ANALYSIS OF URINE AND OTHER BODY FLUIDS

QUIZ

1. A urine specimen was stored

uncapped at 5C without
preservation and retested at 2pm.
Which of the following test results
would be changed due to these
storage conditions?
a Glucose
b Ketones
c Proteins
d Nitrite

Answer: B
The sample is mistreated by being
uncapped. It is refrigerated, which will
prevents bacteria from
reproducing( so d is incorrect), and
from metabolizing glucose(so a is
incorrect). Ketones can evaporate,
but protein will not.

2. Which of the following would be

affected by allowing a urine
specimen to remain at room
temperature for 3 hours before
analysis?
a Occult blood
b Specific gravity
c pH
d Proteins

Answer: C
Consider whether a substance can
increase or decrease outside the
body. No more blood can be produce.
Although the RBC may rupture, they
will still make a positive result on a
biochemical strip. The amount of
solutes wont change, so specific
gravity wont change. pH is affected
by metabolism of the urine
components by bacteria, and room
temperature is warm enough for this
to occure. Protein will not increase or
decrease.

3. Creatinine clearance is measured

in:
a mg/dL
b mg/24 hours
c mL/min
d mL/24 hours

Answer: C
The formula for Creatinine Clearance
is Urine Creatinine x Urine Volume per
minute divided by Plasma Creatinine.

4. Microalbumin can be measured

by a random urine collection. An
increased microalbumin is
predictive of:
a Diabetes mellitus
b Nephropathy

Answer: B
Patients with hypertensions and
diabetes mellitus are at risk for
kidney disease. Detection of small
amounts of albumin in the urine

c Hypertension
d Nephrotic syndrome

predict eventual kidney disease. The

advantage of this sensitive detection
is that patients with microalbuminuria
can be treated with anti-hypertensive
medications and followed up more
intensely to delay nephropathy.

5. Milky urine from a 24-year old

woman would most likely contain:
a Spermatozoa
b Many white blood cells
c Red blood cells
d Bilirubin

Answer: B
White blood cells can highly
contribute to the milky appearance of
the urine. Spermatozoa on the other
hand will not demonstrate a milky
appearance.

6. A brown-black urine would most

likely contain:
a Bile pigment
b Porphyrin
c Melanin
d Blood cells

Answer: C
Melanin is the cause of brown-black
color of urine, porphyrin
demonstrates port wine color, blood
cells demonstrates red color of urine.

7. The yellow color of urine is

primarily due to:
a Urochrome
b Urobilin
c Uroerythrin
d Urobilinogen

Answer: A
Urochrome is the primary pigment of
urine which demonstrates its yellow
color.

8. Isosthenuria is associated with a

specific gravity which is usually:
a Variable between 1.000 to 1.005
b Variable between 1.015 to 1.020
c Fixed around 1.010
d Fixed around 1.020

Answer: C
Isosthenuria is a normal specific
gravity fixed around 1.010.

9. An anti-diuretic hormone
deficiency is associated with a:
a Specific gravity around 1.031
b Low specific gravity
c High specific gravity
d Variable specific gravity

Answer: B
Anti-diuretic hormone shows low
specific gravity due to the high
concentration of urine.

10. Calibration of refractometers is

Answer: C

done by measuring the specific

gravity of distilled water and:
a Protein
b Glucose
c Sodium chloride
d Urea

Sodium chloride is also used as a

calibrator of refractometers because
it has a set specific gravity and is
cheap.

11. A 17-year old girl decided to go

on a diet. After 1 week of starving
herself, what substance would most
likely be found in her urine:
a Protein
b Ketones
c Glucose
d Blood

Answer: B
Ketones do not appear in the urine
during normal states, it appears when
metabolized fat is broken down.

12. A 2-year old child had a positive

urine ketone. This would most likely
be caused by:
a Vomiting
b Anemia
c Hypoglycaemia
d Biliary tract obstruction

Answer: A
Vomiting leads dehydration and
utilization of fat energy. Fat
metabolism produces ketones.

13. A test area of a urine reagent

strip is impregnated with only
sodium nitroprusside. This section
will react with:
a Acetoacetic acid
b Leukocyte esterase
c Beta-hydrobutyric acid
d Ferric chloride

Answer: A
Sodium nitroprusside will react with
acetoacetic acid.

14. A reagent strip area

impregnated with stabilized,
diazotized 2,4-dichloroaniline will
yield a positive reaction with:
a Bilirubin
b Hemoglobin
c Ketones
d Urobilinogen

Answer: A
Bilirubin is detected by diazotized
2,4-dichloroaniline.

15. A urine specimen is analyzed for

glucose by a glucose oxidase
reagent strip and a copper
reduction test. If both results are
positive, which of the following
interpretations is correct?
a Galactose is present
b Glucose is present
c Lactose is not present
d Sucrose is not present

Answer: B
Glucose uses the principle of glucose
oxidase and copper reduction test.

