Body Fluid Analysis Practice Questions

MLS 4510

If CSF tubes numbered 2 and 3 CANNOT be analyzed within 1 hour, the correct procedure would be to:

Refrigerate tube 3 and leave 2 at room temperature

Calculate the WBC count using a 1:10 dilution, 64 cells are counted in five large squares on both sides of the hemocytometer.

640 cells/µL

On a xanthochromic CSF specimen, which of the following test should not be performed?

Lactate level

A positive cryptococcal antigen test with a negative India ink preparation may indicate:

Rheumatoid factor

Myelin basic protein is measured in the CSF to assess the condition of patients with which of the following?

Multiple sclerosis

Three tubes of CSF are sent to the laboratory and show blood in all tubes, but decreasing in amounts from 1 to 3. How should this observation be interpreted?

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

The average volume of CSF in an adult is…

90–150 mL

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

Using the following laboratory results, determine what type of meningitis is present

WBC count: 1000/µL

Lymphocyte: 10%

Neutrophils: 90%

Protein: 150 mg/dL

Glucose: 15 mg/dL

Blood glucose: 90 mg/dL

Lactate: 40 mg/dL

Bacterial

Which condition does NOT produce elevated CSF protein?

Fluid leakage

To determine whether IgG is being produced within the central nervous system, the laboratory must calculate the:

IgG index

Examination of a CSF shows 1,000 WBCs, of which 75% are lymphocytes and 25% are monocytes. This finding is consistent with:

Viral meningitis

Which is NOT a function of the cerebrospinal fluid (CSF)?

Transmission of neurological impulses

A xanthochromic CSF specimen will appear:

Yellow and clear

The CSF circulates through the brain and spinal cord in the:

Subarachnoid space

Another name for a peritoneal effusion is:

Ascites

A pleural fluid pH of 6.0 indicates:

Esophageal rupture

Which of the following best represents a hemothorax?

Blood Hct: 30, fluid Hct: 20

Which of the following causes is not associated with transudate?

Increased hydrostatic pressure

Which of the following causes is not associated with exudate?

Congestive heart failure

During normal production of serous fluid, the slight excess of fluid is:

Absorbed by the lymphatic system

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

Effusion

The membrane that lines the wall of a cavity is the:

Parietal

All of the following are characteristics of mesothelial cells except:

Absence of nucleoli

Differentiation between bacterial peritonitis and cirrhosis is done by performing a/an:

Absolute neutrophil count

Why are fluid:serum protein and lactic dehydrogenase ratios performed on serous fluids?

To classify transudates and exudates

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

Acetic acid

All of the following are abnormal when seen in synovial fluid EXCEPT:

Synovial lining cells

The procedure for collecting synovial fluid is called:

Arthrocentesis

Which synovial crystal appears due to purine metabolism or leukemia chemotherapy?

Monosodium urate

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

Wet preparation

In what condition is the synovial fluid glucose most likely to be within normal limits?

Hemorrhagic arthritis

The primary function of synoviocytes is to:

Provide nutrients for the joint

The highest synovial WBC count should be found in a patient suffering from which of the following kinds of arthritis?

Septic

The chemical test performed most frequently on synovial fluid is:

Glucose

In an examination of synovial fluid under compensated polarized light, rhomboid-shaped crystals are observed.

What color would these crystals be when aligned parallel to the slow vibration?

Blue

What is the most prominent cell type seen in a normal bronchoalveolar lavage fluid (BAL)?

Macrophages

If BAL specimens cannot be analyzed immediately they should be:

Centrifuged and resuspended in a nutrient-supplemented media for testing

A pale, frothy-looking stool is indicative of:

Excess fat

Large orange-red droplets seen on direct microscopic examination of stools that have been mixed with Sudan III stain can represent:

Neutral fats

What is the instillation volume for cellular examination and culture for BAL specimens?

100 to 300 mL in 20 to 50 aliquots of sterile saline

Which of the following is NOT secreted into the small intestine by the pancreas?

Bile salts

The normal brown color of feces is produced by:

Urobilin

A milky or light brown-beige-colored BAL fluid indicates a/an:

Pulmonary alveolar proteinosis

A vaginal fluid was collected from a 25-year-old female that showed the following results: appearance is pink with flocculent discharge, pH is 3.9, whiff test is negative, many gram-positive rods, clue cells are absent.

What is your interpretation of these results?

Patient is normal and menstruating.

An amniocentesis is performed on a woman whose last two pregnancies have resulted in stillbirths due to hemolytic disease of the fetus and newborn. A screening test performed at the hospital is positive for bilirubin, and the specimen is sent to a reference laboratory for a bilirubin scan.

Doctors are concerned when the report comes back negative, and they question if the…

Specimen was exposed to light.

