Urinalysis and Body Fluids 6th Edition By Susan King Strasinger -Test Bank

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Urinalysis and Body Fluids 6th Edition By Susan King Strasinger -Test Bank

Chapter 6: Microscopic Examination of Urine

 

 

 

Multiple Choice

 

 

 

  1. The recommended centrifugation setting for preparation of the urine sediment is:
  2. 400 RPM for 10 minutes
  3. 1000 RPM for 5 minutes
  4. 400 RCF for 5 minutes
  5. 1000 RCF for 10 minutes

 

ANS: C

DIF: Level 1

OBJ: 3

TOP: Centrifugation

 

 

 

  1. The number of fields that should be examined when quantitating urinary sediment constituents is:
  2. 2
  3. 5
  4. 10
  5. 20

 

ANS: C

DIF: Level 1

OBJ: 3

TOP: Examination of the sediment

 

 

 

  1. The predecessor of the standardized urine microscopic examination was the:
  2. Sternheimer count
  3. Addis count
  4. Kova system
  5. T-system

 

ANS: B

DIF: Level 1

OBJ: 3

TOP: Technique

 

 

 

  1. The two factors that determine relative centrifugal force are:
  2. Radius of rotor head and revolutions per minute (RPM)
  3. Radius of rotor head and time of centrifugation
  4. Diameter of rotor head and RPM
  5. RPM and time of centrifugation

 

ANS: A

DIF: Level 1

OBJ: 3

TOP: Centrifugation

 

 

 

  1. A lipid droplet that does not stain with Sudan III may be composed of:
  2. Triglycerides
  3. Cholesterol
  4. Neutral fats
  5. Chylomicrons

 

ANS: B

DIF: Level 1

OBJ: 4

TOP: Sediment stains

 

 

 

  1. A urine specimen is referred for cytodiagnostic urine testing to detect the presence of:
  2. Trichomonas vaginalis
  3. Blitter cells
  4. Malignant cells
  5. Spermatozoa

 

ANS: C

DIF: Level 1

OBJ: 5

TOP: Examining the sediment

 

 

 

  1. To standardize the sediment concentration for microscopic analysis one must:
  2. Centrifuge the entire urine collection
  3. Use only the urine tubes and pipettes for a single commercial system
  4. Interchange the urine tubes and pipettes from several commercial systems
  5. Use only the parts of the commercial system that you want

 

ANS: B

DIF: Level 1

OBJ: 3

TOP: Commercial systems

 

 

 

  1. The purpose of scanning the perimeter of urine sediment placed under a conventional glass slide is to:
  2. Identify types of casts
  3. Detect renal tubular epithelial cells
  4. Evaluate the overall sediment composition
  5. Detect the presence of casts

 

ANS: D

DIF: Level 1

OBJ: 2

TOP: Examining the sediment

 

 

 

  1. All of the following are reported as the quantity per high-power field except:
  2. Casts
  3. Red blood cells (RBCs)
  4. White blood cells (WBCs)
  5. Bacteria

 

ANS: A

DIF: Level 1

OBJ: 3

TOP: Microscopic examination

 

 

 

  1. The most probable structures to be stained by the Prussian blue stain are:
  2. Renal tubular epithelial cells
  3. WBCs
  4. Transitional epithelial cells
  5. Urothelial cells

 

ANS: A

DIF: Level 2

OBJ: 4

TOP: Sediment stains

 

 

 

  1. The purpose of including glucose as a significant chemical parameter by a laboratory that performs macroscopic screening is to check for the presence of:
  2. WBC casts
  3. Hyaline casts
  4. Trichomonas vaginalis
  5. Candida albicans

 

ANS: D

DIF: Level 2

OBJ: 3

TOP: Macroscopic screening

 

 

 

  1. 10 mL of urine is centrifuged, and 9.5 mL of urine is decanted. The sediment concentration factor is:
  2. 5
  3. 12
  4. 20
  5. 24

 

ANS: C

DIF: Level 2

OBJ: 3

TOP: Commercial systems

 

 

 

  1. Calculation of the number of RBCs per milliliter of urine requires knowledge of all of the following except the:
  2. Number of high-power fields per milliliter of urine
  3. Speed of centrifugation
  4. Number of high-power fields per viewing area
  5. Area of a high-power field

 

ANS: B

DIF: Level 2

OBJ: 3

TOP: Technique

 

 

 

  1. A medical laboratory science student consistently obtains lower RBC counts than the instructor. A possible reason for this might be:
  2. Failure to completely resuspend the sedimented specimen
  3. Reading the same cells twice
  4. Counting all crenated cells twice
  5. Using too much stain

 

ANS: A

DIF: Level 3

OBJ: 3

TOP: Technique

 

 

 

  1. Centrifugation of less than the recommended 12 mL of urine for the microscopic examination will:
  2. Produce a false-negative sulfosalicyclic acid (SSA)
  3. Produce a false-positive SSA
  4. Increase the number of cellular elements
  5. Decrease the number of cellular elements

 

ANS: D

DIF: Level 3

OBJ: 3

TOP: Technique

 

 

 

  1. Substances found in the urinary sediment that can be confirmed using polarized light are:
  2. WBCs
  3. Casts
  4. Ketone bodies
  5. Lipids

 

ANS: D

DIF: Level 1

OBJ: 6

TOP: Microscopy

 

 

 

  1. Using polarized microscopy, which of the following is/are birefringent?
  2. Cholesterol
  3. Triglycerides
  4. Fatty acids
  5. Neutral fats

 

ANS: A

DIF: Level 1

OBJ: 6

TOP: Microscopy

 

 

 

  1. Identification of oval fat bodies can be verified using:
  2. Bright-field microscopy
  3. Phase contrast
  4. Polarized light
  5. Interference-contrast microscopy

 

ANS: C

DIF: Level 1

OBJ: 6

TOP: Microscopy

 

 

 

  1. Using a bright-field microscope, the final magnification of a high-power field is:
  2. 10X
  3. 40X
  4. 400X
  5. 1000X

 

ANS: C

DIF: Level 1

OBJ: 6

TOP: Microscopy

 

 

 

  1. To detect the presence of casts, the sediment is examined using:
  2. Increased light under high power
  3. Increased light under low power
  4. Reduced light under high power
  5. Reduced light under low power

 

ANS: D

DIF: Level 2

OBJ: 6

TOP: Microscopy

 

 

 

  1. Optimal viewing is obtained by performing Köhler illumination adjustment to the:
  2. Field diaphragm
  3. Condenser
  4. Operative diaphragm
  5. Rheostat

 

ANS: B

DIF: Level 2

OBJ: 6

TOP: Microscopy

 

 

 

  1. To increase the probability of detecting urine sediment constituents that have a low refractive index, clinical laboratories often use:
  2. Phase-contrast microscopy
  3. Polarizing microscopy
  4. Interference-contrast microscopy
  5. Bright-field microscopy

