AUBF 3rd Lecture Exam

Coverage: UA 4 and Test for Renal Functions

[Link] Choice: Which of the following variables are required in the MDRD-simplified formula?
(2 Points)
a. serum creatinine, age, sex, race
b. serum creatinine, blood urea nitrogen, race, age, sex
c. ideal body weight, serum creatinine, serum albumin, age, sex, race
d. age, sex, blood urea nitrogen, serum creatinine, serum albumin, race
e. age, sex, serum albumin, race
[Link] Multiple Choice: Which of these compounds crystallize easily in acidic pH:
1. Organic compounds
2. Inorganic compounds
3. Iatrogenic compounds
(2 Points)
1, 2, 3
1, 2
2, 3
None of the given choices
[Link] Multiple Choice: RTE cells which are oval in shape, eccentrically placed nucleus:
1. Collecting ducts
2. Distal convoluted tubules
3. Proximal convoluted tubules
(2 Points)
1
2
3
None of the given choices
[Link] Multiple Choice: The most clinically significant of the epithelial cells:
1. Transitional epithelial cells
2. Clue cells
3. Renal Tubular epithelial cells
4. Oval fat bodies
(2 Points)
3, 4
1
2
3
[Link] Multiple Choice: Which of these urinary crystals are soluble in dilute HAc:
1. Amorphous phosphate
2. Calcium phosphate
3. Triple phosphate
4. Uric acid
(2 Points)
1, 2, 3
1, 3
 2, 4
4, 3, 2, 1
[Link] Choice: The most widely used method of creatinine measurement which uses trinitrophenol is the:
(2 Points)
a. Hare method
b. Jaffe reaction
c. Creatinine aminohydrolase method
d. Horseradish peroxidase reaction
e. Phenolsulfonphthalein test
[Link] Choice: The endocrinologist diagnosed a patient with neurogenic diabetes insipidus after undergoing ADH
challenge. Which of the following is the patient’s results?
(2 Points)
a. Urine osmolality >800 mOsm, urine:serum 3:1
b. Urine osmolality >800 mOsm, urine:serum 1:1
c. Urine osmolality <400 mOsm, urine:serum 1:1
d. Urine osmolality <400 mOsm, urine:serum 3:1
e. None of the choices
[Link] Choice: The gold standard reference method for measurement of urea is:
(2 Points)
a. Iodophenol method
b. Diacetyl monoxime method
c. Isotope dilution mass spectrophotometry
d. Thermal conductivity gas chromatography
e. Freezing point osmometry
[Link] Multiple Choice: The following are TRUE to squamous epithelial cells, EXCEPT:
1. The largest flattened cell with central spherical nucleus
2. Clinically significant are the Clue cells
3. Represent normal sloughing of old cells
4. Originate from the lining of renal pelvis and calyces
(2 Points)
1, 2, 3
3
None of the given choices
[Link] Choice: A male patient’s GFR is 75 mL/min/1.73m2. This indicates:
(2 Points)
a. reduced glomerular filtration without uremia
b. normal glomerular filtration rate
c. renal tubular dysfunction
d. renal failure
e. none of the choices
[Link] Choice: The following statements are true about urea, EXCEPT:
(2 Points)
a. Urea concentration in the serum depends largely on the protein intake.
 b. Urea is freely filtered in the glomerulus and is secreted in the distal convoluted tubules.
c. The amount of urea reabsorbed in the proximal tubule varies greatly depending on the status of effective
vascular volume.
d. Urea clearance approaches unity with glomerular filtration rate in advanced renal failure.
e. All statements are true.
[Link] Multiple Choice: Uric acid Crystals:
1. Four sided flat plates (whetstones)
2. Birefringent under polarized microscopy
3. Usually encountered in refrigerated specimen
4. Often confused with Cystine crystals
(2 Points)
1, 2
2, 3
1, 3
1, 2, 4
[Link] Multiple Choice: Which of the following is NOT True with Toluidine blue stain?
