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AUBF- Answer-KEY - Aubf

Medical Technology (Southwestern University PHINMA)

Studocu is not sponsored or endorsed by any college or university

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Put ALL answers on a piece of whole sheet of paper only. This is a GROUP TASK and OPEN
NOTES.

I. GROSS EXAMINATION OF NORMAL URINE. Give the observed characteristics or values of

a urine sample obtained from a normal patient. (2 points each)

Color colorless to yellow

Clarity clear
Odor aromatic

24-Hour Urine Volume 600 to 2000 mL (0.6-2.0L)

25-Specific gravity 1.005-1.035

26-Osmolality ~285 mOsm/kg H2O for isosthenuric urine

II. PHYSIOLOGY OF GUT. Given the structures of the genitourinary tract (GUT) below, providethe
unique function opposite each. (2 points each)

Glomerulus filters blood of cells and proteins; formation of ultrafiltrate

Afferent arteriole deliver blood to the glomeruli
Efferent arteriole delivers blood ultrafiltrate from glomeruli to peritubular capillaries
Proximal convoluted tubule reabsorption of H2O & Na+ to renal cells (glucose, Cl- & amino acids are
reabsorbed also)
Ascending loop renal cell reabsorption of Na+ & Cl- with release of K+(but not H2O)
Descending loop renal cell reabsorption of H2O (but not salt); increased concentration of
tubular fluid
Distal convoluted tubule ADH-dependent tubular reabsorption of mostly H2O as well as Na+
(aldosterone dependent)
Collecting tubule collection fo 1% of the total filtered plasma referred to as urine
Ureter passageway of urine from kidney to bladder
Urinary bladder temporary storage(reservoir) of urine

III. MULTIPLE CHOICE.Choose the letter that corresponds to the correct answer for
each of the following items. You are not allowed to change your answer. Any erasure or
correction made on an answer shall make the answer incorrect.

1. The normal straw color of urine is largely due to the presence of

A. urochrome C. uroerythrin
B. bilirubin D. biliverdin

2. Emptying the bladder or urine voiding is otherwise known as

A. deglutition C. micturition
B. diuresis D. renal incontinence

3. Which set of parts involved in urine formation is correctly sequenced?

A. glomerulus, proximal convoluted tubule, loop of Henle, renal pelvis, collecting
ducts, ureter, urinary bladder, urethra
B. glomerulus, proximal convoluted tubule, renal pelvis, loop of Henle, collecting
ducts, ureter, urinary bladder, urethra
C. glomerulus, proximal convoluted tubule, loop of Henle, collecting ducts, renal
pelvis, ureter, urinary bladder, urethra
D. glomerulus, proximal convoluted tubule, collecting ducts, loop of Henle, renal
pyramid, ureter, urinary bladder, urethra
4. The procedure of wet urinalysis starts with the
A. urine collection and transport C. sediment assessment
B. sample identification D. chemical testing

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5. Amino acid disorders are characterized by the passage of urine with

A. distinct colors C. characteristic odors
B. turbid appearance D. presence of amino acids

6. The presence of smoky urine is most likely indicative of

A. hemoglobinuria C. hemosiderinuria
B. hematuria D. hemophilia

7. One of the following is characterized by a turbid urine due to leakage of lymph:

A. pyuria C. bacteruria
B. chyluria D. cylindruria

8. Brick dust refers to which of the following crystals?

A. amorphous phosphates C. amorphous urates
B. uric acid D. calcium oxalate

9. Gross examination of urine samples involve all of the following except

A. assessment of odor C. pH and specific gravity testing
B. reporting of urine color D. measurement of urine volume

10. The clearing of turbidity due to the addition of a dilute acid confirms the presence of
A. amorphous urates C. bacteria
B. amorphous phosphates D. leukocytes and pus cells

11. The presence of casts in the urine is called

A. chyluria C. cylindruria
B. casturia D. crystalluria

12. The purpose of collecting timed urine samples is for obtaining

A. more yield, thus, increased sample volume
B. higher concentration of a particular substance tested
C. more urinary sediments such as cells, crystals and casts
D. ensure high degree of accuracy and precision of chemical tests

13. Any transient increase in urinary volume is termed

A. diuresis C. polyuria
B. hypersthenuria D. urolithiasis

14. The most commonly encountered abnormal color of urine is

A. yellow C. colorless
B. red-brown D. brown

15. The TS (Total Solids) meter or refractometer is used to measure

A. specific gravity C. clarity (appearance)
B. urinary volume D. urine osmolality

16. The presence of many mucus threads in the urine indicates

A. renal inflammatory episode C. normal kidney function
B. slightly dysfunctional bladder D. urine processing artifact

17. PKU or phenylketonuria is a disease characterized by the voiding of a

A. red-brown colored urine C. mousy-smelling urine
B. highly concentrated urine D. milky cloudy urine

18. A reagent strip is sometimes referred to as the

A. test strip C. chemstrip
B. dipstick D. multistix

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19. Regarded as the routine or basic urinalysis is the

A. wet urinalysis C. reagent strip urinalysis
B. special cytologic urinalysis D. chemical urinalysis

20. Macroscopic examination of urine includes the following except

A. appearance C. chemical testing using multistix
B. specific gravity determination D. sediment examination

21. In the event that only one urine specimen is obtained, which correct sequence should be
followed in wet urinalysis?
1. bacteriologic examination 3. examination for crystals and casts
2. check for contamination 4. glucose testing

A. 1-2-3-4 C. 1-2-4-3
B. 2-1-4-3 D. 2-1-3-4

22. The patient’s degree of hydration and urine concentration can be estimated by examining
A. urine clarity C. urine color
B. urine odor D. urine crystals

23. Small cloudy patches in normal urine due to the presence of mucus is called
A. nebula C. nubecula
B. smokiness D. flocculence

24. Which pigment causes the production of yellow foam ?

A. uroerythrin C. bilirubin
B. hemoglobin D. indicant
25. Presence of intact red blood cells is called
A. hematuria C. hemosiderinuria
B. hemoglobinuria D. hematinuria

26. Homogentisic acid forms brown-black urine upon long standing -- a condition known as
A. porphyria C. melaninuria
B. alkaptonuria D. urobilinuria

27. Which of these urinary constituents can be cleared through acidification?

A. amorphous urates C. pus cells
B. amorphous phosphates D. bacteria

28. The dye Oil Red O is used to demonstrate the presence of

A. hematuria C. lipiduria
B. chyluria D. pyuria

29. Excretion by an adult of more than 500 mL. of urine with a specific gravity of 1.018 at
night is known as
A. polyuria C. polydipsia
B. nocturia D. nocturnal oliguria

30. Which of the following statements is not true?

A. High volumes of urine result in a low specific gravity.
B. The aromatic odor of freshly voided urine is of undetermined source.
C. Cloudy urine is not common and not necessarily pathologic.
D. Aside from urochrome, there are other pigments that give normal urine a yellow
color.

