Chapter 9 | Cerebrospinal Fluid Flashcards
(380 cards)
1
Q
The functions of the CSF include all of the following except:
A
Producing an ultrafiltrate of plasma
2
Q
The CSF flows through the:
A
Arachnoid space
3
Q
Substances present in the CSF are controlled by the:
A
Blood–brain barrier
4
Q
What department is the CSF tube labeled 3 routinely sent to?
A
Hematology
5
Q
The CSF tube that should be kept at room temperature is:
A
Tube 2
6
Q
Even distribution of blood in all tubes
A
Intracranial hemorrhage
7
Q
Xanthochromic supernatant
A
Intracranial hemorrhage
8
Q
Concentration of blood in tube 1 is greater than in tube 3
A
Traumatic tap
9
Q
Specimen contains clots
A
Traumatic tap
10
Q
The presence of xanthochromia can be caused by all of the following except:
A
A recent hemorrhage
11
Q
A web-like pellicle in a refrigerated CSF specimen indicates:
A
Tubercular meningitis
12
Q
Given the following information, calculate the CSF WBC count: cells counted, 80; dilution, 1:10; large Neubauer squares counted, 10.
A
800
13
Q
A CSF WBC count is diluted with:
A
Acetic acid
14
Q
A total CSF cell count on a clear fluid should be:
A
Counted undiluted
15
Q
The purpose of adding albumin to CSF before cytocentrifugation is to:
A
D. Both A and B
Increase the cell yield
Decrease the cellular distortion
16
Q
The primary concern when pleocytosis of neutrophils and lymphocytes is found in the CSF is:
A
Meningitis
17
Q
Neutrophils with pyknotic nuclei may be mistaken for:
A
Nucleated RBCs
18
Q
The presence of which of the following cells is increased in a parasitic infection?
A
Eosinophils
19
Q
Macrophages appear in the CSF after:
A
D. All of the above
Hemorrhage
Repeated spinal taps
Diagnostic procedures
20
Q
Nucleated RBCs are seen in the CSF as a result of:
A
Bone marrow contamination
21
Q
After a CNS diagnostic procedure, which of the following might be seen in the CSF?
A
D. All of the above
Choroidal cells
Ependymal cells
Spindle-shaped cells
22
Q
Hemosiderin granules and hematoidin crystals are seen in:
A
Macrophages
23
Q
Myeloblasts are seen in the CSF:
A
As a complication of acute leukemia
24
Q
Cells resembling large and small lymphocytes with cleaved nuclei represent:
A
Lymphoma cells
25
The reference range for CSF protein is:
15 to 45 g/dL
26
CSF can be differentiated from serum by the presence of:
Globulin
27
In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is:
Prealbumin
28
Elevated CSF protein values can be caused by all of the following except:
Fluid leakage
29
The integrity of the blood–brain barrier is measured using the:
CSF/serum albumin index
30
Given the following results, calculate the IgG index: CSF IgG, 50 mg/dL; serum IgG, 2 g/dL; CSF albumin, 70 mg/dL; serum albumin, 5 g/dL.
1.8
31
The CSF IgG index calculated in Study Question 27 indicates:
Synthesis of IgG in the CNS
32
The finding of oligoclonal bands in the CSF and not in the serum is seen with:
Multiple sclerosis
33
A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL suggests:
Bacterial meningitis
34
A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of:
60 mg/dL
35
CSF lactate will be more consistently decreased in:
Bacterial meningitis
36
Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome?
Ammonia
37
Before performing a Gram stain on CSF, the specimen must be:
Centrifuged
38
All of the following statements are true about cryptococcal meningitis except:
The WBC count is over 2000
39
The test of choice to detect neurosyphilis is the:
FTA-ABS
40
Maturation of spermatozoa takes place in the:
Epididymis
41
Enzymes for the coagulation and liquefaction of semen are produced by the:
Prostate gland
42
The major component of seminal fluid is:
Fructose
43
If the first portion of a semen specimen is not collected, the semen analysis will have which of the following?
