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91 Cards in this Set
- Front
- Back
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? |
Microscopic examination (muscle fiber screening)
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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? |
Quantitative fecal fat test
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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) |
Bulky and frothy
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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. |
Muscle fiber screening & the gelatin test for trypsin.
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How is a muscle fiber test performed
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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. |
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Undigested fibers
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Striations vertically and horizontally
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Partially digested
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Striation in one direction
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Digested
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No visible striations
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False Negative for Muscle Fiber
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Failure to include red meat in diet
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False Positive for Muscle Fiber
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Rapid Transit time due to use of laxatives
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What confirmatory test can be performed on muscle fiber tests?
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Quantitative fecal fat test.
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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? |
Secretory Diarrhea
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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. |
Lactoferin latex agglutination test
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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? |
Osmotic diarrhea
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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? |
Fecal pH
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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? |
Acidic
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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? |
Lactose intolerance
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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? |
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.) |
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Monosodium Urate
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Gout
Needle shaped Birefringent - yellow parallel, blue in perpendicular |
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Calcium pyrophosphate
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Pseudogout (CPPD)
Rod-shaped Birefringent + yellow perpendicular, blue in parallel |
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Hydroxyapatite crystals
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Birefringent -
Alizarin Red S detectable |
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Corticosteroid crystals
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Variable Birefringent
Blunt jagged |
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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?
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Glucose and Uric Acid
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A synovial fluid specimen has a high cell count and requires dilution to be counted. Which of the following diluents should be used?
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Normal Saline
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Which of the following substances will not increase the turbidity of synovial fluid?
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Hyalutonate
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Which of the following components is not normally present in synovial fluid?
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Fibrinogen
(RA, lipid, Rise bodies, Hemosiderin) |
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Which of the following hematology values best frames the upper reference limits for synovial fluid?
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WBC 200
PMNs 25% RBC 2000 |
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Which of the following organisms account for the majority of septic arthritis cases in young & middle-age adults?
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Neisseria gonorrhoeae
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In which condition is the synovial fluid glucose most likely to be within normal limits?
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Hemorrhagic arthritis
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In which type of arthritis is the synovial WBC count likely to be greater than 50,000/uL?
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Septic Arthritis
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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;
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Hyaluronic acid clots in the presence of acetic acid, its synovial fluid which has hyaluronic acid.
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Transudate
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Clear, Protein ratio 0.5, LD ratio 0.6, Cholesterol 45 ratio 0.3
Cirrhosis CHF Uremia Autoimmune |
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Exudate
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Cloudy, Protein ratio 0.55, LD ratio .66, Cheloesterol 60 ratio 0.33
Malignancy Bacterial Esophageal rupture |
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Which of the following mechanisms is responsible for the formation of serous fluid in body cavities?
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a. Ultrafiltration of the circulating blood plasma
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A pleural or peritoneal fluid amylase level two times higher than the serum amylase level can be found in effusions resulting from?
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Pancreatitis
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A glucose concentration difference greater than 30 mg/dL between the serum and an effusion is associated with?
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Exudate (30 mg or more < Serum level)
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Condition in which glucose is decreased in effusion
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Cancer, bacterial infections, rheumatoid pleuritis
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Chylous (Blockage) and pseudochylous (Chronic dissorder) effusions are differentiated by their?
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Colesterol (Lower than serum vs higher)
Triglycerides (Higher vs Lower) |
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Pleural transudates differ from pleural exudates in that transudates have:
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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.) |
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Pleural Fluid from a patient with congestive heart failure would be expected to:
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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.) |
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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?
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Pleural effusion exudate
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Which of the following conditions is commonly associated with a chylous effusion?
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Lymphatic Obstruction
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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.
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Exudate
(Serum Albumin- Fluid Albumin = > /= 1.1 means fluid is a transudate and if less than 1.1 means fluid is an exudate.) |
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What tests would you do to determine if the fluid was urine?
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urea and creatinine content.
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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
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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 |
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Normal crystals in Acid urine
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• Uric acid
• Calcium oxalate • Amorphous urates |
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Abnormal Crystals in Acid Urine
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• Cysteine
• Leucine • Tyrosine • Cholesterol • Bilirubin • Sulfonamides • Ampicillin • Radiographic dye |
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Normal Crystals in Basic Urine
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• Triple phosphate
• Calcium carbonate • Ammonium biurate • Amourphous phosphates • Calcium phosphate |
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Name the order the blood for an ultra filtrate will travel for excretion by the kidney
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Renal artery, Afferent arteriole, Glomerulus, Efferent arteriole, Peritubular capillaries, Renal vein
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Name the order the ultra filtrate will travel for excretion by the kidney
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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
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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
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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 |
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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? |
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.) |
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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? |
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 |
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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? |
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.) |
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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? |
Chemical testing strips
Pipettes KOVA TUBES Waste containers Microscopes Disposable hemocytometers |
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In a Brightfield microscope, which lens produces the primary image magnification?
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The objective lens
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Which of the following WILL NOT cause erroneous results in a 24-hour timed urine collection?
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when the collection starts & ends in the evening
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A volume in excess of 2000 mL of urine excreted over a 24-hour period is known as?
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Polyuria
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Which component of the nephron is located exclusively in the renal medulla?
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The loop of Henle
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Which of the following statements about CSF glucose is false?
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(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 |
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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
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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.) |
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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 |
Request a new 24hr urine sample
(calculated clearance in excess of 140mL/min is greater than the upper physiological limit.) |
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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 |
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) |
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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 |
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.) |
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As total magnification increases, the field of view:
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Decreases
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A substance that refracts light in two directions is said to be:
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Birefringence
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The microscopic component that gathers and focuses the illumination light onto the specimen being viewed is the:
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Condenser
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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?
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2mL
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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:
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Chemistry or Serology
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The substance present in high concentration in the seminal fluid that is thought to serve as a nutrient for spermatozoa is:
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Fructose
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The most probable structures to be stained by the Prussian blue stain are:
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To confirm that the granules are Hemosiderin (PB stains the granules) and is used for checking whether if iron is present.
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To detect the presence of casts the sediment is examined using:
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Reduced light under low power.
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Dilute alkaline urine should be examined carefully for the presence of:
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Leukocytes
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Urine sediments containing increased white blood cells should be observed closely for the presence of
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Bacteria
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Clue cells are derived from:
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Squamous epithelial cell
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The presence of hypochromic, irregularly-shaped red blood cells in the urine sediment is?
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a. The presence of glomerular bleeding
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Sediment constituents that are used to differentiate between upper and lower urinary tract infections are:
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The location of epithelial cells in the urinary tract in ascending order is: Squamous, transitional & Renal tubular.
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Broadcasts may form as a result of:
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Chronic renal failure
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The finding of increased hyaline and granular casts in the urine of an otherwise healthy person may be the result of:
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Dehydration, Following strenuous exercise, In patients with fever.
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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? |
Sperm concentration (normal > 20 million)
morphology (normal > 30%) motility (normal > 50%) |
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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? |
21,000,000
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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? |
1,800,000
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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? |
The semen analysis was already repeated so it indicates infernality.
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The presence of which of the following crystals is associated with nephrotic syndrome?
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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)
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Pre-renal
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Decreased BP, Hemorrage, Burns, Surgery, Speticemia
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Renal
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Acute glomerulonephritis, Acute tubular necrosis, Acute interstitial nephritis, Ethylene glycol ingestion
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Post-renal
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Renal calculi, Tumors, Crystallization of substances
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Fecal Case 1
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Not available
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Fecal Case 2
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Not available
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Fecal test 3
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Not available
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Urine morphologies
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Not available
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