a. Cartilage cell seen in inflammatory arthritis
b. A PMN with inclusions formed by immune complexes
c. A plasma cell seen in rheumatoid arthritis
d. A macrophage containing large inclusions
115. Which statement about synovial fluid in rheumatoid arthritis (RA) is true?
a. Synovial-serum IgG is usually 1:2 or higher
b. Total hemolytic complement is elevated
c. Ninety percent of RA cases test positive for rheumatoid factor in synovial fluid
d. Demonstration of rheumatoid factor in joint fluid is diagnostic for RA
116. All of the measurement statements below about amniotic fluid bilirubin are true except:
a. The 410-nm peak is due to hemoglobin and the 450-nm peak bilirubin
b. To correct for hemolysis 5% of the 410-nm absorbance is subtracted from the 450-nm reading
c. Chloroform extraction improves accuracy if a large amount of hemoglobin is present
d. In normal amniotic fluid, bilirubin increases with gestational age
117. All of the following statements about alpha fetoprotein (AFP) are true except:
a. Maternal serum may be used to screen for open neural tube defects
b. Levels must be evaluated relative to gestational age
c. Elevated levels in amniotic fluid are specific for spina bifida
d. Amniotic fluid AFP assay should be performed if serum levels are abnormal
118. All of the following statements regarding the L/S ratio are true except:
a. A ratio of 2:1 or greater indicates adequate pulmonary surfactant
b. A ratio of 3.0 indicates fetal lung maturity even in the presence of hemolysis
c. Sphingomyelin levels increase during the third trimester
d. A phosphatidyl glycerol spot indicates fetal lung maturity even if blood or meconium is present
119. In Turner syndrome the modal chromosome count and number of Barr bodies are:
Chromosomes Barr bodies
a. 45 0
b. 46 1
c. 46 2
d. 47 2
120. Given the urinalysis results below, select the most appropriate course of action pH
8.0 Protein Trace Glucose Neg
Ketone Small Blood Neg Nitrite Neg
0-2 RBCs/HPF 20-50 WBCs/HPF
Bacteria Large CaCO3 crystals Small
a. call for a new specimen because urine was contaminated in vitro
b. recheck pH because CaCO3 does not occur at alkaline pH
c. report immediately; results indicate urinary tract infection
d. report all results except bacteria, because the nitrite test was negative
121. All of the following statements regarding pregnancy testing are true except:
a. Alpha subunits of hCG, LH, and FSH are very similar
b. Antibodies against the beta subunit of hCG do not crossreact with LH
c. Enzyme immunoassays detect less than 25 mIU/mL hCG
d. Serum is not used for pregnancy tests based on EIA since proteins interfere
122. All of the statements below accurately describe (hCG) levels except:
a. Levels of hCG rise throughout pregnancy
b. In ectopic pregnancy serum hCG doubling time is below expected levels
c. In choriocarcinoma hCG levels are greatly elevated
d. hCG can take up to 4 weeks to return to baseline after delivery or abortion
123. Which of the following statements about amniotic fluid is true?
a. Amniotic fluid creatinine greater than 1.5 mg/dL is evidence of fetal maturity
