MLT-111 Urinalysis & Body Fluids Exam 4
(T/F) Neutrophils may be present in normal CSF.
True
(T/F) Xanthochromic CSF may appear pink, orange, or yellow.
True
The normal CSF protein is: a.15 to 45 mg/dL b.15 to 45 g/dL c.50 to 100 mg/dL d.50 to 100 g/dL
a.15 to 45 mg/dL
The presence of argentaffin cell tumors can be detected by the presence in the urine of: a.5-HIAA b.Melanin c.Homogentisic acid d.Serotonin
a.5-HIAA
Which of the following is not an organic acidemia? a.5-HIAA b.Isovaleric c.Propionic d.Methylmalonic
a.5-HIAA
Sperm motility after 1 hour should be at least: a.50% b.60% c.70% d.80%
a.50%
A positive urine Clinitest reaction can be seen in patients with: a.Alkaptonuria b.Melanuria c.Cystinuria d.Tyrosyluria
a.Alkaptonuria
Accumulation of large amounts of homogentisic acid in the urine is the result of which of the following disorders? a.Alkaptonuria b.Tyrosyluria c.PKU d.Homocystinuria
a.Alkaptonuria
Which disorder is not associated with urine odor? a.Alkaptonuria b.PKU c.Maple syrup urine disease d.Isovaleric acidemia
a.Alkaptonuria
Using the following laboratory results, determine what type of meningitis is present: WBC count: 1,000/µL Glucose: 15 mg/dL Lymphocytes: 10% Blood glucose: 90 mg/dL Neutrophils: 90% Lactate: 40 mg/dL Protein: 150 mg/dL a.Bacterial b.Viral c.Fungal d.Tubercular
a.Bacterial
A positive Guthrie test is interpreted by observing: a.Bacterial growth occurs around the positive control disc and the patient disc b.Bacterial growth occurs around the positive control disc but not around the patient disc c.No bacterial growth occurs around either disc d.Bacterial growth occurs only around the negative control disc
a.Bacterial growth occurs around the positive control disc and the patient disc
The specimen of choice when testing for protoporphyrin is: a.Blood b.Urine c.Bile d.Feces
a.Blood
Cell counts on CSF are performed on: a.Cells as they are counted in the hemocytometer b.Cover-slipped wet preparations c.Stained smears prepared from the undiluted specimen d.Stained smears prepared from a concentrated specimen
a.Cells as they are counted in the hemocytometer
Cells seen in the CSF following pneumoencephalography are: a.Choroid plexus b.Lymphocytes c.Highly vacuolated d.Reactive mesothelial cells
a.Choroid plexus
Which is not a symptom of inherited porphyrias? a.Fanconi syndrome b.Neurological c.Psychiatric d.Photosensitivity
a.Fanconi syndrome
Which condition does not produce elevated CSF protein? a.Fluid leakage b.Meningitis c.Multiple sclerosis d.Hemorrhage
a.Fluid leakage
In patients with alkaptonuria, the abnormal metabolite that is present in the urine is: a.Homogentisic acid b.Alkaptonpyruvate c.Phenylpyruvate d.Tyrosine
a.Homogentisic acid
A urinalysis and a dinitrophenylhydrazine (DNPH) test are performed on an infant who is failing to thrive. If the DNPH test is positive, what result in the urinalysis will also be positive? a.Ketones b.Glucose c.Protein d.Bilirubin
a.Ketones
An increased amount of prostatic fluid in a semen specimen will: a.Lower the pH b.Raise the pH c.Increase the motility d.Decrease the motility
a.Lower the pH
Melanoma cells in the CSF must be differentiated from: a.Macrophages containing hemosiderin b.Noncleaved lymphoma cells c.Medulloblastoma cells d.Ependymal cells
a.Macrophages containing hemosiderin
Dilution of CSF before performing a total cell count should be made using: a.Normal saline b.Deionized water c.Acetic acid d.Acetic acid containing methylene blue
a.Normal saline
If the first portion of the ejaculation is not collected, which parameter of the semen analysis is most critically affected? a.Sperm concentration b.pH c.Sperm motility d.Morphology
a.Sperm concentration
Which is not included in computer-assisted semen analysis? a.Sperm morphology b.Sperm count c.Trajectory of sperm motion d.Velocity of sperm motility
a.Sperm morphology
When using routine morphology criteria, the normal value is greater than: a.15% normal forms b.30% normal forms c.50% normal forms d.50% normal forms
b.30% normal forms
Calculate using a 1:20 dilution and the five RBC counting squares of the Neubauer counting chamber, an average of 54 sperm is counted. The sperm concentration is: a.54,000/cc b.54,000,000/mL c.108,000/cc d.108,000,000/mL