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31. A urine sample with a specific gravity of 1.010 is described as

A. hyposthenuric C. hypersthenuric
B. normosthenuric D. isosthenuric

32. Which parameter cannot be measured using reagent strip technology?

A. specific gravity C. glucose
B. urinary pH D. osmolality

33. Sound wave frequency and falling drop method are performed to assess the urine
A. osmolality C. specific gravity
B. acidity or alkalinity D. water content

34. The state of hydration of the patient can be assessed by all of the following except
A. urine osmolality C. urine specific gravity
B. urine volume and color D. urine pH

35. The presence of high amounts of indican will give a urine sample a
A. red-violet color C. brown-black color
B. yellow-orange color D. blue-green color

36. The average adult on a normal diet produces a 24-hour urine with a pH of about
A. 5.0 C. 7.0
B. 6.0 D. 7.4

37. At night, during the mild respiratory acidosis of sleep, a more acidic urine is formed. The
acidity is largely due to the buildup of
A. casts and crystals C. organic acids
B. carbon dioxide D. ketone bodies

38. A diet high in meat and cranberries will

A. lower urinary pH C. increase urinary pH
B. produce neutral pH D. not affect urine pH

39. The ill effects of salicylic acid poisoning would be aggravated by which of the following:
A. diet rich in meat C. diet high in citrus fruits
B. intake of sodium bicarbonate D. prohibition of acid phosphate ingestion

40. In the tubular cells, the passing filtrate acquire hydrogen ions in exchange for
A. ammonium ions C. sodium ions
B. bicarbonate ions D. chloride ions

41. Which pair of dipstick and its number of chemical parameters is incorrect?
A. Multistix 10 SG - 10 C. Diastix – 2
B. Uristix -2 D. Chemstrip G – 1

42. The Uristix reagent strip can detect

A. glucose only C. protein only
B. glucose and protein only D. glucose and protein among others
43. The titratable acidity of a 24-hour urine collected in ice utilizes as titrant the
A. 0.1N NaHCO3 C. 0.1N NaCl
B. 0.1N NaOH D. 0.1N NaNO3

44. Bacterial growth in urine specimen is characterized by all of the following except
A. clouding that cannot be cleared by acidification
B. clouding that can be removed by paper filtration
C. marked alkaline shift to a pH > 8.0
D. marked unsuitability as sample for bacterial culture

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45. The most accurate means of determining the pH of urine samples is the
A. blue and red litmus paper method
B. pH meter with a glass electrode
C. titratable acidity testing using a 24-hour urine sample (in ice)
D. reagent strip using bromthymol blue and methyl red

46. The protein uromucoid is secreted by the cells in the distal tubular cells andascending
loop of Henle. It is highly associated with cast formation. It is also referred to as the
A. Bence Jones protein C. Retinol-binding protein
B. Tamm-Horsfall glycoprotein D. Immunoglobulin light chains

47. The presence of Bence Jones protein the urine is suggestive of

A. Overflow proteinuria C. Multiple myeloma
B. Cylindruria D. Functional proteinuria

48. A hazy urine with high protein content collected after a heavy exercise is an example of
A. Intermittent proteinuria C. Postural proteinuria
B. Persistent proteinuria D. Functional proteinuria

49. To detect the kinds of protein in the urine, what is needed is

A. Multistix 10 SG C. Electrophoresis
B. Salting-out process D. Dye-binding tests

50. The catabolic products derived from lipids which can become potentially toxic are the
A. sugar monomers C. ketone bodies
B. benzene derivatives D. fatty acids

51. When lipid is lost in the urine, many granular casts, fatty casts and oval fat bodies are
found in the urine sediment. Oval fat bodies are actually
A. hyaline casts with lipid deposits C. droplets of cholesterol esters
B. fat-laden renal tubular epithelial cells D. lipoproteins forming oval crystals

52. Tubular pattern proteinuria is seen in all of the following conditions except
A. Fanconi’s syndrome C. Wilson’s disease
B. Pyelonephritis D. Nephrotic syndrome

53. The tubular pattern proteinuria cannot be easily detected using reagent strip methods
due to the type of protein involved – the low molecular weight proteins such as alpha-1-
microglobulin, light-chain immunoglobulins and lysozymes. On the other hand,
glomerular pattern proteinuria is detected because the protein involved is mainly
A. albumin C. medium-chain immunoglobulins
B. Bence Jones protein D. Tamm Horsfall protein

54. Type of proteinuria characterized by the excretion of 4 g. of protein /day is described as

A. heavy C. minimal
B. moderate D. overflow

55. Also referred to as orthostatic proteinuria is

A. postural proteinuria C. Bence Jones proteinuria
B. intermittent proteinuria D. functional proteinuria

56. Which substance may affect urinary pH testing?

A. protein C. glucose
B. ketone bodies D. bilirubin

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57. Which statement regarding protein testing is not true?

A. Reagent strips are not sensitive in measuring globulins but sensitive to albumin.
B. Both albumin and globulins can be precipitated using SSA and TCA.
C. Reagent strips can be used in assessing the degree of proteinuria.
D. Both reagent strips and SSA and TCA methods are for urine protein screening.

58. What substance in the urine is tested using the Kjeldahl method and Biuret reaction?
A. glucose C. ketone bodies
B. protein D. bilirubin

59. Bence Jones protein is best detected in urine via

A. Heat and precipitation technic C. Protein electrophoresis
B. TCA-Biuret method D. Coomassie blue dye-binding test
60. Which blood glucose level exceeds the renal threshold for glucose leading to glucosuria?
A. 100 mg/dL C. 130 mg/dL
B. 157 mg/dL D. 220 mg/dL

61. Urine glucose testing serves to check endocrine function to diagnose the disease
A. Diabetes insipidus C. Diabetes mellitus
B. Hyperglycemia D. Glucosuria

62. The common thing about using reagent strips for glucose testing such as Clinistix,
Multistix and Chemstrip is the
A. double sequential enzyme reaction C. type of chromogen used
B. reaction time D. procedural steps

63. The copper reduction tablet test for glucose is the

A. Clinistix C. Clinitest
B. Bilitest D. Chemstrip G

64. What enzyme will oxidize glucose into gluconic acid and hydrogen peroxide?
A. hexokinase C. glucokinase
B. glucose oxidase D. glucose peroxidase

65. The range of drops required of the urine sample in the glucose testing using Clinitest is
A. 2 to 5 C. 5 to 8
B. 5 to10 D. 10 to 15

66. O-toluidine is the chromogen used in which reagent strip for glucose?
A. Clinistix C. Multistix
B. Chemstrip-G D. Clinitest

67. All of the following are reducing sugars except

A. glucose C. galactose
B. fructose D. sucrose

68. If a pass through phenomenon happens in the glucose test using Clinitest, one should do
A. retesting using lesser amount of urine sample
B. recollection of urine sample and retesting glucose
C. confirm the result using Benedict’s method
D. no additional testing and results obtained can be reported

69. In galactokinase deficiency, galactose cannot be converted to glucose. From what sugar
was the galactose that appears in the urine derived?
A. sucrose C. lactose
B. maltose D. starch

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70. Which of the following tests is the most specific for urinary glucose testing?
A. Clinitest C. Benedict’s test
B. Clinistix D. Copper reduction test

71. What compound of copper is colored red?

A. CuOH C. CuSO4
B. Cu2O D. CuO

72. What method is best to measure the individual reducing sugars in urine?
A. Copper reduction method C. Thin layer chromatography
B. Clinitest D. Clinistix

73. What organic substances are products of incomplete lipid metabolism?

A. free fatty acids C. bile pigments
B. ketone bodies D. porphyrins

74. The most abundant among these organic substances in the urine is
A. beta-hydroxybutyric acid C. diacetic acid
B. acetone D. urea

