Body Fluid Analysis Final Exam Questions

A 25-year-old pregnant woman comes to the outpatient clinic with symptoms of lower back pain, urinary frequency, and a burning

sensation when voiding. Her pregnancy has been normal up to this time. She is given a sterile container and asked to collect a midstream clean-catch urine specimen. Routine urinalysis results are as follows:

COLOR: Pale yellow

CLARITY: Hazy

SP. GRAVITY: 1.005

PH: 8.0

PROTEIN: Trace

GLUCOSE: Negative

KETONES: Negative

BLOOD: Small

BILIRUBIN: Negative

UROBILINOGEN: Normal

NITRITE: Positive

LEUKOCYTE: 2+ Microscopic 6–10 RBCs/hpf

Heavy bacteria 40–50 WBCs/hpf Moderate squamous epithelial cells

What is the significance of the blood and protein tests?

Urinary Tract irritation from infection

Results of a urinalysis performed on a patient scheduled for gallbladder surgery are as follows:

COLOR: Amber

CLARITY: Hazy

SP. GRAVITY: 1.022

PH: 6.0

PROTEIN: Negative

GLUCOSE: Negative

KETONES: Negative

BLOOD: Negative

BILIRUBIN: Moderate

UROBILINOGEN: Normal

NITRITE: Negative

LEUKOCYTES: Negative

What would you see if you were to shake this specimen?

Yellow foam

Results of a urinalysis performed on a patient scheduled for gallbladder surgery are as follows:

COLOR: Amber

CLARITY: Hazy

SP. GRAVITY: 1.022

PH: 6.0

PROTEIN: Negative

GLUCOSE: Negative

KETONES: Negative

BLOOD: Negative

BILIRUBIN: Moderate

UROBILINOGEN: Normal

NITRITE: Negative

LEUKOCYTES: Negative

What confirmatory test can be performed on this specimen?

Ictotest

Results of a urinalysis performed on a patient scheduled for gallbladder surgery are as follows:

COLOR: Amber

CLARITY: Hazy

SP. GRAVITY: 1.022

PH: 6.0

PROTEIN: Negative

GLUCOSE: Negative

KETONES: Negative

BLOOD: Negative

BILIRUBIN: Moderate

UROBILINOGEN: Normal

NITRITE: Negative

LEUKOCYTES: Negative

If blood were drawn from this patient, how might the appearance of the serum be described?

Icteric

Results of a urinalysis performed on a patient scheduled for gallbladder surgery are as follows:

COLOR: Amber

CLARITY: Hazy

SP. GRAVITY: 1.022

PH: 6.0

PROTEIN: Negative

GLUCOSE: Negative

KETONES: Negative

BLOOD: Negative

BILIRUBIN: Moderate

UROBILINOGEN: Normal

NITRITE: Negative

LEUKOCYTES: Negative

What special handling is needed for serum and urine specimens from this patient?

Protection from light

A patient taken to the emergency department following an episode of syncope has a fasting blood glucose level of 450 mg/dL. Results of the routine urinalysis are as follows:

COLOR: Pale yellow

CLARITY: Clear

SP. GRAVITY: 1.020

PH: 5.0

PROTEIN: 1+

GLUCOSE: 250mg/dL

KETONES: Negative

BLOOD: Negative

BILIRUBIN: Negative

UROBILINOGEN: Negative

NITRITE: Negative

LEUKOCYTES: Negative

Explain the correlation between the patient’s blood and urine glucose results.

The renal threshold for glucose is exceeded.

A patient taken to the emergency department following an episode of syncope has a fasting blood glucose level of 450 mg/dL. Results of the routine urinalysis are as follows:

COLOR: Pale yellow

CLARITY: Clear

SP. GRAVITY: 1.020

PH: 5.0

PROTEIN: 1+

GLUCOSE: 250mg/dL

KETONES: Negative

BLOOD: Negative

BILIRUBIN: Negative

UROBILINOGEN: Negative

NITRITE: Negative

LEUKOCYTES: Negative

What is the most probable metabolic disorder associated with this patient?

