Urinalysis Ch7-15
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crujonez Plus on July 10, 2012
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Terms | Definitions |
|---|---|
 1. Quality assessment refers to | A. Analysis of testing controls B. Increased productivity C. Precise control results D. Quality of specimens and patient care |
| 2. During laboratory accreditation inspections, procedure manuals are examined for the presence of | A. Critical values B. Procedure references C. Procedures for specimen preservation D. All of the above |
| 3. Urinalysis procedure manuals are reviewed | A. By the supervisor on each shift B. Weekly by the pathologist C. Only when a procedure is changed D. Annually by a designated authority |
| 4. As supervisor of the urinalysis laboratory you have just adopted a new procedure. You should | A. Put the package insert in the procedure manual B. Put a complete, referenced procedure in the manual C. Notify the microbiology department D. Put a cost analysis study in the procedure manual |
| 5. Indicate whether each of the following would be considered a 1) preanalytical, 2) analytical, or 3) postanalytical factor by placing the appropriate number in the space | ____Reagent expiration date ____Rejection of a cotaminated specimen ____Construction of a Levy-Jennings chart ____Telephoning a positive Clinitest result on a newborn ____Calibrating the centrifuge ____Collecting a timed urine specimen |
| 6. Deionized water used for the preparation of reagents should be checked for | A. Calcium content B. Bacterial content C. Filter contamination D. pH, purity and bacteria |
| 7. Would a control sample that has accidentally become diluted produce a trend or a shift in the Levy-Jennings plot? | A. Trend B. Shift |
| 9. What steps are taken when the results of reagentstrip QC are outside of the stated confidence limits? | A. Check the expiration date of the reagent strip B. Run a new control C. Open a new reagent strips container D. All of the above |
| 10. When a new bottle of qc material is opened, what information is placed on the label? | A. The supervisor's initials B. The lot number C. The date and the laboratory worker's initials D. The time the bottle was opened |
| 11. When a control is run, what information is documented? | A. The lot number B. Expiration date of the control C. The test results D. All of the above |
| 12. State which of the CLIA categories is assigned to each of the following laboratory tests by placing the appropriate number in front of the test | 1. Waived 2. PPM 3. Moderate complexity 4. High complexity ____A. Reagent strip urinalysis ____B. Urine culture ____C. Complete urinalysis using the Clinitek 500 ____D. Urine microscopic ____E. Urine pregnancy test |
| 13. How often does CLIA' 88 require documentation of technical competency? | A. Every 6 months B. Once a year C. Twice the first year and then annually D. Twice the first year and then every 5 years |
| 14. Who are the laboratory's "customers" in CQI? | A. Physicians B. Patients' family members C. Patients D. All of the above |
| 15. What is the primary goal of TQM? | A. Increased laboratory productivity B. Improved patient outcomes C. Reliability of test results D. Precise test results |
| 16. Match the purpose for developing each of the following | 1. Flowcharts 2. Cause-and-effect diagrams 3. Pareto charts 4. Run charts ____A. Determine cyclic and seasonal differences compared to an average ____B. Break down a process into steps ____C. Identify the major contributors to a problem ____D. Determine the cause of a problem |
| 17. True or False | Most medical errors are the fault of individuals, not the system. |
| 8. The presence of fatty casts is associated with all of the following except | A. Nephrotic syndrome B. Focal segmental glomeruloscierosis C. Nephrogenic diabetes insipidus D. Minimal change disease |
| 9. High levels of proteinuria are early symptoms of | A. Alport syndrome B. Diabetic nephropathy C. IgA nephropathy D. Nephrotic syndrome |
| 10. Ischemia frequently produces | A. Acute renal tubular necrosis B. Minimal change disorder C. Acute renal failure D.BothAandC |
| 11. A disorder associated with polyuria and low specific gravity is | A. Renal glucosuria B. Cystitis C. Nephrogenic diabetes insipidus D. Focal segmental glomeruloscierosis |
| 12. An inherited or accquired disorder producing a generalized defect in tubular reabsorption is | A. Alport syndrome B. Acute interstitial nephritis C. Fanconi syndrome D. Renal glucosuria |
| 13. The presence of renal tubular epithelial cells and casts is an indication of | A. Acute interstitial nephritis B. Chronic glomerulonephritis C. Minimal change disease D. Acute tubular necrosis |
| 14. Differentiation between cystitis and pyelonephritis is aided by the presence of | A. WBC casts B. RBC casts C. Bacteria D. Granular casts |
| 15. The presence of WBCs and WBC casts with no bacteria seen is indicative of | A. Chronic pyelonephritis B. Acute tubular necrosis C. Acute interstitial nephritis D. Both B and C |
| 16. End-stage renal disease is characterized by all of the following except | A. Hypersthenuria B. Isosthenuria C. Azotemia D. Electrolyte imbalance |
| 17. Broad and waxy casts are most likely associated with | A. Nephrotic syndrome B. Chronic renal failure C. Focal segmental glomerulosclerosis D. Acute renal failure |