75. The most abundant among these inorganic urine constituents is

A. sodium C. bicarbonate
B. chloride D. potassium

76. Ketonuria may be seen in all of the following conditions except

A. fasting C. excessive exercise
B. type I diabetes mellitus D. carbohydrate-rich diet

77. Sodium nitroferricyanide reaction (Acetest) is specific for urinary

A. urobilinogen C. bilirubin
B. diacetate D. sucrose

78. Rothera’s wet method can detect all of the following except
A. acetoacetic acid C. acetone
B. beta-hydroxybutyrate D. ketone bodies

79. The main ingredient of the Gerhardt’s test for the detection of urine diacetic acid is
A. nitroprusside C. ferric chloride
B. nitroferricyanide D. sulfobromophthalein

80. Which of the following substances is an oxidizing agent?

A. ascorbic acid C. hydrogen peroxide
B. glutathione D. uric acid

81. If delay in testing for ketone bodies cannot be prevented, the urine sample should be
A. kept capped at room temperature C. discarded and replaced by a newone
B. added with preservative D. refrigerated at 2-10 degrees Celsius

82. The Multistix reagent pad for blood uses of the chromogen tetramethylbenzidine which,
in the presence of blood, causes a color change from
A. yellow to red C. yellow to orange
B. yellow to green D. yellow to purple

83. What red-brown pigment in the urine is produced after rhabdomyolysis?

A. hemoglobin C. intact RBCs
B. myoglobin D. hemosiderin

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84. Which of the following is not a breakdown product of hemoglobin?

A. bilirubin C. hemosiderin
B. amino acids D. haptoglobin

85. The Diazo (p-nitrobenzenediazonium p-toluene sulfonate) tablet test is for the detection
of urine
A. hemoglobin C. urobilinogen
B. bilirubin D. myoglobin

86. Ehrlich’s aldehyde reaction is the formation of reddish-brown color due to

A. urobilinogen C. bilirubin
B. nitrite D. leukocyte esterase
87. Bilirubin can be detected using all of the following methods except
A. Ictotest C. Diazo reagent strip
B. Yellow foam test D. Blondheim method

88. Schwartz-Watson test differentiates between the presence of urobilinogen and

A. hemoglobin C. bilirubin
B. porphyrins D. porphobilinogen

89. Inverse Ehrlich’s reaction is also known as

A. Hecht’s test C. Hoesch’s test
B. Nitrite test D. Leukocyte esterase test

90 & 91. A positive nitrite test indicates A. (90) C. while a positive leukocyte esterase
test indicates (91) .
A. bacteriuria C. pyuria
B. cylindruria D. crystalluria

92. C-Stix reagent strips are impregnated with buffered phosphomolybdates to detect
A. ascorbic acid C. citric acid
B. 5-hydroxyindoleacetic acid D. melanin

93. The 5-hydroxyindole acetic acid (5-HIAA) is a byproduct of metabolism of

A. porphyrins C. serotonin
B. indicant D. ascorbic acid

94. If serotonin is derived from the amino acid tryptophan, melanin is derived from which
amino acid?
A. glycine C. cysteine
B. tyrosine D. methionine

95. Defects in the synthesis of heme moiety of hemoglobin would cause

A. lead poisoning C. porphyrias
B. in vitro hemolysis D. hemorrhagic fever

96. What apparatus is required to detect the lavender to violet fluorescence of porphyrins
after acidification of urine sample and addition of glacial acetic acid:ethyl acetate mixture?
A. Microscope C. Wood’s lamp
B. TS meter D. UV light

97. Which of the following has a peroxidase-like activity?

A. hexokinase C. heme
B. myoglobin D. hydrogen peroxide

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98. The most abundant among the ketone bodies which accounts 78% of the total in urine is
A. acetone C. acetoacetic acid
B. beta-hydroxybutyric acid D. urea

99. Which pathologic condition would cause a positive Acetest?

A. diabetes mellitus C. diabetes insipidus
B. nephrotic syndrome D. high fat diet

100. Which chemical parameter is not found in Multistix 10 SG?

A. Urobilinogen C. Nitrite
B. Ascorbic acid D. Leukocyte esterase
GOOD LUCK!

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SOUTHWESTERN UNIVERSITY
COLLEGE OF MEDICAL TECHNOLOGY
Formative Test 1 in AUBF Lecture

II. MATCHING TYPE. Match column A with column B. Write your answer on the spaces provided.
Letters only.
Column A Column B
Urine Appearance and their Causes

_C__1. Colorless A. methemoglobin, melanin

_F__2. Cloudy B. hemoglobin, beets, myoglobin
_J__3. Smoky C. very dilute urine, diabetes insipidus
_H_4. Milky D. bilirubin-biliverdin
_B_5. Red E. indicans, Pseudomonas infection
_A_6. Brown-black F. bacteriuria, phosphates, urates, pus cells
_E_7. Blue-green G. concentrated urine, urobilin in excess
_I__8. Yellow H. fat, emulsified paraffin, pyuria
_D_9. Yellow-green I. acriflavine
_G_10. Yellow orange J. blood in the urine (intact RBCs)
K. None of the above
ANSWERS: 1C-2F-3J-4H-5B-6A-7E-8I-9D-10G
Characteristics of Urine & Associated Conditions

_C__11. Sweaty feet odor A. MSUD

_E__12. Odor of cabbage or hops B. Filariasis, lymph node obstruction
_H__13. Mousy odor C. Isovaleric and glutaric acidemia
_F__14. Rotting fish smell D. Major long bone and pelvic bones
_J__15. Rancid smell E. Methionine malabsorption
_A__16. Maple syrup odor F. Trimethylaminuria
_I__17. Sweetish or Fruity odor G. Alkaptonuria
_G__18. Blackening upon long standing of urine H. Phenylketonuria
_B__19. Chyluric urine due to leakage of lymph I. Diabetes mellitus
_D__20. Lipiduria J. Tyrosinemia
K. None of the above
ANSWERS: 1C-2E-3H-4F-5J-6A-7I-8G-9B-10D
Column A Column B
Urine Parameters
_B_21. normal pH of glomerular filtrate A. about 6.0
_C_22. normal urine volume at night B. 7.4
_E_23. oliguric urine C. not more than 400 mL
_D_24. polyuric urine D. more than 2L/day
_F_25. normal range of spec. grav. For random urine E. not more than 500 mL
_J_26. osmolality of urine with spec. grav. of 1.010 F. 1.005-1.035
_G_27. normal range for 24-Hr urine spec. grav. G. 1.016-1.022
_I_28. correction for spec. grav. value due to proteins H. deduction of 0.004 per 1g/dL substance
_H_29. correction for spec. grav. value due to glucose I. deduction of 0.003 per 1g/dL substance
_A_30. pH of urine of a normal person on a Western dietJ. approximately 285 mOsm
K. above 300 mOsm
ANSWERS: 1B-2C-3E-4D-5F-6J-7G-8I-9H-10A

END

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SOUTHWESTERN UNIVERSITY
COLLEGE OF MEDICAL TECHNOLOGY
AUBF LAB Formative Test 1

I. MATCHING TYPE. Match column A (Urine Substances/Parameters) with column B (Urine Test
Methods). Write your answers on the spaces provided. A number may have more than one
answers and a lettered choice can be used more than once. Letters only.
Column A Column B
C 1. H+ ion concentration A. Tetramethylbenzidine method
G 2. Specific gravity B. Fouchet’s test
A 3. Blood C. Litmus test
B, I, P 4. Bilirubin D. Fantus test
K 5. Acetone E. Graduated cylinder method
N 6. Indican F. Seliwanoff’s test
O 7. Calcium G. Urinometer method
D 8. Chloride H. Hart’s test
K, I 9. Diacetic acid I. Ferric chloride test
H 10. Beta-OHbutyrate J. Sulfosalicylic acid test
E 11. Volume measurement K. Rothera’s test
J 12. Protein L. Benedict’s test
M, L 13. Glucose M. Clinitest
M, L 14. Fructose N. Obermeyer’s test
A 15. Hemoglobin O. Sulkowitch test
P. Diazo method
Q. None of the above

MATCHING TYPE: Match column A with column B. Letters only. You are not allowed to change your answer.

