exam 5 Flashcards by Vanessa Beltran

1.Which of the following statements about serous fluid–filled body cavities is true?
1. A parietal membrane is attached firmly to the body cavity wall.
2. Serous fluid acts as a lubricant between opposing membranes.
3. A serous membrane is composed of a single layer of flat mesothelial cells.
4. The visceral and parietal membranes of an organ are actually a single continuous membrane.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

D. All are correct

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Which of the following mechanisms is responsible for the formation of serous fluid in body cavities?
A. Ultrafiltration of circulating blood plasma
B. Selective absorption of fluid from the lymphatic system
C. Diuresis of solutes and water across a concentration gradient
D. Active secretion by mesothelial cells that line the serous membranes

A. Ultrafiltration of circulating blood plasma

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Which of the following conditions enhances the formation of serous fluid in a body cavity?
A. Increased lymphatic absorption
B. Increased capillary permeability
C. Increased plasma oncotic pressure
D. Decreased capillary hydrostatic pressure

B. Increased capillary permeability

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The pathologic accumulation of fluid in a body cavity is called
A. an abscess.
B. an effusion.
C. pleocytosis.
D. paracentesis.

B. an effusion

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5.Paracentesis and serous fluid testing are performed to
1. remove serous fluids that may be compressing a vital organ.
2. determine thepathologic cause of an effusion.
3. identify an effusion as a transudate or an exudate.
4. prevent volume depletion caused by the accumulation of fluid in body cavities.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

A. 1, 2, and 3 are correct

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Thoracentesis refers specifically to the removal of fluid from the
A. abdominal cavity.
B. pericardial cavity.
C. peritoneal cavity.
D. pleural cavity.

D. pleural cavity

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Which of the following tubes could be used for a bacterial culture of serous fluid?
A. EDTA
B. Sodium citrate
C. Sodium fluoride
D. Sodium heparin

D. Sodium hepariN

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8.Serous fluid for bacterial culture should be stored at
A. −20°C.
B. 2°C to 8°C.
C. 20°C to 24°C.
D. 36°C to 38°C.

C. 20°C to 24°C.

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Which of the following parameters best identifies a fluid as a transudate or an exudate?
A. Color and clarity
B. Leukocyte and differential counts
C. Total protein and specific gravity measurements
D. Total protein ratio and lactate dehydrogenase ratio

D. Total protein ratio and lactate dehydrogenase ratio

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Chylous and pseudochylous effusions are differentiated by their
A. physical examinations.
B. cholesterol concentrations.
C. triglyceride concentrations.
D. leukocyte and differential counts.

C. triglyceride concentrations

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Which of the following conditions is most often associated with the formation of a transudate?
A. Pancreatitis
B. Surgical procedures
C. Congestive heart failure
D. Metastatic neoplasm

C. Congestive heart failure

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12.Match the type of serous effusion most often associated with each pathologic condition.
Pathologic Condition
Type of Serous
Effusion
__ A. Neoplasms
__ B. Hepatic cirrhosis
__ C. Infection
__ D. Rheumatoid arthritis
__ E. Trauma
__ F. Nephrotic syndrome
TYPE OF serous effusion
1. exudate
2. transducate

a. 1
b. 2
c. 1
d. 1
e.1
f.2

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Which of the following features is not a characteristic of malignant cells?
A. Irregular nuclear membrane
B. Uneven nuclear chromatin distribution
C. Less than normal nucleus-to-cytoplasm ratio
D. Multiple prominent nucleoli with irregular borders

C. Less than normal nucleus-to-cytoplasm ratio

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Which of the following laboratory findings on an effusion does not indicate a specific diagnosis?
A. Lupus erythematosus cells found during the microscopic examination
B. A serous fluid glucose concentration less than 60 mg/dL
C. Microorganisms identified by Gram or acid-fast stain
D. Malignant cells identified during the microscopic or cytologic examination

B. A serous fluid glucose concentration less than
60 mg/dL

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An abnormally low fluid pH value is useful when evaluating conditions associated with
A. pleural effusions.
B. pleural and pericardial effusions.
C. pericardial and peritoneal effusions.
D. pleural, pericardial, and peritoneal effusions

A. pleural effusions

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A pleural or peritoneal fluid amylase level two times higher than the serum amylase level can be found in effusions resulting from
A. pancreatitis.
B. hepatic cirrhosis.
C. rheumatoid arthritis.
D. lymphatic obstruction.

A. pancreatitis

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A glucose concentration difference greater than 30 mg/
dL between the serum and an effusion is associated with
A. pancreatitis.
B. hepatic cirrhosis.
C. rheumatoid arthritis.
D. lymphatic obstruction.

