LEC Flashcards
1
Q
For an accurate evaluation of CSFf glucose, a blood
glucose test must be run for comparison. When
should the medical technologist draw blood for
glucose determination?
o 1 hr before lumbar tap
o 1 hr after lumbar tap
o 2 hrs after lumbar tap
o 2 hrs before lumbar tap
A
o 2 hrs before lumbar tap
2
Q
What is the preferred method of collection for
cerebrospinal fluid?
o Thoracentesis
o Amniocentesis
o Lumbar tap
o Paracentesis
A
o Lumbar tap
3
Q
Sister Theresa, an old lady had several episodes of
unbearable headaches after surviving a terrible fall.
Recently, her physician requested for CSF analysis.
Her laboratory results showed:
Total CSF Protein: 30 g/dL
CSF Lactate: 27 mg/dL
Predominant cell in differential count: macrophages
with remnants of RBCs Based on the laboratory
results and history of patient, what specific disorder
does patient Theresa have?
o Bacterial meningitis
o St. Theresa is normal, her protein and lactate
levels are within range
o Intracranial hemorrhage
o Tubercular meningitis
A
o Intracranial hemorrhage
4
Q
As the medtech on duty, you have observed the
following characteristics of red CSFf sample from a
patient:
I. Concentration of blood in tube 1 is greater than in
tube 3 after collection
II. Presence of clots in the sample
III. Presence of intact RBCs
o Traumatic tap
o Japanese encephalitis
o Intracranial hemorrhage
o Cysticercosis
A
o Traumatic tap
5
Q
A lumbar puncture should not be performed on
patients with _______
o Encephalitis and meningitis
o Inflammation over or near the puncture site
o Dementia
o Multiple sclerosis
A
o Inflammation over or near the puncture site
6
Q
Increased CSF glutamine is commonly associated
with what disease?
o Hepatitis
o Multiple myeloma
o Reye syndrome
o Bacterial infection
A
o Reye syndrome
7
Q
- All of the following can cause xanthochromia in CSF
except?
o Increased numbers of white blood cells
o Erythrocytes from severe head injuries
o Increased serum levels of carotene
o Elevated serum levels of bilirubin
A
o Increased numbers of white blood cells
8
Q
- What protein is only seen in CSF and not in serum?
o Carbohydrate-deficient transferrin
o Tau protein
o Both A and B
o NOTA
A
o Both A and B
9
Q
This disorder of the CNS is characterized by the
presence of oligoclonal bands in CSF protein
electrophoresis, increased IgG index and presence
of myelin basic protein in CSF
o Medulloblastoma
o Multiple sclerosis
o Panencephalitis
o Viral meningitis
A
o Multiple sclerosis
10
Q
Dr. Subong requested an India Ink preparation and
latex agglutination tests to the CSF of her patient
with unknown cause of meningitis. The results
obtained were both positive in the two tests. What
could be the possible pathogen?
o Taenia saginata
o Naegleria fowleri
o Cryptococcus neoformans
o Neisseria meningitidis
A
o Cryptococcus neoformans
11
Q
How is the cerebrospinal fluid produced?
o Ultrafiltration of plasma in the 3rd and 4th ventricles of the brain
o Diffusion of plasma into the CNS
o Degradation of ependymal cells lining the brain
and spinal cord
o Secretion by the choroid plexuses
A
o Ultrafiltration of plasma in the 3rd and 4th ventricles of the brain
12
Q
- These cells are believed to be the producers of
Immunoglobulin G. They are present in the CSF if
the patient has multiple sclerosis. What are these
cells?
o Spindle-shaped cells
o Lymphoblasts
o Erythrophagocytizing macrophages
o Plasmacytes
A
o Plasmacytes
13
Q
Which of the following body fluids supplies
nutrients to the nervous tissue, removes metabolic
wastes, produces mechanical barriers to cushion the
brain and spinal cord against trauma?
o Amniotic fluid
o Cerebrospinal fluid
o Synovial fluid
o Peritoneal fluid
A
o Cerebrospinal fluid
14
Q
Increased presence of lymphocytes and monocytes
is CSF is called what?
o Pleocytosis
o Xanthochromia
o Pellicle formation
o Pyknosis
A
o Pleocytosis
15
Q
What is the appearance of a normal cerebrospinal
fluid?