Column A Column B
TYPES OF RENAL FUNCTION TESTS
C 16. Water clearance test A. Test measuring GFR (Glomerular filtration rate)
C 17. PAH clearance test B. Test measuring RPF (Renal plasma flow)
C 18. PSP dye excretion test C. Tubular function test
C 19. Urine osmolality test
B 20. Jaffe reaction for creatinine testing
C 21. Refractometer method
A 22. Creatinine clearance test
B 23. Creatinine/BUN ratio
B 24. Phosphotungstic acid method
C 25. Fishberg concentration test

II. URINALYSIS APPARATUSES. Label correctly the parts of A) Refractometer and B) Binocular
compound microscope.
A) Refractometer (12 points)
Daylight plate calibration screw focus adjustment

Main prism assembly Rubber grip eyepiece

B) Binocular Compound Microscope. Label
− 10 MECHANICAL PARTS
1. arm
2. revolving nosepiece
3. mechanical stage
4. stage aperture
5. base
6. stage clip
7. coarse adjustment knob
8. fine adjustment knob
9. lamp switch
10. light ADJUSTMENT knob)

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− 3 ILLUMINATING PARTS
1. Condenser
2. iris diaphragm
3. lamp

− 5 MAGNIFYING PARTS
1. Scanner
2. LPO
3. HPO
4. OIO
5. ocular or eyepiece).

III. IDENTIFICATION. Identify each of the following:

1. the functional and structural units of the kidneys

− nephrons
2. the nephron part consisting of descending and ascending loops
− Loop of Henle
3. the endocrine gland located just above the kidney
− Adrenal gland
4. the principal role of the kidneys
− Urine formation/excretion of waste products via urine
5. the hydrostatic pressure within the capillaries in the glomerulus
− 75mmHg
6. the collective term for the capillary plexus and associated arterioles
− Glomerular tuft
7. a substance that appear only after reaching a minimum blood level
− Threshold substance
8. the glomerular portion whose function is assessed by PAH excretion
− Proximal Convoluted Tubules (PCT)
9. the term for precipitates formed anywhere in the urinary tract
− calculi
10. the nephron part whose function is assessed by dilution and concentration tests
− Distal Convoluted Tubules (DCT)

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IV. ENUMERATION. Enumerate the following:

1 – 3………..Renal hormones
− Erythropoietin (EPO)
− renin
− activated vitamin D3]
4 – 10………Parts of the nephron
− glomerulus
− Bowman’s capsule
− PCT
− loop of Henle
− DCT)
11 - 15. …….Physiological events that occur in the tubules
− reabsorption of Na ions
− reabsorption of water
− secretion of substances
− excretion of K & H ions
− chloride ion transport among others

V. SEQUENCING. Assign a number to each of the following structures in order to come up with the correct sequence
of A) conducting blood (from renal artery to inferior vena cava) and B) conducting urine (from afferent
arteriole to urethra) in the kidneys. (20 points)

A) 5 afferent arteriole B) 8 renal pelvis

1 arcuate arteries 7 renal pyramid
6 peritubular capillaries 1 glomerular tuft
2 interlobar arteries 2 PCT
3 interlobular arteries 5 DCT
4 efferent arteries 10 urinary bladder
7 arcuate veins 9 ureters
9 interlobar veins 4 Henle’s ascending limb
10 renal vein 3 Henle’s descending limb
8 interlobular veins 6 collecting duct

ANSWERS:

VI. BRIEF DISCUSSION. Answer the following questions briefly. Write your answers on the spaces provided.

1) Why is the first morning urine ideal for routine analysis and bacterial culture? Give three (3) reasons.
(3 points)
− most concentrated
− highly acidic
− bladder incubated
2) What are four (4) requisites of a good container for urinalysis? (4 points)
− Clear
− wide-mouthed
− screw-capped (leak proof)
− sterile
3) If a first morning urine is requested, why is a midstream catch required? (2 points)
− to remove interfering squamous epithelial cells during microscopic exam
4) Give (5) parameters that are measured or assessed in physical examination of urine. (5 points)
− Color
− Odor
− Volume

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− clarity (character)
− spec. grav. & Osmolality
5) Cite two (2) differences between aerobic urine culture and anaerobic urine culture. (4 points)
− aerobic culture requires early morning sterile collection while anaerobic culture requires sterile
suprapubic aspiration (SPS)
6) Give an example of a timed specimen and cite its specific purpose. (3 points)
− 2-hour for urobilinogen testing & 24-hour for creatinine clearance testing
7) Explain the physical examination in routine urinalysis by giving the five (5) urine parameters tested and a
short discussion of how each is correctly performed. (15 points)
− color and clarity require bright lighting during observation of well-mixed newly and properly
collected samples; volume is done via approximation and accurately by using a graduated flask
after all testing is done; specific gravity via dipstick or refractometry or urinometer; osmolality
by freezing point depression technique

VII. DIFFERENTIATION. Copy the tables and fill in with the necessary information regarding: A) Routine
Wet Urinalysis (RU) and B) Urine Collection Techniques. (23 points)
A)
MAIN PARTS WHAT IS PRIMARILY DONE
Specimen evaluation Check acceptability of sample and how the specimen was
collected & transported

Physical Exam of Determine physical parameters of urine macroscopically

Urine
Chemical exam of Determine the chemical substances qualitatively and
urine quantitatively

Microscopic Exam of Determine structures found in urine sediments

urine

B)
TYPES OF URINE MAIN MATERIAL/S LABORATORY TEST THAT CAN BE
SAMPLES NEEDED FOR PERFORMED ON THE SAMPLE
COLLECTION COLLECTED
Large screw-capped Creatinine clearance
24-hour urine (Timed containers, coolant
samples) or refrigerator, acid
preservatives, &
graduated cylinder
Early morning sample Ideal sterile Aerobic culture & Routine urinalysis
midstream catch containers

Suprapubic aspiration Ideal sterile syringe Anaerobic culture

(SPA)

Catheterized sample Sterile catheter Anaerobic culture & routine urinalysis

assembly
Random direct urine Ideal clean Drug screening & routine urinalysis
collection containers

GOOD LUCK!

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ANSWER KEY AUBF LEC Formative Test 2

URINE FORMATION & RENAL FUNCTION TESTS
What are the 3 renal functions associated with urine formation?
Correct answer: Glomerular filtration, tubular secretion & tubular reabsorption. Plasma
ultrafiltrate is acidified and concentrated in the process.
During urine formation, which materials are not allowed to filter through in large amounts?
Correct answer:

What is the functional unit of the kidneys?

