PRACTITIONER) NEWEST 2026 FINAL EXAM
GUIDE WITH FREQUENTLY TESTED
QUESTIONS
Which test is used to stage chronic kidney disease? Correct
Answer eGFR, normal >90mL/min, stage 5 (renal failure
<15mL/min)
eGFR less reliable in which people? Correct Answer -drastic
increase/reduction in muscle mass (bodybuilders, amputees,
wasting disorders), pregnancy, acute renal failure
-if ate meat within 12 hours of blood test
Blood Urea Nitrogen (BUN) definition Correct Answer Not as
sensitive as serum creatinine or GFR. Measure of kidney's ability
to excrete urea (waste product of protein metabolism)
If BUN abnormal what should you do? Correct Answer Check
GFR, if normal likely that renal function is normal. Renal failure,
high-protein diet, CHF and drugs are other causes of elevated
BUN
,What is BUN-to-creatinine ratio used for? Correct Answer
Evaluates dehydration, hypovolemia and acute renal failure. Also
used to classify type of renal failure (renal, infrarenal, postrenal)
What do epithelial cells in urinalysis mean? Correct Answer Large
number- contaminated sample
Small number- normal
Normal number of leukocytes (leukocyte esterase) present on
urinalysis? Correct Answer Less than or equal to 10/mL; presence
of leukocytes in urine (pyuria) in males is always abnormal
RBCs on urinalysis Correct Answer Less than 5 cells is normal,
elevated with kidney stones, pyelonephritis and cystitis. May be
contaminated by hemorrhoids or menses.
Protein on urinalysis Correct Answer Indicates either
pyelonephritis (resolves after treatment) or kidney disease.
NOTE: only picks up albumin not microalbumin (Bence-Jones
proteins); order 24 hr urine for protein & creatinine clearance
Nitrites on urinalysis Correct Answer Formed by certain types of
bacteria that break nitrates into nitrites; primarily E. coli
,Interpretation of Urine for Culture and Sensitivity Correct Answer
Greater than or equal to 10^5 (100,000) CFU/mL of a single
bacteria. If multiple bacteria than contaminated sample. Lower
values indicate bacteriuria.
What are casts shaped like on urinalysis? Correct Answer Shaped
like cylinders because formed in renal tubules
Hyaline casts indicate? Correct Answer Normal, may be seen in
concentrated urine
WBC casts indicate? Correct Answer Infection (UTI or
pyelonephritis)
RBC casts indicate? Correct Answer Proteinuria and are
diagnostic for glomerulonephritis
Urinalysis is more sensitive in males or females? Correct Answer
Males
Most common bacteria causing UTIs? Correct Answer E.coli, then
Staphylococcus saprophyticus, P. mirabilis, and K. pnueumoniae
Treatment for uncomplicated UTI (>age 18)? Correct Answer
Bactrim or Septra (TMP/SMX) x 3 days
, Sulfa allergic: Nitrofurantoin or Augmentin x 3 days
If symptoms persist 48-72 hrs after initiating tmt for UTI what
should you do? Correct Answer -urinalysis, culture and sensitivity
-rule out pyelonephritis
-switch to ciprofloxacin or orofloxacin for 7-10 days
Phenazopyridine (Pyridium) use known as OTC AZO or Uristat
Correct Answer Give in conjuction with abx for UTI, will stain
contact lenses and turn urine orange.
Avoid pyridium in whom? Correct Answer Individuals with
liver/renal disease and G6PD anemia
What are complicated UTIs? Correct Answer Males, diabetics,
pregnant women, children/elderly, immunocompromised,
recurrent UTIs, anatomic renal anomalies
Treatment for complicated UTIs? Correct Answer Treat 7 days or
longer, urinalysis & urine C/S before and after treatment
UTI in males Correct Answer Refer to urologist