b. Very high creatinine indicates that the bladder was punctured accidentally
c. Amniotic fluid is centrifuged at high speed to prevent loss of surfactant
d. Open neural tube defects are associated with high levels of acetylcholine
124. Genetic mosaicism results from:
a. Balanced translocation during meiosis
b. Nondisjunction during meiosis
c. Nondisjunction during mitosis in the early embryo
d. Translocation during development of the blastocyst
125. Which statement regarding fecal trypsin screening is true?
a. Deficiency of trypsin causes clearing of an x-ray film
b. It is useful in screening adults for steatorrhea
c. Fecal trypsin deficiency in newborns is associated with cystic fibrosis
d. Stool is diluted in phosphate buffer at pH 7.0
126. A pediatric urine sample of less than 10 mL gave the following results:
Specific gravity 1.015 Protein 2+
Blood large 5-10 RBCs/HPF 5-10 WBCs/HPF
Select the most appropriate course of action
a. Report these results; blood and protein correlate with microscopic results
b. Report biochemical results only; request a new sample for the microscopic examination
c. Request a new sample and report as QNS (quantity not sufficient)
d. Multiply cells/HPF X mL urine concentrated and report corrected range
127. Given the urinalysis below, select the most appropriate course of action pH
6.5 Protein Neg
Glucose Neg Ketone Trace
Blood Neg Bilirubin Neg
Mucus Small Ammonium urate Large
a. Recheck urine pH
b. Report these results, assuming acceptable quality control
c. Repeat the dry reagent strip tests to confirm the ketone result
d. Request a new sample and repeat the urinalysis
128. All of the following statements regarding gastric acidity are true except:
a. The BAO:PAO is normally below 0.2
b. Pentagastrin is the stimulant of choice for determining PAO
c. A fasting gastric pH above 4.0 is diagnostic of achlorhydria
d. Highest BAO levels are associated with Zollinger-Ellison syndrome
129. Given the following dry reagent strip urinalysis results, select the most appropriate course of action. pH
8.0 Protein 1+ Glucose Neg
Ketone Neg Blood Neg Nitrite Neg
Bilirubin Neg
a. Report the results assuming acceptable quality control
b. Check pH with a pH meter before reporting
c. Perform a turbidimetric protein test and report instead of the dipstick protein
d. Request a new specimen
130. Given the data for creatinine clearance below, select the most appropriate course of action
Volume 2.8 L/day Surface area 1.73 m2
Urine creat 100 mg/dL Serum creat 1.2 mg/dL
a. Report a creatinine clearance of 162 mL/min
b. Repeat the urine creatinine; results point to a dilution error
c. Request a new 24-hour urine sample
d. Request patient age and sex
131. The fern test:
a. Distinguishes amniotic fluid from maternal urine c. Is run on the spectrophotometer
b. Is performed on vaginal secretions d. Is a wet mount
132. Post stimulation specimens for maximum acid output are collected:
a. analyzed and reported the same as basal specimens
b. as a total 1-hour specimen, which is analyzed and reported as milliequivalents of acid output
c. in the same manner as basal specimens but analyzed only for pH
d. as a 2-hour specimen and analyzed for peak acidity
133. Reasons for analyzing amniotic fluid include the following EXCEPT:
a. To diagnose genetic and congenital neural tube disorders
b. To assess fetal liver maturity
c. To assess fetal lung maturity
d. To detect fetal distress from hemolytic disease of the newborn
134. The following is true about amniotic fluid specimen collection and handling:
a. Fifty milliliters of amniotic fluid is typically collected
b. Glass containers are used for cytogenetic studies
c. Typical amniotic fluid is colorless to pale yellow and slightly cloudy
d. Amniotic fluid is always refrigerated
135. The most common cause of death in the premature newborn:
a. Hemolytic disease of the newborn c. Respiratory distress syndrome
b. Neural tube defects d. Excess lamellar bodies

136. A ΔA450 value that falls into zone 1 indicates:

a.A normal finding without significant hemolysis c. Severe hemolysis
b.Moderate hemolysis d. High fetal risk
137. In bacterial vaginosis, in trichomoniasis, and in postmenopausal women, the vaginal pH is:
a. Above 4.5 c. below 3.8
b. Between 3.8 and 4.5 d. It is above 4.5 in some of these and bloe 3.8 in others
138. Which of these specimensis best for the detection of Pneumocystis jiroveci?
a. Bronchoalveolar lavage c. Bronchial washings
b. Vaginal secretions d. Amniotic fluid
139. An advantage of the guaiac tests over the other fecal occult blood tests is that they are:
a. Not overly sensitive c. The most specific
b. The most sensitive d. Do not need special diet
140. Who should be screened annually for occult blood?
a. Infants and pediatric patients c. Cystic fibrosis patients
b. Adults older than age 50 d. All adults
141. No formation of a “string” when dispensing synovial fluid from a syringe indicates that:
a. Collection was traumatic c. Inflammation is present
b. Fibrinogen levels are low d. The fluid is normal
142. An elevated amylase is obtained on a stat serum collected at 8 PM. A delta check flag for amylase occurs because of a normal
result from 8 AM. Amylase is also ordered on an 8 PM urine sample. Select the most appropriate course of action.