Decreased sperm count
44
Failure of laboratory personnel to document the time a semen sample is collected primarily affects the interpretation of semen:
Viscosity
45
Liquefaction of a semen specimen should take place within:
1 hour
46
A semen specimen delivered to the laboratory in a condom has a normal sperm count and markedly decreased sperm motility. This indicates:
Antispermicide in the condom
47
An increased semen pH may be caused by:
D. All of the above
Prostatic infection
Decreased prostatic secretions
Decreased bulbourethral gland secretions
48
Proteolytic enzymes may be added to semen specimens to:
Decrease the viscosity
49
The normal sperm concentration is:
More than 20 million/mL
50
Given the following information, calculate the sperm concentration: dilution, 1:20; sperm counted in five RBC squares on each side of the hemocytometer, 80 and 86; volume, 3 mL.
83 million/mL
51
Using the above information, calculate the sperm concentration when 80 sperm are counted in 1 WBC square and 86 sperm are counted in another WBC square.
16.6 million/mL
52
The primary reason to dilute a semen specimen before performing a sperm concentration is to:
Immobilize the sperm
53
When performing a sperm concentration, 60 sperm are counted in the RBC squares on one side of the hemocytometer and 90 sperm are counted in the RBC squares on the other side. The specimen is diluted 1:20. The:
Specimen should be rediluted and counted
54
Sperm motility evaluations are performed:
Within 1 hour of collection
55
The percentage of sperm showing average motility that is considered normal is:
50%
56
The purpose of the acrosomal cap is to:
Penetrate the ovum
57
The sperm part containing a mitochondrial sheath is the:
Midpiece
58
All of the following are associated with sperm motility except the:
Head
59
The morphologic shape of a normal sperm head is:
Oval
60
Normal sperm morphology when using the WHO criteria is:
>30% normal forms
61
Additional parameters measured by Kruger’s strict morphology include all of the following except:
Vitality
62
Round cells that are of concern and may be included in sperm counts and morphology analysis are:
D. Both A and B
Leukocytes
Spermatids
63
If 5 round cells per 100 sperm are counted in a sperm morphology smear and the sperm concentration is 30 million, the concentration of round cells is:
1.5 million
64
Following an abnormal sperm motility test with a normal sperm count, what additional test might be ordered?
Eosin-nigrosin stain
65
Follow-up testing for a low sperm concentration would include testing for:
Seminal fluid fructose
66
The immunobead test for antisperm antibodies:
D. All of the above
Detects the presence of male antibodies
Determines the presence of IgG, IgM, and IgA antibodies
Determines the location of antisperm antibodies
67
Measurement of -glucosidase is performed to detect a disorder of the:
Epididymis
68
A specimen delivered to the laboratory with a request for prostatic acid phosphatase and glycoprotein p30 was collected to determine:
A possible rape
69
Following a negative postvasectomy wet preparation, the specimen should be:
Centrifuged and reexamined
70
Standardization of procedures and reference values for semen analysis is primarily provided by the:
WHO
71
The functions of synovial fluid include all of the following except:
Removal of cartilage debris
72
The primary function of synoviocytes is to:
Provide nutrients for the joints
73
Which of the following is not a frequently performed test on synovial fluid?
Uric acid
74
The procedure for collecting synovial fluid is called:
Arthrocentesis
75
Match the following disorders with their appropriate group:
____ Gout
____ Neisseria gonorrhoeaeinfection
____ Systemic lupus erythematosus
____ Osteoarthritis
____ Hemophilia
____ Rheumatoid arthritis
____ Heparin overdose
Noninflammatory
____ Osteoarthritis
Inflammatory
____ Gout
____ Systemic lupus erythematosus
____ Rheumatoid arthritis
Septic
____ Neisseria gonorrhoeaeinfection
Hemorrhagic
____ Hemophilia
____ Heparin overdose
76
Normal synovial fluid resembles:
Egg white
77
Before testing, very viscous synovial fluid should be treated with:
Hyaluronidase
78
Addition of a cloudy, yellow synovial fluid to acetic acid produces a/an:
Easily dispersed clot
79
Which of the following could be the most significantly affected if a synovial fluid is refrigerated before testing?