C. rheumatoid arthritis

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Which of the following actions can adversely affect the
chances of obtaining a positive stain or culture when performing
microbiological studies on infectious serous fluid?
A. Using a large volume of serous fluid for the inoculum
B. Storing serous fluid specimens at refrigerator temperatures
C. Using an anticoagulant in the serous fluid collection container
D. Concentrating the serous fluid before preparing smears for staining

B. Storing serous fluid specimens at refrigerator temperatures

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1.Which of the following tasks is a function of synovial fluid?
1. Providing lubrication for a joint
2. Assisting in the structural support of a joint
3. Transporting nutrients to articular cartilage
4. Synthesizing hyaluronate and degradative enzymes
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

B. 1 and 3 are correct.

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Which of the following statements is a characteristic of normal synovial fluid?
A. Synovial fluid is viscous.
B. Synovial fluid is slightly turbid.
C. Synovial fluid is dark yellow.
D. Synovial fluid forms small clots on standing.

A. Synovial fluid is viscous

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Which of the following components is not normally present in synovial fluid?
A. Fibrinogen
B. Neutrophils
C. Protein
D. Uric acid

A. Fibrinogen

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Which of the following substances will not increase the turbidity of synovial fluid?
A. Fat
B. Crystals
C. Hyaluronate
D. White blood cells

C. Hyaluronate

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Abnormally decreased viscosity in synovial fluid results from
A. mucin degradation by leukocytic lysosomes.
B. overproduction of synovial fluid by synoviocytes.
C. autoimmune response of synoviocytes in joint disease.
D. depolymerization of hyaluronate by neutrophilic enzymes

D. depolymerization of hyaluronate by neutrophilic
enzymes.

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A synovial fluid specimen is received in the laboratory 2 hours after collection. Which of the following changes to the fluid will most likely have taken place?
A. The specimen will have clotted.
B. The uric acid concentration will have decreased.
C. Crystals may have precipitated or dissolved.
D. The lactate concentration will have decreased because of anaerobic glycolysis.

C. Crystals may have precipitated or dissolved.

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7. Which of the following anticoagulants does not have the potential to precipitate out in crystalline form when used for synovial fluid specimens? A. Sodium citrate B. Sodium heparin C. Lithium heparin D. Potassium oxalate

B. Sodium heparin

8. A synovial fluid specimen has a high cell count and requires dilution to be counted. Which of the following diluents should be used? A. Normal saline B. Dilute acetic acid (2%) C. Dilute methanol (1%) D. Phosphate buffer solution (0.050 mol/L)

A. Normal saline

9. Which of the following results from synovial fluid analysis indicates a joint disease process? A. A few synoviocytes present in the fluid B. A white blood cell count lower than 200 cells/μL C. A red blood cell count lower than 2000 cells/μL D. A differential count showing greater than 25% neutrophils

D. A differential count showing greater than 25% neutrophils

10. Differentiation of synovial fluid crystals, based on their birefringence, is achieved using A. transmission electron microscopy. B. phase-contrast microscopy. C. direct polarizing microscopy. D. compensated polarizing microscopy

D. compensated polarizing microscopy

11.The microscopic examination of synovial fluid for crystals can be difficult because 1. numerous artifacts are also birefringent. 2. few crystals may be present. 3. free-floating crystals can become enmeshed or hidden in fibrin. 4. different crystals can closely resemble each other morphologically. A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct.

D. All are correct

12. Which of the following crystals characteristically occurs in patients with gout? A. Cholesterol crystals B. Hydroxyapatite crystals C. Monosodium urate crystals D. Calcium pyrophosphate dihydrate crystals

C. Monosodium urate crystals

13. In synovial fluid, which of the following crystals is not birefringent? A. Cholesterol crystals B. Hydroxyapatite crystals C. Monosodium urate crystals D. Calcium pyrophosphate dihydrate crystals

B. Hydroxyapatite crystals

14.Assuming that a patient is fasting, which of the following analytes is normally present in the synovial fluid in essentially the same concentration as in the blood plasma? 1. Glucose 2. Lactate 3. Uric acid 4. Protein A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct

B. 1 and 3 are correct.

15. Which of the following findings provides a definitive diagnosis of a specific joint condition? A. Staphylococcal bacteria identified by Gram stain B. Corticosteroid crystals identified during the microscopic examination C. A plasma–synovial fluid glucose difference exceeding 20 mg/dL D. Greater than 25 white blood cells/μL observed during the microscopic examination

A. Staphylococcal bacteria identified by Gram stain

16. Analysis of a synovial fluid specimen reveals the following: * Cloudy, yellow-green fluid of low viscosity * Total leukocyte count of 98,000 cells/μL * Plasma–synovial fluid glucose difference of 47 mg/dL Based on the information provided and Table 11.2, this specimen most likely would be classified as A. noninflammatory. B. inflammatory. C. septic. D. hemorrhagic.

