PRE-BOARD EXAMINATION IN CLINICAL MICROSCOPY (PART3)

1. The fluid leaving the glomerulus has a specific gravity of:

a. 1.005 b. 1.010 c. 1.015 d. 1.020
2. An unidentified fluid is received in the laboratory with a request to determine if the fluid is urine or another body
fluid. Using routine laboratory tests, what tests would determine that the fluid is most probably urine:
a. glucose and ketones b. urea and creatinine c. uric acid and amino acids d. protein and amino acids
3. A patient presenting with polyuria, nocturia, polydipsia and a high urine specific gravity is exhibiting symptoms
of what disorder?
a. diabetes insipidus b. diabetes mellitus c. UTI d. uremia
4. An unpreserved urine specimen collected at 8 a.m. and remaining at room temperature until the afternoon shift
arrives can be expected to have:
1. decreased glucose and ketones 3. decreased pH and turbidity
2. increased bacteria and nitrite 4. increased cellular elements
a. 1, 2 and 3 b. 1, 2 and 4 c. 1 and 2 d. 4 only
5. What three changes will affect the results of microscopic examination of urine if not tested within 2 hours?
a.decreased bacteria, decreased red blood cells, decreased casts
b.increased bacteria, increased red blood cells, increased casts
c. increased bacteria, decreased red blood cells, decreased casts
d.decreased bacteria, increased red blood cells, increased casts
6. What chemical can be used to preserve a specimen for a culture and a routine urinalysis?
a. boric acid b. formalin c. sodium fluoride d. thymol
7. The substance normally found in urine that is principally responsible for the yellow coloration of urine is:
a. bilirubin b. melanin c. urochrome d. carotene
8. A yellow-brown specimen that produces a yellow foam when shaken can be suspected of containing:
a. bilirubin b. carrots c. hemoglobin d. Rhubarb
9. Specimens from patients receiving treatment for UTI frequently appear:
a. clear and red b. viscous and orange c. dilute and pale yellow d. cloudy and red
10. Under what conditions will a port-wine urine color be observed in a urine specimen?
a. the patient has eaten Clorets c. urine containe porphyrins
b. melanin is present d. the patient has Pseudomonas infection
11. The pH of a freshly voided urine specimen may range between:
a. 3.5 and 8.0 b. 3.5 and 9.0 c. 4.0 and 8.5 d. 4.5 and 8.0
12. A correlation exists between a specific gravity of 1.050 and a:
a. 2+ glucose b. 2+ protein c. first morning specimen d. radiographic dye infusion
13. A urine specimen has a specific gravity of 1.008 has been diluted 1:5. The actual specific gravity is:
a. 1.008 b. 1.040 c. 1.055 d. 5.040
14. The method for determining a specific gravity that is based on the principle that the frequency of a sound wave
entering a solution changes in proportion to the density of the solution is:
a. colorimeteric b. harmonic oscillation densitometry c. refractometry d. urinometry
15. The reagent strip used for detection of protein in urine is most reactive to:
a. albumin b. hemoglobin c. beta globulins d. gamma globulins
16. The principle of the reagent strip for glucose is based on which of the following reactions?
a. hexokinase b. copper reduction c. alkaline ferricyanide d. glucose-oxidase peroxidase
17. The primary reagent in the reagent strip test for ketones is:
a. glycine b. lactose c. sodium hydroxide d. sodium nitroprusside
18. Ketonuria may be caused by all of the following except:
a. bacterial infections b. diabetic acidosis c. starvation d. vomiting
19. A speckled pattern on the blood pad of the reagent strip indicates:
a. hematuria b. hemoglobinuria c. myoglobinuria d. all of the above
20. An elevated urine bilirubin with a normal urobilinogen is indicative of:
a. cirrhosis of the liver b. hemolytic disease c. hepatitis d. biliary obstruction
21. In the Watson-Schwartz differentiation test, the substance(s) not extracted into butanol is/are:
a. urobilinogen b. porphobilinogen c. Ehrlich reactive substances d. all of the above
22. The Hoesch test is used to monitor or screen patients for the presence of:
a. urobilinogen b. nitrite c. porphobilinogen d. leukocyte esterase
23. The reagent strip for nitrite used the:
a. Greiss reaction b. Hoesch reaction c. Peroxidase reaction d. Pseudoperoxidase reaction
24. All of the following can be detected by the leukocyte esterase reaction except:
a. neutrophils b. eosinophils c. lymphocytes d. basophils
25. Screening tests for urinary infection combine the leukocyte esterase test with the test for:
a. pH b. nitrite c. protein d. blood
26. To quantify formed elements such as white blood cells, red blood cells, and casts in a 12-hour urine specimen,
which of the following procedures is used?
