AUBF FINALS 2023

Reading time: 60 seconds

a. pH, blood and bilirubin

b. Urobilinogen and nitrite

c. Protein and leukocytes

d. pH and ketones

b. Urobilinogen and nitrite

What is the normal stool pH?

a. 5.0 to 6.0

b. 7.0 to 8.0

c. 5.0 to 7.0

d. 4.5 to 8.0

b. 7.0 to 8.0

The normal kidney performs all of the following functions, EXCEPT:

a. Removes metabolic waste products from the blood

b. Regulates the acid-base balance in the body

c. Remove excess protein from the blood

d. Regulates the water content in the body

c. Remove excess protein from the blood

What type of tube for gastric fluid collection is passed through the nose?

a. Rehfuss tube

b. Levin tube

c. Diagnex tube

d. None of these

b. Levin tube

For drug testing analysis, the urine temperature within 4 minutes should be between:

a. 35.2 - 37.5°C

b. 32.5 - 35.7°C

c. 35.7 - 37.2°C

d. 32.5-37.7°C

d. 32.5-37.7°C

When heated at 40-60°C, a clear urine becomes cloudy; and when heated at 100°C. the urine become clear again. This may be due to the presence of;

a. Urates

b. Phosphates

c. WBCs

d. Bence-Jones protein

d. Bence-Jones protein

A black urine with a pH of 8.5 should be:

a. Tested for melanin and homogentisic acid

b. Tested for blood and bilirubin

c. Returned to the nurse's station d. Discarded and the doctor notified

a. Tested for melanin and homogentisic acid

Storage of reagent strips should include:

1. Refrigeration

2. Dark container

3. Dessicant in the bottle

4. Tightly closed bottle

a. 1, 2 and 3

b. 1, 3 and 4

c. 2, 3 and 4

d. 1, 2, 3 and 4

c. 2, 3 and 4

Quality control on reagent strips must be performed at the beginning and whenever:

a. A physician questions a patient's results

b. A different technician performs the test

c. A new bottle of strips is opened

d. A new student is training in the lab

c. A new bottle of strips is opened

A fresh urine specimen should be requested when the following result is found:

a. 4+ glucose and 3+ protein

b. pH 9.0

c. Specific gravity 1.025

d. Leukocytes 1+

b. pH 9.0

Reagent: tetrachlorophenol tetrabromosulfonphthalein

a. Glucose

b. Protein

c. Nitrite

d. Specific gravity

b. Protein

Reagent: 4-methoxybenzene-diazoniumtetrafluorobo rate

a. Bilirubin

b. Urobilinogen

c. Nitrite

d. Leukocytes

b. Urobilinogen

A college student has a 2+ protein on a routine urinalysis performed on a random specimen. A repeat test on a first morning specimen is negative. The most probable cause of these results is:

a. Nephrotic syndrome

b. Orthostatic proteinuria

c. UTI

d. Mislabeled specimen

b. Orthostatic proteinuria

Specific tests for glucose:

a. Have an enzyme which reacts with glucose

b. Reduce copper

c. React with nonglucose reducing substances

d. May give a false-positive reaction with ascorbic acid

a. Have an enzyme which reacts with glucose

The reagent strip nitroprusside reaction is positive in:

1. Starvation

2. Diabetic acidosis

3. Malabsorption

4. Vomiting

a. 1, 2 and 3

b. 2, 3 and 4

c. 1 and 2

d. 1, 2, 3 and 4

d. 1, 2, 3 and 4

A spotted reaction on the reagent strip reaction for blood indicates:

a. Hematuria

b. Hemoglobinuria

c. Myoglobinuria

d. Porphyrinuria

a. Hematuria

What action would you take with the following results:

