Media Lab - Urinalysis and Coag (All levels) Part 2

When a patient has a bile duct obstruction, the bilirubin test portion of the reagent strip is:

a. negative because unconjugated bilirubin is increased and cannot be excreted by the kidneys

b. positive because unconjugated bilirubin is increased and cannot be excreted by the kidneys

c. negative because conjugated bilirubin is increased and cannot be excreted by the kidneys

d. positive because conjugated bilirubin is increased and cannot be excreted by the kidneys

positive because conjugated bilirubin is increased and cannot be excreted by the kidneys

Which form of bilirubin is indicated by a positive urine reagent strip test?

a. conjugated

b. unconjugated

c. both conjugated and unconjugated

d. bilirubin bound to albumin

both conjugated and unconjugated

True or false: Urobilinogen production is low or absent in biliary obstruction, which will be detected on the urine dipstick.

false

True or false: Urine chemical reagent strips readers can utilize any manufacturer's dipsticks.

False

When an automated or semiautomated method is used to read urine chemical reagent strips, quality control testing must be performed:

a. once a week

b. with each specimen

c. with each new instrument operator

d. every day of patient testing

every day of patient testing

Which of the following situations suggest a traumatic tap occurred?

a. more blood is in tube 4 than tubes 1, 2, or 3

b. immediate centrifugation reveals pink supernatant

c. blood clots are present

d. 3+ turbidity is present

blood clots are present

True or False: Xanthochromia in a premature infant may be due to an immature blood-brain barrier.

True

In moderately bloody specimen, 250 cells are counted in 10 squares. The diluation is 1:100. What is the count/microliter?

a. 2.5 x 10^2

b. 2.5 x 10^3

c. 2.5 x 10^4

d. 2.5 x 10^5

2.5 x 10^4

A cell count is ordered on a CSF sample that is bloody. Which of the following procedures would improve count accuracy?

a. dilute the sample to minimize the number of red blood cells in the squares being counted

b. use spinal diluting fluid, a mixture of acetic acid and crystal violet

c. use an automated hematology cell counter

d. use fluorescent microscopy

use spinal diluting fluid, a mixture of acetic acid and crystal violet

True of False: Cytocentrifugation is the recommended method for preparing a CSF sample for examination of cellular morphology.

True

A medical laboratory technician decides to make a 1:20 dilution of cerebrospinal fluid (CSF) after briefly evaluating a portion of the sample microscopically. After making the dilution and charging the chambers, the number of cells that are observed in each of the large squares of the hemocytometer is >100. What should the technician do to obtain the most accurate count?

a. count all four corner squares

b. make a smaller dilution

c. make a larger dilution

d. count the large center square

make a larger dilution

True or False: Nucleated blood cells will always have the same appearance on a cytocentrifuged smear as they do on a peripheral blood smear.

False

The intrinsic pathway for coagulation begins with the activation of which of the following factors?

a. I

b. II

c. V

d. XII

XII

The final common pathway begins with the activation of which of the following factors?

a. I

b. II

c. X

d. XIII

X

Heparin inhibits the clotting of blood by neutralizing the effect of which of the following?

a. thrombin

b. calcium ions

c. platelets

d. factor VIII

thrombin

Warfarin is an antagonist of which of the following vitamins?

a. B

b. C

c. D

d. K

K

What crystals are found in alkaline urine with a colorless prism shape with oblique ends; "coffin-lid" shaped?

a. uric acid

b. calcium oxalate

c. calcium carbonate

d. triple phosphate

triple phosphate

What crystals are variably shaped: flat diamond, rhombic, or lemon shaped with a yellowish-brown coloration?

a. uric acid

b. calcium oxalate

c. calcium carbonate

d. triple phosphate

uric acid

What crystals have a refractile square envelope shape and can be seen in acid or neutral urine?

a. uric acid

b. calcium oxalate

c. calcium carbonate

d. triple phosphate

calcium oxalate

What crystals are colorless with a dumbbell or spherical appearance and are found in alkaline urine?

a. uric acid

b. calcium oxalate

c. calcium carbonate

d. triple phosphate

calcium carbonate

Glitter call is a term used to describe a specific type of:

a. ketone body

b. oval fat body

c. bacteria

d. neutrophil

neutrophil

A technologist performed urine microscopic testing on a patient who submitted a urine sample following strenuous exercising. Which of the following casts is most likely to be found in this urine sample?

a. hyaline casts

b. white cell casts

c. granular casts

d. waxy casts

hyaline casts

A college student is treated in the hospital for suspeced meningitis. Which cells should be identified in the CSF report for the cytospin field that is shown?

a. monocytes

b. blast cells

c. lymphocytes

d. plasma cells

lymphocytes

The nephron includes all of the following except:

a. urethra

b. glomerulus

c. loop of Henle

d. proximal convoluted tubule

urethra

The indicators used in the pH test region of the chemical reagent strips for urine are:

a. methyl red and bromthymol red

a. methyl blue and bromthymol blue

a. methyl red and bromthymol blue

a. methyl blue and bromthymol red

methyl red and bromthymol blue

A yellow coloration found in fresh CSF supernatant is termed?

a. xanthochromia

b. hemolysis

c. jaundice

d. hyperlipidemia

xanthochromia

Kidneys perform all of the following functions except:

a. acid-base balance

b. hormone production

c. reabsorption of waste products

d. water and electrolyte balance

reabsorption of waste products

Oliguria is usually correlated with:

a. acute glomerulonephritis

b. diabetes mellitus

c. hepatitis

d. tubular damage

acute glomerulonephritis

Normal adult CSF may have 0-5 WBC/microliter. Which of the following cell types account fr 60-100% of these WBCs?