 

ANS: A

DIF: Level 2

OBJ: 6

TOP: Microscopy

 

 

 

  1. The presence of crenated RBCs in the urine sediment is associated with:
  2. Rrauma
  3. Hypersthenuria
  4. Hyposthenuria
  5. Urinary tract infection

 

ANS: B

DIF: Level 1

OBJ: 8

TOP: RBCs

 

 

 

  1. Dilute alkaline urine should be examined carefully for the presence of:
  2. Yeast
  3. Renal tubular epithelial cells
  4. Ghost RBCs
  5. Fatty casts

 

ANS: C

DIF: Level 1

OBJ: 8

TOP: RBCs

 

 

 

  1. A patient with severe back pain and 15 to 20 RBCs/hpf in the urine sediment may have:
  2. Renal calculi
  3. Acute glomerulonephritis
  4. Nephrotic syndrome
  5. Osteomyelitis

 

ANS: A

DIF: Level 2

OBJ: 8

TOP: RBCs

 

 

 

  1. Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except:
  2. Observation of budding in yeast cells
  3. Increased refractility of oil droplets
  4. Lysis of yeast cells by acetic acid
  5. Lysis of RBCs by acetic acid

 

ANS: C

DIF: Level 2

OBJ: 8

TOP: RBCs

 

 

 

  1. Ghost RBCs most frequently occur with a urine specimen that exhibits the following:
  2. High pH, high specific gravity
  3. High pH, low specific gravity
  4. Low pH, high specific gravity
  5. Low pH, low specific gravity

 

ANS: B

DIF: Level 2

OBJ: 8

TOP: RBCs

 

 

 

  1. The presence of hypochromic, irregularly shaped RBCs in the urine sediment can indicate:
  2. A coagulation disorder
  3. Menstrual contamination
  4. Urinary tract infection
  5. Glomerular bleeding

 

ANS: D

DIF: Level 2

OBJ: 8

TOP: RBCs

 

 

 

  1. Glitter cell is a term used to describe a specific type of:
  2. Ketone body
  3. Renal tubular epithelial cell
  4. Neutrophil
  5. Oval fat body

 

ANS: C

DIF: Level 1

OBJ: 9

TOP: WBCs

 

 

 

  1. An increase in urinary WBCs is called:
  2. Pyelonephritis
  3. Cystitis
  4. Urethritis
  5. Pyuria

 

ANS: D

DIF: Level 1

OBJ: 9

TOP: WBCs

 

 

 

  1. Urine sediments containing increased WBCs should be observed closely for the presence of:
  2. Hyaline casts
  3. Granular casts
  4. Bacteria
  5. Urothelial cells

 

ANS: C

DIF: Level 1

OBJ: 9

TOP: WBCs

 

 

 

  1. Eosinophils are found in the urine in cases of:
  2. Nephrotic syndrome
  3. Cystitis
  4. Acute interstitial nephritis
  5. Renal lithiasis

 

ANS: C

DIF: Level 2

OBJ: 9

TOP: WBCs

 

 

 

  1. Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit brownian movement are:
  2. Indicative of pyelonephritis
  3. Basophils
  4. Mononuclear leukocytes
  5. Glitter cells

 

ANS: D

DIF: Level 2

OBJ: 9

TOP: WBCs

 

 

 

  1. Oval fat bodies are:
  2. Squamous epithelial cells that contain lipids
  3. Renal tubular epithelial cells that contain lipids
  4. WBCs that have phagocytized lipids
  5. People who fail to work out regularly

 

ANS: B

DIF: Level 1

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. The type of cells that line the bladder and ureters are called:
  2. Squamous
  3. Renal tubular
  4. Transitional
  5. Basal

 

ANS: C

DIF: Level 1

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. Initial microscopic focusing on the urinary sediment is frequently performed by referencing:
  2. Mucus
  3. Squamous epithelial cells
  4. RBCs
  5. Hyaline casts

 

ANS: B

DIF: Level 1

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. In ascending order, the location of epithelial cells in the urinary tract is:
  2. Squamous, transitional, renal tubular
  3. Transitional, renal tubular, squamous
  4. Renal tubular, transitional, squamous
  5. Squamous, renal tubular, urothelial

 

ANS: A

DIF: Level 1

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. Clue cells are derived from:
  2. Renal tubular epithelial cells
  3. Trichomonas vaginalis
  4. Histiocytes
  5. Squamous epithelial cells

 

ANS: D

DIF: Level 1

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. The organisms attached to a clue cell are:
  2. Gardnerella vaginalis
  3. Trichomonas vaginalis
  4. Escherichia coli
  5. Candida albicans

 

ANS: A

DIF: Level 1

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. Urothelial cells routinely occur in all of the following shapes except:
  2. Spherical
  3. Cylindroid
  4. Polyhedral
  5. Caudate

 

ANS: B

DIF: Level 1

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. Which of the following cells found in increased numbers in the urine sediment is only indicative of nephron damage?
  2. Erythrocytes
  3. WBCs
  4. Squamous epithelial cells
  5. Renal tubular cells

 

ANS: D

DIF: Level 2

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. The type of cell most likely to appear stained with bilirubin is:
  2. Renal tubular
  3. Neutrophil
  4. Squamous
  5. Transitional

 

ANS: A

DIF: Level 2

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. Collection of a midstream clean-catch specimen will alleviate contamination by:
  2. Renal tubular epithelial cells
  3. RBCs
  4. Transitional epithelial cells
  5. Squamous epithelial cells

 

ANS: D

DIF: Level 2

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. Which of the following cells can both be found in both a vaginal wet prep and in urine sediment?
  2. Yeast cell and clue cell
  3. Transitional and renal epithelial cell
  4. Clue cell and squamous cell
  5. Renal and squamous cells

 

ANS: A

DIF: Level 2

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. Spherical transitional epithelial cells can be differentiated from renal tubular epithelial cells by observing the:
  2. Centrally located nucleus in renal tubular cells
  3. Granular cytoplasm in renal tubular cells
  4. Centrally located nucleus in transitional cells
  5. Granular cytoplasm in transitional cells

 

ANS: C

DIF: Level 2

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. The finding of renal tubular epithelial cells containing yellow-brown granules correlates with a positive reagent strip test for:
  2. Blood
  3. Bilirubin
  4. Glucose
  5. Nitrite

 

ANS: A

DIF: Level 2

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. The primary factor that favors the formation of urinary casts is:
  2. Urinary stasis
  3. High pH
  4. Positive blood
  5. Low specific gravity

 

ANS: A

DIF: Level 1

OBJ: 12

TOP: Casts

 

 

 

  1. The major constituent of urinary casts is:
  2. Lipoprotein
  3. Bence Jones protein
  4. Uromodulin protein
  5. Amino acids

