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UA Flashcards Unit 2

1) Diseases affecting the glomerulus are primarily caused by:

Immunological disorders

2) All of the following are symptoms of acute glomerulonephritis except:

A. Periorbital edemaB. HematuriaC. ProteinuriaD. Hypoalbuminemia

D

3) The major cause of the nephrotic syndrome in children is:

Minimal change disease

4) Damage to the glomerulus can occur as a result of all of the following except:

A. Increased filtration of electrolytesB. Deposition of immune complexesC. Deposition of amyloid materialsD. Cellular infiltration

A

5) The buildup of crescentic formations on the glomerular capillaries is characteristic of:

Rapidly progressive glomerulonephritis

6) The most common cause of end-stage renal disease is:

Diabetic nephropathy

7) A renal disorder associated with heroin abuse is:

Focal segmental glomerulosclerosis

8) Blood tests can be used to confirm the diagnosis of acute glomerulonephritis because of the detection of:

Antistreptococcal antibodies

9) Goodpasture syndrome and Wegener’s granulomatosis are associated with the presence of which of the following in the urine sediment?

Red blood cell casts

10) The presence of which crystals can be associated with nephrotic syndrome?

Cholesterol

11) A patient with symptoms of pulmonary hemoptysis and urinary hematuria should be tested for:

Antiglomerular basement membrane antibody

12) Which of the following disorders has the most favorable patient prognosis?

A. Rapidly progressive glomerulonephritisB. Henoch-Schönlein purpuraC. IgA nephropathyD. Goodpasture syndrome

B

13) Glomerular basement membrane thickening occurs in membranous glomerulonephritis as a result of deposition of:

IgG immune complexes

14) The presence of heavy proteinuria is most characteristic of:

Nephrotic syndrome

15) The pronounced edema associated with nephrotic syndrome is related to the:

Hypoalbuminemia

16) Oval fat bodies and fatty casts are characteristic urine sediment constituents in patients with:

Nephrotic syndrome

17) A decrease in systemic blood flow affects the Ischemia

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renal tubules by producing:18) Glucosuria and generalized aminoaciduria are

characteristics of:Fanconi syndrome

19) Which inherited renal disorder manifests itself in the development of gout in teenage years?

Uromodulin-associated kidney disease

20) In which part of the kidney is uromodulin produced?

Proximal and distal tubules

21) Which of the following renal disorders is most likely to be inherited?

A. Nephrotic syndromeB. Acute interstitial nephritisC. Acute tubular necrosisD. Fanconi syndrome

D

22) Administration of a nephrotoxic antibiotic to a patient with a decreased glomerular filtration rate may cause:

Acute tubular necrosis

23) The presence of increased renal tubular epithelial cell casts is most indicative of:

Acute tubular necrosis

24) Infection of the bladder is termed Cystitis25) Cystitis can be differentiated from

pyelonephritis by:The presence of white blood cell casts

26) In diabetic nephropathy, solid material deposited around the capillary tufts includes:

Glycosylated protein

27) The finding of bacterial casts can be associated with:

Acute pyelonephritis

28) The most serious tubulointerstitial disorder is: Chronic pyelonephritis29) An increased urinary eosinophils are diagnostic

for:Acute interstitial nephritis

30) Microscopic urinalysis findings of a patient with acute interstitial nephritis include all of the following except:

A. BacteriaB. White blood cellsC. Red blood cellsD. White blood cell casts

A

31) Acute renal failure may be classified as all of the following except:

A. Rapidly progressiveB. PrerenalC. RenalD. Postrenal

A

32) In which disorder would waxy and broad casts be most likely to be seen?

Chronic renal failure

33) Causes of acute renal failure can include all of the following except:

A. MalignancyB. Goodpasture syndromeC. Acute tubular necrosisD. Renal calculi

B

34) Most renal calculi are composed of: Calcium35) Lithotripsy is a procedure that is performed to: Aid in the remove of renal calculi

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36) The microscopic hematuria associated with renal lithiasis is caused by:

Tissue irritation

37) All of the following may be helpful in preventing the formation of renal calculi except:

A. Increased hydrationB. Increased exerciseC. Dietary restrictionsD. Adjustment of urine pH

B

38) Initial screening for PKU performed on newborns before their discharge from the hospital uses a blood sample rather than a urine sample because:

Increased serum phenylalanine can be detected earlier

39) A routine urinalysis is performed on a specimen that has turned dark after standing in the laboratory. The urine is acidic and has negative chemical tests except for the appearance of a red color on the ketone area of the reagent strip. One should suspect:

Melanuria

40) A positive Guthrie test is interpreted by observing:

Bacterial growth occurs around the positive control disc and the patient disc

41) Patients who have unusually fair complexions can be indicative for phenylketonuria because:

Tyrosine is not available for conversion to melanin

42) A false-positive reaction for urinary ketones could be present in patients who have:

Melanuria

43) A positive urine Clinitest reaction can be seen in patients with:

A. Alkaptonuria

44) Confirmation of maple syrup urine disease is made on the basis of:

MS/MS

45) A disease that causes large amounts of branched-chain amino acids to be excreted in the urine is:

Maple syrup urine disease

46) Urine with the characteristic odor of “sweaty feet” and a positive ketone test indicates:

Isovaleric acidemia

47) Which of the following foods contains serotonin, which can interfere with 5-HIAA testing?