Diabetes mellitus

A urine sample could have which of the following formed elements and still be considered ‘normal’?

1 to 2 hyaline casts

Which of the following urine specimens is considered normal?

A clear yellow urine specimen that becomes cloudy upon refrigeration

A patient collecting a midstream clean-catch specimen voids immediately into the container.

Which of the microscopic results would be affected?

Squamous epithelial cells

A patient collecting a midstream clean-catch specimen voids immediately into the container.

Which of the following would be most affected?

Clarity

A patient brings a first morning specimen to the laboratory at 7:00 a.m. What could the patient say that would make the specimen satisfactory for testing?

The time of collection was less than 2 hours ago

In which of the following disorders would waxy and broad casts be most likely to be seen?

Chronic Renal Failure

Increased urinary eosinophils are diagnostic for:

Acute interstitial nephritis

Oval fat bodies and fatty casts are characteristic urine sediment constituents in patients with:

Nephrotic syndrome

During a routine visit with the gynecologist, a 60-year-old woman complained of vaginal dryness and soreness. During the examination, the health-care provider noted erythema (redness) of the vaginal mucosa. The pH of the vaginal secretions was 6.0. The KOH and amine (whiff) tests were negative. The microscopic exam revealed epithelial cells, RBCs, WBCs and decreased lactobacilli. What is her probable diagnosis?

Atrophic vaginitis

A sexually active teenager visited the Women's Clinic complaining of vaginal itching and soreness. She indicated that she was experiencing increased vaginal secretions that were frothy and yellow-to-green. Upon examination, the health-care provider noted small amount of bleeding (hemorrhages) on her cervix and performed a pH test on the secretions. The pH was 5.5 and the wet prep demonstrated "swimming" organisms. What is the probable diagnosis?

Trichomoniasis

A 30-year-old woman has symptoms of dysuria, vaginal itching, and a white, curd-like discharge. During her visit to the Women's Clinic, the patient revealed that she had recently completed a regimen of broad-spectrum antibiotics as treatment for a urinary tract infection. Her healthcare provider takes a swab of the vaginal secretions for analysis. What is her probable diagnosis?

Candidiasis

A pale, frothy-looking, foul-smelling stool is indicative of _________________.

Excess fat

A red looking stool is indicative of:

Lower GI bleeding

All of the following are a cause of osmotic diarrhea except:

Enterotoxin producing organism

The alveolar epithelial cells of the fetal lungs produce and secrete phospholipids and proteins in the form of:

Lamellar bodies

Which of the following indicates fetal lung maturity?

D

Which of the following color/condition pairs is incorrectly matched with regard to amniotic fluid?

Yellow/biliverdin

Which of the following can be used to evaluate prostate function and, when present in decreased amounts, is associated with prostate gland disorders?

Zinc

The normal appearance of freshly ejaculated semen is:

opalescent, grayish, viscous

Motility assessment of sperm includes evaluation of:

speed and forward progression

When staining a seminal fluid sample for vitality, the analysis report notes that 75% of the sperm are stained. What does that mean?

The majority of the sperm are dead.

During a seminal fluid analysis, the fluid fails to liquefy one hour after collection. Which function/parameter will be affected?

Sperm motility

What is an example of an inflammatory synovial fluid?

Rhematoid arthritis

Which of the following statements is true about healthy synovial fluid?

It is viscous.

All of these statements are true with regard to synovial fluid except:

its uric acid and total protein concentrations are equivalent to those of blood plasma

Why is polarized microscopy used for synovial samples?

To identify crystals

All of the following statements about monosodium urate (MSU) crystals and calcium pyrophosphate dehydrate (CPPD) crystals are true except:

MSU crystals can polarize light; CPPD crystals cannot.