 

ANS: C

DIF: Level 1

OBJ: 12

TOP: Casts

 

 

 

  1. Waxy casts are most easily differentiated from hyaline casts by their:
  2. Color
  3. Size
  4. Granules
  5. Refractivity

 

ANS: D

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. Urinary casts are formed in the:
  2. Distal and collecting tubules
  3. Distal tubules and loops of Henle
  4. Proximal and distal tubules
  5. Proximal tubules and loops of Henle

 

ANS: A

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. Which of the following elements would most likely be found in an acidic concentrated urine that contains protein?
  2. Ghost RBCs
  3. Casts
  4. Bacteria
  5. Triple phosphate crystals

 

ANS: B

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. Sediment constituents that are used to differentiate between upper and lower urinary tract infections are:
  2. WBCs
  3. WBC clumps
  4. RBCs and WBCs
  5. WBC casts

 

ANS: D

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. To differentiate a bacterial cast from a granular cast, a clinical laboratory scientist could:
  2. Perform a Gram stain
  3. Use polarizing microscopy
  4. Perform a Hansel stain
  5. Add acetic acid to the sediment

 

ANS: A

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. The type of cast most closely associated with tubular damage is the:
  2. WBC cast
  3. Epithelial cell cast
  4. RBC cast
  5. Fatty cast

 

ANS: B

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. The only type of cast capable of polarization is the:
  2. Waxy cast
  3. Hyaline cast
  4. Fatty cast
  5. Granular cast

 

ANS: C

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. Broad casts may form as a result of:
  2. Extreme urinary stasis
  3. Strenuous exercise
  4. Increase in loss of amino acids
  5. Dehydration

 

ANS: A

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. The finding of increased hyaline and granular casts in the urine of an otherwise healthy person may be the result of:
  2. Fecal contamination
  3. Recent strenuous exercise
  4. Early urinary tract infection
  5. Analyzing an old specimen

 

ANS: B

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. Hyaline casts may degenerate into:
  2. Granular casts
  3. Fatty casts
  4. Broad casts
  5. Waxy casts

 

ANS: D

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. Waxy casts can be found in the urine sediment:
  2. In patients with renal failure
  3. Of an alkaline urine
  4. Whenever abnormal protein is present
  5. When urine is not correctly preserved

 

ANS: A

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. The urinary sediment constituent most closely associated with bleeding within the nephron is the:
  2. RBC
  3. RBC cast
  4. WBC cast
  5. Hyaline cast

 

ANS: B

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. Which of the following differentiates a waxy cast from a fiber most effectively?
  2. Waxy casts do not polarize light, and fibers do.
  3. Waxy casts are more refractile than fibers.
  4. Waxy casts have rounded ends, and fibers do not.
  5. Waxy casts are thicker on the edge, and fibers are thicker in the center.

 

ANS: A

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. All of the following may be seen in the urine following strenuous exercise except:
  2. Protein
  3. Glucose
  4. Hyaline casts
  5. Granular casts

 

ANS: B

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. To distinguish a cellular cast from a clump of cells, the clinical laboratory scientist should:
  2. Check for dysmorphic cells
  3. Look carefully for a cast matrix
  4. Determine if free-standing cells are present
  5. Examine the sediment using polarizing microscopy

 

ANS: B

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. Granular casts present in the urine following strenuous exercise can:
  2. Represent disintegration of cellular casts
  3. Contain cellular lysosomes
  4. Be pathogenic for renal disease
  5. Represent a prerenal condition

 

ANS: B

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. All of the following are associated with severe urinary stasis except:
  2. Granular casts
  3. Waxy casts
  4. WBC casts
  5. Broad casts

 

ANS: C

DIF: Level 2

OBJ: 13

TOP: Casts

 

 

 

  1. Identification of urinary crystals is based on shape and:
  2. Urine pH and crystal solubility
  3. Urine protein and crystal size
  4. Urine bilirubin and glucose
  5. Urine pH and crystal size

 

ANS: A

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. Urinary crystals that appear yellow to reddish-brown are:
  2. Calcium oxalate
  3. Triple phosphate
  4. Cholesterol
  5. Uric acid

 

ANS: D

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. To dissolve amorphous urates, you could:
  2. Warm the specimen to body temperature
  3. Add concentrated sodium hydroxide
  4. Add dilute hydrochloric acid
  5. Add dilute acetic acid

 

ANS: A

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. Nonpathogenic or “normal” crystals found in acidic urine include:
  2. Calcium oxalate, uric acid, amorphous urates
  3. Calcium oxalate, uric acid, sulfonamides
  4. Uric acid, amorphous urates, triple phosphate
  5. Uric acid, calcium carbonate, bilirubin

 

ANS: A

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. All of the following crystals can be found in acid urine except:
  2. Cholesterol
  3. Tyrosine
  4. Cystine
  5. Ammonium biurate

 

ANS: D

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. Abnormal crystals are most frequently seen in a urine that is:
  2. Acid
  3. Neutral
  4. Alkaline
  5. Collected for 24 hours

 

ANS: A

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. Information that aids in the identification of crystals includes all of the following except:
  2. Urine temperature
  3. Urine pH
  4. Crystal solubility
  5. Crystal birefringence

 

ANS: A

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. Which of the following crystals occurs in two very distinct forms?
  2. Ammonium biurate
  3. Calcium oxalate
  4. Leucine
  5. Cholesterol

 

ANS: B

DIF: Level 1

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. Nonpathogenic or “normal” crystals found in alkaline urine include:
  2. Calcium oxalate, uric acid, amorphous urates
  3. Calcium oxalate, uric acid, sulfonamides
  4. Uric acid, amorphous urates, calcium carbonate
  5. Triple phosphate, calcium carbonate, ammonium biurate

 

ANS: D

DIF: Level 2

OBJ: 15

TOP: Urinary crystals

 

 

 

  1. Crystals found in the urine that are associated with pathogenic disease include:
  2. Calcium oxalate and uric acid
  3. Leucine and tyrosine
  4. Heavy amorphous phosphates
  5. Triple phosphate and ammonium biurate

 

ANS: B

DIF: Level 2

OBJ: 16

TOP: Urinary crystals

 

 

 

  1. Which of the following crystals is associated with ethylene glycol ingestion?
  2. Uric acid
  3. Calcium oxalate monohydrate
  4. Triple phosphate
  5. Calcium oxalate dihydrate

 

ANS: B

DIF: Level 2

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. A urine specimen refrigerated overnight is cloudy and has a pH of 6. The turbidity is probably due to:
  2. Amorphous phosphates
  3. Amorphous urates
  4. Triple phosphate crystals
  5. Calcium oxalate crystals

 