| 18. Postrenal acute renal failure could be caused by | A. Ischemia B. Acute tubular necrosis C. Acute interstitial nephritis D. Malignant tumors |
| 19. The most common composition of renal calculi is | A. Calcium oxalate B. Magnesium ammonium phosphate C. Cystine D. Uric acid |
| 20. Urinalysis on a patient being evaluated for renal calculi would be most beneficial if it showed | A. Heavy proteinuria B. Calcium oxalate crystals C. Macroscopic hematuria D. Microscopic hematuria |
| 1. All states require newborn screening for PKU for early | A. Modifications of diet B. Administration of antibiotics C. Detection of diabetes D. Initiation of gene therapy |
| 2. All of the following disorders can be detected by newborn screening except | A. Tyrosyluria B. MSUD C. Melanuria D. Galactosemia |
| 3. The best specimen for early newborn screening is a | A. Timed urine specimen B. Blood specimen C. First morning urine specimen D. Fecal specimen |
| 4. Abnormal urine screening tests categorized as an overflow disorder include all of the following except | A. Alkaptonuria B. Galactosemia C. Melanuria D. Cystinuria |
| 5. Which of the following disorders is not associated with the phenylalanine-tyrosine pathway? | A. MSUD B. Alkaptonuria C. Albinism D. Tyrosinernia |
| 6. Urine screening tests for PKU utilize | A. Microbial inhibition B. Nitroso-napthol C. Dinitrophenyihydrazine D. Ferric chloride |
| 7. The least serious form of tyrosylemia is | A. Immature liver function B. Type 1 C. Type 2 D. Type 3 |
| 8. An overflow disorder of the phenylalanine-tyrosine pathway that could produce a false-positive reaction with the reagent strip test for ketones is | A. Alkaptonuria B. Melanuria C. MSUD D. Tyrosyluria |
| 9. An overflow disorder that could produce a false-positive reaction with clinitest is | A. Cystinuria B. Alkaptonuria C. Indicanuria D. Porphyrinuria |
| 10. A urine that turns black after sitting by the sink for several hours could be indicative of | A. Alkaptonuria B. MSUD C. Melanuria D. BothAandC |
| 11. Ketonuria in a newborn is an indication of | A. MSUD B. Isovaleric acidemia C. Methylmalonic acidemia D. All of the above |
| 12. Urine from a newborn with MSUD will have a significant | A. Pale color B. Yellow precipitate C. Milky appearance D. Sweet odor |
| 13. A substance that reacts with p-nitroaniline is | A. Isovaleric acid B. Propionic acid C. Methylmalonic acid D. Indican |
| 14. Which of the following has a significant odor? | A. Isovaleric acidemia B. Propionic acidemia C. Methylmalonic acidemia D. Indicanuria |
| 15. Hartnup disease is a disorder associated with the metabolism of | A. Organic acids B. Tryptophan C. Cystine D. Phenylalanine |
| 16. 5-HIAA is a degradation product of | A. Heme B. Indole C. Serotonin D. Melanin |
| 17. Elevated urinary levels of 5-HIAA are associated with | A. Carcinoid tumors B. Hartnup disease C. Cystinuria D. Platelet disorders |
| 18. False-positive levels of 5-HIAA can be caused by a diet high in | A. Meat B. Carbohydrates C. Starch D. Bananas |
| 19. Place the appropriate letter in front of the following statements | A. Cystinuria B. Cystinosis ____IEM ____Inherited disorder of renal tubules ____Fanconi syndrome ____Cystine deposits in the cornea ____Early renal calculi formation |
| 20. Urine from patients with cystine disorders will react with | A. Dinitrophenylhydrazine B. Sodium cyanide C. Ehrlich reagent D. 1-Nitroso-napthol |
| 21. Blue diaper syndrome is associated with | A. Lesch-Nyhan syndrome B. Phenylketonuria C. Cystinuria D. Hartnup disease |
| 22. Homocystinuria is caused by failure to metabolize | A. Lysine B. Methionine C. Arginine D. Cystine |
| 23. Early detection is most valuable for correction of | A. Homocystinuria B. Cystinuria C. Indicanuria D. Porphyrinuria |
| 24. The Ehrlich reaction will only detect the presence of | A. Aminolevulinic acid B. Porphobilinogen C. Coproporphyrin D. Protoporphyrin |
| 25. Acetylacetone is added to the urine prior to performing the Ehrlich test when checking for | A. Aminolevulinic acid B. Porphobilinogen C. Uroporphyrin D. Coproporphyrin |
| 26. The classic urine color associated with porphyria is | A. Dark yellow B. Indigo blue C. Pink D. Port wine |
| 27. Which of the following specimens can be used for porphyrin testing? | A. Urine B. Blood C. Feces D. All of the above |
| 28. The two stages of heme formation affected by lead poisoning are | A. Porphobilinogen and uroporphyrin B. Aminolevulinic acid and porphobilinogen C. Coproporphyrin and protoporphyrin D. Aminolevulinic acid and protoporphyrin |
| 29. Hurler, Hunter, and Sanfilippo syndromes are hereditary disorders affecting metabolism of | A. Porphyrins B. Fumes C. Mucopolysaccharides D. Tryptophan |
| 30. Many uric acid crystals in a pediatric urine specimen may indicate | A. Hurler syndrome B. Lesch-Nyhan disease C. Melitunia D. Sanfilippo syndrome |
| 31. Deficiency of the GALT enzyme will produce a | A. Positive Clinitest B. Glycosuria C. Galactosemia D. Both A and C |
| 32. Match the metabolic urine disorders with their classic urine abnormalities | ____PKU ____Indicanuria ____Cystinuria ____Homogentisic acid ____Lesch-Nyhan disease A. Sulfur odor B. Sweaty feet odor C. Orange sand in diaper D. Mousy odor E. Black color F Blue color |
