CLINCAL MICROSCOPY (URINALYSIS AND OTHER BODY FLUIDS)

INSTRUCTION: Select the best answer for each of the following questions. Mark only one
answer for each item

1. A medical technology student is performing Fehling’s and Rothera’s tests on a urine

sample.Both yielded a positive reaction. In a reagent strip, this is equivalent to a:
a. Positive bilirubin and Ketones
b. Positive glucose
c. Positive glucose and ketones
d. Positive ketones
2. In Hartnup Disease, Urine produces:
a. A red color after addition with Ehrlich reagent
b. A violet color in the obermayer’s test
c. A and B
d. Transient blue color after addition of ferric chloride reagent
3. It pertains to a difficulty or pain in urination:
a. Dysuria c. Melituria
b. Pyuria d. Acholuria
4. The renal vein carries:
a. Filtered blood with solutes and wastes
b. Filtered blood with reabsorbed water
c. Unfiltered blood with reabsorbed water and substances
d. Filtered blood with reabsorbed water and substances
5. In chronic renal failure, which of the following is false?
a. Urine SG equals the glomerular filtrate SG
b. A telescoped sediment is observed
c. Increased clearance of nonprotein nitrogenous compounds
d. Presence of broad waxy casts
6. The reagents ethyleneglycoldiaminoethylethertetraacetic and bromthymol blue produce yellow
color when the polyelectrolyte detects numerous ions in urine. Chronic production of this type
of urine may cause kidney stone formation.
a. Both are true c. only the 1st statement is correct
b. Both are false d. only the 2nd statement is correct
7. A specimen diluted 1:5 with a reading of 1.010 would have an actual specific gravity of:
a. 1.050 c. 1.002
b. 1.020 d. 5.000
8. An amber urine specimen is sent to the laboratory for examination. Which of the following is
true?
a. It may react with nitroso-naphthol reagent
b. It may contain three types of crystals
c. A and B
 d. It is from a patient suffering from a delayed hemolytic transfusion reaction
9. A 50-year-old man weighing 72 kilograms has a serum creatinine of 1.1 mg/dL, predict his
creatinine clearance.
a. 82 mL/min c. 102 mL/min
b. 92 mL/ min d. indetereminate
10. In genetically susceptible persons, ingestion of blackberries can produce:
a. Red urine color in acidic urine
b. Red urine color in alkaline urine
c. Black urine color in acidic urine
d. Fruity odor
11. Following rhabdomyolysis, which if the following is true?
a. RTE cells are observed in urine
b. It produces clear red urine precipitated by ammonium sulfate
c. It causes tea-colored urine that produces yellow foam when shaken
d. Plasma creatinine is decreased
12. Sucrose produces:
a. Brown color on glucose reagent pad containing potassium iodide
b. Greenish brown color in benedict’s reagent
c. Yellow color on glucose reagent pad containing tetramethylbenzidine
d. Brick red color on benedict’s reagent
13. Persons known to form renal calculi are most likely to exhibit crytalluria during what season?
a. Summer c. autumn
b. Winter d. any season
14. The recommended capacity of the container for routine urinalysis is:
a. 40 mL b. 50 mL c. 65 mL d. 80 mL
15. Positive result in the kingsburry-clark test:
a. Blue color b. turbidity c. Green color d. Yellow precipitate
16. A patient is being evaluated for the possibility of having diabetes mellitus. His fasting serum
glucose was 100mg/dL while urine glucose is 100mg/dL. Interpret the results:
a. He has diabetes mellitus
b. He has impaired fasting glucose
c. He has impaired renal function
d. Indeterminate
17. Which of the following organisms is urinary nitrite positive?
a. Sthaphylococcus saphrophyticus c. Enterobacter aerogenes
b. Candida albicans d. enterococcus faecalis
18. An emotionally stressed person will show:
a. Cylindruria c. hematuria
b. Dysuria d. lipiduria
19. The presence of increased ascorbate in urine can cause false-positive results in which of the
following reagent strip parameters?
 1. Blood 3. Glucose
2. Bilirubin 4. Nitrite
a. 1 and 2 c. 4 only
b. 1,2,3 and 4 d. none of these
20. A type of urinary crystal with a cigarette butt appearance is:
a. Calcium phosphate c. Hippuric acid
b. Calcium sulfate d. sulfonamide
21. Which of the following is true regarding quality assurance in the urinalysis section of the
laboratory?