b.54,000,000/mL
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.The tubes were numbered in the wrong sequence, as one would expect increasing amounts of blood b.A traumatic or bloody tap is suspected and, in all likelihood, no pathogenic significance should be attached to the presence of the blood c.The pathological presence of RBCs and reported to the supervisor immediately d.A pathological presence of RBCs, but because the RBC morphology is normal there is minimal importance
b.A traumatic or bloody tap is suspected and, in all likelihood, no pathogenic significance should be attached to the presence of the blood
To determine whether a questionable specimen is semen, the specimen should be tested for: a.Alkaline phosphatase b.Acid phosphatase c.DNA d.Citrate and zinc
b.Acid phosphatase
Absence of a normal sperm acrosome can: a.Decrease sperm motility b.Affect ovum penetration c.Affect semen liquefaction d.Decrease sperm concentration
b.Affect ovum penetration
Which of the following compounds does not react directly with either Ehrlich reagent or fluorescence? a.Uroporphyrin b.Aminolevulinic acid c.Coproporphyrin d.Porphobilinogen
b.Aminolevulinic acid
The presence of hemosiderin containing macrophages in CSF indicates: a.Fungal meningitis b.Cerebral hemorrhage c.Reye syndrome d.Multiple sclerosis
b.Cerebral hemorrhage
CSF is formed in the _______________ and reabsorbed by the _______________. a.Ventricles, spinal cord b.Choroid plexus, arachnoid granulations c.Arachnoid space, blood-brain barrier d.Blood-brain barrier, arachnoid granulations
b.Choroid plexus, arachnoid granulations
Urine from a child suspected of having lead poisoning has a red fluorescence under Wood's lamp. This finding is: a.Inconsistent with lead poisoning because porphobilinogen does not fluoresce b.Consistent with lead poisoning because coproporphyrin fluoresces under ultraviolet light c.Consistent with lead poisoning only if uroporphyrin is also increased d.Consistent only if protoporphyrin can be demonstrated using Ehrlich reagent
b.Consistent with lead poisoning because coproporphyrin fluoresces under ultraviolet light
Patients who produce kidney stones at an early age should be tested for the presence of: a.Organic acidemia b.Cystinuria c.Maple syrup urine disease d.PKU
b.Cystinuria
Evaluation of sperm motility includes: a.Determining the appearance of the tail piece b.Differentiation between forward and lateral movement c.Two evaluations performed 3 hours apart d.Two evaluations performed 3 days apart
b.Differentiation between forward and lateral movement
A false-positive test for 5-HIAA may result if the patient: a.Does not collect a complete 24-hour urine b.Does not receive appropriate diet instructions c.Fails to fast before specimen collection d.Stores the specimen in the refrigerator overnight
b.Does not receive appropriate diet instructions
Which of these disorders is not caused by defects in the phenylalanine-tyrosine pathway? a.Alkaptonuria b.Hartnup disease c.Tyrosyluria d.PKU
b.Hartnup disease
The silver nitroprusside test detects the presence of: a.Propionic acid b.Homocystine c.Uroporphyrin d.Cystine
b.Homocystine
Increased CSF eosinophils are associated with: a.Multiple sclerosis b.Introduction of foreign material c.Human immunodeficiency virus d.Viral meningitis
b.Introduction of foreign material
Myelin basic protein is measured in the CSF to assess the condition of patients with: a.Cerebral hemorrhage b.Multiple sclerosis c.Bacterial meningitis d.Neurosyphilis
b.Multiple sclerosis
Which cannot be used to immobilized sperm before performing a sperm concentration? a.Heat b.Normal saline c.Sodium bicarbonate d.Tap water
b.Normal saline
Which of the following foods contain serotonin, which can interfere with 5-HIAA testing? a.Apples b.Pineapples c.Watermelons d.Oranges
b.Pineapples
Chemical analysis of CSF shows that the fluid contains: a.Plasma chemicals in the same concentration as in the plasma b.Plasma chemicals in concentrations different from those in the plasma c.More chemicals than are found in plasma d.Fewer chemicals than are found in plasma
b.Plasma chemicals in concentrations different from those in the plasma
