CM

Question 1

The only tissue in the body that is hypertonic with respect to normal plasma (i.e., its osmolality is greater than 290 mOsm/kg):

a. Glomerulus
b. Convoluted tubules
c. Renal cortex
d. Renal medulla

Answer 1

D. Renal Medulla

Question 2

Intraabdominal infections: Peritonitis

aerobic or anaerobic bacteria?

Answer 2

Aerobic bacteria

Question 3

Urine color

1. Phenazopyridine (Pyridium) - drug commonly administered for urinary tract infection
2. Phenindione - anticoagulant
3. Phenol when oxidized
4. Phenol derivatives- interfere with copper reduction tests
5. Argyrol (antiseptic) - color disappears with ferric chloride

Answer 3

1. Orange-yellow
2. Orange-yellow
3. Blue-green
4. Black
5. Black

Question 4

HANDWASHING: The mechanical action of rubbing the hands together and soaping under the fingernails is the most important part of the process. (BAILEY)

Answer 4

Noted

Question 5

What is the LAST STEP in the handwashing procedure?

Dry hands with a paper towel.
Turn off faucet with a clean paper towel to prevent recontamination.
Rub to form lather, create friction, and loosen debris.
Rinse hands in a downward position.

Answer 5

Turn off faucet with a clean paper towel to prevent recontamination.

Question 6

The required amount of urine for drug testing (COC):

5 to 10 mL
10 to 15 mL
20 to 30 mL
30 to 45 mL

Answer 6

30 to 45 mL

Question 7

Acceptable urine temperature for drug testing (COC):

20 to 24C
30 to 35C
32.5 to 37.7C
37.7 to 42C

Answer 7

32.5 to 37.7C

Question 8

Primary inorganic component of urine:

Urea
Creatinine
Chloride
Potassium

Answer 8

Chloride

UREA: primary ORGANIC component; product of protein and amino acid
metabolism

CHLORIDE: primary INORGANIC component; found in combination with sodium (table salt) and many other inorganic substances

Question 9

Polyuria, an increase in daily urine volume:

Greater than 400 mL/day in adults
Greater than 1200 mL/day in adults
Greater than 2L/day in adults
Greater than 2.5 L/day in adults

Answer 9

Greater than 2.5 L/day in adults

Normal daily urine output is usually 1200 to 1500 mL, a range of 600 to 2000 mL is considered normal.

Polyuria, an increase in daily urine volume (greater than 2.5 L/day in adults and 2.5 to 3 mL/kg/day in children), is often associated with diabetes mellitus and diabetes insipidus; however, it may be artificially induced by diuretics, caffeine, or alcohol, all of which suppress the secretion of antidiuretic hormone.

Oliguria, a decrease in urine output (which is less than 1 mL/kg/hr in infants, less than 0.5 mL/kg/hr in children, and less than 400 mL/day in adults), is commonly seen when the body enters a state of dehydration as a result of excessive water loss from vomiting, diarrhea, perspiration, or severe burns.

Question 10

The most routinely used method of urine preservation is:

Boric acid
Formalin
Refrigeration
Sodium fluoride

Answer 10

Refrigeration

The most routinely used method of preservation is refrigeration at 2°C to 8°C, which decreases bacterial growth and metabolism.

If the urine is to be cultured, it should be refrigerated during transit and kept refrigerated until cultured up to 24 hours.2 The specimen must return to room temperature before chemical testing by reagent strips.

Question 11

A 24-hour urine for CATECHOLAMINE determination may be preserved with:

Formalin
Boric acid
Hydrochloric acid, 6N
Sodium Fluoride

Answer 11

Hydrochloric acid, 6N

FROM HENRY: 24-HOUR URINE COLLECTION PRESERVATIVES

None (refrigerate): amino acids, amylase, calcium, citrate, chloride, copper, creatinine, delta ALA, glucose, 5-HIAA, heavy metals (arsenic, lead, mercury), histamine, immunoelectrophoresis, lysozyme, magnesium, methylmalonic acid, microalbumin, mucopolysaccharides, phosphorus, porphobilinogen, porphyrins, potassium, protein, protein electrophoresis, sodium, urea, uric acid, xylose tolerance

10 g boric acid: aldosterone, cortisol
10 mL 6N HCl: catecholamines, cystine, homovanillic acid, hydroxyproline, metanephrines, oxalate, VMA

If processing delayed longer than 24 hours: equal amounts of 50% alcohol, Saccomanno’s fixative, and SurePath or Preserve CT Cytologic examination

Question 12

In the three-glass collection technique for diagnosis of prostatic infection, which tube is used as a control for

First specimen
Second specimen
Third specimen
None of these

Answer 12

Second specimen

Question 13

The human kidneys receive approximately ___ % of the blood pumped through the heart at all times.

Approximately 5%
Approximately 15%
Approximately 25%
Approximately 50%

Answer 13

Approximately 25%

Question 14

The part of the nephron that functions as a SIEVE:

Glomerulus
Loop of Henle
Proximal convoluted tubules
Distal convoluted tubules

Answer 14

Glomerulus

Question 15

It corrects renal blood flow in the following ways: causing VASODILATION OF THE AFFERENT ARTERIOLES and CONSTRICTION OF THE EFFERENT ARTERIOLES, stimulating reabsorption of sodium and water in the proximal convoluted tubules, and triggering the release of the sodium-retaining hormone aldosterone by the adrenal cortex and antidiuretic hormone by the hypothalamus:

Renin
Angiotensin I
Angiotensin II
Aldosterone

Answer 15

Angiotensin II

Question 16

The original reference method for clearance tests:

Creatinine clearance
Inulin clearance
Urea clearance
Beta2- microglobulin

Answer 16

Inulin clearance

Question 17

Calculate the creatinine clearance using these date obtained from a person with 1.73 m2 body surface area: serum creatinine: 1.8 mg/dL; urine creatinine: 54 mg/dL; and urine volume 640 mL in 24 hours.

3 mL/min
13 mL/min
21 mL/min
68 mL/min

Answer 17

13 mL/min

Urine volume (mL/min)
640 mL/24 hours x 1 hour/60 minutes = 0.44 mL/min.

Creatinine clearance (mL/min)
Formula: UV/P (patient is of the average body surface area)
[(54 mg/dL) x (0.44 mL/min)]/1.8 mg/dL = 13.2 mL/min

Question 18

Calculate the creatinine clearance using these data: Serum creatinine: 1.8 mg/dL; urine volume: 640 mL in 24 hours; urine creatinine: 54 mg/dL; and body surface area: 1.25 m2.

1.1 mL/min
5 mL/min
13 mL/min
18 mL/min

Answer 18

Urine volume (mL/min)
640 mL/24 hours x 1 hour/60 minutes = 0.44 mL/min

Creatinine clearance (mL/min)
Formula: (UV/P) x (1.73 m2/A)
[(54 mg/dL) (0.44 mL/min) / 1.8 mg/dL] x 1.73 m2/1.25 m2 = 18.3 mL/min

Question 19

The test most commonly associated with tubular secretion and renal blood flow

Creatinine clearance
Fishberg test
Mosenthal test
p-aminohippuric acid (PAH) test

Answer 19

p-aminohippuric acid (PAH) test

Question 20

Patients with DIABETES INSIPIDUS tend to produce urine in _____ volume with _____ specific gravity.

Increased; decreased
Increased; increased
Decreased; decreased
Decreased; increased

Answer 20

Increased; decreased

DIABETES INSIPIDUS: high urine volume, low specific gravity
DIABETES MELLITUS: high urine volume, high specific gravity

Question 21

A catheterized urine specimen is collected:

After stimulating urine production with intravenous histamine
By aspirating it with a sterile syringe inserted into the bladder
Following midstream, clean-catch urine collection procedures
From a sterile tube passed through the urethra into the bladder

Answer 21

From a sterile tube passed through the urethra into the bladder

Question 22

All of the following should be discarded in biohazardous waste containers EXCEPT:

Urine specimen containers, urine
Towels used for decontamination
Disposable lab coats
Blood collection tubes

Answer 22

Urine specimen containers, urine

Question 23

The correct method for labeling urine specimen containers is to:

Attach the label to the lid
Attach the label to the bottom
Attach the label to the container
Use only a wax pencil for labeling

Answer 23

Attach the label to the container

Labels must be ATTACHED TO THE CONTAINER, NOT TO THE LID, and should not become detached if the container is refrigerated or frozen.

Question 24

Storage of urine specimens for BILIRUBIN and UROBILINOGEN testing:

Clear container
Amber container
Preserved with formalin
None of these

Answer 24

Amber container

Question 25

First-morning urine, EXCEPT: Routine screening Pregnancy testing Urobilinogen determination Evaluation of orthostatic proteinuria

Answer 25

Urobilinogen determination AFTERNOON SPECIMEN (2 PM to 4 PM) UROBILINOGEN DETERMINATION GREATEST UROBILINOGEN EXCRETION

Question 26

Phenol derivatives found in certain intravenous medications produce ______ urine on oxidation. Yellow Orange Green Purple

Answer 26

Green STRASINGER PAGE 62: Green STRASINGER PAGE 62: Brown/black

Question 27

The clarity of a urine sample should be determined: Using glass tubes only, never plastic Following thorough mixing of the specimen After addition of salicylic acid After the specimen cools to room temperature

Answer 27

Following thorough mixing of the specimen In routine urinalysis, clarity is determined in the same manner that ancient physicians used: by visually examining the MIXED SPECIMEN while holding it IN FRONT OF A LIGHT SOURCE. The specimen should, of course, be in a clear container.

Question 28

Many particulates, print blurred through urine: Hazy Cloudy Turbid Milky

Answer 28

Cloudy Clear: no visible particulates, transparent Hazy: few particulates, print easily seen through urine Cloudy: many particulates, print blurred through urine Turbid: print cannot be seen through urine Milky: may precipitate or be clotted

Question 29

Sensitivity of the urine specific gravity reagent pad: 1.010 to 1.035 1.015 to 1.035 1.000 to 1.002 1.000 to 1.030

Answer 29

1.000 to 1.030

Question 30

A routine urinalysis on a urine specimen collected from a hospitalized patient revealed a specific gravity greater than 1.050 with the use of REFRACTOMETRY. The best explanation for this specific gravity result is that the urine: Old and has deteriorated Contains radiographic contrast media Concentrated because the patient is ill and dehydrated Contains abnormally high levels of sodium and other electrolytes because the patient is taking diuretics

Answer 30

Contains radiographic contrast media Abnormally high results—above 1.040—are seen in patients who have recently undergone an intravenous pyelogram. This is caused by the excretion of the injected radiographic contrast media. The reagent strip specific gravity measures only ionic solutes, thereby eliminating the interference by the large organic molecules, such as urea and glucose, and by radiographic contrast media and plasma expanders that are included in physical measurements of specific gravity

Question 31

Cabbage urine odor: Isovaleric acidemia Methionine malabsorption Phenylketonuria Urinary tract infection

Answer 31

Methionine malabsorption Aromatic: normal Foul, ammonia-like: bacterial decomposition, urinary tract infection Fruity, sweet: ketones (diabetes mellitus, starvation, vomiting) Maple syrup: maple syrup urine disease Mousy: phenylketonuria Rancid: tyrosinemia Sweaty feet: isovaleric acidemia Cabbage: methionine malabsorption Bleach: contamination

Question 32

A lack of any urine odor may indicate: Acute tubular necrosis Isovaleric acidemia Methionine malabsorption Phenylketonuria

Answer 32

Acute tubular necrosis

Question 33

All of the following are important to protect the integrity of reagent strips EXCEPT: Removing the desiccant from the bottle Storing in an opaque bottle Storing at room temperature Resealing the bottle after removing a strip

Answer 33

Removing the desiccant from the bottle

Question 34

Which of the following tests is affected LEAST by standing or improperly stored urine? Glucose Protein pH Bilirubin

Answer 34

Protein

Question 35

A sensitive, although not specific indicator of damage to the kidneys: Urea Creatinine Proteinuria Ketonuria

Answer 35

Proteinuria

Question 36

An indicator of PREECLAMPSIA: Cylindruria Hematuria Ketonuria Proteinuria

Answer 36

Proteinuria

Question 37

Concentration of SSA in the cold precipitation method: 1% sulfosalicylic acid 3% sulfosalicylic acid 5% sulfosalicylic acid 10% sulfosalicylic acid

Answer 37

3% sulfosalicylic acid

Question 38

REPORTING OF SSA TURBIDITY: Turbidity, granulation, no flocculation: Trace 1+ 2+ 3+ 4+

Answer 38

2+ SULFOSALICYLIC ACID (3% SSA) PRECIPITATION TEST Negative No increase in turbidity <6 mg/dL Trace Noticeable turbidity 6-30 mg/dL 1+ Distinct turbidity with no granulation 30-100 mg/dL 2+ Turbidity with granulation, no flocculation 100-200 mg/dL 3+ Turbidity with granulation and flocculation 200-400 mg/dL 4+ Clumps of protein >400 mg/dL

Question 39

Significant albumin excretion rate (AER): 0.02 to 1 ug/min 1 to 2 ug/min 5 to 15 ug/min 2 to 20 ug/min 20 to 200 ug/min

Answer 39

20 to 200 ug/min

Question 40

Sensitivity of the Multistix protein pad: 1 to 5 mg/dL albumin 5 to 10 mg/dL albumin 10 to 15 mg/dL albumin 15 to 30 mg/dL albumin

Answer 40

15 to 30 mg/dL albumin

Question 41

Bence Jones protein precipitates at temperatures between ___, and redissolves at near ___ ° C. Precipitates at 100-120C, and redissolves at 60C Precipitates at 10 to 20C, and redissolves at 100C Precipitates at 80-100C, and redissolves at 60C Precipitates at 40 to 60C, and redissolves at 100C

Answer 41

Precipitates at 40 to 60C, and redissolves at 100C

Question 42

The principle of “protein error of indicators” is based on: Protein changing the pH of the specimen Protein changing the pKa of the specimen Protein accepting hydrogen from the indicator Protein giving up hydrogen to the indicator

Answer 42

Protein accepting hydrogen from the indicator

Question 43

A patient’s random urine consistently contains a trace of protein but no casts, cells, or other biochemical abnormality. The first voided morning sample is consistently negative for protein. These findings can be explained by: Normal diurnal variation in protein loss Early glomerulonephritis Orthostatic or postural albuminuria Microalbuminuria

Answer 43

Orthostatic or postural albuminuria

Question 44

A urine specimen is tested by a reagent strip test and the sulfosalicylic acid test to determine whether protein is present. The former yields a negative protein, whereas the latter results in a reading of 2+ protein. Which of the following statements best explains this difference? Urine contained excessive amount of amorphous urates or phosphates that caused the turbidity seen with SSA Urine pH was greater than 8, exceeding the buffering capacity of the strip, thus causing false-negative reaction Protein other than albumin must be present in the urine Reading time of the reagent strip test was exceeded, causing a false negative reaction to be detected

Answer 44

Protein other than albumin must be present in the urine

Question 45

Most frequently performed chemical analysis on urine: Bilirubin Glucose Ketone Protein

Answer 45

Glucose

Question 46

A patient sends the following question to an online consumer health Web site: "I am a 22-year-old female who experienced increasing headaches, thirst, and decreasing energy. I was studying in the library when I felt lightheaded and passed out. I was taken to a hospital emergency department and they told me that my serum Acetest® was 40 mg/dL and urine glucose was 500 mg/dL. What does this mean?" How would you reply? Your lab results pattern suggests diabetes mellitus. You probably have been crash dieting recently. The two results do not fit any disease pattern. The tests need to be repeated because they could not possibly occur together.

Answer 46

Your lab results pattern suggests diabetes mellitus. A positive urine glucose plus a positive serum ketone strongly suggest uncontrolled diabetes mellitus. There is an increased rate of fatty acid oxidation occurring in light of the inaccessibility of the glucose, especially to skeletal muscle. If the patient had only been dieting, the glucose would be negative.

