MIDTERMS Flashcards by Kay Cee

Most glomerular disorders are caused by:
A. Sudden drops in blood pressure
B. Immunologic disorders
C. Exposure to toxic substances
D. Bacterial infections

B. Immunologic disorders

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. Dysmorphic RBC casts would be a significant finding
with all of the following except:
A. Goodpasture syndrome
B. AGN
C. Chronic pyelonephritis
D. Henoch-Schönlein purpura

C. Chronic pyelonephritis

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Occasional episodes of macroscopic hematuria over periods of 20 or more years are seen in patients with:
A. Crescentic glomerulonephritis
B. IgA nephropathy
C. Nephrotic syndrome
D. GPA

B. IgA nephropathy

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Antiglomerular basement membrane antibody is seen
with:
A. GPA
B. IgA nephropathy
C. Goodpasture syndrome
D. Diabetic nephropathy

C. Goodpasture syndrome

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ANCA is diagnostic for:
A. IgA nephropathy
B. GPA
C. Henoch-Schönlein purpura
D. Goodpasture syndrome

B. GPA

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Respiratory and renal symptoms are associated with all
of the following except:
A. IgA nephropathy
B. GPA
C. Henoch-Schönlein purpura
D. Goodpasture syndrome

A. IgA nephropathy

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The presence of fatty casts is associated with all of the
following except:
A. Nephrotic syndrome
B. FSGS
C. Nephrogenic DI
D. MCD

C. Nephrogenic DI

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The highest levels of proteinuria are seen with:
A. Alport syndrome
B. Diabetic nephropathy
C. IgA nephropathy
D. NS

D. NS

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Ischemia frequently produces:
A. Acute renal tubular necrosis
B. MCD
C. Renal glycosuria
D. Goodpasture syndrome

A. Acute renal tubular necrosis

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A disorder associated with polyuria and low specific
gravity is:
A. Renal glucosuria
B. MCD
C. Nephrogenic DI
D. FSGS

C. Nephrogenic DI

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An inherited disorder producing a generalized defect in
tubular reabsorption is:
A. Alport syndrome
B. AIN
C. Fanconi syndrome
D. Renal glycosuria

C. Fanconi syndrome

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A teenage boy who develops gout in his big toe and has
a high serum uric acid should be monitored for:
A. Fanconi syndrome
B. Renal calculi
C. Uromodulin-associated kidney disease
D. Chronic interstitial nephritis

C. Uromodulin-associated kidney disease

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The only protein produced by the kidney is:
A. Albumin
B. Uromodulin
C. Uroprotein
D. Globulin

B. Uromodulin

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The presence of RTE cells and casts is an indication of:
A. AIN
B. CGN
C. MCD
D. ATN

D. ATN

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Differentiation between cystitis and pyelonephritis is
aided by the presence of:
A. WBC casts
B. RBC casts
C. Bacteria
D. Granular casts

A. WBC casts

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The presence of WBCs and WBC casts with no bacteria
is indicative of:
A. Chronic pyelonephritis
B. ATN
C. AIN
D. Both B and C

C. AIN

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ESRD is characterized by all of the following except:
A. Hypersthenuria
B. Isosthenuria
C. Azotemia
D. Electrolyte imbalance

A. Hypersthenuria

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Prerenal acute renal failure could be caused by:
A. Massive hemorrhage
B. ATN
C. AIN
D. Malignant tumors

A. Massive hemorrhage

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The most common component of renal calculi is:
A. Calcium oxalate
B. Magnesium ammonium phosphate
C. Cystine
D. Uric acid

A. Calcium oxalate

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Urinalysis on a patient with severe back pain being
evaluated for renal calculi would be most beneficial if it
showed:
A. Heavy proteinuria
B. Low specific gravity
C. Uric acid crystals
D. Microscopic hematuria

D. Microscopic hematuria

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Abnormal urine screening tests categorized as an overflow
disorder include all of the following except:
A. Alkaptonuria
B. Galactosemia
C. Melanuria
D. Cystinuria

C. Melanuria

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All states require newborn screening for PKU for early:
A. Modifications of the diet
B. Administration of antibiotics
C. Detection of diabetes
D. Initiation of gene therapy

A. Modifications of the diet

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All of the following disorders can be detected by newborn
screening except:
A. Tyrosyluria
B. MSUD
C. Melanuria
D. Galactosemia

C. Melanuria

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The best specimen for early newborn screening is a:
A. Timed urine specimen
B. Blood specimen
C. First morning urine specimen
D. Fecal specimen

B. Blood specimen

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Which of the following disorders is not associated with the phenylalanine–tyrosine pathway? A. MSUD B. Alkaptonuria C. Albinism D. Tyrosinemia