o Bloody
o Milky
o Xanthochromic
o Crystal clear
A
o Crystal clear
16
Q
Hematoidin-laden macrophages present in CSF
could indicate what condition?
o Metastatic carcinoma
o Viral meningitis
o Multiple sclerosis
o Intracranial hemorrhage
A
o Intracranial hemorrhage
17
Q
What is the most frequently performed chemical
test in CSF?
o Glucose
o Lactate
o Protein
o Glutamine
A
o Protein
18
Q
What is the reference value for CSF lactate?
o 10-24 g/dL
o 15-45 mg/dL
o 8018 mg/dL
o 10-24 mg/dL
A
o 10-24 mg/dL
19
Q
Serologic procedures performed in CSF like VDRL
and FTA-Abs is useful in diagnosis of what disease?
o Multiple sclerosis
o Guillain-barre syndrome
o Neurosyphilis
o Reye syndrome
A
o Neurosyphilis
20
Q
After a successful lumbar puncture, what
department is tube labeled 1 routinely sent to?
o Microbiology
o Histopathology
o Chemistry
o Hematology
A
o Chemistry
21
Q
The concentration of which of the following
substances can be sued to positively identify the
presence of seminal fluid, particularly in forensic
cases?
o Acid phosphatase
o Citric acid
o Fructose
o Choline
A
o Acid phosphatase
22
Q
- Spermatogenesis occurs in the seminiferous tubules
but where does development of flagella takes
place?
o Ejaculatory duct
o Prostate gland
o Bulbourethral glands
o Epididymis
A
o Epididymis
23
Q
Sperm motility evaluation is routinely performed
when?
o Immediately after the semen is collected
o At 6 hour intervals for 1 day
o After 3 hrs of incubation
o Within 1hr of collection
A
o Within 1hr of collection
24
Q
Sperm cells which exhibit slow speed and some
lateral movement are graded as ______
o 4.0
o 1.0
o 3.0
o 2.0
A
o 3.0
25
What is the purpose of addition of proteolytic
enzymes (alpha-chymotrypsin and bromelain) to
semen that has not yet liquefied after two hours?
o Increase the viscosity
o Stain the sperm cells
o Neutralize the specimen
o Decrease the viscosity
o Decrease the viscosity
26
What are the physical characteristics of normal
semen?
o Grayish white color, translucent, musty odor
o Grayish-white color, translucent, sweet odor
o Yellowish, transparent, musky odor
o Reddish, opaque, sweaty feet odor
o Grayish white color, translucent, musty odor
27
7. Semen analysis is routinely performed and plays an
important role in all of the following except?
o Diagnosis of prostate cancer
o Forensic studies of rape cases
o Evaluation of effectiveness of vasectomy
o Establishment of cause of infertility
o Diagnosis of prostate cancer
28
Which of the following is not a requirement when
collecting semen specimens?
o Specimen must be collected in a clean, dry,
wide-mouth plastic containers
o The entire ejaculate must be completely
collected
o The patient should abstain from sexual activity
for at least 2 days after the collection
o Specimen must be maintained near body
temperature during transport
o The patient should abstain from sexual activity
for at least 2 days after the collection
29
What do spermatozoa metabolize for the energy
needed for flagella to propel along the female
reproductive system?
o Glucose
o Hyaluronic acid
o Fructose
o Flavin
o Fructose
30
Calculate the total sperm count given the following
information
o 35 million sperms/mL
o 2.5 million sperms/mL
o 140 million sperms/mL
o 37 million sperms/mL
o 140 million sperms/mL
31
A physician requested a test for sperm viability.
What must the medical technologist do to assess
sperm vitality?
o Make a smear in the slide and stain with
o Papanicolaus’’s or Giemsa’s stain
o Place a drop of semen in the slide and cover it
with coverslip
o Stain it with equal amount of eosin-nigrosin
stain
o Add diluting fluid and charge it in a Neubauer
counting chamber
o Stain it with equal amount of eosin-nigrosin
stain
32
Which of the following structures produces most of
the fluid found in semen?
o Bulbourethral glands
o Seminal vesicles
o Prostate gland
o Epididymis
o Seminal vesicles
33
13. What is the primary purpose of diluting a semen
specimen using cold distilled water or 1% formalin
before performing sperm concentration?