| 1. The functions of the CSF include all of the following except | A. Removal of metabolic wastes B. Producing an ultrafiltrate of plasma C. Supplying nutrients to the CNS D. Protection of the brain and spinal cord |
| 2. The CSF flows through the | A. Choroid plexus B. Pia mater C. Arachnoid space D. Dura mater |
| 3. Substances present in the CSF are contolled by the | A. Arachnoid granulations B. Blood-brain barrier C. Presence of one-way valves D. Blood-CSF barrier |
| 4. The CSF tube labeled 3 is sent to | A. The hematology department B. The chemistry department C. The microbiology department D. The serology department |
| 5. The CSF tube that should be refrigerated is | A. Tube 1 B. Tube 2 C. Tube 3 D. Tube 4 |
| 6. Place the appropriate letter in front of the statement that best describes CSF specimens in these two conditions | A. Traumatic tap B. Intracranial hemorrhage _____Even distribution of blood in all tubes _____Xanthochromic supernatant _____Concentration of blood in tube 1 is greater than in tube 3 _____Specimen contains clots |
| 7. The presence of xanthochromia can be caused by all of the following except | A. Immature liver function B. RBC degradation C. A recent hemorrhage D. Elevated CSF protein |
| 8. A web-like pellicle in a refrigerated CSF specimen is indicative of | A. Tubercular meningitis B. Multiple sclerosis C. Primary CNS malignancy D. Viral meningitis |
| 9. Given the following information, calculate the CSF WBC count cells counted, 80; dilution, 1:10; large Neubauer squares counted, 10.: | A. 8 B. 80 C. 800 D. 8000 |
| 10. A CSF WBC count is diluted with | A. Distilled water B. Normal saline C. Acetic acid D. Methylene blue |
| 11. A total CSF cell count on a clear fluid should be | A. Reported as normal B. Not reported C. Diluted with normal saline D. Counted undiluted |
| 12. The purpose of adding albumin to CSF before cytocentrifugation is to | A. Increase the cell yield B. Decrease the cellular distortion C. Improve the cellular staining D. BothAandB |
| 13. The primary concern when pleocytosis of neutrophils and lymphocytes is found in the CSF is | A. Meningitis B. CNS malignancy C. Multiple sclerosis D. Hemorrhage |
| 14. Neutrophils with pyknotic nuclei may be mistaken for | A. Lymphocytes B. Nucleated RBCs C. Malignant cells D. Spindle-shaped cells |
| 15. The presence of which of the following cells is increased when a CNS shunt malfunctions? | A. Neutrophils B. Macrophages C. Eosinophils D. Lymphocytes |
| 16. Macrophages appear in the CSF following | A. Hemorrhage B. Repeated spinal taps C. Diagnostic procedures D. All of the above |
| 17. Nucleated RBCs are seen in the CSF as a result of | A. Elevated blood RBCs B. Treatment of anemia C. Severe hemorrhage D. Bone marrow contamination |
| 18. Following a CNS diagnostic procedure, which of the following might be seen in the CSF? | A. Choroidal cells B. Ependymal cells C. Spindle-shaped cells D. All of the above |
| 19. Hemosiderin granules and hematoidin crystals are seen in | A. Lymphocytes B. Macrophages C. Ependyrnal cells D. Neutrophils |
| 20. Myeloblasts are seen in the CSF | A. In bacterial infections B. In conjunction with CNS malignancy C. Following cerebral hemorrhage D. As a complication of acute leukemia |
| 21. Cells resembling large and small lymphocytes with cleaved nuclei represent | A. Lymphoma cells B. Choroid cells C. Melanoma cells D. Medulloblastoma cells |
| 22. The normal value of CSF protein is | A. 6-8 g/dL B. 15—45 g/dL C. 6-8 mg/dL D. 15—45 mg/dL |
| 23. CSF can be differentiated from plasma by the presence of | A. Albumin B. Globulin C. Prealbumin D. Tau transferrin |
| 24. In plasma, the second most prevalent protein is lgG; in CSF, the second most prevalent protein is | A. Transferrin B. Prealbumin C. IgA D. Ceruloplasmin |
| 25. Elevated CSF protein values can be caused by all of the following except | A. Meningitis B. Multiple sclerosis C. Fluid leakage D. CNS malignancy |
| 26. The integrity of the blood-brain barrier is measured using the | A. CSF/serum albumin index B. CSF/serum globulin ratio C. CSF albumin index D. CSF IgG index |
| 27. Given the following results, calculate the lgG index- CSF IgG, 50 mg/dL; serum IgG, 2 gmldL; CSF albumin, 70 mg/dL; serum albumin, 5 gmldL. | A. 0.6 B. 6.0 C. 1.8 |
| 28. The CSF IgG index calculated in Study Question 27 is indicative of | A. Synthesis of IgG in the CNS B. Damage to the blood-brain barrier C. Cerebral hemorrhage D. Lymphoma infiltration |
| 29. The finding of oligoclonal bands in the CSF and not in the serum is seen with | A. Multiple myeloma B. CNS malignancy C. Multiple sclerosis D. Viral infections |
| 30. A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL is suggestive of | A. Fungal meningitis B. Viral meningitis C. Tubercular meningitis D. Bacterial meningitis |
| 31. A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of | A. 20 mg/dL B. 60 mg/dL C. 80 mg/dL D. 120 mg/dL |
| 32. CSF lactate will be more consistantly decreased in | A. Bacterial meningitis B. Viral meningitis C. Fungal meningitis D. Tubercular meningitis |
| 33. Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome? | A. Ammonia B. Lactate C. Glucose D. ketoglutarate |
