Urinalysis and Body Fluids 11/2022

Strasinger/Di Lorenzo - 6th Edition

CHAPTER 1 - SAFETY AND QUALITY ASSESSMENT 10. Centrifuging an uncapped specimen may produce a
1. In the urinalysis laboratory the primary source in the biologic hazard in the form of:
chain of infection would be: a. Vectors
a. Patients b. Sharps contamination
b. Needle sticks c. Aerosols
c. Specimens d. Specimen contamination
d. Bio-hazardous waste 11. An employee who accidentally spills acid on his arm
2. The best way to break the chain of infection is: should immediately:
a. Hand sanitizing a. Neutralize acid with a base
b. Personal protective equipment b. Hold the arm under running water for 15
c. Aerosol prevention minutes
d. Decontamination c. Consult the MSDSs
3. The current routine infection control policy developed d. Wrap the arm in gauze and go to the emergency
by CDC and followed in all health-care setting is: department
a. Universal precautions 12. When combining acid and water, ensure that:
b. Isolation precautions a. Acid is added to water
c. Blood and body fluid precautions b. Water is added to acid
d. Standard precautions c. They are added simultaneously
4. An employee who is accidentally exposed to a possible d. Water is slowly added to acid
blood-borne pathogen should immediately: 13. An employee can learn the carcinogenic potential of
a. Report to a supervisor potassium chloride by consulting the:
b. Flush the area with water a. Chemical hygiene plan
c. Clean the area with disinfectant b. Material safety data sheets
d. Receive HIV prophylaxis c. OSHA standards
5. Personnel in the urinalysis laboratory should wear lab d. Urinalysis procedure manual
coats that: 14. Employees should not work with radioisotopes if they
a. Do not have buttons a. Wearing contact lenses
b. Are fluid resistant b. Allergic to iodine
c. Have short sleeves c. Sensitive to latex
d. Have full length zippers d. Pregnant
6. All of the following should be discarded in biohazardous 15. All of the following are safe to do when removing the
waste containers except: source of an electric shock except:
a. Urine specimen containers a. Pulling the person away from the instrument
b. Towels used for decontamination b. Turning off the circuit breaker
c. Disposable lab coats c. Using a glass container to move the instrument
d. Blood collection tubes d. Unplugging the instrument
7. An employer who fails to provide sufficient gloves for 16. The acronym PASS refers to:
the employees may be fined by the: a. Presence of vital chemicals
a. CDC b. Operation of a fire extinguisher
b. NFPA c. Labeling of hazardous material
c. OSHA d. Presence of radioactive substances
d. FDA 17. The system used by firefighters when a fire occurs in
8. An acceptable disinfectant for blood and body fluid the laboratory is:
decontamination is: a. MSDS
a. Sodium hydroxide b. RACE
b. Antimicrobial soap c. NFPA
c. Hydrogen peroxide d. PASS
d. Sodium hypochlorite 18. A class ABC fire extinguisher contains:
9. Proper handwashing includes the following except: a. Sand
a. Using warm water b. Water
b. Rubbing to create a lather c. Dry chemicals
c. Rinsing hands in a downward position d. Acids
d. Turning on the water with a paper towel

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Urinalysis and Body Fluids 11/2022
Strasinger/Di Lorenzo - 6th Edition
19. The first thing to do when a fire is discovered is to: 28. As supervisor of the urinalysis laboratory, you have
a. Rescue persons in danger just adopted a new procedure. You should:
b. Activate the alarm system a. Put the package insert in the procedure manual
c. Close door to other areas b. Put a complete, reference procedure in the
d. Extinguish the fire if possible manual
20. If a red rash is observed after removing gloves, the c. Notify the microbiology department
employee: d. Put a cost analysis study in the procedure
a. May be washing her hands too often manual
b. May have developed a latex allergy 29. Pre-examination (1)
c. Should apply cortisone cream Examination(2)
d. Should not rub the hands so vigorously Post- examination(3)
21. Pipetting by mouth is:
a. Acceptable for urine but not serum 2 Reagent expiration date
b. Not acceptable without proper training 1 rejecting a contaminated specimen
c. Acceptable for reagents but not specimens 2 constructing a Levy-Jennings chart
d. Not acceptable in the laboratory 3 Telephoning a (+) Clinitest result on a newborn
22. The NFPA classification symbol contains information 2 Calibrating the centrifuge
on all of the following except: 1 Collecting a timed urine specimen
a. Fire hazards 30. The testing of sample from an outside agency and the
b. Biohazards comparison of results with participating laboratories is
c. Reactivity called:
d. Health hazards a. External QC
23. The classification of a fire that can be extinguished b. Electronic QC
with water is: c. Internal QC
a. Class A d. Proficiency testing
b. Class B 31. A color change that indicates that a sufficient amount
c. Class C of patient’s specimen or reagent is added correctly to the
d. Class D test system would be an example of:
24. Employees are required to provide free immunization a. External QC
for: b. Electronic QC
a. HIV c. Internal QC
b. HTLV-1 d. Proficiency testing
c. HBV 32. What steps are taken when the results of reagent
d. HCV strip QC are outside of the stated confidence limits?
25. A possible-physical hazard in the hospital is: a. Check the expiration date of the reagent strip
a. Wearing close-toed shoes b. Run a new control
b. Not wearing jewelry c. Open a new reagent strip container
c. Having short hair d. All of the above
d. Running to answer the telephone 33. When a new bottle of QC material is opened. What
26. Quality assessment refers to: information is placed on the label?
a. Analysis of testing controls a. The supervisor’s initials
b. Increased productivity b. The lot number
c. Precise control results c. The date and the laboratory workers initials
d. Quality of specimens and patient care d. The time the bottle was opened
27. During laboratory accreditation inspections, 34. When a control is run, what information is
procedure manuals are examined for the presence of: documented?
a. Critical values a. The lot number
b. Procedure references b. Expiration date of the control
c. Procedures for specimen preservation c. The test results
d. All of the above d. All of the above

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Urinalysis and Body Fluids 11/2022
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CHAPTER 2 - INTRODUCTION TO URINALYSIS 44. For general screening the most frequently collected
35. The average daily output of urine is: urine is a:
a. 200 mL a. Random
b. 500 mL b. First morning
c. 1200 mL c. Midstream clean-catch
d. 2500 mL d. Timed
36. An unidentified fluid is received in the laboratory with 45. The primary advantage of a first-morning urine
a request to determine whether the fluid is urine or specimen over a random specimen is that it:
another body fluid. Using urine laboratory tests, what test a. Is less contaminated
would determine that the fluid is most probably urine? b. Is more concentrated
a. Glucose and ketones c. Is less concentrated
b. Urea and creatinine d. Has a higher volume
c. Uric acid and amino acids 46. If a routine urinalysis and a culture are requested on
d. Protein and amino acids a catheterized specimen, then:
37. The primary inorganic substance found in urine is: a. Two separate containers must be selected
a. Sodium b. The routine urinalysis is performed firs t
b. Phosphate c. The patient must be recatheterized
c. Chloride d. The culture is performed first
d. Calcium 47. If a patient fails to discard the first specimen when
38. A patient presenting with polyuria, nocturia, collecting a timed specimen the:
polydipsia, and a low urine specific gravity is exhibiting a. Specimen must be recollected
symptoms of: b. Results will be falsely elevated
a. Diabetes insipidus c. Results will be falsely decreased
b. Diabetes mellitus d. Both A and B
c. Urinary tract infection 48. The primary cause of unsatisfactory results in an
d. Uremia unpreserved routine specimen not tested for 8 hrs is:
39. A patient with oliguria might progress to having: a. Bacterial growth
a. Nocturia b. Glycolysis
b. Polyuria c. Decreased pH
c. Polydipsia d. Chemical oxidation
d. Anuria 49. Prolonged exposure of a preserved urine specimen to
40. All of the following are characteristics of light will cause:
recommended containers except: a. Decrease glucose
a. A flat bottom b. Increase cells and casts
b. A capacity of 50mL c. Decreased bilirubin
c. A snap-on lid d. Increased bacteria
d. Are disposable 50. Which of the following would be least affected in a
41. Labels for urine containers are: specimen that has remained unpreserved at room
a. Attached to the container temperature for more than 2 hours?
b. Attached to the lid a. Urobilinogen
c. Placed on the container prior to collection b. Ketones
d. Not detectable c. Protein
42. A urine specimen may be rejected by the laboratory d. Nitrite
for all of the following reasons except the fact that the: 51. Bacterial growth in an unpreserved specimen will:
a. Requisition states the specimen is catheterized a. Decrease clarity
b. Specimen contains toilet paper b. Increase bilirubin
c. Label and requisition do not match c. Decrease pH
d. Outside of the container has fecal material d. Increase glucose
contamination 52. The most sterile specimen collected is a:
43. A cloudy specimen received in the laboratory may a. Catheterized
have been preserved using: b. Midstream clean-catch
a. Boric acid c. Refrigeration c. Three glass
b. Chloroform d. formalin d. Suprapubic

