Medical Lab Science: Review & Answers

MEDICAL LABORATORY SCIENCE SUMMATIVE EXAM REVIEW QUESTIONS #10 + ANSWERS & RATIONALIZATIONS 1. 2. 3. 4. 5. 6. 7. 8. 9. Normal synovial fluid will be able to form ___ cm string. a. 1 to 2 cm b. 2 to 3 cm c. 3 to 4 cm d. 4 to 6 cm Hyaluronate polymerization can be measured using a Ropes, or Mucin Clot Test. When added to a solution of 2% to 5% acetic acid, normal synovial fluid forms: a. No clot b. Friable clot c. Soft clot d. Solid clot surrounded by clear fluid Before testing, very viscous synovial fluid should be treated with: a. Normal saline b. Hyaluronidase c. Distilled water d. Hypotonic saline 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 Synovial fluid WBC count of 800/µL: a. Non-inflammatory → <1,000/uL b. Immunologic → 2,000 to 75,000/uL c. Crystal-induced → 100,000/uL d. Septic → 50,000 to 100,000/uL e. Hemorrhagic → equal to blood → Note: WBC count <200 cells/µL are considered normal. Fragments of degenerating proliferative synovial cells or microinfarcted synovium: a. Ragocytes → RE cell; w/ dark cytoplasmic granules b. Reiter cells → phagocytosed one or more neutrophils c. Rice bodies d. Ochronotic shards Pepper-like particles are pieces of pigmented cartilage that has eroded and broken loose into the fluid. a. Reiter cells b. Ragocytes c. Rice bodies d. Ochronotic shards Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are: a. Monosodium urate → uric acid b. Cholesterol c. Calcium pyrophosphate d. Apatite Normal synovial fluid glucose values are based on the blood glucose level, simultaneous blood and synovial fluid samples should be obtained, preferably after the patient has fasted for ___ hours to allow equilibration between the two fluid. a. 6 hours b. 8 hours c. 10 hours d. 12 hours 10. Normal synovial fluid glucose should: a. Same as blood glucose value b. More than 5 mg/dL lower than the blood value c. More than 10 mg/dL lower than the blood value d. Not be more than 10 mg/dL lower than the blood value 11. Normal synovial fluid protein: a. Less than 10 g/dL of protein b. More than 10 g/dL of protein c. Less than 3 g/dL of protein d. More than 3 g/dL of protein 12. The uric acid concentration in synovial fluid is ___ to that in blood plasma. a. Higher b. Lower c. Equivalent d. Variable 13. What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses? a. Fetal cell metabolism b. Fetal swallowing c. Fetal urine d. Transfer of water across the placenta 14. Portion of the amniotic fluid arises from all of the following, EXCEPT: a. Fetal urine b. Fetal respiratory tract c. Amniotic membrane d. Umbilical cord e. Bone marrow 15. Family history of chromosome abnormalities, such as trisomy 21 (Down syndrome), amniocentesis may be indicated at: a. 1 to 14 weeks b. 15 to 18 weeks → test for genetic/ developmental defects c. 20 to 42 weeks → test for fetal lung maturity, hemolytic disease d. Any of these 16. The amount of amniotic fluid increases in quantity throughout pregnancy, reaching a peak of approximately ______ mL during the third trimester, and then gradually decreases prior to delivery. a. 400 to 800 mL b. 800 mL to 1,200 mL c. 1,200 to 1,500 mL d. 2,000 to 4, 000 mL 17. A maximum of ___ mL of amniotic fluid is collected in sterile syringes. a. 5 mL b. 10 mL c. 20 mL d. 30 mL 18. 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? a. AFP levels b. Foam stability index c. Lecithin/sphingomyelin ratio d. Phosphatidyl glycerol detection 1 19. In the foam or shake test, amniotic fluid is mixed with: a. 1% NaOH b. 3% acetic acid c. 70% ethanol d. 95% ethanol 20. A rapid test for FLM that does not require performance of thin-layer chromatography is: a. AFP levels b. Amniotic acetylcholinesterase c. Aminostat-FLM d. Bilirubin scan 21. The presence of phosphatidyl glycerol in amniotic fluid fetal lung maturity tests must be confirmed when: a. Hemolytic disease of the newborn is present b. The mother has diabetes c. Amniotic fluid is contaminated by hemoglobin d. Neural tube disorder is suspected 22. Microviscosity of amniotic fluid is measured by: a. Thin-layer chromatography b. Immunologic agglutination c. Spectrophotometer d. Fluorescence polarization 23. O.D. 650 a. Acetylcholinesterase b. Bilirubin → 450 nm c. Lamellar bodies → 650 nm d. Oxyhemoglobin → 410 nm 24. Amniotic fluid for OD 650: a. Addition of ethanol b. Addition of methanol c. Centrifuged at 2000 g for 10 minutes d. Mix the sample by gentle inversion or by placing the test tube on a tube rocker 25. Method for counting lamellar bodies: a. Densitometry b. Flow cytometry c. Impedance d. Radiofrequency 26. Amniotic fluid for lamellar body count: a. Addition of ethanol b. Addition of methanol c. Centrifuged at 2000 g for 10 minutes d. Mix the sample by gentle inversion or by placing the test tube on a tube rocker 27. Bacterial, viral, and protozoan infections produce increased secretion of water and electrolytes, which