| 34. Prior to performing a Gram stain on CSF, the specimen must be | A. Filtered B. Warmed to 37°C C. Centrifuged D. Mixed |
| 35. All of the following statements are true about cryptoccocal meningitis except | A. An India Ink preparation is positive B. A starburst pattern is seen on Gram stain C. The WBC count is over 2000 D. A confirmatory immunology test is available |
| 36. The test of choice to detect neurosyphilis is the | A. RPR B. VDRL C. FTA D. 2.8 |
| 1. Maturation of spermatozoa takes place in the | A. Sertoli cells B. Seminiferous tubules C. Epididymis D. Seminal vesicles |
| 2. Enzymes for the coagulation and liquefaction of semen are produced by the | A. Seminal vesicles B. Bulbourethral glands C. Ductus deferens D. Prostate gland |
| 3. The major component of seminal fluid is | A. Glucose B. Fructose C. Acid phosphatase D. Citric acid |
| 4. If the first portion of a semen specimen is not collected, the semen analysis will have an abnormal | A. ph B. Viscosity C. Sperm concentration D. Sperm motility |
| 5. Failure of laboratory personnel to document the time a semen sample is collected primarily affects the interpretation of semen | A. Appearance B. Volume C. ph D. Viscosity |
| 6. Liquefaction of a semen specimen should take place within | A. 1 hour B. 2 hours C. 3 hours D. 4 hours |
| 7. A semen specimen delivered to the laboratory in a condom has a normal sperm count and markedly decreased sperm motility. This is indicative of | A. Decreased fructose B. Antispermicide in the condom C. Increased semen viscosity D. Increased semen alkalinity |
| 8. An increased semen ph may be caused by | A. Prostatic infection B. Decreased prostatic secretions C. Decreased bulbourethral gland secretions D. All of the above |
| 9. Proteolytic enzymes may be added to semen specimens to | A. Increase the viscosity B. Dilute the specimen C. Decrease the viscosity D. Neutralize the specimen |
| 10. The normal sperm concentration is | A. Below 20 million per microliter B. Above 20 million per milliliter C. Below 20 million per milliliter D. Above 20 million per microliter |
| 11. Given the following information, calculate the sperm concentration dilution, 1 to 20; sperm counted in five RBC squares on each side of the hemocytometer, 80 and 86; volume, 3 mL. | A. 80 million per milliliter B. 83 million per milliliter C. 86 million per milliliter D. 169 million per microliter |
| 12. Using the above information, calculate the sperm concentration when 80 sperm are counted in 1 WBC square and 86 sperm are counted in another WBC square | A. 83 million per milliliter B. 166 million per ejaculate C. 16.6 million per milliliter D. 50 million per ejaculate |
| 13. The primary reason to dilute a semen specimen before performing a sperm concentration is to | A. Immobilize the sperm B. Facilitate the chamber count C. Decrease the viscosity D. Stain the sperm |
| 14. When performing a sperm concentration, 60 sperm are counted in the RBC squares on one side of the hemocytometer and 90 sperm are counted in the RBC squares on the other side. The specimen is diluted 1 to 20. The | A. Specimen should be rediluted and counted B. Sperm count is 75 million per milliliter C. Sperm count is greater than 5 million per milliliter D. Sperm concentation is abnormal |
| 15. Sperm motility evaluations are performed | A. Immediately after the specimen is collected B. Within 1—2 hours of collection C. After 3 hours of incubation D. At 6-hour intervals for one day |
| 16. Sperm motility is evaluated on the basis of | A. Speed B. Direction C. Tail movement D. Both A and B |
| 17. The percentage of sperm showing average motility that is considered normal is | A. 25% B. 50% C. 60% D. 75% |
| 18. All of the following are grading criteria for sperm motility except | A. Rapid straight-line movement B. Rapid lateral movement C. No forward progression D. No movement |
| 19. The purpose of the acrosomal cap is | A. Ovum penetration B. Protection of the nucleus C. Energy for tail movement D. Protection of the neckpiece |
| 20. The sperm part containing a mitochondrial sheath is the | A. Head B. Neckpiece C. Midpiece D. Tail |
| 21. All of the following are associated with sperm motility except the | A. Head B. Neckpiece C. Midpiece D. Tail |
| 22. The morphologic shape of a normal sperm head is | A. Round B. Tapered C. Oval D. Amorphous |
| 23. Normal sperm morphology when using the WHO criteria is | A. >30% normaI forms B. <30% normaI forms C. >15% abnormal forms D. <15% normal forms |
| 24. Additional parameters measured by Kruger strict morphology include all of the following except | A. Viability B. Presence of vacuoles C. Acrosome size D. Tail length |
| 25. Round cells that are of concern and may be included in sperm counts and morphology analysis are | A. Leukocytes B. Spermatids C. RBCs D. BothAandB |
| 26. If 5 round cells per 100 sperm are counted in a sperm morphology smear and the sperm concentation is 30 million, the concentraton of round cells is | A. 150,000 B. 1.5 million C. 300,000 D. 15 million |
| 27. Following an abnormal sperm motility test with a normal sperm count, what additional test might be ordered? | A. Fructose level B. Zinc level C. Mar test D. Eosin-nigrosin stain |
| 28. Follow-up testing for a low sperm concentration would include testing for | A. Antisperm antibodies B. Seminal fluid fructose C. Sperm viability D. Prostatic acid phosphatase |