Correct answer: Nephrons. Nephron consists of the glomerulus, Bowman's capsule, PCT, loop of
Henle, & DCT.
Where does glucose reabsorption happen in the nephrons?
Correct answer: In the proximal convoluted tubules.

Which hormone controls the distal tubular reabsorption of water?

Correct answer: ADH (antidiuretic hormone) produced and secreted in the posterior pituitary
gland.

Which hormone controls the reabsorption of sodium in the PCT?

Correct answer: Aldosterone produced by the adrenal cortex. Reabsorption of sodium is linked to
excretion of potassium and hydrogen ions.

What are the main constituents of urine?

Correct answer: Water, urea, sodium & chloride. Urea, the major breakdown product of proteins,
accounts for about half of the entire dissolved solutes in the urine.

What tests could be done on an unknown fluid to determine if it is urine?

Correct answer: Urea, creatinine, Na & Cl. Urine have higher concentrations of these substances
compared with other body fluids.

What is osmolality?
Correct answer: The measurement of the number of solute particles per unit of solvent,
irrespective of molecular weight.

How is osmolality measured in most clinical laboratories?

Correct answer: By freezing point depression. Each mOsm of solute lowers the freezing point of
the urine by 0.00186degC.

What quality control is required for osmometers?

Correct answer: They should be checked daily with controls of known osmolality.

Why is osmolality a better measurement of kidney function than specific gravity?

Correct answer: It is a better reflection of the concentrating ability of the kidneys and it is not
disproportionately affected by high molecular weight substances like glucose and protein.

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What is normal urine osmolality?

Correct answer: It can range from 50 - 1400 mOsm/kg. depending on factors such as diet and
exercise. In a healthy person with a regular diet and fluid intake, urine osmolality is usually 500-
850 mOsm/kg of HOH.

What is the normal ratio of urine to plasma osmolality?

Correct answer: Under normal conditions, at least 1:1 and after controlled fluid intake, 3:1.

Name a test that measures the glomerular filtration rate (GFR).

Correct answer: creatinine clearance test or urea clearance test

What is the formula of calculating the creatinine clearance test?

Correct answer: UV/P x 1.73/A where: U - urine creatinine in mg/dl; V - urine volume in mL/minute
(24 hour urine/1440); P - plasma creatinine in mg/dl; and A - patient's body surface area in square
meter (determined by height and weight and obtained from a nomogram)

Calculate the creatinine clearance from the data below: Urine creatinine = 127 mg/dl; Plasma
creatinine = 1.4 mg/dl; 24 hour urine volume = 1.5 liters and patient's body surface area = 1.5 square
meters
Correct answer: (127) (1500/1440) /1.4 multiplied by 1.73/1.5 = 109 ml/min

What is the normal creatinine clearance?

Correct answer: Males: 97-137 ml/min; females = 88-128 ml/min. Creatinine clearance decreases
with age (about 6.5 ml/min per decade).

What is the greatest source of error in the performance of a creatinine clearance?

Correct answer: An improperly timed urine collection. A 24-hour urine collection requires the 1st
voided urine to be discarded and all the voided urine collected til the 24th hour included.

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PHYSICAL EXAMINATION OF URINE

What is the preferred method of preservation of urine for routine urinalysis?
Correct answer: Refrigeration up to 6-8 hours. This slows the multiplication of bacteria, but does
not prevent the lytic effect of low specific gravity or alkaline pH. Refrigeration may induce crystal
formation, which can obscure other elements in the urine sediment. Warming the specimen to 37
degrees Celsius prior to centrifugation may dissolve these crystals

What is the preferred specimen for routine urinalysis?

Correct answer: The first morning specimen, since it is the most concentrated. It also has the
lowest pH of the day, so the formed elements are preserved better. Dilute random urines may
result in false-negative results for chemical and/or microscopic analysis.

Ideally, how soon after collection should a urine specimen be tested?

Correct answer:

What changes occur in a urine specimen at room temperature?

Correct answer: The pH increases as bacteria breakdown urea to ammonia Glucose decreases
due to metabolism by bacteria and cells. Ketones, bilirubin, and urobilinogen are lost. Cells and
casts lyse.

What is the clinical significance of specific gravity?

Correct answer:

Which substance contribute most to specific gravity of normal urine?

Correct answer: Urea and sodium chloride
What is the normal specific gravity of a random urine?
Correct answer: 1.015

What is the normal specific gravity of a 24 hour urine?

Correct answer: 1.025

What is hyposthenuria and what is its significance?

Correct answer: Urine specific gravity less than 1.010. It indicates that the kidneys have lost their
concentrating ability.

What is isosthenuria and what is its significance?

Correct answer:

How is urine specific gravity affected by diabetes mellitus?

Correct answer: It is increased due to the presence of glucose. Glucose molecules have a large
effect on specific gravity because of their molecular weight. In this case, the specific gravity is
not a true reflection of the kidney's concentrating ability and the specific gravity should be
corrected.

A urine with a specific gravity reading of 1.035 by refractometer contains 1g/dL of glucose and 1g/dL
of protein. What is the corrected specific gravity?

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Correct answer: 1.028. For each g/dL of glucose, 0.0004 is subtracted and for each gram of
protein, 0.0003 is subtracted.

How is the accuracy of the refractometer checked?

Correct answer: It is checked daily with distilled water (1.000) and commercial controls or
solutions of known specific gravity such as 3% NaCl (1.015), 5% NaCl (1.022), or 9% sucrose
(1.034).

The specific gravity of distilled water reads 1.004 on a refractometer. What should be done before
testing specimens?
Correct answer: The set screw of the refractometer should be adjusted to give a reading of 1.000

A urine specific gravity is off the scale of the refractometer. The technologist dilutes the urine 1:2 and
reads the result as 1.020. What is value should be reported?
Correct answer: 1.040. The last two digits must be multiplied by the reciprocal of the dilution (2).
(Some feel that the dilution is not necessary and that the specific gravity just be reported as
greater than 1.035)

What is the other name for refractometer?

Correct answer: T.S. meter (total solid meter)

How does the refractometer measure specific gravity?

Correct answer: By refractive index, a comparison between the velocity of light in air and the
velocity of light in a solution.

Urine is removed from the refrigerator and tested for specific gravity by refractometer, What
correction is required for temperature?
Correct answer: None. The refractometer is temperature compensated.

A urine has a specific gravity of 1.040 by refractometer. What might be the cause of the high specific
gravity?
Correct answer: Since specific gravity of 1.040 is physiologically impossible, it indicates the
presence of an iatrogenic (medical administered) high-molecular-weight solute, such as
radiopaque dyes (radiographic contrast media, x-ray dye). Although large quantities of glucose
also raise the specific gravity by refractometer, it remains physiologically possible range (1.002-
1.035)

What is the principle of the specific gravity determination of the reagent strips?
Correct answer: It is based on a change in pK (dissociation constant) of a polyelectrolyte on the
reagent strip. The polyelectrolyte ionizes in proportion to the number of ions in solution, causing
a color change in the indicator. An advantage of this method is that it measure only ionic solutes,
so it is not affected by large organic molecules, such as glucose or x-ray dyes. Protein does
increase the results slightly because proteins are anions.

Are specific gravity by reagent strip and by refractometer the same?

Correct answer: No. Substances in the urine do not ionize, such as glucose, x-ray dyes, dextran or

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other high-molecular-weight intravenous fluids (plasma expanders) will increase specific gravity
by refractometer, but not by reagent strip.