16. When using the Sulfosalicylic

acid test, false positive protein
results may occur in the presence
of:
a Ketones
b Alkali
c Glucose
d Radiographic contrast media

Answer: D
Radiographic contrast media can
interfere and cause false positive
results.

17. In most compound microscope,

the ocular lens has a magnification
of:
a 10x
b 40x
c 50x
d 100x

Answer: A
Ocular lens has a magnification of
10x, the high power objective 40x,
100x for oil immersion objective.

18. The best way to lower the light

intensity of the microscope is to:
a Lower the condenser
b Adjust the aperture diaphragm
c Lower the rheostat
d Raise the condenser

Answer: B and C
Adjusting the aperture diagram can
limit the light entering from the
microscope eye piece. Also in
lowering the intensity of light.

19. Oval fat bodies are:

a Squamous epithelial cells that
contain lipids
b RTE cells that contain lipids
c Free-floating fat droplets
d White blood cells with
phagocytised lipids

Answer: B
Rte cells contains lipids thats why its
called oval fat bodies.

20. The presence of leukocytes in

urine is known as:
a Chyluria
b Hematuria
c Leukocytosis
d Pyuria

Answer: D
Pyuria is said to have the presenve of
leukocytes in the urine. Hematuria is
the presence of blood in the urine.
Chyluria is the chylus appearance of
urine.

21. The possibility of detecting

glitter cells is associated with urine
that is:
a Acidic
b Dilute
c Alkaline
d Concentrated

Answer: B
In only in the dilute urine are glitter
cells seen.

22. An eosinophil count may be

requested from a patient with
suspected:
a Acute glomerulonephritis
b Cystitis
c Renal lithiasis
d Acute interstitial nephritis

Answer: D
Acute interstitial nephritis is caused
by an allergic reaction resulting in
inflammation of the renal tubules.
The reaction is frequently caused by a
medication. As a result of the allergic
reaction, eosinophils are increased.
An eosinophil count can aid in
confirming the diagnosis.

23.Clue cells are a form of:

a Squamous epithelial cell
b White blood cells
c Urothelial cell
d Renal tubular epithelial cell

Answer: A
Clue cells are squamous epithelial
cells which contains Gardrenella
vaginalis.

24. Which of the following cells is

most likely to be seen in the urine
sediment following a
catheterization procedure?
a. Squamous epithelial cell
b. White blood cells
c. Urothelial cell
d. Renal tubular epithelial cell

Answer: C
Urothelial cells are seen in patients
after catheterization from the lining of
urethra.

25. The primary component of most

Answer: A

urinary calculi is:

a Calcium
b Uric acid
c Leucine
d Cholesterol

Calcium is commonly a primary

component of most urinary calculi.

26. Which of the following is an

abnormal crystal prescribed as a
hexagonal plate?
a Cystine
b Tyrosine
c Leucine
d Cholesterol

Answer: A
Cystine is a hexagonal plate crystal
that is colorless and is seen in acidic
urine.

27. Which of the following crystals

may be seen in acidic urine?
a Calcium carbonate
b Calcium oxalate
c Calcium phosphate
d Amorphous phosphate

Answer: B
Calcium oxalate is an acidic/normal
urinary crystal. Calcium carbonate is
seen in alkaline urine. Calcium
phosphate and amorphous phosphate
is seen in alkaline/neutral.

28. Using polarized microscopy,

which of the following urinary
elements are birefringent?
a Cholesterol
b Triglyceride
c Fatty acid
d Neutral fat

Answer: A
Cholesterol when used by polarized
microscope shows birefringent.

29. A white precipitate in a urine

specimen with a pH of 7.5 would
most probably be caused by:
a Amorphous urates
b WBCs
c Amorphous phosphates
d Bacteria

Answer: C
Amorphous phosphate is seen in
alkaline urine and can cause white
precipitates.

30. Cholesterol crystals will most

likely be observed in urine that
contains:
a 3+ glucose
b 4+ protein
c WBC casts

Answer: B
Increased lipids in the urine is a
characteristic of the nephrotic
syndrome. Massive amounts of
protein also are associated with the

d Triple phosphate crystals

nephrotic syndrome. The crystals

form more readily in urine that has
been refrigerated.

31. The finding of a large amount of

uric acid crystals in a urine
specimen from a 6-month old boy:
a May actually be diaper fibers
b Could indicate Lesch-Nyhan
syndrome
c Should not be reported
d May indicate improper feeding

Answer: B
Lesch-Nyhan syndrome is an
inherited disorder of purine
metabolism. The first indication of
this disorder may be the presence of
uric acid indicating the incomplete
metabolism of dietary purines.

32. Triple phosphate crystals are

found in:
a Acid pH and is nonpathologic
b Alkaline pH and is nonpathologic
c Acid pH and is pathologic
d Alkaline pH and is pathologic

Answer: B
Triple phosphate crystals are found in
alkaline urine and is nonpathologic.