ANS: B

DIF: Level 2

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. All of the following affect the formation of crystals except:
  2. Urine specific gravity
  3. Urine pH
  4. Urinary casts
  5. Urine temperature

 

ANS: C

DIF: Level 2

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. Cystine crystals are often confused with:
  2. Cholesterol crystals
  3. Leucine crystals
  4. Uric acid crystals
  5. Triple phosphate crystals

 

ANS: C

DIF: Level 2

OBJ: 16

TOP: Urinary crystals

 

 

 

  1. Formation of crystals due to medications is most frequently caused by:
  2. Inadequate hydration
  3. Incorrect timing of medication doses
  4. Medication overdoses
  5. Use of expired antibiotics

 

ANS: A

DIF: Level 2

OBJ: 16

TOP: Urinary crystals

 

 

 

  1. Calcium carbonate crystals can be distinguished from bacteria by:
  2. Warming the sediment
  3. Refrigerating the specimen
  4. Checking the pH of the specimen
  5. Adding acetic acid

 

ANS: D

DIF: Level 2

OBJ: 15

TOP: Urinary crystals

 

 

 

  1. Which of the following results should have testing repeated?
  2. Positive blood and protein
  3. pH 7.0 with uric acid crystals
  4. Positive bilirubin and urobilinogen
  5. pH 8.0, WBCs, and triple phosphate crystals

 

ANS: B

DIF: Level 3

OBJ: 14

TOP: Urinary crystals

 

 

 

  1. The significance of seeing bacteria in the urine sediment is increased when:
  2. RBCs and casts are present
  3. The patient has an elevated temperature
  4. The specimen is cloudy
  5. WBCs are present

 

ANS: D

DIF: Level 1

OBJ: 18

TOP: Urinary sediment artifacts

 

 

 

  1. Yeast may appear in the urine sediment in all of the following forms except:
  2. Mycelial
  3. Biconcave
  4. Oval
  5. Budding ovals

 

ANS: B

DIF: Level 1

OBJ: 17

TOP: Urinary sediment artifacts

 

 

 

  1. Schistosoma haematobium would most likely be found in the urine from a:
  2. Foreign-service employee
  3. Marathon runner
  4. Diabetic patient
  5. Health-care worker

 

ANS: A

DIF: Level 1

OBJ: 17

TOP: Urinary sediment artifacts

 

 

 

  1. Motility by which of the following is most noticeable during the urine sediment examination?
  2. Spermatozoa
  3. Candida albicans
  4. Trichomonas vaginalis
  5. Escherichia coli

 

ANS: C

DIF: Level 1

OBJ: 18

TOP: Urinary sediment artifacts

 

 

 

  1. Urine sediment artifacts frequently differ from true sediment constituents by their:
  2. Location in the specimen
  3. Appearance
  4. Refractility
  5. Number present

 

ANS: C

DIF: Level 1

OBJ: 18

TOP: Urinary sediment artifacts

 

 

 

  1. Under polarized light, all of the following will exhibit the Maltese cross formation except:
  2. Starch granules
  3. Oval fat bodies
  4. Pollen grains
  5. Fatty casts

 

ANS: C

DIF: Level 2

OBJ: 17

TOP: Urinary sediment artifacts

 

 

 

  1. In an unpreserved and old urine specimen, there could be difficulty differentiating between bacteria and:
  2. Yeast
  3. Mucus
  4. Amorphous phosphates
  5. Pollen grains

 

ANS: C

DIF: Level 2

OBJ: 17

TOP: Urinary sediment artifacts

 

 

 

  1. Which of the following is most likely to be found in the urine of a diabetic patient?
  2. Trichomonas vaginalis
  3. Escherichia coli
  4. Staphylococcus saprophyticus
  5. Candida albicans

 

ANS: D

DIF: Level 2

OBJ: 18

TOP: Urinary sediment artifacts

 

 

 

  1. Specimens containing mucus may be erroneously reported as containing:
  2. Bacteria
  3. Yeast
  4. Hyaline casts
  5. Oval fat bodies

 

ANS: C

DIF: Level 2

OBJ: 17

TOP: Urinary sediment artifacts

 

 

 

NARRBEGIN: 06-nar-01

Choose the appropriate urine sediment stain for the following functions:

NARREND

 

 

 

  1. Enhance nuclear detail.
  2. Sudan III
  3. Hansel stain
  4. Prussian blue
  5. Toluidine blue

 

ANS: D

NAR: 06-nar-01

DIF: Level 1

OBJ: 4

TOP: Sediment stains

 

 

 

  1. Stain oval fat bodies.
  2. Sudan III
  3. Hansel stain
  4. Prussian blue
  5. Sternheimer-Malbin

 

ANS: A

NAR: 06-nar-01

DIF: Level 1

OBJ: 4

TOP: Sediment stains

 

 

 

  1. Stain eosinophils.
  2. Sudan III
  3. Hansel stain
  4. Prussian blue
  5. Toluidine blue

 

ANS: B

NAR: 06-nar-01

DIF: Level 1

OBJ: 4

TOP: Sediment stains

 

 

 

  1. Stain hemosiderin granules.
  2. Hansel stain
  3. Prussian blue
  4. Toluidine blue
  5. Sternheimer-Malbin

 

ANS: B

NAR: 06-nar-01

DIF: Level 1

OBJ: 4

TOP: Sediment stains

 

 

 

NARRBEGIN: 06-nar-02

The following results are obtained on a urinalysis from a student athlete:

NARREND

 

 

 

  1. Based on the information given, what is causing the crenated RBCs?
  2. Elevated protein
  3. Presence of hyaline casts
  4. High specific gravity
  5. Presence of granular casts

 

ANS: C

NAR: 06-nar-02

DIF: Level 2

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, why is only a trace of blood detected by reagent strip?
  2. Protein inhibition
  3. Acid pH
  4. Crenated RBCs
  5. Dilute specimen

 

ANS: C

NAR: 06-nar-02

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, name another form of RBC that could be present in this urine sediment.
  2. Glitter cells
  3. Spherocytes
  4. Hypochromic
  5. Dysmorphic

 

ANS: D

NAR: 06-nar-02

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, what is the most probable cause of the abnormal results?
  2. Sports injury
  3. Glomerular damage
  4. Strenuous exercise
  5. Dehydration

 

ANS: C

NAR: 06-nar-02

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, what type of specimen should the student be asked to collect for retesting?
  2. First morning
  3. Timed 8-hour
  4. Midstream clean-catch
  5. Second morning

 

ANS: A

NAR: 06-nar-02

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

NARRBEGIN: 06-nar-03

The following results are obtained on a catheterized specimen from a patient with symptoms of urinary tract infection:

NARREND

 

 

 

  1. Based on information provided, is this report consistent with a urinary tract infection?
  2. Yes
  3. No

 