a. Repeat the stat amylase; report only if the delta check limit is not exceeded
b. Repeat both the AM and PM amylase and report only if they agree
c. Request a new specimen; do not report results of the stat sample
d. Perform amylase on the 8 PM urine sample; if elevated, report the stat amylase
143. Triple phosphate crystals:
a. resemble coffin lids c. usually seen in acid urine
b. are long and sharp pointed d. may appear as cover slip particles
144. Given the urinalysis results below, select the most appropriate course of action.
Color Yellow Transparent Clear
pH 6.0 Protein Neg
Glucose Neg Ketone Neg
Blood Neg Bilirubin Neg
Bilirubin granules Small
a. Perform a tablet test for bilirubin before reporting
b. Request a new sample
c. Recheck the pH
d. Perform a test for urinary urobilinogen
145. A 5-hour urinary D-xylose test performed on a 7-year-old boy who was given 0.5 grams of D-xylose per pound I 15%. The
2-hour timed blood D-xylose level is 15 mg/dL (lower reference limit 30 mg/dL). Select the most appropriate action
a. Request that a beta carotene absorption test be performed
b. Repeat the urinary result since it is borderline
c. Request a retest using a 25 g dose of D-xylose
d. Request a retest using only 1–hour timed blood sample
146. A biochemical profile gives the following results:
Creatinine 1.4 mg/dL; BUN 35 mg/dL; K 5.5 mmol/L
All other results are normal and all tests are in control. Urine from the patient has an osmolality of 975 mOsm/kg. Select the
most appropriate course of action.
a. Check for hemolysis
b. Repeat the BUN and report only if normal
c. Repeat the serum creatinine and report only if elevated
d. Report these results
147. A 2 PM urinalysis shows a trace glucose level by the dry reagent strip test. A fasting blood glucose drawn 8 hours earlier is
100 mg/dL. No other results are abnormal. Select the most appropriate course of action.
a. Repeat the urine glucose test and report if positive
b. Perform a test for reducing sugars and report the result
c. Perform a quantitative urine glucose; report as trace if greater than 100 mg/dL
d. Request a new urine specimen
148. Following a transfusion reaction, urine from a patient gives positive tests for blood and protein. The specific gravity is
1.015. No RBCs or WBCs are seen in the microscopic exam. These results:
a. Indicate renal injury induced by transfusion reaction
b. Support the finding of an extravascular transfusion reaction
c. Support the finding of an intravascular transfusion reaction
d. Rule out a transfusion reaction caused by RBC incompatibility
149. A urine sample taken after a suspected transfusion reaction tests positive for blood, but intact RBCs are not seen on
microscopic exam. Which one test result would rule out an intravascular hemolytic transfusion reaction?
a. Negative urine urobilinogen
b. Serum unconjugated bilirubin below 1.0 mg/dL
c. Serum potassium below 6.0 mmol/L
d. Plasma free hemoglobin below 0.5 mg/dL
150. Sudan IV stains:
a. fat globules orange-red c. fat globules clear with shiny edges
b. fat globules blue d. white cells
151. Given the urinalysis results below, select the most appropriate course of action pH
5.0 Protein Neg Glucose 1%
Ketone Moderate Blood Neg Bilirubin Neg
SSA protein 1%
a. Report the SSA protein result instead of the dry reagent strip result
b. Call for a list of medications administered to the patient
c. Perform a quantitative urinary albumin
d. Perform a test for microalbuminuria
152. A 24-hour urine sample from an adult submitted for measurement of catecholamine levels gives a result of 200

μg/day (upper reference limit 150 μg/day). The 24-hour urine creatinine level is 0.6 g/day. Select the best course of action.
