Body Fluids Final (Clsc)

Front 1

Laboratory studies are being performed on a 5-year-old boy to determine whether there is a metabolic reason for his continued failure to gain weight. In addition to having blood drawn, the patient has a sweat chloride collected, provides a random stool sample, and is asked to collect a 72-hour stool sample.
-What kind of testing can be performed on this sample?

Back 1

Microscopic examination (muscle fiber screening)

Front 2

Laboratory studies are being performed on a 5-year-old boy to determine whether there is a metabolic reason for his continued failure to gain weight. In addition to having blood drawn, the patient has a sweat chloride collected, provides a random stool sample, and is asked to collect a 72-hour stool sample.
-What are the confirmatory tests performed?

Back 2

Quantitative fecal fat test

Front 3

Laboratory studies are being performed on a 5-year-old boy to determine whether there is a metabolic reason for his continued failure to gain weight. In addition to having blood drawn, the patient has a sweat chloride collected, provides a random stool sample, and is asked to collect a 72-hour stool sample.
-What are the appearance of stool specimens (example, black, tarry, pale yellow, etc)

Back 3

Bulky and frothy

Front 4

Laboratory studies are being performed on a 5-year-old boy to determine whether there is a metabolic reason for his continued failure to gain weight. In addition to having blood drawn, the patient has a sweat chloride collected, provides a random stool sample, and is asked to collect a 72-hour stool sample.
-If a diagnosis of cystic fibrosis is suspected, state two screening tests that can be performed on a stool specimen to aid in the diagnosis.

Back 4

Muscle fiber screening & the gelatin test for trypsin.

Front 5

How is a muscle fiber test performed

Back 5

Prepared by emulsifying a small amount of stool in 10% alcoholic eosin
Enhances the muscle fiber striations
Slide is examined for exactly 5 minutes
Red stained fibers are counted.

Front 6

Undigested fibers

Back 6

Striations vertically and horizontally

Front 7

Partially digested

Back 7

Striation in one direction

Front 8

Digested

Back 8

No visible striations

Front 9

False Negative for Muscle Fiber

Back 9

Failure to include red meat in diet

Front 10

False Positive for Muscle Fiber

Back 10

Rapid Transit time due to use of laxatives

Front 11

What confirmatory test can be performed on muscle fiber tests?

Back 11

Quantitative fecal fat test.

Front 12

Microscopic screening of a stool from a patient exhibiting prolonged diarrhea shows increased fecal neutrophils and normal qualitative fecal fats and meat fibers.
-What type of diarrhea do these results suggest?

Back 12

Secretory Diarrhea

Front 13

Microscopic screening of a stool from a patient exhibiting prolonged diarrhea shows increased fecal neutrophils and normal qualitative fecal fats and meat fibers.
-Name an additional test that can provide more diagnostic information.

Back 13

Lactoferin latex agglutination test

Front 14

Microscopic screening of a stool from a patient exhibiting prolonged diarrhea shows increased fecal neutrophils and normal qualitative fecal fats and meat fibers.
-If the test result for fecal neutrophils was negative and the fecal fat concentration increased, what type of diarrhea is suggested?

Back 14

Osmotic diarrhea

Front 15

A watery black stool from a neonate is received in the laboratory with requests for an Apt test, fecal pH, and a Clinitest.
-Which of these tests cannot be performed on this specimen?

Back 15

Fecal pH

Front 16

A watery black stool from a neonate is received in the laboratory with requests for an Apt test, fecal pH, and a Clinitest.
-If the Clinitest result is positive, what pH reading can be expected?

Back 16

Acidic

Front 17

A watery black stool from a neonate is received in the laboratory with requests for an Apt test, fecal pH, and a Clinitest.
-The infant’s hemoglobin remains constant at 18 g/dL. What was the significance of the black stool?

Back 17

Lactose intolerance

Front 18

A watery black stool from a neonate is received in the laboratory with requests for an Apt test, fecal pH, and a Clinitest.
-Would this infant be expected to have ketonuria?