C. septic.

17. An analysis of a synovial fluid specimen reveals the following: * Yellow fluid of high viscosity * Total leukocyte count of 300 cells/μL * Plasma–synovial fluid glucose difference of 17 mg/dL Based on the information provided and Table 11.2, this specimen would most likely be classified as A. noninflammatory. B. inflammatory. C. septic. D. hemorrhagic

A. noninflammatory.

1. Seminal fluid analysis is routinely performed to evaluate which of the following? A. Prostate cancer B. Postvasectomy status C. Penile implant status D. Premature ejaculation

B. Postvasectomy status

2.Which of the following structures contribute(s) secretions to semen? 1. Epididymis 2. Prostate gland 3. Seminal vesicles 4. Seminiferous tubules A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct

D. All are correct

3. Which of the following structures performs an endocrine and an exocrine function? A. Testes B. Epididymis C. Prostate gland D. Seminal vesicles

A. Testes

4. The primary function of semen is to A. nourish the spermatozoa. B. coagulate the ejaculate. C. transport the spermatozoa. D. stimulate sperm maturation

C. transport the spermatozoa.

6. Which of the following is a requirement when collecting semen specimens? A. The patient should abstain from sexual intercourse for at least 2 days after the collection. B. Only complete collections of the entire ejaculate are acceptable for analysis. C. A single semen specimen is sufficient for the evaluation of male fertility. D. Semen specimens must be evaluated within 3 hours after collection.

B. Only complete collections of the entire ejaculate are acceptable for analysis

7. Which of the following conditions adversely affects the quality of a semen specimen? A. The use of silastic condoms B. The time of day the collection is obtained C. The collection of the specimen in a glass container D. The storage of the specimen at refrigerator temperatures

D. The storage of the specimen at refrigerator temperatures

8. Which of the following statements regarding semen is true? A. Semen usually coagulates within 30 minutes after ejaculation. B. For semen to liquefy before 60 minutes is abnormal. C. After liquefaction, the viscosity of normal semen is similar to that of water. D. After liquefaction, the presence of particulate matter is highly indicative of a bacterial infection.

C. After liquefaction, the viscosity of normal semen is similar to that of water

9. Which of the following statements regarding the manual evaluation of sperm motility is not true? A. Sperm motility most often is graded subjectively. B. Sperm motility is affected adversely by temperature. C. Sperm motility assesses speed and forward progression. D. Sperm motility should be evaluated initially and at 2 hours after collection.

D. Sperm motility should be evaluated initially and at 2 hours after collection

10. Which of the following statements regarding sperm concentration is true? A. Sperm concentration within a single individual is usually constant. B. Sperm concentration depends solely on the period of abstinence. C. In a normal ejaculate, sperm concentration ranges from 20 million to 250 million per mL. D. For fertility purposes, sperm concentration is more important than sperm motility

C. In a normal ejaculate, sperm concentration ranges from 20 million to 250 million per mL.

11. Which of the following statements regarding sperm morphology is true? A. Sperm morphology is usually evaluated using a peroxidase stain. B. Stained smears of fresh semen can be used to evaluate sperm morphology. C. Sperm morphology is evaluated using ×400 (highpower) magnification. D. Normal semen contains at least 80% sperm with normal morphology.

B. Stained smears of fresh semen can be used to evaluate sperm morphology

12. Which of the following parameters directly relates to and provides a check of the sperm motility evaluation? A. Agglutination evaluation B. Concentration determination C. Morphology assessment D. Vitality assessment

D. Vitality assessment

13. Microscopically, immature spermatogenic cells are often difficult to distinguish from A. bacteria. B. erythrocytes. C. leukocytes. D. epithelial cells.

C. leukocytes

14. A semen pH greater than 7.8 is associated with A. premature ejaculation. B. obstruction of the vas deferens. C. abnormal seminal vesicle function. D. infection of the male reproductive tract

D. infection of the male reproductive tract

15.Fructose in semen assists in the evaluation of which of the following? 1. The secretory function of the seminal vesicles 2. The functional integrity of the epididymis 3. The functional integrity of the vas deferens 4. The secretory function of the prostate gland A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct.

