Clinical Microscopy Progress Exams

Variables in the Cockroft and Gault formula:

1. Urine ceatinine

2. Serum creatinine

3. Age

4. Race

5. Gender

6. Body weight in kilograms

7. BUN

8. Albumin

A. 1,2,3,4,

B. 5,4,3,2,1

C. 2,3,5,6

D. 1,6,4,8

C. 2,3,5,6

Variables in the MODIFICATION OF DIET IN RENAL DISEASE (MDRD) formula:

1. Urine ceatinine

2. Serum creatinine

3. Age

4. Race

5. Gender

6. Body weight in kilograms

7. BUN

8. Albumin

A. 1,2,3,4,5

B. 1,3,6,7,8

C. 2,4,5,7,8

D. 2,3,4,5,7,8

D. 2,3,4,5,7,8

In the urinalysis laboratory the primary source in the chain of infection would be:

A. Patients

B. Needlesticks

C. Specimens

D. Biohardous wastes

C. Specimens

All of the following should be discarded in biohazardous waste containers except:

A. Urine specimen containers

B. Towels used for decontamination

C. Disposable lab coats

D. Blood collection tubes

A. Urine specimen containers

An acceptable disinfectant for blood and body fluid decontamination is:

A. Sodium hydroxide

B. Antimicrobial soap

C. Hydrogen peroxide

D. Sodium hypochlorite

D. Sodium hypochlorite

Centrifuging an uncapped specimen may produce a biologic hazard in the form of:

A. Vectors

B. Sharps contamination

C. Aerosols

D. Specimen contamination

C. Aerosols

The first thing to do when a fire is discovered is to:

A. Rescue person in danger

B. Activate the alarm system

C. Close doors to other areas

D. Extinguish the fire if possible

A. Rescue person in danger

If a red rash is observed after removing gloves, the employee:

A. May be washing her hands too often

B. May have developed a latex allergy

C. Should apply cortisone cream

D. Should not rub the hands so vigorously

B. May have developed a latex allergy

The classification of a fire that can be extinguished with water is:

A. Class A

B. Class B

C. Class C

D. Class D

A. Class A

Employers are required to provide free immunization for:

A. HIV

B. HTLV-1

C. HBV

D. HCV

C. HBV

The current routine infection control policy developed by CDC and followed in all health-care settings is:

A. Universal precautions

B. Isolation precautions

C. Blood and body fluid precautions

D. Standard precautions

D. Standard precautions

Which of the following would be least affected in a specimen that has remained unpreserved at room temperature for more than 2 hours?

A. Urobilinogen

B. Ketones

C. Protein

D. Nitrite

C. Protein

Which of the tubules is impermeable to water?

A. Proximal convoluted tubule

D. Descending loop of Henle

C. Ascending loop of Henle

D. Distal convoluted tubule

C. Ascending loop of Henle

Decreased production of ADH: (two possible answers)

A. Produces a large volume of urine

B. Produces high urine volume

C. Increases ammonia excretion

D. Affects active transport of sodium

B. Produces high urine volume

The largest source of error in creatinine clearance tests is:

A. Secretion of creatinine

B. Improperly timed urine specimens

C. Refrigeration of the urine

D. Time of collecting blood sample

B. Improperly timed urine specimens

Variables that are included in the MDRD-IDSM estimated creatinine clearance calculations include all of the following except:

A. Serum creatinine

B. Weight

C. Age

D. Gender

B. Weight

A patient with a viscous orange specimen may have been:

A. Treated for urinary tract infection

B. Taking vitamin B

C. Eating fresh carrots

D. Taking antidepressants

A. Treated for urinary tract infection

Orange in alkaline urine, colorless in acid urine

A. Phenazopyridine (Pyridium)

B. Phenindione

C. Methyldopa

D. Metronidazole (Flagyl)

B. Phenindione

The principle of refractive index is to compare:

A. Light velocity in solutions with light velocity in solids

B. Light velocity in air with light velocity in solutions

C. Light scattering by air with light scattering by solutions

D. Light scattering by particles in solution

B. Light velocity in air with light velocity in solutions

A specimen with a specific gravity of 1.001 would be considered:

A. Hyposthenuric

B. Not urine

C. Hypersthenuric

D. Isosthenuric

B. Not urine

Leaving excess urine on the reagent strip after removing it from the specimen will:

A. Cause run-over between reagent pads

B. Alter the color of the specimen

C. Cause reagents to leach from the pads

D. Not affect the chemical reactions

A. Cause run-over between reagent pads

Testing a refrigerated specimen that has not warmed to room temperature will adversely affect:

A. Enzymatic reactions

B. Dye-binding reactions

C. Sodium nitroprusside reaction

D. Diazo reactions

A. Enzymatic reactions

Quality control of reagent strips is performed:

A. Using positive and negative controls

B. When results are questionable

C. At least once every 24 hours

D. All of the above

D. All of the above

All of the following are important to protect the integrity of reagent strips except:

A. Removing the desiccant from the bottle

B. Storing in an opaque bottle

C. Storing at room temperature

D. Resealing the bottle after removing a strip

A. Removing the desiccant from the bottle

A urine specimen with a pH of 9.0:

A. Indicates metabolic acidosis

B. Should be recollected

C. May contain calcium oxalate crystals

D. Is seen after drinking cranberry juice

B. Should be recollected

The principle of the protein error of indicators reaction is that:

A. Protein keeps the pH of the urine constant

B. Albumin accepts hydrogen ions from the indicator

C. Indicator accepts hydrogen ions from albumin

D. Albumin changes the pH of the urine

B. Albumin accepts hydrogen ions from the indicator

Testing for microalbuminuria is valuable for early detection of kidney disease and monitoring patients with:

A. Hypertension

B. Diabetes mellitus

C. Cardiovascular disease risk

D. All of the above

D. All of the above

The primary reason for performing a Clinitest is to:

A. Check for high ascorbic acid levels

B. Confirm a positive reagent strip glucose

C. Check for newborn galactosuria

D. Confirm a negative glucose reading

C. Check for newborn galactosuria

A speckled pattern on the blood pad of the reagent strip indicates:

A. Hematuria

B. Hemoglobinuria

C. Myoglobinuria

D. All of the above

A. Hematuria

An elevated urine bilirubin with a normal urobilinogen is indicative of:

A. Cirrhosis

B. Hemolytic disease

C. Hepatitis

D. Biliary obstruction

D. Biliary obstruction

A positive nitrite test and a negative leukocyte esterase test is an indication of a:

A. Dilute random specimen

B. Specimen with lysed leukocytes

C. Vaginal yeast infection

D. Specimen older than 2 hours

D. Specimen older than 2 hours

Initial screening of the urine sediment is performed using an objective power of:

A. 4x

B. 10x

C. 40x

D. 100x

B. 10x

Crenated RBCs are seen in urine that is:

A. Hyposthenuric

B. Hypersthenuric

C. Highly acidic

D. Highly alkaline

B. Hypersthenuric

Differentiation among RBCs, yeast, and oil droplets maybe accomplished by all of the following except:

A. Observation of budding in yeast cells

B. Increased refractility of oil droplets

C. Lysis of yeast cells by acetic acid

D. Lysis of RBCs by acetic acid

C. Lysis of yeast cells by acetic acid

When pyuria is detected in a urine sediment, the slide should be carefully checked for the presence of:

A. RBCs

B. Bacteria

C. Hyaline casts

D. Mucus

B. Bacteria

The largest cells in the urine sediment are:

A. Squamous epithelial cells

B. Urothelial epithelial cells

C. Cuboidal epithelial cells

D. Columnar epithelial cells

A. Squamous epithelial cells

Following an episode of hemoglobinuria, RTE cells may contain:

A. Bilirubin

B. Hemosiderin granules

C. Porphobilinogen

D. Myoglobin

B. Hemosiderin granules

A structure believed to be an oval fat body produced a Maltese cross formation under polarized light but does not stain with Sudan III. The structure:

A. Contains cholesterol

B. Is not an oval fat body

C. Contains neutral fats

D. Is contaminated with immersion oil

A. Contains cholesterol

The finding of yeast cells in the urine is commonly associated with:

