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1. A urine with characteristic sulfur odor may be seen in: 16. Hurler, Hunter and Sanfilippo syndrome are hereditary disorders
a. Cystinuria affecting metabolism of:
b. Trimethylaminuria a. Tryptophan c. Mucopolysaccharides
c. Acute renal failure b. Purines d. Porphyrins
d. Glutaric acidemia 17. In lead poisoning porphyria, the characteristic urine color is:
2. A specimen with a strong ammonia odor and a heavy white a. Normal c. Purple
precipitate when it arrives in the laboratory may require: b. Red d. Brown-black
a. Collection of a fresh specimen 18. Urinary screening tests for mucopolysaccharides:
b. Centrifugation 1. Acid albumin 3. Cyanide-Nitroprusside
c. Urine culture 2. CTAB 4. Nitroso-napthol
d. Addition of acetic acid a. 1 and 2 c. 1, 2 and 3
3. A correlation exists between a specific gravity of 1.040 and a: b. 2 only d. 3 and 4
a. 4+ protein 19. He published a book about the ‘pisse prophets’ or charlatans
b. 2+ glucose without medical credentials who offer their predictions to the public
c. Radiographic dye infusion for a healthy fee:
d. First morning specimen a. Ivan Folling c. Thomas Bryant
4. A patient with a 1+ protein reading in the afternoon is asked to b. Garrod d. Frederik Dekkers
submit a first morning specimen. The second specimen has negative 20. Freshly voided normal urine is usually clear; however, if it is
protein. This patient most likely is: alkaline, a white turbidity may be present due to:
a. Positive for orthostatic proteinuria a. Bilirubin c. Bacteria
b. Positive for clinical proteinuria b. Amorphous urates d. Amorphous phosphates
c. Positive for Bence-Jones proteinuria 21. Autoantibody(ies) involved in Pernicious anemia:
d. Positive for microalbuminuria a. Anti-parietal cell c. Both A and B
5. Urinalysis on a patient with severe back and abdominal pain is b. Anti-intrinsic factor d. Anti-myelin sheath
frequently performed to check for: 22. The normal GFR is approximately:
a. Bilirubinuria c. Hematuria a. 60 mL/min c. 650 mL/min
b. Proteinuria d. Hemoglobinuria b. 120 mL/min d. 1,200 mL/min
6. Urinometer – specific gravity readings are affected by: 23. Who discovered alkaptonuria in 1864?
a. Glucose c. Alkaline urine a. Cotugno c. Garrod
b. Radiographic dye d. A and B b. Thomas Addis d. Thudichum
7. The reagent strip reaction that requires the 30-second reaction 24. What is the negative color in Micral test?
time is: a. Yellow c. White
a. Bilirubin c. Ketones b. Red d. Purple
b. Leukocyte esterase d. Specific gravity 25. The best single indicator of renal disease is:
8. Which of the reagents below is used to detect urobilinogen in a. Glycosuria c. Proteinuria
urine? b. Polyuria d. Pyuria
a. Tetrahydrobenzoquinolin 26. Which type of microscopy is used to detect cholesterol from oval
b. Sodium nitroferricyanide fat bodies and fatty casts?
c. Hoesch reagent a. Phase-contrast c. Interference-contrast
d. Ehrlich reagent b. Polarizing d. Dark-field
9. All of the statements below regarding urine bilirubin tests are true 27. Which urinary crystal can assume the greatest variety of forms?
EXCEPT: a. Cystine c. Phosphate
a. A positive test indicates either liver or hepatobiliary disease b. Oxalate d. Uric acid
b. The test detects only unconjugated bilirubin 28. The creatinine clearance on a patient who has a plasma
c. High levels of ascorbate usually interfere creatinine of 2.0 mg/dL, a urine creatinine of 120 mg/dL, and a urine
d. Prolonged light exposure can cause false-negative results volume of 2,160 mL per 24 hours is:
10. A positive test for blood in urine can occur in the following a. 30 mL/minute
EXCEPT: b. 60 mL/minute
a. Extravascular hemolytic anemia c. 90 mL/minute
b. Rhabdomyolysis d. 120 mL/minute
c. Intravascular hemolytic anemia 29. The “tram tracking” appearance of the glomerulus when seen
d. Renal lithiasis under the microscope can be indicative of which renal disorder?