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54. Which of the following would not be given to a 62. Secretion of renin is stimulated by:
patient prior to the collection of a midstream clean-catch a. Juxtaglomerular cells
specimen? b. Angiotensin I and II
a. Sterile container c. Macula densa cells
b. Iodine cleanser d. Circulating angiotensin-converting enzyme
c. Antiseptic towelette 63. The hormone aldosterone is responsible for:
d. Instructions a. Hydrogen ion secretion
55. Urine specimen collection for drug testing requires b. Potassium secretion
the collector to do all of the following, except: c. Chloride-retention
a. Inspect the specimen color d. Sodium retention
b. Perform reagent strip testing 64. The fluid leaving the glomerulus has a specific gravity
c. Read the specimen temperature of:
d. Fill out a chain-of-custody form a. 1.005
b. 1.010
CHAPTER 3 - RENAL FUNCTION c. 1.015
56. The type of nephron responsible for renal d. 1.020
concentration is the: 65. For active transport to occur, a chemical:
a. Cortical a. Must combine with a carrier protein to create
b. Juxtaglomerular electrochemical energy
57. The function of the peritubular capillaries is: b. Must be filtered through the proximal
a. Reabsorption convoluted tubule
b. Filtration c. Must be in higher concentration in the filtrate
c. Secretion than in the blood
d. Both A and C d. Must be in higher concentration in the blood
58. Blood flows through the nephron in the following than in the filtrate
order: 66. Which of the tubules is impermeable to water?
a. Efferent areteriole,peritubular capillaries, vasa a. Proximal convoluted tubule
recta, afferent arteriole b. Descending loop of henle
b. Peritubular capillaries,afferent arteriole,vasa c. Ascending loop of henle
recta,efferent arteriole d. Distal convoluted tubule
c. Afferent arteriole,peritubular capillaries,vasa 67. Glucose will appear in the urine when the:
recta, efferent arteriole a. Blood level of glucose is 200mg/dL
d. Efferent arteriole, vasa recta, peritubular b. Tm for glucose is exceeded
capillaries, afferent arteriole c. Renal threshold for glucose is exceeded
59. Filtration of protein is prevented in the glomerulus d. All of the above
by: 68. Concentration of the tubular filtrate by the
a. Hydrostatic pressure countercurrent mechanism depends on all of the following
b. Oncotic pressure except:
c. Renin a. High salt concentration in the medulla
d. Glomerular filtration barrier b. Water impermeable walls of the ascending loop
60. The renin-angiotensin-aldosterone system is of henle
responsible for all of the following except: c. Reabsorption of Sodium and Chloride from the
a. Vasoconstriction of the afferent arteriole ascending loop of henle
b. Vasoconstriction of the efferent arteriole d. Reabsorption of water in the descending loop
c. Reabsorbing sodium of henle
d. Releasing aldosterone 69. ADH regulates the final urine concentration by
61. The primary chemical affected by the controlling:
renin-angiotensin-aldosterone system is: a. Active reabsorption of Sodium
a. Chloride b. Tubular permeability
b. Sodium c. Passive reabsorption of urea
c. Potassium d. Passive reabsorption of Chloride
d. Hydrogen

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Urinalysis and Body Fluids 11/2022
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70. Decreased production of ADH: 78. Variables that are included in the MDRD-IDSM
a. Produces low urine volume estimated creatinine clearance calculations include all of
b. Produces high urine volume the following except:
c. Increases ammonia excretion a. Serum creatinine
d. Affects active transport of sodium b. Weight
71. Bicarbonate ions filtered by the glomerulus are c. Age
returned to the blood: d. Gender
a. In the proximal convoluted tubule 79. An advantage to using Cystatin C to monitor GFR is that:
b. Combined with hydrogen ions a. It does not require urine collection
c. By tubular secretion b. It is not secreted by the tubules
d. All of the above c. It can be measured by immunoassay
72. If ammonia is not produced by the distal convoluted d. All of the above
tubule, the urine pH will be: 80. Solute dissolved in solvent will:
a. Acidic a. Raise the vapor pressure
b. Basic b. Lower the boiling point
73. Place the appropriate letter in front of the following c. Decrease the osmotic pressure
clearance substances: A. Exogenous B. Endogenous d. Lower the freezing point
81. Substances that may interfere with freezing point
___ beta-2-microglobulin measurement of urine and serum osmolarity include all of
___creatinine the following except:
___cystatin C a. Ethanol
___ 125-I-iothalmate b. Lactic acid
c. Sodium
74. The largest source of error in creatinine clearance d. Lipids
tests is: 82. Clinical osmometers use NaCl as a reference solution
a. Secretion of creatinine because:
b. Improperly timed urine specimen a. 1 g molecular weight of NaCl will lower the
c. Refrigeration of urine freezing point 1.86ºC
d. Time of collecting blood sample b. NaCl is readily frozen
75. Given the following information, calculate the c. NaCl is partially ionized similar to the
creatinine clearance: composition of urine
24hr urine volume: 1000mL d. 1 g equivalent weight of NaCl will raise the
Serum creatinine: 2.0mg/dL freezing point of 1.86ºC
Urine creatinine: 200mg/dL 83. The normal serum osmolarity is:
a. 50 to 100 mOsm
= 1000ml/1440 = 0.694 b. 275 to 300 mOsm
= (200 x 0.69) / 2.0 = 69 mL/min c. 400 to 500 mOsm
d. 3 times the urine osmolarity
76. Clearance tests used to determine the glomerular 84. After controlled fluid intake, the urine-to-serum
filtration rate must measure substances that are: osmolarity ratio should be atleast:
a. Not filtered by the glomerulus a. 1:1
b. Completely reabsorbed by the proximal b. 2:1
convoluted tubule c. 3:1
c. Secreted in the distal convoluted tubule d. 4:1
d. Neither reabsorbed or secreted by the tubules 85. Calculate the free water clearance from the following
results:
77. Performing a clearance test using radionucleotides: Urine volume in 6 hours: 720mL
a. Eliminates the need to collect urine Urine osmolarity: 225 mOsm
b. Does not require an infusion Plasma osmolarity: 300 mOsm
c. Provides visualization of the filtration
d. Both A and C

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86. To provide an accurate measure of renal blood flow, a 94. Specimens that contain hemoglobin can be visually
test substance should be completely: distinguished from those that contain RBCs because:
a. Filtered by the glomerulus a. Hemoglobin causes a clear, yellow specimen
b. Reabsorbed by the tubules b. Hemoglobin produces a cloudy, pink specimen
c. Secreted when it reaches the distal convoluted c. RBCs produce a cloudy red specimen
tubule d. RBCs produce a clear red specimen
d. Cleared on each contact with functional renal 95. A patient with a viscous orange specimen may have
tissue been
87. Given the following data, calculate the effective renal a. Treated for a urinary tract infection
plasma flow: b. Taking vitamin B pills
Urine volume in 2 hrs: 240 mL c. Eating fresh carrots
Urine PAH: 150 mg/dL d. Taking antidepressants
Plasma PAH: 0/5 mg/dL 96. The presence of a pink precipitate in a refrigerated
88. Renal tubular acidosis can be caused by the: specimen is caused by:
a. Production of excessively acidic urine due to a. Hemoglobin
increased filtration of hydrogen ions b. Urobilin
b. Production of excessively acidic urine due to c. Uroerythrin
increased secretion of hydrogen ions d. Beets
c. Inability to produce an acidic urine due to 97. Microscopic examination of a clear urine that produces
impaired production of ammonia a white precipitate after refrigeration will show:
d. Inability to produce an acidic urine due to a. Amorphous urates
increased production of ammonia b. Porphyrins
89. Tests performed to detect renal tubular acidosis after c. Amorphous phosphates
administering an ammonium chloride load include all of d. Yeast
the following except: 98. The color of urine containing porphyrins will be:
a. Urine ammonia a. Yellow-brown
b. Arterial pH b. Green
c. Urine pH c. Orange
d. Titratable acidity d. Port-wine
~END~ 99. Which of the following specific gravity would be most
likely to correlate with a pale yellow urine?
CHAPTER 4 - PHYSICAL EXAMINATION OF URINE a. 1.005
90. The concentration of a normal urine specimen can be b. 1.010
estimated by which of the following? c. 1.020
a. Color d. 1.030
b. Clarity 100. Which of the following specific gravity measured by a
c. Foam refractometer is 1.029, and the temperature of urine is
d. Odor 14ºC. The specific gravity should be reported as:
91. The normal pale yellow color of urine is produced by: a. 1.023
a. Bilirubin b. 1.027
b. Hemoglobin c. 1.029
c. Urobilinogen d. 1.032
d. Urochrome 101. The principle of refractive index is to compare:
92. Presence of bilirubin in a urine specimen produces a: a. Light velocity in solutions with light velocity in
a. Yellow foam when shaken solids
b. White foam when shaken b. Light velocity in air with light velocity in
c. Cloudy specimen solutions
d. Yellow-red specimen c. Light scattering by air with light scattering by
93. A urine specimen containing melanin will appear: solutions
a. Pale pink d. Light scattering by particles in solution
b. Dark yellow
c. Blue green
d. Black

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102. A correlation exists between a specific gravity by 110. An osmole contains:
refractometer of 1.050 and a: a. One gram molecular weight of solute dissolved
a. 2+ glucose in one liter solvent
b. First morning specimen b. One gram molecular weight of solute dissolved
c. 2+ protein in one kilogram of solvent
d. Radiographic dye infusion c. Two gram molecular weights of solute dissolved
103. A cloudy urine specimen turns black upon standing in one liter solvent
and has a specific gravity of 1.012. The major concern d. Two gram molecular weights of solute dissolved
about this specimen would be: in one kilogram of solvent
a. Color
b. Turbidity 111. The unit of osmolality measured in the clinical
c. Specific gravity laboratory is the:
d. All of the above a. Osmole
104. A specimen with a specific gravity of 1.035 would be b. Milliosmole
considered: c. Molecular weight
a. Isosthenuric d. Ionic charge
b. Hyposthenuric 112. In the reagent strip specific gravity reaction the
c. Hypersthenuric polyelectrolyte:
d. Not urine a. Combines with hydrogen ion in response to ion
105. A specimen with a specific gravity of 1.001 would be concentration
considered: b. Releases hydrogen ion in response to ion
a. Hyposthenuric concentration
b. Not urine c. Releases hydrogen ions in response to pH
c. Hypersthenuric d. Combines with sodium ions in response to pH
d. Isosthenuric 113. Which of the following will react in the reagent strip
106. A strong odor of ammonia in specimen could indicate: specific gravity test?
a. Ketones a. Glucose
b. Normalcy b. Radiographic dye
c. Phenylketonuria c. Protein
d. An old specimen d. Chloride