Pineapples

48) The presence of maple syrup urine disease is first suspected by the presence of abnormal urine:

Odor

49) The finding of a “blue diaper” is indicative of a defect in the metabolism of:

Tryptophan

50) Patients who produce kidney stones at an early age should be tested for the presence of:

Cystinuria

51) Porphyrins are intermediary compounds in the formation of:

Heme

52) The specimen of choice when testing for protoporphyrin is:

Blood

53) The most common cause of acquired porphyria is:

Lead poisoning

A. Fanconi syndromeB. Neurologic

A

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C. PsychiatricD. Photosensitivity54) The presence of porphobilinogen in the urine

can be suspected when:Acidic urine turns a port wine color after standing

55) Urine from a child suspected of having lead poisoning has a red fluorescence under Wood’s lamp. This finding is:

Consistent with lead poisoning because coproporphyrin fluoresces under ultraviolet light

56) The concept of vampires is associated with: Porphyrias57) Characteristic urine odors are associated with

all of the following disorders except:A. AlkaptonuriaB. PKUC. Maple syrup urine diseaseD. Isovaleric acidemia

A

58) The presence of amino acids is of particular concern in which population?

Newborns

59) All of the following can be classified as metabolic rather than renal disorders except:

A. TyrosyluriaB. Maple syrup urine diseaseC. CystinuriaD. Indicanuria

C

60) The presence of “orange sand” in an infant’s diaper is indicative of:

Lesch-Nyhan disease

61) A patient diagnosed with Lesch-Nyhan disease can have all of the following conditions, except:

A. CystinosisB. Increase in uric acidC. Self-destructive tendenciesD. Severe motor defects

A

62) Mental retardation is a symptom of all of the following except:

A. Hurler’s syndromeB. GalactosuriaC. PKUD. Cystinuria

D

63) Melituria refers to an increase in urinary: Sugar64) GALT deficiency is a disorder affecting the

metabolism of:Galactose

Choose the characteristic odor for the following disorders:65) Phenylketonuria

Mousy

66) Cystinosis Sulfur67) Isovaleric acidemia Sweaty feet68) Maple syrup urine disease SweetTrue/False69) Failure of a metabolic pathway to reach

completion may be caused by an inborn error of metabolism

True

70) Persons diagnosed with PKU should avoid foods containing the chemical additive aspartame

True

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71) The 2,4-dinitrophenylhydrazine reaction is the confirmatory test for maple syrup urine disease

False

72) Argentaffin cell tumors produce large amounts of serotonin

True

73) Both cystine and leucine crystals are present in the urine of patients with cystinuria

False

74) The free erythrocyte protoporphyrin test is the recommended screening test for lead poisoning

True

75) Uric acid crystals are frequently seen in the urine of pediatric patients.

False

76) The presence of a massive amount of urinary calcium oxalate crystals is indicative of Lesch-Nyhan disease

False

77) A negative reagent strip test for glucose and a positive Clinitest on a pregnant woman are associated with gestational diabetes

False

78) If CSF tubes numbered 2 and 3 cannot be analyzed within 1 hour, the correct procedure is to:

Refrigerate tube 3 and leave tube 2 at room temperature

79) A xanthochromic CSF specimen will appear: Yellow and clear80) Cell counts on CSF are performed on: Cells as they are counted in the hemocytometer81) A broad spectrum of reactive and nonreactive

lymphocytes in the CSF is associated with:Viral meningitis

82) The third tube of CSF collected from a lumbar puncture shoul be used for:

Hematology tests

83) The primary disadvantage in using a cytocentrifuge to prepare CSF differential slides is:

Cellular distortion

84) Nucleated red blood cells (RBCs) seen in the CSF indicate:

Bone marrow contamination from the puncture

85) White blood cell (WBC) counts on clear CSF specimens are performed:

On undiluted specimens if there is no cell overlapping

86) To determine the WBC count on a cloudy CSF specimen that contains both RBCs and WBCs, it is necessary to:

Dilute the specimen using glacial acetic acid

87) An increase in neutrophils with pyknotic nuclei can be seen in which situation?

Traumatic tap specimen

88) When using the cytocentrifuge, a daily control slide of saline and albumin is prepared to check:

A. The correct centrifuge speedB. For the presence of WBCsC. For bacterial contaminationD. The pH of staining buffer

C

89) Three tubes of CSF are submitted to the laboratory. They are numbered 1, 2, and 3 and show blood in all tubes but decreasing in amount as one inspects tubes 1 through 3. This observation should be interpreted as:

A traumatic or bloody tap is suspected and, in all likelihood, no pathogenic significance should be attached to the presence of the blood

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90) The presence of hemosiderin containing macrophages in CSF indicates

Cerebral hemorrhage

91) A CSF specimen, in which there is uneven distribution of blood among the three tubes and clots are detected, is an indication of:

