Urine/Body Fluids
A technologist performed a STAT spinal fluid count by pipetting undiluted spinal fluid in a Neubauer Counting Chamber and counting both sides of the chamber ( 4 large WBC squares on each side). A total of 54 White Cells were counted. How many White Cells would there be per cubic millimeter? Select one: a.3.80 b.67.5 c.13.5 d.300 e.540
13.5
A dilution commonly used for a routine sperm count is: Select one: a.1:2 b.1:20 c.1:200 d.1:400
1:20
Below are the urinalysis results of a female patient completed within two hours of collection. The slight turbidity observed correlates most likely with which of the following results? Protein= +1 WBC= 15 RBC= 1 Bacteria= +2 Select one: a.pH b.Bacteria, RBC, and the WBC c.Specific gravity d.None of the above
Bacteria, RBC, and the WBC
The elements indicated by the arrows are more likely to be seen in patients with which condition? Select one: a.Bacterial infection b.Nephrotic syndrome c.Diabetes d.Renal failure
Bacterial infection
A 3-year old girl was brought to the ER with a temperature of 103o F, lethargy, and cervical rigidity. Three tubes of cloudy CSF were delivered to the Lab, and preliminary test result showed: WBC: 4,500 / uL Differential : 88% neutrophils Glucose: 15 mg/dL 12% lymphocytes Protein: 140 mg/dL Gram stain: No organisms observed From these results, what preliminary diagnosis SHOULD the physician consider? Select one: a.Brain tumor b.Bacterial meningitis c.viral meningitis d.Subdural hematoma
Bacterial meningitis
Which is the best method for examination of synovial crystals: Select one: a.Phase contrast b.Darkfield microscopy c.Bright field microscopy d.Polarized light
Polarized light
A daily urine output which is over 2500 mL/24 hours is referred to as: Select one: a.Anuria b.Oliguria c.Polyuria d.Pyuria
Polyuria
The cells shown in the image to the right are: Select one: a.Transitional epithelial cells b.Renal tubular epithelial cells c.Yeast cells d.Squamous epithelial cells
Transitional epithelial cells
Normal crystals that can be found in urine include: Select one: a.Leucine b.Tyrosine c.Cystine d.Triple phosphate
Triple phosphate
What is the identification of these crystals seen in a urine with an acid pH? Select one: a.Uric acid b.Calcium oxlate c.Triple phosphate d.Calcium carbonate
Calcium oxlate
Match the following terms with the statement that best describes each: Meninges Transudate Pleurisy Effusion
-membrane covering the brain under the skull -fluid accumulation due to malfunction of ability to form and reabsorb fluid -inflammation of the pleural membranes -excess accumulation of fluid within the body serous cavities
How many white blood cells (WBCs) would be considered normal for adult cerebrospinal fluid? Select one: a.Any number of WBCs is considered abnormal b.0-5 WBCs/uL c.6-10 WBCs/uL d.up to 30 WBCs/uL
0-5 WBCs/uL
What is the optimal time to begin initial microscopic examination of a semen specimen, assuming liquefaction is complete? Select one: a.30 minutes b.2 hours c.4 hours d.8 hours
30 minutes
What is the lower reference limit for progressive motility of spermatozoa when performing a semen analysis? Select one: a.12% b.22% c.32% d.40%
32%
Which of the following would be considered normal for a glucose level in cerebrospinal fluid? Select one: a.30 mg/dL b.60 mg/dL c.120 mg/dL d.150 mg/dL
60 mg/dL
What is the approximate volume of spinal fluid in an adult? Select one: a.10-40 mL b.50-70 mL c.90-150 mL d.200-500 mL
90-150 mL
What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hrs? Select one: a. 9.5 mL/min b. 13.6 mL/min c. 95 mL/min d.136 mL/min
95 mL/min
The sediment from a freshly collected urine specimen is examined microscopically. In addition to bacteria, what other finding from the list below would further indicate the presence of a urinary tract infection (UTI)? Select one: a.0 - 2 cuboidal epithelial cells/high power field (HPF) b.> 100 white blood cells (WBCs)/ HPF c.10 - 20 squamous epithelial cells/ HPF d.Rare hyaline cast/ low power field (LPF)
> 100 white blood cells (WBCs)/ HPF
Below is a urinalysis report on a 37-year-old woman seen in the ER with headache, hypertension, weight loss and mild edema: Color: redClarity: cloudy Sp. Gravity 1.010 pH 5.0 Glucose: negative Protein: 3+ Ketones: negative Nitrite: negative Blood: moderate Urobilinogen: normalMicroscopic:25-50 RBC2-4 WBC2-5 granular casts2-5 hyaline casts0-2 RBC casts few epithelial cells Based on the urinalysis report above, the MOST probable diagnosis of this patient's condition is: Select one: a.Acute glomerulonephritis b.Acute pyelonephritis c.Acute cystitis d.Nephrotic syndrome