ANS: A

NAR: 06-nar-03

DIF: Level 2

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, which of these results would concern a urinalysis supervisor?
  2. Elevated protein
  3. renal tubullar epithelial cells
  4. Blood
  5. Absence of WBC casts

 

ANS: B

NAR: 06-nar-03

DIF: Level 2

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, what is the most probable cause of an error in the report?
  2. Specimen mix-up
  3. RTEs are spherical transitional cells
  4. Analyzing a catheterized specimen
  5. Both B and C

 

ANS: D

NAR: 06-nar-03

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

NARRBEGIN: 06-nar-04

Urinalysis results on a patient being monitored following an adverse reaction occurring during surgery are:

NARREND

 

 

 

  1. Based on the information provided, what substance is causing the positive reagent strip reaction for blood?
  2. Hemoglobin
  3. Myoglobin
  4. RBCs
  5. Peroxide contamination

 

ANS: A

NAR: 06-nar-04

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, what is the significance of the elevated urobilinogen reading?
  2. Constipation
  3. Liver damage
  4. Intravascular hemolysis
  5. Urine color

 

ANS: C

NAR: 06-nar-04

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, what is the composition of the dirty, brown casts?
  2. Melanin
  3. Methemoglobin
  4. Coarse granules
  5. RBCs

 

ANS: B

NAR: 06-nar-04

DIF: Level 3

OBJ: 13

TOP: Microscopic case study

 

 

 

  1. What is the significance of the RTE cells and casts based on the information provided?
  2. Tubular damage
  3. Decreased urine flow
  4. Glomerular damage
  5. Possible malignancy

 

ANS: A

NAR: 06-nar-04

DIF: Level 3

OBJ: 13

TOP: Microscopic case study

 

 

 

  1. What is the probable composition of the yellow-brown granules based on the information provided?
  2. Hemoglobin
  3. Uric acid
  4. Hemosiderin
  5. Disintegrating RTE cells

 

ANS: C

NAR: 06-nar-04

DIF: Level 3

OBJ: 17

TOP: Microscopic case study

 

 

 

  1. Based on the information provided, how could the composition of the granules be confirmed?
  2. With Prussian blue stain
  3. With polarized microscopy
  4. With Hansel stain
  5. With phase microscopy

 

ANS: A

NAR: 06-nar-04

DIF: Level 3

OBJ: 18

TOP: Microscopic case study

 

 

 

True/False

 

 

 

  1. To adjust the intensity of light in a bright-field microscope, the condenser should be raised or lowered.

 

ANS: False

DIF: Level 1

OBJ: 6

TOP: Microscopy

 

 

 

  1. When changing magnification using a parfocal microscope, focusing is performed using the coarse adjustment knob.

 

ANS: False

DIF: Level 1

OBJ: 6

TOP: Microscopy

 

 

 

  1. In the urinalysis laboratory, a bright-field microscope can be converted to a polarizing microscope.

 

ANS: True

DIF: Level 1

OBJ: 6

TOP: Microscopy

 

 

 

  1. The finding of increased urinary WBCs is not significant unless increased bacteria are also present.

 

ANS: False

DIF: Level 2

OBJ: 9

TOP: WBCs

 

 

 

  1. Renal tubular epithelial cells from the distal convoluted tubule are smaller than those from the proximal convoluted tubule.

 

ANS: True

DIF: Level 2

OBJ: 10

TOP: Epithelial cells

 

 

 

  1. A structure resembling a cast but having a tapered end should not be reported as a cast.

 

ANS: False

DIF: Level 1

OBJ: 12

TOP: Casts

 

 

 

  1. WBC casts should always be accompanied by significant bacteriuria.

 

ANS: False

DIF: Level 1

OBJ: 13

TOP: Casts

 

 

 

  1. To be considered significant, yeast cells in the urine sediment should be accompanied by leukocytes.

 

ANS: True

DIF: Level 1

OBJ: 17

TOP: Urinary sediment artifacts

 

 

 

  1. Trichomonas vaginalis is not found in urine from male patients.

 

ANS: False

DIF: Level 1

OBJ: 17

TOP: Urinary sediment artifacts

 

 

 

Matching

 

 

 

Choose the correct microscope part needed to perform the following functions:

  1. Condenser
  2. Oculars
  3. Diopter adjustment knob
  4. Rheostat
  5. Nose piece

 

  1. Focus light on the specimen
  2. Hold the objectives
  3. Increase objective resolution
  4. Control light intensity
  5. Regulate interpupillary distance

 

119. ANS: A DIF: Level 1 OBJ: 6 TOP: Microscopy
120. ANS: E DIF: Level 1 OBJ: 6 TOP: Microscopy
121. ANS: B DIF: Level 1 OBJ: 6 TOP: Microscopy
122. ANS: D DIF: Level 1 OBJ: 6 TOP: Microscopy
123. ANS: C DIF: Level 1 OBJ: 6 TOP: Microscopy

 

 

 

Choose the description for the following urine crystals:

  1. Thorny apple
  2. Coffin lid
  3. Notched corners
  4. Hexagonal
  5. Dumbbell

 

  1. Ammonium biurate
  2. Calcium carbonate
  3. Triple phosphate
  4. Cystine
  5. Cholesterol

 

124. ANS: A DIF: Level 1 OBJ: 15 TOP: Urinary crystals
125. ANS: E DIF: Level 1 OBJ: 15 TOP: Urinary crystals
126. ANS: B DIF: Level 1 OBJ: 15 TOP: Urinary crystals
127. ANS: D DIF: Level 1 OBJ: 16 TOP: Urinary crystals
128. ANS: C DIF: Level 1 OBJ: 16 TOP: Urinary crystals

 

 

 

State if a urinalysis supervisor would be concerned or not concerned about the following results:

  1. Concerned
  2. Not concerned

 

  1. Enterobius vermicularis and waxy casts in a cloudy specimen from a pediatric patient
  2. RBC casts in a specimen with a negative reagent strip test for blood
  3. Triple phosphate and ammonium biurate crystals in a specimen with a pH of 8.0
  4. Candida albicans and leukocytes in a specimen with a negative nitrite test
  5. 2–3 granular casts/lpf in a refrigerated specimen containing many amorphous crystals
  6. Many budding yeasts in a clear, red specimen from a bedridden, diabetic patient

 

129. ANS: A DIF: Level 3 OBJ: 13 TOP: Microscopic case study
130. ANS: A DIF: Level 3 OBJ: 13 TOP: Microscopic case study
131. ANS: B DIF: Level 3 OBJ: 15 TOP: Microscopic case study
132. ANS: B DIF: Level 3 OBJ: 17 TOP: Microscopic case study
133. ANS: A DIF: Level 3 OBJ: 13 TOP: Microscopic case study
134. ANS: B DIF: Level 3 OBJ: 17 TOP: Microscopic case study

