clinical biochemistry II practice quizzes exam 2

Whenever the reagent pad shows a negative result for blood and the microscopic examination reveals RBC, the technician should suspect the presence of:

hemoglobinuria

reagent strip SG indirectly estimates urine density on the basis of

charged solutes

the reagent pad for blood detection is impregnated with:

chromogen and peroxide

false positive levels of 5-HIAA can be caused by a diet high in:

bananas

which of the following crystals are found in MSUD

leucine

urine formation occurs as the plasma filtrate passes through the renal structures in the following order:

nephron, renal pelvis, ureters, bladder

loss of the ability of the kidney to concentrate and dilute urine will result in a fixed specific gravity of_____

1.010

what renal hormones stimulates the production of red blood cells?

erythropoietin

a lab based in Europe sends a report to a physician in Chicago, the patient’s urea was as 21.4 mg/dl. What is the calculated BUN in mg/dl?

10

Elevated urinary levels of 5-HIAA are associated with:

carcinoid tumors

Substances that require elimination from the body by renal excretion include:

 Urea, creatinine, and uric acid

The all-purpose stain commonly used to enhance visualization of urine sediment is

Sternheimer-Malbin stain

A finding of increased numbers of casts and/or the presence of abnormal casts must be accompanied by a finding of:

Proteinuria

The technician performs a UA and a copper reduction test on a 19-month-old child. The reagent strip shows a positive result for glucose; the copper reduction test also produces a positive result. Which of the following is most likely present in the urine?

Glucose

Increased levels of BUN with normal levels of creatinine usually indicates the following:

 pre-renal disorders

Which condition would be the most likely condition to produce a negative urine bilirubin result but also an increased urobilinogen result?

 Hemolysis (Transfusion reaction)

A reagent test strip impregnated with a diazonium salt such as diazotized 2,4-dichloroaniline may be used to determine which analyte?

Bilirubin

While examining a microscopic sediment specimen, the technician sees 1 to 3 squamous epithelial cells that appear soft and finely granular with shaggy edges. He reports:

clue cells

A urine that turns black after sitting by the sink for several hours could be indicative of:

alkaptonuria or melanuria

The classic urine color associated with porphyria is:

Port wine

Which process allows water to move from an area of lower concentration to an area of higher concentration?

 countercurrent exchange mechanism

Blue diaper syndrome is associated with:

 Hartnup disease

Which of the following disorders is not associated with the phenylalanine-tyrosine pathway

MSUD

If the urine dipstick test for glucose is negative but the reducing substances test is positive, what inborn error of metabolism is suspected?

galactosemia

A 45-year-old man with polycystic disease is admitted to the hospital. The technician scans for casts and notes very large, colorless, hyaline-like casts that appear to have sharp, well-defined edges, some lateral fissures, and uneven ends. She checks the UA chemical analysis

Broad, waxy casts

Urine from a newborn with MSUD will have a significant:

 Sweet odor

Which of the following tests are used to monitor diabetic patients for diabetic nephropathy (kidney damage)?

Microalbumin reagent strip test

Upon review of the urinalysis printout, the technician notes a urine pH of 9.0 on one specimen. The other test results were negative, except for nitrites, which tested positive. The next step is:

Double-check the time of collection, transport, and storage

Which of the following is NOT one of the four major processes of the nephron?

Adsorption

5-HIAA is a degradation product of:

Serotonin

Which of the following is associated with cystinuria, but not cystinosis?

Early renal calculi formation

A urine crystal that is NOT considered clinically significant is:

Amorphous urates

Many uric acid crystals in a pediatric urine specimen may indicate:

Lesch-Nyhan disease

Hartnup disease is a disorder associated with the metabolism of:

 Tryptophan

Water reabsorption in the collecting tubules is controlled by

ADH

The two stages of heme formation affected by lead poisoning are:

Aminolevulinic acid and protoporphyrin

An overflow disorder that could produce a false-positive reaction with Clinitest procedure is:

Alkaptonuria

A clear, pale yellow synovial fluid with good viscosity and a WBC count of 1000 should be classified as:

Noninflammatory

Crystals that appear to be rhombic-shaped and are blue when aligned with the slow vibration of red compensated polarized light are:

Calcium pyrophosphate

Neutrophils that contain precipitated rheumatoid factor in their cytoplasm are called:

Ragocytes

A cloudy, yellow-green synovial fluid with 100,000 white blood cells (WBCs), a predominance of neutrophils, and a decreased glucose should be classified as:

Septic

CSF electrophoresis can be used to confirm the diagnosis of multiple sclerosis and would be expected to show which of the following?