Crystal examination
80
The highest WBC count can be expected to be seen with:
Septic arthritis
81
When diluting a synovial fluid WBC count, all of the following are acceptable except:
Acetic acid
82
The lowest percentage of neutrophils would be seen in:
Noninflammatory arthritis
83
All of the following are abnormal when seen in synovial fluid except:
Synovial lining cells
84
Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are:
Monosodium urate
85
Synovial fluid crystals associated with inflammation in dialysis patients are:
Calcium oxalate
86
Crystals associated with pseudogout are:
Calcium pyrophosphate dihydrate
87
Synovial fluid for crystal examination should be examined as a/an:
Wet preparation
88
Crystals that have the ability to polarize light are:
D. All of the above
Corticosteroid
Monosodium urate
Calcium oxalate
89
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?
Yellow
90
If crystals shaped like needles are aligned perpendicular to the slow vibration of compensated polarized light, what color are they?
Negative
91
Negative birefringence occurs under red-compensated polarized light when:
Fast light runs against the molecular grain of the crystal
92
Synovial fluid cultures are often plated on chocolate agar to detect the presence of:
Neisseria gonorrhoeae
93
The most frequently performed chemical test on synovial fluid is:
Calcium
94
Which of the following chemistry tests can be performed on synovial fluid to determine the severity of RA?
Lactate
95
Serologic tests on patients’ serum may be performed to detect antibodies causing arthritis for all of the following disorders except:
Pseudogout
96
The primary purpose of serous fluid is to:
Lubricate serous membranes
97
The membrane that lines the wall of a cavity is the:
Parietal
98
During normal production of serous fluid, the slight excess of fluid is:
Absorbed by the lymphatic system
99
Production of serous fluid is controlled by:
D. All of the above
Capillary oncotic pressure
Capillary hydrostatic pressure
Capillary permeability
100
An increase in the amount of serous fluid is called a/an:
Effusion
101
Pleural fluid is collected by:
Thoracentesis
102
A. Transudate
B. Exudate
____ Caused by increased hydrostatic pressure
____ Caused by increased capillary permeability
____ Caused by decreased oncotic pressure
____ Caused by congestive heart failure
____ Malignancy related
____ Tuberculosis related
____ Endocarditis related
____ Clear appearance
A. Transudate
____ Caused by increased hydrostatic pressure
____ Malignancy related
____ Tuberculosis related
B. Exudate
____ Caused by increased capillary permeability
____ Caused by decreased oncotic pressure
____ Caused by congestive heart failure
____ Endocarditis related
____ Clear appearance
103
Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids:
To classify transudates and exudates
104
Which of the following requires the most additional testing?
Exudate
105
An additional test performed on pleural fluid to classify the fluid as a transudate or exudate is the:
Fluid:cholesterol ratio
106
A milky-appearing pleural fluid indicates:
D. Both A and B
Thoracic duct leakage
Chronic inflammation
107
Which of the following best represents a hemothorax?
Blood HCT: 30 Fluid HCT: 20
108
All of the following are normal cells seen in pleural fluid except:
Mesothelioma cells
109
A differential observation of pleural fluid associated with tuberculosis is:
Decreased mesothelial cells
110
All of the following are characteristics of malignant cells except:
Absence of nucleoli
111
A pleural fluid pH of 6.0 indicates:
Esophageal rupture
112
Plasma cells seen in pleural fluid indicate:
Tuberculosis infection
113
A significant cell found in pericardial or pleural fluid that should be referred to cytology is a:
Mesothelioma cell
114
Another name for a peritoneal effusion is:
Ascites
115
A test performed primarily on peritoneal lavage fluid is a/an:
RBC count
116
The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the:
Serum ascites albumin gradient
117
Given the following results, classify this peritoneal fluid: serum albumin, 2.2 g/dL; serum protein, 6.0 g/dL; fluid albumin, 1.6 g/dL.
Exudate
118
Differentiation between bacterial peritonitis and cirrhosis is done by performing a/an:
Absolute neutrophil count
119
Detection of the CA 125 tumor marker in peritoneal fluid indicates:
Ovarian cancer
120
Chemical tests primarily performed on peritoneal fluid include all of the following except:
Amylase
121
Cultures of peritoneal fluid are incubated:
D. Both A and B
Aerobically
Anaerobically
122
Which of the following is not a function of amniotic fluid?
Allows carbon dioxide and oxygen exchange
123
What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses?
Fetal urine
124
Which of the following is not a reason for decreased amounts of amniotic fluid?
Fetal failure to begin swallowing
125
Why might a creatinine level be requested on an amniotic fluid?