| 29. The immunobead test for antisperm antibodies | A. Detects the presence of male antibodies B. Determines the presence of IgG, 1gM, and IgA antibodies C. Determines the location of antisperm antibodies D. All of the above |
| 30. Measurement of Œ-glucosidase is performed to detect a disorder of the | A. Seminiferous tubules B. Epididymis C. Prostate gland D. Bulbourethral glands |
| 31. A specimen delivered to the laboratory with a request for prostatic acid phosphatase and glycoprotein p30 was collected to determine | A. Prostatic infection B. Presence of antisperm antibodies C. A possible rape D. Successful vasectomy |
| 32. Following a negative postvasectomy wet preparation, the specimen should be | A. Centrifuged and reexamined B. Stained and reexamined C. Reported as no sperm seen D. Both A and B |
| 33. Standardization of procedures and reference values for semen analysis is primarily provided by the | A. Manufacturers of instrumentation B. WHO C. Manufacturers of control samples D. Clinical laboratory improvement amendments |
| 1. The functions of synovial fluid include all of the following except | A. Lubrication for the joints B. Removal of cartilage debris C. Cushioning joints during jogging D. Providing nutrients for cartilage |
| 2. The primary function of synoviocytes is to | A. Provide nutrients for the joints B. Secrete hyaluronic acid C. Regulate glucose filtration D. Prevent crystal formation |
| 3. Which of the following is not a frequently performed test on synovial fluid? | A. Uric acid B. WBC count C. Crystal examination D. Gram stain |
| 4. The procedure for collection of synovial fluid is called | A. Synovialcentesis B. Arthrocentesis C. Joint puncture D. Arteriocentesis |
| 5. Match the following disorders with their appropriate group | A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic ____Gout ____N. gonorrhoeae infection ____Lupus erythematosus ____Osteoarthritis ____Hemophilia ____Rheumatoid arthritis ____Heparin overdose |
| 6. Normal synovial fluid resembles | A. Egg white B. Normal serum C. Dilute urine D. Lipemic serum |
| 7. Powdered anticoagulants should not be used in tubes for synovial fluid testing because it interferes with | A. Cell counts B. Glucose tests C. Crystal examination D. Differentials |
| 8. Addition of a cloudy, yellow synovial fluid to acetic acid produces alan | A. Yellow-white precipitate B. Easily dispersed clot C. Solid clot D. Opalescent appearance |
| 9. To determine if a fluid is synovial fluid, it should be mixed with | A. Sodium hydroxide B. Hypotonic saline C. Hyaluronidase D. Acetic acid |
| 10. The highest WBC count can be expected to be seen with | A. Noninflammatory arthritis B. Inflammatory arthritis C. Septic arthritis D. Hemorrhagic arthritis |
| 11. When diluting a synovial fluid WBC count, all of the following are acceptable except | A. Acetic acid B. Isotonic saline C. Hypotonie saline D. Saline with saponin |
| 12. The lowest percentage of neutophils would be seen in | A. Noninflammatory arthritis B. Inflammatory arthritis C. Septic arthritis D. Hemorrhagic arthritis |
| 13. All of the following are abnormal when seen in synovial fluid except | A. RA cells B. Reiter cells C. Synovial lining cells D. Lipid droplets |
| 14. Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are | A. Monosodium urate B. Cholesterol C. Calcium pyrophosphate D. Apatite |
| 15. Synovial fluid crystals associated with inflammation in dialysis patients are | A. Calcium pyrophosphate B. Calcium oxalate C. Corticosteroid D. Monosodium urate |
| 16. Crystals associated with pseudogout are | A. Monosodium urate B. Calcium pyrophosphate C. Apatite D. Corticosteroid |
| 17. Synovial fluid for crystal examination should be examined as alan | A. Wet preparation B. Wright stain C. Gram stain D. Acid-fast stain |
| 18. Crystals that have the ability to polarize light are | A. Corticosteroid B. Monosodium urate C. Calcium oxalate D. All of the above |
| 19. In an examination of synovial fluid under compensated polarized light, rhombic-shaped crystals are observed. What color would these crystals be when aligned parallel to the slow vibration? | A. White B. Yellow C. Blue D. Red |
| 20. If crystals shaped like needles are aligned perpendicular to the slow vibration of compensated polarized light, what color are they? | A. White B. Yellow C. Blue D. Red |
| 21. Negative birefringence occurs under compensated polarized light when | A. Slow light is impeded more than fast light B. Slow light is less impeded than fast light C. Fast light runs against the molecular grain of the crystal D. Both B and C |
| 22. Synovial fluid cultures are often plated on chocolate agar to detect the presence of | A. Neisseria gonorrhoeae B. Staphylococcus agalactiae C. Streptococcus viridans D. Enterococcus faecalis |
| 23. The most frequently performed chemical test on synovial fluid is | A. Total protein B. Uric acid C. Calcium D. Glucose |
| 24. Serologic tests on patients' serum may be performed to detect antibodies causing arthritis for all of the following disorders except | A. Pseudogout B. Rheumatoid arthritis C. Lupus erythematosus D. Lyme arthritis |