11. Some of the urea which is filtered by the glomerulus is a. Membranous glomerulonephritis
reabsorbed in the tubules approximately: b. Membranoproliferative glomerulonephritis
a. 40% c. 70% c. IgA nephropathy
b. 10% d. 100% d. Nephrotic syndrome
12. A reagent test strip impregnated with diisopropylbenzene 30. A renal calculi described as mustard-colored is:
dehydroperoxide tetramethylbenzi-dine may be used to detect which a. Cystine c. Calcium oxalate
analyte? b. Triamterene d. Uric acid
a. Bilirubin c. Nitrite 31. Performing bronchoalveolar lavage (BAL) is important in the
b. Blood d. Urobilinogen diagnosis of ______ in immunocompromised patients:
13. What is the expected pH range of a first-morning urine a. Primary atypical pneumonia
specimen? b. Pneumocystis jiroveci pneumonia
a. 3.5-8.0 c. 4.0-8.5 c. Tuberculosis
b. 5.0-6.0 d. 4.5-8.0 d. Paragonimiasis
14. False positive levels of 5-HIAA can be caused by a diet high in: 32. What is the next urine parameter to be read after glucose,
a. Bananas c. Pineapples bilirubin, ketones and S.G. in the reagent strip?
b. Tomatoes d. All of these a. Urobilinogen c. A and B
15. Blue diaper syndrome is associated with: b. Blood d. Leukocytes
a. Lesch-Nyhan syndrome 33. Which of the following cell types is responsible for the secretion
b. Hartnup disease of hydrochloric acid in the stomach?
c. Alkaptonuria a. Parietal cells c. G cells
d. Dubin-Johnson syndrome b. Chief cells d. All of these
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34. Which of the following pleural fluid values represents a a. 1 and 2 c. 1, 3 and 4
hemothorax? b. 1 and 4 d. 1, 2, 3 and 4
a. Blood hct: 44 Fluid hct: 25 49. True about indican:
b. Blood hct: 40 Fluid hct: 32 a. Soluble in butanol, insoluble in chloroform
c. Blood hct: 36 Fluid hct: 20 b. Soluble in chloroform, insoluble in butanol
d. All of these c. Soluble in both chloroform and butanol
35. Reagent(s) used in the bilirubin reagent strip: d. Insoluble in both chloroform and butanol
a. 2,4-dichloroaniline 50. A negative urine pregnancy test performed on a random
b. 2,6-dichlorobenzene specimen may need to be repeated using a:
c. Either A and B a. Clean-catch specimen
d. 4-methoxybenzene-diazonium-tetrafluoroborate b. Fasting specimen
36. Rubner’s test detects which type of sugar(s)? c. First morning specimen
1. Sucrose 3. Glucose d. 24-hour specimen
2. Lactose 4. Pentose 51. What is the purpose of adding bluing agent to the toilet water
a. 1, 2 and 3 c. 1 and 2 reservoir in drug specimen collection procedure?
b. 2 and 3 d. 2 only a. To prevent specimen adulteration
37. No forward progression: b. To check for the urine temperature
a. 4.0 c. (b) c. To prevent false-positive results
b. 1.0 d. (a) d. To avoid bacterial contamination
38. A sweat chloride of 70 mEq/L is indicative of: 52. In a three-glass collection specimen, all specimens contain
a. Multiple sclerosisc. Cystic fibrosis significant amounts of pus cells and bacteria. This could be indicative
b. Excessive sweating d. Biliary obstruction of:
39. Who discovered albuminuria in 1964 by boiling urine samples? a. An old specimen or contamination
a. Frederik Dekkersc. Thudichum b. Prostatic infection
b. Cotugno d. Garrod c. Urinary tract infection
40. The molecules of CPPD crystals align perpendicular to the long d. Any of these
axis of the crystal. When the slow vibration passes through the 53. Which of the following crystals may be usually found in acidic
crystal, it will show: urine?