107. The microscopic of a clear res urine is reported as

many WBCs and epithelial cells. What does this suggest?
a. Urinary tract infection
b. Dilute random specimen
c. Hematuria
d. Possible mix up of specimen and sediment
108. Which of the following would contribute the most to
urine osmolality?
a. One osmole of glucose
b. One osmole of urea
c. One osmole of sodium chloride
d. All contribute equally
109.Which of the following colligative properties is not
stated correctly?
a. The boiling point is raised by solute
b. The freezing point is raised by solute
c. The vapor pressure is lowered by solute
d. The osmotic pressure is raised by solute

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Urinalysis and Body Fluids 11/2022
Strasinger/Di Lorenzo - 6th Edition
CHAPTER 5 - CHEMICAL EXAMINATION OF URINE 123. 1 - Pre- renal 2 - Renal 3 - Post-renal
114. Leaving excess urine on the reagent strip after 2 Microalbuminuria
removing it from the specimen will: 1 Acute phase reactants
a. Cause run-over between reagent pads 2 Pre-eclampsia
b. Alter the color of the specimen 3 Vaginal inflammation
c. Cause specimens to leach from the pads 1 Multiple myeloma
d. Not affect the chemical reactions 2 Orthostatic proteinuria
115. Failure to mix a specimen before inserting the reagent 3 Prostatitis
strip will primarily affect the:
a. Glucose reading 124. The principle of the protein error of indicators
b. Blood reading reaction is that:
c. Leukocyte reading a. Protein keeps the pH of the urine constant
d. Both B and C b. Albumin accepts hydrogen ions from the
116. Testing a refrigerated specimen that has not warmed indicator
to room temperature will adversely affect: c. The indicator accepts hydrogen ions from the
a. Enzymatic reactions albumin
b. Dye-binding reactions d. Albumin changes the pH of the urine
c. Sodium nitroprusside reaction 125. All of the following will cause false-positive protein
d. Diazo reaction reagent strip values except:
117. The reagent strip reaction that requires the longest a. Microalbuminuria
reaction time is the: b. Highly buffered alkaline urines
a. Bilirubin c. Delay in removing the reagent strip from the
b. pH specimen
c. Leukocyte esterase d. Contamination by quaternary ammonium
d. Glucose compounds
118. Quality control reagent strips is performed: 126. A patient with a 2+ protein reading in the afternoon is
a. Using positive and negative controls asked to submit a first morning specimen. The second
b. When results are questionable specimen has a negative protein reading. This patient is:
c. Atleast once every 24 hours a. Positive for orthostatic proteinuria
d. All of the above b. Negative for orthostatic proteinuria
119. All of the following are important to protect the c. Positive for Bence Jones protein
integrity of reagent strips except: d. Negative for clinical proteinuria
a. Removing the desiccant from the bottle 127. Testing for microalbuminuria is valuable for early
b. Storing in an opaque bottle detection of kidney disease and monitoring patients with:
c. Storing at room temperature a. Hypertension
d. Resealing the bottle after removing a strip b. Diabetes mellitus
120. The principle of the reagent strip test for pH is the: c. Cardiovascular disease risk
a. Protein error of indicators d. All of the above
b. Greiss reaction 128. The primary chemical on the reagent strip in the
c. Dissociation of polyelectrolyte Micral test for microalbumin binds to:
d. Double indicator reaction a. Protein
121. A urine specimen with a pH of 9.0: b. Antihuman albumin antibody
a. Indicates metabollic acidosis c. Conjugated enzyme
b. Should be recollected d. Galactosidase
c. May contain calcium oxalate crystals 129. All of the following are true for the ImmunoDip test
d. Is seen after drinking cranberry juice for microalbumin except:
122. In the laboratory, a primary consideration associated a. Unbound antibody migrates farther than bound
with pH is: antibody
a. Identifying urinary crystals b. Blue latex particles are coated with antihuman
b. Monitoring vegetarian diets albumin antibody
c. Determining specimen acceptability c. Bound antibody migrates further than unbound
d. Both A and C antibody
d. It utilizes an immunochromatographic principle

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130. The principle of the protein-high pad on the Multistix 139. The three intermediate products of fat metabolism
Pro reagent strip is the: include all of the following except:
a. Diazo reaction a. Acetoacetic acid
b. Enzymatic dye-binding reaction b. Ketoacetic acid
c. Protein error of indicators c. β-hydroxybutyric acid
d. Microalbumin-micral test d. Acetone
131. Which of the following is not tested on the Multistix 140. The most significant reagent strip test that is
Pro reagent strip? associated with a positive ketone result is:
a. Urobilinogen a. Glucose
b. Specific gravity b. Protein
c. Creatinine c. pH
d. Protein-high d. Specific gravity
132. The principle of the protein-low reagent pad on the 141. The primary reagent in the reagent strip test for
Multistix Pro is the: ketones is:
a. Binding of albumin to sulphonaphthalein dye a. Glycine
b. Immunologic binding of albumin to antibody b. Lactose
c. Reverse protein error of indicators reaction c. Sodium hydroxide
d. Enzymatic reaction between albumin and dye d. Sodium nitroprusside
133. The principle of the creatinine reagent pad on 142. Ketonuria may be caused by all of the following
microalbumin reagent strips is the: except:
a. Double indicator reaction a. Bacterial infections
b. Diazo reaction b. Diabetic acidosis
c. Pseudoperoxidase reaction c. Starvation
d. Reduction of a chromogen d. Vomiting
134. The purpose of performing an albumin:creatinine ratio 143. Urinalysis on a patient with severe back and
is to: abdominal pain is frequently performed to check for:
a. Estimate the glomerular filtration rate a. Glucosuria
b. Correct for hydration in random specimens b. Proteinuria
c. Avoid interference for alkaline urines c. Hematuria
d. Correct for abnormally colored urines d. Hemoglobinuria
135. A patient with a normal blood glucose and a positive
urine glucose should be further checked for: 144. 1 - Hemoglobinuria 2- Myoglobinuria
a. Diabetes mellitus 1 - Associated with transfusion reactions
b. Renal disease 2 - Clear red urine and pale yellow plasma
c. Gestational diabetes 1 - Clear red urine and red plasma
d. Pancreatitis 2 - Associated with rhabdomyolosis
136. The principle of the reagent strip tests for glucose is 1 - Produces hemosiderin granules in urinary
the: sediments
a. Peroxidase activity of glucose 2 - Associated with acute renal failure
b. Glucose oxidase reaction
c. Double sequential enzyme reaction 145. The principle of the reagent strip test fer blood is
d. Dye-binding of glucose and chromogen based on the:
137. All of the following may produce a false-negative a. Binding of heme and a chromogenic dye
glucose reactions except: b. Peroxidase activity of heme
a. Detergent contamination c. Reaction of peroxide and chromogen
b. Ascorbic acid d. Diazo activity of heme
c. Unpreserved specimens 146. A speckled pattern on the blood pad of the reagent
d. Low urine temperature strip indicates:
138. The primary reason for performing a Clinitest is to: a. Hematuria
a. Check for high ascorbic acid levels b. Hemoglobinuria
b. Confirm a positive reagent strip glucose c. Myoglobinuria
c. Check for newborn galactosuria d. All of the above
d. Confirm a negative glucose reading

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147. Products of hemoglobin degradation: 156. A positive nitrite test and a negative leukocyte
1 Conjugated bilirubin esterase test is an indication of a:
2 Unconjugated bilirubin a. Dilute random specimen
3 Urobilinogen and stercobilinogen b. Specimen with lysed leukocytes
4 Urobilin c. Vaginal yeast infection
148. The principle of the reagent strip test for bilirubin is d. Specimen older than 2 hours
the: 157. All of the following can be detected by the leukocyte
a. Diazo reaction esterase reaction except:
b. Ehrlich reaction a. Neutrophils
c. Greiss reaction b. Eosinophils
d. Peroxidase reaction c. Lymphocytes
149. An elevated urine bilirubin with a normal urobilinogen d. Basophils
is indicative of: 158. Screening tests for urinary infection combine the
a. Cirrhosis of the liver leukocyte esterase test with the test for:
b. Hemolytic disease a. pH
c. Hepatitis b. Nitrite
d. Biliary obstruction c. Protein
150. The primary cause of a false-negative bilirubin d. Blood
reaction is: 159. The principle of the leukocyte esterase reagent strip
a. Highly pigmented urine test uses a:
b. Specimen contamination a. Peroxidase reaction
c. Specimen exposure to sunlight b. Double indicator reaction
d. Excess conjugated bilirubin c. Diazo reaction
151. The purpose of the special mat supplied with the d. Dye-binding technique
Ictotest tablets is that: 160. The principle of reagent strip test for specific gravity
a. Bilirubin remains on the surface of the mat uses the dissociation constant of a(n):
b. It contains the dye needed to produce color a. Diazonium salt
c. It removes interfering substances b. Indicator dye
d. Bilirubin is absorbed into the mat c. Polyelectrolyte
152. The reagent in the Multistix reaction for urobilinogen d. Enzyme substrate
is: 161. A specific gravity of 1.005 would produce the
a. A diazonium salt reagent strip color:
b. Tetramethylbenzidine a. Blue
c. p-Dimethylaminobenzaldehyde b. Green
d. Hoesch reagent c. Yellow
153. The primary problem with urobilinogen tests using d. Red
Ehrlich reagent is: 162. Reagent strip-specific gravity readings are affected
a. Positive reactions with porphobilinogen by:
b. Lack of specificity a. Glucose
c. Positive reaction with Ehrlich’s reactive b. Radiographic dye
substances c. Alkaline urine
d. All of the above d. All of the above
154. The reagent strip for nitrite uses:
a. Greiss reaction
b. Ehrlich reaction
c. Peroxidase reaction
d. Pseudoperoxidase reaction
155. All of the following can cause a negative nitrite
reading except:
a. Gram-positive bacteria
b. Gram-negative bacteria
c. Random urine specimen
d. Heavy bacterial infections

