Clinical Microscopy
1.
The primary chemical affected by the renin-angiotensin-aldosterone system is:
a. Chloride
b. Sodium
c. Potassium
d. Hydrogen
2.
The fluid leaving the glomerulus has a specific gravity of:
a. 1.005
b. 1.010
c. 1.015
d. 1.020
3.
What are the variables included in the Cockgroft and Gault formula for
creatinine clearance?
1.
Age 3. Urine creatinine
2.
Sex 4. Body weight
a. 1, 2 and 3
b. 1 and 3
c. 1, 2 and 4
d. 1, 2, 3 and 4
4.
The average total volume of urine produced by a normal adult every 24 hours is
about:
a. 750 mL
b. 1200 mL
c. 2000 mL
d. 2400 mL
5.
An abnormal decrease in urine production is called:
a. Anuria
b. Oliguria
c. Polyuria
d. Dysuria
6.
Cloudiness in a freshly-voided urine could indicate the presence of:
a. Protein
b. Sugar
c. WBCs
d. Any of these
7.
Which of these plasma substances is NOT normally filtered through the
glomerulus in significant amounts?
a. Protein
b. Glucose
c. Creatinine
d. Urea
8.
Which term is defined as a urine volume in excess of 2000 mL excreted over a
24-hour period?
a. Anuria
b. Oliguria
c. Polyuria
d. Hypersthenuria
9.
Which of the following will contribute to a specimen’s specific gravity if it
is present in a person’s urine?
a. 50-100 RBC/hpf
b. 85 mg/dL glucose
c. 3+ amorphous phosphates
d. Moderate bacteria
10.
Why is the first-voided morning urine specimen the most desirable specimen for
routine urinalysis?
a. Most dilute specimen of the day
b. Less contamination by microorganisms
c. It can detect orthostatic proteinuria
d. Most concentrated specimen of the day
11.
Freshly voided normal urine is usually clear; however, if it is alkaline, a
white turbidity may be present due to:
a. Yeast cells
b. Uroerythrin
c. WBCs
d. Amorphous phosphates
12.
A strong odor of cabbage in a urine specimen could indicate:
a. Methionine malabsorption
b. Trimethylaminuria
c. Phenylketonuria
d. Tyrosyluria
13.
A specimen with a strong ammonia odor and a heavy white precipitate when it
arrives in the laboratory may require:
a. Collection of a fresh specimen
b. Centrifugation
c. Dilution for specific gravity
d. Testing under a hood
14.
A correlation exists between a specific gravity of 1.050 and a:
a. 2+ protein
b. 2+ glucose
c. Radiographic dye infusion
d. First morning specimen
15.
A yellow-brown specimen that produces a yellow foam when shaken can be
suspected of containing:
a. Carrots
b. Hemoglobin
c. Rhubarb
d. Bilirubin
16.
A patient with a 1+ protein reading in the afternoon is asked to submit a first
morning specimen. The second specimen also has a 1+ protein. This patient is:
a. Positive for orthostatic proteinuria
b. Negative for orthostatic proteinuria
c. Positive for Bence Jones proteinuria
d. Negative for clinical proteinuria
17.
Urinalysis on a patient with severe back and abnominal pain is frequently
performed to check for:
a. Bilirubinuria
b. Proteinuria
c. Hematuria
d. Hemoglobinuria
18.
Reagent strip – specific gravity readings are affected by:
a. Glucose
b. Radiographic dye
c. Alkaline urine
d. All of the above
19.
The reagent strip reaction that requires the longest reaction time is:
a. Bilirubin
b. Leukocyte esterase
c. pH
d. Glucose
20.
The enzyme dipstick test for glucose has a sensitivity of:
a. 10 mg/dL
b. 50 mg/dL
c. 100 mg/dL
d. 200 mg/dL
21.
Which of the following is true of the detection of urinary glucose?
a.
Any reducing substance can give a false positive reaction w/ copper reduction
test for glucose
b.
The copper reduction method is specific for glucose
c.
Glucose cannot appear in the urine in the absence of elevated plasma glucose
d.
Ketonuria may produce a false positive dipstick test for glucose
22.
