Medical Lab Science Review: Hematology, Chemistry & Urinalysis

MEDICAL LABORATORY SCIENCE 8. SUMMATIVE EXAM REVIEW QUESTIONS #24 + ANSWERS & RATIONALIZATIONS 1. 2. 3. 4. 5. 6. 7. Which of the following hematologic tests may not be part of the usual complete blood count? a. Hematocrit b. Hemoglobin c. Platelet estimate d. Reticulocyte count RBCs appear gray, WBCs are too dark, eosinophil granules are gray, not orange. All are probable causes, EXCEPT: a. Stain or buffer too alkaline b. Inadequate rinsing c. Prolonged staining d. Underbuffering e. Heparinized sample → RBCS appear gray, WBCS are too dark eosinophil granules are gray, not orange are caused by: ▪ Stain or buffer too alkaline (most common) ▪ Inadequate rinsing ▪ Prolonged staining ▪ Heparinized blood sample → RBCS are too pale or are red WBCS are barely visible are caused by: ▪ Stain or buffer too acidic (most common) ▪ Underbuffering (too short) ▪ Over-rinsing RBCs are too pale and or red, WBCs are barely visible. All are probable causes, EXCEPT: a. Stain or buffer too acidic b. Underbuffering c. Over-rinsing d. Heparinized blood sample The bleeding time test is almost always prolonged when the platelet count is: a. <10 × 109/L b. <50 × 109/L c. <100 × 109/L d. >100 × 109/L Which of the following is most likely to activate the alternative pathway of complement activation? a. Lipopolysaccharides b. Glycoproteins c. Haptens d. lgG complexed with antigen Which of the following chemical classes of antigens is most likely to activate the alternative pathway of the complement? a. Proteins b. Lipids c. Polysaccharides d. Haptens A patient’s serum IgA as measured by RID was 40 mg/dL. Another laboratory reported Iaboratory reported IgA absent. A possible explanation for this discrepancy is that the: a. Rabbit antiserum was used in the RID plates b. IgA has an Fc deletion c. IgA antiserum has kappa specificity d. Patient serum has antibodies against a protein inthe antiserum 9. 10. 11. 12. 13. 14. 15. Antibodies to which of the following viral antigens are usually the first to be detected in HIV infection? a. gp120 b. gp160 c. gp41 d. p24 Solution used for direct fecal smear examination: a. Distilled water b. Normal saline solution c. Phosphate buffer d. Tap water Red diamond or fire hazard, classified according to Flash Point: a. A to C b. A to D c. 1 to 10 d. 0 to 4 What is the proper order for putting on protective clothing? a. Gloves first, then gown, mask last b. Gown first, then gloves, mask last c. Gown first, then mask, gloves last d. Mask first, then gown, gloves last What is the correct order for removing protective clothing? a. Gloves, gown, mask b. Gown, gloves, mask c. Gown, mask, gloves d. Mask, gown, gloves Work is being done with Mycobacterium tuberculosis in the microbiology laboratory. It is important that you enter this laboratory while work is being done with positive samples. What is the most important personal protective equipment you should don before entering this laboratory? a. Carbon cartridge respirator b. Mask c. Gloves d. N95 HEPA filter respirator A laboratorian, properly dressed in white pants, laboratory coat, and shoes, prepares to leave the laboratory for lunch. In addition to washing his hands, he should a. Put on safety goggles b. Remove his laboratory coat c. Wipe the bench with water d. Remove polyvinyl gloves and place them into lab coat pocket for future use Which order of events should be followed at the conclusion of a laboratory worker’s shift in order to prevent the spread of bloodborne pathogens? a. Remove gloves, disinfect area, wash hands, remove lab coat b. Disinfect area, remove gloves, remove lab coat, wash hands c. Disinfect area, remove gloves, wash hands, remove lab coat d. Remove gloves, wash hands, remove lab coat, disinfect area 1 16. An employee who accidently spills acid on his arm should immediately: a. Neutralize the acid with a base b. Hold the arm under running water for 15 minutes c. Consult the MSDSs d. Wrap the arm in gauze and go to the emergency room 17. More than 66% of filtered water, sodium, and chloride and 100% of filtered glucose, amino acids, and proteins are reabsorbed in the: a. Collecting tubules b. Distal tubules c. Loops of Henle d. Proximal tubules 18. Water reabsorption occurs throughout the nephron EXCEPT in the: a. Cortical collecting tubules b. Proximal convoluted tubules c. Ascending limb of the loops of Henle d. Descending limb of the loops of Henle 19. Antidiuretic hormone regulates the reabsorption of: a. Water in the collecting tubules b. Sodium in the collecting tubules c. Sodium in the distal convoluted tubule d. Water and sodium in the loop of Henle 20. The final concentration of the urine is determined within the: a. Collecting ducts b. Distal convoluted tubules c. Loops of Henle d. Proximal convoluted tubules 21. Evaluation of polyuria: a. Culture b. Routine urinalysis c. Urine osmolality d. Urine protein 22. Which of the following is the urine specimen of choice for cytology studies? a. First morning specimen b. Random specimen c. Midstream “clean catch” collection d. Timed collection 23. Substances that show diurnal variation in their