Which measurement is more accurate-specific gravity by refractometer or specific gravity by reagent

strip?
Correct answer: Specific gravity by reagent strip. It is the ionic solute that refers to the
concentrating ability of the kidneys and the reagent strip detects only ionic solute. It is not
affected by the presence of the non-ionic solutes that falsely elevate specific gravity by
refractometer.

How does urine pH affect specific gravity by reagent strip?

Correct answer: Specimens with a pH of 6.5 or higher have decreased readings of interference
with the color indicator. Reagent strips manufacturers recommend adding 0.005 to specific
gravity reading when the pH is 6.5 or higher.

What is normal daily urine volume?

Correct answer: 1200-1500 mL.

What is the normal ratio of day to night urine volume?

Correct answer: 3:1

What is diuresis?
Correct answer: Increased urine production.

What is polyuria?
Correct answer: Urine production over 2000 mL per day.

What is oliguria?
Correct answer: Urine production less than 500 mL per day

What is anuria?
Correct answer: No urine production

What is the volume of urine produced affected by diabetes mellitus?

Correct answer: It is increased, due to solute diuresis. The kidneys do not reabsorb excess
glucose, so increased amounts of water must be excreted to remove glucose from the body. The
specific gravity of the urine is high because of the glucose present.

How is the volume of urine produced affected by diabetes insipidus?

Correct answer: It is increased. The deficiency of ADH results in less water reabsorption in the
renal tubules. The specific gravity of the urine is low.

How do some laboratories check the completeness of the 24 hour urine specimen?
Correct answer: by measuring the urine creatinine. Values less than 1 gram/24 hours indicate an
incomplete collection.

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What is responsible for the color of normal urine?

Correct answer: Primarily urochrome, a yellow pigment, and to a lesser extent, uroerythrin (red)
and urobilin (orange-red).

What might cause the urine to be almost colorless (straw)?

Correct answer: Dilute urine.

What are some causes of amber urine?

Correct answer: Urine with high specific gravity, bilirubin, large doses of vitamin A, pyridium, and
nitrofurantoin.

If a urine drops a yellow foam on top when it is shaken, what abnormal test result would be expected
on the reagent strip?
Correct answer: Positive bilirubin

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CHEMICAL EXAM OF URINE

Under CLIA '88, what is the level of complexity for urinalysis by reagent strip or tablet?
Correct answer:

How should reagent strips for urine testing be stored?

Correct answer: In their original container, with a dessicator, and at room temperature.

A urine specimen for routine urinalysis has been refrigerated overnight. Prior to testing, what two
things should be done to the specimen?
Correct answer: It should be brought to room temperature and thoroughly mixed. The enzymatic
reactions on the strips may be inhibited if the urine is cold and false-negative results may be
obtained if RBCs and WBCs have settled to the bottom of the specimen container.

Under CLIA '88, how often must controls be run on reagent strips?
Correct answer: Two levels of controls (positive and negative) must be run every 24 hours and
whenever a new bottle of reagent is opened. Distilled water is not recommended as a negative
control because reagent strip reactions are designed to perform at an ionic concentration
consistent with urine.
A technologist notices that a urine specimen is intensely colored. Why is this an important
observation?
Correct answer:

How does a vegetarian diet affect the urine pH?

Correct answer: It results in an alkaline urine.
What are the normal values for the tests on the urine reagent strip?
Correct answer: pH: random urine 4.5-8, first AM specimen 5-6
Protein: negative or trace
Blood: negative
Nitrite: negative
Leukocyte esterase: negative
Glucose: negative
Ketones: negative
Bilirubin: negative
Urobilinogen: less then or equal to 1 EU/dL

What is the principle of the protein test on the reagent strip?

Correct answer: It is based on the protein error of indicator. A buffer in the reagent pad maintains
the pH at 3, a pH at which the indicator should be yellow; however, if protein is present, the
indicator changes to green or blue.

How could the protein reaction be adversely affected by dipping the reagent strip in the urine?
Correct answer: If the citrate buffer is washed out, a false-positive occurs because the pH of the
urine causes a color change in the indicator.

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Which protein(s) does the reagent strip detect?

Correct answer: Albumin.

Which proteins are detected by the acid precipitation tests for protein?
Correct answer: Albumins, globulins, Bence Jones Proteins

Which acid is commonly used to precipitate urine protein?

Correct answer: Sulfosalicylie acid (SSA).
The protein precipitation test should be performed on the supernatant of a centrifuged urine to
avoid false-positive reactions. Before automated reagent strip readers, it was common practice
to confirm all positive protein results with an SSA test. Today, more selective criteria are us ed.
For example, some labs perform SSA testing on highly alkaline urines since these can overcome
the acid buffer system of the reagent strip, producign false-positive protein results.

Why is the test for protein included in a routine urinalysis?

Correct answer: It is an early indicator of renal disease.

What are some causes of false-positive results in protein precipitation tests?

Correct answer: Turbidity, radiographic contrast media, and some drugs such as penicillin,
sulfonamides, cephalosporins, and tolbutamide.

How does the preservative thymol interfere with urinalysis tests?

Correct answer: It can cause a false-positive protein in acid precipitation tests.

What might account for a positive protein precipitation test with a negative reagent strip?
Correct answer: A protein other than albumin, such as Bence-Jones protein. The discrepancy
could also be due to a false-positive precipitation test due to factors listed above.

How can a highly buffered alkaline urine cause erroneous protein results?
Correct answer: It can cause a false-negative precipitation test by neutralization of the acid
reagent. It can also cause a false-positive protein on the reagent strip if the citrate buffer is
overcome and the pH of the reagent square
increased. The increased pH would cause the pH indicator to change color. Some labs acidify the
specimen and retest with a reagent strip.

What are Bence Jones proteins?

Correct answer: Free immunoglobulin light chains, either kappa or lambda. They may be present
in the urine of patients with multiple myeloma.

Discuss the solubility characteristics of Bence Jones proteins.

Correct answer: They precipitate at 40-60° C and redissolve at 100° C. The usual method of
detecting Bence Jones proteins is urine electrophoresis. They appear as a peak in the gamma
region.

What is orthostatic proteinuria?

Correct answer: A benign proteinuria most commonly seen in young adults. It is characterized by
protein in the urine after standing. The first morning urine is negative for protein.

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A patient's serum demonstrates an M-spike in the gamma region on serum protein electrophoresis.
His urine also shows a spike in the same region. An intern notices that the protein was negative on the
urinalysis report and calls the lab to point out the discrepancy. What is the explanation for this
apparent discrepancy?
Correct answer:

A patient is instructed to collect a 24-hour urine for a quantitative protein test. The patient begins the
collection on Monday morning at 6 AM. Subsequent specimens collected at 10 AM, 1 PM, 5 PM, and
11 PM Monday and the 6 AM specimen on Tuesday are added to the container. How will the results of
the quantitative protein test be affected?
Correct answer: The results will be falsely elevated because this is actually a more than 24-hour
collection. The 6 AM Monday collection should have been discarded.

What reagents are used in the glucose test on the reagent strip?
Correct answer: Glucose oxidase/peroxidase

Which sugar(s) does the reagent strip detect?

Correct answer: The reagent strip is specific for glucose.

What is the significance of a positive urine glucose?

Correct answer: It usually indicates an elevated blood glucose and is commonly seen in
uncontrolled diabetes.