a. Guthrie count b. Addis count c. Rothera count d. Folin-Lowry count
27. Which of the following reported as number per LPF?
a. RBCs b. WBCs c. crystals d. casts
28. The final phase of degeneration that granular casts undergo is represented by which of the following casts?
a. broad b. cellular c. waxy d. fatty
29. Which of the following lipids is/are stained by Sudan III?
a. cholesterol b. neutral fats c. triglycerides d. both B and C
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30. Which of the following lipids is/are capable of polarizing light?

a. cholesterol b. neutral fats c. triglycerides d. both B and C
31. The purpose of the Hansel stain is to identify:
a. neutrophils b. renal tubular cells c. eosinophils d. monocytes
32. Crenated RBCs are seen in urine that is:
a. hyposthenuric b. hypersthenuric c. highly acidic d. highly alkaline
33. The finding of dysmorphic RBCs is indicative of:
a. glomerular bleeding b. renal calculi c. traumatic injury d. coagulation disorders
34. When pyuria is detected in a sediment, the slide should be carefully checked for the presence of:
a. RBCs b. bacteria c. hyaline casts d. mucus
35. The predecessor of the oval fat body is the:
a. histiocyte b. urotehlial cell c. monocyte d. renal tubular cell
36. The finding of yeast cells in the urine is commonly associated with:
a. cystitis b. diabetes mellitus c. pyelonephritis d. liver disorders
37. The majority of casts are formed in the:
a. proximal convoluted tubules c. distal convoluted tubules
b. ascending loop of Henle d. descending loop of Henle
38. A person submitting a urine specimen following a strenuous exercise routine can normally have all of the
following in the sediment except:
a. hyaline casts b. granular casts c. RBC casts d. WBC casts
39. WBC casts are primarily associated with:
a. pyelonephritis b. cystitis c. glomerulonephritis d. viral infections
40. Crystals associated with liver disease include all of the following except:
a. bilirubin b. leucine c. cystine d. tyrosine
41. Differentiation between cystitis and pyelonephritis is aided by the presence of:
a. WBC casts b. RBC casts c. bacteria d. granular casts
42. The most common composition of renal calculi is:
a. calcium oxalate b. magnesium ammonium phosphate c. cystine d. uric acid
43. The Guthrie test is a:
a. bacterial inhibition test c. chemical procedure measured by spectrophotometer
b. fluorometric procedure d. bacterial agglutination test
44. A mousy odor in the urine is associated with:
a. phenylketonuria b. isovaleric acidemia c. cystinuria d. Cystinosis
45. Hartnup disease is a disorder associated with the metabolism of:
a. organic acids b. tryptophan c. cystine d. phenylalanine
46. Elevated levels of 5-HIAA are associated with:
a. carcinoid tumors b. Hartnup disease c. cystinuria d. platelet disorders
47. Hurler’s and Sanfilippo’s syndromes present with mental retardation and increased urinary:
a. porphyrins b. amino acids c. maltose d. mucopolysaccharides
48. The identification of the presence of human chorionic gonadotropin in a urine specimen indicates:
a. glomerulonephritis b. nephroyic syndrome c. diabetes mellitus d. pregnancy
49. The functions of the CSF include all of the following except:
a. removal of metabolic wastes c. supplying nutrients to the CNS
b. producing an ultrafiltrate of plasma d. protection of the brain and spinal cord
50. The CSF tube labeled 3 is sent to:
a. the hematology department c. the microbiology department
b. the chemistry department d. the serology department
51. The CSF tube that should be refrigerated is:
a. tube 1 b. tube 2 c. tube 3 d. tube 4
52. A web like pellicle in a refrigerated CSF specimen is indicative of:
a. tubercular meningitis b. multiple sclerosis c. primary CNS malignancy d. viral meningitis
53. The normal value of CSF protein is:
a. 6-8 g/dL b. 15-45 g/dL c. 6-8 mg/dL d. 15-45 mg/dL
54. CSF can be differentiated from plasma by the presence of:
a. albumin b. globulin c. prealbumin d. tau transferrin
