CLINICAL MICROSCOPY Flashcards
When a part of the first portion of the ejaculate is missing,
A. Specimen will liquefy
B. Specimen will not clot
C. Sperm count decreases
D. PH decreases
C. Sperm count decreases
Dermatan sulfate, keratan sulfate, and heparan sulfat are elevated in:
A. Porphyria cutanea tarda
B. Homocystinuria
C. Mucopolysaccharidosis
D. Cystinosis
C. Mucopolysaccharidosis
Following a transfusion reaction, urine from a patient gives positive tests for blood and protein. The SG is 1.015. No RBCs or WBCs are seen in the microscopic examination. These results:
A. Indicate renal injury induced by transfusion reaction
B. Support the finding of an extravascular transfusion reaction
C. Support the finding of an intravascular transfusion reaction
D. Rule out a transfusion reaction caused by RBC incompatibility
C. Support the finding of an intravascular transfusion reaction
Which of the following can be used as a marker for urinary bladder cancer?
1.BTA
2.BFP
3.NMP
4.CYFRA 21-1
A. 1,2,3, and 4
B. 1,3, and 4
C. 2,3, and 4
D. 1 and 3
A. 1,2,3, and 4
Given the following urinalysis results, select the most appropriate course of action:
pH = 5.0
Blood = Neg
Ketone = Moderate
Protein = Neg
Bilirubin = Neg
SSA protein = 1+
Glucose = 1,000 mg/dL
A. Report the SSA protein result instead of the dry regeant strip result
B. Call for a list of medications administered to the patient
C. Perform a quantitative urinary albumin
D. Perform atest for microalbuminuria
B. Call for a list of medications administered to the patient
It measures the rate at which the kidneys are able to remove a filterable substance from the blood:
A. Concentration test
B. Clearance test
C. Secretion test
D. Excretion test
B. Clearance test
Addition of urine before the start of 24-hour collection period causes _____ results:
A. False-increased
B. False-decreased
A. False-increased
Pre-eclampsia causes:
A. Pyuria
B. Bilirubinuria
C. Hematuria
D. Proteinuria
D. Proteinuria
Interpret the reaction = Glucose oxidase (+), Clinitest (+):
A. Combined glucosuria and lactosuria
B. Lactosuria only
C. Glucosuria only
D. Ascorbic acid interference
A. Combined glucosuria and lactosuria
Urinalysis results froma 35-year-old woman are:
SG = 1.015
Glucose = Small
Leukocytes = Moderate
pH = 7.5
Ketone = Neg
Protein = Trace
Blood = Neg
Microscopic Findings:
RBCs = 5-10/HPF
WBCs = 25-50/HPF
Select the most appropriate course of action:
A. Recheck the blood reaction; if negative, look for budding yeast
B. Repeat the WBC count
C. Report all results except blood
D. Request a list of medications
A. Recheck the blood reaction; if negative, look for budding yeast
Effect of antibiotics on nitrite reagent strip:
A. False-negative
B. False-positive
A. False-negative
This is the most difficult urne sediment element to be recognized by a medical technology student:
A. Uric acid crystals
B. Squamous epithelial cells
C. RBCs
D. WBCs
C. RBCs
A lamellar body count (LBC) was perrformed on an amniotic fluid sample that was slightly pink in color within 1 hour of specimen collection. The sample was stored at 4C prior to analysis. The result was 25,000/uL, classified as intermediate risk of respiratory distress syndrome. The physician waited 24 hours and collected a new sample that was counted within 2 hours of collection on the same instrument. The LBC count of the new sample was 14,000/uL and the patient was reclassified as high risk. Which statement best explains these results?
A. Loss of lamellar bodies occurred in the second sample because of storage
B. Blood caused by a falsely elevated result for the first sample
C. The fetal status changed in 24 hours owing to respiratory illness
D. The difference in counts is the result of day-to-day physiological and instrument variance
B. Blood caused by a falsely elevated result for the first sample (bec of slightly pink in color)
Which of the following is an analytical error?
A. Misinterpretation of quality control data
B. Patient misidentification
C. Inability to identify interfering substances
D. Incorrect storage or preservation of urine
A. Misinterpretation of quality control data
Development of rhabdomyolysis has been found to be a side effect in certain patients taking medications such as:
A. Mepacrine
B. Multivitamins
C. Levodopa
D. cholesterol-lowering statins
D. cholesterol-lowering statins
Myoglobin in urine must be at what concentration to produce red color?