Back 18

No
(the clinitest is not an indicative of glucose, it is mainly used to test for inflammatory necrotizing entercolitis for carbohydrates intolerance or lactose intolerance.)

Front 19

Monosodium Urate

Back 19

Gout
Needle shaped
Birefringent - yellow parallel, blue in perpendicular

Front 20

Calcium pyrophosphate

Back 20

Pseudogout (CPPD)
Rod-shaped
Birefringent + yellow perpendicular, blue in parallel

Front 21

Hydroxyapatite crystals

Back 21

Birefringent -
Alizarin Red S detectable

Front 22

Corticosteroid crystals

Back 22

Variable Birefringent
Blunt jagged

Front 23

Assuming that a patient is fasting, which of the following analytes is normally present in the synovial fluid in essentially the same concentration as the blood plasma?

Back 23

Glucose and Uric Acid

Front 24

A synovial fluid specimen has a high cell count and requires dilution to be counted. Which of the following diluents should be used?

Back 24

Normal Saline

Front 25

Which of the following substances will not increase the turbidity of synovial fluid?

Back 25

Hyalutonate

Front 26

Which of the following components is not normally present in synovial fluid?

Back 26

Fibrinogen
(RA, lipid, Rise bodies, Hemosiderin)

Front 27

Which of the following hematology values best frames the upper reference limits for synovial fluid?

Back 27

WBC 200
PMNs 25%
RBC 2000

Front 28

Which of the following organisms account for the majority of septic arthritis cases in young & middle-age adults?

Back 28

Neisseria gonorrhoeae

Front 29

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

Back 29

Hemorrhagic arthritis

Front 30

In which type of arthritis is the synovial WBC count likely to be greater than 50,000/uL?

Back 30

Septic Arthritis

Front 31

A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Addition of acetic acid results in turbidity and a clot. This indicates that;

Back 31

Hyaluronic acid clots in the presence of acetic acid, its synovial fluid which has hyaluronic acid.

Front 32

Transudate

Back 32

Clear, Protein ratio 0.5, LD ratio 0.6, Cholesterol 45 ratio 0.3
Cirrhosis
CHF
Uremia
Autoimmune

Front 33

Exudate

Back 33

Cloudy, Protein ratio 0.55, LD ratio .66, Cheloesterol 60 ratio 0.33
Malignancy
Bacterial
Esophageal rupture

Front 34

Which of the following mechanisms is responsible for the formation of serous fluid in body cavities?

Back 34

a. Ultrafiltration of the circulating blood plasma

Front 35

A pleural or peritoneal fluid amylase level two times higher than the serum amylase level can be found in effusions resulting from?

Back 35

Pancreatitis

Front 36

A glucose concentration difference greater than 30 mg/dL between the serum and an effusion is associated with?

Back 36

Exudate (30 mg or more < Serum level)

Front 37

Condition in which glucose is decreased in effusion

Back 37

Cancer, bacterial infections, rheumatoid pleuritis

Front 38

Chylous (Blockage) and pseudochylous (Chronic dissorder) effusions are differentiated by their?

Back 38

Colesterol (Lower than serum vs higher)
Triglycerides (Higher vs Lower)

Front 39

Pleural transudates differ from pleural exudates in that transudates have:

Back 39

An LD fluid/serum ratio=0.25
(LD fluid/serum less than 0.6, protein less than 3g/dL, a Sg less than 1.015, and cholesterol less than 60mg/dL.)

Front 40

Pleural Fluid from a patient with congestive heart failure would be expected to:

Back 40

Be a transudate effusion
(CHF result in a change in pressure causing an increase in hydrostatic pressure or decrease in oncotic pressure, resulting in a transudate effusion.)

Front 41

A fluid sample was collected by thoracentesis. A serum sample was collected immediately afterward. The LD fluid to serum ratio was 0.9. There were 5,000 WBC/uL, with 75% PMNs (segs). Which of the following describes the fluid?