CHEMICAL

Color = Yellow

Blood = Negative

Appearance = Hazy

Urobilinogen = 1.0 EU

S. G.= 1.015

Nitrite = Negative

pH = 8.0

Bilirubin = Negative

Protein = Trace

MICROSCOPIC

Glucose = negative

WBC/hpf = 4-8

Ketones = negative

RBC/hpf = 20-30

a. Call the floor because the urobilonogen is over the panic value

b. Notify the floor that the specimen is too old

c. Recheck the sediment

d. Question the reagent strip pH and leukocyte reactions

c. Recheck the sediment

Ghost RBCs most frequently occur with:

a. High pH, high SG

b. High pH, low SG

c. Low pH, high SG

d. Low pH, low SG

b. High pH, low SG

Urine volume required by the Iris Mass Gravity Meter:

a. 2 mL

b. 8 mL

c. 10 mL

d. 15 mL

a. 2 mL

Renal calculi that is describe as yellow-brown in color and somewhat greasy:

a. Phosphate

b. Uric acid

c. Calcium oxalate

d. Cystine

d. Cystine

Crystals found in the urine that are associated with disease include:

a. Calcium oxalate and uric acid

b. Leucine and tyrosine

c. Heavy amorphous phosphates d. Triple phosphate and ammonium biurate

b. Leucine and tyrosine

Examination of the urine sediment for the presence of casts should be performed:

a. With increased light under high power

b. With increased light under low power

c. With reduced light under high power

d. With reduced light under low power

d. With reduced light under low power

True about calcium oxalate stones:

1. Yellowish to brownish red

2. Rough-surfaced

3. Major constituents of all types of renal calculi

4. Very hard calculi

a. 1, 2, 3 and 4

b. 2, 3 and 4

c. 1, 3 and 4

d. 3 only

b. 2, 3 and 4

What sample is used in the Diagnex Tubeless test for gastric analysis?

a. Urine

b. Stool

c. Blood

d. Gastric fluid

a. Urine

PDCA stands for:

a. Plan-Do-Choose-Act

b. Plan-Develop-Confirm-Act

c. Plan-Do-Check-Act

d. Plan-Develop-Check-Act

c. Plan-Do-Check-Act

The finding of increased hyaline and granular casts in the urine of an otherwise healthy person may be the result of:

a. Fecal contamination

b. Recent strenuous exercise

c. Early UTI

d. Renal disease

b. Recent strenuous exercise

A device used to calibrate centrifuge:

a. Tachometer

b. Galvanometer

c. Stopwatch

d. A and C

d. A and C

A routine UA is performed on a specimen that has turned black after standing in the laboratory. The urine is acidic & has negative chemical tests except for the appearance of a red color on the ketone area of the strip. One should suspect:

a. Phenylketonuria

b. Diabetic ketoacidosis

c. Alkapatonuria

d. Melanuria

d. Melanuria

Characteristic urine odors are associated with all of the following, EXCEPT:

1. Alkaptonuria

2. Phenylketonuria

3. Maple syrup urine disease

4. Isovaleric acidemia

a. 1, 2, 3 and 4

b. 1 only

c. 2, 3 and 4

d. 1 and 4

b. 1 only

Which of the following factors is most likely to cause a brown-colored seminal fluid?

a. Bile pigment

b. Blood

c. Continence

d. Urine contamination

b. Blood

The Sulkowitch test screens for urinary:

a. Glucose

b. Oxalate

c. Calcium

d. Ammonia

c. Calcium

Three tubes of CSF labeled 1, 2 and 3 are received in the laboratory. They should be distributed as follows:

a. Hematology #1, chemistry #2, and microbiology #13

b. Hematology #2, chemistry #3 and microbiology #1

c. Hematology #3, chemistry #1 and microbiology #2

d. Hematology #1, chemistry #3 and microbiology #2

c. Hematology #3, chemistry #1 and microbiology #2

In the sputum analysis, the only clinical significance of this finding is its resemblance to Blastomyces:

a. Creola bodies

b. Myelin globules

c. Curschmann's spirals

d. Blue bodies

b. Myelin globules

WBC counts on clear CSF specimens are performed:

a. Using electronic counters

b. Only if more than 200 cells are present

c. On diluted specimens if there is no cell overlapping

d. On specimens diluted 1:200 with gentian violet

c. On diluted specimens if there is no cell overlapping

A broad spectrum of reactive and nonreactive lymphocytes in the CSF is associated with:

a. Bacterial meningitis

b. Fungal meningitis

c. Tubercular meningitis

d. Viral meningitis

d. Viral meningitis

Which of the following is the best way of determining urine clarity?