1. Lyses RBC’s
2. Enhances nuclear detail
3. Identifies bacterial casts
4. Differentiates WBC’s and Renal Tubular Epithelial Casts

(2 Points)
2, 4
1, 3
1, 2, 3
None of the given choices
[Link] Multiple Choice: Conditions associated with normal increase of Hyaline casts in urine:
1. Emotional stress
2. Strenuous exercise
3. Allergic reaction
4. Dehydration
(2 Points)
1, 2, 3
1, 2, 4
2, 4
1, 4
[Link] Multiple Choice: Which of these factors can cause formation of urinary crystals:
1. High specific gravity
2. pH which affects solubility
3. Changes in temperature
4. Solute concentration
(2 Points)
1, 2
1, 3, 4
2, 3, 4
4, 3, 2, 1
[Link] Multiple Choice: How to differentiate RBC’s from yeast cells:
1. Observe budding in yeast cells
 2. Lyses of yeast cells by acetic acid
3. Lyses of RBC’s by 2% acetic acid
4. Observe for the normal appearance of RBC’s
(2 Points)
1, 2, 3
1, 2
3, 4
1, 3, 4
[Link] Choice: Which of the following GFR formulas is appropriate to use for pediatric patients?
(2 Points)
a. GFR = 175 x SCr^-1.154 x Age^-0.203 x (1.212 for black) x (0.742 for women)
b. GFR = 170 x SCr^-0.999 x Age^-0.176 x (0.762) x (1.180 if black) x BUN^-0.170 x SAlb^0.318
c. GFR = [(140-age)(IBW)]/(72 x SCr) x 0.85 if female
d. GFR = 39.1 {height in m/Cr in mg/dL} x [1.8/cystatin C in mg/dL]^0.294 x [30/BUN in mg/dL]^0.169 x (1.099 if
male) x [height in m/1.4]^0.188
e. GFR = 186 x (serum creatinine)-1.154 x Age-0.203 x (1.212 for black) x (0.742 for women)
[Link] Choice: The number of moles of solute in a kilogram of solvent is evaluated by:
(2 Points)
a. Glomerular filtration
b. Renal concentrating ability
c. Renal blood flow
d. Tubular secretion
e. Osmotic gradient
[Link] Multiple Choice: Which of the following are TRUE to Waxy/Broad Casts:
1. Blunt, uneven, brittle looking edges
2. Represent extreme urine stasis
3. Renal failure cast
4. Severe nephron damage
(2 Points)
1, 2, 3
1, 2
1, 2, 4
4, 3, 2, 1
[Link] Multiple Choice: True to Urinary Casts, EXCEPT:
1. Formed within the lumen of Distal convoluted tubules and collecting ducts
2. Cylindrical in shape, parallel sides, rounded ends
3. Formed within the Proximal convoluted tubules
4. Major component – Tamm-Horsfall Protein
(2 Points)
3
2
2, 3
None of the given choices
[Link] Multiple Choice: Triple phosphate crystals:
1. Ammonium magnesium phosphate
2. Abnormal urine crystals
 3. Normal crystals seen in alkaline urine
4. Coffin-lid crystals
(2 Points)
1, 3, 4
1, 2
1, 3
2, 4
[Link] Choice: The normal serum osmolarity is:
(2 Points)
a. 50 – 100 mOsm
b. 100 – 275 mOsm
c. 275 – 300 mOsm
d. 400 – 500 mOsm
e. Above 500 mOsm
[Link] Multiple Choice: Which of these structures usually disintegrate in dilute alkaline urine:
1. RBC’s and WBC’s
2. Casts
3. Crystals
4. Amorphous substance
(2 Points)
1, 2
1, 2, 3
2, 3
none of the given choices
[Link] Multiple Choice: Which of these findings is associated with Bacteriuria:
1. Increase pus cells (WBC’s)
2. Increase RBC’s
3. Nitrate and leukocyte esterase test (+)
4. Presence of yeast cells
(2 Points)
1, 3
2, 4
1, 2, 3
1, 3, 4
[Link] Choice: Which of the following tests utilizes exogenous products to evaluate for GFR?
