MEDICAL LABORATORY SCIENCE SUMMATIVE EXAM REVIEW QUESTIONS #25 + ANSWERS & RATIONALIZATIONS 1. 2. 3. 4. 5. 6. 7. 8. 9. Blue diaper syndrome is associated with: a. Lesch-Nyhan syndrome b. Phenylketonuria c. Cystinuria d. Hartnup disease An unknown fluid can be positively identified as CSF by determining the: a. Lactate concentration b. Albumin concentration c. Presence of oligoclonal banding on electrophoresis d. Presence of carbohydrate-deficient transferrin on electrophoresis CSF can be differentiated from plasma by the presence of: a. Albumin b. Globulin c. Prealbumin d. Tau transferrin CSF cell count should be performed immediately, because WBCs particularly granulocytes) and RBCs begin to lyse within: a. 1 hour b. 2 hours c. 3 hours d. 4 hours → Any cell count should be performed immediately, because WBCs (particularly granulocytes) and RBCs begin to lyse within 1 hour, with 40% of the leukocytes disintegrating after 2 hours. → Specimens that cannot be analyzed immediately should be refrigerated. Normal synovial fluid WBC count: a. Less than 20/µL b. Less than 200/µL c. Less than 800/µL d. Less than 2,000/µL The normal sperm concentration is: a. Below 20 million per microliter b. Above 20 million per milliliter c. Below 20 million per milliliter d. Above 20 million per microliter The normal sperm count is: a. Below 20 million per milliliter b. Above 20 million per milliliter c. Below 40 million per ejaculate d. Above 40 million per ejaculate The purpose of the acrosomal cap is: a. Ovum penetration b. Protection of the nucleus c. Energy for tail movement d. Protection of the neckpiece The sperm part containing a mitochondrial sheath is the: a. Head b. Neckpiece c. Midpiece d. Tail 10. All of the following are associated with sperm motility EXCEPT the: a. Head → for ovum penetration b. Neckpiece c. Midpiece d. Tail 11. Sperms exhibit no forward progression: a. 0 b. 1.0 c. 3.0 d. 4.0 12. Slow forward progression, noticeable lateral movement: a. a b. b c. c d. d 13. Computer-Assisted Semen Analysis (CASA): 1. Sperm velocity 2. Sperm trajectory 3. Sperm morphology 4. Sperm concentration 14. 15. 16. 17. 18. 19. a. 1 and 2 b. 3 and 4 c. 1, 2 and 3 d. 1, 2, 3 and 4 Measurement of bilirubin in amniotic fluid: a. Agglutination b. Fluorometry c. Spectrophotometry d. Turbidimetry Liley graph Zone 2: a. Not affected fetus b. Mildly affected fetus c. Moderate hemolysis and require careful monitoring anticipating an early delivery or exchange transfusion upon delivery d. Severe hemolysis and suggests a severely affected fetus. Intervention through induction of labor or intrauterine exchange transfusion must be considered In the foam or shake test, amniotic fluid is mixed with: a. 1% NaOH b. 3% acetic acid c. 70% ethanol d. 95% ethanol Which of the following substances is responsible for the characteristic color of normal feces? a. Bilirubin b. Hemoglobin c. Urobilin d. Urobilinogen Which of the following substances is not a component of normal feces? a. Bacteria b. Blood c. Electrolytes d. Water The term “occult” blood describes blood that: a. Is produced in the lower GI tract b. Is produced in the upper GI tract c. Is not visibly apparent in the stool specimen d. Produces a black, tarry stool 1 20. Tests for the detection of “occult” blood rely on the: a. Reaction of hemoglobin with hydrogen peroxide b. Pseudoperoxidase activity of hemoglobin c. Reaction of hemoglobin with ortho-tolidine d. Pseudoperoxidase activity of hydrogen peroxide 21. Direct fat stain: a. 10% alcoholic eosin b. 1% sodium hydroxide c. Sudan III in 95% ethanol d. Sudan III, acetic acid and heat 22. Number of orange-red fat droplets in direct fat stain indicative of steatorrhea: a. Greater than 10/hpf b. Greater than 50/hpf c. Greater than 60/hpf d. Greater than 100/hpf 23. Normal neutral fats with increased amount of fatty acids: a. Malabsorption