A. 25 mg/dL
B. 50 mg/dL
C. 5 to 10 mg/dL
D. 100 mg/dL
A. 25 mg/dL
Effect of highly pigmented red urine on ketones reagent strip:
A. False-negative
B. False-positive
B. False-positive
Oval fat bodies are usually reported as:
A. Average number per HPF
B. Avergae number per LPF
C. Rare, few, moderate, many per LPF
D. Rare, few, moderate, many per HPF
A. Average number per HPF
A male patient has sperm cells having decreased motility with normal count. What could be the possible abnormality?
A. Test done too early
B. Femal antisperm antibodies
C. Male antisperm antibodies
D. Viability
D. Viability
A CSF sample submitted for cell sounts has a visible clot. What is the best course of action?
A. Count RBCss and WBCs manually after diluting the fluid with normal saline
B. Tease the cells out of the clot befpre counting, then dilute with WBC counting fluid
C. Request new sample
D. Perform a WBC count without correction
C. Request new sample
Positive result in the 2,4-dinitrophenylhydrazine test:
A. Blue color
B. Gray precipitate
C. Yellow turbidity
D. Emerald green color
C. Yellow turbidity
When hexagonal laminated crystals are oboserved on microscopic examination, the next thing to do is:
A. Report the finding as cystine crystals
B. Perform test such as cyanide nitroprusside test
C. Add ammonia reagent to the urine sediment
D. Ignore. These crystals are only artifacts
B. Perform test such as cyanide nitroprusside test
A CSF CytoPrep smear shows many smudge cells and macrophage with torn cell membranes. What most likely caused this problem?
A. Failure to add albumin to the cytospin cup
B. Failure to collect the CSF in EDTA
D. Improper alignment
A. Failure to add albumin to the cytospin cup
The sesitivity of the Ictotest tablets is:
A. 0.01 to 0.05 mg/dL
B. 0.20 to. 0.40 mg/dL
C. 0.40 to 0.80 mg/dL
D. 0.05 to 0.10 mg/dL
D. 0.05 to 0.10 mg/dL
To adapt dark-field microscopy into a bright-field microscope, what part of it should be replaced?
A. Condenser
B. Oculars
C. Objectives
D. Diaphragm
A. Condenser
The most common abnormal urine color is:
A. Deep yellow
B. Orange
C. Red brown
D. Green
C. Red brown
The most commonly encountered meningitis in the clinical laboratory is currently:
A. Bacterial meningitis
B. Cryptococcal meningitis
C. Tubercular meningitis
D. Aseptic meningitis
B. Cryptococcal meningitis
Foveolar cells in the stomach produce:
A. Mucus
B. Gastrin
C. HCl
D. Pepsinogen
A. Mucus
In bile duct obstruction, the reaction of urobilinogen reagent strip in urine is:
A. 4 EU
B. 8 EU
C. Negative
D. Normal
D. Normal
Which of the following will not dissolve in dilute acetic acid?
A. Bacteria
B. Amorphous phosphates
C. Apatite
D. Struvite
A. Bacteria
Urine specimen was sent to the laboratory for analysis. During physical examination, you noticed a distinct caramel odor. You can presumptively identify that this sample is from patient with MSUD when:
A. Ferric chloride tube test yields a bue-green color
B. It gave an orange-red color reaction with nitroso-naphtol
C. It produced yellow turbidity after adding dinitrophenylhydrazine
D. It turned black after addition of silver nitrate and ammonium hydroxide
C. It produced yellow turbidity after adding dinitrophenylhydrazine
Which of the following sistuations will be requested for a repeat collection?
1. An intense blue color in the pH pad and a uniform pink color in the nitrite pad in the reagent strip
2. Presence of thorny-apple crystals
3. A cloudy urine with a strong odor of ammonia
4. A hazy specimen with a specific gravity of 1.040 by refractometer
A. 1,2, and 3
B. 2 and 3
C. 1,2,3, and 4
D. 1 and 3
A. 1,2, and 3
A 50-year old man weighing 72 kilograms has a serum creatinine of 1.1 m/dL. Predict his creatinine clearance.