(2 Points)
a. Cystatin C
b. Β trace protein
c. Inulin
d. Beta-2 microglobulin
e. Phenolsulfonphthalein
[Link] Choice: Using the Schwartz Formula, calculate the eGFR of this patient:
5 years old male
serum creatinine 2.5 mg/dL
height 3’6”
(2 Points)
 a. 20 mL/min
b. 26 mL/min
c. 23 mL/min
d. 17 mL/min
e. 32 mL/min
[Link] Multiple Choice: WBC’s exposed to hypotonic urine exhibits Brownian movement:
1. Eosinophils
2. Basophils
3. Glitter cells
4. Mononuclear leukocytes
(2 Points)
1, 4
2, 3
3
None of the given choices
[Link] Choice: Which of the following statements is TRUE about creatinine clearance?
(2 Points)
a. Dietary restrictions are required during the 24 hours preceding the test.
b. Creatinine clearance is dependent upon lean body mass
c. Fluid intake must be restricted to below 600 mL in the 6 hours preceding the test.
d. Creatinine clearance is mainly determined by renal tubular function.
e. All statements are correct.
[Link] Choice: Which of the following tests is usually first affected in renal disease?
(2 Points)
a. Glomerular filtration rate
b. Tubular reabsorption test
c. Tubular secretion test
d. Renal blood flow test
e. Estimated glomerular filtration rate
[Link] Choice: 1. Calculate the effective renal plasma flow, given the following values:
urine PAH=170 mg/dL
plasma PAH=0.4 mg/dL
urine volume in 2H=240 mL
(2 Points)
a. 102,000 mL/min
b. 1.8 mL/min
c. 16,320 mL/min
d. 850 mL/min
e. 0.56 mL/min
[Link] Choice: If a female patient’s GFR is 14 mL/min/1.73m2, this means:
(2 Points)
a. normal glomerular filtration rate
b. renal tubular dysfunction
 c. reduced glomerular filtration without uremia
d. renal failure
e. none of the choices
[Link] Choice: Cystatin C levels are required in computing for GFR in which formula?
(2 Points)
a. Cockroft-Gault Formula
b. Schwartz Formula
c. Modified Schwartz Formula
d. Simplified MDRD Formula
e. Modification of Diet in Renal Disease Formula
[Link] Multiple Choice: Leucine Crystals:
1. Less frequently seen than tyrosine
2. Yellow brown spheres with radial striations
3. Fine colorless to yellow needles
4. Disorder of amino acid metabolism
(2 Points)
3, 4
1, 2
1, 3
1, 2, 4
[Link] Choice: Serum albumin is required in this formula:
(2 Points)
a. Cockroft-Gault Formula
b. Modified Schwartz Formula
c. Simplified MDRD Formula
d. Modification of Diet in Renal Disease Formula
e. Schwartz Formula
[Link] Multiple Choice: Polarizing microscopy:
1. Can refract light in two dimensions at 90 degree to each other (birefringent)
2. Forming a halo or light around the specimen
3. Confirms presence of fats (cholesterol)
4. Object appear dark against a light background
(2 Points)
1, 2, 3
1, 2
3, 4
1, 3
[Link] Choice: For accurate measurement of the glomerular filtration rate, the test substance must be:
(2 Points)
a. filtered and neither absorbed nor secreted
b. filtered and completely reabsorbed
c. filtered and secreted
d. filtered and partially absorbed
e. filtered and absorbed
[Link] Choice: Which of the following statements regarding renal function is true?

(2 Points)
a. Glomeruli are far more permeable to water and salt that other capillaries.
b. The collecting tubule reabsorbs sodium and secretes potassium in response to vasopressin.
c. The thick ascending limb is highly permeable to water and urea.
d. The collecting tubule is permeable to water only in the presence of aldosterone.
e. All statements are true.