a. Hold the specimen in front of a white background

b. Place a light on your behind

c. Hold the specimen in front of a newspaper print

d. View through a dark container

c. Hold the specimen in front of a newspaper print

LDH isoenzymes appearing in the CSF are derived from:

a. Damage to the blood-brain barrier

b. Contamination due to traumatic tap

c. Neutrophils and lymphocytes

d. Neutrophils, lymphocytes, and brain cells

d. Neutrophils, lymphocytes, and brain cells

The purpose of diluting semen specimens with sodium bicarbonate and formalin prior to 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 specimen

d. Immobilize and preserve the specimen

The normal acrosomal cap should encompass:

a. 1/2 of the sperm head

b. 1/3 of the sperm nucleus

c. 3/4 of the sperm head

d. 1 /4 of the sperm nucleus

a. 1/2 of the sperm head

Semen specimens should be analyzed:

a. Immediately upon receipt

b. Prior to liquefaction

c. After liquefaction

d. One hour after collection

c. After liquefaction

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

1. Collection in a sterile container 2. Collection after a 3-day period of sexual abstinence

3. Collection at the laboratory followed by 1 hour of refrigeration 4. Collection at home and delivery to the laboratory within 1 hour

a. 1, 2 and 3

b. 1, 2 and 4

c. 2, 3 and 4

d. 1, 2, 3 and 4

b. 1, 2 and 4

True about normal sperm cell morphology

1. Head: 3 um wide x 5 um long

2. Tail: 30 um long

3. Acrosomal cap: 1 /2 of sperm head

4. Midpiece: contains mitochondria

a. 3 and 4

b. 1, 3 and 4

c. 2, 3 and 4

d. 1, 2, 3 and 4

b. 1, 3 and 4

True about synovial fluid:

1 Surrounds all joints in the body 2. Found only in the knee

3. Acts as a lubricant

4. Supplies nourishment to cartilage

a. 1 and 3

b. 1, 3 and 4

c. 2, 3 and 4

d. 1, 2 and 3

b. 1, 3 and 4

Correct matches regarding synovial fluid:

1. Normal = clear, pale yellow

2. Crystal = milky

3. Traumatic tap = blood streaks

4. Sepsis = uniform blood

a. 1 and 3

b. 1, 3 and 4

c. 1, 2 and 3

d. 1, 2, 3 and 4

c. 1, 2 and 3

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

a. Forms a solid clot when added to hyaluronidase

b. Forms a solid clot when added to glacial acetic acid

c. Forms a friable clot when added to hydrochloric acid

d. Does not form a clot when added to glacial acetic acid

b. Forms a solid clot when added to glacial acetic acid

Examination of synovial fluid under direct polarized light reveals intracellular needle-shaped crystals that appear white against the black background. When a red compensator is added and the crystals are aligned with the slow vibration, they appear yellow against the red background. These crystals are:

a. Monosodium rate showing positive birefringence

b. Monosodium urate showing negative birefringence

c. Calcium pyrophosphate showing positive birefringence

d. Calcium pyrophosphate showing negative birefringence

b. Monosodium urate showing negative birefringence

An arthrocentesis performed on a patient with SLE produces a cloudy yellow fluid with 2000 WBCs of which 55% are neutrophils. The fluid would be classified as:

a. Noninflammatory

b. Immunologic

c. Septic

d. Crystal-induced

b. Immunologic

Effusions produced by conditions that directly affect the serous membranes are termed:

a. Transudates

b. Exudates

c. Both of these

d. None of these

b. Exudates

A milky pleural fluid becomes clear after extraction with either. This fluid contained:

a. Chylous material from thoracic duct leakage

b. Pseudochylous material from thoracic duct leakage

c. Chylous material from inflammation

d. Pseudochylous material from inflammation

a. Chylous material from thoracic duct leakage

Type of effusion is empysema:

a. Pleural exudates

b. Pericardial transudate

c. Peritoneal exudates

d. Pleural transudate

a. Pleural exudates

A renal calculi described as yellowish to brownish red in color with a moderately hard consistency is:

a. Cystine

b. Phosphate

c. Calcium oxalate

d. Uric acid

d. Uric acid

Which of the following urinalysis findings include contradictory results that should not be reported?