A. MSUD

The least serious form of tyrosylemia is: A. Immature liver function B. Type 1 C. Type 2 D. Type 3

A. Immature liver function

An overflow disorder of the phenylalanine–tyrosine pathway that would produce a positive reaction with the reagent strip test for ketones is: A. Alkaptonuria B. Melanuria C. MSUD D. Tyrosyluria

C. MSUD

An overflow disorder that could produce a false-positive reaction with the Clinitest procedure is: A. Cystinuria B. Alkaptonuria C. Indicanuria D. Porphyrinuria

B. Alkaptonuria

A urine that turns black after sitting by the sink for several hours could be indicative of: A. Alkaptonuria B. MSUD C. Melanuria D. Both A and C

D. Both A and C

Ketonuria in a newborn is an indication of: A. MSUD B. Isovaleric acidemia C. Methylmalonic acidemia D. All of the above

D. All of the above

Urine from a newborn with MSUD will have a significant: A. Pale color B. Yellow precipitate C. Milky appearance D. Sweet odor

D. Sweet odor

Hartnup disease is a disorder associated with the metabolism of: A. Organic acids B. Tryptophan C. Cystine D. Phenylalanine

B. Tryptophan

5-HIAA is a degradation product of: A. Heme B. Indole C. Serotonin D. Melanin

C. Serotonin

Elevated urinary levels of 5-HIAA are associated with: A. Carcinoid tumors B. Hartnup disease C. Cystinuria D. Platelet disorders

A. Carcinoid tumors

False-positive levels of 5-HIAA can be caused by a diet high in: A. Meat B. Carbohydrates C. Starch D. Bananas

D. Bananas

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS IEM

Cystinosis

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS Inherited disorder of tubular reabsorption

Cystinuria

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS Fanconi syndrome

Cystinosis

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS Early renal calculi formation

Cystinuria

IDENTIFY IF IT IS CYSTINURIA OR CYSTINOSIS Cystine deposits in the cornea

Cystinosis

Blue diaper syndrome is associated with: A. Lesch-Nyhan syndrome B. Phenylketonuria C. Cystinuria D. Hartnup disease

D. Hartnup disease

Homocystinuria is caused by failure to metabolize: A. Lysine B. Methionine C. Arginine D. Cystine

B. Methionine

The Ehrlich reaction will detect only the presence of: A. Uroporphyrin B. Porphobilinogen C. Coproporphyrin D. Protoporphyrin

B. Porphobilinogen

Acetyl acetone is added to the urine before performing the Ehrlich test when checking for: A. Aminolevulinic acid B. Porphobilinogen C. Uroporphyrin D. Coproporphyrin

B. Porphobilinogen

The classic urine color associated with porphyria is: A. Dark yellow B. Indigo blue C. Pink D. Port wine

D. Port wine

Which of the following specimens can be used for porphyrin testing? A. Urine B. Blood C. Feces D. All of the above

D. All of the above

The two stages of heme formation affected by lead poisoning are: A. Porphobilinogen and uroporphyrin B. Aminolevulinic acid and porphobilinogen C. Coproporphyrin and protoporphyrin D. Aminolevulinic acid and protoporphyrin

D. Aminolevulinic acid and protoporphyrin

Hurler, Hunter, and Sanfilippo syndromes are hereditary disorders affecting the metabolism of: A. Porphyrins B. Purines C. Mucopolysaccharides D. Tryptophan

C. Mucopolysaccharides

Many uric acid crystals in a pediatric urine specimen may indicate: A. Hurler syndrome B. Lesch-Nyhan disease C. Melituria D. Sanfilippo syndrome

B. Lesch-Nyhan disease

Deficiency of the GALT enzyme will produce a: A. Positive Clinitest B. Glycosuria C. Galactosemia D. Both A and C

D. Both A and C

identify the metabolic urine disorders with their classic urine abnormalities Mousy odor

PKU

identify the metabolic urine disorders with their classic urine abnormalities Blue color

Indicanuria

identify the metabolic urine disorders with their classic urine abnormalities Sulfur odor

Cystinuria

identify the metabolic urine disorders with their classic urine abnormalities Black color

Alkaptonuria

identify the metabolic urine disorders with their classic urine abnormalities Orange sand in diaper

Lesch-Nyhan disease

identify the metabolic urine disorders with their classic urine abnormalities Sweaty feet odor

Isovaleric acidemia

Macroscopic screening of urine specimens is used to: A. Provide results as soon as possible B. Predict the type of urinary casts present C. Increase cost-effectiveness of urinalysis D. Decrease the need for polarized microscopy

C. Increase cost-effectiveness of urinalysis

Variations in the microscopic analysis of urine include all of the following except: A. Preparation of the urine sediment B. Amount of sediment analyzed C. Method of reporting D. Identification of formed elements

