Misc Labs final

Question 1

HCG is present in _______ days after conception

a. 3-10
b. 5-10
c. 10-14
d. 3-7

Answer 1

a. 3-10

Question 2

In what case may beta HCG be present in a male

Answer 2

with the presence of germ cell tumors

Question 3

Beta HCG is normally used to measure what?

a. fertility
b. gestational age
c. pregnancy (pos or neg)
d. sex of fetus

Answer 3

b. gestational age

Question 4

urine needs to be concentrated for an accurate pregnancy test. The ideal specific gravity is

a. 1.005
b. 1.010
c. 1.250
d. 1.004

Answer 4

a. 1.005

Question 5

Wet mount used to be the reccomended test for the presence of trichomonas in vaginal fluid. Now the reccomended test is _____

Answer 5

Nucleic acid testing (NAAT) though the wet mount is still widely used in conjuction with NAAT

Question 6

Presence of clue cells in saline is indicative of

a. trichomonas
b. yeast infection
c. BV (gardneralla vaginosis)
d. chlamydia

Answer 6

c. BV (gardneralla vaginosis)

Question 7

what is on this wet mount

Answer 7

clue cells. BV!

Question 8

What is on this wet mount

Answer 8

trichomonas. The small round cells will have flagella and they will move around the slide

Question 9

You suspect your patient has a yeast infection. First you do a wet mount and you see no abnormal cells. You have one more thing to do…… what is the preperation of the slide for your next step?

Answer 9

KOH

Question 10

what is on this slide and what makes you sure of the dx?

Answer 10

Candida (yeast)

You can see the hyphal element (strings… aka spaghetti and meatball appearance)

Question 11

An indication that a pt may have prostate cancer on a PSA test?

Answer 11

a PSA level greater than 4ng/ml

Question 12

The age that is reccomended to start PSA screenings in the general male population

a. 40
b. 50
c. 65
d. 35

Answer 12

b. 50

(40 if there is fam hx)

Question 13

Where is the prostate is PSA present?

Answer 13

lumen

Question 14

just to review……

IgM is _______ infection

IgG is ______infection or ______

Answer 14

IgM is acute infection

IgG is past infection or vaccination

Question 15

if both IgG and IgM are present this means…

Answer 15

That there is a current infection and the body is actively creating antibodies (good job immune system)

Question 16

True or false……. there is a high rate of ANA positvity with Lupus and mixed connective tissue disease?

Answer 16

True

Question 17

Which marker is indicative of drug induced lupus

a. Anti-histone
b. Anti-dsDNA
c. Anti nucleolar

D. Anti RNP

Answer 17

a. antihistone

Question 18

What antibodies are commonly presnt in sjogrens dz? check all that apply

a. ANA
b. Anticentromere

C. Anti-Ro

d. Anti-La
e. Anti-scl- 70

Answer 18

a,c,d

ANA

Anti-Ro

Anti-La

Question 19

Rheumatoid factor is not _____ for RA but is usually positive

Answer 19

specific

Question 20

Rheumatoid factor can also be present in…..

Answer 20

other autoimmune dz, viral infections, endocarditis, TB, hepatitis, mono, syphilis, leukemia

Question 21

What is usually present long before the onset of symptoms of RA

Answer 21

Anti cyclic citruillinated peptide antibodies

(anti CCP)

Question 22

Name the acute phase reactants

Answer 22

CRP

ESR

fibrinogen

haptoglobin

prealbumin

ferritin

Question 23

Bacterial infections will show ______ CRP

and Viral will show ______CRP

a. increased, increased
b. Decreased, decreased
c. increased, no change

D. no change, decreased

Answer 23

C. increased with bacterial, no significant change with viral

Question 24

Fun fact: with covid ESR and CRP both ______

Answer 24

increase

Question 25

ESR takes how long?

a. 30 minutes
b. its a rapid bedside test
c. 2 hours
d. 1 hour

Answer 25

d. 1 hour. CRP is much faster

Question 26

You have a patient and you take a sample of the sinovial fluid from their knee. The sample opaque, a yellow green color, and has a WBC of 50,000. After seeing this you are concerned about what?

Answer 26

Infectious process

Question 27

You have a patient and you test their sinovial fluid as well (strange day in your primary care clinic) the fluid is not very viscous and is a yellow ish color. What is your first thought?

Answer 27

This is an inflammitory process, but you probably need more info

Question 28

You sent out that sinovial fluid for some additional analyisis. It came back with monosodium urate crystals present. You know that if you obtain a uric acid level it may be normal despite what is present in the sinovial fluid. What condition is this consistent with

Answer 28

Gout

Question 29

pseudogout is identified by what?

a. uric acid levels that are low
b. calcium pyrophosphate crystals
c. monosodium urate crystals
d. calcified sediment in urine

Answer 29

b. calcium pyrophosphate crystals

Question 30

d-dimer measures what….

Answer 30

fibrin degredation products

Question 32

You have a patient that is highly suspicious for a DVT according to the wells criteria. Should you or should you not obtain a d-dimer

Answer 32

You should not

Question 33

D-dimer is a _______test

A. rule in

b. rule out
c. a waste of time
d. a test of high sensitivity and specificity

Answer 33

b. it is a rule out test. A negative test rules out a clot 95-99% of the time.

Question 34

A test that is 95% sensitive means that

a. 5 % of people will test postive but not actually have the disease or condition
b. 5% of those tested will test negative but actually have the disease
c. 5% of the tests are contaminated and will have to be thrown out
d. the test will be a negative result 95% of the time.

Answer 34

b. 5% of those tested will test negative but actually have the disease