a. pH 8.0, protein trace, moderate calcium oxalate crystals

b. pH 7.5, nitrite positive, many amorphous phosphates

c. pH 6.0, bilirubin positive, moderate triple phosphate crystals

d. pH 6.0, glucose trace, rare yeast cells

b. pH 7.5, nitrite positive, many amorphous phosphates

What is the sequence of cast formation starting from the most significant?

a. Waxy, hyaline, cellular, coarsely granular, finely granular

b. Cellular, coarsely granular, finely granular, hyaline, waxy

c. Hyaline, cellular, finely granular, coarsely granular, waxy

d. Waxy, finely granular, coarsely granular, cellular, hyaline

b. Cellular, coarsely granular, finely granular, hyaline, waxy

Renal disease that is caused by anti-neutrophilic cytoplasmic auto-antibody (ANCA) that binds to neutrophils in vascular walls producing damage to small vessels in the lungs and glomerulus:

a. Alport syndrome

b. Focal segmental glomerulosclerosis

c. Wegener's granulomatosis

d. Nephrotic syndrome

c. Wegener's granulomatosis

The presence of myelin basic protein (MBP) in the CSF may indicate:

a. Multiple myeloma

b. Multiple sclerosis

c. Myelin sheath destruction

d. B and C

b. Multiple sclerosis

An amniotic fluid creatinine level of >2.0 mg/dL indicates:

a. Mature fetal lungs

b. Renal disorder

c. Fetal age of more than 36 wks d. neural tube defects

c. Fetal age of more than 36 wks

Seminal fluid viscosity graded as 4 is describes as:

a. Watery

b. Fair

c. Friable

d. Gel-like

d. Gel-like

A 45-year old man has just experienced a car accident. He has several crush injuries, broken bones and numerous abrasions. A random urinalysis specimen shows the significant findings:

Color = Reddish-brown

RBC = 0-2/hpf

Clarity = Clear

WBC = 0-2/hpf

pH = 6.5 0-2/1pf

Hyaline casts = 1-3/lpf

Protein = 1+

Granular casts = 0-2/lpf

Blood = 4+

How are these results possible?

a. The positive blood result is due to intravascular hemolysis

b. The positive blood result is due to rhabdomyolysis

c. Old specimen. Repeat urinalysis d. The specimen was contaminated with acetic acid

b. The positive blood result is due to rhabdomyolysis

SSS grading: "distinct turbidity with no granulation"

a. 1+

b. 2+

c. 3+

d. trace

a. 1+

A urinalysis is performed on a specimen from a patient with diabetes insipidus. Which of the following laboratory data sets is most consistent with this diagnosis? Specific gravity & Glucose & 24-hr Urine volume

a. 1.005, negative, 3, 500 ml

b. 1.005, positive, 3, 500 mL

c. 1.020, positive, 2, 850 ml

d. 1.020, negative, 3, 000 mL

a. 1.005, negative, 3, 500 ml

A clean-catch urine is submitted to laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hours later, the specimen is sent to the microbiology department for culture. The specimen should be:

a. Cultured when nitrite is positive b. Cultures when Gram stain shows bacteria

c. Rejected

d. Autoclaved then cultured

c. Rejected

The following are the recommended conditions in using and preserving reagent strips, EXCEPT:

a. Keep at room temperature

b. Closed tightly

c. Store in a dark container

d. Blotted on the tissue face down

d. Blotted on the tissue face down

Amniotic fluid is tested for the concentration of lamellar bodies. This test determines

a. Fetal age

b. Fetal lung maturity

c. Hemolytic disease of the newborn

d. Neural tube defects

b. Fetal lung maturity

What is (are) the variable (s) not included in the Cockgroft and Gault formula for creatinine clearance?