A. 82 mL/min
B. 92 mL/min
C. 102 mL/min
D. Indeterminate
A. 82 mL/min
Which of the following organisms, when present in urine will not produce a positive nitrite test?
1. Yeast
2. Enterococcus
3. Trichomonas vaginalis
A. 1 and 3
B. 1, 2, and 3
C. 2 ad 3
D. 1 only
B. 1, 2, and 3
The following results were obtained on an ascitic fluid: serum albumin, 2.8 g/dL; fluid albumin,1.2 g/dL. Identify if the effusion is an transudate or exudates, and the most probable cause of effusion.
A. Transudate; congestive heart failure
B. Exudate; bacterial peritonitis
C. Transudate; hepatic cirrhosis
D. Transudate; colorectal cancer
C. Transudate; hepatic cirrhosis
Given the following values, the patient is most likely suffering from:
CSF albumin = 84 mg/dL
Serum albumin = 4.2 g/dL
A. Multiple sclerosis
B. Bacterial meningitis
C. Hyperglycorrhachia
D. Reye’s syndrome
B. Bacterial meningitis
The renal threshold for sodium is:
A. 120 mmol/L
B. 70 mmol/L
C. 170 mmol/L
D. None
A. 120 mmol/L
Not untrue about Tamm-Horsfall protein, EXCEPT:
1. It is the main protein component of both casts and mucus
2. It can cause a positive reagent strip test result for protein
3. It is a glycoprotein secreted by the renal tubular cells
4. It can be found in both norml and abnormal urine
A. 1,2, & 3
B. 2 and 4
C. 2 only
D. 1, 3 & 4
C. 2 only
Fecal enymes such as trypsin, chymotrypsin and elastase I are used to detect:
A. Pancreatic insufficency
B. Carbohydrate intolerance
C. Secretory diarrhea
D. All of these
A. Pancreatic insufficiency
An amniotic fluid specimen was sent tothe laboratory for examinationo. When tested for O.D. 450, it has a maximum absorbance at 410 nm. This indicates:
A. Presence of phospholipid
B. Erythroblastosis fetalis
C. Intra-amniotic hemorrhage
D. the specimen was exposed to light
C. Intra-amniotic hemorrhage
An emotionally stressed person may occasionally exhibit:
A. Cylindruria
B. Dysuria
C. Hematuria
D. Lipiduria
A. Cylindruria
When hexagonal laminated crystals are observed on microscpic examination, the nest thing to do is:
A. Report the finding as cystine crystals
B. Perform test such as cyanide nitroprusside test
C. Add amonia reagent to the urine sediment
D. Ignore. These crystals are only artifacts
B. Perform test such as cyanide nitroprusside test
Concentration of cetyltrimethylammonium bromide used for detecting mucopolysaccharides in urine:
A. 5%
B. 1%
C. 10%
D. 3%
A. 5%
When performing differential count on a CSF specimen, the sample should be cytocentrifudged for how long?
A. 3-5 minutes
B. 5-10 minutes
C. 15-20 minutes
D. 2-3 minutes
B. 5-10 minutes
If the voided sample PRIOR to collectionperiod is included in the 24 hour sample, clearance will be:
A. Falsely high
B. Falsely low
A. Falsely high
Which of the following tess does not have a negative readiing on reagent strip color charts?
A. Blood
B. Glucose
C. Ketones
D. Uroblinogen
D. Urobilinogen
What are pseudocasts?
A. Mucus threads that are shorter in length
B. Amorphous urates that deposit in uniform cylindrical shapes
C. Casts with a tapered end formed at the junction of ascending LH and DCT
D. Diaper fibers that resemble casts
B. Amorphous urates that deposit in uniform cylindrical shapes
Which of the following is true regarding uric acid and cystine?
1. Both crystals polarize
2. Both are soluble in ammonia
3. Both will dissolve in dilute HCl
4. Cystine is cyanide-nitropusside (+)
A. 2 and 4
B. 1, 2, and 4
C. 4 only
D. 1, 2, 3 and 4
C. 4 only
Associate with exudative effusion, EXCEPT:
A. Parapneumonic effusion
B. Hodgkin’s disease
C. Endocarditis
D. salt and fluid retention
D. Salt and fluid retention
Acetic acid is added to a urine sediment. Which of the following will remain intact?