a. Check urine pH to verify that it was less than 2.0
b. Report the result in micrograms of catecholamines per milligram of creatinine
c. Request a new 24-hour urine sample
d. Measure the VMA and report the catecholamine result only if elevated
153. Urinalysis results from a 35-year-old female are:
SG 1.015 pH 7.5 Protein Trace
Glucose Small Ketone Neg Blood Neg
5-10 RBCs/HPF 25-30 WBCs/HPF
Leukocyte esterase Mod
Select the most appropriate course of action.
a. Recheck the blood reaction; if negative look for budding yeast
b. Repeat the WBC count
c. Report all results except blood
d. Request a list of medications
154. A routine urinalysis gives the following results:
PH 6.5 Protein Neg
Glucose Trace Ketone Neg
Blood Neg 5-10 blood casts/LPF
Mucus Small Amorphous crystals Large
These results are most likely explained by:
a. False-negative blood reaction c. Pseudocasts of urate mistaken for true casts
b. False-negative protein reaction d. Mucus mistaken for casts
155. A toluidine blue chamber count on CSF gives the following values:
CSF Counts Peripheral Blood Counts
WBCs 10 X 106/L WBCs 5 X 109/L
RBCs 1.000 X 106/L RBCs 5 X 1012/L
After correcting the WBC count in CSF, one should next:
a. Report the WBC count as 9 X 106/L without additional testing
b. Report the WBC count and number of PMNs identified by the chamber count
c. Perform a differential on a direct smear of the CSF
d. Concentrate CSF using a cytocentrifuge and perform a differential
156. Diffusion of reagent on urine sticks occurs:
a. because stick is dipped too long c. does not happen
b. is not dipped long enough d. too much time passes before reading results
157. A blood-tainted pleural fluid is submitted for culture. Which test result would be most conclusive in classifying the fluid as
an exudate?
Test Result
a. LD fluid : serum 0.65
b. Total protein 3.2 g/dL

c. RBC count 10,000/μL

d. WBC count 1,500/μL

158. Results of a fetal lung maturity (FLM) study from a patient with diabetes mellitus are:
L/S 2.0;
Phosphatidyl glycerol (PG) Pos; Creatinine
2.5 mg/dL
Given these results one should:
a. Recommend repeating the L/S ratio in 24 hours
b. Perform scanning spectrophotometry on the fluid to determine if blood is present
c. Repeat the L/S ratio after 4 hours and report those results
d. Report results as valid
159. A quantitative serum hCG is ordered on male patient. One should:
a. Perform the test and report the result
b. Request that the order be cancelled
c. Perform the test and report the result if negative
d. Perform the test and report the result only if greater than 25 U/L
160. In Diabetes mellitus the specific gravity is found to be:
a. high b. low c. unchanged d. negative
161. Defective metabolism of phenylalanine causes:
a. tyrosinuria b. glycinuria c. phenylketonuria d. leucine
162. When urine is stained with Sudan IV these appear orange-red:
a. crystals b. cast c. fat globules d. white cells

163. A 3 year old is tested for enzymatic glucose reaction which is negative and a Clinitest® which is positive. How would you report
this?