override the reabsorptive ability of the large intestine, leading to: a. Osmotic diarrhea b. Secretory diarrhea c. Either of these d. None of these 28. Maldigestion (impaired food digestion) and malabsorption (impaired nutrient absorption by the intestine) contribute to: a. Osmotic diarrhea b. Secretory diarrhea c. Either of these d. None of these 29. The brown color of the feces results from intestinal oxidation of stercobilinogen to ______. a. Bilirubin b. Blood c. Urobilinogen d. Urobilin 30. A pale, frothy stool is indicative of which of the following? a. Barium testing b. Osmotic diarrhea c. Steatorrhea d. Excess carbohydrates 31. Stool specimens that appear ribbon-like are indicative of which condition? a. Bile-duct obstruction b. Colitis c. Intestinal constriction d. Malignancy 32. The normal composition of feces includes all of the following EXCEPT: a. Bacteria b. Blood c. Electrolytes d. Water 33. By far the most frequently performed fecal analysis is the detection of: a. Carbohydrates b. Fats c. Leukocytes d. Occult blood (hidden blood) 34. Guaiac tests for detecting occult blood rely on the: a. Reaction of hemoglobin with hydrogen peroxide b. Pseudoperoxidase activity of hemoglobin c. Reaction of hemoglobin with ortho-toluidine d. Pseudoperoxidase activity of hydrogen peroxide 35. Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent: a. Cholesterol b. Fatty acids c. Neutral fats d. Soaps 36. Microscopic examination of stools mixed with Sudan III and glacial acetic acid and then heated will show small orange-red droplets that represent: a. Fatty acids and soaps b. Fatty acids and neutral fats c. Fatty acids, soaps, and neutral fats d. Soaps 37. What is the significance of an APT test that remains pink after addition of sodium hydroxide? a. Fecal fat is present b. Fetal hemoglobin is present c. Fecal trypsin is present d. Vitamin C is present → APT Test ▪ Fetal hemoglobin = pink after addition of NaOH ▪ Maternal blood = yellow brown supernatant 38. Liquefaction of a semen specimen should take place within: a. 1 hour b. 2 hours c. 3 hours d. 4 hours 2 39. Sperm motility evaluations are performed: a. Immediately after the specimen is collected b. Within 1 hour of collection c. After 3 hours of incubation d. At 6-hour intervals for 1 day 40. The percentage of sperm showing average motility that is considered normal is: a. 25% b. 50% c. 60% d. 75% 41. Failure of laboratory personnel to document the time a semen sample is collected primarily affects the interpretation of semen: a. Appearance b. Volume c. pH d. Viscosity 42. Location of sperm nucleus: a. No nucleus b. Head c. Neck d. Tail 43. The purpose of the acrosomal cap is to: a. Penetrate the ovum b. Protect the nucleus c. Create energy for tail movement d. Protect the neckpiece 44. Measurement of α-glucosidase is performed to detect a disorder of the: a. Seminiferous tubules b. Epididymis c. Prostate gland d. Bulbourethral glands 45. Follow-up testing for a low sperm concentration would include testing for: a. Antisperm antibodies b. Seminal fluid fructose c. Sperm vitality d. Prostatic acid phosphatase 46. Following an abnormal sperm motility test with a normal sperm count, what additional test might be ordered? a. Fructose level b. Zinc level c. MAR test d. Eosin-nigrosin stain 47. Given the following information, calculate the sperm concentration: dilution, 1:10; sperm counted in 25 RBC squares on each side of the hemocytometer, 198 and 202; seminal fluid volume is 4 mL. a. 20 M/mL b. 20 M/ejaculate c. 80 M/mL d. 80 M/ejaculate → Sperm concentration: → 48. Given the following information, calculate the sperm count: dilution, 1:10; sperm counted in 25 RBC squares on each side of the hemocytometer, 198 and 202; seminal fluid volume is 4 mL. a. 20 M/mL b. 20 M/ejaculate c. 80 M/mL d. 80 M/ejaculate → Sperm count = sperm conc. x seminal fluid volume → Solution: = 20 x 4 = 80 M/ejaculate 49. When performing a sperm concentration, 60 sperms are counted in the RBC squares on one side of the hemocytometer and 90 sperms are counted in the RBC squares on the other side. The specimen is diluted 1:20. a. Specimen should be rediluted and counted b. Sperm count is 75 million/mL c. Sperm count is greater than 5 million/mL d. Sperm concentration is abnormal 50. For postvasectomy semen analysis, specimens are routinely tested: a. Beginning at 1 month postvasectomy and continuing until two consecutive monthly specimens show no spermatozoa. b. Beginning at 2 months postvasectomy and continuing until two consecutive monthly specimens show no spermatozoa. c. Beginning at 2 months postvasectomy and continuing until three consecutive monthly specimens show no spermatozoa. d. Beginning at 3 months postvasectomy and continuing until three consecutive monthly specimens show no spermatozoa. Multiplied by 1,000 to convert µL to mL. Solution: = [ (200 x 10) / (1 x 0.1) ] x 1000 = 20,000 x 1.000 = 20 M/mL 3