Differentiate amniotic fluid from maternal urine
126
Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of:
Bilirubin
127
How are specimens for FLM testing delivered to and stored in the laboratory?
Delivered on ice and refrigerated
128
Why are amniotic specimens for cytogenetic analysis incubated at 37°C prior to analysis?
To prolong fetal cell viability and integrity
129
Fetal death
Red-brown
130
Normal
Colorless
131
Presence of bilirubin
Yellow
132
Presence of meconium
Dark green
133
A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte?
Bilirubin
134
Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus?
Moderately affected fetus that requires close monitoring
135
The presence of a fetal neural tube disorder may be detected by:
Increased maternal serum alpha-fetoprotein
136
True or False: An AFP MoM value greater than two times the median value is considered an indication of a neural tube disorder.
T
137
When severe HDN is present, which of the following tests on the amniotic fluid would the physician not order to determine whether the fetal lungs are mature enough to withstand a premature delivery?
AFP levels
138
When performing an L/S ratio by thin-layer chromatography, a mature fetal lung will show:
Lecithin twice as concentrated as sphingomyelin
139
True or False: Phosphatidyl glycerol is present with an L/S ratio of 1.1.
T
140
A rapid immunologic test for FLM that does not require performance of thin-layer chromatography is:
Aminostat-FLM
141
Does the failure to produce bubbles in the Foam Stability Index indicate increased or decreased lecithin?
Decreased
142
The presence of phosphatidyl glycerol in amniotic fluid fetal lung maturity tests must be confirmed when:
The mother has maternal diabetes
143
A lamellar body count of 50,000 correlates with:
OD at 650 nm of 0.150 and an L/S ratio of 2.0
144
In what part of the digestive tract do pancreatic enzymes and bile salts contribute to digestion?
.Small intestine
145
Where does the reabsorption of water take place in the primary digestive process?
Large intestine
146
Which of the following tests is notperformed to detect osmotic diarrhea?
Fecal neutrophils
147
The normal composition of feces includes all of the following except:
Blood
148
What is the fecal test that requires a 3-day specimen? A.Fecal occult blood
Quantitative fecal fat testing
149
The normal brown color of the feces is produced by:
Urobilin
150
Diarrhea can result from all of the following except:
Increased reabsorption of intestinal water and electrolytes
151
Stools from persons with steatorrhea will contain excess amounts of:
Fat
152
Which of the following pairings of stool appearance and cause does notmatch?
Yellow-green: barium sulfate
153
Stool specimens that appear ribbon-like are indicative of which condition?
Intestinal constriction
154
A black tarry stool is indicative of:
Upper GI bleeding
155
Chemical screening tests performed on feces include all of the following except:
Pilocarpine iontophoresis
156
Secretory diarrhea is caused by:
Vibrio cholerae
157
The fecal osmotic gap is elevated in which disorder?
Osmotic diarrhea
158
Microscopic examination of stools provides preliminary information as to the cause of diarrhea because:
Neutrophils are present in conditions that affect the intestinal wall
159
True or False: The presence of fecal neutrophils would be expected with diarrhea caused by a rotavirus.
F
160
Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent:
Neutral fats
161
Microscopic examination of stools mixed with Sudan III and glacial acetic acid and then heated will show small orange-red droplets that represent:
Fatty acids, soaps, and neutral fats
162
When performing a microscopic stool examination for muscle fibers, the structures that should be counted:
Have two-dimensional striations
163
A value of 85% fat retention would indicate:
Steatorrhea
164
Which of the following tests would not be indicative of steatorrhea?
Fecal occult blood
165
The term “occult” blood describes blood that:
Is not visibly apparent in the stool specimen
166
What is the recommended number of samples that should be tested to confirm a negative occult blood result?
Two samples taken from different parts of three stools
167
The immunochemical tests for occult blood:
Test for human globulin
168
Guaiac tests for detecting occult blood rely on the:
Pseudoperoxidase activity of hemoglobin
169
What is the significance of an APT test that remains pink after addition of sodium hydroxide?
Fetal hemoglobin is present.
170
In the Van de Kamer method for quantitative fecal fat determinations, fecal lipids are:
Converted to fatty acids prior to titrating with sodium hydroxide
171
A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to digest gelatin may have:
Cystic fibrosis
172
A stool specimen collected from an infant with diarrhea has a pH of 5.0. This result correlates with a:
Positive Clinitest
173
Which of the following tests differentiates a malabsorption cause from a maldigestion cause in steatorrhea?