Traumatic tap

92) The presence of xanthochromia and an increased D-dimer test in the CSF is indicative of:

A cerebral hemorrhage

93) Examination of a CSF shows 1000 WBCs, of which 75% are lymphocytes and 25% are monocytes. This finding is consistent with:

Viral meningitis

94) Damage to the blood-brain barrier by Mycobacterium tuberculosis may cause the CSF to:

Contain a pellicle or clot

95) Dilution of CSF prior to performing a total cell count should be made using:

Normal saline

96) Increased CSF eosinophils are associated with: Introduction of foreign material97) Melanoma cells in the CSF must be

differentiated from:Macrophages containing hemosiderin

98) Conditions that produce elevated CSF protein include all of the following except:

A. Fluid leakageB. MeningitisC. Multiple sclerosisD. Hemorrhage

A

99) Myelin basic protein is measured in the CSF to assess the condition of patients with:

Multiple sclerosis

100) Measurement of CSF lactate is useful for monitoring cases of:

Bacterial meningitis

101) The CSF/serum albumin index is performed to determine:

The integrity of the blood-brain barrier

102) To determine if IgG is being produced within the central nervous system, the laboratory must calculate the:

IgG index

103) The lowest levels of CSF lactate can be found in patients with:

Bacterial meningitis

104) Crystals with a bright yellow color seen in macrophages are called:

Hematoidin

105) The presence of increased glutamine in the CSF can indicate:

Reye’s syndrome

106) Gram stains performed on CSF specimens are helpful in the:

Detection of bacterial and fungal meningitis

107) Specimens from patients suspected of having fungal meningitis should be tested with:

Gram stain and India ink

108) India ink preparations are useful in the diagnosis of:

Fungal meningitis

109) When a CSF specimen is received in the microbiology laboratory, the first thing the technologist should do is:

Centrifuge the specimen

110) A questionable India ink preparation on the CSF from an immunocompromised patient should be further tested using:

A cryptococcal antigen test

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111) Which of the following structures contain one-way valves?

Arachnoid granulations

112) A report of many gram-positive cocci on a clear CSF sample with a normal cell count may be the result of:

Use of contaminated albumin in the cytocentrifuge

113) A positive cryptococcal antigen test with a negative India ink preparation may indicate:

The presence of rheumatoid factor

114) A false-positive CSF serologic test for neurosyphilis in a treated patient can occur if:

Fluid from a traumatic tap is tested by the FTA-ABS test

115) A positive serum FTA-ABS and a negative VDRL on CSF indicate:

Successfully treated syphilis

116) A patient previously diagnosed with acquired immunodeficiency arrives in the emergency room with symptoms of meningitis. A lumbar puncture is performed.

Using the information provided, in addition to Gram stain, what additional testing should be performed?

Cryptococcal antigen test

117) A patient previously diagnosed with acquired immunodeficiency arrives in the emergency room with symptoms of meningitis. A lumbar puncture is performed.

Based on the information provided, what diagnostically significant observation might be made on the Gram stain?

Starburst microbial pattern

118) A patient previously diagnosed withacquired immunodeficiency arrives in the emergency room with symptoms of meningitis. A lumbar puncture is performed. Based on the information provided, what type of meningitis would most probably be suspected in this patient?

Fungal

119) True or False? Xanthochromic CSF may appear pink, orange, or yellow.

True

120) True or False? Neutrophils may be present in normal CSF.

True

121) True or False? The formation of clots does not occur in CSF that does not contain blood.

False

122) True or False? The presence of macrophages containing hematoidin crystals indicates a recent hemorrhage.

False

123) True or False? Oligoclonal bands are located in the gamma region of the CSF protein electrophoresis.

True

124) True or False? When calculating an IgG index, the serum albumin concentration must be converted to milligrams per deciliter.

False

125) True or False? A CSF lactate level should not be performed on a xanthochromic specimen.

True

126) True or False? Bacterial antigen tests have replaced the Gram stain as the method of choice for detecting meningitis.

False

127) True or False? The recommended serologic False

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test for the diagnosis of neurosyphilis is the rapid plasma reagin test.

128) Semen analysis on postvasectomy patients should be performed:

Until two consecutive monthly specimens show no sperm

129) To determine if a questionable specimen is semen, the specimen should be tested for:

Acid phosphatase

130) Absence of a normal sperm acrosome can: Affect ovum penetration131) Yellow color in a semen specimen may be

caused by all of the following except:A. UrineB. Preservation at room temperatureC. MedicationsD. Prolonged abstinence

B

132) Normal semen should liquefy: Within 1 hour133) An increased amount of prostatic fluid in a

semen specimen will:Lower the pH

134) If the first portion of the ejaculation is not collected, which parameter of the semen analysis is most critically affected?