a. both are clinically significant, report both results
b. one is incorrect, report the negative results
c. one is incorrect, report the positive results
d. should be reported as “positive” because the Benedict’s test is more sensitive
164. Calcium oxalate crystals:
a. have refractile cross c. are found in urine
b. small square crystals d. all of these
165. Fume blood function may be checked rather easily by noting the disposal of smoke or fumes produced after cautiously bringing
close together two applicator sticks whose cotton tips have been dipped in:
a. hydrochloric acid and sodium peroxide c. strong ammonia and vinegar
b. hydrochloric acid and strong ammonia d. ammonia water and dilute perchloric acid
166. Even though large cylinders of compressed gases are color coded usually, they should also have:
a. warning signs posted on the cylinders c. flash point warning labeled
b. contents clearly marked on the cylinder d. methods of storage listed on the cylinder
167. A fast evaporation rate be applied to a product with an evaporation rate:
a. 0.8 – 1.0 b. 1.0-1.5 c. 3.0-4.0 d. 0.4-0.8
168. A particularly troublesome substance to recover in the laboratory is:
a. sodium droplets c. magnesium “balls”
b. metallic mercury d. lithium gases
169. In the microbiology department, all work done with potentially highly infectious specimens should be performed:
a. in a fire-proof, specially ventilated area with explosion-proof switches
b. in a space with good ventilation, preferrably in a fume hood
c. in a clean-air hoods
d. on an open cabinet bench that can be easily disinfected
170. The “emergency procedures” section of the laboratory fire safety manual should provide instructions for:
1. alarm activation and evacuation 3. Procedures for extinguishing clothing fires
2. equipment shutdown procedure
a. 1 only b. 2 only c. 2 and 3 d. all of these
171. As far as laboratory safety is concerned:
a. the storeroom should be laid out to segregate incompatible chemicals
b. one should know you are always to pout water into acid and not conversely
c. one should realize mouth pipetting of all liquid chemicals is safe, provided is done inside a chemical hood
d. all of the above
172. It is known that vapors released by low flash point flammable liquids which have been stored in refrigerators have been
known to cause explosions:
a. when coming into contact with the refrigerator light bulb or switch
b. when the air inside the refrigerator falls to excessively cold temperatures
c. when coming into contact with vapors from other, non-flammable liquids
d. when the space inside the refrigerator does not provide for adequate air circulation
173. Reactivity data concerning possible hazardous chemical should explain what could happen if the chemical is combined with:
a. water, air, or other chemicals c. air, solids, or other chemicals
b. water, air, or other solids d. water, solids, or other chemicals
174. Grounding containers during a transfer of flammables is essential to:
a. keep the product safe from 2-prong plug-ins
b. avoid flash prong problems
c. stop static electricity as an ignition source
d. promote tranquility among fellow laboratory workers
175. What is “PEL”?
a. Physicians Eligibility and Licensing Code c. Physicians Electric Liability Code
b. Permissible exposure Limit d. Possible Electric Liability
176. What is TLV as set by the American Conference of Governmental Industrial Hygienists?
a. Threshold Limit Value c. Trade Limit Viability
b. Technical and Labelling Viscosity d. Trade Labelling Values
177. One of a potential hazardous chemical’s physical and chemical characteristics found in supplied data found in the
written hazard communication program would be:
a. boiling and melting points c. hydration and dehydration points
b. thawing points d. viscosity level
178. After running 10 miles in a race, the patient seeks medical care at the local emergency room because of excessive vomiting
and diarrhea. The most probable urine specific gravity would be:
a. 1.002 b. 1.010 c. 1.040 d. 1.000
179. Which statement is correct regarding angiotensin II?
a. it is a hormone secreted by the kidneys and is inert
b. it causes vasoconstriction of renal arterioles and releases aldosterone that retains sodium ions
c. it causes reabsorption of potassium ions in the proximal tubules
d. it acts to correct renal blood flow by releasing aldosterone
180. A pH of more than 7.0 may indicate:
a. gall bladder infection
b. uncontrolled diabetes mellitus
c. normal response following a meal
d. viral infection
181. Which statement is correct for the leukocyte strip test?
a. when negative, a urine microscopic is performed
b. detects lysed leukocytes
c. indicates possible viral UTIs
d. may indicate high concentrations of bilirubin
182. Ketonuria may indicate:
a. menstruation
b. hemolytic anemia
c. rapid weight loss
d. none of the above
183. Joe is a teacher who stands most of the day at the blackboard. He also has diabetes mellitus, which is usually controlled,
but isn’t today. In addition, Joe is getting over hepatitis A from the food he ate at the local pub. Choose the urinalysis result
that best fits this case.