b. Maldigestion c. Both of these d. None of these 24. Reagent for the APT test: a. Hydrochloric acid b. Potassium hydroxide c. Sodium hydroxide d. Sulfuric acid 25. Normal stool pH: a. pH 4 to 5 b. pH 5 to 6 c. pH 6 to 7 d. pH 7 to 8 26. Factors needed in the computation using CockroftGault formula, except: a. Age b. Plasma creatinine c. 24 hour urine d. Body weight 27. Which of the tubules is impermeable to water? a. PCT b. Descending loop of Henle c. Ascending loop of Henle d. DCT e. Sodium and osmolality 28. What is the normal odor of urine? a. Ammoniacal b. Fragrant c. Fruity d. Woody 29. Which of the following is seen in a normal urine a. Nitrite b. Calcium c. Urobilinogen → present in small amounts d. Protein 30. All of the following are normal crystals seen in acidic urine, EXCEPT: a. Uric acid b. Amorphous urates c. Cystine d. Calcium oxalate 31. The following are normal crystals seen in alkaline urine, EXCEPT: a. Amorphous phosphate b. Triple phosphate c. Calcium phosphate d. Leucine crystal 32. Many uric acid crystals in a pediatric urine spx may indicate: a. Hurler syndrome b. Lesch-Nyhan diseasae c. Melituria d. Sanfilippo syndrome 33. On what tube will you perform CSF VDRL? a. Tube 1 b. Tube 2 and 3 c. Tube 3 and 4 d. Tube 2 34. Cultures of peritoneal fluid are incubated: a. Aerobically b. Anaerobically c. At 37°C and 42°C d. Both A and B 35. 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 36. Which of the following can be mistaken as myelin globules in sputum? a. Blastomyces b. Cryptococcus c. Histoplasma d. Candida 37. Which of the following may resemble lymphocytes in CSF? a. Blastomyces b. Cryptococcus c. Histoplasma d. Candida 38. Larva in sputum: a. Ascaris b. Paragonimus c. Both of these d. None of these 39. Ova (eggs) in sputum a. Ascaris b. Paragonimus c. Both of these d. None of these 40. Formed elements in sputum are best studied by cytological techniques? a. Gram stain b. Giemsa stain c. Wright’s stain d. Pap’s stain 41. Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids: a. When malignancy is suspected b. To classify transudates and exudates c. To determine the type of serous fluid d. When a traumatic tap has occurred 2 42. The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the: a. Fluid:serum albumin ratio b. Serum:ascites albumin gradient c. Fluid:serum lactic dehydrogenase ratio d. Absolute neutrophil count 43. iQ 200 preclassifies (autoclassified by the analyzer) the following urine particles EXCEPT: a. Nonsquamous epithelial cells b. Unclassified casts c. Bacteria d. Uric acid crystals 44. Which of the following urine sediment particles cannot be autovalidated but will be flagged and must be reviewed by laboratory personnel? a. RBCs b. WBCs c. RTEs d. Squamous epithelial cells 45. Inability to digest the gelatin in the X-ray film test a deficiency in ____ production a. Elastase b. Gastrin c. Pepsin d. Trypsin 46. Which test is most sensitive and specific enzyme in detecting persons with chronic pancreatitis? a. Fecal trypsin b. Fecal chymotrypsin c. Fecal elastase d. Plasma lipase 47. All of the following can affect sperm count, except: a. Smoking b. Drugs of abuse c. Alcohol d. Caffeine 48. Which of the following substances will cause urine to produce red fluorescence when examined with a UV lamp (360 nm) a. Myoglobulin b. Porphobilinogen (PBG) c. Urobilin d. Coproporphyrin 49. When performing a sperm concentration 60 sperm are count 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. The: a. Specimen should be rediluted and counted b. Sperm count is 75 million/mL c. Sperm count is greater than 5 M/mL d. Sperm concentration is abnormal 50. If 5 round cells per 100 sperm are counted in a sperm morphology smear and the sperm concentration is 30 million, the concentration of round cells is: a. 150,000 b. 1.5 million c. 300,000 d. 15 million → Solution: 3