A. Amorphous phosphates and bacteria
B. Bilirubin crystals
C. Calcium phosphate crystals
D. Calcium oxalate crystals
D.Calcium oxalate crystals
Who discovered calculi made up of cystine in 1810?
A. William Wollaston
B. Archibald Garrod
C. Stanley Benedict
D. Richard bright
A. William Wollaston
Produces foam in urine:
A. Protein and bilirubin
B. Bilirubin and pyridium
C. Phenazopyridine
D. Bilirubin, protein and phenazoppyridine
D. Bilirubin, protein and phenazoppyridine
Sucrose produces:
A. Brown color on glucose reagent pad containing potassium iodide
B. Greenish brown color on Benedict’s reagent
C. Yellow color on glucose reagent pad containing tetramethylbenzidine
D. Brick red color on Benedict’s reagent
C. Yellow color on glucose reagent pad containing tetramethylbenzidine
This is protein that functions as a biological glue, attaching fetal sacto uterine lining, and may also be used as an indicator of pre-term delivery:
A. Fetal fibronectin
B. Fibrin glue
C. Alpha-fetoprotein
D. hCG
A. Fetal fibronectin
A glucose reagent strip reading of 3+ is equivlent to ____ of urine glucose:
A. 2000 mg/dL
B. 1000 mg/dL
C. 500 mg/dL
D. 250 mg/dL
B. 1000 mg/dL
Color of RTE cells using the sternheimer-Malbin stain:
A. Not stained
B. Pale blue
C. Pale pink
D. Orange-purple
D. Orange-purple
Pregnancy test kits may detect hCG in urine sample in as little as ____ days after conception:
A. 3
B. 10
C. 15
D. 20
B. 10
Slide angle when preparing smears for sperm morphology:
A. 15
B. 25
C. 30
D. 45
D. 45
Reagent pads impregnated with diazonium salt, EXCEPT:
1. Lekocytes
2. Bilirubin
3. Urobilinogen
4. Nitrite
A. 4 only
B. None of these
C. 1, 2, and 3
D. 1, 2, 3 and 4
A. 4 only
As the sperms die off, which part of hem will remain and may be present for 7 days after intercourse?
A. Tail
B. Neck
C. Head
D. None
C. Head
A 12-year old girl complains of swelling of her eyelids, abdomen, and ankles. She had been in good health until several months ago, when she gained some weight and noted swelling of her lower legs. An X-ray film of the chest shows bilateral pleural effusions, without evidence of lung disease. Urinalysis reveals heavy proteinuria (8g per 24hours) without hematuria. A percutaneous needle biopsy of the kidney discloses no morphologic abnormalities by light miscrocopy. Which of the following best decribes this patient’s medical condtion?
A. Focal segmental glomerulosclerosis
B. Hereditary nephritis
C. Membranous glomerulopathy
D. Nephrotic syndrome
D. Nephrotic syndrome
An 8-year old boy presents with headache, dizziness, and malaise. He was seen for a severe sore throat 2 weeks ago. Physical examination reveals facial edema. The blood pressure is 180/100 mmHg. A 24-hour urine collention demonstrates oliguria, and urinalysis shows hematuria. Which of the following best describes this patient’s medical condition?
A. Hereditary nephritis
B. Membranous glomerulonephritis
C. Minimal change nephritic syndrome
D. Postinfectious glomerulonephritis
D. Postinfectious glomerulonephritis
What finding on micscopic urinalysis indicaes that hematuria in the patient described in question 62 (8-year old boy with heachache, dizziness, and malaise with facial edema. BP of 180/110mmHg) is caused by a renal process, rather than bleeding from another site in the urinary tract?
A. Hemoglobin crystals
B. Phagocytosed hemoglobin
C. Red blood cell casts
D. White blood cell casts
C. Red blood cell casts
A 4-year old girl presents with swelling of the legs and ankles. Physical examination reveals pitting edema of the lower extremities. Urinalysis show 2+ proteinuria. The urinary sediment contains no inflammatory cells or red blood cells. Serum levels of BUN and creatinine are normal. The patient recovers completely after a course of corticosteroids. Which of the following pathologic findings might be expected in the urine prior to treatment with corticosteriods?