Failure of the fetus to begin swallowing will result in:

Polyhydraminos

Interference with the amniotic fluid bilirubin analysis on centrifuged fluid is most likely caused by:

Oxyhemoglobin

You receive a call from a physician’s office asking about “extra swabs” for a vaginal secretions collection for a possible Neisseria infection. Which of the following swabs cannot be used and why?

Sterile wood shaft swabs with cotton because they are toxic to the organism.

The foam, or shake, test is a screening test for amniotic fluid…

Surfactants

Alpha-fetoprotein is produced by the fetal:

Liver

Normal semen should liquefy…

Within 1 hour

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

Centrifuged

Semen analysis on post-vasectomy patients should be performed:

Until two consecutive monthly specimens show no sperm

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

Lower pH

Evaluation of sperm motility includes…

Differentiation between forward and lateral movement.

Semen viscosity is most closely related to specimen…

Liquefaction

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

200

Which test best correlates with the severity of HDFN?

Amniotic fluid bilirubin

Which is the reference method for FLM?

L/S ratio

Which of the following statements regarding the L/S ratio is true?

A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent respiratory distress syndrome.

What is the term for sperm when the anterior portion of the headpiece is smaller than normal?

Acrosomal deficiency

A provider sends a sperm specimen asking for analysis of sperm viability. Which of the following stains should be used?

Eosin

Which of the following tests would be normal in pancreatic insufficiency?

d-Xylose absorption

A 6 year-old patient’s CSF shows primarily monocytes (65%), rather than lymphocytes like normal. How should this be interpreted?

Not of concern because the standard majority-lymphocyte ratio may be switched in children.

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

Production of fetal urine

The method of choice for testing amniotic fluid contaminated with hemoglobin for fetal lung maturity is…

Amniostat

False-negative results for upper GI bleeding can be caused by:

Degradation of hemoglobin to porphyrin

In the determination of fetal lung maturity, which of the following components is produced by the body at the 35th week of gestation?

Phosphatidyl glycerol

A synovial fluid with a normal WBC count from a patient with a normal serum uric acid contains extracellular birefringent crystals under polarized light.

A possible reason for this finding is that the…

Specimen was collected in powdered EDTA.

When performing protein electrophoresis on CSF, why is it important to also simultaneously perform serum protein electrophoresis?

To determine whether oligoclonal banding in the CSF is due to a neurologic inflammation

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.

India ink preparations of CSF are used to diagnose…

Fungal meningitis

Yellow color in a semen specimen may be caused by all of the following except:

Preservation at room temperature

What is the significance of an ascitic fluid exudate with a positive CA 125 and negative CEA?

Ovarian cancer

A fern test is performed to differentiate between…

Urine and amniotic fluid.

Tests for the detection of fecal occult blood rely on which chemical reaction?

Pseudoperoxidase activity of hemoglobin

Before performing a cell count of a highly viscous synovial fluid, it may be necessary to incubate the fluid with…

Hyaluronidase

What color BAL would a heavy smoker be expected to have?

Grey

In addition to routine culture media, a synovial fluid culture should include:

Chocolate agar

The concentration of which of the following chemicals found in synovial fluid differs most noticeably from the plasma concentration?

Protein

The average volume of CSF in the adult is…

90–150 mL

When testing for vaginal pH, the healthcare provider collecting the specimen should…

Place the specimen on the pH paper before placing the swab into the saline solution.

The recommended specimen for quantitative fecal testing is a…

72-hour specimen

Which of the following characteristics best describes a pleural fluid as an exudate instead of a transudate?

Fluid-to-serum cholesterol ratio greater than 0.3

Which of the following is the location that provides a transport medium and energy for sperm motility?

Seminal vesicles

To determined whether an unknown fluid is synovial fluid, the fluid can be tested…

By adding acetic acid and observing clot formation.

The principle of the foam stability index is that phopholipids…

Reduce the surface tension of an alcoholic solution.

PCR testing for meningitis is based on…

Amplification of RNA

Which of the following pairings of stool appearance and cause do not correspond?

Yellow-green & barium sulphate

Increased AFP in amniotic fluid should be further tested for…

Acetylcholinesterase

When examining a specimen for the presence of sperm, the type of microscopy recommended for use is…

Phase

The presence of increased glutamine in the CSF can indicate:

Reye syndrome

A vaginal pH value of 6.0 could indicate which of the following conditions?

Bacterial infection

Which of the following parameters directly relates to and provides a check on the sperm motility evaluation?

Viability stain

A stool pH of 5.0 correlates with a…

Positive Clinitest

An IgG index greater than 0.77 indicates…

Synthesis of IgG within the CNS.

Crystals seen in stool after it has been mixed with acetic acid & Sudan III stain, and heated may be composed of…

Cholesterol