Urine Analysis

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October 6 University *

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MICROBIOLO

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Biology

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Nov 24, 2024

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docx

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25

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  You answered the question correctly . Detection of a fruity odor in a fresh urine sample may be indicative of which of the following: The correct answers are highlighted below Starvation Yeast infection Bacterial infection Diabetes mellitus Feedback14 Conditions such as starvation and diabetes mellitus can lead to an increase of ketones in the urine, giving the urine a "fruity", sweet type of odor.   You answered the question incorrectly . Charcot-Leyden crystals in stool may be associated with an immune response and are thought to be the breakdown products of: The correct answer is highlighted below neutrophils eosinophils monocytes lymphocytes basophils Feedback2 Charcot-Leyden crystals in stool are thought to be created from damaged eosinophil byproducts. These crystals have a strong association, although they are rare, with parasitic infections or allergic reactions.   You answered the question correctly .
An increased number of these cells, when found upon microscopic examination of urine is termed: The correct answer is highlighted below Glycosuria Hematuria Uremia Normal urine Feedback2 Hematuria indicates the presence of red blood cells in the urine.   You answered the question correctly . A patient who has a primarily vegetarian diet will most likely have an acid urine pH. The correct answer is highlighted below True False Feedback2 This statement is false. A patient who has a primarily vegetarian diet will most likely have an alkaline urine pH. A low-carbohydrate diet as well as the ingestion of citrus fruits can also lead to a more alkaline urine sample.   You answered the question incorrectly .
The crystals that are seen in this image are triple phosphate crystals. The correct answer is highlighted below True False Feedback2 These are cholesterol crystals.   You answered the question correctly . Which of the following conditions produce glycosuria? (Choose ALL correct answers) The correct answers are highlighted below Diabetes mellitus Multiple myeloma Impaired tubular reabsorption/advanced kidney failure Preeclampsia Feedback14 Diabetes mellitus and impaired tubular reabsorption/advanced kidney failure can cause glycosuria. Glycosuris is defined as the presence of glucose in the urine. It most commonly results from diabetes mellitus and impaired tubular reabsorption, but may also occur in pregnancy and in patients taking adrenocorticosteroids.   You answered the question correctly .
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A cystine crystal is seen in this image. The correct answer is highlighted below True False Feedback1 This is true; a cystine crystal is depicted in this image. Cystine crystals are present in acidic urine, are typically colorless, and have a characteristic hexagonal shape (also described as appearing similar to a benzene ring). These crystals are associated with cystinuria.   You answered the question correctly . Parasites which can be found in urinary sediment include all of the following EXCEPT : The correct answer is highlighted below Enterobius vermicularis Trichomonas vaginalis Plasmodium malariae Schistosoma haematobium Feedback3 Plas modium malariae is the only parasite that is listed that could NOT potentially be seen in urine sediment. Plasmodium is a blood parasite.
Both Enterobius vermicularis and Trichomonas vaginalis could potentially arrive in the urine as contaminants from other sources; Enterobius from fecal contamination and Trichomonas from vaginal secretions. Of the parasites that are listed, only Schistosoma haematobium is a true urinary tract parasite.   You answered the question correctly . Many white blood cells (WBCs) are present in this image of urine sediment that is observed using brightfield microscopy. The correct answer is highlighted below True False Feedback2 This slide shows many red blood cells (RBCs.)   You answered the question correctly . A urine production of less than 400 mL/day is: The correct answer is highlighted below Consistent with normal renal function and water balance Termed isosthenuria Defined as oliguria Associated with diabetes mellitus caused by moderate dehydration Feedback3 Oliguria is defined as the production of a decreased amount of urine. This can be defined as a daily urine production of less than 400 mL.
  You answered the question correctly . Which of the following cast(s) might be found in the urine of a healthy individual after strenuous exercise: The correct answers are highlighted below Epithelial cell casts Hyaline casts Granular casts Waxy casts Feedback Hyaline and/or granular casts may be seen in healthy individuals for a short time period after strenuous exercise.   You answered the question incorrectly . What type of white blood cell is seen MOST frequently in urine sediment with infections of the urinary system? The correct answer is highlighted below Eosinophil Lymphocyte Monocyte Neutrophil Plasma cell Feedback Neutrophils are typically increased in urinary bacterial infections.   You answered the question correctly . Match the following urine chemical reagent strip test pads to the disease or disorder that would most likely cause a positive test result. Your answers are on the left. The correct answers are on the right and highlighted.