1. Centrifuges are routinely disinfected every 2 weeks
2. Laboratory sinks should be disinfected daily
3. In calibrating refractometer, 9% sucrose should give an SG reading of 1.022 ± 0.00`
4. In calibrating urinometer, potassium sulfate should give an SG reading of 1.020
a. 1 and 3 c. 2 only
b. 1, 2 and 3 d. 2 and 4
22. The main cause of an aromatic urine odor is (are):
a. Volatile acids c. 2 only
b. 1, 2 and 3 d. 2 and 4
23. Which of the following renal diseases characterizes a NEPHRITIC syndrome?
a. Cystitis c. Pyelonephritis
b. Glomerulonephritis d. Minimal change disease
24. Chronic production of sulfonamide crystals in urine:
a. May cause RTE cells to appear in urine
b. May indicate inadequate hydration
c. A and B
d. Is insignificant in patients undergoing antibiotic therapy
25. A person who eats a lot of tomatoes may produce:
a. 5-HIAA in urine
b. 5-HIAA and calcium oxalatecrystals in urine
c. Calcium oxalate crystals in urine
d. 5-HIAA and dark yellow urine
26. Correct matches regarding ferric chloride tube test reactions, EXCEPT:
a. Alkaptonuria- transient blue color
b. Tyrosyluria- transient green color
c. Phenylketonuria- transient blue-green color
d. Melanuria- gray-black color
27. In Sanfilippo syndrome:
a. Mental retardation is present
b. Skeletal structure is abnormal
c. There are skeletal and mental abnormalities
d. Mucopolysaccharides accumulate in the cornea of the eye
28. Urine specimen used for addis count should not be tested for:
a. Glucose only c. Benedict’s test
b. Glucose and blood d. Glucose, blood and Benedict’s test
29. Which of the following does not produce a positive reaction with blood reagent strip?
a. Methemoglobin c. Detergents
b. Hemoglobin d. None of this
30. Porphobilinogen will produce red color when combined with:
a. P-dimethylaminobenzaldehyde
b. 4-methoxybenzene-diazonium-tetrafluoroborate
c. Both of these
d. None of these
31. A color-blinded person:
a. Cannot perform physical urine examination incorrectly
b. Cannot perform chemical urine examination correctly
c. Cannot perform physical, chemical and microscopic examination correctly
d. Can perform all phases in urine testing correctly
32. An air-conditioning unit in the laboratory has malfunctioned. This will hasten:
a. The precipitation of amorphous urates in urine
b. The alkalinzation of urine
c. The oxidation of bilirubin
d. All of these
33. Pernicious anemia:
1. Dangerous 3. Achlorhydria
2. No intrinsic factor 4. Gastric pH of <6.0
a. 1, 2 and 3 b. 2, 3 and 4 c. 1, 2 and 4 d. 1, 2, 3 and 4
34. Performing bronchoalveolar lavage on cigarette smoker patients would demonstrate:
a. An elevated CD4/CD8 ratio c. Heart failure cells
b. An elevated neutrophil count d. eosinophilia
35. The role of alveolar macrophage is:
a. To line the alveolar surface c. both
b. To produce surfactant d. neither
36. Patients with nephrotic syndrome are at risk of infection and coagulation disorders.
a. True c. infection only
b. False d. coagulation disorders only
37. A cloudy urine becomes clear after addition of acetic acid, and then produces a blue color after
addition of o-toluidine reagent. The sample probably contained:
a. Glucose and yeast c. amorphous crystals
b. Leukocytes d. blood
38. Yellow-brown highly refractile globules were seen adhering to a cast matrix. They do not exhibit
maltese cross on polarizing microscope. After addition of an organic solvent, they disappeared.
The elements are most likely:
 a. Fat globules c. oil from immersion objective
b. Myelin globules d. contaminants
39. In alkaptonuria, urine contains increased:
1. Maleyacetoacetic acid 3. P-hydroxyphenlpyruvic acid
2. Alkapton 4. 2,5-dihydroxyphenylacetic acid
a. 1, 2 and 4 b. 3 and 4 c. 2 and 4 d. 2 only
40. Cysteine crystals are reported:
a. Average number pre LPF c. Rare, few, moderate or many
b. Average number per HPF d. Present or absent
41. Not untrue about tamm-horsfall protein, EXCEPT:
1. It is the main protein component of both cast and mucus
2. It can cause a positive reagent strip test result for protein
3. It is a glycoprotein secreted by the renal tubular cells
4. It can be found in both normal and abnormal urine
a. 1, 2 and 3 c. 2 only
b. 2 and 4 d. 1, 3 and 4
42. Infants with PKU may have lighter skin and hair color than normal infants. The treatment for
PKU is a low phenylalanine diet.
