BODY FLUIDS EXAM 3 STUDY GUIDE 2025

An HIV-positive patient develops edema, elevated cholesterol and triglyceride levels, heavy proteinuria and deposits of Immunoglobulin M and C3

focal segmented glomerulonephritis

A patient with a history of intermittent hematuria following strenuous exercise has an elevated serum immunoglobulin A level.

IgA nephropathy

Following ingestion of mushrooms found growing in his garden, a man develops symptoms of oliguria, lethargy, and edema. Many RTE cells are observed in his urinalysis.

Acute tubular necrosis

A patient whose microalbuminuria has progressed to a 2+ urine protein.

diabetic nephropathy

An eosinophil count may be requested on urine from a patient with suspected:

acute interstitial nephritis

A 40-year-old female tennis player with tendonitis is taking large doses of an over-the

counter nonsteroidal anti-inflammatory agent. After taking the medication for several

weeks, she develops a skin rash and observes a decrease in urine volume

What is the most diagnostic reagent strip result in this urinalysis?

negative nitrite

A 40-year-old female tennis player with tendonitis is taking large doses of an over-the

counter nonsteroidal anti-inflammatory agent. After taking the medication for several

weeks, she develops a skin rash and observes a decrease in urine volume

How does your above answer correlate with the microscopic results?

No bacteria seen

A 40-year-old female tennis player with tendonitis is taking large doses of an over-the

counter nonsteroidal anti-inflammatory agent. After taking the medication for several

weeks, she develops a skin rash and observes a decrease in urine volume

What additional test might be requested on this specimen?

Urine eosinophil stain

A 40-year-old female tennis player with tendonitis is taking large doses of an over-the

counter nonsteroidal anti-inflammatory agent. After taking the medication for several

weeks, she develops a skin rash and observes a decrease in urine volume

What is the probable diagnosis?

Acute Interstitial nephritis

Which blood test result below is used to confirm the diagnosis of acute glomerulonephritis?

antistreptococcal antibodies

Urinalysis results on a female patient who brings a urine specimen to the physician’s office for her annual physical are below:

Color: yellow Clarity: Specific gravity: pH:

Protein Glucose: Ketones:

Blood: Bilirubin: Urobilinogen: Nitrite Leukocyte esterase:

Microscopic: Squamous epithelial cells: WBC/hpf Bacteria:

What action should be taken?

Microscopic urinalysis findings with acute interstitial nephritis include all of the following except

bacteria

In diabetic nephropathy, which of the following solid material is deposited around the capillary tufts?

Glycosylated protein

Which of the following can differentiate a Cystitis from pyelonephritis?

the presence of white blood cell casts

Which of the following are oval fat bodies and fatty casts characteristic constituents in urine sediment?

nephrotic syndrome

The buildup of crescentic formations on the glomerular capillaries is characteristic of:

Rapidly Progressive Glomerulonephritis

A patient with SLE has the following urinalysis results:

Color: Clarity: Specific gravity:

pH: Protein: Glucose: Ketones:

Blood: Bilirubin: Urobilinogen: Nitrite: Leukocyte esterase:

Microscopic

RBC/hpf: WBC/hpf: Cast/lpf : hyaline RBC,

These results would be associated with:

Chronic glomerulonephritis

State two reasons for the appearance of overflow metabolites in the urine.

inherited and metabolic

What is the most common cause of acquired porphyria?

lead poisoning

Name two physical characteristics of urine that can alert medical personnel to the possibility of a metabolic disorder.

color and odor

Phenylketonuria is caused by:

Lack of the enzyme phenylalanine hydroxylase

When performing a Guthrie test

• heel stick from baby

• fill in filter paper circles with blood

• make lawn of B. subtilis on media with beta-2-thienylalanine

• place disks on culture media

• if phenylalanine is present b.subtilis will grow

Which of the following below are epithelial casts are most indicative?

tubular necrosis

The following urinalysis results are obtained from a newborn:

Color: Protein: Blood:

Clarity: Glucose: Urobilinogen:

Specific gravity: Ketones: Nitrite:

pH: Bilirubin: Leukocyte esterase: Clinitest:

What additional unusual characteristic might be found in this urine?

odor

The following urinalysis results are obtained from a newborn:

Color: Protein: Blood:

Clarity: Glucose: Urobilinogen:

Specific gravity: Ketones: Nitrite:

pH: Bilirubin: Leukocyte esterase: Clinitest:

What screening test should be performed on this specimen?

DNPH

The following urinalysis results are obtained from a newborn:

Color: Protein: Blood:

Clarity: Glucose: Urobilinogen:

Specific gravity: Ketones: Nitrite:

pH: Bilirubin: Leukocyte esterase: Clinitest:

What is the infant's most probable disorder?