D-xylose test
174
All states require newborn screening for PKU for early:
Modifications of diet
175
All of the following disorders can be detected by newborn screening except:
Melanuria
176
The best specimen for early newborn screening is a:
Blood specimen
177
Abnormal urine screening tests categorized as an overflow disorder include all of the following except:
Melanuria
178
Which of the following disorders is not associated with the phenylalanine-tyrosine pathway?
MSUD
179
The least serious form of tyrosylemia is:
Immature liver function
180
An overflow disorder of the phenylalanine-tyrosine pathway that would produce a positive reaction with the reagent strip test for ketones is:
MSUD
181
An overflow disorder that could produce a false-positive reaction with Clinitest procedure is:
Alkaptonuria
182
A urine that turns black after sitting by the sink for several hours could be indicative of:
A. Alkaptonuria
C. Melanuria
183
Ketonuria in a newborn is an indication of:
A. MSUD B. Isovaleric acidemia C. Methylmalonic acidemia
184
Urine from a newborn with MSUD will have a significant:
Sweet odor
185
Hartnup disease is a disorder associated with the metabolism of:
Tryptophan
186
. 5-HIAA is a degradation product of:
Serotonin
187
Elevated urinary levels of 5-HIAA are associated with:
Carcinoid tumors
188
False-positive levels of 5-HIAA can be caused by a diet high in:
Bananas
189
IEM
Cystinosis
190
Inherited disorder of tubular reabsorption
Cystinuria
191
Fanconi syndrome
Cystinosis
192
Cystine deposits in the cornea
Cystinosis
193
Early renal calculi formation
Cystinuria
194
Blue diaper syndrome is associated with:
Hartnup disease
195
Homocystinuria is caused by failure to metabolize:
Methionine
196
The Ehrlich reaction will only detect the presence of:
Porphobilinogen
197
Acetyl acetone is added to the urine before performing the Ehrlich test when checking for:
Porphobilinogen
198
The classic urine color associated with porphyria is:
Port wine
199
Which of the following specimens can be used for porphyrin testing?
A. Urine B. Blood C. Feces
200
The two stages of heme formation affected by lead poisoning are:
Aminolevulinic acid and protoporphyrin
201
Hurler, Hunter, and Sanfilippo syndromes are hereditary disorders affecting metabolism of:
Mucopolysaccharides
202
Many uric acid crystals in a pediatric urine specimen may indicate:
Lesch-Nyhan disease
203
Deficiency of the GALT enzyme will produce a:
A. Positive Clinitest
C. Galactosemia
204
PKU
Mousy odor
205
Indicanuria
Blue color
206
Cystinuria
Sulfur odor
207
Alkaptonuria
Black color
208
Lesch-Nyhan disease
Orange sand in diaper
209
Isovaleric acidemia
Sweaty feet odor
210
Most glomerular disorders are caused by:
Immunologic disorders
211
Dysmorphic RBC casts would be a significant finding with all of the following except:
Chronic pyelonephritis
212
Occasional episodes of macroscopic hematuria over periods of 20 or more years are seen with:
IgA nephropathy
213
Antiglomerular basement membrane antibody is seen with:
Goodpasture syndrome
214
Antineutrophilic cytoplasmic antibody is diagnostic for:
Wegener granulomatosis
215
Respiratory and renal symptoms are associated with all of the following except:
Goodpasture syndrome
216
The presence of fatty casts is associated with all of the following except:
Nephrogenic diabetes insipidus
217
The highest levels of proteinuria are seen with:
Nephrotic syndrome
218
Ischemia frequently produces
Acute renal tubular necrosis
219
A disorder associated with polyuria and low specific gravity is:
Nephrogenic diabetes insipidus
220
An inherited disorder producing a generalized defect in tubular reabsorption is:
Fanconi syndrome
221
A teenage boy who develops gout in his big toe and has a high serum uric acid should be monitored for:
Uromodulin-associated kidney disease
222
The only protein produced by the kidney is:
Uromodulin
223
The presence of renal tubular epithelial cells and casts is an indication of:
Acute tubular necrosis
224
Differentiation between cystitis and pyelonephritis is aided by the presence of:
WBC casts
225
The presence of WBCs and WBC casts with no bacteria is indicative of:
Acute interstitial nephritis
226
End-stage renal disease is characterized by all of the following except:
Hypersthenuria
227
Prerenal acute renal failure could be caused by:
Massive hemorrhage
228
The most common composition of renal calculi is:
Calcium oxalate
229
Urinalysis on a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed:
Microscopic hematuria
230
Macroscopic screening of urine specimens is used to:
Provide results as soon as possible
231
Variations in the microscopic analysis of urine include all of the following except:
Identification of formed elements
232
All of the following can cause false-negative microscopic results except:
Dilute alkaline urine
233
The two factors that determine relative centrifugal force are:
Diameter of rotor head and rpm
234
When using the glass slide and cover-slip method, which of the following might be missed if the cover slip is overflowed?