Fluid from a patient with congestive heart failure is collected by thoracentesis and sent to the laboratory for testing. It appears clear

and pale yellow and has a WBC count of 450/mL, fluid to serum protein ratio of 0.35, and fluid to serum LD ratio of 0.46. What type of fluid was collected?

Transudate

A chylous effusion can be differentiated from a pseudochylous effusion by which of the following results? The chylous effusion will have:

Triglycerides 120 mg/dL; chylomicrons present

A physician receives a laboratory report on a peritoneal fluid specimen from a 72-year-old male. The physician scans the report for the following results:

Based on these results, the physician determines that the effusion was most likely a(n):

Exudate

Normal CSF lactate levels are commonly found in patients with which type of meningitis?

Viral

Which of the following is a TRUE statement about CSF?

A CSF/Albumin index of less than 9 is considered normal.

Which of the following can be present in CSF in small numbers yet still considered to be normal?

Lymphocytes

A patient has a CSF albumin value of 28 mg/dL and a serum value of 6 mg/dL. What is the CSF/Albumin index?

4.7

Upon performing a spinal tap on a 32-year-old male patient, the physician notes an "opening" CSF pressure of 200 mm Hg (elevated). The physician proceeds to remove what amount of CSF?

2mL

The physician performs a spinal tap and hands you the first tube. You note that it is extremely bloody. The second and third tubes are equally bloody. You surmise that the presence of blood is most likely due to:

a subarachnoid hemorrhage

Which of these is not a form of diarrhea that we studied in class?

Fatty

The equation ________ = 2 x (Na fecal + K fecal) helps us calculate this.

fecal osmolality

Pale, greasy, spongy, or pasty and foul-smelling stool probably is associated with the excretion of ______ g fat/ day.

8.0

A stool specimen which scores a 2 on the Bristol Stool Scale is indicative of ____________.

mild constipation

A non-pathogenic reason for a clay colored, chalky, or white stool is ____________.

barium

Fecal fat is stained with all of the following EXCEPT ____________________.

Acridine orange

You are examining a stool specimen when you see the following structure. How do you report the finding?

meat fiber

Fecal analysis is useful in the diagnosis all of the following conditions except ________.

diabetes mellitus

A 65-year-old woman presents to the clinic with a chief complaint of diarrhea for the past month. Previous bacterial, ova, and parasitic testing was negative. Fecal osmolality testing is performed, and the result is 330 mOsm/kg. The fecal sodium is 75
mEq/L, and the fecal potassium is 103 mEq/L. The patient is suffering from ________.

osmotic diarrhea

A 40-year-old woman with heavy menstrual periods is diagnosed with anemia and prescribed 180 mg/dL of iron per day. She is told that she can expect the color of her feces to be _____________.

black

An increased number of meat fibers (creatorrhea) in feces correlates with _______________.

impaired digestion

Semi-automated urine chemistry analyzers require the user to _____________________.

dip the sticks manually

Which one of these is NOT a surfactant that determines fetal lung maturity?

Meconium

How many days must stool be collected to assay Quantitative Fecal Fat?

2-3 days

On the Bristol Stool Scale, a "Type 6" is indicative of ______________.

mild diarrhea

Leukocyte Esterase positivity on a urine test strip directly measures the presence of WBCs. Indirectly, it indicates the presence of ______________________.

bacteria

A specific protein band for CSF is called _________________ and is one of two transferrin bands.

the tau protein

Based on pseudo-peroxidase activity of hemoglobin heme and resulting in color change, the Guaiac-based methodology tests for _________________.

occult blood

Digestion and absorption of nutrients occurs in the ________________.

small intestine

The type of renal disease that results from toxic or infectious substances is called ________________.

tubular

Most fluid counts for WBCs use a low concentration of acetic acid to clear the RBCs. Which fluid should NOT be treated with acetic acid?

synovial fluid

What is the name of this?

hemocytometer