A. Cystitis

B. Diabetes mellitus

C. Pyelonephritis

D. Liver disorders

B. Diabetes mellitus

All of the following contribute to urinary crystals formation except:

A. Protein concentration

B. pH

C. Solute concentration

D. Temperature

A. Protein concentration

Casts and fibers can usually be differentiated using:

A. Solubility characteristics

B. Patient history

C. Polarized light

D. Fluorescent light

C. Polarized light

Three-dimensional images:

A. Bright-field microscope

B. Phase contrast microcope

C. Interference contrast microscope

D. Fluorescent microscope

C. Interference contrast microscope

Anti-neutrophilic cytoplasmic antibody is diagnostic for:

A. IgA nephropathy

B. Wegener granulomatosis

C. Henoch-Schönlein purpura

D. Goodpasture syndrome

B. Wegener granulomatosis

The only protein produced by the kidney is:

A. Albumin

B. Uromodulin

C. Uroprotein

D. Globulin

B. Uromodulin

The presence of renal tubular epithelial cells and casts is an indication of:

A. Acute interstitial nephritis

B. Chronic glomerulonephritis

C. Minimal change disease

D. Acute tubular necrosis

D. Acute tubular necrosis

Urinalysis on a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed:

A. Heavy proteinuria

B. Low specific gravity

C. Uric acid crystals

D. Microscopic hematuria

D. Microscopic hematuria

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

A. Meat

B. Carbohydrates

C. Starch

D. Bananas

D. Bananas

Which type of urine sample is needed for a D-xylose absorption test on an adult patient?

A. 24-hour urine sample collected with 20 mL of 6N HCl

B. 2-hour timed postprandial urine preserved with boric acid

C. 5-hour timed urine kept under refrigeration

D. Random urine preserved with formalin

C. 5-hour timed urine kept under refrigeration

In automated microscopy, Sysmex UF series, the DNA within the cells is stained by the orange dye:

A. Carbocyanine

B. Phenathridine

C. Eosin

D. Bromcresol green

B. Phenathridine

In automated microscopy, Sysmex UF series, the nuclear membranes, mitochondria, and negatively charged cell membranes are stained with a green dye:

A. Carbocyanine

B. Phenathridine

C. Eosin

D. Bromcresol green

A. Carbocyanine

The UF-100 and UF-50 use laser-based flow cytometry along with:

A. Impedance detection

B. Impedance detection and forward light scatter

C. Impedance detection and fluorescence

D. Impedance detection and forward light scatter

E. Impedance detection, forward light scatter and fluorescence

E. Impedance detection, forward light scatter and fluorescence

Graphic display of size distribution of any small sediment particles (ranging from 1 to 6 um2) found during the microscopic examination; helps to decide whether bacteria are present in these small ranges or if the detected particles are small crystals or amorphous.

A. Near-infrared reflectance spectroscopy

B. Reflectance photometery

C. Small-particle histogram

D. Mass gravity meter

C. Small-particle histogram

The functions of the CSF include all of the following except:

A. Removing metabolic wastes

B. Producing an ultrafiltrate of plasma

C. Supplying nutrients to the CNS

D. Protecting the brain and spinal cord

A. Removing metabolic wastes

What department is the CSF tube labeled 3 routinely sent to?

A. Hematology

B. Chemistry

C. Microbiology

D. Serology

A. Hematology

The presence of xanthochromia can be caused by all of the following except:

A. Immature liver function

B. RBC degradation

C. A recent hemorrhage

D. Elevated CSF protein

C. A recent hemorrhage

A web-like pellicle in a refrigerated CSF specimen indicates:

A. Tubercular meningitis

B. Multiple sclerosis

C. Primary CNS malignancy

D. Viral meningitis

A. Tubercular meningitis

CSF total cell count is diluted with:

A. Distilled water

B. Normal saline

C. Acetic acid

D. Hypotonic saline

B. Normal saline

A CSF WBC count is diluted with:

A. Distilled water

B. Normal saline

C. Acetic acid

D. Hypotonic saline

C. Acetic acid

A total CSF cell count on a clear fluid should be:

A. Reported as normal

B. Not reported

C. Diluted with normal saline

D. Counted undiluted

D. Counted undiluted

The purpose of adding 30% albumin to CSF before cytocentrifugation is to:

A. Increase the cell yield

B. Decrease the cellular distortion

C. Improve cellular staining

D. Increase cell yield and decrease cellular distortion

D. Increase cell yield and decrease cellular distortion

Neutrophils with pyknotic nuclei may be mistaken for:

A. Lymphocytes

B. Nucleated RBCs

C. Malignant cells

D. Spindle-shaped cells

B. Nucleated RBCs

Macrophages appear in the CSF after:

A. Hemorrhage

B. Repeated spinal taps

C. Diagnostic procedures

D. All of the above

D. All of the above

Nucleated RBCs are seen in the CSF as a result of:

A. Elevated blood RBCs

B. Treatment of anemia

C. Severe hemorrhage

D. Bone marrow contamination

D. Bone marrow contamination

Myeloblasts are seen in the CSF:

A. In bacterial infections

B. In conjunction with CNS malignancy

C. After cerebral hemorrhage

D. As a complication of acute leukemia

D. As a complication of acute leukemia

The reference range for CSF protein is:

A. 6 to 8 g/dL

B. 15 to 45 g/dL

C. 6 to 8 mg/dL

D. 15 to 45 mg/dL

D. 15 to 45 mg/dL

Elevated CSF protein values can be caused by all of the following except:

A. Meningitis

B. Multiple sclerosis

C. Fluid leakage

D. CNS malignancy

C. Fluid leakage

The integrity of the blood-brain barrier is measured using the:

A. CSF/serum albumin index

B. CSF/serum globulin ratio

C. CSF albumin index

D. CSF IgG index

A. CSF/serum albumin index

Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome?

A. Ammonia

B. Lactate

C. Glucose

D. Alpha-ketoglutarate

A. Ammonia

Determining CSF ________ provides an indirect test for the presence of excess ammonia in the CSF.

A. Alpha-ketoglutarate

B. Glucose

C. Glutamine

D. Lactate

C. Glutamine

Before performing a Gram stain on CSF, the specimen must be:

A. Filtered

B. Warmed to 37C

C. Centrifuged

D. Mixed

C. Centrifuged

Particular attention should be paid to the Gram stain for the CLASSIC STARBURST PATTERN produced by:

A. Hemophilus influenzae

B. Neisseria meninigitidis

C. Cryptococcus neoformans

D. Coccidioides immitis

C. Cryptococcus neoformans

Maturation of spermatozoa takes place in the:

A. Sertoli cells

B. Seminiferous tubules

C. Epidiymis

D. Seminal vesicles

C. Epidiymis

Enzymes for the coagulation and liquefaction of semen are produced by the:

A. Seminal vesicles

B. Bulbourethral glands

C. Ductus deferens

D. Prostate gland

D. Prostate gland

If the first portion of a semen specimen is not collected, the semen analysis will have which of the following?

A. Decreased pH

B. Increased viscosity

C. Decreased sperm count

D. Decreased sperm motility

C. Decreased sperm count

A semen specimen delivered to the laboratory in a condom has a normal sperm count and markedly decreased sperm motility. This indicates:

A. Decreased fructose

B. Antispermicide in the condom

C. Increased semen viscosity

D. Increased semen alkalinity

B. Antispermicide in the condom

Liquefaction of a semen specimen should take place within:

A. 1 hour

B. 2 hours

C. 3 hours

D. 4 hours

A. 1 hour

Proteolytic enzymes may be added to semen specimens to:

A. Increase the viscosity

B. Dilute the specimen

C. Decrease the viscosity

D. Neutralize the specimen

C. Decrease the viscosity

The primary reason to dilute a semen specimen before performing a sperm concentration is to:

A. Immobilize the sperm

B. Facilitate chamber count

C. Decrease the viscosity

D. Stain the sperm

A. Immobilize the sperm

For determination of sperm concentration, both sides of the Neubauer hemocytometer are loaded and allowed to settle for 3 to 5 minutes; then they are counted, and the counts should agree within ___%.

