Urines/Body fluids

What is the lower reference limit for sperm concentration according to the World Health Organization, WHO Laboratory Manual for the Examination and Processing of Human Semen, WHO press, Geneva, Switzerland, 2010?

15 x 106 spermatozoa/mL

will present with markedly decreased glucose and increased protein results. Bacterial organisms would most likely be seen upon Gram stain of the CSF fluid.

Bacterial meningitis

A cell count is ordered on a CSF sample that is bloody. Which of the following procedures would improve count accuracy?

Dilute the sample to minimize the number of red blood cells in the squares being counted.

is ovoid in shape with one side flattened. The embryo is separated from the shell by a clear space.

Enterobius vermicularis (pinworm) ova

are the causative agent for gout.

Monosodium urate crystal

What type of white blood cell is seen MOST frequently in urine sediment with infections of the urinary system?

Neutrophil

is considered an important factor in the etiology of carcinoma of the bladder. The ova are elongated and are 60 X 160 microns. They are a yellowish color, slightly transparent, and possess a delicate terminal spine.

Schistosoma haematobium

In order to avoid falsely elevated spinal fluid cell counts one should:

Select an aliquot from the last tube collected

Normal fecal specimens contain all of the following, EXCEPT:

Shigella spp.

have a characteristic oval body with a long thin tail and are 50 microns in length.

Sperm

Cholesterol crystals

Stairstep or staircase Plates with notched ends

The reaction which differentiates crystals from starch is:

Starch stains blue black with iodine

Which acid is most frequently used to precipitate protein for confirmatory urinalysis tests?

Sulfosalicylic

How many white blood cells (WBCs) would be considered normal for adult cerebrospinal fluid?

0-5 WBCs/µL

The volume of urine recommended for centrifugation for a microscopic examination is:

10 - 15 mL

Tyrosine crystals

Abnormal, found in liver disease Fine, delicate needles

A 1:10 dilution is made on a CSF sample. Five squares on each side of the hemacytometer are counted for a total of 10 squares and a total of 150 cells are recorded. What is the count per microliter?

According to the formula on the right, here is how we arrive a the 1500 cells per microliter:Cells/µL = 150 x 10/ 10 x 0.1 µL Cells/µL = 1500 / 1 = 1500/µL or

The ketone component that is measured by the nitroprusside reaction is:

Acetoacetic acid

Oliguria is usually correlated with:

Acute glomerulonephritis

Which of the following substances are detected with Clinitest® tablets?

All reducing substances

CSF pleocytosis can refer to:

An increased number of lymphocytes in a CSF when compared to a normal sample.

After suspecting that his patient may have lung disease, the physician sends a bronchoalveolar lavage (BAL) to the laboratory for examination. What is the cell type noted by the arrows in this cytospin sample?

Bronchial lining cells

Prominent vacuolation involving the cytoplasm of abnormal lymphoblast-like cells seen in the peritoneal body fluid preparation shown is a distinctive feature of which disease?

Burkitt Lymphoma

Which of the following would be the most characteristic finding in synovial fluid in a case of pseudogout?

Calcium pyrophosphate crystals

Which of the following areas of the brain and spinal cord is responsible for producing CSF?

Choroid plexuses

Conditions that produce elevated CSF protein levels include all of the following EXCEPT:

Fluid leak

Significantly increased levels of ketones are typically detected in the urine with all of the following conditions, EXCEPT?

Following a low-impact exercise routine

All of the following are standard methods for measuring the specific gravity of urine, EXCEPT:

Freezing point depression

laboratory results will show a normal protein level and a normal to decreased glucose level. Further testing to determine a fungal meningitis infection includes latex agglutination and positive fungal growth on cultures.

Fungal meningitis

Nitrates in urine are reduced to nitrites by:

Gram-negative bacteria

A reagent strip test for hemoglobin has been reported positive. Microscopic examination fails to yield red blood cells. This patient's urine condition can be called:

Hemoglobinuria

False-positive tests for protein on a urine reagent strip may be caused by the following conditions, EXCEPT:

High protein diet

The glucose result on a urine specimen from an infant is negative on the urine chemical reagent strip, what is the next step?

It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances.

Which of the following can cause a false positive result for ketones?

L-Dopa metabolites

Normal adult CSF may have 0-5 white blood cells (WBCs)/µL. Which of the following cell types account for 60-100% of these WBCs?

Lymphocytes

A semen sample for semen analysis should generally be received at the testing site within what period of time?

One hour

The Sudan III stain is used to confirm the presence of:

Oval fat bodies

All of the following are directly involved in the production of semen EXCEPT?

Pituitary gland

Effusion fluids are classified as transudates or exudates. According to Light's criteria, all of the following applies to an exudate EXCEPT?

Pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum

Which of the following is an example of a macroscopic urinalysis abnormality?

Positive protein

Which of the following is true about Bence-Jones protein when performing the heat precipitation test?

Precipitates between 40° and 60°C but redissolves at 100°C

Which of the following statements is true for the reagent strip procedure?

Prolonged immersion may wash out reagents.

The primary site of reabsorption of glomerular filtrate is the:

Proximal convoluted tubule

Semi-automated and automated urine chemical reagent strip readers:

Remove subjectivity allowing for better reproducibility

All of the following specimen collection methods should be used if urine cultures are also required, EXCEPT?

Routinely voided

Identify the large, foamy cells in the joint fluid image shown to the right.

Synovial lining cells

Which of the following is true of glucose levels in the CSF of an otherwise healthy individual?

The CSF glucose should be about 60 to 70% of the plasma glucose level.

measuring 8 - 15 microns with a characteristic pear shape. It has multiple anterior flagella and the nucleus is often apparent.

Trichomonas is highly motile

A patient presents to the emergency room with severe headaches, nausea, and vomiting. CSF chemistry results are as follows: Protein - 74 mg/dL (15-45 mg/dL) Glucose - 53 mg/dL (40-85 mg/dL) Based on the patient's complaints and the above laboratory results what is the most probable condition?

Viral Meningitis

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?

WBC = 54 / (8 squares x 0.1 µL) = 67.5/µL