Acute glomerulonephritis
Oliguria is usually correlated with: Select one: a.Acute glomerulonephritis b.Diabetes mellitus c.Hepatitis d.Tubular damage
Acute glomerulonephritis
The reagent strip method for protein primarily tests for which type of protein? Select one: a.Globulin b.Bence-Jones protein c.Albumin d.Mucoprotein
Albumin
False-positive tests for protein on a urine reagent strip may be caused by: Select one: a.Blood presence in the specimen b.High amounts of bilirubin c.Alkaline medication d.All of the above
Alkaline medication
Which of the following characteristics of cerebrospinal fluid are considered abnormal? Select one: a.Turbidity b.Bloody appearance c.Xanthochromia d.All of the above
All of the above
Which of the following conditions produce glycosuria? Select one: a.Diabetes mellitus b.Fanconi's syndrome c.Impaired tubular reabsorption/advanced kidney failure d.All of the above
All of the above
A patient who has a primarily vegetarian diet will most likely have: Select one: a.An acid urine pH b.An alkaline urine pH c.A neutral pH d.pH is not affected by the patient's diet
An alkaline urine pH
Substances found in urinary sediment that are more easily distinguished by use of polarized microscope are: Select one: a.WBC b.RBC c.Waxy casts d.Anisotropic cholesterol droplets
Anisotropic cholesterol droplets
Which of the following ketones is NOT detected in the Acetest® tablet method? Select one: a.Acetone b.Beta-hydroxybutyric acid c.Acetoacetic acid d.Beta-hydroxybutyric acid and acetone
Beta-hydroxybutyric acid
Bacterial contamination of a urine specimen from a normal healthy individual could originate from all of the following except: Select one: a.Contaminated urine container b.Vagina c.Bladder d.Vulva
Bladder
Which of the following statements is true for the reagent strip procedure? Select one: a.Prolonged immersion may wash out reagents. b.Blot the reagent strip with a paper towel before placing on the tray of the dipstick reader c.All tests require the same reading times d.The expiration date on the reagent strip container does not matter, as long as the controls are acceptable.
Blot the reagent strip with a paper towel before placing on the tray of the dipstick reader
Identify the urine sediment elements indicated by the arrows in this microscopic field. Select one: a. Calcium oxalate crystals b.Uric acid crystals c.Amorphous urate crystals d.Cystine crystals
Calcium oxalate crystals
CSF lymphocytosis is associated with all of the following except: Select one: a.Cerebral abscess b.Viral meningitis c.Chronic fungal meningitis d.Chronic tuberculous meningitis
Cerebral abscess
The crystals seen in this image are ____? Select one: a.Leucine crystals b.Cholesterol crystals c.Bilirubin crystals d.Cystine crystals
Cholesterol crystals
Where does most cerebrospinal fluid (CSF) originate? Select one: a.Cerebral arachnoid space b.Choroid plexus c.Ventricles d.Lumbar region
Choroid plexus
Where does most cerebrospinal fluid originate? Select one: a.Cerebral arachnoid space b.Choroid plexus c.Ventricles d.Lumbar region
Choroid plexus
The Clinitest® reaction is based on which of the following principles? Select one: a.Copper reduction b.Ortho-toluidine oxidation c.Diazotization of sugars d.Enzyme reaction
Copper reduction
Which of the following tests would be used in the assessment of glomerular filtration? Select one: a.24 hour urine protein b.Creatinine clearance c.PSP test d.Urea
Creatinine clearance
An India Ink preparation is used to identify: Select one: a.Crystals in synovial fluid b.Cryptococcus neoformans in CSF c.Bacteria in CSF d.WBCs in synovial fluid
Cryptococcus neoformans in CSF
A urine production of less than 400 mL/day is: Select one: a.Consistent with normal renal function and water balance b.Termed isosthenuria c.Defined as oliguria d.Associated with diabetes mellitus
Defined as oliguria
A test for microalbuminuria is used most often to monitor patients with which of the following diseases or conditions? Select one: a.Diabetes b.Bacterial infection c.Multiple myeloma d.Hepatitis C
Diabetes
A 62-year-old man drank an unknown liquid in a suicide attempt, and his urine contained crystals similar in shape to those shown in this image. This man MOST likely ingested:
Ethylene glycol
An increased number of these cells, when found upon microscopic examination of urine is termed: Select one: a.Glycosuria b.Hematuria c.Uremia d.Normal urine
Hematuria