a. positive bilirubin, negative glucose and acid urine pH
b. positive glucose, positive bilirubin and acid pH
c. high urine specific gravity, negative bilirubin and negative blood
d. normal urine pH with all negative urine chemistries
184. Which of the following can indicate chronic renal disease and is also seen in patients who have ingested ethylene glycol?
a. Cystine b. calcium oxalate c. calcium phosphate d. triple phosphate
185. Falsely decreased values for gastric acidity will occur if the:
a. patient is intubated while fasting
b. patient swallowing large amounts of saliva
c. aspiration is performed continuously over the collection period
d. patient receives histalog during the collection period
186. Normal fasting gastric appears:
a. yellow and frothy
b. pale yellow with food particles
c. pale gray and slightly mucoid
d. crystal clear
187. All of the following statements regarding urinary crystals are true except:
a. Amorphous phosphates are dissolved by heat
b. Amorphous phosphates form a white sediment after centrifugation
c. Amorphous urates form a pink sediment after centrifugation
d. Amorphous urates can be cleared by addition of warm saline
188. At pH 7.0, phenol red changes from:
a. yellow to red b. red to yellow c. colorless to red d. red to colorless
189. Post stimulation specimens from persons with pernicious anemia will show:
a. no increased acidity and a pH above 6.0
b. no increased acidity and a pH below 6.0
c. increased acidity and a pH below 6.0
d. increased acidity and a pH below 3.5
190. Hexagonal uric acid crystals can be distinguished from cystine crystals because:
a. Uric acid is insoluble in hydrochloric acid and cystine is not
b. Cystine gives a positive nitroprusside test after reduction with sodium cyanide
c. Cystine crystals are colorless
d. All of these
191. All of the following statements regarding crystals in urine are true except:
a. Abnormal crystals are seen only in acid or neutral urine
b. Cholesterol crystals are anisotropic and confirmed by polarizing microscopy
c. Refrigeration enhances the formation of amorphous crystals
d. Bilirubin crystals may be present even when the chemical test for bilirubin is negative
192. Which of the following characterizes prerenal failure but not renal disease?
a. BUN:creatinine ratio greater than 20:1 c. Low daily excretion of sodium
b. Urine:plasma osmolal ratio greater than 2:1 d. All of the above
193. All of the following statements regarding differentiation of acute and chronic renal failure are true except:
a. Potassium may be normal in chronic renal failure due to salt wasting
b. Polyuria occurs in chronic failure due to scarring of collecting tubules
c. Nocturia and dehydration are common in chronic failure
d. Hematuria is uncommon in chronic renal failure
194. Which of the following conditions is known to cause glomerulonephritis?
a. Diabetes mellitus
b. Autoimmune damage following recent respiratory infection with Group A Streptococcus
c. Systemic lupus erythematosus (SLE)
d. All of the above
195. Acute pyelonephritis is commonly caused by:
a. Bacterial infection of medullary interstitium
b. Circulatory failure
c. Renal calculi
d. Antigen-antibody reactions within the glomeruli
196. All of the following statements regarding obstructive renal disease are true except:
a. Anuria can result from severe renal calculi
b. Postrenal failure can be caused by malignancy as well as stones
c. Infection may induce stone formation by altering filtrate or urine pH
d. Hematuria is not usually seen in postrenal failure
197. All of the following statements regarding urinary calculi are true except:
a. Most kidney stones are composed of uric acid
b. Hyperparachyroidism is a common cause of hypercalciuria
c. Hyperparathyroidism promotes calcium phosphate calculi by increasing urine pH
d. Calculi often are associated with urinary tract infections