 

Chapter 7: Renal Disease

 

 

 

Multiple Choice

 

 

 

  1. Diseases affecting the glomerulus are primarily caused by:
  2. Trauma
  3. Diabetes
  4. Immunological disorders
  5. Toxic chemicals

 

ANS: C

DIF: Level 1

OBJ: 2

TOP: Glomerular disorders

 

 

 

  1. All of the following are symptoms of acute glomerulonephritis except:
  2. Periorbital edema
  3. Hematuria
  4. Proteinuria
  5. Hypoalbuminemia

 

ANS: D

DIF: Level 1

OBJ: 4

TOP: Glomerular disorders

 

 

 

  1. The major cause of the nephrotic syndrome in children is:
  2. IgA nephropathy
  3. Minimal change disease
  4. Membranous glomerulonephritis
  5. Rapidly progressive glomerulonephritis

 

ANS: B

DIF: Level 1

OBJ: 4

TOP: Glomerular disorders

 

 

 

  1. Damage to the glomerulus can occur as a result of all of the following except:
  2. Increased filtration of electrolytes
  3. Deposition of immune complexes
  4. Deposition of amyloid materials
  5. Cellular infiltration

 

ANS: A

DIF: Level 1

OBJ: 4

TOP: Glomerular disorders

 

 

 

  1. The buildup of crescentic formations on the glomerular capillaries is characteristic of:
  2. Goodpasture syndrome
  3. Rapidly progressive glomerulonephritis
  4. Wegener’s granulomatosis
  5. IgA nephropathy

 

ANS: B

DIF: Level 1

OBJ: 4

TOP: Glomerular disorders

 

 

 

  1. The most common cause of end-stage renal disease is:
  2. Acute glomerulonephritis
  3. Diabetic nephropathy
  4. Minimal change disease
  5. Alport syndrome

 

ANS: B

DIF: Level 1

OBJ: 15

TOP: Glomerular disorders

 

 

 

  1. A renal disorder associated with heroin abuse is:
  2. Nephrotic syndrome
  3. Membranoproliferative glomerulonephritis
  4. Chronic glomerulonephritis
  5. Focal segmental glomerulosclerosis

 

ANS: D

DIF: Level 1

OBJ: 9

TOP: Glomerular disorders

 

 

 

  1. Blood tests can be used to confirm the diagnosis of acute glomerulonephritis because of the detection of:
  2. M protein
  3. Electrolyte imbalance
  4. Antistreptococcal antibodies
  5. Decreased serum albumin

 

ANS: C

DIF: Level 2

OBJ: 4

TOP: Glomerulonephritis

 

 

 

  1. Goodpasture syndrome and Wegener’s granulomatosis are associated with the presence of which of the following in the urine sediment?
  2. Hyaline casts
  3. Red blood cell casts
  4. Waxy casts
  5. White blood cell casts

 

ANS: B

DIF: Level 2

OBJ: 4

TOP: Glomerulonephritis

 

 

 

  1. The presence of which of the following crystals can be associated with nephrotic syndrome?
  2. Cholesterol
  3. Tyrosine
  4. Cystine
  5. Ampicillin

 

ANS: A

DIF: Level 2

OBJ: 8

TOP: Glomerular disorders

 

 

 

  1. A patient with symptoms of pulmonary hemoptysis and urinary hematuria should be tested for:
  2. Antiglomerular basement membrane antibody
  3. Antistreptolysin O antibody
  4. Antistreptococcal antibody
  5. Anti-IgM antibody

 

ANS: A

DIF: Level 2

OBJ: 4

TOP: Glomerular disorders

 

 

 

  1. Which of the following disorders has the most favorable patient prognosis?
  2. Rapidly progressive glomerulonephritis
  3. Henoch-Schönlein purpura
  4. IgA nephropathy
  5. Goodpasture syndrome

 

ANS: B

DIF: Level 3

OBJ: 4

TOP: Glomerular disorders

 

 

 

  1. Glomerular basement membrane thickening occurs in membranous glomerulonephritis as a result of deposition of:
  2. IgA immune complexes
  3. IgG immune complexes
  4. Protein components
  5. Amyloid material

 

ANS: B

DIF: Level 2

OBJ: 6

TOP: Glomerular disorders

 

 

 

  1. The presence of heavy proteinuria is most characteristic of:
  2. Acute glomerulonephritis
  3. Acute interstitial nephritis
  4. Pyelonephritis
  5. Nephrotic syndrome

 

ANS: D

DIF: Level 2

OBJ: 8

TOP: Glomerular disorders

 

 

 

  1. The pronounced edema associated with nephrotic syndrome is related to the:
  2. Lipidemia
  3. Hypoalbuminemia
  4. Decreased glomerular filtration rate
  5. Lipiduria

 

ANS: B

DIF: Level 2

OBJ: 8

TOP: Glomerular disorders

 

 

 

  1. Oval fat bodies and fatty casts are characteristic urine sediment constituents in patients with:
  2. Chronic glomerulonephritis
  3. Acute interstitial nephritis
  4. Nephrotic syndrome
  5. Wegener’s granulomatosis

 

ANS: C

DIF: Level 2

OBJ: 8

TOP: Glomerular disorders

 

 

 

  1. A decrease in systemic blood flow affects the renal tubules by producing:
  2. Nephrotoxins
  3. Ischemia
  4. Electrolyte imbalance
  5. Inflammation

 

ANS: B

DIF: Level 1

OBJ: 10

TOP: Tubular disorders

 

 

 

  1. Glucosuria and generalized aminoaciduria are characteristics of:
  2. Fanconi syndrome
  3. Nephrotic syndrome
  4. Focal segmental glomerulosclerosis
  5. Diabetes mellitus

 

ANS: A

DIF: Level 1

OBJ: 12

TOP: Tubular disorders

 

 

  1. Which inherited renal disorder manifests itself in the development of gout in teenage years?
  2. Fanconi syndrome
  3. Diabetes mellitus
  4. Uromodulin-associated kidney disease
  5. Chronic glomerulonephritis

 

ANS: C

DIF: Level 1

OBJ: 12

TOP: Tubular disorders

 

 

 

  1. In which part of the kidney is uromodulin produced?
  2. Proximal and distal tubules
  3. Descending and ascending loop of Henle
  4. Bowman’s capsule and nephrons
  5. Nephrons and collecting duct

 

ANS: A

DIF: Level 1

OBJ: 12

TOP: Tubular disorders

 

 

 

  1. Which of the following renal disorders is most likely to be inherited?
  2. Nephrotic syndrome
  3. Acute interstitial nephritis
  4. Acute tubular necrosis
  5. Fanconi syndrome

 

ANS: D

DIF: Level 1

OBJ: 12

TOP: Tubular disorders

 

 

 