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CHAPTER 6 - MICROSCOPIC EXAMINATION OF 171. The Sternheimer-Malbin stain is added to urine
URINE sediments to do all of the following except:
163. Macroscopic screening of urine specimen is used to: a. Increase visibility of sediment constituents
a. Provide results as soon as possible b. Change the constituents refractive index
b. Predict the type of urinary casts present c. Decrease the precipitation of crystals
c. Increase cost-effectiveness of urinalysis d. Delineate constituent structures
d. Decrease the need for polarized microscopy 172. Nuclear detail can be enhanced by:
164. Variations in the microscopic analysis of urine include a. Prussian blue
all of the following except: b. Toluidine blue
a. Preparation of urine sediment c. Acetic acid
b. Amount of sediment analyzed d. Both B and C
c. Method of reporting 173. Which of the following lipids stained by Sudan III?
d. Identification of formed elements a. Cholesterol
165. All of the following can cause false-negative b. Neutral fats
microscopic results except: c. Triglycerides
a. Braking the centrifuge d. Both B and C
b. Failure to mix the specimen
c. Dilute alkaline urine 174. Which of the following lipids is/are capable of
d. Using midstream clean-catch specimen polarizing light?
166. The two factors that determine relative centrifugal a. Cholesterol
force are: b. Triglycerides
a. Radius of rotor head and rpm c. Neutral fats
b. Radius of rotor head and time of centrifugation d. Both A and B
c. Diameter of rotor head and rpm 175. The purpose of the Hansel stain is to identify:
d. RPM and time of centrifugation a. Neutrophils
b. Renal tubular cells
167. When using the glass slide and cover slip method, c. Eosinophils
which of the following might be missed if the coverslip is d. Monocytes
overflowed? 176. Crenated RBCs are seen in urine that is:
a. Casts a. Hyposthenuric
b. RBCs b. Hypersthenuric
c. WBCs c. Highly acidic
d. Bacteria d. Highly alkaline
168. Initial screening of the urine sediment is performed 177. Differentiation among RBCs, yeast and oil droplets
using an objective power of: may be accomplished by all of the following except:
a. 4x a. Observation of budding in yeast cells
b. 10x b. Increased refractility of oil droplets
c. 40x c. Lysis of yeast cells by acetic acid
d. 100x d. Lysis of RBCs by acetic acid
169. Which of the following should be used to reduce light
intensity in bright-field microscopy? 178. A finding of dysmorphic RBCs is indicative of:
a. Centering screws a. Glomerular bleeding
b. Aperture diaphragm b. Renal calculi
c. Rheostat c. Traumatic injury
d. Condenser aperture diaphragm d. Coagulation disorders
170. Which of the following are reported as number per 179. Leukocytes that stain pale blue with Sternheimer-
lpf? Malbin stain and exhibit brownian movement are:
a. RBCs a. Indicative of pyelonephritis
b. WBCs b. Basophils
c. Crystals c. Mononuclear leokocytes
d. Casts d. Glitter cells

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180. Mononuclear leukocytes are sometimes mistaken for: 190. A structure believed to be an oval fat body produced a
a. Yeast cells Maltese cross formation under polarized light but does not
b. Squamous epithelial cells stain with Sudan III. The structure:
c. Pollen grains a. Contains cholesterol
d. Renal tubular cells b. Is not an oval fat body
181. When pyuria is detected in a urine sediment, the slide c. Contains neutral fats
should be carefully checked for the presence of: d. Is contaminated with immersion oil
a. RBCs 200. The finding of yeast cells in the urine is commonly
b. Bacteria associated with:
c. Hyaline casts a. Cystitis
d. Mucus b. Diabetes mellitus
182. Transitional epithelial cells are sloughed from the: c. Pyelonephritis
a. Collecting duct d. Liver disorders
b. Vagina 201. The primary component of urinary mucus is:
c. Bladder a. Bence jones protein
d. Proximal convoluted tubule b. Microalbumin
183. The largest cells in the urine sediment are: c. Uromodulin
a. Squamous epithelial cells d. Orthostatic protein
b. Urothelial epithelial cells 202. The majority of casts are formed in the:
c. Cuboidal epithelial cells a. Proximal convoluted tubules
d. Columnar epithelial cells b. Ascending lood of henle
184. A clinically significant squamous epithelial cell is the: c. Distal convoluted tubules
a. Cuboidal cell d. Collecting ducts
b. Clue cell 203. Cylindruria refers to the presence of:
c. Caudate cell a. Cylindrical renal tubular cells
d. Columnar cell b. Mucus-resembling casts
185. Forms of transitional cells includes all, except: c. Hyaline and waxy casts
a. Spherical d. All types of casts
b. Caudate 204. A person submitting a urine specimen following a
c. Convoluted strenuous exercise routine can normally have all of the
d. Polyhedral following in the sediment except:
186. Increased transitional cells are indicative of: a. Hyaline casts
a. Catheterization b. Granular casts
b. Malignancy c. RBC casts
c. Pyelonephritis d. WBC casts
d. Both A and B 205. Prior to identifying an RBC cast, all of the following
187. A primary characteristic used to identify renal tubular should be observed except:
epithelial cells is: a. Free-floating RBCs
a. Elongated structure b. Intact RBCs in the cast
b. Centrally located nucleus c. Presence of a cast matrix
c. Spherical appearance d. A positive reagent strip blood reaction
d. Eccentrically located nucleus 206. WBC casts are primarily associated with:
188. Following an episode of hemoglobinuria, RTE cells a. Pyelonephritis
may contain: b. Cystitis
a. Bilirubin c. Glomerulonephritis
b. Hemosiderin granules d. Viral infections
c. Porphobilinogen 207. The shape of the RTE cell associated with renal tubular
d. Myoglobin casts is primarily:
189. The predecessor of the oval fat body is the: a. Elongated
a. Histiocyte b. Cuboidal
b. Urothelial cell c. Round
c. Monocyte d. Columnar
d. Renal tubular cell

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208. When observing RTE casts, the cells are primarily: 218.
a. Embedded in a clear matrix
b. Embedded in a granular matrix Pink sediment Amorphous urates
c. Attached to a surface matrix Yellow-brown,whetstone Uric Acid
d. Stained by components of the urine filtrate Ovoid Calcium Oxalate Monohydrate
209. The presence of fatty casts is associated with:
Envelopes Calcium Oxalate Dihydrate
a. Nephrotic syndrome
b. Crush injuries
c. Diabetes mellitus 219.
d. All of the above
210. Nonpathogenic granular casts contain: “Coffin lids” Triple phosphate
a. Cellular lysosomes White precipitate Amorphous phosphate
b. Degenerated cells Thin prisms Calcium phosphate
c. Protein aggregates Thorny apple Ammonium biurate
d. Gram-positive cocci Dumbbell shape Calcium carbonate
211. All of the following are true about waxy casts except:
a. Represent extreme urine stasis 220.
b. May have a brittle consistency
c. They require staining to be visualized Hexagonal plates Cystine
d. Contains degenerated granules Fine needles seen in Liver disease Tyrosine
212. Observation of broad casts represents: Notched corners Cholesterol
a. Destruction of tubular walls Concentric circles, radial striations Leucine
b. Dehydration and high fever Bundles following refrigeration Ampicillin
c. Formation in the collecting ducts Flat plates, high specific gravity Radiographic dye
d. Both A and C Bright yellow clumps Bilirubin
213. All of the following contribute to urinary crystals
formation except:
221.
a. Protein concentration
b. pH
c. Solute concentration Low refractive index objects may be Bright-field
d. Temperature overlooked
214. The most valuable initial aid for identifying crystals in
Forms halo of light around object Phase
a urine specimen is:
a. pH Objects split light into two beams Polarized
b. Solubility Indirect light is reflected off the Dark-field
c. Staining object
d. Polarized microscopy Detects specific wavelength of light Fluorescent
215. Crystals associated with severe liver disease include all emitted from objects
of the following except:
Three-dimensional images Interference
a. Bilirubin
contrast
b. Leucine
c. Cystine
d. Tyrosine
216. All of the following crystals routinely polarize except:
a. Uric acid
b. Cholesterol
c. Radiographic dye
d. Cystine
217. Casts and fibers can usually be differentiated using:
a. Solubility characteristics
b. Patient history
c. Polarized light
d. Fluorescent light