| 25. Serologic testing of synovial fluid for fibrinogen and C-reactive protein is performed to | A. Determine clot formation B. Determine the amount of inflammation C. Detect osteoarthritis D. Diagnose rheumatoid arthritis |
| 1. The primary purpose of serous fluid is | A. Removal of waste products B. Lowering of capillary pressure C. Lubrication of serous membranes D. Nourishing serous membranes |
| 2. The membrane that lines the wall of a cavity is the | A. Visceral B. Peritoneal C. Pleural D. Parietal |
| 3. During normal production of serous fluid, the slight excess of fluid is | A. Absorbed by the lymphatic system B. Absorbed through the visceral capillaries C. Stored in the mesothelial cells D. Metabolized by the mesothelial cells |
| 4. Production of serous fluid is controlled by | A. Capillary oncotic pressure B. Capillary hydrostatic pressure C. Capillary permeability D. All of the above |
| 5. An increase in the amount of serous fluid is called a/an | A. Exudate B. Transudate C. Effusion D. Malignancy |
| 6. Pleural fluid is collected by | A. Pleurocentesis B. Paracentesis C. Pericentesis D. Thoracentesis |
| 7. Place the appropriate letter in front of the following statements describing transudates and exudates | A. Transudate B. Exudate ___Caused by increased capillary permeability ___Caused by increased hydrostatic pressure ___Caused by decreased oncotic pressure ___Caused by congestive heart failure ___Malignancy related ___Tuberculosis related ___Nephrotic syndrome related ___Cloudy appearance |
| 8. Fluid-to—serum protein and lactic dehydrogenase ratios are performed on serous fluids | A. When malignancy is suspected B. To classify transudates and exudates C. To determine the type of serous fluid D. When a traumatic tap has occurred |
| 9. Which of the following requires the most additional testing | A. Transudate B. Exudate |
| 10. An additional test performed on pleural fluid to classify the fluid as a transudate or exudate is the | A. WBC count B. RBC count C. Fluid-to-cholesterol ratio D. Fluid-to—serum protein gradient |
| 11. A milky-appearing pleural fluid is indicative of | A. Thoracic duct leakage B. Chronic inflammation C. Microbial infection D. Both A and B |
| 12. Which of the following best represents a hemothorax? | A. Blood HCT: 42 Fluid HCT: 15 B. Blood HCT: 42 Fluid HCT: 10 C. Blood HCT: 30 Fluid HCT: 10 D. Blood HCT: 30 Fluid HCT: 20 |
| 13. All of the following are normal cells seen in pleural fluid except | A. Mesothelial cells B. Neutrophils C. Lymphocytes D. Mesothelioma cells |
| 14. A differential observation of pleural fluid associated with tuberculosis is | A. Increased neutrophils B. Decreased lymphocytes C. Decreased mesothelial cells D. Increased mesothelial cells |
| 15. All of the following are characteristics of malignant cells except | A. Cytoplasmic molding B. Absence of nucleoli C. Mucin-containing vacuoles D. Increased N:C ratio |
| 16. A pleural fluid pH of 6.0 is indicative of | A. Esophageal rupture B. Mesothelioma C. Malignancy D. Rheumatoid effusion |
| 17. A mesothelioma cell seen in pleural fluid indicates | A. Bacterial endocarditis B. Primary malignancy C. Metastatic lung malignancy D. Tuberculosis infection |
| 18. Another name for a peritoneal effusion is | A. Peritonitis B. Lavage C. Ascites D. Cirrhosis |
| 19. The test performed on peritoneal lavage fluid is | A. WBC count B. RBC count C. Absolute neutrophil count D. Amylase |
| 20. The recommended test for determining if peritoneal fluid is a transudate or an exudate is the | A. Fluid-to—serum albumin ratio B. Serum ascites albumin gradient C. Fluid-to—serum lactic dehydrogenase ratio D. Absolute neutrophil count |
| 21. Given the following results, classify this peritoneal fluid- serum albumin, 2.2 g/dL; serum protein, 6.0 gldL; fluid albumin, 1.6 g/dL. | A. Transudate B. Exudate |
| 22. Differentiation between bacterial peritonitis and cirrhosis is done by performing alan | A. WBC count B. Differential C. Absolute neutrophil count D. Absolute lymphocyte count |
| 23. Detection of the CA 125 tumor marker in peritoneal fluid is indicative of | A. Colon cancer B. Ovarian cancer C. Gastric malignancy D. Prostate cancer |
| 24. Chemical tests primarily performed on peritoneal fluid include all of the following except | A. Lactose dehydrogenase B. Glucose C. Alkaline phosphatase D. Amylase |
| 25. Cultures of peritoneal fluid are incubated | A. Aerobically B. Anaerobically C. At 37°C and 42°C D. Both A and B |
| 1. Which of the following is not a function of amniotic fluid? | A. Allow movement of the fetus B. Carbon dioxide and oxygen exchange C. Protect fetus from extreme temperature changes D. Protective cushion for the fetus |
| 2. What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses? | A. Fetal cell metabolism B. Fetal swallowing C. Fetal urine D. Transfer of water across the placenta |
| 3. Which of the following is not a reason for decreased amounts of amniotic fluid? | A. Fetus fails to begin swallowing B. Increased fetal swallowing C. Membrane leakage D. Urinary tract defects |
| 4. Why might a creatinine level be requested on an amniotic fluid? | A. Detect oligohydramnios B. Detect polyhydramnios C. Differentiate amniotic fluid from maternal urine D. Evaluate lung maturity |
| 5. Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of | A. Alpha fetoprotein B. Bilirubin C. Cells for cytogenetics D. Lecithin |