Back 41

Pleural effusion exudate

Front 42

Which of the following conditions is commonly associated with a chylous effusion?

Back 42

Lymphatic Obstruction

Front 43

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.

Back 43

Exudate
(Serum Albumin- Fluid Albumin = > /= 1.1 means fluid is a transudate and if less than 1.1 means fluid is an exudate.)

Front 44

What tests would you do to determine if the fluid was urine?

Back 44

urea and creatinine content.

Front 45

A urine specimen containing the substance indicated is kept unpreserved at Room temperature for 4 hours. Identify the probable change to that substance increase, decrease, or no change

Back 45

Color - Increased
Clarity - Decreased
Odor - Increased
pH - Increased
Glucose - Decreased
Ketones - Decreased
Bilirubin - Decreased
Urobilinogen - Decreased
Nitrite - Increased
Formed elements - Decreased
Bacteria - Increased
Protein - No change

Front 46

Normal crystals in Acid urine

Back 46

• Uric acid
• Calcium oxalate
• Amorphous urates

Front 47

Abnormal Crystals in Acid Urine

Back 47

• Cysteine
• Leucine
• Tyrosine
• Cholesterol
• Bilirubin
• Sulfonamides
• Ampicillin
• Radiographic dye

Front 48

Normal Crystals in Basic Urine

Back 48

• Triple phosphate
• Calcium carbonate
• Ammonium biurate
• Amourphous phosphates
• Calcium phosphate

Front 49

Name the order the blood for an ultra filtrate will travel for excretion by the kidney

Back 49

Renal artery, Afferent arteriole, Glomerulus, Efferent arteriole, Peritubular capillaries, Renal vein

Front 50

Name the order the ultra filtrate will travel for excretion by the kidney

Back 50

Renal vein, Afferent arteriole, Glomerulus, Bowman's capsule, PCT, Loop of Henle, DCT, Collecting Duct, Renal papilla, Minor calyx, Major Calix, Renal pelvis, Ureter, Bladder, Urethra

Front 51

A physician is setting up a small clinical in a rural area. She needs a basic urinalysis laboratory and supplies for sending out urine specimens to various reference laboratories. All of the patients will be seen on an outpatient basis and will frequently be asked collect

Back 51

Midstream clean catch (would also be useful for the UA bacterial studies. A downside is it requires a more complicated method of collection which some patients might not follow properly)
The use of preservatives

Front 52

A physician is setting up a small clinical in a rural area. She needs a basic urinalysis laboratory and supplies for sending out urine specimens to various reference laboratories.
-What type of specimen should be appropriate for both routine UA and bacteriologic culture? What order will the analysis take place? Why?

Back 52

Midstream clean catch due to the lack of contamination
1st – Physical Examination (Macroscopic analysis should be done first. It can proved preliminary information that one might expect upon further testing.)
2nd - Reagent stick analysis (due to the quickness and ease of this test.)
3rd – Microscopic Examination (This step allows for visual examination of any formed elements in the specimen. This step can be used to identify and monitor infections of the urinary tract, any metabolic disorders and kidney or liver disease.)
4th - Urine Culture (Cultures can be last since they are not as time sensitive as some of the chemical elements in urine, such as bilirubin and ketones.)

Front 53

A physician is setting up a small clinical in a rural area. She needs a basic urinalysis laboratory and supplies for sending out urine specimens to various reference laboratories.
-What essential supplies for collection purposes should be recommended?

Back 53

Specimen container labels
Urine collection containers
Cups for collection & transportation
24-Hour Collection cups
Urine Preservatives
Culture & Sensitivity testing (C&S)
Adequate/appropriate light protection

Front 54

A physician is setting up a small clinical in a rural area. She needs a basic urinalysis laboratory and supplies for sending out urine specimens to various reference laboratories.
-What preservatives would be most useful and why?

Back 54

Boric acid (Formed elements are preserved, also preserves the urine for culture & sensitivity testing. Only drawback is it interferes with reading the pH.)