Which of the reagents below is used to detect urobilinogen in urine?
a. p-Dinitrobenzene
b. p-Aminosalicylate
c. p-Dichloroaniline
d. p-Dimethylaminobenzaldehyde
23.
All of the statements below regarding urine bilirubin tests are true EXCEPT:
a.
A positive test indicates either liver or hepatobiliary disease
b.
The test detects only conjugated bilirubin
c.
High levels of ascorbate usually do not interfere
d.
Standing urine may become falsely negative due to bacterial hydrolysis
24.
A positive test for blood in urine can occur in the following EXCEPT:
a. Extravascular hemolytic anemia
b. Crush injury
c. Malignancy of the kidney or urinary
system
d. Renal calculi
25.
Which of the following is the major organic substance found in urine?
a. Sodium
b. Glucose
c. Chloride
d. Urea
26.
A reagent test strip impregnated with an aromatic amine such as p-arsanilic
acid or sulfanilamide may be used to detect which analyte?
a. Bilirubin
b. Blood
c. Nitrite
d. Urobilinogen
27.
What is the expected pH range of a freshly voided urine specimen?
a. 3.5-8.0
b. 3.5-9.0
c. 4.0-8.5
d. 4.5-8.0
28.
False positive levels of 5-HIAA can be caused by a diet high in:
a. Bananas
b. Tomatoes
c. Pineapples
d. All of these
29.
Blue diaper syndrome is associated with:
a. Lesch-Nyhan syndrome
b. Hartnup disease
c. Alkaptonuria
d. Dubin-Johnson syndrome
30.
Hurler, Hunter and Sanfilippo syndrome are hereditary disorders affecting
metabolism of:
a. Tryptophan
b. Purines
c. Mucopolysaccharides
d. Porphyrins
31.
Uroporphyrinogen decarboxylase deficiency is associated with which of the
following?
a. Acute intermittent porphyria (AIN)
b. Hereditary coproporphyria (HCP)
c. Congenital erythropoietic porphyria
(CEP)
d. Porphyria cutanea tarda (PCT)
32.
Urinary screening tests for mucopolysaccharides:
1.
Acid albumin 3.
Cyanide-Nitroprusside
2.
CTAB 4. Nitroso-naphthol
a. 1 and 2
b. 2 only
c. 1, 2 and 3
d. 3 and 4
33.
He discovered phenylketonuria from a mentally retarded child with a peculiar
mousy odor to his urine:
a. Ivan Folling
b. Garrod
c. Cotugno
d. Frederik Dekkers
34.
A clinically significant epithelial cell is the:
a. Cuboidal cell
b. Clue cell
c. Caudate cell
d. Squamous epithelial cell
35.
When using the glass slide and coverslip method, which of the following might
be missed if the coverslip is overflowed?
a. RBCs
b. WBCs
c. Casts
d. Bacteria
36.
Which of the following should be used to reduce light intensity in bright-field
microscopy?
a. Centering screws
b. Aperture diaphragm
c. Rheostat
d. Condenser aperture diaphragm
37.
The finding of dysmorphic RBCs is indicative of:
a. Renal calculi
b. Traumatic injury
c. Glomerular bleeding
d. Coagulation disorders
38.
The primary component of urinary mucus is:
a. Albumin
b. Uromodulin
c. Goblet cells
d. Beta2-microglobulin
39.
The purpose of the Hansel stain is to identify:
a. Neutrophils
b. Monocytes
c. Renal tubular cells
d. Eosinophils
40.
What is the normal value for urinary eosinophils?
a. >10%
b. <1%
c. >1%
d. <10%
41.
A disorder characterized by the disruption of the electrical charges that
produce the tightly fitting podocyte barrier resulting in massive loss of
proteins and lipids:
a. Alport syndrome
b. Nephrotic syndrome
c. IgA nephropathy
d. Lipid nephrosis
42.
Visicoureteral reflux or the reflux of urine from the bladder back into the
ureters may result to:
a. Acute glomerulonephritis
b. Cystitis
c. Acute pyelonephritis
d. Acute interstitial nephritis
43.