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CHAPTER 7 - RENAL DISEASE 233. An inherited disorder producing generalized defect in
223. Most glomerular disorders are caused by: tubular reabsorption is:
a. Sudden drops in blood pressure a. Alport syndrome
b. Immunologic disorders b. Acute interstitial nephritis
c. Exposure to toxic substances c. Fanconi syndrome
d. Bacterial infections d. Renal glycosuria
224. Dysmorphic RBC casts is significant t all, except: 234. A teenage boy who developed gout in his big toe and
a. Goodpasture syndrome has a high serum uric acid should be monitored for:
b. Acute glomerulonephritis a. Fanconi syndrome
c. Chronic pyelonephritis b. Renal calculi
d. Henoch-Schӧnlein purpura c. Uromodulin-associated kidney disease
225. Occasional episodes of macroscopic hematuria over d. Chronic interstitial nephritis
periods of 20 or more years are seen with: 235. The only protein produced by the kidney is:
a. Crescentic glomerulonephritis a. Albumin
b. IgA nephropathy b. Uromodulin
c. Nephrotic syndrome c. Uroprotein
d. Wegener granulomatosis d. Globulin
226. Antiglomerular basement membrane antibody: 236. The presence of RTE cells and casts is an indication of:
a. Wegener granulomatosis a. Acute interstitial nephritis
b. IgA nephropathy b. Chronic glomerulonephritis
c. Goodpasture syndrome c. Minimal change disease
d. Diabetic nephropathy d. Acute tubular necrosis
227. Antineutrophilic cytoplasmic antibody diagnostic for: 237. Differentiation between cystitis and pyelonephritis:
a. IgA nephropathy a. WBC casts
b. Wegener granulomatosis b. RBC casts
c. Henoch-Schӧnlein purpura c. Bacteria
d. Goodpasture syndrome d. Granular casts
228. Respiratory and renal symproms are associated with 238. Presence of WBCs and WBC cast with no bacteria is:
all of the following except: a. Chronic pyelonephritis
a. IgA nephropathy b. Acute tubular necrosis
b. Wegener granulomatosis c. Acute interstitial nephritis
c. Henoch-Schӧnlein purpura d. Both B and C
d. Goodpasture syndrome 239. End-stage renal disease is characterized by all, except:
229. The presence of fatty casts is associated w/ all, except: a. Hypersthenuria
a. Nephrotic syndrome b. Isosthenuria
b. Focal segmental glomerulosclerosis c. Azotemia
c. Nephrogenic diabetes insipidus d. Electrolyte imbalance
d. Minimal change disease 240. Prerenal acute renal failure could be caused by:
230. The highest levels of proteinuria are seen in: a. Massive hemorrhage
a. Alport syndrome b. Acute tubular necrosis
b. Diabetic nephropathy c. Acute interstitial nephritis
c. IgA nephropathy d. Malignant tumors
d. Nephrotic syndrome 241. The most common composition of renal calculi is:
231. Ischemia frequently produces: a. Calcium oxalate
a. Acute renal tubular necrosis b. Magnesium ammonium phosphate
b. Minimal change disorder c. Cystine
c. Renal glycosuria d. Uric acid
d. Goodpasture’s syndrome 242. Urinalysis on a patient w/ severe back pain being
232. A disorder associated w/ polyuria and low Specific Gr: evaluated for renal calculi would be more beneficial with:
a. Renal glucosuria a. Heavy proteinuria
b. Minimal change disease b. Low specific gravity
c. Nephrogenic diabetes insipidus c. Uric acid crystals
d. Focal segmental glomerulosclerosis d. Microscopic hematuria

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CHAPTER 8 - URINE SCREENING FOR 252. Ketonuria in a newborn is an indication of:
METABOLLIC DISORDERS a. MSUD
243. All states require newborn screening for PKU for early: b. Isovaleric acidemia
a. Modifications of diet c. Methylmalonic acidemia
b. Administration of antibiotics d. All of the above
c. Detection of diabetes 253. Urine from a newborn with MSUD will have a
d. Initiation of gene theraphy significant:
244. All of the following disorders can be detected by a. Pale color
newborn screening, except: b. Yellow precipitate
a. Tyrosyluria c. Milky appearance
b. MSUD d. Sweet odor
c. Melanuria 254. Hartnup disease is a disorder associated with
d. Galactosemia metabolism of:
245. The best specimen for early newborn screening is a: a. Organic acids
a. Timed urine specimen b. Tryptophan
b. Blood specimen c. Cystine
c. First morning urine specimen d. Phenyalanine
d. Fecal specimen 255. 5-HIAA is a degradation product of:
246. Abnormal urine screening tests categorized as an a. Heme
overflow disorder include all of the following, except: b. Indole
a. Alkaptonuria c. Serotonin
b. Galactosemia d. Melanin
c. Melanuria 256. Elevated urinary levels of 5-HIAA are associated with:
d. Cystinuria a. Carcinoid tumors
247. Which of the following disorders is not associated with b. Hartnup disease
the phenyalanine-tyrosine pathway? c. Cstinuria
a. MSUD d. Platelet disorders
b. Alkaptonuria 257. False-positive levels of 5-HIAA can be caused by a diet
c. Albinism high in:
d. Tyrosinemia a. Meat
248. The least serious form of tyrosylemia is: b. Carbohydrates
a. Immature liver function c. Starch
b. Type 1 d. Bananas
c. Type 2 258. A. Cystinuria
d. Type 3 B. Cystinosis
249. An overflow disorder of the phenylalanine-tyrosine
pathway that would produce a positive reaction with the B IEM
reagent strip test for ketones is: A Inherited disorder of tubular reabsorption
a. Alkaptonuria B Fanconi syndrome
b. Melanuria B Cystine deposits in the cornea
c. MSUD A Early renal calculi formation
d. Tyrosyluria
250. An overflow disorder that could produce a 259. Blue diaper syndrome is associated with:
false-positive reaction with Clinitest procedure is: a. Lesch-nyhan syndrome
a. Cystinuria b. Phenylketonuria
b. Alkaptonuria c. Cystinuria
c. Indicanuria d. Hartnup disease
d. Porphyrinuria 260. Homocystinuria is caused by failure to metabolize:
251. A urine that turns black after several hours: a. Lysine
a. Alkaptonuria b. Methionine
b. MSUD c. Arginine
c. Melanuria d. Cystine
d. Both A and C

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261. The Ehrlich reaction will only detect the presence of: CHAPTER 9 - CEREBROSPINAL FLUID
a. Uroporphyrin 270. The functions of CSF include all the following except:
b. Porphobilinogen a. Removing metabolic wastes
c. Coproporphyrin b. Producing an ultrafiltrate of plasma
d. Protoporphyrin c. Supplying nutrients to the CNS
262. Acetyl acetone is added to the urine before d. Protecting the brain and spinal cord
performing the Ehrlich test when checking for: 271. The CSF flows through the:
a. Aminolevulinic acid a. Choroid plexus
b. Porphobilinogen b. Pia mater
c. Uroporphyrin c. Arachnoid space
d. Coproporphyrin d. Dura mater
263. The classic urine color associated with porphyria is: 272. Substances present in the CSF are controlled by the:
a. Dark yellow a. Arachnoid granulations
b. Indigo blue b. Blood-brain barrier
c. Pink c. Presence of one-way valves
d. Port-wine d. Blood-CSF barrier
264. Which of the following specimens can be used for 273. What department is the CSF tube labeled 3 routinely
porphyrin testing? sent to?
a. Urine a. Hematology
b. Blood b. Chemistry
c. Feces c. Microbiology
d. All of the above d. Serology
265. The two stages of heme formation affected by lead 274. The CSF tube that should be kept at room
poisoning are: temperature is:
a. Porphobilinogen and uroporphyrin a. Tube 1
b. Aminolevulinic acid and porphobilinogen b. Tube 2
c. Coproporphyrin and protoporphyrin c. Tube 3
d. Aminolevulinic acid and protoporphyrin d. Tube 4
266. Hurler, Hunter and Sanfilippo syndromes are 275. A. Traumatic Tap
hereditary disorders affecting metabolism of: B. Intracranial hemorrhage
a. Porphyrins B Even distribution of blood in all tubes
b. Purines B Xanthochromic supernatant
c. Mucopolysaccharides A Concentration of blood in Tube 1 is > Tube 3
d. Tryptophan A Specimen contains clots
267. Many uric acid crystals in a pediatric urine specimen 276. The presence of xanthochromia can be caused by all
may indicate: of the following except:
a. Hurler syndrome a. Immature liver function
b. Lesch-Nyhan disease b. RBC degradation
c. Melituria c. A recent hemorrhage
d. Sanfilippo syndrome d. Elevated CSF protein
268. Deficiency of GALT enzyme will produce a: 277. A web-like pellicle in a refrigerated CSF specimen
a. Positive clinitest indicates:
b. Glycosuria a. Tubercular meningitis
c. Galactosemia b. Multiple sclerosis
d. Both A and C c. Primary CNS malignancy
269. d. Viral meningitis
Mousy odor Phenylketonuria
278. Given the following information, calculate the CSF
Blue color Indicanuria
WBC count: cells counted. 80; dilution, 1:10; Large
Sulfur odor Cystinuria
Neubauer squares counted, 10.
Black color Alkaptonuria
a. 8
Orange sand in diaper Lesch-Nyhan disease
b. 80
Sweaty feet odor Isovaleric acidemia c. 800
d. 8000

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279. A CSF WBC count is diluted with: 288. Hemosiderin granules and hematoidin crystals are
a. Distilled water seen in:
b. Normal saline a. Lymphocytes
c. Acetic acid b. Macrophages
d. Hypotonic saline c. Ependymal cells
280. A total CSF count on a clear fluid should be: d. Neutrophils
a. Reported as normal 289. Myeloblasts are seen in the CSF:
b. Not reported a. In bacterial infections
c. Diluted with normal saline b. In conjunction with CNS malignancy
d. Counted undiluted c. After cerebral hemorrhage
281. The purpose of adding albumin CSF before d. As a complication of acute leukemia
cytocentrifugation is to: 290. Cells resembling large and small lyphocytes with
a. Increase the cell yield cleaved nuclei represent:
b. Decrease the cellular distortion a. Lymphoma cells
c. Improve the cellular staining b. Choroid cells
d. Both A and B c. Melanoma cells
d. Medulloblastoma cells
282.The primary concern when pleocytosis of neutrophils 291. The reference range for CSF protein is:
and lymphocytes is found in the CSF is: a. 6 to 8 g/dL
a. Meningitis b. 15 to 45 g/dL
b. CNS malignancy c. 6 to 8 mg/dL
c. Multiple sclerosis d. 15 to 45 mg/dL
d. Hemorrhage 292. CSF can be differentiated from serum by the
283. Neutrophils with pyknotic nuclei may be mistaken for: presence of:
a. Lymphocytes a. Albumin
b. Nucleated RBCs b. Globulin
c. Malignant cells c. Prealbumin
d. Spindle-shaped cells d. Tau transferrin
284.The presence of which of the following cells is 293. In serum, the second most prevalent protein is IgG;
increased in a parasitic infection: in CSF, the second most prevalent protein is:
a. Neutrophils a. Transferrin
b. Macrophages b. Prealbumin
c. Eosinophils c. IgA
d. Lymphocytes d. Ceruloplasmin
285. Macrophages appear in the CSF after: 294. Elevated CSF protein values can be caused by all of
a. Hemorrhage the following except:
b. Repeated spinal taps a. Meningitis
c. Diagnostic procedures b. Multiple sclerosis
d. All of the above c. Fluid leakage
286. Nucleated RBCs are seen in the CSF as a result of: d. CNS malignancy
a. Elevated blood RBCs 295. The integrity of the blood-brain barrier is measured
b. Treatment of anemia using the:
c. Severe hemorrhage a. CSF/serum albumin index
d. Bone marrow contamination b. CSF/serum globulin ratio
287. After a CNS diagnotic procedure, which of the c. CSF albumin index
following might be seen in the CSF? d. CSF IgG index
a. Choroidal cells 296. Given the following results, calculate the IgG index:
b. Ependymal cells CSF IgG;50mg/dL; serum IgG, 2g/dL; CSF albumin, 70mg/dL;
c. Spindle-shaped cells serum albumin, 5g/dL
d. All of the above a. 0.6
b. 6.0
c. 1.8
d. 2.8

