Lab Science Exam: Analyzing Urine & Microscopy #8

MEDICAL LABORATORY SCIENCE 8. SUMMATIVE EXAM REVIEW QUESTIONS #08 + ANSWERS & RATIONALIZATIONS 1. 2. 3. 4. 5. 6. Bilirubin combines with 2,6-dichlorobenzenediazonium-tetrafluoroborate in an acid medium to produce an azodye, with colors ranging from: a. Green to blue b. Green to brown c. Pink to purple d. Yellow to orange → 2,4-dichloroaniline diazonium salt = Tan → 2,6-dichlorobenzene-diazonium tetrafluoroborate = Pink to violet The purpose of the special mat supplied with the Ictotest tablets is that: a. Bilirubin remains on the surface of the mat b. It contains the dye needed to produce color c. It removes interfering substances d. Bilirubin is absorbed into the mat All of the following are contained in the Multistix urine glucose pad, EXCEPT: a. Glucose oxidase b. Gluconic acid c. Peroxidase d. Potassium iodide → Glucose pads in Multistix and Chemstrip: False negative glucose pad: a. Oxidizing agents b. Detergent c. Refrigerator temperature d. None of these The primary reason for performing a Clinitest is to: a. Check for high ascorbic acid levels b. Confirm a positive reagent strip glucose c. Check for newborn galactosuria d. Confirm a negative glucose reading False negative urobilinogen reagent strip: a. Formalin b. Methyldopa c. Porphobilinogen d. Sulfonamides → False Urobilinogen reagent strip causes: 9. 10. 11. 12. 13. 14. 15. 7. Test for requires patients on a diet that contains green vegetables: a. Bilirubin b. Glucose c. Ketone d. Nitrite 16. Primary test for diagnosing and monitoring bacterial infection: a. Glucose and ketones b. Leukocyte esterase c. Nitrite d. Culture Esterases also are present in which parasite? a. Enterobius b. Giardia c. Schistosoma d. Trichomonas When semi-automated urine chemistry analyzers are used, the color that develops on the reaction pads is measured by: a. Spectrophotometry b. Reflectance photometry c. Fluorescence photometry d. Comparing reaction pads with a color chart Reflectance photometry uses the principle that light reflection from the test pads ______ in proportion to the intensity of color produced by the concentration of the test substance. a. Increases b. Decreases c. Variable d. Undetermined → In reflectance photometry, a monochromatic light source is directed toward the reagent pads by placing a filter between the light source and the reflective surface of the pad or by using a Light-Emitting Diode (LED) to provide the specific wavelength needed for each test pad color reaction. Type of microscope used for routine urinalysis: a. Bright-field microscope b. Phase contrast microscope c. Polarizing microscope d. Interference contrast microscope It enhances visualization of elements with low refractive indices: a. Bright-field microscope b. Dark-field microscope c. Phase contrast microscope d. Interference contrast microscope Type of microscope that forms halo of light around an object: a. Bright-field b. Dark-field microscope c. Polarizing microscope d. Phase-contrast It produces a three-dimensional microscopy image and layer by- layer imaging of a specimen: a. Bright-field microscope b. Phase contrast microscope c. Polarizing microscope d. Interference contrast microscope Kohler illumination is: a. Method to ensure optimal contrast and resolution b. Method to magnify objects c. An indication of the type of light source in use d. One method of phase contrast magnification 1 → Köhler Illumination ▪ Light microscope illumination system that consists of a substage light source, field diaphragm, condenser, and aperture diaphragm. ▪ These are adjusted in sequence to optimize specimen illumination, resolution, contrast, and depth of field. 17. Initial magnification: a. Condenser b. Rheostat c. Ocular d. Objective 18. Further magnification: a. Condenser b. Rheostat c. Ocular d. Objective 19. Primary components of the lens system: 1. Oculars 2. Objectives 3. Coarse adjustment knob 4. Fine adjustment knobs 20. 21. 22. 23. 24. 25. a. 1 and 2 b. 3 and 4 c. 1, 2 and 3 d. 1, 2, 3 and 4 Centrifugation for urine microscopic examination: a. RCF of 100 for 2 minutes b. RCF of 400 for 5 minutes c. RCF of 500 for 5 minutes d. RCF of 500 for 10 minutes Initial screening of the urine sediment is performed using an objective power of: a. 4x b. 10x c. 40x d. 100x Nuclear detail can be enhanced by: a. Prussian blue b. Toluidine blue c. Acetic acid d. Both B and C When pyuria is detected in a sediment, the slide should be carefully checked for the presence of: a. RBCs b. Bacteria c. Hyaline casts d. Mucus Glitter cells in KOVA stain: a. Violet → neutrophils b. Light blue → glitter cells c. Pink d. Black → The most frequently used stain in urinalysis is the Sternheimer-Malbin stain, which consists of crystal violet and safranin O.6 The stain is available commercially