Question 47

Glucosuria not accompanied by hyperglycemia can be seen in which of the following? Hormonal disorders Gestational diabetes Diabetes mellitus Renal disease

Answer 47

RENAL GLYCOSURIA Glycosuria occurs in the absence of hyperglycemia when the reabsorption of glucose by the renal tubules is compromised. This is frequently referred to as “renal glycosuria” and is seen in end-stage renal disease, cystinosis, and Fanconi syndrome

Question 48

The primary reason for performing a Clinitest is to: Check for high ascorbic acid levels Confirm a positive reagent strip glucose Check for newborn galactosuria Confirm a negative glucose reading

Answer 48

Check for newborn galactosuria Depending on the laboratory population Clinitest is often performed on pediatric specimens from patients up to at least the age of 2 years. Galactose in the urine of a newborn represents an “inborn error of metabolism” in which lack of the enzyme galactose-1-phosphate uridyl transferase prevents breakdown of ingested galactose and results in failure to thrive and other complications, including death. All states have incorporated screening for galactosemia into their required newborn screening programs because early detection followed by dietary restriction can control the condition.

Question 49

Negative Clinitest: Glucose Galactose Lactose Sucrose

Answer 49

Sucrose

Question 50

A urine sample that tests positive for ketones but negative for glucose is most likely from a patient suffering from: Diabetes mellitus Diabetes insipidus Polydipsia Starvation

Answer 50

Starvation

Question 51

Ketonuria may be caused by all of the following except: Bacterial infections Diabetic acidosis Starvation Vomiting

Answer 51

Bacterial infections

Question 52

The primary reagent in the reagent strip test for ketones is: Glycine Lactose Sodium hydroxide Sodium nitroprusside

Answer 52

Sodium nitroprusside

Question 53

Positive result in the ketone reagent pad: Brown Blue Pink Purple

Answer 53

Purple

Question 54

Reagent pad positive result in the presence of hemoglobin or myoglobin: Brown Red Pink-purple Green-blue

Answer 54

Green-blue

Question 55

A speckled pattern on the blood pad of the reagent strip indicates: Hematuria Hemoglobinuria Myoglobinuria All of the above

Answer 55

Hematuria

Question 56

The LE test detects the presence of esterase in the granulocytic white blood cells (neutrophils, eosinophils, and basophils) and monocytes, but not lymphocytes.

Answer 56

Noted

Question 57

Bilirubin combines with 2,6-dichlorobenzene-diazonium-tetrafluoroborate in an acid medium to produce an azodye, with colors ranging from: Green to blue Green to brown Pink to purple Yellow to orange

Answer 57

Pink to purple BILIRUBIN REAGENT PAD 2, 4-dichloroaniline diazonium salt: TAN 2,6-dichlorobenzene-diazonium-tetrafluoroborate: PINK TO VIOLET

Question 58

Which of the following are characteristic urine findings from a patient with hemolytic jaundice? A positive test for bilirubin and an increased amount of urobilinogen A positive test for bilirubin and a decreased amount of urobilinogen A negative test for bilirubin and an increased amount of urobilinogen A negative test for bilirubin and a decreased amount of urobilinogen

Answer 58

A negative test for bilirubin and an increased amount of urobilinogen

Question 59

Which of the following results show characteristic urine findings from a patient with an obstruction of the bile duct? A positive test for bilirubin and an increased amount of urobilinogen A positive test for bilirubin and a decreased amount of urobilinogen A negative test for bilirubin and an increased amount of urobilinogen A negative test for bilirubin and a decreased amount of urobilinogen

Answer 59

A positive test for bilirubin and a decreased amount of urobilinogen

Question 60

False positive Ehrlich’s reaction for urobilinogen, EXCEPT: Porphobilinogen Formalin Indican Sulfonamides

Answer 60

Formalin UROBILINOGEN REAGENT PAD (MULTISTIX) False-positive: Porphobilinogen Indican p-aminosalicylic acid Sulfonamides Methyldopa Procaine Chlorpromazine Highly pigmented urine False-negative: Old specimens Preservation in formalin

Question 61

The positive reagent strip test for nitrite in this patient is probably caused by which of the following? An infection from gram-negative bacteria An infection from gram-positive bacteria A yeast infection An old urine specimen, unsuitable for examination

Answer 61

An infection from gram-negative bacteria

Question 62

A positive nitrite test and a negative leukocyte esterase test is an indication of a: Dilute random specimen Specimen with lysed leukocytes Vaginal yeast infection Specimen older than 2 hours

Answer 62

Specimen older than 2 hours False-positive results are obtained if nitrite testing is not performed on fresh samples, because multiplication of contaminant bacteria soon produces measurable amounts of nitrite. A true positive nitrite test should be accompanied by a positive leukocyte esterase test.

Question 63

Reagent pad contains para-arsanilic acid or sulfanilamide: pH Protein Leukocyte Nitrite

Answer 63

Nitrite Nitrite is detected by the Greiss reaction, in which nitrite at an acidic pH reacts with an aromatic amine (para-arsanilic acid or sulfanilamide) to form a diazonium compound that then reacts with tetrahydrobenzoquinolin compounds to produce a pink-colored azodye.

Question 64

Positive reagent pad for nitrite: Blue Brown Pink Purple

Answer 64

Pink Nitrite is detected by the Greiss reaction, in which nitrite at an acidic pH reacts with an aromatic amine (para-arsanilic acid or sulfanilamide) to form a diazonium compound that then reacts with tetrahydrobenzoquinolin compounds to produce a pink-colored azodye.

Question 65

Nitrite tests should be performed on first morning specimens or specimens collected after urine has remained in the bladder for at least ___ hours. At least 1 hour At least 2 hours At least 3 hours At least 4 hours

Answer 65

At least 4 hours Nitrite tests should be performed on first morning specimens or specimens collected after urine has remained in the bladder for at least 4 hours.

Question 66

Chemical testing in urine that requires patients to include diet that contains green vegetables: Bilirubin Glucose Ketone Nitrite

Answer 66

Nitrite The reliability of the test depends on the presence of adequate amounts of nitrate in the urine. This is seldom a problem in patients on a normal diet that contains green vegetables; however, because diet usually is not controlled prior to testing, the possibility of a false-negative result owing to lack of dietary nitrate does exist.

Question 67

High urine specific gravity: False positive nitrite False negative nitrite False positive blood False positive glucose

Answer 67

False negative nitrite HIGH URINE SPECIFIC GRAVITY FALSE POSITIVE: Protein FALSE NEGATIVE: Glucose, blood, nitrite

Question 68

The reagent strip reaction that requires the longest reaction time is the: Bilirubin pH Leukocyte esterase Glucose

Answer 68

Leukocyte esterase READING TIMES 30 seconds: glucose, bilirubin 40 seconds: ketone 45 seconds: specific gravity 60 seconds (1 minute): pH, protein, blood, urobilinogen and nitrite 120 seconds (2 minutes): leukocyte esterase

Question 69

All of the following can be detected by the leukocyte esterase reaction except: Neutrophils Eosinophils Lymphocytes Basophils

Answer 69

Lymphocytes The LE test detects the presence of esterase in the granulocytic white blood cells (neutrophils, eosinophils, and basophils) and monocytes, but not lymphocytes.

Question 70

Urine volume frequently used because multiparameter reagent strips are easily immersed in this volume: 5 mL volume 12 mL volume 30 mL volume 45 mL volume

Answer 70

12 mL volume

Question 71

Centrifugation speed that produces an optimum amount of urine sediment with the least chance of damaging the elements: 5 minutes at a relative centrifugal force (RCF) of 400 5 minutes at a relative centrifugal force (RCF) of 500 5 minutes at a relative centrifugal force (RCF) of 600 5 minutes at a relative centrifugal force (RCF) of 1,000

Answer 71

5 minutes at a relative centrifugal force (RCF) of 400

Question 72

Initial magnification: Objective Ocular

Answer 72

Objective SLIDE > OBJECTIVE > OCULAR Objective: FIRST LENS SYSTEM, INITIAL MAGNIFICATION Ocular: SECOND LENS SYSTEM, FURTHER MAGNIFICATION

Question 73

Further magnification: Objective Ocular

Answer 73

Ocular

Question 74

Microscope component that GATHERS AND FOCUSES THE ILLUMINATION LIGHT onto the specimen for viewing. Aperture diaphragm Rheostat Condenser Ocular

Answer 74

Condenser

Question 75

Which of the following should be used to REDUCE LIGHT INTENSITY in bright-field microscopy? Aperture diaphragm Rheostat Condenser Objective

Answer 75

Rheostat

Question 76

Type of microscope that ENHANCES VISUALIZATION OF ELEMENTS WITH LOW REFRACTIVE INDICES, such as hyaline casts, mixed cellular casts, mucous threads, and Trichomonas. Fluorescence microscope Interference-contrast microscope Phase-contrast microscope Polarizing microscope

Answer 76

Phase-contrast microscope

Question 77

A type of microscope that produces a three-dimensional microscopy-image and layer-by-layer imaging of a specimen Fluorescence microscope Interference-contrast microscope Phase-contrast microscope Polarizing microscope

Answer 77

Interference-contrast microscope

Question 78

Of all the urine sediment elements, _____ are the most difficult to recognize. RBCs WBCs RTE cells Sperms

Answer 78

RBCs

Question 79

Significant number of eosinophils in urine: More than 1% eosinophils More than 5% eosinophils More than 10% eosinophils More than 15% eosinophils

Answer 79

More than 1% eosinophils

Question 80

FECAL CONTAMINATION of a urine specimen can also result in the presence of ova from intestinal parasites in the urine sediment. The most common contaminant is: Enterobius vermicularis Schistosoma haematobium Trichomonas vaginalis Entamoeba histolytica

Answer 80

Enterobius vermicularis

Question 81

MOST FREQUENT PARASITE ENCOUNTERED IN THE URINE: Enterobius vermicularis Schistosoma haematobium Trichomonas vaginalis Entamoeba histolytica

Answer 81

Trichomonas vaginalis

Question 82

Reporting of Trichomonas vaginalis: With WBCs With motility

Answer 82

With motility

Question 83

When not moving, Trichomonas is more difficult to identify and may resemble a: WBC Transitional epithelial cell Renal tubular epithelial cell All of these

Answer 83

All of these

Question 84

Reporting of spermatozoa: Do not report Rare, few, moderate or many per LPF Rare, few, moderate or many per HPF Present, based on laboratory protocol

Answer 84

Present, based on laboratory protocol

Question 85

Only elements found in the urinary sediment that are unique to the kidney: Red blood cells Epithelial cells Casts Crystals

Answer 85

Casts

Question 86

During microscopy casts are usually seen: Center of coverslip Near the edge of coverslip Outside the coverslip All of these

Answer 86

Near the edge of coverslip

Question 87

Casts increased in CONGESTIVE HEART FAILURE: Granular casts Hyaline casts WBC casts Epithelial casts

Answer 87

Hyaline casts

Question 88

Pyelonephritis can be differentiated from cystitis by the presence of ________. Eosinophils Hyaline casts WBC casts Bacteriuria

Answer 88

WBC casts

Question 89

Which of the following could be a broad cast? Hyaline cast Granular cast Waxy cast All of these

Answer 89

All of these

Question 90

Most commonly seen broad casts: RBC and WBC casts WBC and epithelial casts Hyaline and granular casts Granular and waxy casts

Answer 90

Granular and waxy casts

Question 91

A 62-year-old patient with hyperlipoproteinemia has a large amount of protein in his urine. Microscopic analysis yields moderate to many fatty, waxy, granular and cellular casts. Many oval fat bodies are also noted. This is most consistent with: Nephrotic syndrome Acute pyelonephritis Viral infection Acute glomerulonephritis

Answer 91

Nephrotic syndrome

Question 92

Reporting of normal crystals: Averaged and reported per LPF Averaged and reported per HPF Rare, few, moderate or many per LPF Rare, few, moderate or many per HPF

Answer 92

Rare, few, moderate or many per HPF

Question 93

Lemon-shaped crystals: Ammonium biurate Calcium phosphate Uric acid Triple phosphate

Answer 93

Uric acid

Question 94

Increased amounts of these crystals in fresh urine is seen in patients with leukemia who are receiving chemotherapy: Calcium phosphate Calcium oxalate Triple phosphate Uric acid

Answer 94

Uric acid

Question 95

MT notices calcium oxalate crystals in urine, but the atypical form. To confirm identity of these crystals: Soluble with acetic acid Soluble with dilute HCl Soluble with acetic acid and dilute HCl None of these

Answer 95

Soluble with dilute HCl

Question 96

Crystals associated with ethylene glycol poisoning: Envelope or pyramidal crystals Oval or dumbbell crystals

Answer 96

Oval or dumbbell crystals

Question 97

Apatite crystals: Calcium phosphate Monohydrate calcium oxalate Dihydrate calcium oxalate Triple phosphate

Answer 97

Calcium phosphate Calcium phosphate: APATITE Monohydrate calcium oxalate: WHEWELLITE Dihydrate calcium oxalate: WEDDELITE Triple phosphate: STRUVITE

Question 98

Calculi formation at pH > 7: Uric acid, cystine, xanthine Triple phosphate, calcium phosphate Calcium oxalate, apatite All of these

Answer 98

Triple phosphate, calcium phosphate pH < 5.5: Uric acid, cystine, or xanthine calculi pH 5 to 6: Calcium oxalate and apatite calculi pH >7: Magnesium ammonium phosphate or calcium phosphate

Question 99

Calculi associated with RAPID PROTEIN CATABOLISM: Calcium oxalate Cystine Uric acid None of these

Answer 99

Uric acid URIC ACID AND URATE CALCULI 1. Gout 2. Polycythemia 3. Leukemia 4. Lymphoma 5. Liver disease 6. Acid isohydria 7. Theophylline and thiazide therapy 8. Conditions associated with rapid protein catabolism

Question 100

Calculi associated with EXCESSIVE GLYCOGEN BREAKDOWN: Calcium oxalate Cystine Uric acid None of these

Answer 100

Calcium oxalate CALCIUM OXALATE CALCULI 1. Oxaluria 2. Incomplete catabolism of carbohydrates 3. Isohydria at pH 5.5 to 6.0 4. Excessive glycogen breakdown

Question 101

The most common composition of renal calculi is: Calcium oxalate Magnesium ammonium phosphate Cystine Uric acid

Answer 101

Calcium oxalate

Question 102

Urinalysis on a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed: Heavy proteinuria Low specific gravity Uric acid crystals Microscopic hematuria

Answer 102

Microscopic hematuria

Question 103

Positive result for the acid-albumin and CTAB test for mucopolysaccharides: White turbidity Yellow turbidity Yellow spot Blue spot

Answer 103

White turbidity

Question 104

Positive result for the METACHROMATIC STAINING SPOT TEST for mucopolysaccahrides: White turbidity Yellow turbidity Yellow spot Blue spot

Answer 104

Blue spot

Question 105

Key to the diagnosis is the demonstration of antineutrophilic cytoplasmic antibody (ANCA) in the patient’s serum: Berger disease Goodpasture's syndrome Henoch-Schonlein purpura Wegener granulomatosis

Answer 105

Wegener granulomatosis Wegener granulomatosis causes a granuloma-producing inflammation of the small blood vessels primarily of the kidney and respiratory system. Key to the diagnosis of Wegener granulomatosis is the demonstration of antineutrophilic cytoplasmic antibody (ANCA) in the patient’s serum.

Question 106

The presence of renal tubular epithelial cells and casts is an indication of: Acute interstitial nephritis Chronic glomerulopnephritis Minimal change disease Acute tubular necrosis

Answer 106

Acute tubular necrosis Urinalysis findings include mild proteinuria, microscopic hematuria, and, most noticeably, the presence of RTE cells and RTE cell casts containing tubular fragments consisting of three or more cells.

Question 107

Increased eosinophils, WBC casts without bacteria: Acute glomerulophritis Acute interstitial nephritis Acute pyelonephritis Acute tubular necrosis

Answer 107

Acute interstitial nephritis AIN is primarily associated with an allergic reaction to medications that occurs within the renal interstitium, possibly caused by the medication binding to the interstitial protein. Urinalysis results include hematuria, possibly macroscopic, mild to moderate proteinuria, numerous WBCs, and WBC casts without bacteria. Differential leukocyte staining for the presence of increased eosinophils may be useful to confirm the diagnosis.