Which of the following is not a porphyrin? a.Uroporphyrin b.Porphobilinogen c.Protoporphyrin d.Coproporphyrin
b.Porphobilinogen
Yellow color in a semen specimen may be caused by all of the following except: a.Urine b.Preservation at room temperature c.Medications d.Prolonged abstinence
b.Preservation at room temperature
A sperm motility report graded 2.0 is interpreted as: a.Average motility and Brownian movement b.Slow forward motility with noticeable lateral movement c.Slow forward motion in a straight line d.Abnormal motility with normal direction
b.Slow forward motility with noticeable lateral movement
While performing a sperm morphology examination, a medical laboratory scientist counts 10 neutrophils per 100 mature sperm. To determine whether this observation is significant, the medical laboratory scientist must also know the: a.Specimen volume b.Sperm concentration c.Patient's white blood cell (WBC) count d.Sperm count
b.Sperm concentration
When performing protein electrophoresis on CSF, why is it important to also perform a serum protein electrophoresis? a.To determine that the correct patient sample is used b.To determine whether oligoclonal banding in the CSF is due to a neurological inflammation c.To determine cases of neurosyphilis d.To determine the stage of a neoplastic disorder
b.To determine whether oligoclonal banding in the CSF is due to a neurological inflammation
Which is not a function of the cerebrospinal fluid (CSF)? a.Nutritional enrichment of nervous tissue b.Transmission of neurological impulses c.Removal of metabolic waste products d.Protection of neurological tissue from trauma
b.Transmission of neurological impulses
Patients who have unusually fair complexions can be indicative for phenylketonuria because: a.Phenylalanine is not produced b.Tyrosine is not available for conversion to melanin c.Melanin is converted to homogentisic acid d.Phenylalanine disrupts liver function
b.Tyrosine is not available for conversion to melanin
Using the following laboratory results, determine what type of meningitis is present: WBC count: 400/µL WBC count: 400/L Lymphocytes: 90% Glucose: 70 mg/dL Monocytes: 8% Blood glucose: 100 mg/dL Neutrophils: 2% Lactate: 18 mg/dL a.Bacterial b.Viral c.Fungal d.Tubercular
b.Viral
Normal semen should liquefy: a.Immediately after ejaculation b.Within 1 hour c.Within 3 hours d.After exposure to diluting fluid
b.Within 1 hour
The normal sperm concentration is: a.140 to 200 million/mL b.10 to 90 million/mL c.20 to 160 million/mL d.50 to 100 million/mL
c.20 to 160 million/mL
When performing sperm morphology analysis, the minimum number of sperm that should be evaluated is: a.50 b.100 c.200 d.500
c.200
The average volume of CSF in an adult is: a.10 to 60 mL b.50 to 100 mL c.90 to 150 mL d.200 to 250 mL
c.90 to 150 mL
The presence of xanthochromia and an increased D-dimer test in the CSF is indicative of: a.A traumatic tap b.Multiple sclerosis c.A cerebral hemorrhage d.Viral meningitis
c.A cerebral hemorrhage
Semen specimens should be processed for analysis: a.Immediately on receipt in the laboratory b.Before complete liquefaction c.After complete liquefaction d.1 hour after arriving in the laboratory
c.After complete liquefaction
The finding of persistent ketonuria in a newborn is: a.The finding of persistent ketonuria in a newborn is: b.Indicative of juvenile diabetes mellitus c.Associated with methylmalonic aciduria d.Seen with severe lead poisoning
c.Associated with methylmalonic aciduria
Which is not proper for collection of a semen specimen? a.In a sterile container b.After a 3-day period of sexual abstinence c.At the laboratory followed by 1 hour of refrigeration d.At home and delivery to the laboratory within 1 hour
c.At the laboratory followed by 1 hour of refrigeration
The primary disadvantage in using a cytocentrifuge to prepare CSF differential slides is: a.Frequent bacterial contamination b.Uneven distribution of cells c.Cellular distortion d.Increased cost
c.Cellular distortion
Damage to the blood-brain barrier by Mycobacterium tuberculosis may cause the CSF to: a.Appear blood-streaked b.Appear xanthochromic c.Contain a pellicle or clot d.Contain decreased protein
c.Contain a pellicle or clot