a. Both statements are true b. only the 1st statement is true
b. Both statements are false d. only the 2nd statement is true
43. Waxy casts accompanied by a negative protein were observed in urine from a 6-month-old girl.
The results are.
a. Discrepant c. indicative of chronic renal failure
b. Normal d. indicative of acute renal failure
44. In bile duct obstruction:
a. Stools are pale yellow c. creatorrhea may occur
b. Stools are acholic d. all are possible
45. Majority of CSF specimens sent to the laboratory from the neurology clinic have glucose
readings less than 50% of the corresponding blood glucose results performed in the clinic. What
do these results mean?
a. All patients are in normal condition
b. There is an outbreak of meningitis in the area
c. Possible technical error
d. Samples are collected from geriatric patients
46. The following are the test results of a spinal fluid specimen from a 43-year old female patient:
Serum albumin = 5.8g/dL CSF albumin = 116.mg/dL
Serum IgG = 0.8g/dL CSF IgG = 1.2mg/dL

Based on these data, the underlying condition of this individual is most probably:

a. Multiple sclerosis c. Meningitis

b. Multiple myeloma d. CSF leakage
47. The presence of crystals in freshly voided urine is most frequently associated with:
a. Aciduria c. Infection
b. Hypersthenuria d. renal disease
48. Large round stones are characteristic of those found in the bladder. Large rounded and
staghorn shapes derive from the renal pelvis.
a. Only 1st statement is true c. both are true
nd
b. Only 2 statement is true d. both are false
49. The rate of proteinuria in nephrotic syndrome is:
a. Greater than 3.5 g/day c. greater than 150 mg/dL/day
b. Greater than 2.5 g/ day d. between 2.5 to 3.5 g/day
50. A very hard, dark-colored and rough renal stone may form in the kidney due to:
a. Increased purine-rich food intake
b. Increased ascorbate-rich food intake
c. A disorder with defective reabsorption of 4 amin acids
d. Proteus vulgaris infection
51. Renal lithiasis patient management technique(s) includes (s):
a. Maintaining the urine at a pH incompatible with crystallization
b. Maintaining adequate hydration
c. Dietary restriction
d. All of these
52. Which hCG level is the positive cutoff point for pregnancy?
a. 25mIU/mL c. 50mIU/mL
b. 25 IU/mL d. 50IU/ mL
53. A watery black stool from a neonate is received in the laboratory with requests for APT test,
fecal pH and Clinitest. Which of these tests would give inaccurate results?
a. Clinitest c. APT test
b. Fecal pH d. None. All tests can be performed
54. Vibrio cholera causes:
a. Osmotic diarrhea accompanied by WBCs
b. Secretory diarrhea accompanied by WBCs
c. Osmotic Diarrhea not accompanied by WBCs
d. Secretory Diarrhea not accompanied by WBCs
55. Hypoglycorrhachia is seen in:
a. Bacterial peritonitis c. form clumps
b. Tubercular meningitis d. septic arthritis
56. Amorphous urates when added with acetic will:
a. Readily dissolve c. form clumps
b. Remain intact d. transform into uric acid crystals
57. If alpha-amylase is added into semen:
a. Semen liquefies c. sperm cells are immobilized
b. Semen coagulates d. fructose is broken down
58. A process of surgical anastomosis of the vas deferens:
a. Vasectomy c. orchidectomy
b. Oophorectomy d. vasovasostomy
59. An amiotic fluid specimen was sent to the laboratory for examination. When tested for O.D.
450, it has a maximum absorbance at 410 nm. This indicates:
a. Presence of phospholipid c. intra-amniotic hemorrhage
b. Erythroblastosis fecalis d. the specimen was exposed to light
60. Who should be screened annually for occult blood?
a. Infants and pediatric patients c. cystic fibrosis patients
b. Adults older than age 50 d. all adults
61. A specimen containing 1.0g/dL of protein and 2.5g/ dL of glucose has a specific gravity reading
of 1.030 using a urinometer. The specimen temperature is 35°C and the urinometer is calibrated
at 25°c. what is the corrected specific gravity reading?