Question 108

The only protein produced by the kidney is: Albumin Uromodulin Uroprotein Globulin

Answer 108

Uromodulin Uromodulin is a more recent name for Tamm-Horsfall protein Uromodulin is a glycoprotein and is the only protein produced by the kidney. It is produced by the proximal and distal convoluted tubules.

Question 109

In automated microscopy, the DNA within the cells is stained by an orange dye: In automated microscopy, the nuclear membranes, mitochondria and negatively charged cell membranes are stained by the green dye: Phenathridine Carbocyanine

Answer 109

PHENATHRIDINE: ORANGE, DNA CARBOCYANINE: GREEN Nuclear membranes, mitochondria, and negatively charged cell membranes

Question 110

1. Single marker that denotes renal failure 2. Marker of renal tubular integrity

Answer 110

1. Creatinine 2. B2-microglobulin To ensure that glomerular filtration is being measured accurately, the substance is analyzed must be one that is neither reabsorbed nor secreted by the tubules

Question 111

Factors need in the computation usig COCKROFT-GAULT Formula except: a. Age b. Plasma creatinine c. 24 hour urine volume d. Body weight

Answer 111

c. 24 hour urine volume

Question 112

1. Most useful as a screening procedure; influenced by the NUMBER AND DENSITY (MW) of the particles 2. MORE ACCURATE; quantitative measurement of renal concentrating ability; measures only the NUMBER OF PARTICLES in a solution

Answer 112

1. Specific gravity 2. Osmometry

Question 113

Blood flows through the nephron in the following order: A. Efferent arteriole, peritubular capillaries, vasa recta, afferent arteriole B. Peritubular capillaries, afferent arteriole, vasa recta, efferent arteriole C. Afferent arteriole, peritubular capillaries, vasa recta, efferent arteriole D. Efferent arteriole, vasa recta, peritubular capillaries, afferent arteriole

Answer 113

C. Afferent arteriole, peritubular capillaries, vasa recta, efferent arteriole Should be Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta

Question 114

Which of the tubules is impermeable to water? A. Proximal convoluted tubule B. Descending loop of Henle C. Ascending loop of Henle D. Distal convoluted tubule

Answer 114

C. Ascending loop of Henle

Question 115

Glucose will appear in the urine when the: A. Blood level of glucose is 200 mg/dL B. Tm for glucose is reached C. Renal threshold for glucose is exceeded D. All of the above

Answer 115

D. All of the above

Question 116

Renal tubular acidosis can be caused by the: A. Production of excessively acidic urine due to increased filtration of hydrogen ions B. Production of excessively acidic urine due to increased secretion of hydrogen ions C. Inability to produce an acidic urine due to impaired production of ammonia D. Inability to produce an acidic urine due to increased production of ammonia

Answer 116

C. Inability to produce an acidic urine due to impaired production of ammonia

Question 117

Clearance tests used to determine the glomerular filtration rate must measure substances that are: A. Not filtered by the glomerulus B. Completely reabsorbed by the proximal convoluted tubule C. Secreted in the distal convoluted tubule D. Neither reabsorbed or secreted by the tubules

Answer 117

D. Neither reabsorbed or secreted by the tubules

Question 118

Osmolality is a measure of: A. Dissolved particles, including ions B. Undissociated molecules only C. Total salt concentration D. Molecule size

Answer 118

A. Dissolved particles, including ions

Question 119

Which of the following urinary parameters are measured during the course of concentration and dilution test to assess renal tubular function? A. Urea, nitrogen, creatinine B. Osmolality and specific gravity C. Sodium and chloride D. Sodium adn osmolality

Answer 119

B. Osmolality and specific gravity

Question 120

An unidentified fluid is received in the laboratory with a request to determine whether the fluid is urine or another body fluid. Using routine laboratory tests, what tests would determine that the fluid is most probably urine? A. Glucose and ketones B. Urea and creatinine C. Uric acid and amino acids D. Protein and amino acids

Answer 120

B. Urea and creatinine

Question 121

A cloudy specimen received in the laboratory may have been preserved using: A. Boric acid B. Chloroform C. Refrigeration D. Formalin

Answer 121

C. Refrigeration

Question 122

For general screening the most frequently collected specimen is a: A. Random one B. First morning C. Midstream clean-catch D. Timed

Answer 122

A. Random one

Question 123

If a patient fails to discard the first specimen when collecting a timed specimen the: A. Specimen must be recollected B. Results will be falsely elevated C. Results will be falsely decreased D. Both A and B

Answer 123

D. Both A and B

Question 124

The primary cause of unsatisfactory results in an unpreserved routine specimen not tested for 8 hours is: A. Bacterial growth B. Glycolysis C. Decreased pH D. Chemical oxidation

Answer 124

A. Bacterial growth

Question 125

Urine specimen collection for drug testing requires the collector to do all of the following except: A. Inspect the specimen color B. Perform reagent strip testing C. Read the specimen temperature D. Fill out a chain-of-custody form

Answer 125

B. Perform reagent strip testing

Question 126

After receiving a 24-hour urine for quantitative total protein analysis, the technologist must first: A. Subculture urine for bacteria B. Add the appropriate preservative C. Screen for albumin using a dipstick D. Measure the total volume

Answer 126

D. Measure the total volume

Question 127

A clean-catch is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hours later, the specimen is sent to the microbiology department for culture. The specimen should: A. Be centrifuged, and the supernatant cultured B. Be rejected due to time delay C. Not be cultured if no bacteria seen D. Be processed for culture only if nitrate is positive

Answer 127

B. Be rejected due to time delay

Question 128

A urine specimen comes to the laboratory 7 hours after it is obtained. It is acceptable for culture only if the specimen has been stored: A. At room temperature B. At 4-7 deg. Celsius C. Frozen D. With a preservative additive

Answer 128

B. At 4-7 deg. Celsius

Question 129

A 24-hour urine from a man who had no evidence of kidney impairment was sent to the laboratory for hormone determination. The volume was 600 mL, but there was some question as to the completeness of the 24-hour collection. The next step would be to: a. perform the hormone determination, since 600 mL is a normal 24-hour urine volume b. check the creatinine level; if it is <1g, do the procedure c. report the hormone determination in mg/dL in case the specimen was incomplete d. check the creatinine level; if it is >1g, do the procedure

Answer 129

d. check the creatinine level; if it is >1g, do the procedure

Question 130

The concentration of a normal urine specimen can be estimated by which of the following? A. Color B. Clarity C. Foam D. Odor

Answer 130

A. Color

Question 131

A urine specific gravity measured by refractometer is 1.029, and the temperature of the urine is 14°C. The specific gravity should be reported as: A. 1.023 B. 1.027 C. 1.029 D. 1.032

Answer 131

C. 1.029 No temperature correction

Question 132

A specimen with a specific gravity of 1.001 would be considered: A. Hyposthenuric B. Not urine C. Hypersthenuric D. Isosthenuric

Answer 132

B. Not urine

Question 133

Which of the following will react in the reagent strip specific gravity test? A. Glucose B. Radiographic dye C. Protein D. Chloride

Answer 133

D. Chloride

Question 134

A patient with uncontrolled diabetes mellitus will most likely have: A. Pale urine with high specific gravity B. Concentrated urine with a high specific gravity C. Pale urine with a low specific gravity D. Dark urine with a high specific gravity

Answer 134

A. Pale urine with high specific gravity

Question 135

A urine specimen collected on an apparently healthy 25-year-old man shortly after he finished eating lunch was cloudy but showed normal results on a multiple reagent strip analysis. The most likely cause of the turbidity is: a. fat b. white blood cells c. urates d. phosphates

Answer 135

d. phosphates

Question 136

A patient urine sample has an increased protein and a high specific gravity. Which of the following would be a more accurate measure of urine concentration? a. osmolality b. ketones c. refractive index d. pH

Answer 136

a. osmolality

Question 137

Use of a refractometer over a urinometer is preferred due to the fact that the refractometer uses: A. Large volume of urine and compensates for temperature B. Small volume of urine and compensates for glucose C. Small volume of urine and compensates for temperature D. Small volume of urine and compensates for protein

Answer 137

C. Small volume of urine and compensates for temperature

Question 138

To prepare a solution appropriate for quality control of the refractometer, a technician should use: A. Urea with SG of 1.040 B. Water with SG of 1.005 C. NaCl with a specific gravity of 1.022. D. Calcium chloride with an osmolarity of 460

Answer 138

C. NaCl with a specific gravity of 1.022.

Question 139

An ammonia-like odor is characteristically associated with urine from patients who: A. Are diabetic B. Have hepatitis C. Have an infection with Proteus spp. D. Have a yeast infection

Answer 139

C. Have an infection with Proteus spp.

Question 140

Leaving excess urine on the reagent strip after removing it from the specimen will: A. Cause run-over between reagent pads B. Alter the color of the specimen C. Cause reagents to leach from the pads D. Not affect the chemical reactions

Answer 140

A. Cause run-over between reagent pads

Question 141

Failure to mix a specimen before inserting the reagent strip will primarily affect the: A. Glucose reading B. Blood reading C. Leukocyte reading D. Both B and C

Answer 141

D. Both B and C

Question 142

The principle of the reagent strip test for pH is the: A. Protein error of indicators B. Greiss reaction C. Dissociation of a polyelectrolyte D. Double indicator reaction

Answer 142

D. Double indicator reaction

Question 143

A urine specimen with a pH of 9.0: A. Indicates metabolic acidosis B. Should be recollected C. May contain calcium oxalate crystals D. Is seen after drinking cranberry juice

Answer 143

B. Should be recollected

Question 144

In the laboratory, a primary consideration associated with pH is: A. Identifying urinary crystals B. Monitoring vegetarian diets C. Determining specimen acceptability D. Both A and C

Answer 144

D. Both A and C

Question 145

A patient with a 2+ protein reading in the afternoon is asked to submit a first morning specimen. The second specimen has a negative protein reading. This patient is: A. Positive for orthostatic proteinuria B. Negative for orthostatic proteinuria C. Positive for Bence Jones protein D. Negative for clinical proteinuria

Answer 145

A. Positive for orthostatic proteinuria

Question 146

A patient with a normal blood glucose and a positive urine glucose should be further checked for: A. Diabetes mellitus B. Renal disease C. Gestational diabetes D. Pancreatitis

Answer 146

B. Renal disease

Question 147

All of the following may produce false-negative glucose reactions except: A. Detergent contamination B. Ascorbic acid C. Unpreserved specimens D. Low urine temperature

Answer 147

A. Detergent contamination

Question 148

A speckled pattern on the blood pad of the reagent strip indicates: A. Hematuria B. Hemoglobinuria C. Myoglobinuria D. All of the above

Answer 148

A. Hematuria

Question 149

The principle of the reagent strip test for bilirubin is the: A. Diazo reaction B. Ehrlich reaction C. Greiss reaction D. Peroxidase reaction

Answer 149

A. Diazo reaction

Question 150

Screening tests for urinary infection combine the leukocyte esterase test with the test for: A. pH B. Nitrite C. Protein D. Blood

Answer 150

B. Nitrite

Question 151

The principle of the leukocyte esterase reagent strip test uses a: A. Peroxidase reaction B. Double indicator reaction C. Diazo reaction D. Dye-binding technique

Answer 151

C. Diazo reaction

Question 152

All of the following can be detected by the leukocyte esterase reaction except: A. Neutrophils B. Eosinophils C. Lymphocytes D. Basophils

Answer 152

C. Lymphocytes

Question 153

A positive nitrite test and a negative leukocyte esterase test is an indication of a: A. Dilute random specimen B. Specimen with lysed leukocytes C. Vaginal yeast infection D. Specimen older than 2 hours

Answer 153

D. Specimen older than 2 hours

Question 154

A test are of a urine reagent strip is impregnated with only sodium nitroprusside. This section will react with: A. Acetoacetic (diacetic) acid B. Leukocyte esterase C. Beta-hydroxybutyric acid D. Ferric chloride

Answer 154

A. Acetoacetic (diacetic) acid

Question 155

A reagent strip area impregnated with stabilized, diazotized 2,4-dichloroaniline will yield a positive reaction with: A. Bilirubin B. Hemoglobin C. Ketones D. Urobilinogen

Answer 155

A. Bilirubin. The student should memorize the chemical reactions for each of the dipstick biochemicals. Diazo reagent is used for bilirubin.

Question 156

Excess urine on the reagent test strip can turn a normal pH result into a falsely acidic pH when which of the following reagents runs into the pH pad? A. Tetrabromphenol blue B. Citrate buffer C. Glucose oxidase D. Alkaline copper sulfate

Answer 156

B. Citrate buffer

Question 157

Microscopic analysis of a urine specimen yields a moderate amount of RBCs in spite of a negative result for occult blood using a reagent strip. The technologist should determine if this patient has taken: A. Vitamin C B. A diuretic C. High blood pressure medicine D. Antibiotics

Answer 157

A. Vitamin C

Question 158

A urine tested with Clinitest exhibits a passthrough reaction and is diluted by adding 2 drops of urine to 10 drops of water. This is a dilution of: A. 1:4 B. 1:5 C. 1:6 D. 1:8

Answer 158

C. 1:6 Dilution: solute/ solution Ratio: solute/ solvent

Question 159

A woman in her ninth-month of pregnancy has a urine sugar that is negative with the urine reagent strip but gives a positive reaction with the copper reduction method. The sugar most likely responsible for these results is: A. Maltose B. Galactose C. Glucose D. Lactose

Answer 159

D. Lactose

Question 160

A urinalysis performed on a 2-week old infant with diarrhea shows a negative reaction with the glucose oxidase reagent strip. A copper reduction tablet test should be performed to check the urine sample for the presence of: A. Glucose B. Galactose C. Bilirubin D. Ketones

Answer 160

B. Galactose

Question 161

Variations in the microscopic analysis of urine include all of the following except: A. Preparation of the urine sediment B. Amount of sediment analyzed C. Method of reporting D. Identification of formed elements

Answer 161

D. Identification of formed elements

Question 162

When using the glass slide and cover-slip method, which of the following might be missed if the cover slip is overflowed? A. Casts B. RBCs C. WBCs D. Bacteria

Answer 162

A. Casts

Question 163

Initial screening of the urine sediment is performed using an objective power of: A. 4× B. 10× C. 40× D. 100×

Answer 163

B. 10×

Question 164

Which of the following are reported as number per lpf? A. RBCs B. WBCs C. Crystals D. Casts

Answer 164

D. Casts

Question 165

Which of the following lipids is/are stained by Sudan III? A. Cholesterol B. Neutral fats C. Triglycerides D. Both B and C

Answer 165

D. Both B and C - orange-red

Question 166

Which of the following lipids is/are capable of polarizing light? A. Cholesterol B. Neutral fats C. Triglycerides D. Both A and B

Answer 166

A. Cholesterol - maltese cross formation

Question 167

Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except: A. Observation of budding in yeast cells B. Increased refractility of oil droplets C. Lysis of yeast cells by acetic acid D. Lysis of RBCs by acetic acid

Answer 167

C. Lysis of yeast cells by acetic acid

Question 168

A finding of dysmorphic RBCs is indicative of: A. Glomerular bleeding B. Renal calculi C. Traumatic injury D. Coagulation disorders

Answer 168

A. Glomerular bleeding

Question 169

Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit brownian movement are: A. Indicative of pyelonephritis B. Basophils C. Mononuclear leukocytes D. Glitter cells

Answer 169

D. Glitter cells

Question 170

A clinically significant squamous epithelial cell is the: A. Cuboidal cell B. Clue cell C. Caudate cell D. Columnar cell

Answer 170

B. Clue cell

Question 171

A primary characteristic used to identify renal tubular epithelial cells is: A. Elongated structure B. Centrally located nucleus C. Spherical appearance D. Eccentrically located nucleus

Answer 171

D. Eccentrically located nucleus

Question 172

The predecessor of the oval fat body is the: A. Histiocyte B. Urothelial cell C. Monocyte D. Renal tubular cell

Answer 172

D. Renal tubular cell

Question 173

A person submitting a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment except: A. Hyaline casts B. Granular casts C. RBC casts D. WBC casts

Answer 173

D. WBC casts - infection

Question 174

All of the following contribute to urinary crystals formation except: A. Protein concentration B. pH C. Solute concentration D. Temperature