The presence of renal tubular epithelial cells and casts is an indication of:
a. Acute interstitial nephritis
b. Chronic glomerulonephritis
c. Minimal change disease
d. Acute tubular necrosis
44.
End-stage renal disease is characterized by all of the following EXCEPT:
a. Electrolyte imbalance
b. Azotemia
c. Hypersthenuria
d. Isosthenuria
45.
Broad and waxy casts are most likely associated with:
a. Nephrotic syndrome
b. Acute renal failure
c. Chronic renal failure
d. Focal segmental glomerulosclerosis
46.
It is described as a genetic disorder showing lamellated and thinning of
glomerular basement membrane:
a. Goodpasture syndrome
b. Alport syndrome
c. Nephrotic syndrome
d. Wegener’s granulomatosis
47.
Casts are formed primarily in which portion of the kidney?
a. Distal convoluted tubule
b. Glomerulus
c. Loop of Henle
d. Proximal convoluted tubule
48.
A parasite associated with a positive leukocyte esterase is:
a. Enterobius
vermicularis
b.
Trichomonas vaginalis
c. Schistosoma
haematobium
d.
Candida albicans
49.
The hormone characteristically present in the blood of pregnant women and
which, when its concentration in the blood reaches a certain point, also
appears in the urine is:
a. Estradiol
b. Aldosterone
c. Progesterone
d. hCG
50.
HCG is produced by which of the following?
a. Cytotrophoblast cells
b. Argentaffin cells
c. Endocervical glandular cells
d. Type II pneumocytes
51.
The most common composition of renal calculi is:
a. Calcium oxalate
b. Magnesium ammonium phosphate
c. Cystine
d. Uric acid
52.
A renal calculi described as yellowish to brownish red in color with a
moderately hard consistency is:
a. Cystine
b. Phosphate
c. Calcium oxalate
d. Uric acid
53.
A renal calculi described as pale and friable is:
a. Cystine
b. Phosphate
c. Calcium oxalate
d. Uric acid
54.
A stool specimen collected from an infant with diarrhea has a pH of 5.0. This
result correlates with a:
a. Positive APT test
b. Negative trypsin test
c. Positive Clinitest
d. Negative occult blood test
55.
What is the gold standard for fecal fat determination?
a. Van de Kamer titration
b. Van den Berg reaction
c. APT test
d, D-Xylose test
56.
Which of the following pairings of stool appearance and cause does not match?
a. Pale, frothy: steatorrhea
b. Black, tarry: blood
c. Yellow-gray: bile duct obstruction
d. Yellow-green: barium sulfate
57.
All of the following statements about CSF are true EXCEPT:
a.
CSF is formed by ultrafiltration of plasma through the choroid plexus
b.
CSF circulates in the subarachnoid space and ventricles of the brain
c.
The chemical composition of CSF is similar to plasma
d.
Reabsorption of CSF occurs via vessels in the sagittal sinus
58.
All of the following are indication of CSF traumatic tap EXCEPT:
a. Clearing of fluid as it is aspirated
b. A clear supernatant after centrifugation
c. Xanthochromia
d. Presence of a clot in the sample
59.
The term used to denote a high WBC count in the CSF is:
a. Empyema
b. Neutrophilia
c. Pleocytosis
d. Lymphocytosis
60.
The limulus lysate test on CSF is a sensitive assay for:
a. Viral meningitis
b. Cryptococcal meningitis
c. Gram positive bacterial exotoxin
d. Gram negative bacterial endotoxin
61.
A normal CSF glucose and lactate level is associated with which type of
meningitis?
a. Viral meningitis
b. Bacterial meningitis
c. Fungal meningitis
d. Tubercular meningitis
62.
The most common cause of male infertility is:
a. Mumps
b. Klinefelter’s syndrome
c. Varicocele
d. Malignancy
63.
Which of the following stains is used to determine sperm viability?
a. Eosin
b. Hematoxylin
c. Papanicolau
d. Methylene blue
64.
Seminal fluid viscosity graded as 4 is described as:
a. Watery
b. Fair
c. Friable
d. Gel-like
65.