Which of the following parameters is generally NOT considered to be a part of a seminal fluid analysis? Select one: a.Sperm count b.Morphology examination c.Viscosity assessment d.Glucose concentration e.Motility
Glucose concentration
Unconjugated bilirubin is conjugated in the liver with which of the following substances to become water soluble? Select one: a.Glycogen b.Glucose oxidase c.Glucuronic acid d.Glycine
Glucuronic acid
Which of the following casts might be found in the urine of a healthy individual after strenuous exercise? Select one: a.Epithelial cell casts and granular casts b.Hyaline casts and granular casts c.Granular casts waxy casts d.Waxy casts and hyaline casts
Hyaline casts and granular casts
Which of the following is NOT a standard method for measuring the specific gravity of urine? Select one: a.Refractometry b.Hydrometry c.Osmolality d.Urine reagent strips
Hydrometry
The primary mechanism responsible for glomerular filtration is: Select one: a.Osmotic gradient b.Concentration of blood components c.Rate of blood flow through the kidneys d.Hydrostatic differential in glomerular tufts
Hydrostatic differential in glomerular tufts
A low CSF glucose level is associated with all the following except: Select one: a.Hyperglycemia b.Fungal meningitis c.Amebic meningitis d.Trichinosis meningitis
Hyperglycemia
Which one of the following statements about urea is false? Select one: a.It accounts for 75% of nonprotein nitrogen excreted b.It is elevated in a variety of glomerular, tubular, interstitial, and vascular renal diseases c.It is decreased in dehydration d.The reference range for normal individuals is 7 to 18 mg/dl when expressed as blood urea nitrogen
It is decreased in dehydration
A test that can be used as a confirmatory test for urobilinogen is: Select one: a.Acetest® b.Ictotest® c.Clinitest d.Watson-Schwartz Test
Ictotest®
Which of the following methods may be employed to definitively identify Bence-Jones proteins? Select one: a.Immunoelectrophoresis b.Sulfosalicyclic acid precipitation c.Heat precipitation at 40-60oC d.Urine dipstick
Immunoelectrophoresis
Which of the following tests confirms the presence of Bence-Jones proteinuria: Select one: a.Protein electrophoresis b.Sulfosalicylic acid precaution c.Cryoprecipitation d.Immunoelectrophoresis
Immunoelectrophoresis
The glucose result on a urine specimen from an infant is negative on the urine chemical reagent strip, what is the next step? Select one: a.It can be reported that the specimen is negative for other reducing substances such as galactose. b.It must be followed by the Acetest® tablet test to check for other reducing substances. c.There is nothing else to do, report the result as negative for glucose. d.It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances.
It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances.
Which of the following may cause a false positive bilirubin result on a urine chemical reagent strip? Select one: a.Urobilinogen b.Presence of nitrites c.Large doses of chloropromazine d.robilin
Large doses of chloropromazine
Which one of the following crystals is NOT found in normal urine? Select one: a.Triple phosphate b.Ammonium biurate c.Calcium oxalate d.Leucine
Leucine
The image is a Wright-Giemsa stained smear (1000X) of cerebrospinal fluid (CSF). The arrows point to cells that may indicate which of the following conditions? Select one: a.Allergic reaction b.Bacterial meningitis c.Leukemia with CNS involvement d.Viral meningitis
Leukemia with CNS involvement
Which of the following is characteristic of an exudate effusion? Select one: a.Leukocyte count greater than 1000 WBC/uL b.Clear appearance c.Protein concentration less than 3.0 g/dL d.Absence of fibrinogen
Leukocyte count greater than 1000 WBC/uL
Normal adult CSF may have 0-5 white blood cells (WBCs) / uL. Which of the following cell types account for 60-100% of these WBCs? Select one: a.Neutrophils b.Lymphocytes c.Monocytes d.Eosinophils
Lymphocytes
A technologist is having trouble differentiating between red blood cells, oil droplets, and yeast cells on a urine microscopy. Acetic acid should be added to the sediment to: Select one: a.Lyse the yeast cells b.Lyse the red blood cells c.Dissolve the oil droplets d.Crenate the red blood cells
Lyse the red blood cells
Which of the following situations suggest a traumatic tap occurred? Select all that apply. Select one or more: a.More blood is in tube 1 than tubes 2,3, or 4. b.Immediate centrifugation reveals pink supernatant. c.Blood clots are present. d.3+ turbidity is present.
More blood is in tube 1 than tubes 2,3, or 4.