Answer 174

A. Protein concentration - CAST

Question 175

All of the following are true about waxy casts except they: A. Represent extreme urine stasis B. May have a brittle consistency C. Require staining to be visualized D. Contain degenerated granules

Answer 175

C. Require staining to be visualized

Question 176

Observation of broad casts represents: A. Destruction of tubular walls B. Dehydration and high fever C. Formation in the collecting ducts D. Both A and C

Answer 176

D. Both A and C

Question 177

All of the following can cause false-negative microscopic results except: A. Braking the centrifuge B. Failing to mix the specimen C. Dilute alkaline urine D. Using midstream clean-catch specimens

Answer 177

D. Using midstream clean-catch specimens

Question 178

Which of the following should be used to reduce light intensity in bright-field microscopy? A. Centering screws B. Aperture diaphragm C. Rheostat D. Condenser aperture diaphragm

Answer 178

C. Rheostat

Question 179

Nuclear detail can be enhanced by: A. Prussian blue B. Toluidine blue C. Acetic acid D. Both B and C

Answer 179

D. Both B and C

Question 180

The purpose of the Hansel stain is to identify: A. Neutrophils B. Renal tubular cells C. Eosinophils D. Monocytes

Answer 180

C. Eosinophils - Using eosin Y and methylene blue

Question 181

Crenated RBCs are seen in urine that is: A. Hyposthenuric B. Hypersthenuric C. Highly acidic D. Highly alkaline

Answer 181

B. Hypersthenuric

Question 182

When pyuria is detected in a urine sediment, the slide should be carefully checked for the presence of: A. RBCs B. Bacteria C. Hyaline casts D. Mucus

Answer 182

B. Bacteria

Question 183

Transitional epithelial cells are sloughed from the: A. Collecting duct B. Vagina C. Bladder D. Proximal convoluted tubule

Answer 183

C. Bladder

Question 184

A structure believed to be an oval fat body produced a Maltese cross formation under polarized light but does not stain with Sudan III. The structure: A. Contains cholesterol B. Is not an oval fat body C. Contains neutral fats D. Is contaminated with immersion oil

Answer 184

A. Contains cholesterol

Question 185

The finding of yeast cells in the urine is commonly associated with: A. Cystitis B. Diabetes mellitus C. Pyelonephritis D. Liver disorders

Answer 185

B. Diabetes mellitus

Question 186

Cylindruria refers to the presence of: A. Cylindrical renal tubular cells B. Mucus-resembling casts C. Hyaline and waxy casts D. All types of casts

Answer 186

D. All types of casts

Question 187

The most valuable initial aid for identifying crystals in a urine specimen is: A. pH B. Solubility C. Staining D. Polarized microscopy

Answer 187

A. pH

Question 188

Crystals associated with severe liver disease include all of the following except: A. Bilirubin B. Leucine C. Cystine D. Tyrosine

Answer 188

C. Cystine

Question 189

Increased transitional cells are indicative of: A. Catheterization B. Malignancy C. Pyelonephritis D. Both A and B

Answer 189

D. Both A and B

Question 190

A microscopic examintion of urine sediment reveals ghost cells. Thes red blood cells are seen urine with a: A. >2% glucose concentration B. Specific gravity of <1.007 C. Large amount of ketone bodies D. Neutral pH

Answer 190

B. Specific gravity of <1.007

Question 191

The centrifuge tube was not discarded and the urine sediment was reevaluated microscopically 5 hours after the above results were reported. A second technologist reported the same results, except 2+ bacteria and no hyaline casts were found. The most probable explanation for the second technologist's findings is: A. Sediment was not agitated before preparing the microscopic slide B. Cast dissolved due to decrease in urine pH C. Cast dissolved due to increase in urine pH D. Cast were never present in the specimen

Answer 191

C. Cast dissolved due to increase in urine pH

Question 192

Which of the following aids in differentiating a spherical transitional cell from a round renal tubular cell? A. Spherical transitional cell is larger B. Eccentrically-placed nucleus in the renal tubular cell C. Eccentrically placed nucleus in the spherical transitional cell D. Round renal tubular cell is larger

Answer 192

B. Eccentrically-placed nucleus in the renal tubular cell

Question 193

To distinguish between a clump of WBCs and WBC cast, it is important to observe: A. The presence of free-floating WBCs B. A positive leukocyte reaction C. A positive nitrite reaction D. The presence of a cast matrix

Answer 193

D. The presence of a cast matrix

Question 194

In a specimen with a large amount of bilirubin, which of the following sediment constituents would be most noticeable bile-stained: A. Squamous epithelial cells B. WBC cast C. Cystine crystals D. Renal tubular epithelial cell casts

Answer 194

D. Renal tubular epithelial cell casts

Question 195

After warming, a cloudy urine clears. This is due to the presence of: A. Urates B. Phosphates C. WBCs D. Bacteria

Answer 195

A. Urates

Question 196

Tiny, colorless, dumbell-shaped crystals were found in an alkaline urine sediment. They most likely are: A. Calcium oxalate B. Calcium carbonate C. Calcium phosphate D. Amorphous phosphate

Answer 196

B. Calcium carbonate

Question 197

Polarized light can often be used to differentiate between: A. Fibers and mucous clumps B. Hyaline and Waxy Cast C. Squamous and Transitional epithelial cells D. Red blood cells and White blood cells

Answer 197

A. Fibers and mucous clumps

Question 198

Most glomerular disorders are caused by: A. Sudden drops in blood pressure B. Immunologic disorders C. Exposure to toxic substances D. Bacterial infections

Answer 198

B. Immunologic disorders

Question 199

Dysmorphic RBC casts would be a significant finding with all of the following except: A. Goodpasture syndrome B. Acute glomerulonephritis C. Chronic pyelonephritis D. Henoch-Schönlein purpura

Answer 199

C. Chronic pyelonephritis - WBC cast

Question 200

Antiglomerular basement membrane antibody is seen with: A. Wegener granulomatosis B. IgA nephropathy C. Goodpasture syndrome D. Diabetic nephropathy

Answer 200

C. Goodpasture syndrome

Question 201

Antineutrophilic cytoplasmic antibody is diagnostic for: A. IgA nephropathy B. Wegener granulomatosis C. Henoch-Schönlein purpura D. Goodpasture syndrome

Answer 201

B. Wegener granulomatosis

Question 202

The highest levels of proteinuria are seen with: A. Alport syndrome B. Diabetic nephropathy C. IgA nephropathy D. Nephrotic syndrome

Answer 202

D. Nephrotic syndrome

Question 203

An inherited disorder producing a generalized defect in tubular reabsorption is: A. Alport syndrome B. Acute interstitial nephritis C. Fanconi syndrome D. Renal glycosuria

Answer 203

C. Fanconi syndrome

Question 204

The only protein produced by the kidney is: A. Albumin B. Uromodulin C. Uroprotein D. Globulin

Answer 204

B. Uromodulin/ Tamm horsefall protein

Question 205

Differentiation between cystitis and pyelonephritis is aided by the presence of: A. WBC casts B. RBC casts C. Bacteria D. Granular casts

Answer 205

A. WBC casts

Question 206

The most common composition of renal calculi is: A. Calcium oxalate B. Magnesium ammonium phosphate C. Cystine D. Uric acid

Answer 206

A. Calcium oxalate - 80%

Question 207

Urinalysis on a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed: A. Heavy proteinuria B. Low specific gravity C. Uric acid crystals D. Microscopic hematuria

Answer 207

D. Microscopic hematuria

Question 208

The best specimen for early newborn screening is a: A. Timed urine specimen B. Blood specimen C. First morning urine specimen D. Fecal specimen

Answer 208

B. Blood specimen

Question 209

A urine that turns black after sitting by the sink for several hours could be indicative of: A. Alkaptonuria B. MSUD C. Melanuria D. Both A and C

Answer 209

D. Both A and C

Question 210

Hartnup disease is a disorder associated with the metabolism of: A. Organic acids B. Tryptophan C. Cystine D. Phenylalanine

Answer 210

B. Tryptophan

Question 211

Blue diaper syndrome is associated with: A. Lesch-Nyhan syndrome B. Phenylketonuria C. Cystinuria D. Hartnup disease

Answer 211

D. Hartnup disease

Question 212

The classic urine color associated with porphyria is: A. Dark yellow B. Indigo blue C. Pink D. Port wine

Answer 212

D. Port wine

Question 213

Which of the following specimens can be used for porphyrin testing? A. Urine B. Blood C. Feces D. All of the above

Answer 213

D. All of the above

Question 214

Hurler, Hunter, and Sanfilippo syndromes are hereditary disorders affecting metabolism of: A. Porphyrins B. Purines C. Mucopolysaccharides D. Tryptophan

Answer 214

C. Mucopolysaccharides

Question 215

Many uric acid crystals in a pediatric urine specimen may indicate: A. Hurler syndrome B. Lesch-Nyhan disease C. Melituria D. Sanfilippo syndrome

Answer 215

B. Lesch-Nyhan disease

Question 216

Homocystinuria is caused by failure to metabolize: A. Lysine B. Methionine C. Arginine D. Cystine

Answer 216

B. Methionine

Question 217

Elevated urinary levels of 5-HIAA are associated with: A. Carcinoid tumors B. Hartnup disease C. Cystinuria D. Platelet disorders

Answer 217

A. Carcinoid tumors

Question 218

5-HIAA is a degradation product of: A. Heme B. Indole C. Serotonin D. Melanin

Answer 218

C. Serotonin

Question 219

Urine from a newborn with MSUD will have a significant: A. Pale color B. Yellow precipitate C. Milky appearance D. Sweet odor

Answer 219

D. Sweet odor

Question 220

False-positive levels of 5-HIAA can be caused by a diet high in: A. Meat B. Carbohydrates C. Starch D. Bananas

Answer 220

D. Bananas

Question 221

Match the metabolic urine disorders with their classic urine abnormalities. ____ PKU ____ Indicanuria ____ Cystinuria ____ Alkaptonuria ____ Lesch-Nyhan disease ____ Isovaleric acidemia A. Sulfur odor B. Sweaty feet odor C. Orange sand in diaper D. Mousy odor E. Black color F. Blue color

Answer 221

D, F, A, E, C, B

Question 222

Which of the following is not a function of amniotic fluid? A. Allows movement of the fetus B. Allows carbon dioxide and oxygen exchange C. Protects fetus from extreme temperature changes D. Acts as a protective cushion for the fetus

Answer 222

B. Allows carbon dioxide and oxygen exchange - placenta

Question 223

What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses? A. Fetal cell metabolism B. Fetal swallowing C. Fetal urine D. Transfer of water across the placenta

Answer 223

C. Fetal urine

Question 224

Why might a creatinine level be requested on an amniotic fluid? A. Detect oligohydramnios B. Detect polyhydramnios C. Differentiate amniotic fluid from maternal urine D. Evaluate lung maturity

Answer 224

C. Differentiate amniotic fluid from maternal urine - estimate for fetal age

Question 225

How are specimens for FLM testing delivered to and stored in the laboratory? A. Delivered on ice and refrigerated B. Immediately centrifuged C. Kept at room temperature D. Delivered in a vacuum tube

Answer 225

A. Delivered on ice and refrigerated

Question 226

Why are amniotic specimens for cytogenetic analysis incubated at 37°C prior to analysis? A. To detect the presence of meconium B. To differentiate amniotic fluid from urine C. To prevent photo-oxidation of bilirubin to biliverdin D. To prolong fetal cell viability and integrity

Answer 226

D. To prolong fetal cell viability and integrity

Question 227

Which of the following is not a reason for decreased amounts of amniotic fluid? A. Fetal failure to begin swallowing B. Increased fetal swallowing C. Membrane leakage D. Urinary tract defects

Answer 227

A. Fetal failure to begin swallowing

Question 228

A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte? A. Bilirubin B. Lecithin C. Oxyhemoglobin D. Sphingomyelin

Answer 228

A. Bilirubin

Question 229

Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus? A. No hemolysis B. Mildly affected fetus C. Moderately affected fetus that requires close monitoring D. Severely affected fetus that requires intervention

Answer 229

C. Moderately affected fetus that requires close monitoring

Question 230

The presence of a fetal neural tube disorder may be detected by: A. Increased amniotic fluid bilirubin B. Increased maternal serum alpha-fetoprotein C. Decreased amniotic fluid phosphatidyl glycerol D. Decreased maternal serum acetylcholinesterase

Answer 230

B. Increased maternal serum alpha-fetoprotein

Question 231

True or False: An AFP MoM value greater than two times the median value is considered an indication of a neural tube disorder

Answer 231

True

Question 232

When severe HDN is present, which of the following tests on the amniotic fluid would the physician not order to determine whether the fetal lungs are mature enough to withstand a premature delivery? A. AFP levels B. Foam stability index C. Lecithin/sphingomyelin ratio D. Phosphatidyl glycerol detection

Answer 232

A. AFP levels

Question 233

When performing an L/S ratio by thin-layer chromatography, a mature fetal lung will show: A. Sphingomyelin twice as concentrated as lecithin B. No sphingomyelin C. Lecithin twice as concentrated as sphingomyelin D. Equal concentrations of lecithin and sphingomyelin

Answer 233

C. Lecithin twice as concentrated as sphingomyelin

Question 234

Does the failure to produce bubbles in the Foam Stability Index indicate increased or decreased lecithin? A. Increased B. Decreased

Answer 234

B. Decreased

Question 235

A lamellar body count of 50,000 correlates with: A. Absent phosphatidyl glycerol and L/S ratio of 1.0 B. L/S ratio of 1.5 and absent phosphatidyl glycerol C. OD at 650 nm of 1.010 and an L/S ratio of 1.1 D. OD at 650 nm of 0.150 and an L/S ratio of 2.0

Answer 235

D. OD at 650 nm of 0.150 and an L/S ratio of 2.0

Question 236

The functions of the CSF include all of the following except: A. Removing metabolic wastes B. Producing an ultrafiltrate of plasma C. Supplying nutrients to the CNS D. Protecting the brain and spinal cord

Answer 236

B. Producing an ultrafiltrate of plasma

Question 237

Substances present in the CSF are controlled by the: A. Arachnoid granulations B. Blood–brain barrier C. Presence of one-way valves D. Blood–CSF barrier

Answer 237

B. Blood–brain barrier

Question 238

What department is the CSF tube labeled 3 routinely sent to? A. Hematology B. Chemistry C. Microbiology D. Serology

Answer 238

A. Hematology

Question 239

The presence of xanthochromia can be caused by all of the following except: A. Immature liver function B. RBC degradation C. A recent hemorrhage D. Elevated CSF protein

Answer 239

C. A recent hemorrhage

Question 240

Given the following information, calculate the CSF WBC count: cells counted, 80; dilution, 1:10; large Neubauer squares counted, 10. A. 8 B. 80 C. 800 D. 8000

Answer 240

C. 800 WBC ct = cd/ad -- 80x10/ 10x0.1

Question 241

A CSF WBC count is diluted with: A. Distilled water B. Normal saline C. Acetic acid D. Hypotonic saline

Answer 241

C. Acetic acid

Question 242

A total CSF cell count on a clear fluid should be: A. Reported as normal B. Not reported C. Diluted with normal saline D. Counted undiluted

Answer 242

D. Counted undiluted

Question 243

The purpose of adding albumin to CSF before cytocentrifugation is to: A. Increase the cell yield B. Decrease the cellular distortion C. Improve the cellular staining D. Both A and B

Answer 243

D. Both A and B

Question 244

The primary concern when pleocytosis of neutrophils and lymphocytes is found in the CSF is: A. Meningitis B. CNS malignancy C. Multiple sclerosis D. Hemorrhage

Answer 244

A. Meningitis

Question 245

Macrophages appear in the CSF after: A. Hemorrhage B. Repeated spinal taps C. Diagnostic procedures D. All of the above

Answer 245

D. All of the above

Question 246

After a CNS diagnostic procedure, which of the following might be seen in the CSF? A. Choroidal cells B. Ependymal cells C. Spindle-shaped cells D. All of the above

Answer 246

D. All of the above

Question 247

The integrity of the blood–brain barrier is measured using the: A. CSF/serum albumin index B. CSF/serum globulin ratio C. CSF albumin index D. CSF IgG index