urinary excretion pattern are best evaluated using: a. First morning specimen b. Midstream “clean catch” specimen c. Random specimen d. Timed collection 24. If refrigeration is used to preserve a urine specimen, which of the following may occur? a. Cellular or bacterial glycolysis will be enhanced b. Formed elements will be destroyed c. Amorphous crystals may precipitate d. Bacteria will proliferate 25. In what circumstance might a sediment be slightly warmed prior to microscopic examination? a. To hemolyze RBCs b. To dissolve amorphous urates c. To increase the specific gravity d. To correct for temperature in determining the specific gravity 26. The clarity of a well-mixed urine specimen that has visible particulate matter and through which newsprint can be seen but not read should be described as: a. Cloudy b. Flocculated c. Slightly cloudy d. Turbid 27. Specimens from patients receiving treatment for urinary tract infections frequently appear: a. Clear and red b. Viscous and orange c. Dilute and pale yellow d. Cloudy and red 28. A fresh brown urine may indicate: a. Acute pyelonephritis b. Cystitis c. Glomerular bleeding d. Nephrotic syndrome 29. 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 30. The double-indicator system used by commercial reagent strips to determine urine pH uses which two indicator dyes? a. Methyl orange and bromphenol blue b. Methyl red and bromthymol blue c. Phenol red and thymol blue d. Phenolphthalein and litmus 31. A urine specimen with a pH of 9.0: a. Is indicative of metabolic acidosis b. Should be recollected c. May contain calcium oxalate crystals d. Is seen after drinking cranberry juice → The pH of freshly excreted urine does not reach above 8.5 in normal or abnormal conditions. A pH above 8.5 is associated with an improperly preserved specimen and indicates that a fresh specimen should be obtained to ensure the validity of the analysis. 32. Which of the following proteins originates in the urinary tract? a. Albumin b. Bence Jones protein c. β2-Microglobulin d. Uromodulin 33. The most significant reagent strip test that is associated with a positive ketone result is: a. Glucose b. Protein c. pH d. Specific gravity 34. Incorporation of the indicator bromthymol blue on the reagent pad measures the change in pH. a. Ketone b. Protein c. Specific gravity d. Urobilinogen 2 35. Indicators change color even though the pH of the reagent remains constant: a. pH b. Specific gravity c. Protein d. None of these 36. Positive urine blood reagent pad: a. Degrees of tan b. Red to brown c. Yellow to orange d. Green to blue 37. A speckled pattern on the blood pad of the reagent strip indicates: a. Hematuria b. Hemoglobinuria c. Myoglobinuria d. All of the above 38. Uniform blue color on the blood pad of the reagent strip: 1. Hematuria 2. Hemoglobinuria 3. Myoglobinuria 39. 40. 41. 42. 43. a. 1 only b. 1 and 2 c. 2 and 3 d. 1, 2 and 3 One (1) Ehrlich unit is equivalent to: a. 1 mg/mL b. 1 mg/dL c. 10 mg/dL d. 10 g/dL Positive for the Greiss reaction: a. Candida albicans b. Escherichia coli c. Neisseria gonorrhoeae d. Staphylococccus saprophyticus A positive nitrite test and a negative leukocyte esterase test is an indication of a: a. Dilute random specimen b. Specimen with lysed leukocytes c. Vaginal yeast infection d. Specimen older than 2 hours Bence Jones protein coagulates at ______ and dissolve at ___. a. 40 to 60 °C; 100 °C b. 60 to 80 °C; 100 °C c. 100 °C; 40 to 60 °C d. 100 °C; 60 to 80 °C 1+ in Benedict’s test: a. Blue b. Green c. Orange d. Yellow → Benedict’s Qualitative Test: ▪ Negative = Blue ▪ 1+ = Green and indicates less than 0.5% sugar ▪ 2+ = Olive green (yellow to green) indicates 0.5 to 1% sugar ▪ 3+ = Yellow indicates 1 to 2% sugar ▪ 4+ = Orange or red precipitate and indicates more than 2% 44. All are components of the Clinitest tablets, EXCEPT: a. Copper sulfate b. Lactose c. Sodium carbonate d. Sodium hydroxide → The Clinitest Tablets contain copper sulfate, sodium carbonate, sodium citrate, and sodium hydroxide. 45. Component of the Acetest tablet: a. Copper sulfate b. Lactose c. Sodium carbonate d. Sodium hydroxide → The Acetest Tablet Test has been used as a confirmatory test for questionable reagent strip results; however, it was primarily used for testing serum and other bodily fluids and dilutions of these fluids for severe ketosis. It provides sodium nitroprusside, glycine, disodium phosphate, and lactose in tablet form. 46. The observation of broad casts represents: a. Destruction of tubular walls b. Dehydration and high fever c. Formation in the collecting ducts d. Both A and C 47. Broad and waxy casts are most likely associated with: a. Nephrotic syndrome b. Chronic renal failure c. Focal segmental glomerulosclerosis d. Acute renal failure 48. The primary component of urinary mucus is: a. Bence Jones protein b. Microalbumin c. Tamm-Horsfall protein d. Orthostatic protein 49. Highly refractile spheres, usually with a dimpled center: a. Hair fibers b. Oil droplets c. Pollen grains d. Starch granules 50. Urine screening tests for PKU utilize: a. Microbial inhibition b. Nitroso-napthol c. Dinitrophenylhydrazine d. Ferric chloride 3