Thymol (is an adequate preservative with the only drawback being interfering with the acid precipitation test for protein.)
Chlorhexidine (Prevents bacterial growth & is useful as a glucose preservative.)

Front 55

A physician is setting up a small clinical in a rural area. She needs a basic urinalysis laboratory and supplies for sending out urine specimens to various reference laboratories.
-What supplies are needed to perform chemical urinalysis in this clinic?

Back 55

Chemical testing strips
Pipettes
KOVA TUBES
Waste containers
Microscopes
Disposable hemocytometers

Front 56

In a Brightfield microscope, which lens produces the primary image magnification?

Back 56

The objective lens

Front 57

Which of the following WILL NOT cause erroneous results in a 24-hour timed urine collection?

Back 57

when the collection starts & ends in the evening

Front 58

A volume in excess of 2000 mL of urine excreted over a 24-hour period is known as?

Back 58

Polyuria

Front 59

Which component of the nephron is located exclusively in the renal medulla?

Back 59

The loop of Henle

Front 60

Which of the following statements about CSF glucose is false?

Back 60

(All True)
60-70 % of plasma glucose
Range is 50-80 mg/dL
Normal CSF to Serum glucose ratio is 0.6.
Traumatic tap can increase glucose levels
Metastatic carcinoma decreases glucose

Front 61

37. A 24 hour urine sample from an adult submitted for catecholamines gives a result of 140 ug/day (upper limit 150 ug/day). The 24 hour urine Creatinine level is 0.6 g/day. Select the best course of action

Back 61

request a new 24hr urine sample
(Urines creatinine of less than 0.8g/day indicates incomplete sample collection. The patients daily catecholamines, excretion would be misinterpret from this result.)

Front 62

Given the data for Creatinine clearance below, select the most appropriate course of action:
Volume=28 L/day; surface are=1.73 m^2;urine
Creatinine=100mg/dL; serum creatinine=1.2mg/dL

Back 62

Request a new 24hr urine sample
(calculated clearance in excess of 140mL/min is greater than the upper physiological limit.)

Front 63

Given the following dry reagent strip urinalysis results, select the most appropriate course of action explain why you choose that answer.
pH 8.0, Protein 1+, Glucose negative, Blood negative, Ketones negative, Nitrites negative, Bilirubin negative

Back 63

Perform a turbidimetric protein test and report instead of the dipstick protein
(Highly buffered alkaline urine may cause a false positive dry reagent strip test by titrating the acid buffer on the reagent pad. The turbidimetric test with SSA is not subject to positive interference by highly buffered alkaline urine)

Front 64

A 6 mL pediatric urine sample is processed for routine urinalysis in the usual manner. The sediment is prepared by centrifuging all of the urine remaining after performing the biochemical tests. The following results are obtained; Explain why you choose that answer
• SG = 1.015; Protein = 2+; Blood = Large
• 5 – 10 RBCs/HPF ; 5-10 WBCs/HPF

Back 64

report biochemical results only request a new sample for microscopic examination
(The discrepancy between the blood reaction and RBC count resulted from spinning less than 12 ml of urine. When volume is below 12 ml, the sample should be diluted with saline to 12 ml before concentrating. Results are multipled by the dilution (12ml/ml urine) to give the correct range.)

Front 65

As total magnification increases, the field of view:

Back 65

Decreases

Front 66

A substance that refracts light in two directions is said to be:

Back 66

Birefringence

Front 67

The microscopic component that gathers and focuses the illumination light onto the specimen being viewed is the:

Back 67

Condenser

Front 68

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

Back 68

2mL

Front 69

The physician removes 1 mL of CSF from a 2-year-old patient and immediately puts it into a properly labeled, single sterile tube. The technician delivers the STAT specimen to:

Back 69

Chemistry or Serology

Front 70

The substance present in high concentration in the seminal fluid that is thought to serve as a nutrient for spermatozoa is:

Back 70

Fructose

Front 71

The most probable structures to be stained by the Prussian blue stain are:

Back 71

To confirm that the granules are Hemosiderin (PB stains the granules) and is used for checking whether if iron is present.