Answer 247

A. CSF/serum albumin index

Question 248

Given the following results, calculate the IgG index: CSF IgG, 50 mg/dL; serum IgG, 2 g/dL; CSF albumin, 70 mg/dL; serum albumin, 5 g/dL. A. 0.6 B. 6.0 C. 1.8 D. 2.8

Answer 248

C. 1.8 IgG index = C/S IgG | C/S Alb -- 50/2 | 70/5 -- 25/14 Synthesis of IgG in the CNS (> 0.70)

Question 249

A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL suggests: A. Fungal meningitis B. Viral meningitis C. Tubercular meningitis D. Bacterial meningitis

Answer 249

D. Bacterial meningitis

Question 250

A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of: A. 20 mg/dL B. 60 mg/dL C. 80 mg/dL D. 120 mg/dL

Answer 250

C. 80 mg/dL CSF glucose = 60-70%

Question 251

All of the following statements are true about cryptococcal meningitis except: A. An India ink preparation is positive B. A starburst pattern is seen on Gram stain C. The WBC count is over 2000 D. A confirmatory immunology test is available

Answer 251

C. The WBC count is over 2000

Question 252

The test of choice to detect neurosyphilis is the: A. RPR B. VDRL C. FAB D. FTA-ABS

Answer 252

B. VDRL

Question 253

Which of the following results is consistent with fungal meningitis? A. Normal CSF glucose B. Pleocytosis of mixed cellularity C. Normal CSF protein D. High CSF lactate

Answer 253

B. Pleocytosis of mixed cellularity

Question 254

Nucleated RBCs are seen in the CSF as a result of: A. Elevated blood RBCs B. Treatment of anemia C. Severe hemorrhage D. Bone marrow contamination

Answer 254

D. Bone marrow contamination

Question 255

CSF can be differentiated from serum by the presence of: A. Albumin B. Globulin C. Prealbumin D. Tau transferrin

Answer 255

D. Tau transferrin

Question 256

The finding of oligoclonal bands in the CSF and not in the serum is seen with: A. Multiple myeloma B. CNS malignancy C. Multiple sclerosis D. Viral infections

Answer 256

C. Multiple sclerosis

Question 257

Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome? A. Ammonia B. Lactate C. Glucose D. α -Ketoglutarate

Answer 257

A. Ammonia

Question 258

CSF lactate will be more consistently decreased in: A. Bacterial meningitis B. Viral meningitis C. Fungal meningitis D. Tubercular meningitis

Answer 258

B. Viral meningitis

Question 259

Before performing a Gram stain on CSF, the specimen must be: A. Filtered B. Warmed to 37°C C. Centrifuged D. Mixed

Answer 259

C. Centrifuged

Question 260

Maturation of spermatozoa takes place in the: A. Sertoli cells B. Seminiferous tubules C. Epididymis D. Seminal vesicles

Answer 260

C. Epididymis

Question 261

If the first portion of a semen specimen is not collected, the semen analysis will have which of the following? A. Decreased pH B. Increased viscosity C. Decreased sperm count D. Decreased sperm motility

Answer 261

C. Decreased sperm count

Question 262

Failure of laboratory personnel to document the time a semen sample is collected primarily affects the interpretation of semen: A. Appearance B. Volume C. pH D. Viscosity

Answer 262

D. Viscosity

Question 263

A semen specimen delivered to the laboratory in a condom has a normal sperm count and markedly decreased sperm motility. This indicates: A. Decreased fructose B. Antispermicide in the condom C. Increased semen viscosity D. Increased semen alkalinity

Answer 263

B. Antispermicide in the condom

Question 264

Given the following information, calculate the sperm concentration: dilution, 1:20; sperm counted in five RBC squares on each side of the hemocytometer, 80 and 86; volume, 3 mL. A. 80 million/mL B. 83 million/mL C. 86 million/mL D. 169 million/µ L

Answer 264

B. 83 million/mL Sperm conc = 83x20 / 0.2x0.1 -- 83000 x 1000

Question 265

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

Answer 265

A. Immobilize the sperm

Question 266

When performing a sperm concentration, 60 sperm are counted in the RBC squares on one side of the hemocytometer and 90 sperm are counted in the RBC squares on the other side. The specimen is diluted 1:20. The: A. Specimen should be rediluted and counted B. Sperm count is 75 million/mL C. Sperm count is greater than 5 million/mL D. Sperm concentration is abnormal

Answer 266

A. Specimen should be rediluted and counted

Question 267

Additional parameters measured by Kruger’s strict morphology include all of the following except: A. Vitality B. Presence of vacuoles C. Acrosome size D. Tail length

Answer 267

A. Vitality

Question 268

If 5 round cells per 100 sperm are counted in a sperm morphology smear and the sperm concentration is 30 million, the concentration of round cells is: A. 150,000 B. 1.5 million C. 300,000 D. 15 million

Answer 268

B. 1.5 million Round cell ct. = NxS/ 100 -- 5x30M/ 100 = 1.5M

Question 269

Following a negative postvasectomy wet preparation, the specimen should be: A. Centrifuged and reexamined B. Stained and reexamined C. Reported as no sperm seen D. Both A and B

Answer 269

A. Centrifuged and reexamined

Question 270

Enzymes for the coagulation and liquefaction of semen are produced by the: A. Seminal vesicles B. Bulbourethral glands C. Ductus deferens D. Prostate gland

Answer 270

D. Prostate gland

Question 271

An increased semen pH may be caused by: A. Prostatic infection B. Decreased prostatic secretions C. Decreased bulbourethral gland secretions D. All of the above

Answer 271

D. All of the above

Question 272

Following an abnormal sperm motility test with a normal sperm count, what additional test might be ordered? A. Fructose level B. Zinc level C. MAR test D. Eosin-nigrosin stain

Answer 272

D. Eosin-nigrosin stain

Question 273

Follow-up testing for a low sperm concentration would include testing for: A. Antisperm antibodies B. Seminal fluid fructose C. Sperm vitality D. Prostatic acid phosphatase

Answer 273

B. Seminal fluid fructose

Question 274

Measurement of α -glucosidase is performed to detect a disorder of the: A. Seminiferous tubules B. Epididymis C. Prostate gland D. Bulbourethral glands

Answer 274

B. Epididymis

Question 275

The functions of synovial fluid include all of the following except: A. Lubrication for the joints B. Removal of cartilage debris C. Cushioning joints during jogging D. Providing nutrients for cartilage

Answer 275

B. Removal of cartilage debris

Question 276

The primary function of synoviocytes is to: A. Provide nutrients for the joints B. Secrete hyaluronic acid C. Regulate glucose filtration D. Prevent crystal formation

Answer 276

B. Secrete hyaluronic acid

Question 277

Which of the following is not a frequently performed test on synovial fluid? A. Uric acid B. WBC count C. Crystal examination D. Gram stain

Answer 277

A. Uric acid

Question 278

Normal synovial fluid resembles: A. Egg white B. Normal serum C. Dilute urine D. Lipemic serum

Answer 278

A. Egg white Synovial = 'Ovum' or egg

Question 279

Before testing, very viscous synovial fluid should be treated with: A. Normal saline B. Hyaluronidase C. Distilled water D. Hypotonic saline

Answer 279

B. Hyaluronidase

Question 280

Which of the following could be the most significantly affected if a synovial fluid is refrigerated before testing? A. Glucose B. Crystal examination C. Mucin clot test D. Differential

Answer 280

B. Crystal examination

Question 281

The highest WBC count can be expected to be seen with: A. Noninflammatory arthritis B. Inflammatory arthritis C. Septic arthritis D. Hemorrhagic arthritis

Answer 281

C. Septic arthritis

Question 282

All of the following are abnormal when seen in synovial fluid except: A. Neutrophages B. Ragocytes C. Synovial lining cells D. Lipid droplets

Answer 282

C. Synovial lining cells

Question 283

Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are: A. Monosodium urate B. Cholesterol C. Calcium pyrophosphate D. Apatite

Answer 283

A. Monosodium urate

Question 284

Synovial fluid for crystal examination should be examined as a/an: A. Wet preparation B. Wright's stain C. Gram stain D. Acid-fast stain

Answer 284

A. Wet preparation

Question 285

In an examination of synovial fluid under compensated polarized light, rhomboid-shaped crystals are observed. What color would these crystals be when aligned parallel to the slow vibration? A. White B. Yellow C. Blue D. Red

Answer 285

B. Yellow

Question 286

If crystals shaped like needles are aligned perpendicular to the slow vibration of compensated polarized light, what color are they? A. White B. Yellow C. Blue D. Red

Answer 286

C. Blue

Question 287

The most frequently performed chemical test on synovial fluid is: A. Total protein B. Uric acid C. Calcium D. Glucose

Answer 287

D. Glucose

Question 288

Serologic tests on patients’ serum may be performed to detect antibodies causing arthritis for all of the following disorders except: A. Pseudogout B. Rheumatoid arthritis C. Systemic lupus erythematosus D. Lyme arthritis

Answer 288

A. Pseudogout

Question 289

Crystals that have the ability to polarize light are: A. Corticosteroid B. Monosodium urate C. Calcium oxalate D. All of the above

Answer 289

D. All of the above

Question 290

Synovial fluid crystals associated with inflammation in dialysis patients are: A. Calcium pyrophosphate dihydrate B. Calcium oxalate C. Corticosteroid D. Monosodium urate

Answer 290

B. Calcium oxalate

Question 291

Crystals associated with pseudogout are: A. Monosodium urate B. Calcium pyrophosphate dihydrate C. Apatite D. Corticosteroid

Answer 291

B. Calcium pyrophosphate dihydrate

Question 292

Synovial fluid cultures are often plated on chocolate agar to detect the presence of: A. Neisseria gonorrhoeae B. Staphylococcus agalactiae C. Streptococcus viridans D. Enterococcus faecalis

Answer 292

A. Neisseria gonorrhoeae

Question 293

When diluting a synovial fluid WBC count, all of the following are acceptable except: A. Acetic acid B. Isotonic saline C. Hypotonic saline D. Saline with saponin

Answer 293

A. Acetic acid

Question 294

Addition of a cloudy, yellow synovial fluid to acetic acid produces a/an: A. Yellow-white precipitate B. Easily dispersed clot C. Solid clot D. Opalescent appearance

Answer 294

B. Easily dispersed clot

Question 295

The primary purpose of serous fluid is to: A. Remove waste products B. Lower capillary pressure C. Lubricate serous membranes D. Nourish serous membranes

Answer 295

C. Lubricate serous membranes

Question 296

During normal production of serous fluid, the slight excess of fluid is: A. Absorbed by the lymphatic system B. Absorbed through the visceral capillaries C. Stored in the mesothelial cells D. Metabolized by the mesothelial cells

Answer 296

A. Absorbed by the lymphatic system

Question 297

Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids: A. When malignancy is suspected B. To classify transudates and exudates C. To determine the type of serous fluid D. When a traumatic tap has occurred

Answer 297

B. To classify transudates and exudates

Question 298

A milky-appearing pleural fluid indicates: A. Thoracic duct leakage B. Chronic inflammation C. Microbial infection D. Both A and B

Answer 298

D. Both A and B

Question 299

Which of the following best represents a hemothorax? A. Blood HCT: 42 Fluid HCT: 15 B. Blood HCT: 42 Fluid HCT: 10 C. Blood HCT: 30 Fluid HCT: 10 D. Blood HCT: 30 Fluid HCT: 20

Answer 299

D. Blood HCT: 30 Fluid HCT: 20

Question 300

A differential observation of pleural fluid associated with tuberculosis is: A. Increased neutrophils B. Decreased lymphocytes C. Decreased mesothelial cells D. Increased mesothelial cells

Answer 300

C. Decreased mesothelial cells

Question 301

A significant cell found in pericardial or pleural fluid that should be referred to cytology is a: A. Reactive lymphocyte B. Mesothelioma cell C. Monocyte D. Mesothelial cell

Answer 301

B. Mesothelioma cell

Question 302

A test performed primarily on peritoneal lavage fluid is a/an: A. WBC count B. RBC count C. Absolute neutrophil count D. Amylase

Answer 302

B. RBC count

Question 303

The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the: A. Fluid:serum albumin ratio B. Serum ascites albumin gradient C. Fluid:serum lactic dehydrogenase ratio D. Absolute neutrophil count

Answer 303

B. Serum ascites albumin gradient

Question 304

Detection of the CA 125 tumor marker in peritoneal fluid indicates: A. Colon cancer B. Ovarian cancer C. Gastric malignancy D. Prostate cancer

Answer 304

B. Ovarian cancer

Question 305

Cultures of peritoneal fluid are incubated: A. Aerobically B. Anaerobically C. At 37°C and 42°C D. Both A and B

Answer 305

D. Both A and B

Question 306

Production of serous fluid is controlled by: A. Capillary oncotic pressure B. Capillary hydrostatic pressure C. Capillary permeability D. All of the above

Answer 306

D. All of the above

Question 307

A pleural fluid pH of 6.0 indicates: A. Esophageal rupture B. Mesothelioma C. Malignancy D. Rheumatoid effusion

Answer 307

A. Esophageal rupture

Question 308

Given the following results, classify this peritoneal fluid: serum albumin, 2.2 g/dL; serum protein, 6.0 g/dL; fluid albumin, 1.6 g/dL. A. Transudate B. Exudate

Answer 308

B. Exudate SAAG SA- AA = 2.2-1.6 = 0.6 <1.1 = exudate >1.1 = transudate

Question 309

Plasma cells seen in pleural fluid indicate: A. Bacterial endocarditis B. Primary malignancy C. Metastatic lung malignancy D. Tuberculosis infection

Answer 309

D. Tuberculosis infection

Question 310

Where does the reabsorption of water take place in the primary digestive process? A. Large intestine B. Pancreas C. Small intestine D. Stomach

Answer 310

A. Large intestine

Question 311

Which of the following tests is not performed to detect osmotic diarrhea? A. Clinitest B. Fecal fats C. Fecal neutrophils D. Muscle fibers

Answer 311

C. Fecal neutrophils - secretory diarrhea

Question 312

The normal composition of feces includes all of the following except: A. Bacteria B. Blood C. Electrolytes D. Water

Answer 312

B. Blood

Question 313

What is the fecal test that requires a 3-day specimen? A. Fecal occult blood B. APT test C. Elastase I D. Quantitative fecal fat testing

Answer 313

D. Quantitative fecal fat testing

Question 314

The normal brown color of the feces is produced by: A. Cellulose B. Pancreatic enzymes C. Undigested foodstuffs D. Urobilin

Answer 314

D. Urobilin

Question 315

Diarrhea can result from all of the following except: A. Addition of pathogenic organisms to the normal intestinal flora B. Disruption of the normal intestinal bacterial flora C. Increased concentration of fecal electrolytes D. Increased reabsorption of intestinal water and electrolytes

Answer 315

D. Increased reabsorption of intestinal water and electrolytes

Question 316

Which of the following pairings of stool appearance and cause does not match? A. Black, tarry: blood B. Pale, frothy: steatorrhea C. Yellow-gray: bile duct obstruction D. Yellow-green: barium sulfate

Answer 316

D. Yellow-green: barium sulfate

Question 317

Microscopic examination of stools provides preliminary information as to the cause of diarrhea because: A. Neutrophils are present in conditions caused by toxin-producing bacteria B. Neutrophils are present in conditions that affect the intestinal wall C. Red and white blood cells are present if the cause is bacterial D. Neutrophils are present if the condition is of nonbacterial etiology

Answer 317

B. Neutrophils are present in conditions that affect the intestinal wall

Question 318

Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent: A. Cholesterol B. Fatty acids C. Neutral fats D. Soaps

Answer 318

C. Neutral fats

Question 319

Microscopic examination of stools mixed with Sudan III and glacial acetic acid and then heated will show small orange-red droplets that represent: A. Fatty acids and soaps B. Fatty acids and neutral fats C. Fatty acids, soaps, and neutral fats D. Soaps

Answer 319

A. Fatty acids and soaps

Question 320

A value of 85% fat retention would indicate: A. Dumping syndrome B. Osmotic diarrhea C. Secretory diarrhea D. Steatorrhea

Answer 320

D. Steatorrhea

Question 321

Guaiac tests for detecting occult blood rely on the: A. Reaction of hemoglobin with hydrogen peroxide B. Pseudoperoxidase activity of hemoglobin C. Reaction of hemoglobin with ortho-toluidine D. Pseudoperoxidase activity of hydrogen peroxide

Answer 321

B. Pseudoperoxidase activity of hemoglobin

Question 322

What is the significance of an APT test that remains pink after addition of sodium hydroxide? A. Fecal fat is present. B. Fetal hemoglobin is present. C. Fecal trypsin is present. D. Vitamin C is present.