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297. The CSF IgG Index calculated in question #296 CHAPTER 10 - SEMEN
indicates: 306. Maturation of spermatozoa takes place in the:
a. Synthesis of IgG in the CNS a. Sertoli cells
b. Damage to the blood-brain barrier b. Seminiferous tubules
c. Cerebral hemorrhage c. Epididymis
d. Lymphoma infiltration d. Seminal vesicles
298. The finding of oligoclonal bands in the CSF and not in 307. Enzymes for the coagulation and liquefaction of
the serum is seen with: semen are produced by the:
a. Multiple myeloma a. Seminal vesicles
b. CNS malignancy b. Bulbourethral glands
c. Multiple sclerosis c. Ductus deferens
d. Viral infections d. Prostate gland
299. A CSF glucose of 15mg/dL, WBC count of 5000, 90% 308. The major component of seminal fluid is:
neutrophils, and protein of 80mg/dL suggests: a. Glucose
a. Fungal meningitis b. Fructose
b. Viral meningitis c. Acid phosphatase
c. Tubercular meningitis d. Citric acid
d. Bacterial meningitis 309. If the first portion of the semen specimen is not
300. A patient with a blood glucose of 120mg/dL would collected, the semen analysis will have which of the
have a normal CSF glucose: following?
a. 20 mg/dL a. Decreased pH
b. 60 mg/dL b. Increased viscosity
c. 80 mg/dL c. Decreased sperm count
d. 120 mg/dL d. Decreased sperm motility
301. CSF Lactate will be more consistently decreased in: 310. Failure of laboratory personnel to document the
a. Bacterial meningitis time a semen sample is collected primarily affects the
b. Viral meningitis interpretation of semen:
c. Fungal meningitis a. Appearance
d. Tubercular meningitis b. Volume
302. Measurement of which of the following can be c. pH
replaced by CSF glutamine analysis in children with Reye d. Viscosity
syndrome? 311. Liquefaction of a semen specimen should take place
a. Ammonia within:
b. Lactate a. 1 hour
c. Glucose b. 2 hours
d. α-Ketoglutarate c. 3 hours
303. Before performing a Gram stain on CSF, the d. 4 hours
specimen must be:
a. Filtered 312. A semen specimen delivered to the laboratory in a
b. Warmed to 37ºC condom has a normal sperm count and marked decreased
c. Centrifuged sperm motility. This indicates:
d. Mixed a. Decreased fructose
304. All of the following statements are true about b. Antispermicide in condom
cryptococcal meningitis except: c. Increased semen viscosity
a. An India ink preparation is positive d. Increased semen alkalinity
b. A starburst pattern is seen on Gram stain 313. An increased semen pH may be caused by:
c. The WBC count is over 2000 a. Prostatic infection
d. A confirmatory immunology test is available b. Decreased prostatic secretions
305. The test of choice to detect neurosyphilis is the: c. Decreased bulbourethral gland secretions
a. RPR d. All of the above
b. VDRL
c. FAB
d. FTA-ABS

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314. Proteolytic enzymes may be added to semen 322. The purpose of the acrosomal cap is to:
specimens to: a. Penetrate the ovum
a. Increase the viscosity b. Protect the nucleus
b. Dilute the specimen c. Create energy for tail movement
c. Decrease the viscosity d. Protect the neckpiece
d. Neutralize the specimen 323. The sperm part containing a mitochondrial sheath is:
315. The normal sperm concentration is: a. Head
a. Less than 20 million/uL b. Neckpiece
b. More than 20 million/mL c. Midpiece
c. Less than 20 million/mL d. Tail
d. More than 20 million/uL 324. All of the following are associated with sperm
316. Given the following information, calculate the sperm motility except the:
concentration: dilution, 1:20; sperm counted in 5 RBC a. Head
squares on each side of the hemocytometer, 80 and 86, b. Neckpiece
volume, 3mL. c. Midpiece
a. 80 million/mL d. Tail
b. 83 million/mL 325. The morphologic shape of a normal sperm head is:
c. 86 million/mL a. Round
d. 169 million/uL b. Tapered
317. Using the above information, calculate the sperm c. Ovoid
concentration when 80 sperm are counted in one WBC d. Amorphous
square and 86 sperm are counted in another WBC square. 326. Normal sperm morphology when using the WHO
a. 83 million/mL criteria is:
b. 166 million per ejaculate a. >30% normal forms
c. 16.6 million/mL b. <30% normal forms
d. 50 million per ejaculate c. >15% abnormal forms
318. The primary reason to dilute a semen specimen d. <15% abnormal forms
before performing a sperm concentration is to: 327. Additional parameters measured by Kruger’s strict
a. Immobilize the sperm morphology include all of the following except:
b. Facilitate the chamber count a. Vitality
c. Decrease the viscosity b. Presence of vacuoles
d. Stain the sperm c. Acrosome size
319. When performing a sperm concentration, 60 sperm d. Tail length
are counted in the RBC squares on one side of the 328. Round cells that are of concern and may be included
hemocytometer and 90 sperm are counted in the RBC in sperm counts and morphology analysis are:
squares on the other side. The specimen is diluted 1:20. a. Leukocytes
The: b. Spermatids
a. Specimen should be rediluted and counted c. RBCs
b. Sperm count is 75 million/mL d. Both A and B
c. Sperm count is greater than 5 million/mL 329. If 5 round cells per 100 sperm are counted in a
d. Sperm concentration is abnormal sperm morphology smear and the sperm concentration is
320. Sperm motility evaluations are performed: 30 million, the concentration of round cells is:
a. Immediately after the specimen is collected a. 150,000
b. Within 1 hour of collection b. 1.5 million
c. After 3 hours of incubation c. 300,000
d. At 6-hour intervals for 1 day d. 15 million
321. The percentage of sperm showing average motility 330. Following an abnormal sperm motility test with a
that is considered normal is: normal sperm count, what additional test might be
a. 25% ordered?
b. 50% a. Fructose level
c. 60% b. Zinc level
d. 75% c. MAR test
d. Eosin-nigrosin stain

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331. Follow-up testing for a low sperm concentration CHAPTER 11 - SYNOVIAL FLUID
would include testing for: 337. The functions of synovial fluid includes all of the
a. Antisperm antibodies following except:
b. Seminal fluid fructose a. Lubrication for the joints
c. Sperm vitality b. Removal of cartilage debris
d. Prostatic acid phosphatase c. Cushioning joints during jogging
332. The immunobead test for antisperm antibodies: d. Providing nutrients for cartilage
a. Detects the presence of male antibodies 338. The primary function of synoviocytes is to:
b. Determines the presence of IgG, IgM, and IgA a. Provide nutrients for the joints
antibodies b. Secrete hyaluronic acid
c. Determines the location of antisperm antibodies c. Regulate glucose filtration
d. All of the above d. Prevent crystal formation
333. Measurement of α-glucosidase is performed to 339. Which of the following is not a frequently
detect a disorder of the: performed test on synovial fluid?
a. Seminiferous tubules a. Uric acid
b. Epididymis b. WBC count
c. Prostate gland c. Crystal examination
d. Bulbourethral glands d. Gram stain
334. A specimen delivered to the laboratory with a 340. The procedure for collecting synovial fluid is called:
request for prostatic acid phosphatase and glycoprotein a. Synovialcentesis
p30 was collected to determine: b. Arthrocentesis
a. Prostatic infection c. Joint puncture
b. Presence of antisperm antibodies d. Arteriocentesis
c. A possible rape 341. A - Non-Inflammatory
d. Successful vasectomy B - Inflammatory
335. Following a negative postvasectomy wet preparation, C - Septic
the specimen should be: D - Hemorrhagic
a. Centrifuged and reexamined
b. Stained and reexamined B - Gout
c. Reported as no sperm seen C - Neisseria gonorrhoea infection
d. Both A and B B - Systemic lupus erythematosus
336. Standardization of procedures and reference values A - Osteoarthritis
for semen analysis is primarily provided by the: D - Hemophilia
a. Manufacturers of instrumentation B - Rheumatoid arhtritis
b. WHO D - Heparin overdose
c. Manufacturers of control samples
d. Clinical laboratory improvement amendments 342. Normal synovial fluid resembles:
a. Egg white
b. Normal serum
c. Dilute urine
d. Lipemic serum
343. Before testing, very viscous synovial fluid should be
treated with:
a. Normal saline
b. Hyaluronidase
c. Distilled water
d. Hypotonic saline
344. Addition of a cloudy, yellow synovial fluid to acetic
acid produces a/an:
a. Yellow-white precipitate
b. Easily dispersed clot
c. Solid clot
d. Opalescent appearance