The sugar present in the seminal fluid in high concentration is:
a. Glucose
b. Lactose
c. Fructose
d. Sucrose
66.
Maturation of spermatozoa takes place in the:
a. Sertoli cells
b. Seminiferous tubules
c. Epididymis
d. Seminal vesicles
67.
Which test for FLM is least affected by contamination with hemoglobin and
meconium?
a. Amniostat-FLM
b. Foam stability
c. Lamellar body count
d. L/S ratio
68.
How are specimens for FLM testing delivered to and stored in the laboratory?
a. Delivered on ice and refrigerated or
frozen
b. Immediately centrifuged
c. Kept at room temperature
d. Protected from light
69.
The presence of a fetal neural tube disorder may be detected by:
a. Increased amniotic fluid bilirubin
b. Increased maternal serum
alpha-fetoprotein
c. Decreased amniotic fluid phosphatidyl
glycerol
d. Decreased maternal serum
acetylcholinesterase
70.
What type of tube for gastric fluid collection is inserted through the mouth?
a. Rehfuss tube
b. Levine tube
c. Diagnex tube
d. None of these
71.
A gastric disorder characterized by achlorhydria due to the presence of
anti-parietal cell antibodies:
a. Zollinger-Ellison disease
b. Helicobacter
pylori infection
c. Pernicious anemia
d. Cystic fibrosis
72.
All of the following may be associated with bronchial asthma EXCEPT:
a. Creola bodies
b. Curschmann’s spirals
c. Charcot-Leyden crystals
d. Pneumoliths
73.
A sputum that is rusty-colored and filled with pus is associated with:
a. Congestive heart failure
b. Lobar pneumonia
c. Tuberculosis
d. Anthracosis
74.
Rice bodies are called so because:
a. It was discovered by Dr. Rice
b. It resembles cooked rice
c. It resembles uncooked rice
d. It resembles polished rice
75.
Lyme arthritis is caused by:
a. Borrelia
recurrentis
b.
Borrelia hermsii
c. Borrelia
burgdorferi
d.
Neisseria gonorrhoeae
76.
CYFRA 21-1 is a tumor marker for:
a. Uterine cancer
b. Colon cancer
c. Lung cancer
d. Breast cancer
77.
This is a sensitive test for the detection of intra-abdominal bleeding:
a. Peritoneal lavage
b. Bronchioalveolar lavage
c. Thoracic lavage
d. Pericardial lavage
78.
What is the method of choice for preservation of routine urinalysis samples?
a. Boric acid
b. Formalin
c. Sodium fluoride
d. Refrigeration
79.
A urine specimen for routine urinalysis would be rejected by the laboratory
because:
a. The specimen had been refrigerated
b. More than 50 mL was in the container
c. The label was placed on the side of the
container
d. The specimen and accompanying request
did not match
80.
Which of the following is the preferred urine specimen for cytology studies?
a. Catheterized
b. First morning
c. Suprapubic aspiration
d. Three-glass collection
81.
Following collection, urine specimens should be delivered to the laboratory
promptly and tested within ___ hour(s)
a. 1
b. 2
c. 3
d. 4
82.
All of the following changes occur in unpreserved urine EXCEPT:
1. Decreased glucose 3.
Increased ketones 5. Incr. urobilinogen
2. Increased pH 4.
Increased clarity 6. Increased bacteria
a. 3, 4 and 5
b. 1, 2 and 6
c. 1, 3 and 5
d. 1, 2, 3, 4, 5 and 6
83.
Which of the following matches regarding specimen collection is/are incorrect?
1.
Arthrocentesis – synovial fluid 3.
Thoracentesis – Ascitic fluid
2. Amniocentesis – amniotic fluid 4. Pericardiocentesis – Pleural fluid
a. 1 and 2
b. 3 and 4
c. 1 and 3
d. 2 and 4
84.
The most representative sample for fecal fat analysis is:
a. First morning
b. 3-day collection
c. 2-day collection
d. None of the above
85.
Three labeled tubes of CSF specimen were sent to the laboratory. Which of these
tubes will be used for cell counting?
a. Tube 1
b. Tube 2
c. Tube 3
d. Any of these
86.