Answer 322

B. Fetal hemoglobin is present.

Question 323

A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to digest gelatin may have: A. Bacterial dysentery B. A duodenal ulcer C. Cystic fibrosis D. Lactose intolerance

Answer 323

C. Cystic fibrosis

Question 324

A stool specimen collected from an infant with diarrhea has a pH of 5.0. This result correlates with a: A. Positive APT test B. Negative trypsin test C. Positive Clinitest D. Negative occult blood test

Answer 324

C. Positive Clinitest

Question 325

Which of the following tests differentiates a malabsorption cause from a maldigestion cause in steatorrhea? A. APT test B. D-xylose test C. Lactose tolerance test D. Occult blood test

Answer 325

B. D-xylose test

Question 326

A black tarry stool is indicative of: A. Upper GI bleeding B. Lower GI bleeding C. Excess fat D. Excess carbohydrates

Answer 326

A. Upper GI bleeding

Question 327

Stool specimens that appear ribbon-like are indicative of which condition? A. Bile-duct obstruction B. Colitis C. Intestinal constriction D. Malignancy

Answer 327

C. Intestinal constriction

Question 328

Chemical screening tests performed on feces include all of the following except: A. APT test B. Clinitest C. Pilocarpine iontophoresis D. Quantitative fecal fats

Answer 328

C. Pilocarpine iontophoresis - sweat

Question 329

Secretory diarrhea is caused by: A. Antibiotic administration B. Lactose intolerance C. Celiac sprue D. Vibrio cholerae

Answer 329

D. Vibrio cholerae

Question 330

REPORTING OF SPERMATOZOA IN URINE Present, based on laboratory protocol

Answer 330

Noted

Question 331

The concentration of hCG is generally at a particular level in serum about 2 to 3days after implantation. This is the concentration at which most sensitive laboratory assays can give a positive serum hCG result. What is the lowest level of hormone for which most current serum hCG tests can give a positive result? 25 mIU/mL 50 mIU/mL 100 mIU/mL 100, 000 mIU/mL

Answer 331

25 mIU/mL In a normal pregnancy, detectable amounts of about 25 mIU/mL β- hCG are secreted 2 to 3 days (48 to 72 hours) after implantation, or approximately 8 to 10 days after conception or fertilization.

Question 332

The most specific assays for human chorionic gonadotropin (hCG) use antibody reagents against which subunit of hCG? Alpha Beta Gamma Chorionic

Answer 332

Beta Alpha subunit of HCG - similar to LH, FSH and TSH Beta subunit is unique for HCG

Question 333

In the card pregnancy test: no band appears at T and a black or gray band is visible at the C position Positive Negative Invalid

Answer 333

Negative CARD PREGNANCY TEST 1. POSITIVE: Two separate black or gray bands, one at T and the other at C, are visible in the results window, indicating that the specimen contains detectable levels of hCG. Although the intensity of the test band may vary with different specimens, the appearance of two distinct bands should be interpreted as a positive result. 2. NEGATIVE: If no band appears at T and a black or gray band is visible at the C position, the test can be considered negative, indicating that a detectable level of hCG is not present. 3. INVALID: If no band appears at C or incomplete or beaded bands appear at the T or C position, the test is invalid. The test should be repeated using another Card Pregnancy Test device. ****If the test band appears very faint, it is recommended that a new sample be collected 48 hours later and tested again using another Card Pregnancy Test device.

Question 334

What department is the CSF tube labeled 3 routinely sent to? Hematology Chemistry Microbiology Serology

Answer 334

Hematology

Question 335

Fourth CSF tube may be drawn for: Cell counts Chemical tests Chemistry and cell counts Microbiology or additional serologic tests

Answer 335

Microbiology or additional serologic tests

Question 336

If only a small amount of CSF is obtained, which is the most important procedure to perform first? Cell count Chemistry Immunology Microbiology

Answer 336

Microbiology

Question 337

A web-like pellicle in a refrigerated CSF specimen indicates: Tubercular meningitis Multiple sclerosis Primary CNS malignancy Viral meningitis

Answer 337

Tubercular meningitis

Question 338

A CSF total cell count is diluted with: Distilled water Normal saline Acetic acid Hypotonic saline

Answer 338

Normal saline Dilutions for total cell counts are made with normal saline, mixed by inversion, and loaded into the hemocytometer with a Pasteur pipette.

Question 339

A CSF WBC count is diluted with: Distilled water Normal saline Acetic acid Hypotonic saline

Answer 339

Acetic acid Lysis of RBCs must be obtained before performing the WBC count on either diluted or undiluted specimens. Specimens requiring dilution can be diluted in the manner described previously, substituting 3% glacial acetic acid to lyse the RBCs. Adding methylene blue to the diluting fluid stains the WBCs, providing better differentiation between neutrophils and mononuclear cells.

Question 340

As little as 0.1 mL of CSF combined with one drop of ________ produces an adequate CELL YIELD when processed with the cytocentrifuge. 10% albumin 30% albumin 1% HCl 3% acetic acid

Answer 340

30% albumin Adding albumin increases the cell yield and decreases the cellular distortion frequently seen on cytocentrifuged specimens.

Question 341

The purpose of adding albumin to CSF before cytocentrifugation is to: Increase the cell yield Decrease the cellular distortion Improve the cellular staining Increase cell yield and decrease cellular distortion

Answer 341

Increase cell yield and decrease cellular distortion Adding albumin increases the cell yield and decreases the cellular distortion frequently seen on cytocentrifuged specimens.

Question 342

The presence of which of the following cells is increased in a parasitic infection? Neutrophils Macrophages Eosinophils Lymphocytes

Answer 342

Eosinophils Increased eosinophils are seen in the CSF in association with parasitic infections, fungal infections (primarily Coccidioides immitis), and introduction of foreign material, including medications and shunts, into the CNS.

Question 343

Fungal infection associated with increased eosinophils in CSF: Blastomyces dermatitidis Coccidioides immitis Cryptococcus neoformans Histoplasma capsulatum

Answer 343

Coccidioides immitis Increased eosinophils are seen in the CSF in association with parasitic infections, fungal infections (primarily Coccidioides immitis), and introduction of foreign material, including medications and shunts, into the CNS.

Question 344

Which of the following may resemble a LYMPHOCYTE in CSF? Blastoyces Coccidioides Cryptococcus Histoplasma

Answer 344

Cryptococcus

Question 345

Nonpathologically significant cells are most frequently seen after DIAGNOSTIC PROCEDURES such as PNEUMOENCEPHALOGRAPHY and in fluid obtained from VENTRICULAR TAPS or during NEUROSURGERY: Choroidal cells Ependymal cells Spindle-shaped cells All of these

Answer 345

All of these

Question 346

Myeloblasts are seen in the CSF: In bacterial infections In conjunction with CNS malignancy After cerebral hemorrhage As a complication of acute leukemia

Answer 346

As a complication of acute leukemia Lymphoblasts, myeloblasts, and monoblasts in the CSF are frequently seen as a serious complication of acute leukemias. Nucleoli are often more prominent than in blood smears.

Question 347

The most frequently performed chemical test on CSF: Glucose determination Lactate determination Protein determination India ink staining

Answer 347

Protein determination The most frequently performed chemical test on CSF is the protein determination.

Question 348

The reference range for CSF protein is: 6 to 8 g/dL 15 to 45 g/dL 6 to 8 mg/dL 15 to 45 mg/dL

Answer 348

15 to 45 mg/dL Reference values for total CSF protein are usually listed as 15 to 45 mg/dL, but are somewhat method dependent, and higher values are found in infants and people over age 40. This value is reported in milligrams per deciliter and not grams per deciliter, as are plasma protein concentrations.

Question 349

CSF can be differentiated from serum by the presence of: Albumin Globulin Prealbumin Tau transferrin

Answer 349

Tau transferrin Transferrin is the major beta globulin present; also, a separate carbohydrate-deficient transferrin fraction, referred to as “tau,” is seen in CSF and not in serum.

Question 350

In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is: Transferrin Prealbumin IgA Ceruloplasmin

Answer 350

Prealbumin

Question 351

Elevated CSF protein values can be caused by all of the following except: Meningitis Multiple sclerosis Fluid leakage CNS malignancy

Answer 351

Fluid leakage Abnormally low values are present when fluid is leaking from the CNS. The causes of elevated CSF protein include damage to the blood–brain barrier, immunoglobulin production within the CNS, decreased normal protein clearance from the fluid, and neural tissue degeneration. Meningitis and hemorrhage conditions that damage the blood–brain barrier are the most common causes of elevated CSF protein.

Question 352

The integrity of the blood–brain barrier is measured using the: CSF/serum albumin index CSF/serum globulin ratio CSF albumin index CSF IgG index

Answer 352

CSF/serum albumin index CSF/SERUM ALBUMIN INDEX An index value less than 9 represents an intact blood– brain barrier. The index increases relative to the amount of damage to the barrier.

Question 353

The finding of oligoclonal bands in the CSF and not in the serum is seen with: Multiple myeloma CNS malignancy Multiple sclerosis Viral infections

Answer 353

Multiple sclerosis

Question 354

Oligoclonal banding in cerebrospinal fluid but not in serum, EXCEPT: Encephalitis Multiple myeloma Neurosyphilis Guillain-Barre disease

Answer 354

Multiple myeloma The presence of two or more oligoclonal bands in the CSF that are not present in the serum can be a valuable tool in diagnosing multiple sclerosis, particularly when accompanied by an increased IgG index. Other neurologic disorders including encephalitis, neurosyphilis, Guillain-Barré syndrome, and neoplastic disorders also produce oligoclonal banding that may not be present in the serum.

Question 355

Measurement of which of the following can be replaced by CSF GLUTAMINE analysis in children with Reye syndrome? Ammonia Lactate Glucose Alpha-ketoglutarate

Answer 355

Ammonia Glutamine is produced from ammonia and alpha-ketoglutarate by the brain cells. This process serves to remove the toxic metabolic waste product ammonia from the CNS. The normal concentration of glutamine in the CSF is 8 to 18 mg/dL. Elevated levels are associated with liver disorders that result in increased blood and CSF ammonia.

Question 356

Before performing a Gram stain on CSF, the specimen must be: Filtered Warmed to 37C Centrifuged Mixed

Answer 356

Centrifuged All smears and cultures should be performed on concentrated specimens because often only a few organisms are present at the onset of the disease. The CSF should be centrifuged at 1500 g for 15 minutes, and slides and cultures should be prepared from the sediment.

Question 357

The procedure recommended by the CDC to diagnose neurosyphilis: RPR VDRL MHA-TP FTA-ABS

Answer 357

VDRL Although many different serologic tests for syphilis are available when testing blood, the procedure recommended by the CDC to diagnose neurosyphilis is the Venereal Disease Research Laboratories (VDRL), even though it is not as sensitive as the fluorescent treponemal antibody-absorption (FTA-ABS) test for syphilis. The rapid plasma regain (RPR) test is not recommended because it is less sensitive than the VDRL.

Question 358

An elevated maternal serum AFP, may indicate an amniocentesis at: 15 to 18 weeks 20 to 42 weeks

Answer 358

15 to 18 weeks INDICATIONS FOR PERFORMING AMNIOCENTESIS INDICATED AT 15 TO 18 WEEKS’ GESTATION  Mother’s age of 35 or older at delivery  Family history of chromosome abnormalities, such as trisomy 21 (Down syndrome)  Parents carry an abnormal chromosome rearrangement  Earlier pregnancy or child with birth defect  Parent is a carrier of a metabolic disorder  Family history of genetic diseases such a sickle cell disease, Tay-Sachs disease, hemophilia, muscular dystrophy, sickle cell anemia, Huntington chorea, and cystic fibrosis  Elevated maternal serum alpha-fetoprotein  Abnormal triple marker screening test  Previous child with a neural tube disorder such as spina bifida, or ventral wall defects (gastroschisis)  Three or more miscarriages INDICATED LATER IN THE PREGNANCY (20 TO 42 WEEKS)  Fetal lung maturity  Fetal distress  HDN caused by Rh blood type incompatibility  Infection

Question 359

The amount of amniotic fluid increases in quantity throughout pregnancy, reaching a peak of approximately ____ mL during the third trimester, and then gradually decreases prior to delivery. 100 to 200 mL 200 to 400 mL 400 to 800 mL 800 to 1, 200 mL

Answer 359

800 to 1, 200 mL

Question 360

A maximum of ___ mL of amniotic fluid is collected in sterile syringes. 5 mL 10 mL 20 mL 30 mL

Answer 360

30 mL

Question 361

Presence of meconium in amniotic fluid: Colorless Blood-streaked Yellow Dark green Dark red-brown

Answer 361

Dark green

Question 362

Dark red-brown amniotic fluid: Traumatic tap, abdominal trauma, intra-amniotic hemorrhage Hemolytic disease of the newborn Meconium Fetal death

Answer 362

Fetal death

Question 363

Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of: Alpha-fetoprotein Bilirubin Cytogenetics Lecithin

Answer 363

Bilirubin

Question 364

Why are amniotic specimens for cytogenetic analysis incubated at 37°C prior to analysis? To detect the presence of meconium To differentiate amniotic fluid from urine To prevent photo-oxidation of bilirubin to biliverdin To prolong fetal cell viability and integrity

Answer 364

To prolong fetal cell viability and integrity

Question 365

How are specimens for FLM testing delivered to and stored in the laboratory? Delivered on ice and refrigerated Immediately centrifuged Kept at room temperature Delivered in a vacuum tube

Answer 365

Delivered on ice and refrigerated

Question 366

Amniotic fluid bilirubin is measured by: Turbidimetric method Dye-binding method Spectrophotometric analysis Fluorometric analysis

Answer 366

Spectrophotometric analysis Amniotic fluid bilirubin is measured by spectrophotometric analysis using serial dilutions. When bilirubin is present, a rise in OD is seen at 450 nm because this is the wavelength of maximum bilirubin absorption.

Question 367

A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte? Bilirubin Lecithin Oxyhemoglobin Sphingomyelin

Answer 367

Bilirubin

Question 368

For OD 450, specimens that are contaminated with blood are generally unacceptable because maximum absorbance of oxyhemoglobin occurs at ___ nm and can interfere with the bilirubin absorption peak Oxyhemoglobin and bilirubin 410 nm Oxyhemoglobin and bilirubin 450 nm Oxyhemoglobin 410 nm, bilirubin 450 nm Oxyhemoglobin 450 nm, bilirubin 410 nm

Answer 368

Oxyhemoglobin 410 nm, bilirubin 450 nm Specimens that are contaminated with blood are generally unacceptable because maximum absorbance of oxyhemoglobin occurs at 410 nm and can interfere with the bilirubin absorption peak. This interference can be removed by extraction with chloroform if necessary.

Question 369

A ΔA450 value that falls into Zone I indicates: Normal finding without significant hemolysis Moderate hemolysis Severe hemolysis High fetal risk

Answer 369

Normal finding without significant hemolysis Zone I: no more than a mildly affected fetus Zone II: moderate hemolysis and require careful monitoring anticipating an early delivery or exchange transfusion upon delivery Zone III: severe hemolysis and suggests a severely affected fetus; intervention through induction of labor or intrauterine exchange transfusion must be considered

Question 370

Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in ZONE II indicates what condition of the fetus? No hemolysis Mildly affected fetus Moderately affected fetus requiring close monitoring Severely affected fetus that requires intervention

Answer 370

Moderately affected fetus requiring close monitoring

Question 371

In the FOAM OR SHAKE TEST, amniotic fluid is mixed with: 1% NaOH 10% NaOH 70% ethanol 95% ethanol

Answer 371

95% ethanol Amniotic fluid is mixed with 95% ethanol, shaken for 15 seconds, and allowed to sit undisturbed for 15 minutes. At the end of this time, the surface of the fluid is observed for the presence of a continuous line of bubbles around the outside edge. The presence of bubbles indicates that a sufficient amount of phospholipid is available to reduce the surface tension of the fluid even in the presence of alcohol, an antifoaming agent.