a. Positive birfringence a. Apatite c. Struvite
b. Negative birefringence b. Leucine d. Ammonium biurate
c. No birefringence 54. A urine specimen with low concentration of urochrome may
d. Weak birefringence indicate:
41. Acetic acid should not be used as a diluents for synovial fluid cell a. Dehydration
count because: b. Recent fluid intake
a. It will cause synovial fluid to clot c. Presence of amorphous urates in the sediment
b. It will polymerize the hyaluronic acid d. High metabolic rate
c. It will decrease the viscosity of the fluid 55. Test for tubular secretion and renal blood flow:
d. A and B a. phenolsulfonphthalein dye test
42. Urine culture tests are best performed on: b. Inulin clearance
a. Catheterized samples c. Specific gravity
b. Suprapubic aspirations d. Osmolarity
c. Random samples 56. 1+ SSA reading:
d. A and B a. Clumps of protein
43. Appropriate urine preservative for glucose analysis: b. Distinct turbidity with no granulation
a. Boric acid c. Sodium fluoride c. Turbidity with granulation and flocculation
b. Formaldehyde d. Saccomanno’s fixative d. Noticeable turbidity
44. Renal disease characterized by deposition of IgA on the 57. A reagent strip with a brown color reaction on the pad
glomerular basement membrane: impregnated with potassium iodide indicates:
a. Membranoproliferative glomerulonephritis a. Proteinuria
b. Chronic glomerulonephritis b. Glucosuria
c. Berger’s disease c. Bilirubinuria
d. Membranous glomerulonephritis d. Hemoglobinuria/Myoglobinuria
45. The two stages of heme formation affected by lead poisoning are: 58. Positive result in the Guthrie bacterial inhibition test for
a. Porphobilinogen and uroporphyrin phenylketonuria:
b. Aminolevulinic acid and porphobilinogen a. No growth around the impregnated disc
c. Aminolevulinic acid and protoporphyrin b. Growth around the impregnated disc
d. Coproporphyrin and protoporphyrin c. Hemolysis
46. A type of mucopolysaccharide disorder where d. Loss of mousy odor
mucopolyssacharides accumulate in the cornea of the eye: 59. All of the following changes occur in unpreserved urine EXCEPT:
a. Hurler syndrome 1. Decreased glucose 4. Increased clarity
b. Alder-Reilly anomaly 2. Decreased pH 5. Incr. urobilinogen
c. Hunter syndrome 3. Increased ketones 6. Increased bacteria
d. Sanfilippo syndrome a. 3, 4 and 5 c. 2, 3, 4 and 5
47. Interfering substances that can cause false-negative result in b. 1, 2 and 6 d. 1, 2, 3, 4, 5 and 6
fecal occult blood testing: 60. Why is the first-voided morning urine specimen the most
1. Aspirin 3. Vitamin C desirable specimen for routine urinalysis?
2. Horseradish4. Red meat a. Most dilute specimen of the day
a. 1, 2 and 3 c. 3 only b. Less contamination by microorganisms
b. 1, 2 and 4 d. 1 only c. It can detect orthostatic proteinuria
48. Findings seen in nephrotic syndrome: d. Most concentrated specimen of the day
1. Fatty casts 61. Factor(s) that differentiate amorphous urates and phosphates is
2. Increased urine albumin (are):
3. Edema 1. Color of the urine sediment
4. Increased serum alpha2-macroglobulin 2. pH
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3. Morphology 75. Which of the following situations requires corrective action before