When using the cytocentrifuge, a daily control slide of saline and albumin is prepared to check: a.The correct centrifuge speed b.For the presence of WBCs c.For bacterial contamination d.The pH of staining buffer
c.For bacterial contamination
The sugar of interest in most cases of infertility is: a.Glucose b.Maltose c.Fructose d.Sucrose
c.Fructose
Porphyrins are intermediary compounds in the formation of: a.Amino acids b.Serotonin c.Heme d.Bilirubin
c.Heme
Under normal conditions, tryptophan that is not reabsorbed in the intestine is removed from the body as: a.Indican in the urine b.Indole in the liver c.Indole in the feces d.Serotonin in the urine
c.Indole in the feces
Urine with the characteristic odor of "sweaty feet" and a positive ketone test indicates: a.Cystinuria b.Alkaptonuria c.Isovaleric acidemia d.Tyrosyluria
c.Isovaleric acidemia
A false-positive reaction for urinary ketones could be present in patients who have: a.Maple syrup urine disease b.PKU c.Melanuria d.Organic acidemia
c.Melanuria
The presence of maple syrup urine disease is first suspected by the presence of abnormal urine: a.Color b.Protein c.Odor d.Amino acids
c.Odor
White blood cell (WBC) counts on clear CSF specimens are performed: a.Using centrifuged specimens b.Only if multiple sclerosis is suspected c.On undiluted specimens if there is no cell overlapping d.On specimens diluted 1:200 with gentian violet
c.On undiluted specimens if there is no cell overlapping
A pink color in the Hoesch test indicates the presence of: a.Urobilinogen b.Myoglobin c.Porphobilinogen d.Nitrite
c.Porphobilinogen
Which of the following will not cause the development of male antisperm antibodies? a.Vasovasostomy b.Infection c.Prolonged abstinence d.Trauma
c.Prolonged abstinence
Which of the following porphyrin compounds cannot be found in urine? a.Aminolevulinic acid b.Coproporphyrin c.Protoporphyrin d.Uroporphyrin
c.Protoporphyrin
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: a.Use a new chamber b.Report the count as 70 million/mL c.Repeat the count d.Load only one side of the counting chamber
c.Repeat the count
CSF is produced primarily by: a.Secretion by cells of the arachnoid villi b.Diffusion from the plasma into the central nervous system (CNS) c.Selective filtration of plasma in the choroid plexus d.Excretions from the ependymal cells lining the CNS
c.Selective filtration of plasma in the choroid plexus
Abnormal amounts of indigo blue in the urine are indicative of a defect in the metabolism of: a.Phenylalanine b.Tyrosine c.Tryptophan d.Cystine
c.Tryptophan
The finding of a "blue diaper" is indicative of a defect in the metabolism of: a.Phenylalanine b.Tyrosine c.Tryptophan d.Cystine
c.Tryptophan
Semen analysis on postvasectomy patients should be performed: a.Within 1 week postvasectomy b.Within 1 month postvasectomy c.Until two consecutive monthly specimens show no sperm d.Until two consecutive monthly specimens show no viable sperm
c.Until two consecutive monthly specimens show no sperm
Examination of a CSF shows 1000 WBCs, of which 75% are lymphocytes and 25% are monocytes. This finding is consistent with: a.Normal spinal fluid b.Bacterial meningitis c.Viral meningitis d.Multiple sclerosis
c.Viral meningitis
A xanthochromic CSF specimen will appear: a.Crystal clear b.White and turbid c.Yellow and clear d.Red and turbid
c.Yellow and clear
A slightly hazy CSF specimen is diluted 1:10 with acetic acid. A total of 50 cells are counted in five large squares on both sides of the Neubauer counting chamber. The count is reported as: a.50 cells/µL b.55 WBCs/µL c.250 cells/µL d.500 WBCs/µL
d.500 WBCs/µL
The finding of increased amounts of the serotonin degradation product 5-HIAA in the urine indicates: a.Platelet disorders b.Intestinal obstruction c.Malabsorption syndromes d.Argentaffin cell tumors
d.Argentaffin cell tumors
Nucleated red blood cells (RBCs) seen in the CSF indicate: a.Recent cerebral hemorrhage b.Acute leukemia c.A ventricular rather than a lumbar puncture d.Bone marrow contamination from the puncture
d.Bone marrow contamination from the puncture
Before reporting a postvasectomy specimen as negative for the presence of sperm, the specimen must be: a.Stained b.Examined under polarized light c.Diluted d.Centrifuged