A. Agree within 5%

B. Agree within 10%

C. Agree within 20%

D. Agree within 30%

B. Agree within 10%

The purpose of the acrosomal cap is to:

A. Penetrate the ovum

B. Protect the the nucleus

C. Create energy for tail movement

D. Protect the neckpiece

A. Penetrate the ovum

The sperm part containing a mitochondrial sheath is the:

A. Head

B. Neckpiece

C. Midpiece

D. Tail

C. Midpiece

All of the following are associated with sperm motility except the:

A. Head

B. Neckpiece

C. Midpiece

D. Tail

A. Head

Additional parameters measured by Kruger's strict morphology include all of the following except:

A. Vitality

B. Presence of vacuoles

C. Acrosome size

D. Tail length

A. Vitality

Round cells that are of concern and may be included in sperm counts and morphology analysis are:

A. Leukocytes

B. Spermatids

C. RBCs

D. Leukocytes and spermatids

D. Leukocytes and spermatids

Following an abnormal sperm motility test with a normal sperm count, what additional test might be ordered?

A. Fructose level

B. Zinc level

C. Mixed agglutination reaction

D. Eosin-nigrosin stain

D. Eosin-nigrosin stain

Follow-up testing for a low sperm concentration would include testing for:

A. Antisperm antibodies

B. Seminal fluid fructose

C. Sperm vitality

D. Prostatic acid phosphatase

C. Sperm vitality

Measurement of alpha-glucosidase is performed to detect a disorder of the:

A. Seminiferous tubules

B. Epididymis

C. Prostate gland

D. Bulbourethral glands

B. Epididymis

A specimen delivered to the laboratory with a request for prostatic acid phosphatase and glycoprotein p30 was collected to determine:

A. Prostatic infection

B. Presence of antisperm antibodies

C. A possible rape

D. Successful vasectomy

C. A possible rape

Following a negative postvasectomy wet preparation, the specimen should be:

A. Centrifuged and reexamined

B. Stained and reexamined

C. Reported as no sperm seen

D. Detect presence of male antibodies

A. Centrifuged and reexamined

Normal synovial fluid resembles:

A. Egg white

B. Normal serum

C. Dilute urine

D. Lipemic serum

A. Egg white

When diluting a synovial fluid WBC count, all of the following are acceptable except:

A. Acetic acid

B. Isotonic saline

C. Hypotonic saline

D. Saline with saponin

A. Acetic acid

Synovial fluid crystals associated with inflammation in dialysis patients are:

A. Calcium pyrophosphate dihydrate

B. Calcium oxalate

C. Corticosteroid

D. Monosodium urate

B. Calcium oxalate

Synovial fluid for crystal examination should be examined as a/an:

A. Wet preparation

B. Wright's stain

C. Gram stain

D. Acid-fast stain

B. Wright's stain

The most frequently performed chemical test on synovial fluid is:

A. Total protein

B. Uric acid

C. Calcium

D. Glucose

D. Glucose

An increase in the amount of serous fluid is called a/an:

A. Exudate

B. Transudate

C. Effusion

D. Malignancy

C. Effusion

Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids:

A. When malignancy is suspected

B. To classify transudates and exudates

C. To determine the type of serous fluid

D. When a traumatic tap has occurred

B. To classify transudates and exudates

A differential observation of pleural fluid associated with tuberculosis is:

A. Increased neutrophils

B. Decreased lymphocytes

C. Decreased mesothelial cells

D. Increased mesothelial cells

C. Decreased mesothelial cells

A pleural fluid pH of 6.0 indicates:

A. Esophageal rupture

B. Mesothelioma

C. Malignancy

D. Rheumatoid effusion

A. Esophageal rupture

Plasma cells seen in pleural fluid indicate:

A. Bacterial endocarditis

B. Primary malignancy

C. Metastatic lung malignancy

D. Tuberculosis infection

C. Metastatic lung malignancy

The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the:

A. Fluid:serum albumin ratio

B. Serum ascites albumin gradient

C. Fluid:serum lactic dehydrogenase ratio

D. Absolute neutrophil count

B. Serum ascites albumin gradient