If seminal fluid fructose analysis will be delayed for more than 2 hours, the
sample should be stored at what condition?
a. Refrigerator temperature
b. Frozen
c. Body temperature
d. Room temperature
87.
It is the process that provides documentation of proper sample identification
from the time of collection to the receipt of laboratory results:
a. Proficiency testing
b. Accreditation
c. Chain of custody
d. Pre-analytical phase
88.
This is also known as the modulation contrast microscope:
a. Nomarski
b. Hoffman
c. Kohler
d. Phase-contrast
89.
It refers to the ability of a microscopic lens to distinguish two small objects
that are a specific distance apart:
a. Parfocal
b. Birefringence
c. Illumination
d. Resolution
90.
Which type of microscopy is used to aid in identification of cholesterol in
oval fat bodies, fatty casts and crystals?
a. Polarizing
b. Phase-contrast
c. Interference-contrast
d. Dark-field
91.
It is based on the principle that the frequency of a sound wave entering a
solution changes in proportion to the density of the solution
a. Harmonic oscillation densitometry
b. Refractive index
c. Urinometer
d. Reagent strip
92.
What is the minimum urine volume required by the Clinitek Atlas automated
instrument?
a. 1 mL
b. 2 mL
c. 7 mL
d. 15 mL
93.
All of the following are important to protect the integrity of reagent strips
EXCEPT:
a. Storing in an opaque bottle
b. Storing at room temperature
c. Removing the dessicant from the bottle
d. Resealing the bottle after removing a
strip
94.
When a control is run, what information is documented?
a. The lot number
b. Expiration date of the control
c. The test results
d. All of the above
95.
Given the following, identify the preanalytical errors:
1.
Patient misidentification 4. Insufficient
urine volume
2.
Poor handwriting 5. Delayed
transport of urine to lab
3.
Reagent deterioration 6. Instrument malfunction
a. 1, 4 and 5 c. 1, 2 and 3
b. 2, 3 and 6 d. 4, 5 and 6
96.
The best way to break the chain of infection is:
a. Decontamination
b. PPE
c. Aerosol prevention
d. Handwashing
97.
An acceptable disinfectant for blood and body fluid decontamination is:
a. NaOH
b. Antimicrobial soap
c. H2O2
d. Sodium hypochlorite
98.
The last thing to do when a fire is discovered is to:
a. Rescue persons in danger
b. Activate the alarm system
c. Close doors to other areas
d. Extinguish the fire if possible
99.
A class ABC fire extinguisher contains:
a. Water
b. Dry chemicals
c. Sand
d. Acid
100.
Correct procedure for handwashing, EXCEPT:
a. Wet hands with warm water
b. Thoroughly clean between fingers for at
least 15 seconds
c. Rinse hands in an upward position
d. Turn off faucets with a clean paper
towel
ANSWER KEY: Clinical Microscopy
1.
B
2.
B
3.
C
4.
B
5.
B
6.
C
7.
A
8.
C
9.
B
10.
D
11.
D
12.
A
13.
A
14.
C
15.
D
16.
B
17.
C
18.
C
19.
B
20.
C
21.
A
22.
D
23.
C
24.
A
25.
D
26.
C
27.
D
28.
D
29.
B
30.
C
31.
D
32.
A
33.
A
34.
B
35.
C
36.
C
37.
C
38.
B
39.
D
40.
B
41.
B
42.
C
43.
D
44.
C
45.
C
46.
B
47.
A
48.
B
49.
D
50.
A
51.
A
52.
D
53.
B
54.
C
55.
A
56.
D
57.
C
58.
C
59.
C
60.
D
61.
A
62.
C
63.
A
64.
D
65.
C
66.
C
67.
A
68.
A
69.
B
70.
A
71.
C
72.
D
73.
B
74.
D
75.
C
76.
C
77.
A
78.
C
79.
D
80.
C
81.
B
82.
A
83.
B
84.
B
85.
C
86.
B
87.
C
88.
B
89.
D
90.
A
91.
A
92.
B
93.
C
94.
D
95.
A
96.
D
97.
D
98.
D
99.
B
100. C