d.Centrifuged
Analysis of urine from an infant whose mother reported a blue staining on the diapers showed increased levels of indican and a generalized aminoaciduria. On the basis of these findings, the infant was diagnosed as having: a.An intestinal obstruction b.A protein malabsorption syndrome c.Fanconi syndrome d.Hartnup disease
d.Hartnup disease
The third tube of CSF collected from a lumbar puncture should be used for: a.Chemistry tests b.Cytology examination c.Microbiology tests d.Hematology tests
d.Hematology tests
The purpose of diluting semen specimens with sodium bicarbonate and formalin before counting is to: a.Ensure liquefaction of the specimen b.Allow motility to be determined while performing the count c.Enhance the cellular morphology d.Immobilize and preserve the sperm
d.Immobilize and preserve the sperm
Initial screening for PKU performed on newborns before their discharge from the hospital uses a blood specimen rather than a urine specimen because: a.Urine specimens are more difficult to collect b.Serum bilirubin levels are routinely measured on all newborns c.It is easier to measure phenylalanine than phenylpyruvic acid d.Increased serum phenylalanine can be detected earlier
d.Increased serum phenylalanine can be detected earlier
When performing sperm morphology analysis on a semen specimen with a sperm concentration of 20 million, 10 spermatids are seen. This result is: a.A normal finding b.Associated with infection c.Normal in a postvasectomy specimen d.Indicative of abnormal sperm maturation
d.Indicative of abnormal sperm maturation
The finding of 3 million neutrophils per milliliter in a semen specimen is: a.A normal result b.Normal when using Kruger's strict criteria c.Indicative of increased prostatic fluid d.Indicative of infection
d.Indicative of infection
Confirmation of maple syrup urine disease is made on the basis of: a.Urine color b.A positive 2,4-dinitrophenylhydrazine test c.A positive ferric chloride test d.MS/MS
d.MS/MS
Which is not included in the motility component of a sperm analysis evaluation? a.Progressive and Brownian movement b.Percentage of motile sperm c.Quality of movement d.Motility of normal and abnormal sperm
d.Motility of normal and abnormal sperm
Hurler and Sanfilippo syndromes present with mental retardation and an increase in what urinary constituent? a.Porphyrins b.Amino acids c.Maltose d.Mucopolysaccharides
d.Mucopolysaccharides
Which porphyrin compound will not exhibit fluorescence under ultraviolet light? a.Protoporphyrin b.Uroporphyrin c.Coproporphyrin d.Porphobilinogen
d.Porphobilinogen
If protein electrophoresis was performed on both serum and CSF, which of the following components would have a higher ratio to total protein in the CSF than in the serum? a.Transferrin b.Ceruloplasmin c.Albumin d.Prealbumin
d.Prealbumin
If CSF tubes numbered 2 and 3 cannot be analyzed within 1 hour, the correct procedure is to: a.Refrigerate both tubes b.Leave both tubes at room temperature c.Refrigerate tube 2 and freeze tube 3 d.Refrigerate tube 3 and leave tube 2 at room temperature
d.Refrigerate tube 3 and leave tube 2 at room temperature
To differentiate between cystinuria and homocystinuria, the urine should be tested with: a.Cyanide nitroprusside b.Ferric chloride c.Clinitest d.Silver nitroprusside
d.Silver nitroprusside
Semen viscosity is most closely related to: a.Sperm concentration b.Specimen volume c.Specimen collection d.Specimen liquefaction
d.Specimen liquefaction
The CSF circulates through the brain and spinal cord in the: a.Arachnoid mater b.Choroid plexuses c.Dura mater d.Subarachnoid space
d.Subarachnoid space
A CSF specimen, in which there is uneven distribution of blood among the three tubes and clots are detected, is an indication of: a.Meningitis b.Cerebral hemorrhage c.Multiple sclerosis d.Traumatic tap
d.Traumatic tap
A yellow semen specimen with a normal sperm concentration and decreased motility may contain: a.Bilirubin b.Carotene c.Bacteria d.Urine
d.Urine
A broad spectrum of reactive and nonreactive lymphocytes in the CSF is associated with: a.Bacterial meningitis b.Allergic reactions c.Cerebral hemorrhage d.Viral meningitis
d.Viral meningitis