Question 372

Increases the OD of the amniotic fluid at 650 nm: AFP Bilirubin Lamellar bodies Oxyhemoglobin

Answer 372

Lamellar bodies OD 650 nm: LAMELLAR BODIES (FETAL LUNG MATURITY) An OD of 0.150 has been shown to correlate well with an L/S ratio of greater than or equal to 2.0 and the presence of phosphatidyl glycerol.

Question 373

When severe HDN is present, which of the following tests on the amniotic fluid would the physician NOT ORDER to determine whether the fetal lungs are mature enough to withstand a premature delivery? AFP levels Foam stability index Lecithin/sphingomyelin ratio Phosphatidylglycerol detection

Answer 373

AFP levels Neural tube defects (NTD) are one of the most common birth defects. It can be detected by maternal serum alpha-fetoprotein (MSAFP) blood test, high-resolution ultrasound, and amniocentesis. Increased levels of alpha-fetoprotein (AFP) in both the maternal circulation and the amniotic fluid can be indicative of fetal neural tube defects, such as anencephaly and spina bifida.

Question 374

True for SPUTUM: Green in color Secreted by the tracheobronchial tree Healthy individual normally produce sputum All of these

Answer 374

Secreted by the tracheobronchial tree SPUTUM is the material secreted by the tracheobronchial tree and brought up by coughing. The healthy individual does not normally produce sputum.

Question 375

Formed elements in sputum are best studied by which CYTOLOGICAL techniques? AFB stain Gram's stain Pap's stain Wright's stain

Answer 375

Pap's stain Pap’s stain: SPUTUM CYTOLOGY Wright’s stain: DIFFERENTIATES NEUTROPHILS FROM EOSINOPHILS

Question 376

Which of the following may resemble MYELIN GLOBULE in sputum? Blastomyces Coccidioides Cryptococcus Histoplasma

Answer 376

Blastomyces Myelin globules: little or no significance but may be mistaken for Blastomyces (yeastlike fungi). They are colorless, round, oval or pea-shaped of various sizes.

Question 377

Dense, crystalline concretions (may be large enough to be grossly visible) may be seen in sputum in: Bronchial asthma Broncholithiasis Pneumonia Tuberculosis

Answer 377

Broncholithiasis

Question 378

Which of the following stimulate the parietal cells to produce hydrochloric acid? Gastrin Intrinsic factor Pepsin Trypsin

Answer 378

Gastrin

Question 379

Gastric tube inserted through the mouth: Gastric tube inserted through the nose: Levin tube Rehfuss tube

Answer 379

Rehfuss tube Levin tube The gastric juice is obtained by insertion of a gastric tube into the stomach 1. REHFUSS tube (introduced through the mouth) 2. LEVIN tube (inserted through the nose) 3. Disposable plastic tubes are usually employe

Question 380

Normal fasting gastric fluid appears: Dark red-brown Clear and pale yellow Pale yellow with food particles Pale gray and slightly mucoid

Answer 380

Pale gray and slightly mucoid

Question 381

What is the preferred gastric stimulant? Histamine Histalog Insulin Pentagastrin

Answer 381

Pentagastrin resembles true gastrin.

Question 382

Hypoglycemia is induced with which of the following to test for the completeness of VAGOTOMY? Histamine Histalog Insulin Pentagastrin

Answer 382

Insulin

Question 383

The cell most frequently seen in bronchoalveolar lavage (BAL): Macrophages Lymphocytes Neutrophils Eosinophils

Answer 383

Macrophages

Question 384

In bronchoalveolar lavage (BAL), which cell type is elevated in CIGARETTE SMOKERS, and in cases of bronchopneumonia, toxin exposure, and diffuse alveolar damage: Macrophages Lymphocytes Neutrophils Eosinophils

Answer 384

Neutrophils

Question 385

Normal lymphocyte count in bronchoalveolar lavage (BAL): Less than 1% Less than 3% 1 to 15% 56 to 80%

Answer 385

1 to 15%

Question 386

The entire process of spermatogenesis takes approximately ___ days. 50 days 70 days 90 days 120 days

Answer 386

90 days When spermatogenesis is complete, the immature sperm (nonmotile) enter the epididymis. In the epididymis, the sperm mature and develop flagella. The entire process takes approximately 90 days. The sperm remain stored in the epididymis until ejaculation, at which time they are propelled through the ductus deferens (vas deferens) to the ejaculatory ducts.

Question 387

Produce most of the fluid present in semen (60%to 70%): Testes and epididymis Seminal vesicles Prostate gland Bulbourethral gland

Answer 387

Seminal vesicles Semen is composed of four fractions that are contributed by the testes, epididymis, seminal vesicles, prostate gland, and bulbourethral glands. The seminal vesicles produce most of the fluid present in semen (60% to 70%), and this fluid is the transport medium for the sperm.

Question 388

Produces milky acidic fluid containing high concentrations of acid phosphatase, citric acid, zinc, and proteolytic enzymes responsible for both the coagulation and liquefaction of the semen following ejaculation: Testes and epididymis Seminal vesciles Prostate gland Bulbourethral gland

Answer 388

Prostate gland Approximately 20% to 30% of the semen volume is acidic fluid produced by the prostate gland. The milky acidic fluid contains high concentrations of acid phosphatase, citric acid, zinc, and proteolytic enzymes responsible for both the coagulation and liquefaction of the semen following ejaculation.

Question 389

Semen is collected following a period of sexual abstinence of at least___ days to not more than ___ days. At least 1 day to not more than 3 days At least 2 days to not more than 7 days At least 5 days to not more than 7 days At least 7 days to not more than 10 days

Answer 389

At least 2 days to not more than 7 days Specimens are collected following a period of sexual abstinence of at least 2 days to not more than 7 days. Specimens collected following prolonged abstinence tend to have higher volumes and decreased motility.

Question 390

Liquefaction of a semen specimen should take place within: 1 hour 2 hours 3 hours 4 hours

Answer 390

1 hour A fresh semen specimen is clotted and should liquefy within 30 to 60 minutes after collection; therefore, recording the time of collection is essential for evaluating semen liquefaction. Failure of liquefaction to occur within 60 minutes may be caused by a deficiency in prostatic enzymes and should be reported.

Question 391

If after 2 hours, the seminal fluid has not liquefied, which of the following may be added to induce liquefaction? Dulbecco's phosphate-buffered saline Dulbecco's phosphate-buffered saline and hyaluronidase Dulbecco's phosphate-buffered saline, alpha-chymotrypsin and bromelain Alpha-chymotrypsin and bromelain

Answer 391

Dulbecco's phosphate-buffered saline, alpha-chymotrypsin and bromelain If after 2 hours the specimen has not liquified, an equal volume of physiologic Dulbecco’s phosphate-buffered saline or proteolytic enzymes such as alpha-chymotrypsin or bromelain may be added to induce liquefaction and allow the rest of the analysis to be performed.

Question 392

Normal seminal fluid volume 2 to 5 mL 3 to 10 mL 10 to 15 mL 15 mL to 20 mL

Answer 392

2 to 5 mL Normal semen volume ranges between 2 and 5 mL. It can be measured by pouring the specimen into a clean graduated cylinder calibrated in 0.1-mL increments.

Question 393

Watery seminal fluid: Viscosity grade of 0 Viscosity grade of 4

Answer 393

Viscosity grade of 0 Ratings of 0 (watery) to 4 (gel-like) can be assigned to the viscosity report.

Question 394

Gel-like seminal fluid: Viscosity grade of 0 Viscosity grade of 4

Answer 394

Viscosity grade of 4 Ratings of 0 (watery) to 4 (gel-like) can be assigned to the viscosity report.

Question 395

Normal pH of semen: pH of 2.0 to 4.0 pH of 4.5 to 8.0 pH of 7.4 to 7.5 pH of 7.2 to 8.0

Answer 395

pH of 7.2 to 8.0 The normal pH of semen is alkaline with a range of 7.2 to 8.0. Increased pH indicates infection within the reproductive tract. A decreased pH may be associated with increased prostatic fluid, ejaculatory duct obstruction, or poorly developed seminal vesicles.

Question 396

Increased pH of semen: Increased prostatic fluid Ejaculatory duct obstruction Poorly developed seminal vesicles Infection within the reproductive tract

Answer 396

Infection within the reproductive tract The normal pH of semen is alkaline with a range of 7.2 to 8.0. Increased pH indicates infection within the reproductive tract. A decreased pH may be associated with increased prostatic fluid, ejaculatory duct obstruction, or poorly developed seminal vesicles.

Question 397

SPERM MOTILITY: slower speed, some lateral movement. SPERM MOTILITY: no forward progression. SPERM MOTILITY: slow forward progression, noticeable lateral movement 0 1.0 2.0 3.0 4.0 a b c d

Answer 397

3.0 0 b 4.0 (a) Rapid, straight-line motility 3.0 (b) Slower speed, some lateral movement 2.0 (b) Slow forward progression, noticeable lateral movement 1.0 (c) No forward progression 0 (d) No movement

Question 398

Included in computer-assisted semen analysis (CASA): Sperm velocity Sperm velocity and trajectory Sperm velocity, trajectory and morphology Sperm velocity, trajectory, sperm concentration and morphology

Answer 398

Sperm velocity, trajectory, sperm concentration and morphology

Question 399

Location of the nucleus of sperm: No nucleus Head Neckpiece Midpiece Tail

Answer 399

Head

Question 400

Critical to ovum penetration: Acrosomal cap Cell membrane Mitochondria Tail

Answer 400

Acrosomal cap

Question 401

The acrosomal cap should encompass approximately ___ of the head and cover approximately___ of the sperm nucleus. Half of the head and covers half of the sperm nucleus Half of the head and covers 2/3 of the sperm nucleus Two-thirds of the head and covers half of the sperm nucleus Two-thirds of the head and covers 2/3 of the sperm nucleus

Answer 401

Half of the head and covers 2/3 of the sperm nucleus

Question 402

It is surrounded by a mitochondrial sheath that produces the energy required by the tail for motility: Head Neckpiece Midpiece Flagellum

Answer 402

Midpiece The midpiece is approximately 7.0 μm long and is the thickest part of the tail because it is surrounded by a mitochondrial sheath that produces the energy required by the tail for motility.

Question 403

Round cells that are of concern and may be included in sperm counts and morphology analysis are: Leukocytes Spermatids RBCs Leukocytes and spermatids

Answer 403

Leukocytes and spermatids Immature sperm and WBCs, often referred to as “round” cells. Only fully developed sperm should be counted. Immature sperm and WBCs, often referred to as “round” cells, must not be included. However, their presence can be significant, and they may need to be identified and counted separately. Stain included in the diluting fluid aids in differentiating between immature sperm cells (spermatids) and leukocytes, and they can be counted in the same manner as mature sperm. A count greater than 1 million leukocytes per milliliter is associated with inflammation or infection of the reproductive organs that can lead to infertility. The presence of more than 1 million spermatids per milliliter indicates disruption of spermatogenesis. This may be caused by viral infections, exposure to toxic chemicals, and genetic disorders.

Question 404

Living sperm cells in the eosin-nigrosin stain: Green against a yellow background Purple against a red background Red against a purple background Not infiltrated by the dye and remain bluish white

Answer 404

Not infiltrated by the dye and remain bluish white Living cells are not infiltrated by the dye and remain bluish white, whereas dead cells stain red against the purple background. Normal vitality requires 50% or more living cells and should correspond to the previously evaluated motility.

Question 405

Dead sperm cells in the eosin-nigrosin stain: Green against a yellow background Purple against a red background Red against a purple background Not infiltrated by the dye and remain bluish white

Answer 405

Red against a purple background Living cells are not infiltrated by the dye and remain bluish white, whereas dead cells stain red against the purple background. Normal vitality requires 50% or more living cells and should correspond to the previously evaluated motility.

Question 406

Seminal fluid specimens can be screened for the presence of fructose using the resorcinol test that produces an _____ color when fructose is present. Black Blue Green Orange

Answer 406

Orange

Question 407

Specimens for fructose levels should be tested within 2 hours of collection or _____ to prevent fructolysis. Frozen Incubated at 37C Preserved with formalin Refrigerated

Answer 407

Frozen

Question 408

Decreased sperm motility with clumping: Decreased sperm vitality Lack of seminal vesicle support medium Female anti-sperm antibodies Male anti-sperm antibodies

Answer 408

Male anti-sperm antibodies The presence of antibodies in a male subject can be suspected when clumps of sperm are observed during a routine semen analysis. Sperm-agglutinating antibodies cause sperm to stick to each other in a head-to-head, head-to-tail, or tail to- tail pattern.1 The agglutination is graded as “few,” “moderate,” or “many” on microscopic examination. Two frequently used tests to detect the presence of antibody-coated sperm are the mixed agglutination reaction (MAR) test and the immunobead test.

Question 409

A decreased neutral alpha-glucosidase suggests a disorder of the: Epididymis Seminal vesicles Prostate gland Bulbourethral gland

Answer 409

Epididymis Just as decreased fructose levels are associated with a lack of seminal fluid, decreased neutral alpha-glucosidase, glycerophosphocholine, and L-carnitine suggest a disorder of the epididymis. Decreased zinc, citric acid, glutamyl transpeptidase, and acid phosphatase indicate a lack of prostatic fluid. Spectrophotometric methods are used to quantitate citric acid and zinc.

Question 410

For post-vasectomy semen analysis, specimens are tested: Beginning 1 month post-vasectomy and continuing until two consecutive monthly specimens show no sperm Beginning 2 months post-vasectomy and continuing until two consecutive monthly specimens show no sperm Beginning 3 months post-vasectomy and continuing until two consecutive monthly specimens show no sperm Beginning 3 months post-vasectomy and continuing until three consecutive monthly specimens show no sperm

Answer 410

Beginning 2 months post-vasectomy and continuing until two consecutive monthly specimens show no sperm

Question 411

Before testing, very viscous synovial fluid should be treated with: Normal saline Hyaluronidase Distilled water Hypotonic saline

Answer 411

Hyaluronidase Very viscous fluid may need to be pretreated by adding one drop of 0.05% hyaluronidase in phosphate buffer per milliliter of fluid and incubating at 37°C for 5 minutes.

Question 412

Normal volume of synovial fluid: Less than 1.5 mL Less than 3.5 mL Less than 7.5 mL Less than 10.5 mL

Answer 412

Less than 3.5 mL

Question 413

A synovial fluid string measuring _____ is considered normal. 0.5 to 1 cm string 1 to 2 cm string 2 to 4 cm string 4 to 6 cm string

Answer 413

4 to 6 cm string

Question 414

ROPE'S (MUCIN CLOT) TEST: when added to a solution of 2% to5% acetic acid, normal synovial fluid forms: No clot Friable clot Soft clot Solid clot

Answer 414

Solid clot When added to a solution of 2% to 5% acetic acid, normal synovial fluid forms a solid clot surrounded by clear fluid. -- Good (solid clot) Fair (soft clot) Low (friable clot) Poor (no clot)

Question 415

Normal synovial fluid WBC count: Less than 200 cells/uL Less than 400 cells/uL Less than 1,000 cells/uL Less than 2,000 cells/uL

Answer 415

Less than 200 cells/uL RBC COUNT: LESS THAN 2,000 cells/uL WBC COUNT: LESS THAN 200 cells/uL SYNOVIAL FLUID WBC COUNT: WBC counts less than 200 cells/uL are considered normal and may reach 100,000 cells/uL or higher in severe infections.

Question 416

Joint disorder with WBC count of 800/uL: Group I, non-inflammatory Group II, inflammatory Group III, septic Group IV, hemorrhagic Normal synovial fluid WBC count

Answer 416

Group I, non-inflammatory SYNOVIAL FLUID WBC COUNT Normal: less than 200 cells/uL Noninflammatory: less than 1, 000 cells/uL Immunologic: 2,000 to 75,000 cells/uL Crystal-induced: up to 100,000 cells/uL Septic: 50,000 to 100,000 cells/uL Hemorrhagic: WBCs equal to blood

Question 417

When diluting a synovial fluid WBC count, all of the following are acceptable except: Acetic acid Isotonic saline Hypotonic saline Saline with saponin

Answer 417

Acetic acid SYNOVIAL FLUID + ACETIC ACID = CLOT FORMATION Traditional WBC diluting fluid cannot be used because it contains acetic acid that causes the formation of mucin clots. If it is necessary to lyse the RBCs, hypotonic saline (0.3%) or saline that contains saponin is a suitable diluent. Methylene blue added to the normal saline stains the WBC nuclei, permitting separation of the RBCs and WBCs during counts performed on mixed specimens.