4. Solubility proceeding with specimen testing?
a. 1, 2 and 3 c. 2, 3 and 4 a. Room temperature of the laboratory is 25 OC
b. 1, 2 and 4 d. 1, 3 and 4 b. Specific gravity of distilled water by refractometer is 1.000
62. Crystals associated with severe liver disease include: c. Temperature of the refrigerator that stores the QC materials is
a. Bilirubin c. Lysine 4OC
b. Tyrosine d. A and B d. Reagent strip protein result is 1+ when using negative control
63. Incorrect match(es) regarding urine crystals and their identifying 76. The following results were obtained on a urine specimen at 9:00
characteristics: AM:
1. Magnesium ammonium phosphate – prism-shaped pH = 6.5 Bilirubin = 2+
2. Cholesterol – flat plates, high specific gravity Protein = 3+ Nitrite = positive
3. Leucine – prism Glucose = 4+ Blood = negative
4. Sulfonamide – sheaves of wheat Ketones = 3+
a. 1 and 4 c. 2 and 3 If this urine specimen was stored uncapped at 4 OC without
b. 1, 2 and 3 d. 3 and 4 preservation and retested at 3:00 PM, which of the following test
64. Casts that indicate extreme urine stasis include: results would be changed due to these storage conditions?
a. Waxy casts c. Hyaline casts a. Glucose c. Bilirubin
b. Fatty casts d. Bacterial casts b. Ketones d. Nitrite
65. In Fanconi syndrome, which part of the nephron is primarily 77. Which of the following matches regarding specimen collection
affected? is/are incorrect?
a. Collecting duct 1. Lumbar puncture – cerebrospinal fluid
b. Distal convoluted tubule 2. Suprapubic aspiration – urine
c. Loop of Henle 3. Arthrocentesis – Ascitic fluid
d. Proximal convoluted tubule 4. Paracentesis – Pleural fluid
66. Urinalysis on a patient being evaluated for renal calculi would be a. 1 and 2 c. 1 and 3
most beneficial if it showed: b. 3 and 4 d. 2 and 4
a. Microscopic hematuria 78. Amount of urine used for IRIS Slideless Microscope:
b. Calcium oxalate crystals a. 1 mL c. 4 mL
c. Hemoglobinuria b. 2 mL d. 6 mL
d. Heavy proteinuria 79. When the medical technologist performs the microscopic
67. The correct method for labeling urine specimen containers is to: examination of urine sediment, which of the following is/are
a. Attach the label to the lid enumerated/estimated using low power magnification?
b. Attach the label to the bottom 1. RBCs 3. Casts 5. Squamous epithelial cells
c. Attach the label to the container 2. WBCs 4. Yeasts 6. Calcium oxalate crystals
d. Use only a wax pencil for labeling a. 1, 2, 4, 5 and 6 c. 3 and 5
68. The pigment responsible for the blue color of horseshoe crab b. 1, 2 and 5 d. 3 only
blood is: 80. RA cell seen in synovial fluid is described as a:
a. Hemoglobin c. Hemozoin a. Vacuolated macrophage with ingested neutrophils
b. Hemocyanin d. Hematein b. Neutrophil containing characteristic ingested round body
69. Which of the following parasites can be seen in sputum samples? c. Large, multinucleated cell
1. Roundworm 3. Hookworm d. Neutrophil with dark cytoplasmic granules containing
2. Threadworm 4. Oriental lung fluke immune complexes
a. 1, 2, 3 and 4 c. 1, 3 and 4 81. Which of the following dyes are used in Sternheimer-Malbin
b. 1, 2 and 3 d. 2, 3 and 4 stain?