A. Eosinophils
B. Lipid droplets
C. RBC casts
D. WBC casts
B. Lipid droplets
For the patient described in question 64 (4 yearold girl with swelling of legs and ankles. 2+ proteinuria and recovers completely after a course of corticosteroids), electron microscopy of renal biopsy specimen prior to treatment would most likely demonstrate which of the following abnormalities?
A. Duplication of capillary basement membranes
B. Electron-dense immune deposits in the capillary basement membrane
C. Electron-dense immune deposits in the mesangium
D. Fusion of podocyte foot processes
D. Fusion of podocyte foot processes
A 14-year old girl presents with a 5-day history of hypertension, oliguria, and hematuria. She was seen 2 weeks earlier for a severe throat infection with group A (beta-hemolytic) streptococci. A kidney biopsy displays glomerulonephritis. Immunofluorescence staining for which of the following proteins would provide the strongest evidence that this patient’s glomerulonephritisis mediated by immune complexes?
A. Complement
B. Fibrinogen
C. Hageman factor (clotting factor XII)
D. Plasminogen
A. Complement
A 20-year old woman is involved in an automobile accident and loses a large amount of blood. In response to hypoxia, interstitial pertiubular cells of the kidney would be expected to release which of the following hormones?
A. Aldosterone
B. Renin
C. Angiotensinogen
D. Erythropoietin
D. Erythropoietin
A 52-year old woman who suffers from diabetes mellitus and frequent urinary tract infections presents with a 3-day history of flank pain, undulating fever, and general malaise. A CBC shows neutrophilic leukocytosis (16,000/uL). Urine cultures reveal more than 100,000 bacteria colonies, composed predominantly of Gram-negative microorganisms. Blood pressure is 170/100 mmHg, BUN is 30 mg/dL, and creatinine is 2.0 mg/dL. Fasting serum glucose is 190 mg/dL. Urinalysis shows 2+ sugar and 1+ protein. Microscopic examination of the urine sediment reveals neutrophils and occasional leukocyte casts. Which of the folllwing is the most likely diagnosis?
A. Acute pyelonephritis
B. Acute tubular necrosis
C. Diabetic nepehropathy
D. Postifectious glomerulonephritis
A. Acute pyelonephritis
A 6-year old child develops fever, abdominal pain, and bloody diarrhea. Several other children in the neighborhood had similar symptoms. The common feature was traced to eating hamburgers at a fast-food restaurant. The clinical course is complicated by the development of acute renal failure. Which of the following is the most likely diagnosis?
A. Acute postinfectious glomerulonephritis
B. Acute pyelonephritis
C. Hemolytic uremic syndrome
D. Acute tubular necrosis
C. Hemolytic uremic syndrome
A 55-year old man dies of chronic renal failure. Examination of his kidneys at autopsy reveals a “staghorn” calculus. Which of the following best describes the pathogenesis of this renal stone?
A. Gout
B. Hypercalclemia
C. Hyperthyroidism
D. Infection
D. Infection
A 65-year old man presents with a recent episode of painless hematuria. Vital signs are normal. All blood tests and urinalysis are normal, excep for the presence of blood in the urine. The patient smokes cigarettes but does not drink alcoholic beverages.Which of the following is the most likely cause of hematuria in this patient?
A. Acute cyctitis
B. Bladderr calculi
C. Carcinoma of the bladder
D. Prostatic carcinoma
C. Carcinoma of the bladder
A 48-year old man presents for a routine physical examination. The patient has a history of hyperlipidemia and nodular prostatic hyperplasia. Physical examination reveals a large mass on the lateral side of the Scrotum, which can be transilluminated. It is found to be composed of dilated blood vessels draining the left testicle. What is the appropriate diagnosis?
A. Epididymitis
B. Hydrocele
C. Spermatocele
D. Varicocele
D. Varicocele
The patient described in question 72 (48 year old man with history of hyperlipidemia and nodular prostatic hyperplasia with large mass on the lateral side of the Scrotum) is at increased risk for which of the following complications?
A. Embryonal carcinoma
B. Infertility
C. Nodular prostatic hyperplasia
D. Seminoma
B. Infertility