o Neutralize the specimen
o Immobilize the sperm cells
o Decrease the viscosity of semen
o Enhance visualization of sperm
o Immobilize the sperm cells
34
If immediate analysis of semen is unavailable, how
does one preserve the semen awaiting
examination?
o Refrigerate it
o Store it at RT (22-27 deg C)
o Keep it at 37 deg C
o Store it at -85 deg C
o Keep it at 37 deg C
35
Which of the following is the function of acrosomal
cap at the tip of sperm’s head?
o Organelle for locomotion
o Contains enzymes for ovum penetration
o Contains DNA
o Contains the mitochondria for energy
production
o Contains enzymes for ovum penetration
36
What is the pH of a normal seminal fluid?
o 5.0-6.0
o 4.5-8.0
o 3.8-4.2
o 7.2-8.0
o 7.2-8.0
37
A semen specimen delivered to the laboratory in a
condom has normal sperm count and markedly
decreased sperm motility. This is indicative of
o Lack of oxygen in condom
o Decreased fructose
o Antispermicide in condom
o Semen is too alkaline
o Decreased fructose
38
All of the following describes abnormal sperm cell
morphology except?
o Oval-shaped head
o Amorphous head
o Double tail
o Long neckpiece
o Oval-shaped head
39
What is the best method for semen collection?
o Coitus interruptus
o Usage of ordinary condoms
o Scraping from vaginal vault
o Masturbation
o Masturbation
40
What stain is used to differentiate living from
nonliving sperm cells?
o Wright’s stain
o Giemsa stain
o Hansel stain
o Eosin-Nigrosin stain
o Eosin-Nigrosin stain
41
Presence of needle-like crystals called monosodium
urates in synovial fluid could indicate what disease?
o Osteoarthritis
o Pseudogout
o Gout
o Renal dialysis
o Gout
42
What is the normal viscosity of synovial fluid?
o Forms a string measuring 4-6 cm
o Pours in droplets
o Forms a solid clot
o NOTA
o Forms a string measuring 4-6 cm
43
Which of the following correctly describes a Reiter
cell?
o Vacuolated macrophage with ingested
neutrophils
o Neutrophils with dark cytoplasmic granules
o Lymphocytes with cleft nuclei
o Large multinucleated cells
o Vacuolated macrophage with ingested
neutrophils
44
Which of the following procedures is performed to
collect synovial or joint fluid?
o Thoracentesis
o Arthrocentesis
o Amniocentesis
o Paracentesis
o Arthrocentesis
45
What is the best anticoagulant for bacterial culture
of synovial fluid?
o Sodium polyanethol sulfonate
o Heparin
o Liquid EDTA
o Sodium fluoride
o Sodium polyanethol sulfonate
46
Before testing, very viscous synovial fluid should be
pretreated first with?
o Normal saline solution
o 0.05% hyaluronidase in phosphate buffer
o 0.5% hyaluronidase in phosphate buffer
o 0.05% hyaluronidase
o 0.05% hyaluronidase in phosphate buffer
47
In a serological test, what antibodies will be
demonstrated by a patient with arthritis due to
Lyme disease?
o Borrelia burdorferi antibodies
o Antibodies against synovial membrane
o Treponema pallidum antibodies
o Anti-nuclear antibodies
o Borrelia burdorferi antibodies
48
Which of the following crystals has the ability to
polarize light?
o Corticosteroid
o Calcium oxalate
o Calcium pyrophosphate
o AOTA
o AOTA
49
All of the following refers to correct procedure of
Ropes test except?
o 1% Acetic Acid is routinely used
o Not routinely performed
o Reporting of “low” signifies friable clot
o Normal synovial fluid
o Forms a solid clot
o 1% Acetic Acid is routinely used
50
Why must we avoid using powdered anticoagulants
for synovial fluid analysis?
o Distorts WBCs and RBCs
o Too expensive
o Lowers glucose levels
o Produces artifacts which interferes with
crystals
o Produces artifacts which interferes with
crystals
51
A 52-year-old man has painful swelling in both
knees. He is hospitalized and an arthrocentesis is
scheduled for the following morning. In the
morning, a fasting blood sugar is drawn for routine
chemistry tests. Synovial fluid is aspired from the
left knee and submitted to the laboratory.