What is the name of the condition in which glucose is excreted in the urine when the blood sugar is
within the normal range?
Correct answer: Renal glucosuria, a defect in the renal tubules' ability to reabsorb glucose.

What effect would contamination of the urine container with oxidizing detergents or bleach have on
the glucose test by reagent strip?
Correct answer: It would result in a false-positive glucose. The blood reaction would also be a
false-positive.

Why is urine testing not recommended as a screen for diabetes mellitus?

Correct answer: Some diabetics develop elevated renal thresholds, so they can have a negative
urine glucose even when their blood sugar is elevated. Blood testing is more sensitive for the
detection of diabetes mellitus.

Which is more specific for glucose, the reagent strip or the copper reduction test?
Correct answer: The reagent strip.
The copper reduction test reacts with all reducing sugars (glucose, galactose, fructose, lactose,
and pentose). Uric acid, creatinine, homogentisic acid, ascorbic acid, chloroform, and
formaldehyde are non-sugar reducing substances that also react in the copper reduction test.

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A physician suspects that his patient is in the early stage of liver disease. The urinalysis shows slightly
increased urobilinogen, but the bilirubin is negative. What might cause these results? What further
urine testing should be performed?
Correct answer:

Which substances in the urine are light sensitive?

Correct answer: Bilirubin and urobilinogen.

What reagents are used in the blood test on the reagent strip?
Correct answer: The test is based on the peroxidase-like activity of hemoglobin. The reagents on
the strip are peroxide and a chromogen. The second step in this reaction is similar to that of the
glucose oxidase test.

What substances will cause a positive blood test on the reagent strip?
Correct answer: Red blood cells, hemoglobin, and myoglobin.

What does a speckled reaction on the blood square of the reagent strip indicate?
Correct answer: Hematuria. The speckled reaction is due to the lysis of RBCs on the reagent pad.

What might cause a positive urine blood test with no RBCs seen in the microscopic examination?
Correct answer: Lysis of the RBCs, hemoglobinuria, or myoglobinuria.

What is the significance of a positive urine nitrite?

Correct answer: Urinary tract infection by nitrate-reducing bacteria.

What are some factors that can cause false-negative nitrite tests?
Correct answer: Less than four hours incubation time in the bladder, insufficient dietary nitrate,
large quantities of ascorbic acid, and degradation of nitrite to nitrogen.

What is the significance of a positive urine leukocyte esterase test?

Correct answer: Urinary tract infection. The advantage of the chemical test is its ability to detect
leukocyte enzymes even if the cells have lysed and are not visible by microscopy.
Which tests on the reagent strip are inhibited by large amounts of vitamin C (ascorbic acid)?
Correct answer: Blood, glucose, bilirubin, nitrites, and leukocyte esterase reactions may be
inhibited. This varies from brand to brand so the manufacturer's package insert should be
consulted.

What are the most reliable indicators of renal disease?

Correct answer: Proteinuria and the presence of casts (other than hyaline).

Which other chemical urinalysis test might be a false-positive due to large amounts of ascorbic acid in
the urine?
Correct answer: The copper reduction test. Vitamin C (ascorbic acid) is a reducing substance.

A urine specimen for a routine urinalysis is yellow, clear, and has no abnormal results when tested by
reagent strip. Is a microscopic examination required?
Correct answer: It depends on the laboratory's policy. Urine such as this have a very low yield of

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abnornal findings on microscopic examination. Some laboratories have adopted a policy of not
performing microscopics on these sepcimens.

How may urine be disposed of after testing?

Correct answer: It may poured down the sink, followed by large amounts of water. Urine
containers should be disposed of in a biohazard container.

What are porphyrins?

Correct answer: Porphyrins (uroporphyrin, coproporphyrin, and protoporhyrin) are precursors in
the synthesis of heme. Porphyrinuria can be due to inherited inborn error of metabolism or
acquired through metabolic disease or exposure to toxic substances. Lead poisoning is most
common cause.

How are porphyrins detected?

Correct answer: The presence of porphyrins can be suspected when the urine has a red or port -
wine color. Porphyrins can be identified based on their fluorescence with UV light.

How is porphobilinogen detected?

Correct answer:

What is porphobilinogen?
Correct answer: The colorless precursor of the porphyrins. It is present in the urine during attacks
of acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria. Attacks may
be precipitated by drugs that affect the liver, such as certain anesthetics or barbiturates.

When is phenylpyruvic acid present in urine?

Correct answer: With phenylketonuria (PKU). It can be detected in the urine by its reaction with
ferric ions in an acid medium to produce a blue-green color. A reagent strip is also available. All
newborns are screened for PKU by a blood test collected on filter paper.

What is the Hoesch test?

Correct answer: A rapid method to detect porphobilinogen that does not require a separation
phase. Two drops of urine are added to 1-2 mL of Ehrlich's reagent. A red color at the top of the
solution indicates the presence of porphobilinogen.

Which hormone in the urine is indicative of pregnancy?

Correct answer: Human chorionic gonadotropin (HCG).
It is produced by the placenta. Although urine can be used for testing, serum tests are more
sensitive. With urine test, false-negative results can occur due to low specific gravity and false-
positives due to proteinuria.

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SOUTHWESTERN UNIVERSITY
COLLEGE OF MEDICAL TECHNOLOGY
Formative Test 1 in AUBF Lecture

II. MATCHING TYPE. Match column A with column B. Write your answer on the spaces provided.
Letters only.
Column A Column B
Urine Appearance and their Causes

_C__1. Colorless A. methemoglobin, melanin

_F__2. Cloudy B. hemoglobin, beets, myoglobin
_J__3. Smoky C. very dilute urine, diabetes insipidus
_H_4. Milky D. bilirubin-biliverdin
_B_5. Red E. indicans, Pseudomonas infection
_A_6. Brown-black F. bacteriuria, phosphates, urates, pus cells
_E_7. Blue-green G. concentrated urine, urobilin in excess
_I__8. Yellow H. fat, emulsified paraffin, pyuria
_D_9. Yellow-green I. acriflavine
_G_10. Yellow orange J. blood in the urine (intact RBCs)
K. None of the above
ANSWERS: 1C-2F-3J-4H-5B-6A-7E-8I-9D-10G
Characteristics of Urine & Associated Conditions

_C__11. Sweaty feet odor A. MSUD

_E__12. Odor of cabbage or hops B. Filariasis, lymph node obstruction
_H__13. Mousy odor C. Isovaleric and glutaric acidemia
_F__14. Rotting fish smell D. Major long bone and pelvic bones
_J__15. Rancid smell E. Methionine malabsorption
_A__16. Maple syrup odor F. Trimethylaminuria
_I__17. Sweetish or Fruity odor G. Alkaptonuria
_G__18. Blackening upon long standing of urine H. Phenylketonuria
_B__19. Chyluric urine due to leakage of lymph I. Diabetes mellitus
_D__20. Lipiduria J. Tyrosinemia
K. None of the above
ANSWERS: 1C-2E-3H-4F-5J-6A-7I-8G-9B-10D
Column A Column B
Urine Parameters
_B_21. normal pH of glomerular filtrate A. about 6.0
_C_22. normal urine volume at night B. 7.4
_E_23. oliguric urine C. not more than 400 mL
_D_24. polyuric urine D. more than 2L/day
_F_25. normal range of spec. grav. For random urine E. not more than 500 mL
_J_26. osmolality of urine with spec. grav. of 1.010 F. 1.005-1.035
_G_27. normal range for 24-Hr urine spec. grav. G. 1.016-1.022
_I_28. correction for spec. grav. value due to proteins H. deduction of 0.004 per 1g/dL substance
_H_29. correction for spec. grav. value due to glucose I. deduction of 0.003 per 1g/dL substance
_A_30. pH of urine of a normal person on a Western dietJ. approximately 285 mOsm
K. above 300 mOsm
ANSWERS: 1B-2C-3E-4D-5F-6J-7G-8I-9H-10A

END

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SOUTHWESTERN UNIVERSITY PHINMA

COLLEGE OF MEDICAL TECHNOLOGY
AUBF LAB Formative Test 2

DIRECTIONS: Write all answers in a whole sheet of paper. You are not allowed to change your answer.