Maple Syrup Disease (MSUD)

Select the appropriate screening test result for the following disorders

PKU

Ferric Chloride - screening

guthrie - specific

Select the appropriate screening test result for the following disorders

TYROSLYURIA

nitroso-naphthol - screening

confirmatory ?

Select the appropriate screening test result for the following disorders

PORPHOBILINOGEN

ehrlich's reaction

Select the appropriate screening test result for the following disorders

HOMOCYSTINURIA

silver nitroprusside - confirms

Select the appropriate screening test result for the following disorders

HURLER'S SYNDROME

CTAB Test

Select the appropriate screening test result for the following disorders

ALKAPTONURIA

clinitest - screening

homogentistic acid test - confirmatory

A false-positive reaction for urinary ketones could be present in:

cystinuria

Match the characteristic odor for the following disorders

PHENYKETONURIA

mousy

Match the characteristic odor for the following disorders

TYROSINEMIA

rancid

Match the characteristic odor for the following disorders

CYSTINOSIS

sulfur

Match the characteristic odor for the following disorders

ISOVALERIC ACADEMIA

sweaty feet

Match the characteristic odor for the following disorders

MAPLE SYRUP URINE DISEASE

sweet

A routine urinalysis is performed on a specimen that has turned xxx after standing in the laboratory. The urine is acidic and has negative chemical tests except for the appearance of a xxxx color on the ketone area of the reagent strip. One should suspect:

melanuria

Inhibition of bacterial growth in the Guthrie test should be interpreted as:

The patient lacks phenylalanine hydroxylase

Abnormal amounts of indigo blue in the urine are indicative of a defect in the metabolism of:

tryptophan

Which statement regarding CSF is true?

Normal values for mononuclear cells are higher for infants than adults

Which of the following findings is consistent with a subarachnoid hemorrhage rather than a traumatic tap?

Xanthochromia

Which of the following can be used to identify a fluid as CSF?

Transferrin T protein

Which of the adult CSF values in the following table are consistent with bacterial meningitis?

WBC: 2,000/uL

Lymph: 5%

Mono 15%

Eos 0%

Neutrophil 80%

Neuroectodermal Cells 0%

Oligoclonal bands are significant in the diagnosis of multiple sclerosis when:

They are seen in CSF and not serum

SITUATION: What is the most likely cause of the following CSF results?

CSF Glucose: XX mg/dL

CSF protein: XX mg/dL

CSF lactate: XX mg/dL

Acute bacterial meningitis

Which of the following conditions is most often associated with normal CSF glucose and protein?

Viral meningitis

Three tubes of CSF are submitted to the laboratory. They are numbered 1, 2, and 3 and all show XXX in all tubes but decreasing in amount in tubes 1 through 3. This observation should be interpreted as:

A traumatic tap

An IgG index greater than 0.08 is indicative of which of the following?

Synthesis of IgG within the CNS

Which of the following can decrease CSF protein?

fluid leakage

When collecting CSF, a difference between opening and closing fluid pressure greater than 100 mm H2O indicates

low CSF fluid

Which of the following CSF test results is most commonly increased in patient with MS?

IgG index

In what suspected condition should a wet prep using a warm slide be examined?

Amoebic meningoencephalitis

the diagnosis of MS is suggested by which findings?

The presence of oligoclonal bands by electrophoresis

Following a head injury, which protein will identify the presence of CSF leakage through the nose?

tau protein

Which of the adult CSF values in the following table are consistent with bacterial meningitis?

Glucose 20 mg/dL

Protein 50 mg/dL

Lactate increased

Given the following information, calculate the CSF WBC count: cells counted, XX; dilution, XX dilution; large Neubauer squares counted, XX

cells counted x df / squares x 0.1

In plasma, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is

prealbumin

The finding of oligoclonal bands in the CSF and not in the serum is seen with:

Multiple scelerosis

A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of:

80 mg/dL

Given the following results, calculate the IgG index

CSF IgG Index = IgG csf / IgG serum x serum alb / csf alb

What is the CSF IgG index indicative of?

values greater than 0.70 indicate synthesis of CNS in spinal column

values less than indicate a compromised BBB

CSF can be differentiated from plasma by the presence of

tau transferrin

A 55-year-old man is brought to the emergency room in a comatose state. He was found at home by his son and appears to have fallen from a ladder. A spinal tap is performed and reveals the following:

Which of the following would be the most specific finding in this patient for a true CNS hemorrhage versus traumatic spinal tap?

consistent amount of blood in all three tubes and xanthochromic (colored) supernatant after centrifugation

macrophages with phagocytized RBCS inside

what is the significance of the WBC count count of XX X 10^9/L?

It is diagnostic for fungal meningitis

A CSF that appears orange should be described as:

xanthochromic