Blood Chemistry Results:
Appearance: Cloudy, yellow
Viscosity: low
Microscopic analysis: many intracellular
needle-shaped crystals with negative birefringence
(yellow)
Glucose: 55 mg/dL
Uric acid: 12.4 mg/dL
Gram stain: negative
The above results are most consistent with a
diagnosis of which of the following disorders?
o Gouty arthritis
o Traumatic arthritis
o Pseudogout
o Rheumatoid arthritis
o Gouty arthritis
52
When dispersing synovial fluid from a syringe, a
short (<5 cm) or no string is formed. Which of the
following conditions is indicated?
o Presence of an inflammatory process
o Presence of mesothelial cell
o Fibrinogen levels are low
o Traumatic collection
o Traumatic collection
53
All of the following findings are indicative of a septic
joint disorder except?
o Yellow-green color
o Neutrophils >75% of total WBC count
o Decreased glucose concentration
o WBC count is around 20,000-50,000/uL
o WBC count is around 20,000-50,000/uL
54
Which of the following chemical tests is most
frequently performed on synovial fluid?
o Total protein
o Glucose
o Antibodies against Treponema pallidum
o Bacterial culture
o Glucose
55
Which of the following provides diagnosis of a
specific joint condition?
o Crystals appearing as plates seen under the
microscope
o Plasma:synovial fluid glucose difference
exceeding 20 mg/dL
o Staphylococcal bacteria identified by Gram
stain and bacterial culture
o Greater than 25 leukocytes per uL observed
during microscopic examination
o Staphylococcal bacteria identified by Gram
stain and bacterial culture
56
During cell count, a medical technologist noticed
that the WBC count is less than 200 WBCs/uL. What
counting procedure must he apply using a Neubauer
counting chamber?
o Count the large middle square only
o Count the 5 small squares used in RBC count
o Count the 4 large corner squares
o Count all 9 large squares
o Count all 9 large squares
57
17. All of the following are causes of inflammatory joint
disorder except?
o Pseudogout
o Scleroderma
o Rheumatoid arthritis
o Osteoarthritis
o Osteoarthritis
58
What is this chronic autoimmune disorder that
primarily attacks joints, causing synovitis and
destroys the articular cartilage of the bones?
o Septic arthritis
o Rheumatoid arthritis
o Lupus erythematosus
o Pseudogout
o Rheumatoid arthritis
59
What viscous fluid is found in the cavities of
movable joints?
o CSF
o Ascites
o Synovial fluid
o Pericardial fluid
o Synovial fluid
60
Why do we avoid using glacial acetic acid as diluent
when performing cell counts for synovial fluid?
o Causes the fluid to clot
o Leaves a precipitate that can be mistaken for
crystals
o Distorts WBC morphology
o Not good in lysing crenated RBCs
o Causes the fluid to clot
61
This kind of effusion has a milky appearance with
greenish tinge. Mixed cells are seen in its differential
counting. In microscopic examination, this effusion
exhibits presence of cholesterol crystals
o Chylous effusion
o Exudative effusion
o Pseudochylous effusion
o Transudative effusion
o Pseudochylous effusion
62
Black pleural fluid is alarming as this could be
indicative of what condition?
o Mesothelioma
o Rupture of amebic liver abscess
o Thoracic duct leakage
o Aspergillus infection
o Aspergillus infection
63
A 32-year old man has pleural effusion. Blood is
drawn and a pleural fluid specimen is obtained by
thoracentesis and sent to the laboratory for
evaluation.
The following results were obtained:
Physical examination: milky
Microscopic examination: predominant
lymphocytes in differential counting; no organisms
seen on Gram stain
Chemical examination: fluid:serum cholesterol ratio
0.39; fluid:serum bilirubin ration 0.76
Based on the results, this pleural fluid specimen is
classified as:
o Invalid
o Transudate
o Exudate
o Secret
o Exudate
64
Which of the following conditions is most often
associated with the formation of the transudate?
o Congestive heart failure
o Systemic lupus erythematosus
o Tuberculosis
o Metastatic neoplasm
o Congestive heart failure
65
Detection of tumor marker CA 125 may signify
what?
o Pancreatic cancer
o Metastatic uterine cancer
o Lung cancer
o Breast cancer
o Metastatic uterine cancer
66
Which of the following terms is another name for
peritoneal effusion?