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345. Which of the following could be the most 354. Crystals that have the ability to polarize light are:
significantly affected if a synovial fluid is refrigerated before a. Corticosteroid
testing? b. Monosodium urate
a. Glucose c. Calcium oxalate
b. Crystal examination d. All of the above
c. Mucin clot test 355. In a nexamination of synovial fluid under
d. Differential compensated polarized light, rhomboid-shaped crystals are
346. The highest WBC count can be expected to be seen observed. What color would these crystals be when aligned
with: parallel to slow vibration?
a. Noninflammatory arthritis a. White
b. Inflammatory arthritis b. Yellow
c. Septic arthritis c. Blue
d. Hemorrhagic arthritis d. Red
347. When diluting a synovial fluid WBC count, all of the 356. If crystals shaped like needles are aligned
following are acceptable except: perpendicular to the slow vibration of compensated
a. Acetic acid polarized light, what color are they?
b. Isotonic saline a. White
c. Hypotonic saline b. Yellow
d. Saline with saponin c. Blue
348. The lowest percentage of neutrophils would be in: d. Red
a. Noninflammatory arthritis 357. Negative birefringence occurs under
b. Inflammatory arthritis red-compensated polarized light when:
c. Septic arthritis a. Slow light is impeded more than fast light
d. Hemorrhagic arthritis b. Slow light is less impeded than fast light
349. All of the following are abnrmal when seen in c. Fast light runs against the molecular grain of
synovial fluid except: the crystal
a. Neutrophages d. Both B and C
b. Ragocytes 358. Synovial fluid cultures are often plate on chocolate
c. Synovial lining cells agar to detect the presence of:
d. Lipid droplets a. Neisseria gonorrhoea
350. Synovial fluid crystals that occur as a result of purine b. Staphylococcus agalactiae
metabolism or chemotherapy for leukemia are: c. Streptococcus viridans
a. Monosodium urate d. Enterococcus faecalis
b. Cholesterol 359. The most frequently performed chemical test on
c. Calcium pyrophosphate synovial fluid is:
d. Apatite a. Total protein
351. Synovial fluid crystals associated with an b. Uric acide
inflammation in dialysis patients are: c. Calcium
a. Calcium pyrophosphate dihydrate d. Glucose
b. Calcium oxalate 360. Which of the following chemistry tests can be
c. Corticosteroid performed on synovial fluid to determine the severity of RA
d. Monosodium urate (Rheumatoid Arthritis)?
352. Crystals associated with pseudogout are: a. Glucose
a. Monosodium urate b. Protein
b. Calcium pyrophosphate dihydrate c. Lactate
c. Apatite d. Uric acid
d. Corticosteroid 361. Serologic tests on patients’ serum may be
353. Synovial fluid for crystal examination should be performed to detect antibodies causing arthritis for all of
examined as a/an: the following disorders except:
a. Wet preparation a. Pseudogout
b. Wright’s stain b. Rheumatoid arthritis
c. Gram stain c. Systemic lupus erythematosus
d. Acid-fast stain d. Lyme arthritis

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CHAPTER 12 - SEROUS FLUID 370. Which of the following requires the most additional
362. The primary purpose of serous fluid is to: testing?
a. Remove waste products a. Transudate
b. Lower capillary pressure b. Exudate
c. Lubricate serous membranes 371. An additional test performed on pleural fluir to
d. Nourish serous membranes classify the fluid as a transudate or exudate is the:
363. The membrane that lines the wall of the cavity is a. WBC count
the: b. RBC count
a. Visceral c. Fluid:cholesterol ratio
b. Peritoneal d. Fluid-to-serum gradient
c. Pleural 372. A milky-appearing pleural fluid indicates:
d. Parietal a. Thoracic duct leakage
364. During normal production of serous fluid, the slight b. Chronic inflammation
excess of fluid is: c. Microbial infection
a. Absorbed by the lymphatic system d. Both A and B
b. Absorbed through the visceral capillaries 373. Which of the following best represents a
c. Strored in the mesothelial cells hemothorax?
d. Metabolized by the mesothelial cells a. Blood HCT: 42 Fluid HCT: 15
365. Production of serous fluid is controlled by: b. Blood HCT: 42 Fluid HCT: 10
a. Capillary oncotic pressure c. Blood HCT: 30 Fluid HCT: 10
b. Capillary hydrostatic pressure d. Blood HCT: 30 Fluid HCT: 20
c. Capillary permeability 374. All of the following are normal cells seen in pleural
d. All of the above fluid except:
366. An increase in the amount f serous fluid is called a. Mesothelial cells
a/an: b. Neutrophils
a. Exudate c. Lymphocytes
b. Transudate d. Mesothelioma cells
c. Effusion
d. Malignancy 375. A differential observation of pleural fluid associated
367. Pleural fluid is collected by: with tuberculosis is:
a. Pleurocentesis a. Increased neutrophils
b. Paracentesis b. Decreased lymphocytes
c. Pericentesis c. Decreased mesothelial cells
d. Thoracentesis d. Increased mesothelial cells
368. A. Transudate 376. All of the following are characteristics of malignant
B. Exudate cells except:
a. Cytoplasmic molding
B - Caused by increased hyrostatic pressure b. Absence of nucleoli
A - Caused by increased capillary permeability c. Mucin-containing vacuoles
A - Caused by decreased oncotic pressure d. Increased nucleus:cytoplasm ratio
A - Caused by congestive heart failure 377. A pleural fluid of pH 6.0 indicates:
B - Malignancy related a. Esophageal rupture
A - Tuberculosis related b. Mesothelioma
B - Endocarditis related c. Malignancy
A - Clear appearance d. Rheumatoid effusion
369. Fluid:serum protein and lactate dehydrogenase 378. Plasma cells seen in pleural fluid indicate:
ratios are performed on serous fluids: a. Bacterial endocarditis
a. When malignancy is suspected b. Primary malignancy
b. To classify transudates and exudates c. Metastatic lung malignancy
c. To determine types of serous fluid d. Tuberculosis infection
d. When a traumatic tap has occurred

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379. A significant cell found in pericardial or pleural fluid CHAPTER 13 - AMNIOTIC FLUID
that should be referred to cytology is a: 388. Which of the following is not a function of amniotic
a. Reactive lymphocyte fluid?
b. Mesothelioma cell a. Allows movement of fetus
c. Monocyte b. Allows carbon dioxide and oxygen exchange
d. Mesothelial cell c. Protects fetus from extreme temperature
380. Another name for a peritoneal effusion is: changes
a. Peritonitis d. Acts as a protective cushion for the fetus
b. Lavage 389. What is the primary cause of the normal increase in
c. Ascites amniotic fluid as a pregnancy progresses?
d. Cirrhosis a. Fetal cell metabolism
381. A test performed primarily on peritoneal lavage fluid b. Fetal swallowing
is a/an: c. Fetal urine
a. WBC count d. Transfer of water across the placenta
b. RBC count 390. Which of the following is not a reason for decreased
c. Absolute neutrophil count amounts of amniotic fluid?
d. Amylase a. Fetal failure to begin swallowing
382. The recommended test for determining whether b. Increased fetal swallowing
peritoneal fluid is a transudate or an exudate is the: c. Membrane leakage
a. Fluid:serum albumin ratio d. Urinary tract defects
b. Serum ascites albumin gradient 391. Why might a creatinine level be requested on an
c. Fluid:serum lactate dehydrogenase ratio amniotic fluid?
d. Absolute neutrophil count a. Detect oligohydramnios
383. Given the following results, classify this peritoneal b. Detect polyhydramnios
fluid: serum albumin, 2.2g/dL; serum protein, 6.0g/dL; fluid c. Differentiate amniotic fluid from maternal urine
albumin, 1.6g/dL. d. Evaluate lung maturity
a. Transudate 392. Amniotic fluid specimens are placed in
b. Exudate amber-colored tubes prior to sending them to the
384. Differentiation between peritonitis and cirrhosis is laboratory to prevent the destruction of:
done by performing a/an: a. Alpha-fetoprotein
a. WBC count b. Bilirubin
b. Differential c. Cells for cytogenetics
c. Absolute neutrophil count d. Lecithin
d. Absolute lymphocyte count 393. How are specimens for FLM testing delivered to and
385. Detection of CA 125 tumor marker in peritoneal stored in the laboratory?
fluid indicates: a. Delivered on ice and refrigerated
a. Colon cancer b. Immediately centrifuged
b. Ovarian cancer c. Kept at room temperature
c. Gastric malignancy d. Delivered in a vacuum tube
d. Prostate cancer 394. Why are amniotic specimens for cytogenetic analysis
386. Chemical tests primarily performed on peritoneal incubated at 37ºC prior to analysis?
fluid include all of the following except: a. To detect the presence of meconium
a. Lactose dehydrogenase b. To differentiate amniotic fluid from urine
b. Glucose c. To prevent photo-oxidation of bilirubin to
c. Alkaline phosphatase biliverdin
d. Amylase d. To prolong fetal cell viability and integrity
387. Cultures of peritoneal fluid are incubated: 395.
a. Aerobically
b. Anaerobically Normal Colorless
c. At 37ºC and 42ºC Presence of meconium Dark-green
d. Both A and B Fetal death Red-brown
Presence of bilirubin Yellow