33. Polarized light can often be

used to differentiate between:
a Fiber and mucus clumps
b Hyaline and waxy casts
c Squamous and transitional
epithelial cells
d RBCs and WBCs

Answer: A
Polarized light differentiates between
fiber and mucus clumps.

34. Which of the following

contaminants has a dimpled center
and will polarize?
a Starch
b Oil droplets
c Air droplets
d Pollen grains

Answer: A
Starch polarizes and has a dimpled
center. Oil droplets does not
demonstrate a dimpled center.

35. Which of the following positive

chemical reactions in most closely
associated with the presence of
yeast in the urine sediment?
a Ketone
b Protein

Answer: C
Glucose in the urine is commonly
associated with yeast formation.

c Glucose
d Blood
36. The normal glomerular filtration
rate is:
a 1 mL/min
b 120 mL/min
c 660 mL/min
d 1,200 mL/min

Answer: B
The normal value for glomerualr
filtration rate is 120mL/min.

37. To avoid falsely elevated spinal

fluid counts:
a Use an aliquot from the first tube
collected
b Use only those specimens showing
no turbidity
c Centrifuge all specimen before
counting
d Select an aliquot from the last
tube collected

Answer: D
The last tube contains less cells and
gives a more accurate result.

38. A physician attempts to aspirate

a knee joint and obtains 0.1 mL of
slightly bloody fluid. The addition of
acetic acid results in turbidity and a
clot. This indicates that:
a The fluid is synovial fluid
b Calcium pyrophosphate crystals
c Corticosteroid crystals
d Talc crystals

Answer: A
Synovial fluid is the only body fluid
that shows turbidity and clot.

39. A sperm count is diluted 1:20

and 50 sperm are counted in 2 large
squares of the Neubauer counting
chamber. The sperm count in
microliters is:
a 5,000
b 50,000
c 500,000
d 5,000,000

Answer: D
Use the formula of cells x dilution x
10 divided by the number of
secondary squares. Then remember
to convert from microliters to
millilitres by multiplying by 1,000.

40. The principal mucin in synovial

Answer: A

fluid
a
b
c
d

is:
Hyaluronate
Albumin
Orosomucoid
Pepsin

Synovial fluids principal mucin is

hyaluronate.

41. Pleural transudates differ from

pleural exudates in that
transudates have:
a Protein values of >4 g/dL
b Specific gravity values of >1.020
c LD values of >200 IU
d Relatively low cell counts

Answer: D
Transudates are thin, watery effusions
with low LD, low protein, and low cell
counts. Exudates are inflammatory or
infectious effusions with high LD,
protein, and WBC.

42. False-positive results can occur

for fecal occult blood due to the
ingestion of:
a Ascorbic acid
b Horseradish
c Acetaminophen
d Blueberries

Answer: B
Horseradish can cause red
discoloration of stool and reacts to
the reagent present.

43. A build up of fluid in a body

cavity is called:
a Effusion
b Transudate
c Exudates
d Metastasis

Answer: A
Effusion is called the build up of the
fluid in the body cavity.

44. Which of the following is the

best indicator of Reye syndrome for
CSF?
a Glutamine
b Ammonia
c ALT
d Lactate

Answer: A
In hepatic encephalopathy, ammonia
levels is the plasma building up, and
ammonia can be found in the spinal
fluid. Ammonia is volatile, and not
easily measured. Glutamine is a
byproduct of ammonia, and is stable,
making it a better choice.

45. The tau isoform of transferrin is

a carbohydrate deficient protein
found only in:
a CSF

Answer: A
Tau can only be seen in cerebral
spinal fluid.

b Sweat
c Amniotic fluid
d Synovial fluid
46. Which marker can be used to
identify a body fluid as semen?
a PSA
b Alkaline phosphatase
c Fructose
d Hyaluronic acid

Answer: A
Prostate specific antigen is only seen
in semen. And is more specific for
semen.

47. Which stain is used to measure

sperm viability?
a Eosin nigrosin
b Wright
c Toluidine blue
d Papanicolaou

Answer: A
Eosin nigrosin stain is the stain used
for sperm viability.

48. Which semen result is

abnormal?
a Sample pours in droplets after 60
minutes
b >50% are motile within 1 hour of
collection
c pH 7.5
d motility of 1.0

Answer: D
A motility of 1.0 shows that the
motility of the sperms are of weak
motility.

49. CSF lactate is increased in cases

of:
a Bacterial meningitis
b Reye encephalopathy
c Spina bifida
d Multiple sclerosis

Answer: A
Lactate is increased in the CSF in
conditions that caused hypoxia. The
highest lactate values(>35mg/dL) are
found in patients with bacterial
meningitis have lactate levels above
normal, but not as high as bacterial
meningitis.

50. Decreased CSF protein can be

found in:
a Meningitis
b Hemorrhage
c Multiple sclerosis
d CSF leakage

Answer: D
CSF leakage decreases the amount of
CSF thus decreasing the protein.