1.

a. Yeast grows best at a low pH with an increased concentration of glucose.

b. Yes, this exceeds the renal threshold.
c. No, yeast is not capable of reducing nitrate to nitrite.
d. Moderate blood with no RBCs.
e. Myoglobin is the cause of the positive chemical test result for blood. The
patient has been bedridden for an extended period of time, causing muscle
destruction.

2. a. The large objects are in a different plane than the uri-

nary constituents.

b. Contamination by artifacts.

c. No, because they are in a different plane.

d. Polarizing microscopy.

3. a. Renal tubules.

b. Yes, viral infections can cause tubular damage.

c. RTE cells absorb the bilirubin-containing urinary fil-

trate.

d. Liver damage inhibits processing of reabsorbed uro-

bilinogen.

e. Disorders producing intravascular hemolysis.

4. a. The patient is taking a pigmented medication, such as

phenazopyridine.

b. Yes

c. An Ictotest could be run but is not indicated by the

patient’s symptoms.

d. Ask what medications the patient is taking.

e. Ampicillin

5. a. Calcium oxalate.

b. Monohydrate and dihydrate calcium oxalate.

c. Oval/dumbell: monohydrate; envelope: dihydrate.

d. Monohydrate.
6. a. Microscopic results do not match the chemical tests for

blood, nitrite, and leukocyte esterase.

b. The specimen has been unpreserved at room tempera-

ture for too long, the cells have disintegrated, and the

bacteria have converted the nitrite to nitrogen.

c. The pH.

d. Ask the clinic personnel to instruct the patient to col-

lect a midstream clean-catch specimen and have the

specimen delivered immediately to the laboratory.

7. a. No, because they are associated with strenuous exercise.

b. The positive blood reaction is from hemoglobinuria or

myoglobinuria resulting from participating in a con-

tact sport. The protein is orthostatic.

c. Increased excretion of RTE cell lysosomes in the pres-

ence of dehydration.

8. a. Yes, the waxy casts are probably an artifact, such as a

diaper fiber. Waxy casts are not associated with nega-

tive urine protein.

b. No, this is normal following an invasive procedure.

c. Yes, tyrosine crystals are seen in severe liver disease;

therefore, the bilirubin should be positive. The crystals

may be an artifact or from a medication.

d. Yes, uric acid crystals may be mistaken for cystine

crystals.

e. Yes, radiographic dye crystals associated with a high

specific gravity resemble cholesterol crystals.

f. No, Trichomonas is carried asymptomatically by men.

g. Yes, calcium carbonate crystals are found in alkaline

urine; therefore, clumps of amorphous urates may be

mistaken for calcium carbonate crystals.