62. A chemical stock room is burning. The materials on fire are scattered on the floor and are know
to contain magnesium and potassium. Metal X is not available in the area. Which of the
following can be used to extinguish the fire?
a. Wet blanket c. multi-purpose extinguisher
b. Sand d. none. Just allow them to burn out
63. The acronym ‘PDMAI’ stands for:
a. Plan-Develop-Measure-Assess- Improve
b. Plan-Design-Measure-Assess-Improve
c. Program-Develop-Maintain-Assess-Improve
d. Plan-Do-Maintain-Assess-Influence
64. A laboratory technician accidentally spills muriatic acid on the floor. He should:
a. Neutralize it with a base, then soak up with rags
b. Flush the area with water, then soak up with rags
c. Flush the area with large amounts of water
d. Use a multi-purpose fire extinguisher
65. The leydig cells of the testes secrete:
a. Inhibin c. aldosterone
b. Testosteron d. FSH
66. A medical Technology student dilutes a synovial fluid prior to performing a WBC count. The
fluid forms a clot. What could be the most probable cause of the clot formation?
a. Fibrinogen c. wrong anticoagulant was used
b. Wrong diluent was used d. improper dilution technique
67. Increased activity of adenosine deaminase is seen in:
a. Transudates b. Exudates c. Normal condition d.None of these
68. Following a head injury, which protein will identify the presence of CSF leakage through the
nose?
a. Prealbumin c. Transferrin
b. MBP d. CRP
69. What is the method of choice when determining if a fluid is actually CSF?
a. Electrophoresis c. TCA test
b. SSA precipitation test d. Coomassie brilliant blue Dye-binding test
70. In assessing sperm motility:
a. Make a smear in slide and stain with Papanicolau’s stain
b. Make a smear in slide and stain with Eosin-nigrosin
c. Dilute with chilled tap water or sodium bicarbonate solution
d. Place a drop of semen in a slide and cover it with cover slip
71. The following results were obtained on an ascetic fluid: Serum albumin, 2.8g/dL; fluid
albumin.1.2 g/dL. Identify if the effusion is a transudate or an exudates and the most probable
cause of the effusion.
a. Transudate; congestive heart failure
b. Exudate; bacterial peritonitis
c. Transudate; hepatic cirrhosis
d. Transudate; colorectal cancer
72. An obsolete way of collecting sweat is
a. Shwachman’s plastic bag method
b. Pilocarpine iontophoresis
c. Direct application of chloride electrode on skin
d. Sunlight exposure
73. Acetic acid is added to a urine sediment. Which of the following will remain intact?
a. Amorphous phosphates and bacteria
b. Bilirubin crystals
c. Calcium phosphate crystals
d. Calcium oxalate crystals
74. A brown discoloration from an infant’s diapers may be suspected of:
a. Hartnup disease c. congenital porphyria
b. Lesch-Nyhan syndrome d. alkaptonuria
75. Who discovered calculi made up of cysteine in 1810?
a. William Wollaston c. anton Ghon
b. Archibald garrod d. Richard Bright
76. Photo-oxidation of bilirubin imparts a yellow-green color to the urine photo-oxidation of large
amounts of excreted urobilinogen to urobilin also produces yellow foam when shaken.
a. Only 1st statement is true c. Both statement are true
nd
b. Only 2 statement is true d. Both statement are false
77. Which of the following amniotic fluid values indicates a possible risk for respiratory distress
syndrome?
a. L/S ratio of 2.5
b. Lamellar body count of 30,000/uL
c. Absorbance level of 0.30 at 450nm
d. Increased acetylcholinesterase activity
78. The synonym for lecithin is:
a. phosphatidylserine c. Phosphatidylinositol
b. phosphatidylethanolamine d. Phophatidylcholine
79. The daily CSF production in adults is approximately:
a. 1000 mL b. 140-170 mL c. 500 mL d. 10-60 mL
80. These provide workers with a summary of the chemical’s characteristics, fire, explosion,
reactivity, and health risks associated with the chemical, and methods for safe handling:
a. Material safety data sheets (MSDS)
b. National Fire Protection agency (NFPA)
c. Health Insurance Portability and Accountability Act (HIPAA)
d. Personal Protective Equipment (PPE)
81. A yellow tinge on a semen specimen could indicate:
a. Infection c. High Flavin content
b. Presence of bilirubin d. Abnormalities
82. Microscopic examination of an ascitid fluid shows many cells with nuclear and cytoplasmic
irregularities. If thyroid profile and CA 125 revealed abnormal results, what other constituent
could be seen in the fluid?