[Link] Multiple Choice: Effects of overflowing in the conventional glass slide method:
1. Casts usually seen near the edges of the cover slips
2. Distortion of cells and crystals
3. Can cause false negative readings
4. May result in the loss of heavier elements
(2 Points)
1, 2, 4
1, 4
2, 3
1, 3
[Link] Multiple Choice: Transitional epithelial cells appear in several forms such as:
1. Cuboidal
2. Polyhedral
3. Caudate
4. Spherical
(2 Points)
1, 3, 4
2, 3, 4
1, 2, 3
4, 3, 2, 1
[Link] Multiple Choice: The supravital stain frequently used for urine sediment:
1. Sedi stain
2. Sternheimer Malbin stain
3. KOVA stain
4. Prescott Brodie
(2 Points)
1, 2
1
2
4, 3, 2, 1
[Link] Choice: What is the advantage of using Cystatin C over creatinine in the measurement of GFR?
(2 Points)
a. The rate of production is not affected by muscle mass, sex or race.
b. Measurement is used for patients with diabetes, lymphoma and multiple myeloma.
c. Serum levels of Cystatin C are low in patients taking cefuroxime and gentamicin.
d. Levels must be corrected for body surface area.
e. None of the choices.
[Link] Choice: What is the ideal body weight of a 170-cm tall male?
(2 Points)
a. 61.6 kg
b. 63.8 kg
c. 78.4 kg
d. 66.1 kg
e. 70.8 kg
[Link] Multiple Choice: Which of the following are generally considered in the microscopic examination of urine:
1. Proper method of specimen preparation
2. Methods and equipment used for visualization
3. Type of stains used
4. Manner of reporting results
(2 Points)
3, 2, 1
4, 3, 2, 1
1, 2, 4
2, 3
[Link] Choice: These substances may interfere with freezing point measurement of urine and serum osmolarity,
EXCEPT:
(2 Points)
a. Lipids
b. Sodium
c. Ethanol
d. Lactic Acid
e. Volatile substances
[Link] Multiple Choice: Conditions associated with Pyuria:
1. Urinary tract infection
2. Cystitis
3. Prostatitis
4. Acute glomerulonephritis
(2 Points)
2, 3
1, 3
1, 4
1, 2, 4
[Link] Choice: Using the Cockroft-Gault Formula, calculate the eGFR of this patient:
25 years old female
height 1.52 m
serum creatinine 5.2 mg/dL

(2 Points)
a. 4 mL/min
b. 8 mL/min
c. 12 mL/min
d. 16 mL/min
a. 20 mL/min
[Link] Multiple Choice: Which of the following best describes Dihydrate Calcium Oxalate crystals:
1. Oval or dumbbell shape
2. Octahedral envelope-like crystals
3. Wedges and rosettes
4. Rhombic
(2 Points)
1
3
2
4
[Link] Multiple Choice: Which of the following are reported as average number per high power field:
1. Casts
2. RBC’s and WBC’s
3. Epithelial cells
4. Crystals
(2 Points)
2, 3
1
2
1, 4
[Link] Choice: Which of the following tests indirectly measures tubular secretion?
(2 Points)
a. Free water clearance
b. p-aminohippuric acid test
c. Mosenthal test
d. Beta trace protein test
e. Cystatin C
[Link] Choice: Which of the following GFR formulas is suitable for this patient? 10-year-old, black, female,
diagnosed with post-streptococcal glomerulonephritis, with serum creatinine=3.5 mg/dL
(2 Points)
a. GFR = 175 x SCr^-1.154 x Age^-0.203 x 1.212 x 0.742
b. GFR = 170 x SCr^-0.999 x Age^-0.176 x 0.762 x 1.180 x BUN x SAlb^0.318
c. GFR = 0.55 x height in cm/ SCr in mg/dL
d. GFR = [(140-age)(IBW)]/(72 x SCr) x 0.85
e. GFR = 186 x (serum creatinine)-1.154 x Age-0.203 x (1.212 for black) x (0.742 for women)