Casts
235
Initial screening of the urine sediment is performed using an objective power of:
10×
236
Which of the following should be used to reduce light intensity in bright-field microscopy?
Rheostat
237
Which of the following are reported as number per lpf?
Casts
238
The Sternheimer-Malbin stain is added to urine sediments to do all of the following except:
Decrease precipitation of crystals
239
Nuclear detail can be enhanced by:
B. Toluidine blue C. Acetic acid
240
Which of the following lipids is/are stained by Sudan III?
B. Neutral fats C. Triglycerides
241
Which of the following lipids is/are capable of polarizing light?
Cholesterol
242
The purpose of the Hansel stain is to identify:
Eosinophils
243
Crenated RBCs are seen in urine that is:
Hypersthenuric
244
Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except:
Lysis of yeast cells by acetic acid
245
A finding of dysmorphic RBCs is indicative of:
Glomerular bleeding
246
Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit brownian movement are:
Glitter cells
247
Mononuclear leukocytes are sometimes mistaken for:
Renal tubular cells
248
When pyuria is detected in a urine sediment, the slide should be carefully checked for the presence of:
Bacteria
249
Transitional epithelial cells are sloughed from the:
Bladder
250
The largest cells in the urine sediment are:
Squamous epithelial cells
251
A clinically significant squamous epithelial cell is the:
Clue cell
252
Forms of transitional epithelial cells include all of the following except:
Convoluted
253
Increased transitional cells are indicative of:
A. Catheterization B. Malignancy
254
A primary characteristic used to identify renal tubular epithelial cells is:
Eccentrically located nucleus
255
Following an episode of hemoglobinuria, RTE cells may contain:
Hemosiderin granules
256
The predecessor of the oval fat body is the:
Renal tubular cell
257
A structure believed to be an oval fat body produced a Maltese cross formation under polarized light but does not stain with Sudan III. The structure:
Contains cholesterol
258
The finding of yeast cells in the urine is commonly associated with:
Diabetes mellitus
259
The primary component of urinary mucus is:
Uromodulin
260
The majority of casts are formed in the:
Distal convoluted tubules
261
Cylindruria refers to the presence of:
All types of casts
262
A person submitting a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment except:
WBC casts
263
Prior to identifying an RBC cast, all of the following should be observed except:
Intact RBCs in the cast
264
WBC casts are primarily associated with:
Pyelonephritis
265
The shape of the RTE cell associated with renal tubular epithelial casts is primarily:
Round
266
When observing RTE casts, the cells are primarily:
Embedded in a clear matrix
267
The presence of fatty casts is associated with:
A. Nephrotic syndrome B. Crush injuries C. Diabetes mellitus
268
Nonpathogenic granular casts contain:
Cellular lysosomes
269
All of the following are true about waxy casts except they:
Require staining to be visualized
270
Observation of broad casts represents:
A. Destruction of tubular walls
C. Formation in the collecting ducts
271
All of the following contribute to urinary crystals formation except:
Protein concentration
272
The most valuable initial aid for identifying crystals in a urine specimen is:
pH
273
Crystals associated with severe liver disease include all of the following except:
Cystine
274
All of the following crystals routinely polarize except:
Cystine
275
Casts and fibers can usually be differentiated using:
Polarized light
276
Envelopes
Calcium oxalate dihydrate
277
Yellow-brown, whetstone
Uric acid
278
Pink sediment
Amorphous urates
279
Ovoid
Calcium oxalate monohydrate
280
Thin prisms
Calcium phosphate
281
“Coffin lids”
Triple phosphate
282
Dumbbell shape
Calcium carbonate
283
White precipitate
Amorphous phosphate
284
Thorny apple
Ammonium biurate
285
Bundles following refrigeration
Ampicillin
286
Bright yellow clumps
Bilirubin
287
Hexagonal plates
Cystine
288
Flat plates, high specific gravity
Radiographic dye
289
Concentric circles, radial striations
Leucine
290
Notched corners
Cholesterol
291
Fine needles seen in liver disease
Tyrosine
292
Indirect light is reflected off the object
Dark-field
293
Objects split light into two beams
Polarized
294
Low refractive index objects may be overlooked
Bright-field
295
Three-dimensional images
Interference contrast
296
Forms halo of light around object
Phase
297
The concentration of a normal urine specimen can be estimated by which of the following?