I.) IDENTIFICATION & ENUMERATION. Identify what each of the following questions are asking for
regarding the Insight multi-parameter reagent strip that you performed during the group practical
examination. Some answers need to be enumerated. (15 points)

1. What is the number of parameters that can be tested using the reagent strip? 11 parameters

2. What does IVD stand for? In-vitro diagnostics

3-5. What three (3) urine components can react with the reagent pad for blood? Hemoglobin,
myoglobin, intact RBCs

6. What specific protein can be tested by the protein test area? albumin

7. What ketone body can give a positive result with the test area for ketone? Diacetic acid
(acetoacetic acid)

8-10. What three (3) strip parameters are normally negative in urine? Blood, nitrite & leucocyte

11. What test strip parameter can be expressed in Ehrlich units? urobilinogen

12. What pH range can diminish the ascorbic acid reaction? pH 8-9

13-15. What three (3) strip parameters are affected by high ascorbic acid levels? Blood, bilirubin,
glucose

II.) MATCHING TYPE: Match column A (Reagent strip parameters) with column B (Chromogens) and
column C (color change from negative to positive). Letters only. (20 points)

Column A Column B Column C

1. Ascorbic acid A. tetramethylbenzidine A. change to pink

2. Bilirubin B. diazotized dichloroaniline B. yellow&green to blue

3. Blood C. p-dimethylaminobenzaldehyde C. orange to green to dark blue

4. Glucose D. nitroprusside D. change to pink-tan

5. Ketones E. tetrabromphenol blue E. pink to purple

6. Leucocytes F. p-arsanilic acid & N-1-naphthylethylene- F. blue-green to yellowgreen

7. Nitrite diamine dihydrochloride G. bluegreen to orange

8. pH G. potassium iodide H. orange to yellow & green to blue

9. Protein H. methyl red and bromthymol blue I. beige-pink to purple

10. SG I. bromthymol blue J. green to brown

J. derivatized pyrrole amino acid ester K. loss of color

K. 2,6-dichlorophenoleneindophenol

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ANSWERS: 1-KG; 2-BD; 3-AC; 4-GJ; 5-DE; 6-JI; 7-FA; 8-HB; 9-EH; 10-IF

To the succeeding items, match column A with column B. Letters only.

URINE PARAMETERS/COMPONENTS & ASSOCIATED CONDITIONS

Column A Column B
H11.Hemosiderinuria A. urate crystals, cholesterol seen as notched plates, calcium sand
O12. Melanuria B. presence of red fluorescence due to uroporphyrin and coproporphyrin
L13. Cylindruria C. intact RBCs producing smoky appearance
A14. Crystalluria D. urine albumin measured by RIA or nephelometry but not dipstick
K15. Bacteriuria E. pentoses, glucose, galactose and sucrose
E16. Glycosuria F. decreased 24-hour urine volume measured
J17. Chyluria G. urine with fixed specific gravity
I18. Lipiduria H. iron deposits in epithelial cells and casts
Q19. Alkaptonuria I. released fatty marrow from crush injuries
F20. Oliguria J. presence of lymphatic fluid in urine
G21. Isosthenuria K. Staphylococcus spp., Proteus vulgaris, Escherichia coli
C22. Hematuria L. casts described as amorphous, hyaline or mixed
M23. Hemoglobinuria M. malaria, bloody alkaline urine and incompatible blood
S24. Pyuria N. rhabdomyolysis
N25. Myoglobinuria O. brown-black colored urine due to melanin
R26. Choluria P. nephrotic syndrome, multiple myeloma and Fanconi syndrome
T27. Nocturia Q. byproducts of homogentisic acid metabolism
B28. Porphyria R. yellow foam test (+) result and presence of green-brown urine
D29. Microalbuminuria S. glittering granular cells, lymphocytes and plasma cells
P30. Proteinuria T. spec. grav. of less than 1.018 of night urine

Column A Column B
Urine Chemical Tests
H31. Hart’s test A. Albumin
B32. 20% SSA B. Total protein
D33. Litmus test C. Bilirubin
E34. Urinometer D. pH
E35. TS meter E. Specific gravity
F36. GOD-peroxidase reaction F. Glucose
C37. Ictotest G. Any reducing sugar
L38. Rothera’s test H. 3-OHbutyric acid
G39. Benedict’s test I. Acetone
J40. Gerhardt’s test J. Diacetic acid
L41. Acetest K. BJP
G42. Clinitest L. Diacetic acid & acetone
K43. Harrison’s protein test
B44. Heat & Acetic acid test
A45. Protein test based on pH error of indicators

III. GROSS EXAMINATION OF NORMAL URINE. Give a hypothetical

description/value/result for each of the following patient urine parameters based on the
condition placed to the left of each parameter. (2 points each)

CONDITION PARAMETER DESCRIPTION/VALUE/RESULT

1.Marked hemoglobinuria Color red to brown to black

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2.Bacteriuria Clarity turbid/cloudy

3.PKU Odor mousy

4.Diabetes insipidus 24-Hour Urine Volume more than 2L

5.Diabetes melllitus Specific gravity High or above 1.020

6.Normal plasma Osmolality 285-310 mOsm/kg of HOH

7.High meat diet pH acidic or pH 4-6

8.Prolonged fasting Ketone bodies positive or present

9.Febrile state Blood positive or present

10. Hyperthyroidism Glucose positive or present

IV.) TRUE OR FALSE. Write T if the statement is correct and write F if the statement is incorrect.

(15 points)

1. The refractometer is an indirect method of measuring specific gravity.

2. The nitrite and leucocyte reagent strip parameters are for testing bacteriuria.

3. The 20% sulfosalicylic acid test for proteins can measure total protein.

4. The concentration of HAc is 20% to precipitate proteins in urine with direct heat.

5. Mixing the urine sample is a must before doing protein testing.

6. Before dipstick testing, mixing the urine sample is not necessary.

7. A dark background is necessary in order to observe the urine color.

8. A white background is useful in observing urine character.

9. The SSA protein precipitation requires heating in the procedure.

10. The urine color and clarity can be correlated in the wet urinalysis.

11. The specific gravity and urine color can be correlated with each other.

12. Distilled water serves as the reference solution in both refractometry and urinometry.

13. pH testing by immersing the litmus paper in the urine is acceptable.

14. The condenser, iris diaphragm and lamp are illuminating parts of the microscope.

15. Proteins in urine is diet-dependent unlike the urine pH and urine volume.

ANSWERS: 1T-2T-3T-4F-5F-6F-7F-8T-9F-10F-11T-12T-13F-14T-15F

GOOD LUCK!!!

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