| 6. How are specimens for FLM testing delivered to and stored in the laboratory? | A. Delivered on ice and refrigerated or frozen B. Immediately centrifuged C. Kept at room temperature D. Delivered in a vacuum tube |
| 7. Why are amniotic specimens for cytogenetic analysis incubated at 37°C prior to analysis? | A. To detect the presence of meconium B. To differentiate amniotic fluid from urine C. To prevent photo-oxidation of bilirubin to biliverdin D. To prolong fetal cell viability and integrity |
| 8. Filtration of amniotic fluid is required to avoid decreased values in the test results for | A. Bilirubin B. Fetal cells C. Phospholipids D. Urea |
| 9. Match the following colors in amniotic fluid with their significance. | A. Colorless B. Dark green C. Red-brown D. Yellow ____1. Fetal death ____2. Normal ____3. Presence of bilirubin ____4. Presence of meconium |
| 10. A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte? | A. Bilirubin B. Lecithin C. Oxyhemoglobin D. Sphingomyelin |
| 11. Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus? | A. No hemolysis B. Mildly affected fetus C. Moderately affected fetus that requires close monitoring D. Severely affected fetus that requires intervention |
| 12. The presence of a fetal neural tube disorder may bedetected by | A. Increased amniotic fluid bilirubin B. Increased maternal serum alpha fetoprotein C. Decreased amniotic fluid phosphatidyl glycerol D. Decreased maternal serum acetycholinesterase |
| 13. True or False | An AFP MoM value greater than two times the median value is considered an indication of a neural tube disorder. |
| 14. When severe HDN is present, which of the following tests on the amniotic fluid would the physician not order to determine whether the fetal lungs are mature enough to withstand a premature delivery? | A. AFP levels B. Foam stability index C. Lecithin\sphingomyelin ratio D. Phosphatidyl glycerol detection |
| 15. The foam or shake test is a screening test for which amniotic fluid substance? | A. Bilirubin B. Lecithin C. Alpha fetoprotein D. Creatinine |
| 16. True or False | Prior to 35 weeks' gestation, the normal L/S ratio is less than 1.6. |
| 17. When performing an L/S ratio by thin-layer chromatography, a mature fetal lung will show | A. Sphingomyelin twice as concentrated as lecithin B. No sphingomyelin C. Lecithin twice as concentrated as sphingomyelin D. Equal concentrations of lecithin and sphingomyelin |
| 18. True or False | Phosphatidyl glycerol is present with an L/S ratio of 1.1. |
| 19. A rapid test for FLM that does not require perfor mance of thin-layer chromatography is | A. AFP levels B. Amniotic acetylcholinesterase C. Aminostat-FLM D. Bilirubin scan |
| 20. Does the failure to produce bubbles in the Foam Stability Index indicate increased or decreased lecithin? | A. Increased B. Decreased |
| 21. Microviscosity of amniotic fluid is measured by | A. Thin-layer chromatography B. Immunologic agglutination C. Spectrophotometer D. Fluorescence polarization |
| 22. The presence of phosphatidyl glycerol in amniotic fluid fetal lung maturity tests must be confirmed when | A. Hemolytic disease of the newborn is present B. The mother has maternal diabetes C. Amniotic fluid is contaminated by hemoglobin D. Neural tube disorder is suspected |
| 24. True or False | An US ratio of 2.0 correlates with a surfactant/albumin ratio of 39 mglg. |
| 25. A lamellar body count of 50,000 correlates with | A. Absent phosphatidyl glycerol and TDx-FLM II ratio of 39 B. US ratio of 1.5 and absent phosphatidyl glycerol C. OD at 650 nm of 1.010 and an L/S ratio of 1.1 D. OD at 650 nm of 0.150 and an L/S ratio of 2.0 |
| 26. Which test for FLM is least affected by contamination with hemoglobin and meconium? | A. Amniostat-FLM B. Foam Stability C. Lamellar Bodies Count D. TDx-FLM II |
| 1. In what part of the digestive tract do pancreatic enzymes and bile salts contribute to digestion? | A. Large intestine B. Liver C. Small intestine D. Stomach |
| 2. Where does the reabsorption of water take place in the primary digestive process? | A. Large intestine B. Pancreas C. Small intestine D. Stomach |
| 3. Which of the following tests is not performed to detect osmotic diarrhea? | A. Clinitest B. Fecal fats C. Fecal neutrophils D. Muscle fibers |
| 4. The normal composition of feces includes all of the following except | A. Bacteria B. Blood C. Electrolytes D. Water |
| 5. What is the fecal test that requires a 3-day specimen? | A. Fecal occult blood B. APT test C. Elastase I D. Quantitative fecal fat testing |
| 6. The normal brown color of the feces is produced by | A. Cellulose B. Pancreatic enzyme C. Undigested foodstuffs D. Urobilin |
| 7. Diarrhea can result from all of the following except | A. Addition of pathogenic organisms to the normal intestinal flora B. Disruption of the normal intestinal bacterial flora C. Increased concentration of fecal electrolytes D. Increased reabsorption of intestinal water and electrolytes |
| 8. Stools from persons with steatorrhea will contain excess amounts of | A. Barium sulfate B. Blood C. Fat D. Mucus |
| 9. Which of the following pairings of stool appearance and cause does not match? | A. Black, tarry: blood B. Pale, frothy: steatorrhea C. Yellow-gray: bile duct obstruction D. Yellow-green: barium sulfate |