a. Psammona bodies c. Breast cancer cells
b. Mesothelial cells d. Plasma cells
83. The protein that is normally exreted in urine includes:
a. Albumin c. Tamm-horsfall protein
b. Bence-jones protein d. None of these
84. All of the following matches are not incorrect, EXCEPT:
a. Inappropriate tests orders- pre-analytical error
b. Technologist error- analytical error
c. Failure to phone critical results- post-analytical error
d. Icteric specimen- pre-analytical error
85. Cannot be filtered by the glomeruli:
a. Alpha2-marcroglobulin
b. Alpha-2-macroglobulin and amylase
c. Tryptophan and macroamylase
d. Alpha-2-marcroglobulin and marcroamylase
86. Methanol:
a. Flammable c. Poisonous and flammable
b. Flammable and combustible d. Flammable, combustible and poisonous
87. Produces foam in urine:
a. Protein and bilirubin c. Phenazopyridine
b. Bilirubin and pyridium d. bilirubin, protein and Phenazopyridine
88. Which of the following sets of drug test specimens could be adulterated?
a. Light rellow urine, SG of 1.0009, temperatire of 25 °C checked w/in 15 mins
b. Amber urine, SG of 1.032, temperature of 35°C checked w/in 4 mins
 c. Yellow-green urine, SG of 1.006, temperature of 27°C checked w/in 4 mins
d. Straw-colored urine, SG of 1.003, temperature of 32.5°C checked w/in 4 mins
89. A flash point number indicates:
a. Burning below 100°C c. Burning below 100°F
b. Burning above 200°F d. Burning below 73°F
90. Trisomy 18:
a. Patau syndrome c. Down syndrome
b. Edward syndrome D. Klinefelter syndrome
91. Method now widely used for screening infant blood sample for specific substances associated
with a particular error of metabolism:
a. Amino acid chromatography
b. Tandem mass spectrophotometry
c. Guthrie bacterial inhibition test
d. Ferric chloride tube test
92. What is the ideal preservative for all types of urine testing?
a. Refrigeration c. Sodium Fluoride
b. Formaldehyde d. None
93. Nubecula, a faint cloud in urine is composed of:
a. Wbc’s rbcs and mucus
b. Rbc’s, mucus and epithelial cells
c. Wbc’s, rbcs and epithelial cells
d. Wbc’s mucus and epithelial cells
94. What is the pH of the glomerular filtrate?
a. 7.4 c. 4.5 to 8.0
b. 5.0 to 6.0 d. 7.0
95. Which of the following is true regarding uric acid and cysteine?
1. Both crystals polarize 3. Both will dissolve in dilute HCl
2. Both are soluble in ammonia 4. Cystine is cyanide-nitroprusside (+)
a. 2 and 4 c. 4 only
b. 1, 2, and 4 d. 1, 2, 3 and 4
96. Pregnancy test kits may detect hCG in urine sample in as little as __ days after conception:
a. 3 b. 10 c. 15 d. 20
97. A semen sample is diluted 1:20 and 15 sperms are counted in 5 RBC squares on both sides of
the neubauer counting chamber. The sperm concentration per mL is _____ and is termed
_____.
a. 7,500,000; azoospermia c. 5,000,000; oligospermia
b. 15,000,000; oligospermia d. 7,500,000; oligospermia
98. The finding of increased nucleated erythrocytes in the CSF indicates:
a. traumatic tap c. leukoerythroblastosis
b. intracranial hemorrhage d. acute leukemia
99. A three-glass collection specimen was submitted to the laboratory for examination. What do the
following results indicate?
1st specimen= nitrite (-), Leukocytes (-)
nd
2 specimen= nitrite (-), Leukocytes (-)
rd
3 specimen = nitrite (+), Leukocytes (-)
a. Prostatic infection c. Contaminated specimen
b. UTI d. Old specimen
100. As a technologist was opening a rubber-stoppered urine collection tube, the specimen
splashed into the face of the technologist and the student with her. Embarrassed, the
technologist noticed that the student was busy and had not even noticed the splash and she said
nothing to the student. They continued working withouth addressing the splash. What ethical
issue was not addressed by the technologist?
a. Confidentiality c. Honesty
b. Trust d. Human rights