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Diabetes mellitus Ketones Renal calculi Blood Hepatitis/cirrhosis Bilirubin Urinary tract infection Nitrites Feedback Ketones- Diabetes mellitus Blood- Renal calculi Bilirubin- Hepatitis/cirrhosis Nitrites- Urinary tract infection   You answered the question correctly . Urine should be at room temperature prior to testing with the reagent strip method. The correct answer is highlighted below True False Feedback This statement is true. Urine should be at room temperature prior to testing with the reagent strip method. Urine strip reactivity can increase with increased urine temperature, so the optimum temperature is 22-26 o C, or room temperature.   You answered the question incorrectly . Which of the following tests included on a urine chemical reagent strip would never be reported out as negative? The correct answer is highlighted below Urobilinogen Bilirubin Leukocyte esterase Blood Nitrite Feedback
Urobilinogen is reported as normal, not negative. A normal urobilinogen result is approximately: 0.2-1.0 Ehr U/dL Question   You answered the question correctly . Identify the urine sediment elements present in this illustration: The correct answer is highlighted below WBC casts Coarse granular casts Waxy casts Fine granular casts Feedback Fine granular cases may represent degenerated cellular casts. They usually indicate renal parenchymal disease, or allograft rejection.   You answered the question incorrectly . When the glucose result on a urine specimen from an infant is negative on the urine chemical reagent strip, it can be assumed that the specimen is negative for other reducing substances such as galactose. The correct answer is highlighted below True False Feedback
The method used on the urine chemical reagent strip is specific for glucose. An additional test, such as Clinitest®, should be used to check for other reducing substances.   You answered the question correctly . What effect may bacterial contamination have on urine pH? The correct answer is highlighted below The bacteria may make the pH more alkaline. The bacteria may make the pH more acidic. The bacteria would not affect urine pH. Feedback A urine pH above 8.0 may indicate that a specimen has been held non-preserved too long, which allows multiplication of urea-splitting bacteria with resultant increase in pH.   You answered the question incorrectly . Abnormal crystals that can be found in urine include: (Choose all that apply.) The correct answers are highlighted below Leucine Tyrosine Cystine Triple phosphate Feedback If the crystals are from solutes that are not normally in the urine, they are considered "abnormal." Abnormal crystals may indicate an abnormal metabolic process. Some of these include: Cystine, tyrosine, and leucine.   You answered the question correctly . Which of the following cells when found upon microscopic examination of the urine would be most indicative of kidney disease:
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The correct answer is highlighted below WBCs and bacteria Tubular epithelial cells Squamous epithelial cells RBCs Feedback Squamous epithelial cells are usually vaginal contaminants.   You answered the question correctly . A voided urine specimen is delivered from the women's clinic to the laboratory six hours after collection. The following results are reported: Color: yellow Protein: negative Bilirubin: negative Clarity: cloudy Glucose: negative Urobilinogen: 0.2 mg/dL Sp. Gravity: 1.020 Ketone: negative Nitrite: positive pH: 9.0 Blood: negative Leukocyte esterase: negative What might these results indicate? The correct answer is highlighted below The patient has a urinary tract infection. The urine may have remained too long at room temperature and bacterial contaminants have affected the nitrite and pH results. The specimen had a preservative added. The leukocyte esterase result is wrong. Feedback These results indicate that the urine may have remained too long at room temperature and bacterial contaminants have affected the nitrite and pH results. Urine samples should be analyzed within a few hours, or stored in the refrigerator. Question Difficulty: Level 4     
  You answered the question correctly . Identify the urine sediment elements shown by the arrow: The correct answer is highlighted below Yeast WBCs Fat Starch crystals Feedback Starch crystals often contaminate normal urine. They appear round to oval, are highly refractile, with an irregular indentation in the center. They may exhibit the "Maltese cross" appearance under polarized light.   You answered the question correctly . If CSF tubes numbered #1, #2 and #3 CANNOT be analyzed within one hour, the correct procedure for the microbiology sample tube is to: The correct answer is highlighted below discard it freeze it leave it at room temperature incubate in a 56 degree water bath refrigerate it Feedback
You must leave the tube at room temperature since refrigerating, freezing, or incubating the specimen at 56 degrees will destroy Neisseria meningitides (if present).  The sample should not be thrown away. Question Difficulty: Level 6   You answered the question incorrectly . What term is used to describe the color in these tubes of cerebrospinal fluid (CSF)? The correct answer is highlighted below Jaundice Xanthochromia Icterus Feedback The term that is used to describe the color in these tubes of CSF is "xanthochromia." Xanthochromia is an abnormal color, usually yellow, orange, or pink, in the supernatant of the CSF sample. It may indicate that a subarachnoid hemorrhage (SAH) has occurred. Jaundice and icterus both describe a yellowing of the skin, mucous membranes, and eyes. Blood plasma/serum that is deep yellow is also described as icteric. Question Difficulty: Level 8  