under a variety of names, including Sedi-Stain and KOVA Stain. Hyaline cast in KOVA stain: a. Dark shade of orange-purple b. Dark shade of blue-purple c. Pale pink or pale purple d. Do not stain → fatty casts 26. Largest cell in urine sediment: a. Squamous epithelial cells b. Transitional epithelial cells c. Renal tubular epithelial cells d. None of these 27. Largest RTE cells originate from the: a. Proximal convoluted tubule b. Distal collecting tubule c. Collecting duct d. None of these 28. RTE cell from the proximal convoluted tubules: a. Columnar or convoluted b. Cuboidal c. Round or oval d. None of these 29. RTE cell from the distal convoluted tubules: a. Columnar or convoluted b. Cuboidal c. Round or oval d. None of these 30. RTE cells from the collecting duct: a. Columnar or convoluted b. Cuboidal c. Round or oval d. None of these 31. Neutrophils lyse rapidly in: a. Acetic acid b. Ether c. Dilute acid urine d. Dilute alkaline urine 32. Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following EXCEPT: a. Observation of budding in yeast cells b. Increased refractility of oil droplets c. Lysis of yeast cells by acetic acid d. Lysis of RBCs by acetic acid 33. Of all the urine sediment elements, ______ are the most difficult to recognize. a. Bacteria b. Epithelial cells c. RBCs d. WBCs 34. RBCs in a dilute urine: a. Crenate b. Dysmorphic c. Swell d. Shrink 35. RBC casts are easily detected under low power by their ______ color. a. Blue color b. Purple color c. Yellow color d. Orange-red color 36. Following an episode of hemoglobinuria, RTE cells may contain: a. Bilirubin b. Hemosiderin granules c. Porphobilinogen d. Myoglobin 37. The order of cast degradation is: a. Cellular > granular > waxy b. Cellular > hyaline > waxy c. Hyaline > cellular > waxy d. Hyaline > granular > waxy 2 38. The presence of waxy casts in a microscopic examination of urine is consistent with a diagnosis of: a. Strenuous exercise b. Pyelonephritis c. Glomerulonephritis d. Chronic renal failure 39. Differentiation between cystitis and pyelonephritis is aided by the presence of: a. WBC casts → (+) upper UTI = pyelonephritis b. RBC casts c. Bacteria d. Granular cast 40. Primary urinalysis results: • Leukocyturia • Bacteriuria • Microscopic hematuria • Mild proteinuria • Increased pH a. Acute interstitial nephritis b. Acute pyelonephritis c. Acute tubular necrosis d. Cystitis 41. Primary urinalysis results: • Leukocyturia • Bacteriuria • WBC casts • Bacterial casts • Microscopic hematuria • Proteinuria a. Acute interstitial nephritis b. Acute pyelonephritis c. Acute tubular necrosis d. Cystitis 42. Urinalysis results include hematuria, possibly macroscopic, mild to moderate proteinuria, numerous WBCs, and WBC casts without the presence of bacteria: a. Acute interstitial nephritis b. Acute pyelonephritis c. Acute tubular necrosis d. Cystitis → Performing differential leukocyte staining for the presence of increased eosinophils may be useful to confirm the diagnosis. 43. Eosinophils are not normally seen in the urine; therefore, the finding of more than ___ eosinophils in urine is considered significant: a. More than 1% b. More than 2% c. More than 3% d. More than 5% → The percentage of eosinophils in 100 to 500 cells is determined. 44. Urinalysis findings include mild proteinuria, microscopic hematuria, and most noticeably the presence of RTE cells and RTE cell casts containing tubular fragments consisting of three or more cell: a. Acute interstitial nephritis b. Acute pyelonephritis c. Acute tubular necrosis → bubble cells, muddy cast d. Cystitis 45. In severe yeast infection: a. Gram-negative coccobacilli b. Pear-shaped flagellate with undulating membrane c. Oval structures that may or may not contain a bud d. Appear as branched, mycelial form 46. The primary component of urinary mucus is: a. Bence Jones protein b. Microalbumin c. Uromodulin → aka Tamm-Horsfall protein d. Orthostatic protein 47. Amorphous urate crystals are soluble in heat and: a. Acetone b. Chloroform c. Dilute alkali d. Ether → Solubility of Normal Urine Crystals 48. The crystal associated with ethylene glycol poisoning has which characteristic appearance: a. Coffin lid b. Thorny apple c. Envelope, pyramidal d. Dumbbell → monohydrate Calcium oxalate 49. During microscopy, a medical technologist suspects that what he see are calcium oxalate crystals, but the uncommon form. These crystals are soluble with: a. Acetic acid b. Dilute HCl c. Both d. None → Calcium oxalate forms: ▪ Dihydrate CaOx - most common form ▪ Monohydrate CaOx - less characteristic and less frequently seen 50. Crystals may be precipitated with if alcohol is added to the urine: a. Amorphous urate crystals b. Bilirubin crystals c. Triple phosphate crystals d. Tyrosine and leucine crystals → Solubility of Abnormal Urine Crystals 3