Increased IgG with oligoclonal bands not seen on serum electrophoresis

Synovial fluid for crystal examination should be:

Examined unstained under direct and red compensated polarized light

Evaluation of sperm motility includes:

Differentiation between forward and lateral movement

Using a 1:10 dilution on a CSF specimen, 64 cells are counted in five large squares on both sides of the hemocytometer. The cell count is

640 cells/µL

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:

Repeat the count

When an L/S ratio by thin-layer chromatography is performed, a mature fetal lung will show:

Lecithin twice as concentrated as sphingomyelin

Myelin basic protein is measured in the CSF to assess the condition of patients with:

Multiple sclerosis

When performing sperm morphology analysis on a semen specimen with a sperm concentration of 20 million, 10 spermatids are seen. This result is

Indicative of abnormal sperm maturation

An increased amount of prostatic fluid in a semen specimen will:

Lower the pH

A primary function of amniotic fluid is to:

Provide protection for the fetus

A CSF glutamine level is an indirect measure of CSF:

Ammonia

Which of the following alpha fetoprotein results would be of concern?

3.0 MoM in amniotic fluid

Development of male antisperm antibodies can be caused by all of the following except:

Prolonged abstinence

When performing sperm morphology analysis, the minimum number of sperm that should be evaluated is

200

The volume of amniotic fluid increases after the first trimester as a result of:

Production of fetal urine

The lowest levels of CSF lactate can be found in patients with:

Bacterial meningitis

The presence of increased glutamine in the CSF can indicate

Reye's syndrome

Vacuolated macrophages containing ingested neutrophils seen in synovial fluid are called

Reiter’s cells

Sperm motility after 1 hour should be at least:

50%

the CSF tube number with the type of analysis.

1. Chemistry

2. Microbiology

3. Hematology

4. Special testing

Crystals that are found in synovial fluid during attacks of gout are most likely:

Monosodium urate

CSF is formed in the _______________ and reabsorbed by the _______________

Choroid plexus, arachnoid granulation

A dark yellow amniotic fluid is caused by:

Bilirubin

The immunobead test detects:

Male antisperm antibodies

The sugar of interest in most cases of infertility is:

Fructose

Nucleated red blood cells (RBCs) seen in the CSF indicate:

Bone marrow contamination from the puncture

Differentiation between a hemothorax and a hemorrhagic effusion on a bloody pleural fluid is done by:

Performing a hematocrit value, because a hemothorax will give a value close to that of blood

A CSF specimen, in which there is an uneven distribution of blood among the three tubes and clots are detected, is an indication of:

Traumatic tap

When an abnormally low sperm count is encountered in a fertility examination, the follow-up test of choice is:

Eosin-nigrosin stain

Proper collection of a semen specimen should include all of the following except:

At the laboratory followed by 1 hour of refrigeration

Using a 1:20 dilution and the 5 RBC counting squares of the Neubauer counting chamber, an average of 54 sperm is counted. The sperm concentration is:

54,000,000/mL

The most frequent concern of premature delivery is underdevelopment of the:

Lungs

A synovial fluid has a high white cell count and requires dilution to determine an accurate count. Which of the following diluents would you choose?

normal saline

Absence of a normal sperm acrosome can:

Affect ovum penetration

To determine if a questionable specimen is semen, the specimen should be tested for:

Acid phosphatase

In the Ropes’ or mucin clot test, normal synovial fluid:

Forms a solid clot when added to glacial acetic acid

The presence of neutrophils containing dark granules in the synovial fluid is associated with:

Rheumatoid arthritis

While performing a sperm morphology examination, a technologist counts 10 neutrophils per 100 mature sperm. To determine if this observation is significant, the technologist must also know the:

Sperm concentration

A milky-appearing synovial fluid can be associated with the presence of

monosodium urate crystals

Using an undiluted specimen, 100 cells are counted in the nine large squares on one side of the hemocytometer. The cell count is:

111 cells/µL

Analysis of amniotic fluid bilirubin levels is performed using:

Spectrophotometry

Exudate fluids usually result from

Inflammation of the serous membrane

An increased level of alpha fetoprotein in amniotic fluid should be further tested for

Acetylcholinesterase

Semen specimens should be processed for analysis

After complete liquefaction

In gout, both serum and synovial fluid will have increased levels of:

Uric acid

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 traumatic or bloody tap is suspected and, in all likelihood, no pathogenic significance should be attached to the presence of the blood

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?

Prealbumin

Prior to reporting a postvasectomy specimen as negative for the presence of sperm, the specimen must be:

Centrifuged

to differentiate between maternal and fetal blood in blood-streaked amniotic fluid, the fluid is tested for:

Fetal hemoglobin

the CSF/serum albumin index is performed to determine:

The integrity of the blood-brain barrier

All of the following can cause crystals to be present in the synovial fluid except:

Increased ingestion of dairy products

Which of the following is characteristic of an exudate?

increased leukocyte count

An IgG index of 1.10 would most likely be seen in a patient diagnosed with:

Multiple sclerosis

All of the following diseases are frequently associated with joint disorders except:

Tuberculosis

A peritoneal fluid with a positive CEA and a negative CA 125 (cancer antigen) indicates:

Gastrointestinal malignancy

Thoracentesis refers specifically to the removal of fluid from the:

pleural cavity