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     You answered the question incorrectly . The nitrite portion of the test strip can be used to: (Choose ALL correct answers) The correct answers are highlighted below Monitor antibiotic therapy Detect a bladder infection in an early stage in pregnant women Screen individuals with recurrent infections Detect presence of cystitis Feedback The nitrite portion of the test strip can be used to monitor antibiotic therapy, detect a bladder infection in an early stage in pregnant women, screen individuals with recurrent infections, and detect presence of cystitis. The test reaction on the urine chemical reagent strip pad for nitrite works by detecting when nitrite in the urine reacts with para-arsanilic acid to form a diazonium compound. This diazonium compound in turn couples with 1,2,3,4- tetrahydrobenzo(h)quinoline-3-ol to produce a pink color. Question Difficulty: Level 9        You answered the question correctly . The reagent strip method for protein primarily tests for which type of protein? The correct answer is highlighted below Globulin Bence-Jones protein Albumin Mucoprotein Feedback The urine reagent strip method for protein primarily indicates increased albumin, although other proteins may also produce a positive result if greatly elevated.
Question Difficulty: Level 4        You answered the question incorrectly . All of the statements below about synovial fluid are true EXCEPT: The correct answer is highlighted below arthrocentesis is performed as a means to evaluate arthritis and other joint disorders synovial fluid is present only in movable joints joint fluid resembles plasma in viscosity joint fluid has approximately the same glucose as plasma Feedback Synovial fluid is actually quite viscous and does not have the same consistency as plasma. The reason for its thicker consistency is to provide cushion and reduce friction between the articular cartilage of synovial joints during movement. Question Difficulty: Level 6        You answered the question incorrectly . How should the production of a blue or purple color on the test pad of an Ictotest® be interpreted? The correct answer is highlighted below Positive for bilirubin Positive for ketones Negative for bilirubin Negative for ketones Feedback
The production of a blue or purple color on the test pad of an Ictotest® be interpreted as positive for bilirubin. Question Difficulty: Level 4   You answered the question correctly . What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hrs? The correct answer is highlighted below 9.5 mL/min 13.6 mL/min 95 mL/min 136 mL/min 1.36 mL/min Feedback One method of calculating a glomerular filtration rate is using creatinine and urine volume to determine creatinine clearance. The equation is as follows: Creatinine Clearance = (urine creatinine X urine flow rate) / plasma creatinine; where urine flow rate = volume in mL /24 hours x h/60 min) In this case = creatinine clearance = 124 X (2200/24 x hour/60) / 2 = 94.7 or 95 ml/min Question Difficulty: Level 7        You answered the question incorrectly .
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What types of cells are present in this field of a cytocentrifuged CSF sample? The correct answers are highlighted below red cells lymphocytes neutrophils blasts Feedback There are no blasts seen in this image. The lymphocytes seen here are mature, though from cytocentrifugation they can appear to have prominent nucleoli similar to blasts. The chromatin pattern of the nucleus in the lymphs shown is mature and clumped. Question Difficulty: Level 5        You answered the question correctly .
The microscopic finding illustrated in this image is a hyaline cast. The correct answer is highlighted below True False Feedback This is a fiber artifact. Question Difficulty: Level 3        You answered the question correctly . True or false? Hyaline casts are present in this slide.
The correct answer is highlighted below True False Feedback This is true. There are approximately 5 hyaline casts in this image. Question Difficulty: Level 3        You answered the question correctly . Excessive carbohydrate loss that may occur due to vomiting, or rapid weight loss may result in the presence of which of following substances not normally contained in the urine? The correct answer is highlighted below glucose bilirubin ketones urobilinogen Feedback Normal urine specimens usually yield negative results for the presence of ketones. Ketone bodies such as acetoacetic acid, beta-hydroxybutyric acid, and acetone can cause positive test results on the urine reagent strip pad for ketones. These intermediate byproducts are associated with the breakdown of fat. Causes: diabetes mellitus, starvation, vomiting, diarrhea, etc. Question Difficulty: Level 4        You answered the question correctly .
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Sulfosalicylic acid can be used to confirm the result of which of the following tests included on a urine chemical reagent strip? The correct answer is highlighted below Protein Glucose Bilirubin Urobilinogen Feedback The SSA reaction is used to detect protein in the urine. Unlike the protein test on the urine chemical reagent strip, the SSA reaction will detect albumin and globulins, and Bence-Jones proteins. This principle is based on the acidification of proteins which causes turbidity and can be measured based on protein concentration present. Question Difficulty: Level 4        You answered the question correctly . Identify the urine sediment element indicated by the arrow in the illustration: The correct answer is highlighted below Mucus thread