Color
298
The normal yellow color of urine is produced by:
Urochrome
299
The presence of bilirubin in a urine specimen produces a:
Yellow foam when shaken
300
A urine specimen containing melanin will appear:
Black
301
Specimens that contain hemoglobin can be visually distinguished from those that contain RBCs because:
Hemoglobin produces a clear, yellow specimen
302
A patient with a viscous orange specimen may have been:
Treated for a urinary tract infection
303
The presence of a pink precipitate in a refrigerated specimen is caused by:
Uroerythrin
304
Microscopic examination of a clear urine that produces a white precipitate after refrigeration will show:
Amorphous phosphates
305
The color of urine containing porphyrins will be:
Port wine
306
Which of the following specific gravities would be most likely to correlate with a pale yellow urine?
1.005
307
A urine specific gravity measured by refractometer is 1.029, and the temperature of the urine is 14°C. The specific gravity should be reported as:
1.029
308
The principle of refractive index is to compare:
Light velocity in air with light velocity in solutions
309
A correlation exists between a specific gravity by refractometer of 1.050 and a:
Radiographic dye infusion
310
A cloudy urine specimen turns black upon standing and has a specific gravity of 1.012. The major concern about this specimen would be:
Color
311
A specimen with a specific gravity of 1.035 would be considered:
Hypersthenuric
312
A specimen with a specific gravity of 1.001 would be considered:
Not urine
313
A strong odor of ammonia in a urine specimen could indicate:
An old specimen
314
The microscopic of a clear red urine is reported as many WBCs and epithelial cells. What does this suggest?
Possible mix-up of specimen and sediment
315
Which of the following would contribute the most to a urine osmolality?
One osmole of sodium chloride
316
Which of the following colligative properties is not stated correctly?
The freezing point is raised by solute
317
An osmole contains:
One gram molecular weight of solute dissolved in one kilogram of solvent
318
The unit of osmolality measured in the clinical laboratory is the:
Osmole
319
In the reagent strip specific gravity reaction the polyelectrolyte:
Releases hydrogen ions in response to ion concentration
320
Which of the following will react in the reagent strip specific gravity test?
Chloride
321
Leaving excess urine on the reagent strip after removing it from the specimen will:
Cause run-over between reagent pads
322
Failure to mix a specimen before inserting the reagent strip will primarily affect the:
B.Blood reading C.Leukocyte reading
323
Testing a refrigerated specimen that has not warmed to room temperature will adversely affect:
Enzymatic reactions
324
The reagent strip reaction that requires the longest reaction time is the:
Leukocyte esterase
325
Quality control of reagent strips is performed:
A. Using positive and negative controls B. When results are questionable C. At least once every 24 hours
326
All of the following are important to protect the integrity of reagent strips except:
Removing the desiccant from the bottle
327
The principle of the reagent strip test for pH is the:
Double indicator reaction
328
A urine specimen with a pH of 9.0:
Should be recollected
329
In the laboratory, a primary consideration associated with pH is:
A. Identifying urinary crystals
C. Determining specimen acceptability
330
Microalbuminuria
renal
331
Acute phase reactants
prerenal
332
Pre-eclampsia
renal
333
Vaginal inflammation
postrenal
334
Multiple myeloma
prerenal
335
Orthostatic proteinuria
renal
336
Prostatitis
postrenal
337
The principle of the protein error of indicators reaction is that:
Albumin accepts hydrogen ions from the indicator
338
All of the following will cause false-positive protein reagent strip values except:
Microalbuminuria
339
A patient with a 2+ protein reading in the afternoon is asked to submit a first morning specimen. The second specimen has a negative protein reading. This patient is:
Positive for orthostatic proteinuria
340
Testing for microalbuminuria is valuable for early detection of kidney disease and monitoring patients with:
A. Hypertension B. Diabetes mellitus C. Cardiovascular disease risk
341
The primary chemical on the reagent strip in the MicralTest for microalbumin binds to:
Antihuman albumin antibody
342
All of the following are true for the ImmunoDip test for microalbumin except:
Unbound antibody migrates farther than bound antibody
343
The principle of the protein-high pad on the Multistix Pro reagent strip is the:
Protein error of indicators
344
Which of the following is not tested on the Multistix Pro reagent strip?
