AUBF - SIR NACINO

Amniotic fluid - Gastric Juice - Duodenal Contents Examination

Which of the following is NOT a function of amniotic fluid?

Promotes fetal digestion

Polyhydramnios is primarily caused by:

Decreased fetal swallowing of amniotic fluid

The specimens collection for amniotic fluid is done through:

Amniocentesis - uses sterile syringe

For Fetal lung maturity testing, the amniotic fluid should be:

Placed on ice and frozen (loss of phospholipids) — which is essential for fetal lung maturity 

The Fern Test is used to:

(Fern test is to detect ruptured amniotic membrane)

Detect ruptured membrane (early pregnancy due to increased Estrogen)

Alpha-fetoprotein (AFP) levels are increased in:

Spina Bifida

Decreased  AFP levels suggest:

Down syndrome (low AFP are associated with chromosomal abnormalities)

The confirmatory test for neural tube defects after an elevated AFP is:

Acetylcholinesterase test - a confirmatory marker for neural tube defect (NTD)

A fetal age of 36 weeks can be indicated by amniotic fluid creatinine of:

2.0 mg/dL or hinger 

(creatinine levels above 2.0 are consistent with 36weeks of gestation) 

hCG is primarily produced by which cells?

Cytotrophoblastic cells of placenta

(during 1st trimester)

Parietal cells of stomach produce

(parietal cells is responsible for secreting HCl)

HCl and intrinsic factor

The chief cells in the stomach are responsible for secreting:

Pepsinogen (chief cells produce pepsinogen—precursor of digestive enzyme PEPSIN)

In Pernicious anemia, destruction of parietal cells lead to:

Achlorhydria (absent of chloride—No HCl secretion)

Zollinger-Ellison syndrome is characterized by:

Gastric adenoma producing excess gastrin

(Gastrin secreting pancreatic tumors causing hyper-acidity) 

In the Diagnex tubeless test, a positive result is indicated by:

(add azure blue dye/ free HCl/ presence after caffeine stimulation)

Blue color in urine

CEREBROSPINAL FLUID:

‘Which structure primarily produces cerebrospinal fluid (CSF)

Choroid plexus 

What is the average rate of CSF production in adults?

20 mL/hour (500mL per DAY)

The total volume of CSF in adults is approximately:

90-150mL according to Henry (140-170 according to strasinger)

The main function of blood-brain barrier is to:

Protect the brain from harmful chemicals in blood

During lumbar puncture, the site for adults is between which vertebrae?

L3-L4

Which CSF appearance indicates xanthochromia ?

Pink - orange - or yellow

Which of the following causes a cloudy or turbid CSF appearance?
(cloudiness means infection)

Elevated protein or WBC’s

Which cell type predominates in bacterial meningitis?

Neutrophils - early stage

Normal CSF WBC count in adults should not exceed:

0-5 cells/uL

Which method is routinely used for CSF cell counting?

Neubauer counting chamber

Which protein concentration is CSF considered normal?

15-45 mg/dL

The presence of oligoclonal bands in CSF electrophoresis indicates:

Inflammation within the CNS

Normal CSF glucose is approximately what percent of plasma glucose?

60-70%

Which CSF test is the recommended procedure by the CDC (centers for disease control) to diagnose neurosyphilis?

VDRL

A pellicle formation in CSF most commonly indicates:

Tubercular meningitis - due to high protein & fibrin

SYNOVIAL FLUID

Which of the following statements best describes synovial fluid?

It is a viscous fluid found in movable joints

(Fluid is reducing friction between bones)

The viscosity of synovial fluid is primarily due to:

Hyaluronic acid (synoviocytes)

What is the normal volume of synovial fluid in a joint?

<3.5mL

Which tube is used for synovial fluid microbiology studies? (interference with bacterial growth)

Tube 1 - Sodium heparin

Which of the following anticoagulants must NOT be used for synovial fluid analysis? 

Powdered anticoagulants and lithium heparin (may interfere in “crystal identification”)

What test is used to assess the viscosity of synovial fluid?

Rope or Mucin Clot Test

Which reagent is used in the mucin clot test for synovial fluid?

2-5% Acetic acid (it precipitates mucin & hyaluronate polymerization)

In a normal synovial fluid, which WBC type is most abundant?

Monocytes/ Macrophage 

What is the normal WBC count in synovial fluid?

<200 /uL

Monosodium urate (MSU) crystals in synovial fluid indicate which condition?

Gout - diagnosis/ increased uric acid

Calcium pyrophosphate dihydrate (CPPD) crystals are associated with:

Pseudogout - degenerative arthritis of endocrine disorders 

Which microscopy technique determines crystal birefringence? 

Compensated polarizing microscopy (+/- birefringence)

Transudate are primarily caused by: 

Systemic disorders affecting pressure regulation 

A pleural fluid hematocrit greater than 50% of whole blood hematocrit indicates:

Hemothorax 

Which of the following conditions most commonly produces exudates? (Infection-Malignancy-Inflammation)

Infection or Malignancy

SEROUD FLUID

Which of the following best describes serous fluid? 

Fluid between visceral and parietal membranes

Which of the following are the three major types of serous fluid? 

(3P’s)

Pleural - Pericardial - Peritoneal 

What is the main function of serous fluid? 

To lubricate and reduce friction between membranes

The accumulation of fluid between serous membrane is called:

Effusion 

Which of the following best defines a transudate? 

Effusion due to systemic disorders that alter hydrostatic pressure

Which of the following is a common cause of transudate formation?

Congestive heart failure

Exudates differ from transudates because they:

are caused by direct membrane damage and inflammation

Which of the following is a cause of exudative effusion? 

Infection

Which anticoagulant is used for serous fluid cell counting and differential counts?

EDTA - preserves cell morphology for cell count and differential analysis

For microbiology and cytology test, serous fluid should be collected in: 

Sterile heparinized tubes

In serous fluid analysis, specimens for pH determination must be:

Kept anaerobically in ice

A pleural fluid hematocrit greater than 50% of whole blood hit indicates:

Hemothorax

In hemorrhagic effusion, how is blood distributed in the pleural fluid?

Evenly distributed

Which of the following correctly differentiates hemothorax from hemorrhagic effusion? 

Hemothorax has a pleural fluid Hct >50% of blood Hct

Which group of bacteria are known causative agent of subacute bacterial endocarditis?

HACEK Group (Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella)

SEMINAL FLUID

Which collection of the following is the most convenient method of semen collection?

Masturbation 

How long should sexual abstinence be observed before semen collection?

2-3 days

What happens if the first portion of ejaculate is missed?

Decreased sperm count and falsely increased pH

Normal semen appearance is described as:

Pearly gray-white and translucent

Increased white turbidity in semen indicates:

Presence of infection 

The normal semen volume is:

2-5mL

Which of the following condition decreases sperm motility?

Increased viscosity

The normal pH of semen is:

7.2 - 8.0

Under Kruger’s strict criteria, normal sperm morphology must be:

>14%

In the Modified Bloom’s Test, live sperm appear:

Unstained, bluish-white

Absence of spermatozoa in semen is termed: 

Azoospermia

What reagent gives an orange-red color in the resorcinol test for semen fructose?

Resorcinol reagent

The function of Prostate -Specific Antigen (PSA) is to:

Regulate seminal fluid viscosity

In the Immunobead Test, attachment of beads to sperm head, neck or tail indicates:

Antisperm antibodies

After vasectomy, semen analysis is continued until:

Two consecutive monthly specimens show no sperm