o Ascites
o Lavage
o Peritonitis
o Pleocytosis
o Ascites
67
A WBC count of >1000 WBCs/uL and dominance of
neutrophil in a pericardial fluid signifies what?
o Appendicitis
o Asbestos contact
o Bacterial endocarditis
o Pericardial tumor
o Bacterial endocarditis
68
Which of the following conditions enhances the
formation of serous fluid in a body cavity?
o Decrease capillary hydrostatic pressure
o Increased plasma oncotic pressure
o Increased lymphatic absorption
o Increased capillary permeability
o Increased plasma oncotic pressure
69
Elevated level of adenosine deaminase in pleural
fluid suggests what disease?
o Esophageal rupture
o Pneumonia
o Tuberculosis
o Pancreatitis
o Tuberculosis
70
An effusion with milky white appearance is strongly
associated with?
o RBCs
o Hemothorax
o TAGS and cholesterol
o Diarrhea
o TAGS and cholesterol
71
Pleural fluid pH lower than 6.0 indicates what
condition?
o Esophageal rupture
o Intestinal perforation
o Chest tube drainage
o Pimples
o Esophageal rupture
72
What is the membrane that covers the organs
within the cavity?
o Parietal membrane
o Chorionic membrane
o Ventricular membrane
o Visceral membrane
o Visceral membrane
73
What is the normal amount of pericardial fluid
between the pericardial serous membranes?
o 1-10 mL
o >100 mL
o 10-50 mL
o 10-20 mL
o 10-50 mL
74
14. Which of the following includes all other in the list?
o Pleural fluid
o Serous fluid
o Pericardial fluid
o Peritoneal fluid
o Serous fluid
75
Which of the following pairs of fluid and collection
process is correctly matched?
o Pleural fluid – pleuracentesis
o Pericardial fluid – thoracentesis
o Peritoneal fluid – peritoneocentesis
o Ascites – paracentesis
o Ascites – paracentesis
76
16. Which of the following best describes a
hemothorax?
o Blood Hct: 30; Pleural fluid Hct: 20
o Blood Hct: 42; Pleural fluid Hct: 15
o Blood Hct: 30; Pleural fluid Hct: 10
o Blood Hct: 30; Pleural fluid Hct: 15
o Blood Hct: 30; Pleural fluid Hct: 20
77
A 60-year old woman has peritoneal effusion. Blood
is drawn and a peritoneal fluid specimen is obtained
by paracentesis and sent to the laboratory or
evaluation.
The following results were obtained:
Physical examination: clear, pale yellow fluid with no
clots present
Microscopic examination: 8 WBC/uL; no malignant
cells seen; no organisms seen on Gram stain
Chemical examination: serum albumin – 2.8 g/dL;
fluid albumin – 1.0 g/dL
Based on the results, this peritoneal fluid specimen
is classified as:
o Exudate
o Transudate
o Invalid
o Secret
o Transudate
78
Which of the following conditions is most often
associated with the formation of exudate?
o Nephrotic syndrome
o Congestive heart failure
o Hepatic cirrhosis
o Neoplasms
o Neoplasms
79
19. All of the following description fits an exudate
except?
o Cloudy appearance
o Fluid serum protein ratio >0.5
o Fluid:serum LD ratio <0.6
o Possible clotting
o Fluid:serum LD ratio <0.6
80
Pathologic accumulation of serous fluid in a body
cavity is called _______
o Transudate
o Exudate
o Pleocytosis
o Effusion
o Effusion
81
Polyhydraminos is characterized by?
o Amniotic fluid > 1200 mL
o Amniotic fluid < 1200 mL
o Amniotic fluid > 1500mL
o Amniotic fluid <800 mL
o Amniotic fluid > 1200 m
82
A spike in 450 nm was observed after an amniotic
fluid is subjected to spectrophotometry. What does
it indicate?
o Fetus is normal
o Fetus is suffering from HDN
o Fetus has decreased bilirubin in his circulation
o Increased meconium
o Fetus is suffering from HDN
83
In the determination of fetal age, amniotic fluid
creatinine can be used. What does it indicate if the
creatinine level obtained is greater than 2.0 mg/dL?