D. Identification of formed elements

All of the following can cause false-negative microscopic results except: A. Braking the centrifuge B. Failing to mix the specimen C. Diluting alkaline urine D. Using midstream clean-catch specimens

D. Using midstream clean-catch specimens

The two factors that determine relative centrifugal force are: A. Radius of rotor head and RPM B. Radius of rotor head and time of centrifugation C. Diameter of rotor head and RPM D. RPM and time of centrifugation

C. Diameter of rotor head and RPM

When using the glass-slide and cover-slip method, which of the following might be missed if the cover slip is overflowed? A. Casts B. RBCs C. WBCs D. Bacteria

A. Casts

Initial screening of the urine sediment is performed using an objective power of: A. 4× B. 10× C. 40× D. 100×

B. 10×

Which of the following are reported as number per lpf? A. RBCs B. WBCs C. Crystals D. Casts

D. Casts

The Sternheimer-Malbin stain is added to urine sediments to do all of the following except: A. Increase visibility of sediment constituents B. Change the constituents’ refractive index C. Decrease precipitation of crystals D. Delineate constituent structures

C. Decrease precipitation of crystals

Nuclear detail can be enhanced by: A. Prussian blue B. Toluidine blue C. Acetic acid D. Both B and C

D. Both B and C

Which of the following lipids is/are stained by Sudan III? A. Cholesterol B. Neutral fats C. Triglycerides D. Both B and C

D. Both B and C

Which of the following lipids is/are capable of polarizing light? A. Cholesterol B. Neutral fats C. Triglycerides D. Both A and B

A. Cholesterol

The purpose of the Hansel stain is to identify: A. Neutrophils B. Renal tubular cells C. Eosinophils D. Monocytes

C. Eosinophils

Crenated RBCs are seen in urine that is: A. Hyposthenuric B. Hypersthenuric C. Highly acidic D. Highly alkaline

B. Hypersthenuric

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

C. Lysis of yeast cells by acetic acid

A finding of dysmorphic RBCs is indicative of: A. Glomerular bleeding B. Renal calculi C. Traumatic injury D. Coagulation disorders

A. Glomerular bleeding

Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit brownian movement are: A. Indicative of pyelonephritis B. Basophils C. Mononuclear leukocytes D. Glitter cells

D. Glitter cells

Sometimes mononuclear leukocytes are mistaken for: A. Yeast cells B. Squamous epithelial cells C. Pollen grains D. Renal tubular cells

D. Renal tubular cells

When pyuria is detected in a urine sediment, the slide should be checked carefully for the presence of: A. RBCs B. Bacteria C. Hyaline casts D. Mucus

B. Bacteria

Transitional epithelial cells are sloughed from the: A. Collecting duct B. Vagina C. Bladder D. Proximal convoluted tubule

C. Bladder

The largest cells in the urine sediment are: A. Squamous epithelial cells B. Urothelial epithelial cells C. Cuboidal epithelial cells D. Columnar epithelial cells

A. Squamous epithelial cells

A squamous epithelial cell that is clinically significant is the: A. Cuboidal cell B. Clue cell C. Caudate cell D. Columnar cell

B. Clue cell

Forms of transitional epithelial cells include all of the following except: A. Spherical B. Caudate C. Convoluted D. Polyhedral

C. Convoluted

Increased transitional cells are indicative of: A. Catheterization B. Malignancy C. Pyelonephritis D. Both A and B

D. Both A and B

A primary characteristic used to identify renal tubular epithelial cells is: A. Elongated structure B. Centrally located nucleus C. Spherical appearance D. Eccentrically located nucleus

D. Eccentrically located nucleus

After an episode of hemoglobinuria, RTE cells may contain: A. Bilirubin B. Hemosiderin granules C. Porphobilinogen D. Myoglobin

B. Hemosiderin granules

The predecessor of the oval fat body is the: A. Histiocyte B. Urothelial cell C. Monocyte D. Renal tubular cell

D. Renal tubular cell

A structure believed to be an oval fat body produced a Maltese cross formation under polarized light but does not stain with Sudan III. The structure: A. Contains cholesterol B. Is not an oval fat body C. Contains neutral fats D. Is contaminated with immersion oil

A. Contains cholesterol

The finding of yeast cells in the urine is commonly associated with: A. Cystitis B. Diabetes mellitus C. Pyelonephritis D. Liver disorders

B. Diabetes mellitus

The primary component of urinary mucus is: A. Bence Jones protein B. Microalbumin C. Uromodulin D. Orthostatic protein

C. Uromodulin

The majority of casts are formed in the: A. Proximal convoluted tubules B. Ascending loop of Henle C. Distal convoluted tubules D. Collecting ducts