  1. Administration of a nephrotoxic antibiotic to a patient with a decreased glomerular filtration rate may cause:
  2. Acute tubular necrosis
  3. Acute interstitial nephritis
  4. Focal segmental glomerulosclerosis
  5. Nephrotic syndrome

 

ANS: A

DIF: Level 2

OBJ: 10

TOP: Tubular disorders

 

 

 

  1. The presence of increased renal tubular epithelial cell casts is most indicative of:
  2. Nephrotic syndrome
  3. Fanconi syndrome
  4. Acute tubular necrosis
  5. Acute pyelonephritis

 

ANS: C

DIF: Level 2

OBJ: 10

TOP: Tubular disorders

 

 

 

  1. Infection of the bladder is termed:
  2. Pyelitis
  3. Nephritis
  4. Cystitis
  5. Bacteriuria

 

ANS: C

DIF: Level 1

OBJ: 14

TOP: Interstitial disorders

 

 

 

  1. Cystitis can be differentiated from pyelonephritis by:
  2. Performing a cystoscopy
  3. The presence of white blood cell casts
  4. Performing blood cultures
  5. The presence of bacteriuria

 

ANS: B

DIF: Level 1

OBJ: 14

TOP: Interstitial disorders

 

 

 

  1. In diabetic nephropathy, solid material deposited around the capillary tufts includes:
  2. IgG
  3. Glycosylated IgA
  4. Glycosylated protein
  5. IgM complexes

 

ANS: C

DIF: Level 1

OBJ: 14

TOP: Interstitial disorders

 

 

 

  1. The finding of bacterial casts can be associated with:
  2. Acute pyelonephritis
  3. Acute interstitial nephritis
  4. Cystitis
  5. Acute glomerulonephritis

 

ANS: A

DIF: Level 1

OBJ: 14

TOP: Interstitial disorders

 

 

 

  1. The most serious tubulointerstitial disorder is:
  2. Acute interstitial nephritis
  3. Acute pyelonephritis
  4. Chronic pyelonephritis
  5. Cystitis

 

ANS: C

DIF: Level 2

OBJ: 14

TOP: Interstitial disorders

 

 

 

  1. An increased urinary eosinophils are diagnostic for:
  2. Acute pyelonephritis
  3. Acute interstitial nephritis
  4. Acute tubular necrosis
  5. Chronic pyelonephritis

 

ANS: B

DIF: Level 2

OBJ: 14

TOP: Interstitial disorders

 

 

 

  1. Microscopic urinalysis findings of a patient with acute interstitial nephritis include all of the following except:
  2. Bacteria
  3. White blood cells
  4. Red blood cells
  5. White blood cell casts

 

ANS: A

DIF: Level 2

OBJ: 14

TOP: Interstitial disorders

 

 

 

  1. Acute renal failure may be classified as all of the following except:
  2. Rapidly progressive
  3. Prerenal
  4. Renal
  5. Postrenal

 

ANS: A

DIF: Level 1

OBJ: 15

TOP: Renal failure

 

 

 

  1. In which of the following disorders would waxy and broad casts be most likely to be seen?
  2. Chronic pyelonephritis
  3. Acute renal failure
  4. Chronic renal failure
  5. Acute interstitial nephritis

 

ANS: C

DIF: Level 2

OBJ: 15

TOP: Renal failure

 

 

 

  1. Causes of acute renal failure can include all of the following except:
  2. Malignancy
  3. Goodpasture syndrome
  4. Acute tubular necrosis
  5. Renal calculi

 

ANS: B

DIF: Level 2

OBJ: 15

TOP: Renal failure

 

 

 

  1. Most renal calculi are composed of:
  2. Ammonium phosphate
  3. Magnesium
  4. Uric acid
  5. Calcium

 

ANS: D

DIF: Level 1

OBJ: 16

TOP: Renal lithiasis

 

 

 

  1. Lithotripsy is a procedure that is performed to:
  2. Prevent the formation of renal calculi
  3. Determine the composition of renal calculi
  4. Aid in the remove of renal calculi
  5. Identify the presence of renal calculi

 

ANS: C

DIF: Level 1

OBJ: 16

TOP: Renal lithiasis

 

 

 

  1. The microscopic hematuria associated with renal lithiasis is caused by:
  2. Glomerular damage
  3. Tubular inflammation
  4. Tissue irritation
  5. Bacterial infection

 

ANS: C

DIF: Level 2

OBJ: 16

TOP: Renal lithiasis

 

 

 

  1. All of the following may be helpful in preventing the formation of renal calculi except:
  2. Increased hydration
  3. Increased exercise
  4. Dietary restrictions
  5. Adjustment of urine pH

 

ANS: B

DIF: Level 2

OBJ: 16

TOP: Renal lithiasis

 

 

 

NARRBEGIN: 07-nar-01

Following recovery from an upper respiratory infection, a 5-year-old boy develops numerous petechiae. He reports that his urine is red. Results of his urinalysis are:

NARREND

 

 

 

  1. Based on the information provided, what other specimen(s) could be collected and tested for the presence of blood?
  2. Sputum
  3. Cerebral spinal fluid
  4. Bronchial washing
  5. Abdominal fluid

 

ANS: A

NAR: 07-nar-01

DIF: Level 3

OBJ: 4

TOP: Glomerular disorders case study

 

 

 

  1. Based on the information provided, how does the presence of petechiae relate to the abnormal results?
  2. Allergic reaction
  3. Decreased vascular integrity
  4. Increased platelets
  5. Increased destruction of red cells

 

ANS: B

NAR: 07-nar-01

DIF: Level 3

OBJ: 4

TOP: Glomerular disorders case study

 

 

 

  1. Based on the information given, what is the most probable diagnosis?
  2. Henoch-Schönlein purpura
  3. Minimal change disease
  4. Wegener’s granulomatosus
  5. Goodpasture syndrome

 

ANS: A

NAR: 07-nar-01

DIF: Level 3

OBJ: 4

TOP: Glomerular disorders case study

 

 

 

NARRBEGIN: 07-nar-02

Indicate whether the following would cause acute renal failure that is of prerenal, renal, or postrenal origin:

NARREND

 

 

 

  1. Trauma requiring transfusion of 8 pints of blood
  2. Prerenal
  3. Renal
  4. Postrenal

 

ANS: A

NAR: 07-nar-02

DIF: Level 3

OBJ: 15

TOP: Glomerular disorders case study

 

 

 

  1. Untreated cystitis
  2. Prerenal
  3. Renal
  4. Postrenal

 

ANS: B

NAR: 07-nar-02

DIF: Level 3

OBJ: 15

TOP: Glomerular disorders case study

 

 

 

  1. Patient with positive blood cultures for Staphylococcus aureus
  2. Prerenal
  3. Renal
  4. Postrenal

 