Urobilinogen
345
The principle of the protein-low reagent pad on the Multistix Pro is the:
Binding of albumin to sulphonphthalein dye
346
The principle of the creatinine reagent pad on microalbumin reagent strips is the:
Diazo reaction
347
The purpose of performing an albumin:creatinine ratio is to:
Estimate the glomerular filtration rate
348
A patient with a normal blood glucose and a positive urine glucose should be further checked for:
Renal disease
349
The principle of the reagent strip tests for glucose is the:
Double sequential enzyme reaction
350
All of the following may produce false-negative glucose reactions except:
Detergent contamination
351
The primary reason for performing a Clinitest is to:
Check for newborn galactosuria
352
The three intermediate products of fat metabolism include all of the following except:
Ketoacetic acid
353
The most significant reagent strip test that is associated with a positive ketone result is:
Glucose
354
The primary reagent in the reagent strip test for ketones is:
Sodium nitroprusside
355
Ketonuria may be caused by all of the following except:
Bacterial infections
356
Urinalysis on a patient with severe back and abdominal pain is frequently performed to check for:
Hematuria
357
Associated with transfusion reactions
Hemoglobinuria
358
Clear red urine and pale yellow plasma
Myoglobinuria
359
Clear red urine and red plasma
Hemoglobinuria
360
Associated with rhabdomyolysis
Myoglobinuria
361
Produces hemosiderin granules in urinary sediments
Hemoglobinuria
362
Associated with acute renal failure
Myoglobinuria
363
The principle of the reagent strip test for blood is based on the:
Peroxidase activity of heme
364
A speckled pattern on the blood pad of the reagent strip indicates:
Hematuria
365
List the following products of hemoglobin degradation in the correct order by placing numbers 1 to 4 in the blank.
1. Conjugated bilirubin
2. Unconjugated bilirubin
3. Urobilinogen and stercobilinogen
4. Urobilin
366
The principle of the reagent strip test for bilirubin is the:
Diazo reaction
367
An elevated urine bilirubin with a normal urobilinogen is indicative of:
Biliary obstruction
368
The primary cause of a false-negative bilirubin reaction is:
Specimen exposure to light
369
The purpose of the special mat supplied with the Ictotest tablets is that:
Bilirubin remains on the surface of the mat.
370
The reagent in the Multistix reaction for urobilinogen is:
p-Dimethylaminobenzaldehyde
371
The primary problem with urobilinogen tests using Ehrlich reagent is:
Positive reactions with porphobilinogen
372
The reagent strip test for nitrite uses the:
Ehrlich reaction
373
All of the following can cause a negative nitrite reading except:
Gram-negative bacteria
374
A positive nitrite test and a negative leukocyte esterase test is an indication of a:
Specimen older than 2 hours
375
All of the following can be detected by the leukocyte esterase reaction except:
Lymphocytes
376
Screening tests for urinary infection combine the leukocyte esterase test with the test for:
Nitrite
377
The principle of the leukocyte esterase reagent strip test uses a:
Diazo reaction
378
The principle of the reagent strip test for specific gravity uses the dissociation constant of a(n):
Polyelectrolyte
379
A specific gravity of 1.005 would produce the reagent strip color:
Blue
380
Reagent strip–specific gravity readings are affected by:
Alkaline urine