C. Distal convoluted tubules

Cylindruria refers to the presence of: A. Cylindrical renal tubular cells B. Mucus-resembling casts C. Hyaline and waxy casts D. All types of casts

D. All types of casts

A person submitting a urine specimen after a strenuous exercise routine normally can have all of the following in the sediment except: A. Hyaline casts B. Granular casts C. RBC casts D. WBC casts

D. WBC casts

Before identifying an RBC cast, all of the following should be observed: A. Free-floating RBCs B. Intact RBCs in the cast matrix C. A positive reagent strip blood reaction D. All of the above

D. All of the above

WBC casts are associated primarily with: A. Pyelonephritis B. Cystitis C. Glomerulonephritis D. Viral infections

A. Pyelonephritis

The shape of the RTE cell associated with RTE casts is primarily: A. Elongated B. Cuboidal C. Round D. Columnar

C. Round

When observing RTE casts, the cells are primarily: A. Embedded in a clear matrix B. Embedded in a granular matrix C. Attached to the surface of a matrix D. Stained by components of the urine filtrate

C. Attached to the surface of a matrix

The presence of fatty casts is associated with: A. Nephrotic syndrome B. Crush injuries C. Diabetes mellitus D. All of the above

D. All of the above

Nonpathogenic granular casts contain: A. Cellular lysosomes B. Degenerated cells C. Protein aggregates D. Gram-positive cocci

A. Cellular lysosomes

All of the following are true about waxy casts except they: A. Represent extreme urine stasis B. May have a brittle consistency C. Require staining to be visualized D. Contain degenerated granules

C. Require staining to be visualized

Observation of broad casts represents: A. Destruction of tubular walls B. Dehydration and high fever C. Formation in the collecting ducts D. Both A and C

D. Both A and C

All of the following contribute to urinary crystals formation except: A. Protein concentration B. pH C. Solute concentration D. Temperature

A. Protein concentration

The most valuable initial aid for identifying crystals in a urine specimen is: A. pH B. Solubility C. Staining D. Polarized microscopy

A. pH

Crystals associated with severe liver disease include all of the following except: A. Bilirubin B. Leucine C. Cystine D. Tyrosine

C. Cystine

All of the following crystals routinely polarize except: A. Uric acid B. Cholesterol C. Radiographic dye D. Cystine

D. Cystine

Casts and fibers usually can be differentiated using: A. Solubility characteristics B. Patient history C. Polarized light D. Fluorescent light

C. Polarized light

Identify the following crystals seen in acidic urine with their description/identifying characteristics Pink sediment

Amorphous urates

Identify the following crystals seen in acidic urine with their description/identifying characteristics Ovoid

Calcium oxalate monohydrate

Identify the following crystals seen in alkaline urine with their description/identifying characteristics: “Coffin lids”

Triple phosphate

Identify the following crystals seen in acidic urine with their description/identifying characteristics Envelopes

Calcium oxalate dihydrate

Identify the following crystals seen in alkaline urine with their description/identifying characteristics: White precipitate

Amorphous phosphate

Identify the following crystals seen in alkaline urine with their description/identifying characteristics: Thin prisms

Calcium phosphate

Identify the following crystals seen in alkaline urine with their description/identifying characteristics: Thorny apple

Ammonium biurate

Identify the following crystals seen in alkaline urine with their description/identifying characteristics: Dumbbell shape

Calcium carbonate

Identify the following abnormal crystals with their description/identifying characteristics: Hexagonal plates

Cystine

Identify the following abnormal crystals with their description/identifying characteristics: Fine needles seen in liver disease

Tyrosine

Identify the following abnormal crystals with their description/identifying characteristics: Notched corners

Cholesterol

Identify the following abnormal crystals with their description/identifying characteristics: Concentric circles, radial striations

Leucine

Identify the following abnormal crystals with their description/identifying characteristics: Bundles after refrigeration

Ampicillin

Identify the following abnormal crystals with their description/identifying characteristics: Flat plates, high specific gravity

Radiographic dye

Identify the following abnormal crystals with their description/identifying characteristics: Bright yellow clumps

Bilirubin

Identify the following types of microscopy with their descriptions: Low-refractive-index objects may be overlooked

Bright-field

Identify the following types of microscopy with their descriptions: Forms halo of light around object

Phase

Identify the following types of microscopy with their descriptions: Objects split light into two beams

Polarized

Identify the following types of microscopy with their descriptions: Indirect light is reflected off the object

Dark-field

Identify the following types of microscopy with their descriptions: Detects specific wavelengths of light emitted from objects

Fluorescent

Identify the following types of microscopy with their descriptions: Three-dimensional images

Interference contrast

MIDTERMS Flashcards

(123 cards)