ANS: A

NAR: 07-nar-02

DIF: Level 3

OBJ: 15

TOP: Glomerular disorders case study

 

 

 

  1. Child who has ingested ethylene glycol
  2. Prerenal
  3. Renal
  4. Postrenal

 

ANS: B

NAR: 07-nar-02

DIF: Level 3

OBJ: 15

TOP: Glomerular disorders case study

 

 

 

  1. Patient with increased transitional epithelial cells in the urine sediment
  2. Prerenal
  3. Renal
  4. Postrenal

 

ANS: C

NAR: 07-nar-02

DIF: Level 3

OBJ: 15

TOP: Glomerular disorders case study

 

 

 

NARRBEGIN: 07-nar-03

The following results are obtained from a urinalysis on a patient who developed membranous glomerulonephritis following hepatitis B infection:

NARREND

 

 

 

  1. What is the most probable disorder associated with these results?
  2. Chronic glomerulonephritis
  3. Focal segmental glomerulosclerosis
  4. Nephrotic syndrome
  5. Renal failure

 

ANS: C

NAR: 07-nar-03

DIF: Level 3

OBJ: 6

TOP: Glomerular disorders case study

 

 

 

  1. How do these results relate to the diagnosis of membranous glomerulonephritis?
  2. Urinalysis results are similar.
  3. Membranous glomerulonephritis progression to an advanced disorder.
  4. They are not related.
  5. The original diagnosis of membranous glomerulonephritis was wrong.

 

ANS: B

NAR: 07-nar-03

DIF: Level 3

OBJ: 6

TOP: Glomerular disorders case study

 

 

 

  1. What is/are the primary structure(s) in the glomerulus that has/have been affected to cause these results?
  2. Endothelial cells
  3. Capillary tufts
  4. Basement membrane
  5. Podocytes

 

ANS: D

NAR: 07-nar-03

DIF: Level 3

OBJ: 6

TOP: Glomerular disorders case study

 

 

 

  1. All of the following blood tests are markedly abnormal in this disorder, except:
  2. Albumin
  3. Cholesterol
  4. Triglyceride
  5. Lactate

 

ANS: D

NAR: 07-nar-03

DIF: Level 3

OBJ: 6

TOP: Glomerular disorders case study

 

 

 

NARRBEGIN: 07-nar-04

A 40-year-old female tennis player with tendonitis is taking large doses of an over-the-counter nonsteroidal anti-inflammatory agent. After taking the medication for several weeks, she develops a skin rash and observes a decrease in urine volume. Results of her urinalysis are:

NARREND

 

 

 

  1. What is the most diagnostic reagent strip result in this urinalysis?
  2. Positive leukocyte esterase
  3. Positive protein
  4. Positive blood
  5. Negative nitrite

 

ANS: D

NAR: 07-nar-04

DIF: Level 3

OBJ: 14

TOP: Interstitial disorders case study

 

 

 

  1. Why does this result correlate with the microscopic results?
  2. Many white blood cells (WBCs) present
  3. Casts present
  4. Many red blood cells present
  5. No bacteria seen

 

ANS: D

NAR: 07-nar-04

DIF: Level 3

OBJ: 14

TOP: Interstitial disorders case study

 

 

 

  1. What additional test might be requested on this specimen?
  2. Creatinine clearance
  3. Prussian blue stain
  4. Urine eosinophil stain
  5. Fungal culture

 

ANS: C

NAR: 07-nar-04

DIF: Level 3

OBJ: 14

TOP: Interstitial disorders case study

 

 

 

  1. What is the probable diagnosis?
  2. Acute interstitial nephritis
  3. Fanconi syndrome
  4. Acute tubular necrosis
  5. Acute glomerulonephritis

 

ANS: A

NAR: 07-nar-04

DIF: Level 3

OBJ: 14

TOP: Interstitial disorders case study

 

 

 

NARRBEGIN: 07-Nar-05

State the most probable disorder that would relate to the following scenarios:

NARREND

 

 

 

  1. A positive antineutrophilic cytoplasmic antibody test is obtained on a patient exhibiting symptoms of pulmonary hemoptysis and urinary hematuria.
  2. Acute glomerulonephritis
  3. Rapidly progressive glomerulonephritis
  4. Goodpasture syndrome
  5. Wegener’s granulomatosis

 

ANS: D

NAR: 07-nar-05

DIF: Level 3

OBJ: 4

TOP: Glomerular disorders case study

 

 

 

  1. An HIV-positive patient develops edema, elevated cholesterol and triglyceride levels, and heavy proteinuria.
  2. Chronic glomerulonephritis
  3. Nephrotic syndrome
  4. Focal segmental glomerulosclerosis
  5. Fanconi syndrome

 

ANS: C

NAR: 07-nar-05

DIF: Level 3

OBJ: 12

TOP: Glomerular disorders case study

 

 

 

  1. A patient with a history of intermittent hematuria following strenuous exercise has an elevated serum immunoglobulin A level.
  2. Minimal change disease
  3. IgA nephropathy
  4. Acute glomerulonephritis
  5. Alport’s disease

 

ANS: B

NAR: 07-nar-05

DIF: Level 3

OBJ: 7

TOP: Glomerular disorders case study

 

 

 

  1. Following ingestion of mushrooms found growing in his garden, a man develops symptoms of oliguria, lethargy, and edema. Many renal tubular epithelial (RTE) cells are observed in his urinalysis.
  2. Fanconi syndrome
  3. Acute tubular necrosis
  4. Nephrotic syndrome
  5. Acute renal failure

 

ANS: B

NAR: 07-nar-05

DIF: Level 3

OBJ: 10

TOP: Tubular disorders case study

 

 

 

  1. An intravenous pyelogram is performed on a child with a history of episodes of urinary frequency and burning and the presence of WBC and bacterial casts.
  2. Acute interstitial nephritis
  3. Minimal change disease
  4. Acute pyelonephritis
  5. Chronic pyelonephritis

 

ANS: D

NAR: 07-nar-05

DIF: Level 3

OBJ: 14

TOP: Interstitial disorders case study

 

 

 

  1. A patient who works in a steel-processing plant presents to the hospital with a normal plasma glucose has consistently elevated reagent strip urine glucose readings.
  2. Nephrogenic diabetes insipidus
  3. Renal glycosuria
  4. Fanconi syndrome
  5. Goodpasture syndrome

 

ANS: C

NAR: 07-nar-05

DIF: Level 3

OBJ: 12

TOP: Renal failure case study

 

 

 

  1. A patient whose microalbuminuria has progressed to a 2+ urine protein.
  2. Alport syndrome
  3. Diabetic nephropathy
  4. Acute renal failure
  5. Nephrogenic diabetes insipidus

 

ANS: B

NAR: 07-nar-05

DIF: Level 3

OBJ: 13

TOP: Renal lithiasis case study