Question 418

Vacuolated macrophage with ingested neutrophils: LE cell Ragocyte Reiter cell Rice bodies

Answer 418

Reiter cell

Question 419

Neutrophil with dark cytoplasmic granules containing immune complexes: LE cell Ragocyte Reiter cell Rice bodies

Answer 419

Ragocyte

Question 420

Synovial fluid crystals found in cases of gout: Calcium phosphate (apatite) Calcium pyrophosphate Calcium oxalate Monosodium urate

Answer 420

Monosodium urate Increased serum uric acid resulting from impaired metabolism of purines; increased consumption of high-purine-content foods, alcohol, and fructose; chemotherapy treatment of leukemias; and decreased renal excretion of uric acid are the most frequent causes of gout.

Question 421

Synovial fluid crystals found in cases of pseudogout: Calcium phosphate (apatite) Calcium pyrophosphate Calcium oxalate Monosodium urate

Answer 421

Calcium pyrophosphate Pseudogout is most often associated with degenerative arthritis, producing cartilage calcification and endocrine disorders that produce elevated serum calcium levels.

Question 422

Synovial fluid crystals found in cases of osteoarthritis: Calcium phosphate (apatite) Calcium pyrophosphate Calcium oxalate Monosodium urate

Answer 422

Calcium phosphate (apatite)

Question 423

Shape of calcium pyrophosphate crystals in synovial fluid: Envelopes Flat, variable-shaped plates Needles Rhomboid square, rods

Answer 423

Rhomboid square, rods

Question 424

Most frequently requested test in synovial fluid: Gram stain and culture Glucose Protein Uric acid

Answer 424

Glucose The most frequently requested test is the glucose determination, because markedly decreased glucose values indicate inflammatory (group II) or septic (group III) disorders.

Question 425

Required tube for synovial fluid glucose analysis: Sterile heparinized Nonanticoagulated Tube with liquid EDTA Tube with sodium fluoride

Answer 425

Tube with sodium fluoride To prevent falsely decreased values caused by glycolysis, specimens should be analyzed within 1 hour or preserved with sodium fluoride. --- Sterile heparinized or SPS: Gram stain and culture Liquid EDTA or heparin: cell counts Sodium fluoride: glucose analysis Non-anticoagulated: all other tests

Question 426

Serous fluid for pH determination must be: Maintained aerobically and incubated at 37C Maintained anaerobically and incubated at 37C Maintained aerobically in ice Maintained anaerobically in ice

Answer 426

Maintained anaerobically in ice

Question 427

Fluid: serum protein and lactic dehydrogenase ratios are performed on serous fluids: When malignancy is suspected To classify transudates and exudates To determine the type of serous fluid When a traumatic tap has occurred

Answer 427

To classify transudates and exudates Traditionally, a variety of laboratory tests have been used to differentiate between transudates and exudates, including appearance, total protein, lactic dehydrogenase, cell counts, and spontaneous clotting. However, the most reliable differentiation is usually obtained by determining the fluid: blood ratios for protein and lactic dehydrogenase.

Question 428

If the blood is from a HEMOTHORAX, the fluid hematocrit is ______ of the whole blood hematocrit. Less than 20% of the whole blood hematocrit More than 20% of the whole blood hematocrit Less than 50% of the whole blood hematcrit More than 50% of the whole blood hematocrit

Answer 428

More than 50% of the whole blood hematocrit

Question 429

These cells are increased in pleural effusions resulting from pancreatitis and pulmonary infarction: Mesothelial cells Neutrophils Lymphocytes Plasma cells

Answer 429

Neutrophils Similar to other body fluids, an increase in pleural fluid neutrophils indicates a bacterial infection, such as pneumonia. Neutrophils are also increased in effusions resulting from pancreatitis and pulmonary infarction.

Question 430

Adenosine deaminase (ADA) levels higher than 40 U/L are highly indicative of: Chylous effusion Pancreatitis Tuberculosis Rheumatoid inflammation

Answer 430

Tuberculosis ADENOSINE DEAMINASE (ADA) ADA levels higher than 40 U/L are highly indicative of tuberculosis. They are also frequently elevated with malignancy.

Question 431

The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the: Fluid:serum albumin ratio Serum ascites albumin gradient Fluid:serum lactic dehydrogenase ratio Absolute neutrophil count

Answer 431

Serum ascites albumin gradient Differentiation between ascitic fluid transudates and exudates is more difficult than for pleural and pericardial effusions. The serum-ascites albumin gradient (SAAG) is recommended over the fluid:serum total protein and LD ratios to detect transudates of hepatic origin. Fluid and serum albumin levels are measured concurrently, and the fluid albumin level is then subtracted from the serum albumin level. A difference (gradient) of 1.1 or greater suggests a transudate effusion of hepatic origin, and lower gradients are associated with exudative effusions.

Question 432

Elements containing concentric striations of collagen-like material and can be seen in benign conditions and are also associated with ovarian and thyroid malignancies: Lipophages Macrophages Mesothelial cells Psammoma bodies

Answer 432

Psammoma bodies

Question 433

Detection of the CA 125 tumor marker in peritoneal fluid indicates: Colon cancer Ovarian cancer Gastric malignancy Prostate cancer

Answer 433

Ovarian cancer The presence of CA 125 antigen with a negative CEA suggests the source is from the ovaries, fallopian tubes, or endometrium.

Question 434

The brown color of feces is due to: Urochrome Uroeythrin Urobilinogen Urobilin

Answer 434

Urobilin The brown color of the feces results from intestinal oxidation of stercobilinogen to urobilin.

Question 435

Blood that originates from the esophagus, stomach, or duodenum takes approximately ___ day(s) to appear in the stool. Approximately 1 day to appear in stool Approximately 3 days to appear in stool Approximately 7 days to appear in stool Approximately 10 days to appear in stool

Answer 435

Approximately 3 days to appear in stool

Question 436

Bulky and frothy stool: Upper GI bleeding Lower GI bleeding Barium sulfate Pancreatic disorders

Answer 436

Pancreatic disorders

Question 437

Black stool: Barium sulfate Bile duct obstruction Beets and food coloring Bismuth (antacid), iron therapy

Answer 437

Bismuth (antacid), iron therapy

Question 438

Microscopic examination reveals presence of fecal WBCs EXCEPT in diarrhea caused by: Enteroinvasive E. coli (EIEC) Salmonella, Shigella Staphylococcos aureus, Vibrio spp. Yersinia, Campylobacter

Answer 438

Staphylococcos aureus, Vibrio spp. Microscopic screening is performed as a preliminary test to determine whether diarrhea is being caused by invasive bacterial pathogens including Salmonella, Shigella, Campylobacter, Yersinia, and enteroinvasive E. coli. Bacteria that cause diarrhea by toxin production, such as Staphylococcus aureus and Vibrio spp., viruses, and parasites usually do not cause the appearance of fecal leukocytes.

Question 439

By far the most frequently performed fecal analysis is the detection of: Carbohydrates Fats Occult blood pH

Answer 439

Occult blood

Question 440

Reagent for the APT test: 1% NaOH 10% NaOH 70% ethanol 95% ethanol

Answer 440

1% NaOH APT Test (Fetal Hemoglobin) The material to be tested is emulsified in water to release hemoglobin (Hb) and, after centrifugation, 1% sodium hydroxide is added to the pink hemoglobin-containing supernatant. In the presence of alkali-resistant fetal hemoglobin, the solution remains pink (HbF), whereas denaturation of the maternal hemoglobin (HbA) produces a yellow-brown supernatant after standing for 2 minutes.

Question 441

Normal stool pH: Between pH 4 and 5 Between pH 5 and 6 Between pH 7 and 8 Between pH 8 and 9

Answer 441

Between pH 7 and 8 Normal stool pH is between 7 and 8; however, increased use of carbohydrates by intestinal bacterial fermentation increases the lactic acid level and lowers the pH to below 5.5 in cases of carbohydrate disorders.

Question 442

Which of the following is the urine specimen of choice for cytology studies? a. First morning specimen b. Random specimen c. Midstream "clean catch" collection d. Timed collection

Answer 442

B Random urine is ideal for cytology studies With prior hydration of the patient, a random "clean catch" urine specimen is ideal for cytology studies

Question 443

Which of the following can be mistaken as myelin globules in sputum? a. Blastomyces b. Cryptococcus c. Histoplasma d. Candida

Answer 443

A

Question 444

Which of the following may resemble lymphocytes in CSF? a. Blastomyces b. Cryptococcus c. Histoplasma d. Candida

Answer 444

B

Question 445

Larva in sputum: a. Ascaris b. Paragonimus c. Both of these d. None of these

Answer 445

A Paragonium = Ova Ascaris = Heart to lung migration = "ASH"

Question 446

Ova in sputum a. Ascaris b. Paragonimus c. Both of these d. None of these

Answer 446

B Paragonium = Ova Ascaris = Heart to lung migration = "ASH"

Question 447

Formed elements in sputum are best studied by which CYTOLOGICAL technique? a. Gram stain b. Giemsa stain c. Wright's stain d. Pap's stain

Answer 447

D. Stained 1. Neoplastic cells 2. Bacteria C. Leukocytes, epithelial cells Pap's stain = sputum cytology Wright's stain = differentiates neutrophils from eosinophils

Question 448

Fluid: serum protein and lactic dehydrogenase ratios are performed on serous fluids: a. When malignancy is suspected b. To classify transudates and exudates c. To determine the type of serous fluid d. When a traumatic tap has occurred

Answer 448

B

Question 449

The recommended test for determining whether PERITONEAL is a transudate or an exudate is the: a. Fluid: serum albumin ratio b. Serum: ascites albumin gradient c. Fluid: serum lactic dehydrogenase ratio d. Absolute neutrophil count

Answer 449

B

Question 450

Which type of urine sample is needed for a D-xylose absorption test on an adult patient? a. 24-hour urine sample collected with 20ml of 6N HCl b. 2-hour timed postprandial urine preserved with boric acid c. 5-hour timed urine kept under refrigeration d. Random urine preserved with formalin

Answer 450

C D-xylose test requires a blood sample taken 5 hours after oral administration of 25 grams of D -xylose, and a 5-hour time urine sample Differential diagnosis of malabsorption If <3 grams = enterogenous malabsorption because pancreatic enzymes are not required for absorption of D-xylose

Question 451

Urine SG by URINOMETER = 1.032 Urine temp = 26C Glucose = 2g/dL a. 1.022 b. 1.024 c. 1.026 d. 1.028

Answer 451

C 26C - 20C = 6C 6C/ 3C = 2 2 X 0.001 = 0.002 1.032 + 0.002 = 1.034 1.034 - [(2)(0.004)] = 1.026

Question 452

iQ 200 preclassifies (autoclassified by the analyzer) the following urine particles EXCEPT: a. Nonsquamous epithelial cells b. Unclassified casts c. Bacteria d. Uric acid crystals

Answer 452

D

Question 453

When performing a sperm concentration, 60 sperms are counted in the RBC squares on one side of the hemocytometer and 90 sperms are counted in the RBC squares on the other side. The specimen is diluted 1:20. The: a. Specimen should be rediluted and counted b. Sperm count is 75 million/ml c. Sperm count is greater than 5 million/mL d. Sperm concentration is abnormal

Answer 453

A

Question 454

Which of the following substances will cause urine to produce red fluorescence when examined with an ultraviolet lamp (360nm)? a. Myoglobin b. Porphobilinogen (PBG) c. Urobilin d. Coproporphyrin

Answer 454

D Produce red fluorescence = Uro, Copro, Proto

Question 455

Which of the following conditions is associated with normal urine color but produces red fluorescence when urine is examined with an ultraviolet (Wood's) lamp? a. Acute intermittent porphyria b. Lead poisoning c. Erythropoietic porphyria d. Porphyria cutanea tarda

Answer 455

B

Question 456

Urinary preservative that can be used for albumin

Answer 456

Boric acid

Question 457

Major organic substance in urine Major inroganic substance in urine

Answer 457

Urea Chloride

Question 458

Rotting fish odor Fruity odor Swimming pool odor Odorless

Answer 458

Trimethylaminuria (galunggong) Acetone/ Ketone Hawkinsinuria Acute tubular necrosis

Question 459

What is equivalent to 1+ grading in reagent strip for protein?

Answer 459

30mg + = 30mg ++ = 100mg +++ = 300mg ++++ = 2000 or more mg

Question 460

1. Albumin-creatinine ratio correlates with 2. To convert a bright field microscope ____ are needed 3. A bright field microscope is easily adapted for dark field microscopy by replacing the ____ with a ____ that contains an ______

Answer 460

1. Microalbumin levels 2. 2 filters 3. condenser; dark field condenser; opaque disk

Question 461

1. Simple stain used to enhance nuclear details of epithelial cells in urine 2. aka Modified Sternheimer Malbin stain; not a simple stain

Answer 461

1. Methylene Blue 2. Kova's stain

Question 462

What is the most common urinary crystal found in alkaline urine?

Answer 462

Triple phosphate/ struvite

Question 463

Emotional imbalance is related to the finding of abnormal serotonin levels. This is due to the abnormal metabolism of this essential amino acid

Answer 463

Tryptophan

Question 464

Urine samples for pregnancy testing should have a specific gravity of at least ______

Answer 464

1.015 or higher

Question 465

What is the principle of lamellar body count?

Answer 465

Platelet channel of automated hematology analyzer using either OPTICAL or IMPEDANCE method for counting

Question 466

Meninges (lines the brain and spinal cord) 1. Lines the skull and vertebral canal 2. Filamentous inner membrane 3. Lines the surface of the brain and spinal cord

Answer 466

'DAS' 1. Outer - DURA MATER 2. Spider web-like - ARACHNOID MATER 3. Inner - PIA MATER Subarachnoid space - where the CSF flows

Question 467

Agents of Bacterial Meningitis 1. Birth to 1 month 2. 1 month - 5 years 3. 5 - 24 years 4. > 24 years 5. Infant, Old, Immunocompromised

Answer 467

1. S. agalactiae 2. H. influenzae 3. N. meningitidis 4. S. pneumoniae 5. L. monocytogenes

Question 468

1. Mineral fibers encrusted with Ferroproteins seen in Asbestos 2. Most predomniant cell in BAL 3. Purpose of Histamine chemicals stimulant in gastric fluid

Answer 468

1. Ferruginous bodies 2. Macrophage 3. Induce gastric fluid secretion

Question 469

What is the purpose of flaming wired loops? A. To prevent cross contamination B. To sterilize

Answer 469

B. To sterilize It is beneficial to flame the inoculating loop between streaks to each area on the agar surface; avoids over inoculation; ensures individual colonies

Question 470

A specimen positive for Hepatitis A virus spilled. What is the proper disinfectant? a. Quaternary ammonium compound b. 90% ethanol c. Soap and water d. Hypochlorite

Answer 470

D. Hypochlorite - Fresh solution daily Routinely: 1 minute (60 secs) HBV: 10 minutes HIV: 2 minutes

Question 471

Amoeba that can survive harsh environments like chlorinated water but is killed at 70 degrees celsius (both) a. Naegleria fowleri b. Acanthamoeba

Answer 471

B. Acanthamoeba Both Naegleria and Acanthamoeba can survive hot temperatures up to 60 to 65 degrees Celsius

Question 472

Sealed bucket centrifuge containing liquid culture media should be unloaded in: a. Fume hood b. Biosafety cabinet c. Disinfected bench tops d. Standard bench tops

Answer 472

B. Biosafety cabinet

Question 473

BSC 1. 70% air is recirculated 2. No recirculation 3. Vertical Laminar flow 4. Routinely used 5. For COVID 19

Answer 473

1. Class IIA 2. Class IIB2 3. Class II 4. Class IIA 5. Class IIA+