55. In plasma, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is:
a. transferring b. prealbumin c. IgA d. ceruloplasmin
56. Elevated CSF protein values can be cause by all of the following except:
a. meningitis b. multiple sclerosis c. fluid leakage d. CNS malignancy
57. The finding of oligoclonal bands in the CSF and not in the serum is seen with:
a. multiple myeloma b. CNS malignancy c. multiple sclerosis d. viral infections
58. A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL is suggestive of:
a. fungal meningitis b. viral meningitis c. tubercular meninigitis d. bacterial meningitis
59. A patient with blood glucose of 120 mg/dL would have a normal CSF glucose of:
a. 20 mg/dL b. 60 mg/dL c. 80 mg/dL d. 120 mg/dL
60. The limulus lysate test on CSF is a sensitive assay for:
a. demyelinating diseases of the spinal cord c. Gram negative bacterial endotoxin
b. cryptococcal meningitis d. Open neural tube defects
61. Pronounced reduction of CSF glucose can be seen in the following conditions, EXCEPT:
a. viral meningitis c. fungal meningitis
b. bacterial meningitis d. tuberculous meningitis
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62. Regarding CSF, all of the following are indications of a traumatic tap, EXCEPT:
a. clearing of the fluid as it is aspirated c. xanthochromia
b. a clear supernatant after centrifugation d. presence of clot in the sample
63. A major CSF chemical that is measured in suspected cases of Reye’s syndrome is:
a. glucose b. glutamine c. lactate d. lactate dehydrogenase
64. Maturation of spermatozoa takes place in the:
a. Sertoli cells b. seminiferous tubules c. epididymis d. seminal vesicles
65. Enzymes for the coagulation and liquefaction of semen are produced by the:
a. seminal vesicles b. bulbourethral glands c. ductus deferens d. prostate gland
66. The normal sperm concentration is:
a. below 20 million per microliter c. below 20 million per milliliter
b. above 20 million per milliliter d. above 20 million per microliter
67. Given the following information, calculate the sperm concentration: dilution 1:20; sperm counted in 5 RBC
squares on each side of the hemacytometer, 80 and 86; volume, 3 mL.
a. 80 million per milliliter c. 86 million per milliliter
b. 83 million per milliliter d. 169 million per microliter
68. All of the following are grading criteria for sperm motility except:
a. rapid straight-line movement c. no forward progression
b. rapid lateral movement d. no movement
69. The immunobead test for antisperm antibodies:
a. detects the presence of male antibodies c. determines the location of the antisperm antibodies
b. determines the pres of IgG, IgA and IgM abs d. all of the above
70. Measurement of -glucosidase is performed to detect a disorder of the:
a. seminiferous tubules b. epididymis c. prostate gland d. bulbourthral gland
71. Normal synovial fluid resembles:
a. egg white b. normal serum c. dilute urine d. lipemic serum
72. Powdered anticoagulants should not be sued in tubes for synovial fluid testing because it interferes with:
a. cell counts b. glucose tests c. crystal examination d. differentials
73. To determine if a fluid is synovial fluid, it should be mixed with:
a. sodium hydroxide b. hypotonic saline c. hyaluronidase d. acetic acid
74. When diluting a synovial fluid WBC count, all of the following are acceptable except:
a. acetic acid b. isotonic saline c, hypotonic saline d. saline with saponin
75. Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are:
a. monosodium urate b. cholesterol c. calcium pyrophosphate d. apatite
76. Crystals associated with psedogout are:
a. Monosodium urate b. calcium pyrophosphate c. apatite d. corticosteroid
77. Neutrophils that contain precipitated rheumatoid factor in their cytoplasm are called:
a. LE cells b. Reiter cells c. ragocytes d. Macrophages
78. A milky appearing pleural fluid is indicative of:
a. thoracic duct leakage b. chronic inflammation c. microbial infection d. both A and B