Bence-Jones proteinuria is associated with all of the following conditions except: Select one: a.Macroglobulinemia b.Pernicious anemia c.Multiple myeloma d.Amyloidosis
Multiple myeloma
Which of the following cells are considered abnormal and clinically significant on a CSF differential? Select one: a.Ependymal b.Myeloblast c.Pia arachnoid mesothelial d.Choroidal cells
Myeloblast
What is the primary functional unit of the kidney? Select one: a.Ureter b.Glomerulus c.Nephron d.Distal convoluted tubule
Nephron
At what temperature should the urine be prior to testing with the reagent strip method? Select one: a.4o C b.37 o C c.Room temperature d.Temperature does not affect test results
Room temperature
To ensure precision and accuracy of the reagent strip tests used for chemical analysis of urine, it is necessary that: Select one: a.Only a positive control be run on a daily basis b.Positive controls be run on a daily basis and negative controls be run when opening a new bottle of test strips c.Positive and negative controls be run on a daily basis and when a new bottle of test strips is opened d.Positive and negative are not required for urine strips
Positive and negative controls be run on a daily basis and when a new bottle of test strips is opened
How should the production of a blue or purple color on the test pad of an Ictotest® be interpreted? Select one: a.Positive for bilirubin b.Positive for ketones c.Negative for bilirubin d.Negative for ketones
Positive for bilirubin
Which of the following is true about Bence-Jones protein when performing the heat precipitation test? Select one: a.Precipitates between 40° and 60°C but redissolves at 100°C b. Precipitates between 60° and 80°C but redissolves at 100°C c.Is dissolved between 40° and 60°C but precipitates around 100°C d.Is dissolved between 60° and 80°C but precipitates around 100°C
Precipitates between 40° and 60°C but redissolves at 100°C
The image is a Wright-Giemsa stained smear (1000X) of cerebrospinal fluid (CSF). What is the identification of the cells that are indicated by the arrows?
Presumptive malignant cells
Upon centrifugation, a cerebrospinal fluid (CSF) sample supernatant exhibited xanthochromia. The image is a Wright-Giemsa stained smear that was made from that CSF sample. What condition is probably related to these macroscopic and microscopic findings? Select one: a.Previous subarachnoid hemorrhage b.Traumatic tap c.Leukemia
Previous subarachnoid hemorrhage
Sulfosalicylic acid (SSA) can be used to confirm the result of which of the following tests included on a urine reagent strip? Select one: a.Protein b.Glucose c.Bilirubin d.Urobilinogen
Protein
The primary site of reabsorption of glomerular filtrate is the: Select one: a.Loop of Henle b.Proximal convoluted tubule c.Distal convoluted tubule d.Collecting duct
Proximal convoluted tubule
Identify the urine sediment elements present in this image observed using bright field microscopy. Select one: a.White blood cells b.Red blood cells c.Squamous epithelial cells d.Yeast
Red blood cells
Which of the following statements is true regarding the storage and handling of urinalysis chemical reagent strips? Select one: a.Make sure all of the pads on the strip have the same color prior to using the strip. b.Touching the reagent areas of the strip will not interfere with test results. c.Remove only enough strips for immediate use. d.The bottle of reagent strips can remain uncovered once it has been opened.
Remove only enough strips for immediate use.
A semen specimen was collected three hours before it was brought to the laboratory for examination. What course of action should be taken? Select one: a.Complete macroscopic and microscopic examination as quickly as possible. b.Report the specimen as compromised on the final report. c.Perform the macroscopic and morphology procedures only. d.Perform the wet mount only.
Report the specimen as compromised on the final report.
Which of the following would best describe what you might observe after a traumatic CSF tap: Select one: a.All tubes pale yellow b.All tubes clear c.All tubes contain equal amounts of blood d.Significantly more RBCs found in tube #1 vs. tube #3
Significantly more RBCs found in tube #1 vs. tube #3
Identity the urine sediment elements shown by the arrow:
Starch crystals
Which of the following would be the most appropriate method to confirm a positive protein from a urine dipstick: Select one: a.Immunoelectropheresis b.Heat precipitation c.Sulfosalicylic acid precipitation d.Protein electrophoresis
Sulfosalicylic acid precipitation
A negative glucose oxidase test and a positive test for reducing sugars in urine indicates: Select one: a.True glycosuria b.A false-negative glucose oxidation reaction c.The presence of a non-glucose reducing sugar such as galactose d.These results are normal
The presence of a non-glucose reducing sugar such as galactose
Which of the following statements is TRUE for specific gravity measured by the urine chemical reagent strip method? Select one: a.High concentrations of protein in urine do not increase the readings when using the urine chemical reagent strip. b.An alkaline pH would not affect the specific gravity result using a reagent strip method. c.The urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen. d.The urine chemical reagent strip method is based on the fact that light is refracted in proportion to the amount of total solids dissolved in the urine.
The urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen.
Which of the following cells when found upon microscopic examination of the urine would be most indicative of kidney disease: Select one: a.WBCs and bacteria b.Tubular epithelial cells c.Squamous epithelial cells d.RBCs
Tubular epithelial cells
The nephron includes all of the following except: Select one: a.Urethra b.Glomerulus c.Loop of Henle d.Proximal convoluted tubule
Urethra
What is the MOST probable condition when a clean catch urine gave these results:Appearance = cloudy, amberpH 5.0Specific Gravity = 1.015,Protein = 1+Glucose = negativeOccult Blood = traceNitrite = positiveMicroscopic = many bacteria and 30 - 40 WBC/HPF. Select one: a.Nephrosis b.Urinary tract infection c.Renal calculus d.Nephritis
Urinary tract infection
What type of cast is shown in the illustration? Select one: a.WBC cast b.RBC cast c.Waxy cast d.Granular cast
WBC cast
The cells that are indicated by the arrows in this urine sediment (using phase contrast microscopy) are: Select one: a.Red blood cells (RBCs) b.White blood cells (WBCs) c.Yeast cells d.Squamous epithelial cells
White blood cells (WBCs)
When an automated or semi-automated method is used to read urine chemical reagent strips, quality control testing must be performed at least how often? Select one: a.Once a week and with each new lot of reagent strips b.With each new lot of reagent strips and every day of patient testing c.With each new instrument operator d.Every day of patient
With each new lot of reagent strips and every day of patient testing
Cell counts on CSF specimens should be performed within what time frame following collection of the CSF sample? Select one: a.Within one hour b.Within four hours c.Within eight hours d.Within 24 hours
Within one hour
What term is used to describe the color in these tubes of cerebrospinal fluid (CSF)? Select one: a.Jaundice b.Xanthochromia c.Icterus
Xanthochromia
The constituents that are indicated by the arrows in this image of a stained urine sediment are: Select one: a.Red blood cells b.Yeast c.Renal epithelial cells d.Leukocytes
Yeast
Cells seen in the microscopic examination of the urine of a 30 year old female which are smaller than RBC's but much the same shape are probably: Select one: a.Yeast cells b.Small lymphocytes c.Squamous epithelial cells d.Trichomonas vaginalis
Yeast cells
Two CSF specimens were sent to the Lab with the following results:Tube #1 = 11,200 rbc/uLTube #2 = 300 rbc/uLThe results on these CSF specimens are indicative of: Select one: a.an infection b.a recent subarachnoid hemorrhage c.a traumatic tap d.an old intracranial bleeding episode e.faulty lab equipment
a traumatic tap
Fecal urobilinogen level may be markedly decreased because of: Select one: a.hemolysis b.decreased intestinal reabsorption of urobilinogen c.increased serum bilirubin d.biliary obstruction e.pancreatitis
biliary obstruction
Charcot-Leyden crystals in stool may be associated with an immune response and are thought to be the breakdown products of: Select one: a.neutrophils b.eosinophils c.monocytes d.lymphocytes e.basophils
eosinophils
All of the statements below about synovial fluid are true EXCEPT: Select one: a.arthrocentesis is performed as a means to evaluate arthritis and other joint disorders b.synovial fluid is present only is movable joints c.joint fluid resembles plasma in viscosity d.joint fluid has approximately the same glucose as plasma
joint fluid resembles plasma in viscosity
If CSF tubes numbered #1, #2 and #3 CANNOT be analyzed within one hour, the correct procedure for the microbiology sample tube is to: Select one: a.discard it b.freeze it c.leave it at room temperature d.incubate in a 56 degree water bath e.refrigerate it
leave it at room temperature
On a Cytospin preparation from a pleural fluid, 50% of the cells have the following characteristics:-uniform, regular arrangement-some cells resemble a "fried egg"-multiple nuclei-smooth nuclear outline and homogeneous chromatin-when present in clumps, there are clear spaces between the cells ("windows")How should these cells be classified? Select one: a.atypical cancer cells b.mesothelial cells c.tumor cells d.ependymal cells
mesothelial cells
A semen sample for semen analysis should generally be received at the testing site within what period of time? Select one: a.One hour b.Two hours c.Three hours d.Four hours
one hour
Xanthochromia in a premature infant may be due to an immature blood-brain barrier. Select one: True False
true