a. neutrophils

b. lymphocytes

c. monocytes

d. eosinophils

lymphocytes

What is the lower reference limit for progressive motility of spermatozoa when performing a semen analysis?

a. 12%

b. 22%

c. 32%

d. 40%

32%

What is the fluid created in the abdominal cavity named?

a. peritoneal fluid

b. amniotic fluid

c. cerebrospinal fluid

d. pleural fluid

peritoneal fluid

What type of white blood cell is seen MOST frequently in urine sediment with infections of the urinary system?

a. eosinophil

b. lymphocyte

c. monocyte

d. neutrophil

neutrophil

When performing a chemical examination of urine, a routine reagent strip test for protein is based on the principle of:

a. precipitation by acid

b. protein-error-of-indicators

c. copper reduction

d. ictotest tablets

protein-error-of-indicators

The following urine test results were obtained from a 6-month-old African American infant who experiences vomiting and diarrhea after milk ingestion and has failed to gain weight:

pH: 5.0

Protein: Negative

Glucose: Negative

Ketones: Negative

Blood: Negative

Bilirubin: Negative

Nitrite: Negative

Urobilinogen: 0.1 EU/dL

Clinitest: 2+

These results are clinically significant in which of the following disorders?

a. diabetes mellitus

b. lactose intolerance

c. galactosemia

d. cystic fibrosis

galactosemia

Two CSF specimens were sent to the Lab with the following results:

Tube 1: 11,200 RBC/microliter

Tube 2: 300 RBC/microliter

The results on these CSF specimens are indicative of:

a. an infection

b. a recent subarachnoid hemorrhage

c. a traumatic tap

d. an old intracranial bleeding episode

a traumatic tap

All of the following white blood cells would produce a positive leukocyte esterase test, except?

a. neutrophils

b. eosinophils

c. basophils

d. lymphocytes

lymphocytes

Which of the following would be the most appropriate method to confirm a positive protein from a urine dipstick?

a. immuoelectrophoresis

b. heat precipitation

c. sulfosalicylic acid precipitation

d. protein electrophoresis

sulfosalicylic acid precipitation

What crystals are seen as colorless hexagonal plates in acidic urine:

a. cholesterol crystals

b. uric acid crystals

c. amorphous urate crystals

d. cystine crystals

cytine crystals

All of the following are standard methods for measuring the specific gravity of urine, except:

a. urine reagent strips

b. freezing point depression

c. refractometry

d. harmonic oscillation densitometry

freezing point depression

A urine concentration test was performed on a patient after a fluid intake deprivation period with the following findings:

After 12 hrs Urine Osmolality = 850 mOsm/Kg

After 16 hrs Urine Osmolality = 850 mOsm/Kg

What do these results indicate?

a. this represents normal kidney function

b. this represents a loss of tubular function and concentrating ability

c. this represents a laboratory error, as these results are not medically possible

d. these results represent end-stage renal disease

this represents normal kidney function

The presence of Bence-Jones protein in urine is associated with which of the following conditions?

a. tuberculosis

b. multiple myeloma

c. UTI

d. diabetes

multiple myeloma

All of the following formed elements may be present in urine sediment and can be identified microscopically except:

a. cells

b. casts

c. crystals

d. protein

protein

Which is the best method for examination of synovial crystals?

a. phase contrast

b. darkfield microscopy

c. brightfield microscopy

d. polarized light

polarized light

A WBC differential count on CSF should be performed using the following technique:

a. wet mount of sample from collection tube

b. stained smear of a cytocentrifuged specimen

c. directly from hemocytometer chamber count

d. directly from stained hemocytometer count

stained smear of a cytocentrigued specimen

Which of the following would be the most characteristic finding in synovial fluid in a case of pseudogout?

a. monosodium urate crystals

b. calcium pyrophosphate crystals

c. macrophase infiltration

d. mixed RBC/WBC infiltration

calcium pyrophosphate crystals

In order to avoid falsely elevated spinal fluid cell counts one should:

a. use an aliquot only from the first tube collected

b. use only those specimens showing no turbidity

c. centrifuge all specimens before counting

d. select an aliquot from the last tube collected

select an aliquot from the last tube collected

Which of the following tests on amniotic fluid would be included when assessing fetal lung maturity:

a. alpha fetoprotein

b. bilirubin

c. L/S ratio

d. fetal hemoglobin

L/S ratio

A spectrophotometric scan of amniotic fluid may be valuable in the determination of which of the following conditions:

a. neural tube defects

b. maternal hypertension

c. hemolytic disease of the newborn

d. maternal diabetes

hemolytic disease of the newborn

Xanthochromia in CSF is characteristic of:

a. encephalitis

b. meningitis

c. septicemia

d. hemorrhage

hemorrhage

Urine pH values can normally vary between:

a. 4.5-8.0

b. 5.0-6.0

c. 7.0-8.0

d. 3.0-7.0

4.5-8.0

A patient reported to her doctor that her stools have been ribbon-like over the last few weeks. What is most likely the cause of the patient's still appearance?

a. diarrhea

b. constipation

c. inflammation of the intestinal wall

d. bowel obstruction

bowel obstruction

All of the statements below about synovial fluid are true except:

a. arthrocentesis is performed as a means to evaluate arthritis and other joint disorders

b. synovial fluid is present only in moveable joints

c. joint fluid resembles plasma in viscosity

d. joint fluid has approximately the same glucose as plasma

joint fluid has approximately the same glucose as plasma

To determine if xanthochromia is present in a CSF sample, the sample must be centrifuged within:

a. 1 hour

b. 2 hours

c. 3 hours

d. 4 hours

1 hour

Acetest can be used to test for ketones in:

a. urine

b. urine and serum

c. urine, serum, and whole blood

d. urine, serum, whole blood, and CSF

urine, serum, and whole blood