Sperm concentration

135) Semen viscosity is most closely related to: Specimen liquefaction136) Proper collection of a semen specimen

should include all of the following except:A. In a sterile containerB. After a 3-day period of sexual abstinenceC. At the laboratory followed by 1 hour of refrigerationD. At home and delivery to the laboratory within 1 hour

C

137) Abnormal sperm morphology is determined by:

Head and tail morphology and size

138) Before analysis, semen specimens should be: Allowed to completely liquefy139) Sperm motility after 1 hour should be at

least:50%

140) Prior to reporting a postvasectomy specimen as negative for the presence of sperm, the specimen must be:

Dentrifuged

141) Sperm can be immobilized before performing a sperm concentration using all of the following except:

A. HeatB. Normal salineC. Sodium bicarbonateD. Tap water

B

142) Evaluation of sperm motility includes: Differentiation between forward and lateral movement143) Computer-assisted semen analysis

determines all of the following except:A. Sperm morphologyB. Sperm countC. Trajectory of sperm motionD. Velocity of sperm motility

A

144) When performing sperm morphology 200

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analysis, the minimum number of sperm that should be evaluated is:

145) When using routine morphology criteria, the normal value is greater than:

30% normal forms

146) When using Kruger’s strict morphology criteria, the normal value is greater than:

14% normal forms

147) Semen specimens should be processed for analysis:

After complete liquefaction

148) The normal sperm concentration is: 20 to 160 million/mL149) A yellow semen specimen with a normal

sperm concentration and decreased motility may contain:

Urine

150) When performing sperm morphology analysis on a semen specimen with a sperm concentration of 20 million, 10 spermatids are seen. This result is:

Indicative of abnormal sperm maturation

151) A sperm motility report graded 2.0 is interpreted as:

Slow forward motility with noticeable lateral movement

152) While performing a sperm morphology examination, a technologist counts 10 neutrophils per 100 mature sperm. To determine if this observation is significant, the technologist must also know the:

Sperm concentration

153) The finding of 3 million neutrophils per milliliter in a semen specimen is:

Indicative of infection

154) The purpose of diluting semen specimens with sodium bicarbonate and formalin before counting is to:

Immobilize and preserve the sperm

155) The motility component of a sperm analysis includes all of the following except evaluation of the

A. Progressive and Brownian movementB. Percentage of motile spermC. Quality of movementD. Motility of normal and abnormal sperm

D

156) Using a 1:20 dilution of semen, a student counts 70 sperm in the five RBC squares on one side of the Neubauer hemocytometer and 82 sperm on the other side. The student should

Repeat the count

157) The sugar of interest in most cases of infertility is

Fructose

158) Development of male antisperm antibodies can be caused by all of the following except

A. VasovasostomyB. InfectionC. Prolonged abstinenceD. Trauma

C

159) The immunobead test detects Male antisperm antibodies

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160) Where there is a lack of prostatic fluid, all of the following chemicals are decreased in the semen except

A. Alpha-glucosidaseB. ZincC. CitrateD. Acid phosphatase

A

161) When examining a specimen for the presence of sperm, the type of microscopy recommended for use is

Phase

162) Sperm function tests include all of the following except the

A. Hamster egg penetration assayB. Cervical mucus penetration testC. Meiosis and mitosis assayD. In vitro acrosome reaction

C

163) All of the following can be used to evaluate continued infertility with a normal sperm count except

A. Semen fructose levelB. Eosin-nigrosin stainC. Plasma and semen agglutinationD. Immunobead test

A

164) A semen specimen in which clumping of sperm is observed should be further tested using the

Immunobead test

165) Which of the following parameters directly relates to and provides a check on the sperm motility evaluation?

Viability stain

166) When an abnormally low sperm count is encountered in a fertility examination, the follow-up test of choice is

Female agglutination studies

167) Which of the following is a normal finding in an eosin-nigrosin stain?

75% of the cells appear bluish white

168) Normal semen analyses accompanied by continued infertility would most probably be caused by

Female antisperm antibodies

169) Spermatogenesis takes place in the Seminiferous tubules170) True/False:A semen pH of 6.0 is associated with a decrease in prostatic fluid

False

171) True/False:Semen specimens can contain HIV and hepatitis viruses

True

172) True/False:Greater than 1 million spermatids per milliliter indicates reproductive tract infection

False

173) True/False:The size of the acrosome and the presence of vacuoles are included when sperm morphology is evaluated using Kruger’s strict criteria

True

174) True/False: True

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Slides for evaluation of sperm morphology can be stained using Papanicolaou stain

175) True/False:The semen analysis is classified as a moderately complex test by the Clinical Laboratory Improvement AmendmentsCLIA

False

176) True/False:The World Health Organization has standardized the performance and reporting of semen analysis

True

177) True/False:Antisperm antibodies are produced by both males and females

True

178) True/False:The immunobead test will differentiate between antisperm antibodies directed against the sperm head and tail

True

179) All of the following statements on synovial fluid are true except that it:

A. Surrounds all joints in the bodyB. Is found only in the kneeC. Acts as a lubricantD. Supplies nourishment to cartilage

B

180) Which of the following descriptions of synovial fluid does not correlate?

Sepsis: uniform blood

181) Crystals that are found in synovial fluid during attacks of gout are most likely:

Monosodium urate

182) In gout, both serum and synovial fluid will have increased levels of:

Uric acid

183) Synovial fluid is produced by: Ultrafiltration of plasma184) The concentration of which of the following

chemicals found in synovial fluid differs most noticeably from the plasma concentration?