1. Age

2. Sex

3. Urine creatinine

4. Body weight

a. 1, 2, and 3

b. 1 and 3

c. 1, 2 and 4

d. 3 only

d. 3 only

HCG is produced by which of the following?

a. Cytotrophoblast cells

b. Argentaffin cells

c. Endocervical glandular cells

d. Type II pneumocytes

a. Cytotrophoblast cells

A tea-colored urine may be caused by:

a. Drinking green tea

b. Bilirubin

c. Rifampin

d. Clorets

b. Bilirubin

To avoid needle stick injuries, what procedure should one always follow?

a. Dispose needles in biohazard red-bag waste

b. Recap contaminated needles before disposing into sharps container

c. Place contaminated sharps into appropriate puncture-resistant, leak-proof container immediately after use

d. Break and bend contaminated needles before disposing into sharps container

b. Recap contaminated needles before disposing into sharps container

A synovial fluid was received in the laboratory for a 27-year old man who had a recent football injury. In the days following the injury, he reported progressively increasing pain and swelling. The final laboratory report was a follows:

Color = Yellow-green

Neutrophils = 95%

Clarity = Cloudy

Lymphocytes = 5%

Viscosity = Low

Glucose = decreased

WBC count = 110, 000/uL

GS/CS = (+) S. aureus

Based on the following results, which is the most probable diagnosis?

a. Hemorrhagic arthritis

b. Crystal-induced arthritis

c. Septic arthritis

d. Rheumatoid arthritis

c. Septic arthritis

Eosinophils and Curschmann's spirals may be found in which of the conditions?

a. Bronchiectasis

b. Chronic bronchitis

c. Lobar pneumonia

d. Bronchial asthma

d. Bronchial asthma

Rice-watery stool is seen in:

a. Cholera

b. Typhoid fever

c. Constipation

d. Cystic fibrosis

a. Cholera

The total renal plasma flow is approximately:

a. 60 mL/min

b. 120 mL/min

c. 600 mL/ min

d. 1200 mL/min

c. 600 mL/ min

A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to digest gelatin may have:

a. Bacterial dysentery

b. Duodenal ulcer

c. Cystic fibrosis

d. Lactose intolerance

c. Cystic fibrosis

Which of the following substances are reabsorbed by the PCT?

1. Sodium

2. Bicarbonate

3. Glucose

4. Urea

a. 1, 2 and 3

b. 2, 3 and 4

c. 1, 3 and 4

d. 1, 2, 3 and 4

d. 1, 2, 3 and 4

Correct procedure for handwashing, EXCEPT:

a. Wet hand with boiling water

b. Clean between fingers for at least 15 seconds

c. Rinse hands in a downward position

d. Turn off faucets with a clean paper towel

a. Wet hand with boiling water

Failure to observe RBC casts in urine specimen can be caused by:

a. Centrifuging an unmixed specimen

b. Staining the specimen

c. Examining the sediment first under LPO

d. Mixing the sediment after decantation

a. Centrifuging an unmixed specimen

Use of a refractometer over a urinometer is preferred due to the fact that the refractometer uses:

a. small urine volume and compensates for temperature

b. small urine volume and compensates for protein

c. Large urine volume and compensates for temperature

d. Large urine volume and compensates for glucose

a. small urine volume and compensates for temperature

Post-stimulation specimens from persons with pernicious anemia will show:

a. No increased acidity and a pH above 6.0

b. No increased acidity and a pH below 6.0

c. Increased acidity and a pH below 6.0

d. Increased acidity and a pH below 3.5

a. No increased acidity and a pH above 6.0

The advantage to using phase-contrast microscopy in urinalysis is to:

a. Enhance constituents with a low refractive index

b. Provide higher magnification

c. Provide a larger field of view

d. Allow constituents to stain more clearly

a. Enhance constituents with a low refractive index

Which of the following are indications of a traumatic tap?

1. Even distribution of blood on 3 tubes

2. Clear supernatant after centrifugation

3. Xanthochromia

a. 1 and 2

b. 2 and 3

c. 2 only

d. 1 only

c. 2 only

Select the renal function test used to measure renal blood flow:

1. Creatinine

2. Urea

3. Specific gravity

4. p-aminohippuric acid

a. 1 and 2

b. 3 only

c. 4 only

d. 1 and 3

a. 1 and 2

Which of the following cells is most likely to be seen in the urine sediment following a catheterization procedure?