Front 72

To detect the presence of casts the sediment is examined using:

Back 72

Reduced light under low power.

Front 73

Dilute alkaline urine should be examined carefully for the presence of:

Back 73

Leukocytes

Front 74

Urine sediments containing increased white blood cells should be observed closely for the presence of

Back 74

Bacteria

Front 75

Clue cells are derived from:

Back 75

Squamous epithelial cell

Front 76

The presence of hypochromic, irregularly-shaped red blood cells in the urine sediment is?

Back 76

a. The presence of glomerular bleeding

Front 77

Sediment constituents that are used to differentiate between upper and lower urinary tract infections are:

Back 77

The location of epithelial cells in the urinary tract in ascending order is: Squamous, transitional & Renal tubular.

Front 78

Broadcasts may form as a result of:

Back 78

Chronic renal failure

Front 79

The finding of increased hyaline and granular casts in the urine of an otherwise healthy person may be the result of:

Back 79

Dehydration, Following strenuous exercise, In patients with fever.

Front 80

A repeat semen analysis for fertility testing is reported as follows:
VOLUME: 3.5 mL SPERM CONCENTRATION: 6 million/mL
VISCOSITY: Normal SPERM MOTILITY: 30%—grade 1.0
PH: 7.5 MORPHOLOGY: <30% normal-forms—30 spermatids/100 sperm
The results correspond with the first analysis.
-Which of the following test results are abnormal?

Back 80

Sperm concentration (normal > 20 million)
morphology (normal > 30%)
motility (normal > 50%)

Front 81

A repeat semen analysis for fertility testing is reported as follows:
VOLUME: 3.5 mL SPERM CONCENTRATION: 6 million/mL
VISCOSITY: Normal SPERM MOTILITY: 30%—grade 1.0
PH: 7.5 MORPHOLOGY: <30% normal-forms—30 spermatids/100 sperm
The results correspond with the first analysis.
-What is the sperm count on this specimen?

Back 81

21,000,000

Front 82

A repeat semen analysis for fertility testing is reported as follows:
VOLUME: 3.5 mL SPERM CONCENTRATION: 6 million/mL
VISCOSITY: Normal SPERM MOTILITY: 30%—grade 1.0
PH: 7.5 MORPHOLOGY: <30% normal-forms—30 spermatids/100 sperm
The results correspond with the first analysis.
-What is the spermatid count?

Back 82

1,800,000

Front 83

A repeat semen analysis for fertility testing is reported as follows:
VOLUME: 3.5 mL SPERM CONCENTRATION: 6 million/mL
VISCOSITY: Normal SPERM MOTILITY: 30%—grade 1.0
PH: 7.5 MORPHOLOGY: <30% normal-forms—30 spermatids/100 sperm
The results correspond with the first analysis.
-Which of the following results should be repeated?

Back 83

The semen analysis was already repeated so it indicates infernality.

Front 84

The presence of which of the following crystals is associated with nephrotic syndrome?

Back 84

acute interstitial nephritis (When present in a urine specimen, these cells are accompanied by increased amounts of protein and cast formation. Oval fat bodies are often associated with nephritic syndrome)

Front 85

Pre-renal

Back 85

Decreased BP, Hemorrage, Burns, Surgery, Speticemia

Front 86

Renal

Back 86

Acute glomerulonephritis, Acute tubular necrosis, Acute interstitial nephritis, Ethylene glycol ingestion

Front 87

Post-renal

Back 87

Renal calculi, Tumors, Crystallization of substances

Front 88

Fecal Case 1

Back 88

Not available

Front 89

Fecal Case 2

Back 89

Not available

Front 90

Fecal test 3

Back 90

Not available

Front 91

Urine morphologies

Back 91

Not available