Protein

185) A turbid synovial fluid with yellow-green color indicates:

Infection

186) All of the following primary cells are seen in normal synovial fluid except:

A. MacrophagesB. NeutrophilsC. MonocytesD. Synovial tissue cells

B

187) All of the following can cause crystals to be present in the synovial fluid except:

A. Metabolic disordersB. Increased ingestion of dairy productsC. Degeneration of cartilageD. Injection of medications

B

188) A cloudy, yellow-green synovial fluid with 100,000 white blood cells (WBCs), a predominance of neutrophils, and a decreased glucose should be classified as:

Septic

189) An arthrocentesis is performed on a patient Inflammatory

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with lupus erythematosus that produces a cloudy yellow fluid with 2000 WBCs, of which 55% is neutrophils. This fluid should be classified as:

190) A clear, pale yellow synovial fluid with good viscosity and a WBC count of 1000 should be classified as:

Noninflammatory

191) To determine if an unknown fluid is synovial fluid, the fluid can be tested:

By adding acetic acid and observing clot formation

192) A milky-appearing synovial fluid can be associated with the presence of:

Monosodium urate crystals

193) Which of the following crystals would most likely be present in conjunction with calcium pyrophosphate crystals in synovial fluid?

Hydroxyapatite

194) The recommended diluting fluid for synovial fluid cell counts is:

Saline

195) Neutrophils that contain precipitated rheumatoid factor in their cytoplasm are called:

Ragocytes

196) All of the following are tests frequently performed on synovial fluid except:

A. Gram stainB. WBC countC. Uric acidD. Differential

C

197) Vacuolated macrophages containing ingested neutrophils seen in synovial fluid are called:

Reiter’s cells

198) Before performing a cell count on highly viscous synovial fluid, it may be necessary to incubate the fluid with:

Hyaluronidase

199) In the Ropes’ or mucin clot test, normal synovial fluid:

Forms a solid clot when added to glacial acetic acid

200) Synovial fluid for crystal examination should be:

Examined unstained under direct and red compensated polarized light

201) Crystals that appear to be rhombic-shaped and are blue when aligned with the slow vibration of red compensated polarized light are:

Calcium pyrophosphate

202) Delayed analysis of synovial fluid affects the results of all of the following tests except the:

A. Mucin clot testB. GlucoseC. Crystal examinationD. WBC count

A

203) The presence of neutrophils containing dark granules in the synovial fluid is associated with:

Rheumatoid arthritis

204) Crystals frequently seen in patients’ joints with chronic inflammation are:

Cholesterol

205) In addition to routine culture media, synovial fluid cultures should include:

Chocolate agar

206) All of the following diseases are frequently B

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associated with joint disorders except:A. Lyme diseaseB. TuberculosisC. Lupus erythematosusD. Rheumatoid arthritis207) Based on the information provided, what is

the significance of the blood-streaked fluid?Traumatic collection

208) Based on the information provided, what type of diluting fluid should be used for the WBC count?

Hypotonic saline

209) Vacuolated macrophages containing ingested neutrophils are called:

Reiter’s cells

210) Fat droplets seen in synovial fluid are associated with:

Crush injuries and Chronic inflammation

211) Synovial fluid crystals seen in patients undergoing renal dialysis most commonly are:

Calcium oxalate

212) True/False: Synovial fluid viscosity is caused by the presence of filtered serum proteins.

False

213) True/False: The polymerization of hyaluronic acid is decreased when arthritis is present.

True

214) True/False: Monosodium urate crystals may be present in synovial fluid from patients receiving chemotherapy for leukemia.

True

215) True/False: Automated cell counters should not be used for synovial fluid cell counts.

False

216) True/False: The predominant cell in normal synovial fluid is the lymphocyte.

False

217) True/False: Monosodium urate crystals are found both extracellularly and intracellularly.

True

218) True/False: Red compensated polarized microscopy separates light into slow and fast rays.

True

219) True/False: Synovial fluid should be routinely cultured for the presence of Borrelia burgdorferi.

False

220) True/False: Normal synovial fluid glucose values are 60% to 70% of the blood glucose.

False

221) Peritoneal lavage is performed to: Detect intra-abdominal bleeding222) Exudate fluids usually result from: Inflammation of the serous membrane223) The pathologic accumulation of fluid in a

body cavity is termed a/an:Effusion

224) Which of the following is most often associated with the formation of a transudate?