a. Urothelial cell

b. Squamous epithelial cell

c. White blood cell

d. Renal tubular epithelial cell

a. Urothelial cell

A medical technologist is having trouble differentiating between RBCs, oil droplets and yeast cells on a urine microscopy, Acetic acid should be added to the sediment to:

a. Lyse the yeast cells

b. Dissolve the oil droplets

c. Enhance the nuclear detail of the red blood cells

d. Lyse the red blood cells

d. Lyse the red blood cells

What is the albumin excretion rate (AER) of patients with microalbuminuria?

a. 0-20 ug/min

b. 20-200 ug/min

c. 300 ug/min

d. 500 ug/min

b. 20-200 ug/min

Which of the following tests is least affected by standing or unpreserved urine?

a. Glucose

b. Protein

c. pH

d. Bilirubin

b. Protein

The results of a urinalysis on a first-morning specimen are:

S.G.= 1.025

pH = 8.0

Protein = negative

Glucose = negative

Microscopic exam shows moderate uric acid crystals. The results were unsatisfactory. What should be done next?

a. Repeat the specific gravity by using refractometer

b. Repeat the pH and microscopic examination

c. Perform confirmatory tests for protein and glucose

d. Report the results. Nothing is discrepant

b. Repeat the pH and microscopic examination

A fire involving heavy metals is classified as a:

a. Class C fire

b. Class B

c. Class E fire

d. Class D Fire

d. Class D Fire

NFPA Health Hazard classification: "Deadly"

a. 1

b. 2

c. 3

d. 4

d. 4

Degree of hazard: "Serious hazard"

a. 0

b. 1

c. 3

d. 4

c. 3

When combining acid and water, ensure that:

a. Acid is added to water

b. Water is added to acid

c. They are added simultaneously d. Water is slowly added to acid

a. Acid is added to water

A 60-year old man is evaluated for back pain. Urine test results include: Microscopic examination S. G.=1.020 WBCs=0-2/hpf pH=6.0 RBCs+0-2/hpf Protein=negative Rare epithelial cells Glucose=negative Urine protein electrophoresis was also performed. It revealed a monoclonal spike in the gamma-globulin region. Which of the following statements best explains these results?

a. Electrophoresis is incorrect and should be repeated

b. Urine protein is falsely-negative due to the S.G.

c. Microscopic examination is falsely-negative due to the S. G.

d. Urine protein is falsely-negative because the reagent strip is not sensitive to Bence-Jones protein

d. Urine protein is falsely-negative because the reagent strip is not sensitive to Bence-Jones protein

Bacterial and yeasts are considered significant in the urine sediment when:

a. Nitrite is positive

b. Protein is positive

c. Specimen is cloudy

d. Leukocytes is positive

d. Leukocytes is positive

What is the renal threshold for glucose?

a. 3.8 mmol/L

b. 6.5 mmol/L

c. 9.4 mmol/L

d. 16.0 mmol/L

c. 9.4 mmol/L

Gold standard for glomerular filtration rate:

a. Creatinine clearance

b. Cystatin C clearance

c. Inulin clearance

d. Urea clearance

c. Inulin clearance

The reading of distilled water by the refractometer is 1.003. What should you do?

a. Subtract 1.003 from each specimen reading

b. Add 1.003 to each specimen reading

c. Use a new refractometer

d. Adjust the set screw

d. Adjust the set screw

Oval fat bodies are often associated with:

a. Nephrotic syndrome

b. Acute glomerulonephritis

c. Chronic renal failure

d. Chronic pyelonephritis

a. Nephrotic syndrome

Preferred urine sample for pregnancy testing:

a. Random

b. Fasting

c. First morning

d. Midstream clean-catch

c. First morning

Which marker can be used to identify a body fluid as semen?

a. Zinc

b. Hyaluronic acid

c. PSA

d. Alkaline phosphatase

c. PSA

Animal used in Hogben bioassay test for hG:

a. Female rabbit

b. Female toad

c. Male rats

d. Male frog

b. Female toad

This type of renal stone is mostly associated with urinary infections involving urea-splitting bacteria:

a. Struvite

b. Sulfonamide

c. Triamterene

d. Silica

a. Struvite

What is the specific gravity of triple distilled water when measured by refractometer?

a. 1.003

b. 3.000

c. 1.000

d. 1.010

c. 1.000