o Fetal age is > than 36 weeks
o Fetal age is > than 34 weeks
o Fetus is happy
o Second trimester of pregnancy
o Fetal age is > than 36 weeks
84
Which of the following amniotic fluid colors is
associated with fetal death?
o Pale yellow
o Dark yellow
o Red-brown
o Dark green
o Red-brown
85
Which of the following correctly describes normal
amniotic fluid when subjected to
spectrophotometry?
o Absorbance is highest at 550 nm and decreases
linearly at 365 nm
o The graph forms a straight horizontal line
because the absorbance reading between 365
to 550 nm is the same
o Absorbance is highest at 365 nm and decreases
linearly at 550 nm
o There is a spike at 450 nm
o Absorbance is highest at 365 nm and decreases
linearly at 550 nm
86
Increased bilirubin in amniotic fluid could be
suggestive of what disease?
o Spina bifida
o Anencephaly
o Hemolytic disease of the newborn
o Glomerulonephritis
o Hemolytic disease of the newborn
87
Amniotic fluid specimens soon after collection are
immediately protected from light to preserve which
of the following substances?
o Protein
o Bilirubin
o Phospholipid
o Fetal cells
o Bilirubin
88
Which of the following is not a function of amniotic
fluid surrounding a developing fetus?
o Provides medium for oxygen and carbon
dioxide exchange in the joints
o Enabled fetal movement
o Protects fetus from extreme temperature
change
o Provides protective cushion for the fetus
o Provides medium for oxygen and carbon
dioxide exchange in the joints
89
After the first trimester, what contributes most to
the amniotic fluid volume?
o Maternal blood
o Fetal urine
o Fetal blood
o Maternal urine
o Fetal urine
90
Which of the following statements about Fern test if
not true?
o Differentiates amniotic fluid from maternal
urine
o Is a screening test for amniotic fluid
o Is a wet mount and utilizes Wright stain
o Is performed on vaginal fluid
o Is performed on vaginal fluid
91
What is the maximum amount of collected amniotic
fluid per single amniocentesis?
o 1 mL
o 50 mL
o 30 mL
o 15 mL
o 30 mL
92
What term denotes the newborn’s first bowel
movement that causes green coloration of the
amniotic fluid?
o Melena
o Meconium
o Hematochezia
o Erythroblastosis fetalis
o Meconium
93
What is the confirmatory test for elevated
alphafetoprotein?
o Foam stability
o Lamellar bodies
o L/S ratio
o Amniotic acetylcholinesterase
o Amniotic acetylcholinesterase
94
14. Increased alpha-fetoprotein in an amniotic fluid may
indicate?
o Megalocephaly
o Fetal lung maturity
o Hemolytic disease of the newborn
o Spina bifida
o Spina bifida
95
To ensure that it is safe for a preterm delivery.
Lecithin/Spingomyelin ratio is performed.
Chloroform added to remove contaminants such as
blood and meconium. An L/S ratio of 1.6 indicates?
o The lungs aren’t matured enough
o Fetal death
o The lungs are matured enough to sustain
outside environment
o It is safe for preterm delivery
o The lungs aren’t matured enough
96
What is the normal L/S ratio for us to say that the
fetal lungs are already matured?
o 0.5
o 2.0
o 1.0
o 1.5
o 2.0
97
After collection of amniotic fluid, why do physicians
discard the first 2-33 mL collected?
o Contaminated with maternal blood, tissue fluid
and cells
o The physician is lost on what he is doing
o The first 3 mL is mainly composed of water
o The first drops are foul-smelling
o Contaminated with maternal blood, tissue fluid
and cells
98
What is the proper handling method for amniotic
fluid to be tested for fetal lung maturity?
o Placed in ice during transport and kept
refrigerated
o Covered with foil and protected from sunlight
o Maintained at 37 deg C
o Pre-heated at 40 deg C to hydrolyze fats
o Placed in ice during transport and kept
refrigerated
99
What is the value of lamellar bodies that suggests
fetal lung maturity?
o 30,000/uL
o 33,000/uL
o 5,000/uL
o 15,000/uL
o 33,000/uL
100
What graph is used to plot absorbance difference at
450 nm ang gestational age to assess the severity of
hemolytic disease of the newborn?
o AChe graph
o Liley graph
o Kleihauer-betke graph
o Reiv graph
o Liley graph