B. 1 and 3 are correct.

16. Which of the following substances can be used to evaluate the secretory function of the prostate gland? A. Carnitine B. Fructose C. pH D. Zinc

D. Zinc

17. The concentration of which of the following substances can be used to positively identify a fluid as seminal fluid? A. Acid phosphatase B. Citric acid C. Fructose D. Zinc

A. Acid phosphatase

1. Which of the following devices should be used to collect a sample of vaginal secretions? A. Cervical brush on a Teflon shaft B. Cotton-tipped swab on a wooden shaft C. Polyester-tipped swab on a plastic shaft D. Wool-tipped swab on a wooden shaft

C. Polyester-tipped swab on a plastic shaft

2. Which of the following organisms is adversely affected if a vaginal secretion specimen is refrigerated? A. Chlamydia trachomatis B. Candida albicans C. Gardnerella vaginalis D. Trichomonas vaginalis

D. Trichomonas vaginalis

3. Which range of pH values is associated with secretions from a healthy vagina? A. 3.8 to 4.5 B. 4.5 to 5.8 C. 5.8 to 6.5 D. 7.0 to 7.4

A. 3.8 to 4.5

4. Which of the following elements is considered abnormal when present in vaginal secretions? A. Bacteria B. Pseudohyphae C. Yeast D. White blood cells

B. Pseudohyphae

5. Which of the following organisms and substances is responsible for the normal pH of the vagina? A. Gardnerella vaginalis and its metabolic byproduct succinic acid B. Lactobacilli spp. and their metabolic byproduct lactic acid C. Mobiluncus spp. and their metabolic byproduct acetic acid D. Prevotella spp. and their metabolic byproduct phenylacetic acid

B. Lactobacilli spp. and their metabolic byproduct lactic acid

6. Which of the following statements best describes a clue cell? A. Degenerating squamous epithelial cells with distinctive keratohyalin granulation B. Budding yeast (e.g., blastoconidia) with small coccobacilli adhering to their surfaces C. Squamous epithelial cells with numerous bacteria adhering to their outer cell membranes D. White blood cells with numerous bacteria completely covering them such that they appear as floating spherical orbs of bacteria

C. Squamous epithelial cells with numerous bacteria adhering to their outer cell membranes

7. Which of the following vaginal secretion results correlate with health? A. pH 3.9; white blood cells, 3 + B. pH 4.2; white blood cells, 1 + C. pH 4.8; white blood cells, rare D. pH 5.5; white blood cells, 2 +

B. pH 4.2; white blood cells, 1 +

8. Which of the following statements best describes the microbial flora of a healthy vagina? A. Large Gram-positive rods predominate. B. Large Gram-positive cocci predominate. C. Small Gram-negative rods predominate. D. Small Gram-variable coccobacilli predominate

A. Large Gram-positive rods predominate

9. Which of the following tests is most helpful in differentiating red blood cells from yeast in vaginal secretions? A. pH B. Amine test C. Wet mount examination D. KOH preparation and examination

D. KOH preparation and examination

10. Which of the following vaginal secretion findings is most diagnostic for bacterial vaginosis? A. pH 5.0 B. Clue cells C. Pseudohyphae D. Parabasal cells

B. Clue cells

11. Which of the following substances is responsible for the foul, fishy odor obtained when the “whiff ” test is performed on vaginal secretions? A. Lactic acid B. Polyamine C. Trimethylamine D. Hydrogen peroxide

C. Trimethylamine

12. Select the condition that correlates best with the following vaginal secretion results: pH: 5.9 Amine test: positive KOH examination: negative Wet mount examination: bacteria, mixed bacterial flora White blood cells: 4 + A. Normal, indicating a healthy vagina B. Bacterial vaginosis C. Candidiasis D. Trichomoniasis

D. Trichomoniasis

13. Select the condition that correlates best with the following vaginal secretion results: pH: 4.6 Amine test: negative KOH examination: negative Wet mount examination: bacteria, large rods predominate White blood cells: 1 + A. Normal, indicating a healthy vagina B. Bacterial vaginosis C. Candidiasis D. Trichomoniasis

A. Normal, indicating a healthy vagina

14. Which of the following proteins is used as a marker of rupture of membranes in pregnant women? A. Fetal fibrinogen B. Fetal fibronectin C. Alpha-1 microglobulin D. Placental alpha microglobulin-1

D. Placental alpha microglobulin-1

15. Scenario: A pregnant woman of 30 weeks’ gestation complains of low back pain and occasional abdominal cramping. Which of the following tests is indicated and why? A. Fetal fibronectin test to determine whether membranes are ruptured B. Fetal fibronectin test to determine whether at risk of preterm delivery C. Placental alpha microglobulin-1 test to determine whether at risk of preterm delivery D. Placental alpha microglobulin-1 test to determine whether membranes are ruptured

C. Placental alpha microglobulin-1 test to determine whether at risk of preterm delivery