Cylindroid Hyaline cast Waxy cast Feedback Hyaline casts generally appear as colorless, homogeneous, and transparent with rounded ends. They can also be seen as a result of dehydration, after diuretic therapy, in renal disease, and transiently as a result of exercise. Question Difficulty: Level 4        You answered the question correctly . The constituents that are indicated by the arrows in this image of a stained urine sediment are: The correct answer is highlighted below Red blood cells Yeast
Renal epithelial cells Leukocytes Feedback These are yeast. They can be distinguished from red blood cell by observing budding of the yeast. Renal epithelial cells and white blood cells have nuclei. These cells do not have nuclei. Leukocytes are also present in this field. Question Difficulty: Level 3        You answered the question correctly . Substances found in urinary sediment that are more easily distinguished by use of polarized microscope are: The correct answer is highlighted below WBC RBC Casts Lipids Crystals Feedback Lipids tend to form a "maltese cross" pattern when viewed in polarized light, which helps to differentiate them from other urine microscopic components. Question Difficulty: Level 7        You answered the question correctly .
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Which of the following tests would be useful in the assessment of glomerular filtration: The correct answer is highlighted below 24 hour urine protein Creatinine clearance PSP test Urea clearance Feedback Creatinine clearance tests are utilized to estimate the glomerular function of the kidney. The creatitine clearance calculation is defined as the volume of plasma that is cleared of creatinine by the kidney per unit of time and uses the following formula: creatinine clearance = Urine creatinine conc x Volume / Plamsa creatinine conc Creatinine clearance measurements have a recommended specimen requirement = 24- hour urine collection. Question Difficulty: Level 3        You answered the question correctly . Match urine color with substance that might have been responsible: Your answers are on the left. The correct answers are on the right and highlighted. White Phosphates Yellow Bilirubin Clear to straw Normal Pale red Red blood cells Feedback Pale red- presence of red blood cells Yellow- presence of bilirubin White- presence of phosphates
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Clear/straw- Normal Question Difficulty: Level 3        You answered the question correctly . Which of the following statements are TRUE regarding the reagent strip test procedure? (Choose ALL of the correct answers) The correct answers are highlighted below Urine should be centrifuged prior to dipping the reagent strip. Urine should be well mixed prior to dipping the reagent strip. When visually reading the reagent strip, all results can be read immediately after dipping the strip in the urine specimen. Prolonged immersion may wash out test reagents. Feedback True Statements: Urine should be well mixed prior to dipping the reagent strip. Prolonged immersion may wash out test reagents. False Statements: Urine should be centrifuged prior to dipping the reagent strip. When visually reading the reagent strip, all results can be read immediately after dipping the strip in the urine specimen. Question Difficulty: Level 5        You answered the question correctly . A patient suspected of a urinary tract infection has a negative nitrite test, but bacteria are present upon microscopic examination. What may have caused this discrepant result? (Choose ALL correct answers)
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The correct answers are highlighted below The bacteria present are not nitrate-reducers. The urine specimen may have been tested too soon after collection. The urine was not held in the bladder for a sufficient amount of time for nitrate to be reduced to nitrite. The urine was in the bladder for more than 4 hours. Feedback When a urine sample shows a negative nitrite test, but bacteria are present upon microscopic examination, the false-negative result could be caused by two possibilities listed in the choices above: The bacteria that is present is not a nitrate-reducer OR the urine was in the bladder for an insufficient amount of time for nitrate to be reduced to nitrite. Question Difficulty: Level 5        You answered the question correctly . Which of the following tests confirms the presence of Bence-Jones proteinuria: The correct answer is highlighted below Protein electrophoresis Sulfosalicylic acid precipitation Cryoprecipitation Immunoelectrophoresis Feedback Immunoelectrophoresis is used to detect the presence of Bence-Jones proteins. Immunoelectrophoresis is used to help detect, diagnose, and monitor the course and treatment of conditions associated with abnormal proteins (such as Bence-Jones), including Multiple Myeloma, Waldenstrom's macroglobulinemia, and a few other related diseases.
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Question Difficulty: Level 6        You answered the question correctly . Which of the following would best describe what you might observe after a traumatic CSF tap: The correct answer is highlighted below All tubes pale yellow All tubes clear All tubes contain equal amounts of blood Significantly more RBCs found in tube #1 vs. tube #3 Feedback A traumatic tap would result in the introduction of more blood in the initial collection tube (#1), than in subsequent tubes (#2 and #3). Question Difficulty: Level 3     
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