Congestive heart failure

225) The cells lining the pleural cavities are primarily:

Mesothelial cells

226) The function of serous fluid is to: Provide lubrication for the serous membranes

227) Production of serous fluid is controlled by all A

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of the following except:A. Lymphatic secretionsB. Hydrostatic pressureC. Oncotic pressureD. Capillary permeability228) Peritoneal fluid is collected by a procedure

called:Paracentesis

229) Serous fluid effusions may result from all of the following except:

A. Congestive heart failureB. Lymphatic obstructionC. Increased capillary permeabilityD. Dehydration

D

230) A pleural fluid delivered to the laboratory on ice would be accompanied by a requisition to test for:

pH

231) Pleural fluid can be better classified as to transudative or exudative origin by performing a:

Fluid-to-serum cholesterol ratio

232) A decrease in the number of mesothelial cells seen on a pleural fluid differential indicates:

Tuberculosis

233) A decrease in the number of mesothelial cells seen on a pleural fluid differential indicates:

Tuberculosis

234) All of the following are unique characteristics of malignant cells except:

A. Hyperchromatic nucleoliB. Cytoplasmic moldingC. Cellular clumpingD. Abnormal nuclear-to-cytoplasm ratios

C

235) Elevated pleural fluid amylase can be indicative of all of the following except:

A. PancreatitisB. Esophageal ruptureC. TuberculosisD. Malignancy

C

236) A blood-streaked pericardial exudate with an increased amount of neutrophils is indicative :

Bacterial endocarditis

237) Structures seen in peritoneal fluid that may be associated with either benign or malignant conditions are:

Psammoma bodies

238) A fluid obtained by thoracentesis has a cholesterol result of 100 mg/dL. This would be classified as a/an:

Pleural exudate

239) Differentiation between a hemothorax and a hemorrhagic effusion on a bloody pleural fluid is done by:

Performing a hematocrit value, because a hemothorax will give a value close to that of blood

240) A pleural fluid pH of less than 6.0 is indicative of:

Esophageal rupture

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241) Requests for amylase and alkaline phosphatase determinations on ascitic fluid are received in suspected cases of:

Gastrointestinal perforations

242) Which of the following tests is valuable in the diagnosis of esophageal rupture?

Pleural fluid pH

243) A milky pleural fluid that stains strongly positive with Sudan III indicates:

Thoracic duct leakage

244) A milky, green-tinged pleural fluid: Stains weakly with Sudan III245) A pericardial exudate from a patient

diagnosed with AIDS might be tested with:An acid-fast stain

246) The test performed on peritoneal lavage fluid is the:

RBC count

247) An ascitic fluid absolute neutrophil count of 1000/µL is most indicative of:

Bacterial peritonitis

248) A screening test performed on a cloudy, green ascitic fluid would be a/an:

Ictotest

249) What is the significance of an ascitic fluid exudate with a positive CA 125 and a negative CEA?

Ovarian malignancy

250) What is the significance of a peritoneal fluid with an elevated creatinine level?

Ruptured bladder

251) What is the significance of a pleural fluid with a hematocrit value of 30% (blood hematocrit: 34%)?

Hemothorax

252) Increased serous fluid can be caused by all of the following except:

A. Lymphatic obstructionB. InflammationC. Increased plasma sodiumD. Increased hydrostatic pressure

C

253) The finding of a mesothelioma cell in pericardial fluid is indicative of:

Metastatic malignancy

254) Normal values for chemistry tests on serous fluid are different from values obtained on serum.

False

255) Transudate serous fluid effusions are a complication of the nephrotic syndrome.

True

256) Additional testing is most frequently performed on transudates rather than exudates.

False

257) A significant finding in a serous effusion is an increase in mesothelial cells.

False

258) Reactive mesothelial cells indicate a malignant effusion.

False

259) Pleural fluid amylase is elevated in cases of pancreatitis.

True

260) Amniotic fluid is formed by all of the C

15


following except:A. Fetal urineB. Fetal cell metabolismC. Fetal swallowingD. Transfer of water across the placenta261) A dark green amniotic fluid is associated

with:Meconium

262) A primary function of amniotic fluid is to: Provide protection for the fetus263) The volume of amniotic fluid increases after

the first trimester as a result of:Production of fetal urine

264) Amniotic fluid for fetal lung maturity testing should be preserved:

In the refrigerator

265) A dark yellow amniotic fluid is caused by: Bilirubin266) Measurement of amniotic fluid creatinine

levels can be used to:Differentiate between amniotic fluid and maternal urine

267) To differentiate between maternal and fetal blood in blood-streaked amniotic fluid, the fluid is tested for

Fetal hemoglobin

268) The presence of a fetal neural tube disorder may be detected by:

Increased maternal serum alpha fetoprotein

269) An increased level of alpha fetoprotein in amniotic fluid should be further tested for:

Acetylcholinesterase

270) Hemolytic disease of the newborn is caused by:

Maternal antibodies

271) Analysis of amniotic fluid bilirubin levels is performed using:

Spectrophotometry

272) Alpha fetoprotein is produced by the fetal: Liver273) The purpose of plotting amniotic fluid

bilirubin on a Liley graph is toDetermine further treatment

274) Hemolytic disease of the newborn endangers the fetus by:

Destroying fetal RBCs

275) The A450 of an amniotic fluid is plotted in zone 3 of a Liley graph. The physician should:

Request testing for fetal lung maturity

276) Interference with the amniotic fluid bilirubin analysis on centrifuged fluid is most likely caused by:

Oxyhemoglobin

277) The foam, or shake, test is a screening test for amniotic fluid:

Surfactants

278) In the determination of fetal lung maturity, which of the following components is produced by the body at the 35th week of gestation?