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396. A significant rise in the OD of amniotic fluid at 405. Does the failure to produce bubbles in the Foam
450nm indicates the presence of which analyte? stability index indicate increased or decreased Lecithin?
a. Bilirubin a. Increased
b. Lecithin b. Decreased
c. Oxyhemoglobin 406. The presence of Phosphatidyl glycerol in amniotic
d. Sphingomyelin fluid fetal lung maturity tests must be confirmed when:
397. Plotting the amniotic fluid OD on a Liley graph a. Hemolytic disease of the newborn is present
represents the severity of hemolytic disease of the b. The mother has maternal diabetes
newborn. A value that is plotted in zine II indicates what c. Amniotic fluid is contaminated by hemoglobin
condition of the fetus? d. Neural tube disorder is suspected
a. No hemolysis 407. A lamellar body count of 50,000 correlates with:
b. Mildly affected fetus a. Absent Phosphatidyl glycerol and L/S ratio of 1.0
c. Moderately affected fetus that requires close b. L/S ratio of 1.5 and absent Phosphatidyl glycerol
monitoring c. OD at 650 nm of 1.010 and an L/S ratio of 1.1
d. Severely affected fetus that requires intervention d. OD at 650 nm of 0.150 and an L/S ratio of 2.0
398. 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
399. An AFP MoM value greater than two times the
median value is considered an indication of a neural tube
disorder.
a. True
b. False
400. 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
401. Prior to 35 weeks gestation, the normal L/S ratio is
less than 1.6.
a. True
b. False
402. When performing an L/S ratio by thin layer
chromatography, a mature fatal lung will show:
a. Sphingomyelin twice as concentrated as lecithin
b. No sphingomyelin
c. Lecithin twice as concentrated as sphingomyelin
d. Equal concentration of lecithin and sphingomyelin
403. Phosphatidyl glycerol is present with L/S ratio of 1.1.
a. True
b. False
404. Phosphatidyl glycerol test for FLM that does not
require performance of thin-layer chromatography is:
a. AFP levels
b. Amniotic acetylcholinesterase
c. Amniostat-FLM
d. Bilirubin scan

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CHAPTER 14 - FECAL ANALYSIS 416. Which of the following pairings of stool appearance
408. In what part of the digestive tract do pancreatic and cause does not match?
enzymes and bile salts contribute to digestion? a. Black,tarry; blood
a. Large intestine b. Pale, frothy; steatorrhea
b. Liver c. Yellow-gray; bile duct obstruction
c. Small intestine d. Yellow-green; barium sulfate
d. Stomach 417. Stool specimens that appear ribbon-like are
409. Where does the reabsorption of water take place in indicative of which condition?
the primary digestive process? a. Bile-duct obstruction
a. Large intestine b. Colitis
b. Pancreas c. Intestinal constriction
c. Small intestine d. Malignancy
d. Stomach 418. A black tarry stool is indicative of:
410. Which of the following tests is not performed to a. Upper GI bleeding
detect osmotic diarrhea? b. Lower GI bleeding
a. Clinitest c. Excess fat
b. Fecal fats d. Excess carbohydrates
c. Fecal neutrophils 419. Chemical screening tests performed on feces include
d. Muscle fibers all of the following except:
411. The normal composition of feces includes all of the a. APT test
following except: b. Clinitest
a. Bacteria c. Pilocarpine iontophoresis
b. Blood d. Quantitative fecal fats
c. Electrolytes 420. Secretory diarrhea is caused by:
d. Water a. Antibiotic administration
412. What is the fecal test that requires a 3-day b. Lactose intolerance
specimen? c. Celiac sprue
a. Fecal occult blood d. Vibrio cholerae
b. APT test 421. The fecal osmotic gap is elevated in which disorder?
c. Elastase I a. Dumping syndrome
d. Quantitative fecal fat testing b. Osmotic diarrhea
413. The normal brown color of the feces is produced by: c. Secretory diarrhea
a. Cellulose d. Steatorrhea
b. Pancreatic enzymes 422. Microscopic examination of stools provides pre
c. Undigested food stuffs liminary information as to the cause of diarrhea because:
d. Urobilin a. Neutrophils are present in conditions caused by
414. Diarrhea can result from all of the following except: toxin-producing bacteria
a. Addition of pathogenic organisms to the normal b. Neutrophils are present in conditions that affect
intestinal flora the intestinal wall
b. Disruption of the normal intestinal bacterial flora c. Red and white blood cells are present if the
c. Increased concentration of fecal electrolytes cause is bacterial
d. Increased reabsorption of intestinal water and d. Neutrophils are present if the condition is of
electrolytes nonbacterial etiology
415. Stools from persons with steatorrhea will contain 423. The presence of fecal neutrophils would be expected
excess amounts of: with diarrhea caused by a rotavirus.
a. Barium sulfate a. True
b. Blood b. False
c. Fat 424. Large orange-red droplets seen on direct microscopic
d. Mucus examination of stools mixed with Sudan III represent:
a. Cholesterol
b. Fatty acids
c. Neutral fats
d. Soaps

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425. Microscopic examination of stools mixed with Sudan 433. What is the significance of an APT test that remains
III and glacial acetic acid and the heated will show small pink after addition of sodium hydroxide?
orange-red droplets that represent: a. Fecal fat is present
a. Fatty acids and sopas b. Fetal hemoglobin is present
b. Fatty acids and neutral fats c. Fecal trypsin is present
c. Fatty acids, soaps, and neutral fats d. Vitamin C is present
d. Soaps 434. In the Van de Kramer method for quantitative fecal
426. When performing a microscopic stool examination for fat determinations, fecal lipids are:
muscle fibers, the structures that should be counted: a. Converted to fatty acids prior to titrating with
a. Are coiled and stain blue sodium hydroxide
b. Contain no visible striations b. Homogenized and titrated to a neutral endpoint
c. Have two-dimensional striations with sodium hydroxide
d. Have vertical striations and stain red c. Measured gravimetrically after washing
427. A value of 85% fat retention would indicate: d. Measured by spectrophotometer after addition
a. Dumping syndrome of Sudan III
b. Osmotic diarrhea 435. A patient whose stool exhibits increased fats,
c. Secretory diarrhea undigested muscle fibers, and the inability to digest gelatin
d. Steatorrhea may have:
428. Which of the following tests would not be indicative a. Bacterial dysentery
of steatorrhea? b. A duodenal ulcer
a. Fecal elastase-1 c. Cystic fibrosis
b. Fecal occult blood d. Lactose intolerance
c. Sudan III 436. A stool specimen collected from an infant with
d. Van de Kramer diarrhea has a pH of 5.0. The result correlates with a:
429. The term “occult” blood describes blood that: a. Positive APT test
a. Is produced in the lower GI tract b. Negative trypsin test
b. Is produced in the upper GI tract c. Positive Clinitest
c. Is not visibly apparent in the stool specimen d. Negative occult blood test
d. Produces a black, tarry stool 437. Which of the following tests differentiates a
430. What is the recommended number of samples that malabsorption cause from a maldigestion cause in
should be tested to confirm a negative occult blood result? steatorrhea?
a. One random specimen a. APT test
b. Two samples taken from different parts of three b. D-xylose test
stools c. Lactose tolerance test
c. Three samples taken from the outermost portion d. Occult blood test
of the stool
d. Three samples taken from different parts of two
stools
431. The immunochemical test for occult blood:
a. Test for human globulin
b. Give false-positive reactions with meat
hemoglobin
c. Can give false-positive reactions with aspirin
d. Are inhibited by porphyrin
432. 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

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CHAPTER 15 - VAGINAL SECRETIONS 446. A squamous epithelial cell covered with coccobacilli
438. Which of the following would not be a reason to that extends beyond the cytoplasm margin is a:
collect a vaginal fluid for analysis? a. Basal cell
a. Vaginitis b. Parabasal cell
b. Complications of pregnancy resulting in preterm c. Clue cell
delivery d. Blastospore
c. Forensic testing in a sexual assault 447. All of the following are diagnostic of bacterial
d. Pregnancy testing vaginosis except:
439. Which of the following organisms might not be a. Vaginal pH of 3.8
detected if the specimen for vaginal secretion analysis had b. Presence of clue cells
been refrigerated? c. Positive amine (whiff) test
a. Prevotella bivia d. Thin, homogenous white-to-gray vaginal
b. Lactobacillus acidophilus discharge
c. Trichomonas vaginalis 448. Which of the following organisms produces lactic
d. Candida albicans acid and hydrogen peroxide to maintain an acid vaginal
440. The appearance of the vaginal discharge in environment?
vulvovaginal candidiasis is described as: a. Gardnerella vaginalis
a. Clear and colorless b. Mobiluncus spp.
b. Thin, homogenous white-to-gray discharge c. Lactobacilli spp.
c. White, curd-like d. β-hemolytic streptococci
d. Yellow-green and frothy 449. All of the following are diagnostic of vulvovaginal
441. A normal range for a vaginal pH is: candidiasis except:
a. 3.8 to 4.5 a. Large numbers of WBCs
b. 5.0 to 6.0 b. Presence of clue cells
c. 6.0 to 7.0 c. ~Vaginal pH of 4.0
d. 7.0 to 7.4 450. All of the following are diagnostic of Trichomoniasis
442. Which of the following tests differentiates budding except:
yeast cells from RBCs? a. Vaginal pH of 6.0
a. pH b. Positive amine (whiff) test
b. Saline wet mount c. Positive KOH test
c. KOH prep d. Motile trichomonads present
d. Whiff test 451. The bacteria associated with desquamative
443. Which of the following constituents is normal in inflammatory vaginitis is:
healthy vaginal fluid secretions? a. β-hemolytic streptococci
a. Lactobacillus b. Trichomonas vaginalis
b. Basal cells c. Gardnerella vaginalis
c. Trichomonas vaginalis d. Mycoplasma hominis
d. pseudohyphae 452. The protein present in vaginal secretions that can
444. Vaginal specimens collected for a saline wet identify patients who are at risk for preterm delivery is:
preparation should be: a. Human chorionic gonadotropin
a. Refrigerated to preserve motility b. Estrogen
b. Prepared as soon as possible c. PAMG-1
c. Mailed to a reference laboratory d. Fetal fibronectin
d. Preserved with potassium hydroxide
445. A positive amine (Whiff) test is observed in which of
the following syndromes?
a. Bacterial vaginosis
~end~
b. Vulvovaginal candidiasis
c. Atrophic vaginitis
d. Desquamative inflammatory vaginitis

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