Urine/Body Fluids

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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


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