Phosphatidyl glycerol

279) Amniotic fluid tests for determining fetal lung maturity include

L/S ratio and lamellar bodies

280) Decreased levels of phosphatidyl glycerol in amniotic fluid can be associated with:

Hyaline membrane disorder SS

281) The test for amniotic fluid lamellar bodies uses which of following?

An automated cell counter

282) The Amniostat agglutination test is performed on amniotic fluid from pregnant women to detect the presence of:

Phosphatidyl glycerol

283) The most frequent concern of premature Lungs

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delivery is underdevelopment of the:284) The principle of the shake test and foam

stability index is that phospholipids:Reduce the surface tension of an alcoholic solution

285) Lamellar bodies contain: Phospholipids286) When an L/S ratio by thin-layer chromatography is

performed, a mature fetal lung will showLecithin twice as concentrated as sphingomyelin

287) The method of choice for testing amniotic fluid contaminated with hemoglobin for fetal lung maturity is:

Amniostat

288) The test of choice for testing amniotic fluid from a diabetic patient for fetal lung maturity is the

Amniostat-FLM

289) A fern test is performed to differentiate between:

Urine and amniotic fluid

290) Failure of the fetus to begin swallowing will result in:

Polyhydramnios

291) The volume of amniotic fluid is regulated by fetal swallowing.

True

292) Amniotic fluid for cytogenetic analysis should be delivered to the laboratory in ice.

False

293) Meconium is composed of bowel constituents

True

294) Acetylcholinesterase testing can be performed on amniotic fluid containing blood, if the specimen is centrifuged.

False

295) Production of both lecithin and sphingomyelin increases after 35 weeks gestation.

False

296) Most laboratories detect the presence of phosphatidylglycerol using thin-layer chromatography.

False

297) When performing the foam stability index, amniotic fluid is mixed with ethanol.

True

298) Pneumocytes in the fetal lungs produce lamellar bodies.

True

299) Lamellar bodies are approximately the same size as red blood cells.

False

300) The normal brown color of the feces is produced by:

Stercobilin

301) Stools from persons with steatorrhea contain excess amounts of:

Fat

302) Which of the following pairings of stool appearance and cause does not match?

Yellow-green: barium sulfate

303) A black, tarry looking stool is indicative of: Upper gastrointestinal (GI) bleeding

304) A pale, frothy looking stool is indicative of: Excess fat

305) All of the following are secreted into the A

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small intestine by the pancreas except:A. Bile saltsB. ChymotrypsinC. LipaseD. Elastase 1306) The recommended specimen for

quantitative fecal testing is a:72-hour specimen

307) The presence of amebic dysentery may be suspected when a stool:

Is coated with blood-streaked mucus

308) The unpleasant odor associated with fecal analysis is caused primarily by:

Bacterial metabolism

309) Diarrhea can result from all of the following except:

A. Disruption of the normal intestinal bacterial floraB. Addition of pathogenic organisms to the normal intestinal floraC. Increased reabsorption of intestinal water and electrolytesD. Increased concentration of fecal electrolytes

C

310) Large orange-red droplets seen on direct microscopic examination of stools that have been mixed with Sudan III stain can represent:

Neutral fats

311) Microscopic examination of stools mixed with Sudan III stain, glacial acetic acid, and then heated will show small orange-red droplets that represent:

Fatty acids, soaps, and neutral fats

312) When performing microscopic examination of a stool for muscle fibers, the structures that are counted:

Have vertical and horizontal striations

313) Crystals seen in a stool after it has been mixed with acetic acid, Sudan III stain, and heated may be composed of:

Cholesterol

314) Wet preparations for the detection of fecal neutrophils are stained with

Methylene blue

315) Microscopic examination of stools for fecal cells provides preliminary information as to the cause of diarrhea because:

Neutrophils are present in conditions that affect the intestinal wall

316) Increased neutrophils in a stool sample may indicate that the patient has which of the following?

Salmonella infection

317) A positive lactoferrin latex agglutination test can indicate which of the following?

Enteroinvasive Escherichia coli

318) The term occult blood in fecal analysis can indicate which of the following?

Blood that is not visibly apparent in the stool specimen

319) A negative trypsin test on a fecal sample can indicate which of the following?

Pancreatic insufficiency

320) To prevent false-positive fecal occult blood B

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results, patients should be instructed to avoid eating all of the following for 3 days before testing except:

A. HorseradishB. ChickenC. MelonsD. Red meat321) Before and during collection of a sample for

quantitative fecal fats, a patient should:Consume 100 g of fat per day

322) The coefficient of fat retention should be at least:

95%

323) The most sensitive fecal enzyme test for the diagnosis of pancreatic insufficiency measures:

Elastase 1

324) A bloody stool from a neonate should be emulsified in water, centrifuged, and the supernatant tested with:

NaOH

325) Tests for the detection of occult blood rely on which chemical reaction?