70. All of the following are indication of CSF traumatic tap EXCEPT: a. Hematoxylin and eosin
a. Uneven blood distribution b. Crystal violet and safranin
b. A clear supernatant after centrifugation c. Methylene blue and eosin Y
c. No clot formation d. Toluidine blue and safranin
d. Absence of erythrophages 82. Bilirubinuria may be associated with:
71. Pilocarpine iontophoresis refers to the specific process of: a. Extravascular hemolytic anemia
a. Separating proteins in CSF b. Viral hepatitis
b. Inducing sweat production c. Bile duct obstruction
c. Measuring pilocarpine in sweat d. B and C
d. Measuring ions in sweat 83. Which of the following substances are excreted in the urine in the
72. The following are results for a certain urine sample analyzed on a largest amount?
morning shift: a. Urea and NaCl c. Creatine and ammonia
Glucose by reagent strip = negative b. Creatine and NaCl d. Urea and glucose
Ketones by reagent strip = negative 84. Urine reagent strips should be stored in a(n):
The results are most consistent with: a. Refrigerator c. Cool dry area
a. Normal condition c. Starvation b. Incubator d. Open jar exposed to air
b. Diabetes mellitusd. High carbohydrate diet 85. Urine samples should be examined within 2 hours of voiding
73. Which protein test is does not detect Bence-Jones protein? because:
a. Heating urine at 40 to 60OC up to 100OC a. RBCs, WBCs and casts agglutinate after standing for
b. SSA precipitation test several hours at room temperature
c. Serum immunoelectrophoresis b. Bacterial contamination will cause alkalinization of urine
d. Reagent strip c. Urobilinogen increases and bilirubin decreases after
74. Which of the following findings is most consistent with bile duct prolonged exposure to light
obstruction? d. Ketones will increase due to bacterial and cellular
Urine Bilirubin Urine Urobilinogen metabolism
a. Positive Decreased 86. Urine from a 60-year old man was noted to turn burgundy red on
b. Negative Increased standing. This change is caused by:
c. Positive Increased a. Indican c. Homogentisic acid
d. Negative Normal b. Melanin d. Porphyrin
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87. Orange sand in diapers:

a. Hartnup disease
b. Lesch-Nyhan syndrome
c. Indicanuria
d. Hyperoxaluria
88. The concentration of a normal urine specimen can be estimated
by which of the following?
a. Color c. Foam
b. Clarity d. Odor
89. Rapid screening test for urinary porphobilinogen:
a. Watson-Schwartz test
b. Hoesch test
c. Diazo reaction
d. Ehrlich reaction
90. Associated with hematuria, EXCEPT:
a. Renal calculi
b. Strenuous exercise
c. Intravascular hemolytic anemia
d. Glomerulonephritis
91. Causes of oligohydramnios:
1. Neural tube defects
2. Decreased fetal swallowing
3. Urinary tract defects
4. Increased fetal swallowing
a. 1 and 2 c. 1, 3 and 4
b. 3 and 4 d. 2, 3 and 4
92. In a 1:20 dilution, 200 sperms are counted in 10 RBC counting
squares. What is the sperm concentration per mL?
a. 100,000,000 c. 200,000,000
b. 10,000,000 d. 20,000,000
93. Seliwanoff’s test is used to determine seminal fluid:
a. Spermine c. Acid phosphatase
b. Choline d. Fructose
94. A total CSF cell count on a turbid fluid should be:
a. Diluted 1:20 c. Diluted 1:10
b. Not reported d. Diluted 1:10,000
95. The CSF tube kept at refrigeration temperature if not yet tested
is:
a. Tube 1 c. Tube 3
b. Tube 2 d. Tube 4
96. Renal calculi that are associated with increased intake of foods
with high purine content:
a. Cystine c. Phosphate
b. Uric acid d. Calcium phosphate
97. CSF/Serum IgG index of less than 0.77 is indicative of:
a. Damage to the blood-brain barrier
b. Multiple sclerosis
c. Multiple myeloma
d. Normal condition
98. The primary reason to dilute a semen specimen before
performing a sperm concentration is to:
a. Immobilize the sperm
b. Facilitate the chamber count
c. Decrease the viscosity
d. Stain the sperm
99. Measurement of neutral-α-glucosidase is performed to detect a
disorder of the:
a. Seminiferous tubules
b. Prostate gland
c. Bulbourethral glands
d. Epididymis
100. The acrosomal cap of a spermatozoon should encompass ___
of the nucleus:
a. one-half c. two-thirds
b. one-third d. three-fourths