79. Detection of CA-125 tumor marker in peritoneal fluid is indicative of:
a. colon cancer b. ovarian cancer c. gastric malignancy d. prostate cancer
80. A transudative effusion is usually caused by all of the following, EXCEPT:
a. congestive heart failure c. Nephrotic syndrome
b. malignancy d. Cirrhosis
81. A useful adjunct test for tuberculous pericarditis in cases with negative stains when tuberculosis is suspected:
a. Lactate dehydrogenase activity c. Adenosine deaminase activity
b. Bilirubin level d. Lactate level
82. Amniotic fluid procedure used to detect neural tube defects is:
a. L/S ratio b. creatinine c. absorbance at 450 nm d. alpha fetoprotein
83. A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte?
a. bilirubin b. lecithin c. oxyhemoglobin d. sphingomyelin
84. The foam or shake test is a screening test for which amniotic fluid substance?
a. bilirubin b. lecithin c. alpha fetoprotein d. creatinine
85. What is the fecal test that requires a 3-day specimen?
a. fecal occult blood test c. Elastase I
b. APT test d. Quantitative fecal fat testing
86. The normal brown color of feces is produced by:
a. cellulose b. pancreatic enzyme c. undigested foodstuffs d. urobilin
87. A black tarry stool is indicative of:
a. upper GI bleeding b. lower GI bleeding c. excess fat d. excess carbohydrate
88. Chemical screening tests performed on feces include all of the following except:
a. APT test b. Clinitest c. pilocarpine iontophoresis d. trypsin digestion
89. Annual testing for fecal occult blood has a high predictive value for the detection of:
a. colorectal cancer c. pancreatic deficiencies
b. malabsorption syndromes d. ulcers
90. What is the significance of an APT test that remains pink after addition of sodium hydroxide?
a. fecal fat is present c. fecal trypsin is present
b. fetal hemoglobin is present d. vitamin C is present
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91. It is used as a safer alternative for testing vagal stimulation of gastric acid secretion. The procedure also
requires gastric intubation, however, instead of administering insulin, patients are given a sandwich to chew
and spit out.
a. Sweat test b. Sham feeding c. Secretin test d. Breath test
92. The test is based on the measurement of 14CO2 in expired air following the ingestion of various 14C-labeled
triglycerides. Steatorrhea from either pancreatic or other causes results in a decreased absorption of
triglycerides by the digestive system. This in turn results in a decrease in expired CO 2 derived from metabolism
of triglyceride fatty acids.
a. Sweat test b. Sham feeding c. Secretin test d. Breath test
93. It is a valuable test for the differential diagnosis of malabsorption. In this procedure, a 25 g dose of pentose
is administered orally. Blood level is determined two hours later; urine excretion over a five-hour
postadministration period is also determined.
a. D-xylose test b. Sham feeding c. Secretin test d. Breath test
94. The most abundant cell seen in the bronchoalveolar lavage is the:
a. neutrophil b. ciliated columnar bronchial epithelial cell c. macrophage d. lymphocyte
95. Bronchoalveolar lavege may be performed on patients with AIDS to detect the presence of:
a. increased helper T cells b. bacterial pneumonia c, Kaposi sarcoma d. Pneumocytis carinii
96. The preferred stimulant of gastric acidity for routine analysis is:
a. histamine b. histalog c. pentagastrin d. insulin
97. The gastric stimulant to determine a successful vagotomy procedure is:
a. insulin b. pepsin c. histamine d. pentagastrin
98. Serum gastrin levels would be greatest in:
a. atrophic gastritis b. Zollinger-Ellison syn c. pernicious anemia d. cancer of the stomach
99. A condition in which a patient shows no response to gastric stimulation is:
a. pernicious anemia b. Zollinger-Ellison syn c. ulcers d. diabetes
100. Yellowish or gray caseous bodies with the size of a pinhead, found in sputum:
a. cheesy masses b. broncholiths c. bronchial casts d. Dittrich plugs

END OF THE EXAM