Pseudoperoxidase activity of hemoglobin

326) In the Van de Kamer method for quantitative fecal fat determinations, fecal lipids are:

Converted to fatty acids before titrating with sodium hydroxide

327) A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to digest gelatin may have:

Cystic fibrosis

328) A stool pH of 5.0 correlates with a: Positive Clinitest329) A bloody stool produced by a newborn

should:Have an Apt test performed on it

330) False-negative results for upper GI bleeding can be caused by:

Degradation of hemoglobin to porphyrin

331) When performing the Apt test, a pink color that remains in the supernatant during testing indicates:

The presence of fetal hemoglobin

332) What is the significance of the pale, frothy stool?

Biliary obstruction

333) The absence of what substance most likely accounts for increased orange droplets?

Bile salts

334) What is the condition indicated by increased orange droplets?

Steatorrhea

335) How long should the slide for muscle fibers sit before being examined?

5 minutes

336) An Apt test performed on a black, tarry stool is negative for fetal hemoglobin.

Concerned; patients may not be receiving dietary instructions

337) In the evaluation of a stool specimen, the results were abnormal in the trypsin test and normal in a chymotrypsin test.

Not concerned; 95% retention is normal

338) Quantitative fecal fat testing performed on a patient maintained on a diet of 100 g of fat per day is 5 g per day. The coefficient of fat retention is reported as normal.

Not concerned; 95% retention is normal

339) An unusual number of positive occult blood tests are reported by a new employee in a satellite clinic.

Concerned; patients may not be receiving dietary instructions

340) The electrolyte content of normal feces is True

19


similar to that of plasma.341) Microbial infections produce osmotic

diarrhea.False

342) A stool that appears black and tarry may be associated with bismuth ingestion

True

343) The neutral fat and split fat stains are confirmatory tests for steatorrhea.

False

344) Staphylococcal food poisoning produces secretory diarrhea and increased fecal neutrophils.

False

345) The guaiac test detects both hemoglobin and porphyrin.

False

346) The Apt test should not be performed on a black, tarry stool.

True

347) True or False? The D-xylose and lactose tolerance tests are abnormal in persons with malabsorption or maldigestion disorders.

True

348) True or False? Steatorrhea is seen in association with decreased elastase 1 in the feces.

True

349) Which of the following is the most likely reason a physician would collect vaginal fluid for analysis?

Vaginitis

350) Which of the following vaginitis conditions is of a noninfectious origin?

Chemical irritation

351) A vaginal secretion collection can be performed to help for all of the following except:

A. Determine causative agentB. Avoid reinfectionC. Prevent pregnancyD. Provide a basis for treatment

C

352) Vaginal secretion collection kits are specific for which of the following?

For the organism sought

353) Which of the following specimen handling combinations is incorrect?

Herpes simplex virus (HSV): room temperature

354) A vaginal fluid collection kit is dropped off in the laboratory for analysis and the technologist notices condensation inside the biohazard bag. Which of the following tests cannot be performed?

Trichomonas motility testing

355) You receive a call from a physician’s practice asking about “extra swabs” for a vaginal secretions collection for Neisseria possible infection. Which of the following swabs cannot be used and why?

Sterile wood shaft swabs with cotton because they are toxic to Neisseria

356) Which of the following secretion combinations are considered to be normal?

White, flocculent discharge

357) A vaginal fluid was collected from a 25-year-old female that showed the following results: appearance is pink with flocculent discharge, pH is 3.9, whiff test is negative, many Gram-

Patient is normal and is menstruating

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positive rods, clue cells are absent. What is your interpretation of these results?

358) When testing for vaginal pH, the health-care provider collecting the sample should:

Place the specimen on the pH paper before placing swab into the saline solution

359) A vaginal pH value of 6.0 could indicate which of the following conditions?

Bacterial infection

360) Which of the following conditions is not likely if a vaginal pH value is greater than 4.5?

Vulvovaginal candidiasis

361) Based on the following description, identify the cell: a large irregular shaped cell that ranges from 25 to 70 microns in diameter with a prominent central nucleus that is 8–10 microns in size, a cytoplasm that contains no granules, with “shaggy” borders.

Clue cell

362) Which diagnostic test uses a 10% solution of potassium hydroxide to detect the volatilization of amines to produce a distinctive odor?

Whiff test

363) Which of the following bacterial characteristics best describes the “normal flora” found in a vaginal specimen?

Gram-positive large rods

364) Normal flora is predominantly of which genus?

Lactobacillus sp

365) Of the following organisms, which one requires DNA probe amplified by the polymerase chain reaction (PCR)?

Trichomonas vaginalis

366) All of the following cellular elements are seen in patients with desquamative inflammatory vaginitis, except:

A. Clue cellsB. Basal cellsC. Red blood cellsD. White blood cells

A

367) All of the following cellular elements can be seen in patients with candidiasis, except:

A. Clue cellsB. White blood cellsC. Epithelial cellsD. Budding yeast

A

368) A female patient presents to her OB/GYN with the following complaints: genital itching, dysuria, and an abnormal looking white “chunky” substance on her undergarments. The immediate next step the physician should take is:

Perform a saline wet prep

369) The fetal fibronectin test is used to determine which of the following conditions?

Preterm delivery

370) The test for placental alpha-1 microglobulin protein is used to determine:

Fetal membrane rupture

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