| 10. Stool specimens that appear ribbon-like are indicative of which condition? | A Bile-duct obstruction B. Colitis C. Intestinal constriction D. Malignancy |
| 11. A black tarry stool is indicative of | A. Upper GI bleeding B. Lower GI bleeding C. Excess fat D. Excess carbohydrates |
| 12. Chemical screening tests performed on feces include all of the following except | A. APT test B. Clinitest C. Pilocarpine iontophoresis D. Trypsin digestion |
| 13. Secretory diarrhea is caused by | A. Antibiotic administration B. Lactose intolerance C. Celiac sprue D. Vibrio cholerae |
| 14. The fecal osmotic gap is elevated in which disorder? | A. Dumping syndrome B. Osmotic diarrhea C. Secretory diarrhea D. Steatorrhea |
| 15. Microscopic examination of stools provides preliminary information as to the cause of diarrhea because | A. Neutrophils are present in conditions caused by toxin-producing bacteria B. Neutrophils are present in conditions that affect the intestinal wall C. Red and white blood cells are present if the cause is bacterial D. Neutrophils are present if the condition is of non-bacterial etiology |
| 16. True or False | The presence of fecal neutrophils would be expected with diarrhea caused by a rotavirus. |
| 17. Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent | A. Cholesterol B. Fatty acids C. Neutral fats D. Soaps |
| 18. Microscopic examination of stools mixed with Sudan III and glacial acetic acid and then heated will show small orange-red droplets that represent | A. Fatty acids and soaps B. Fatty acids and neutral fats C. Fatty acids, soaps, and neutral fats D. Soaps |
| 19. When performing a microscopic stool examination for muscle fibers, the structures that should be counted | A. Are coiled and stain blue B. Contain no visible striations C. Have two-dimensional striations D. Have vertical striations and stain red |
| 20. A value of 85% fat retention would indicate | A. Dumping syndrome B. Osmotic diarrhea C. Secretory diarrhea D. Steatorrhea |
| 21. Which of the following tests would not be indicative of steatorrhea? | A. Fecal elastase-I B. Fecal occult blood C. Sudan III D. Van de Kamer |
| 22. Gum guaiac is preferred over ortho-tolidine for "occult" blood in mass screening tests because | A. There is less interference from dietary hemoglobin B. Ortho-tolidine is less sensitive C. Gum guaiac reacts equally with formed and watery stools D. Filter paper is more easily impregnated with gum guaiac |
| 23. The term "occult" blood describes blood that | A. Is produced in the lower GI tract B. Is produced in the upper GI tract C. Is not visibly apparent in the stool specimen D. Produces a black, tarry stool |
| 24. What is the recommended number of samples that should be tested to confirm a negative occult blood result? | A. One random specimen B. Two samples taken from different parts of three stools C. Three samples taken from the outermost portion of the stool D. Three samples taken from different parts of two stools |
| 25. Which test is more sensitive to upper GI bleeding? | A. Guaic fecal occult blood B. Hemoquant C. Immunochemical fecal occult blood D. Sudan Ill |
| 26. Annual testing for fecal occult blood has a high predictive value for the detection of | A. Colorectal cancer B. Malabsorption syndromes C. Pancreatic deficiencies D. Ulcers |
| 27. Tests for the detection of "occult" blood rely on the | A. Reaction of hemoglobin with hydrogen peroxide B. Pseudoperoxidase activity of hemoglobin C. Reaction of hemoglobin with ortho-tolidine D. Pseudoperoxidase activity of hydrogen peroxide |
| 28. What is the significance of an APT test that remains pink after addition of sodium hydroxide? | A. Fecal fat is present. B. Fetal hemoglobin is present. C. Fecal trypsin is present. D. Vitamin C is present. |
| 29. In the Van de Kamer method for quantitative fecal fat determinations, fecal lipids are | A. Converted to fatty acids prior to titrating with sodium hydroxide B. Homogenized and titrated to a neutral endpoint with sodium hydroxide C. Measured gravimetrically after washing D. Measured by spectrophotometer after addition of Sudan III |
| 30. A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to digest gelatin may have | A. Bacterial dysentery B. A duodenal ulcer C. Cystic fibrosis D. Lactose intolerance |
| 31. A stool specimen collected from an infant with diarrhea has a pH of 5.0. This result correlates with a | A. Positive APT test B. Negative trypsin test C. Positive Clinitest D. Negative occult blood test |
| 32. Which of the following tests differentiates a malabsorption cause from a maldigestion cause in steatorrhea? | A. APT test B. D-xylose test C. Lactose tolerance test D. Occult blood test |
| 23. Match the following principles with the appropriate FLM test. Principle FLM Test: | 1. Amniostat-FLM 2. Lamellar body 3. LIS ratio count 4. Microviscosity test ____A. Immunologic agglutination test ____B. Uses albumin as the internal standard ____C. Uses the platelet channel on a hematology instrument ____D. Uses sphingomyelin as an internal standard |
| 8. A color change that indicates when a patient's specimen or reagent is added correctly would be an example of: | A. External QC B. Equivalent QC C. Internal QC D. Proficiency testing |
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