Strasinger 7th Edition Study Questions PDF

STRASINGER – ANALYSIS OF URINE AND OTHER BODY FLUIDS 7 TH ED. URINALYSIS 11. Correct hand washing includes all of the following except: A. U...

STRASINGER – ANALYSIS OF URINE AND OTHER BODY FLUIDS 7 TH ED. URINALYSIS 11. Correct hand washing includes all of the following except: A. Using warm water Chapter 1: Safety & Quality Management B. Rubbing to create a lather 1. Which of the following organizations publishes guidelines for writing C. Rinsing hands in a downward position procedures and policies in the urinalysis? D. Turning on the water with a paper towel A. CDC B. OSHA 12. Centrifuging an uncapped specimen may produce a biological hazard C. CLSI in the form of: D. CLIA A. Vectors B. Sharps contamination 2. Exposure to toxic, carcinogenic, or caustic agents is what type of C. Aerosols laboratory safety hazard? D. Specimen contamination A. Biological B. Sharps 13. An employee who accidentally spills acid on his arm should C. Chemical immediately: D. Fire/explosive A. Neutralize the acid with a base B. Hold the arm under running water for 15 minutes 3. In the urinalysis laboratory, the primary source in the chain of infection C. Consult the SDS would be: D. Wrap the arm in gauze and go to the emergency department A. Patients B. Needlesticks 14. When combining acid and water, ensure that: C. Specimens A. Acid is added to water D. Biohazardous waste B. Water is added to acid C. They are added simultaneously 4. The best way to break the chain of infection is: D. Water is slowly added to acid A. Hand sanitizing B. Personal protective equipment 15. An employee can learn the carcinogenic potential of potassium C. Aerosol prevention chloride by consulting the: D. Decontamination A. Chemical hygiene plan B. Safety Data Sheet 5. The current routine infection control policy developed by CDC and C. OSHA standards followed in all health-care settings is: D. Urinalysis procedure manual A. Universal Precautions B. Isolation Precautions 16. Employees should not work with radioisotopes if they are: C. Blood and Body Fluid Precautions A. Wearing contact lenses D. Standard Precautions B. Allergic to iodine C. Sensitive to latex 6. An employee who is accidentally exposed to a possible bloodborne D. Pregnant pathogen should immediately: A. Report to a supervisor 17. All of the following are safe to do when removing the source of an B. Flush the area with water electric shock except: C. Clean the area with disinfectant A. Pulling the person away from the instrument D. Receive HIV prophylaxis B. Turning off the circuit breaker C. Using a glass container to move the instrument 7. Personnel in the urinalysis laboratory should wear laboratory coats that: D. Unplugging the instrument A. Do not have buttons B. Are fluid-resistant 18. The acronym PASS refers to: C. Have short sleeves A. Presence of vital chemicals D. Have full-length zippers B. Operation of a fire extinguisher C. Labeling of hazardous material 8. All of the following should be discarded in biohazardous waste D. Presence of radioactive substances containers except: A. Urine specimen containers 19. The system used by firefighters to assess the risk potential when a fire B. Towels used for decontamination occurs in the laboratory is: C. Disposable laboratory coats A. SDS D. Blood collection tubes B. RACE C. NFPA 9. An employer who fails to provide sufficient gloves for the employees D. PASS may be fined by the: A. CDC 20. A class ABC fire extinguisher contains: B. NFPA A. Sand C. OSHA B. Water D. FDA C. Dry chemicals D. Acid 10. An acceptable disinfectant for decontamination of blood and body fluids is: 21. The first thing to do when a fire is discovered is to: A. Sodium hydroxide A. Rescue people in danger B. Antimicrobial soap B. Activate the alarm system C. Hydrogen peroxide C. Close doors to other areas D. Sodium hypochlorite D. Extinguish the fire if possible 22. If a red rash is observed after removing gloves, the employee: 33. The testing of a specimen from an outside agency and the comparison A. May be washing her hands too often of results with participating laboratories is called: B. May have developed a latex allergy A. External QC C. Should apply cortisone cream B. Electronic QC D. Should not rub her hands so vigorously C. Internal QC D. Proficiency testing 23. Pipetting by mouth is: A. Acceptable for urine but not serum 34. A color change indicating that a sufficient amount of a patient’s B. Not acceptable without proper training specimen or reagent is added correctly to the test system would be an C. Acceptable for reagents but not specimens example of: D. Not acceptable in the laboratory A. External QC B. Equivalent QC 24. The NPFA classification symbol contains information on all of the C. Internal QC following except: D. Proficiency testing A. Fire hazards B. Biohazards 35. What steps are taken when the results of reagent strip QC are outside C. Reactivity the stated confidence limits? D. Health hazards A. Check the expiration date of the reagent strip B. Run a new control 25. The GHS requires the following on a chemical label: C. Open a new reagent strips container A. Biohazard symbol, warning sign, environmental impact D. All of the above B. Hazard pictogram, signal words, hazard statement C. Biological symbol, hazard pictogram, long-term effects 36. When a new bottle of QC material is opened, what information is D. Signal words, hazard statement, biological symbol placed on the label? A. The supervisor’s initials 26. The classification of a fire that can be extinguished with water is: B. The lot number A. Class A C. The date and the laboratory worker’s initials B. Class B D. The time the bottle was opened C. Class C D. Class D 37. When a control is run, what information is documented? A. The lot number 27. Employers are required to provide free immunization for: B. Expiration date of the control A. HIV C. The test results B. HTLV-1 D. All of the above C. HBV D. HCV Chapter 2: Urine & Body Fluid Analysis 28. A possible physical hazard in the hospital is: Automation A. Wearing closed-toed shoes B. Not wearing jewelry 1. The principle commonly used to measure the concentration of a C. Having short hair particular analyte in the chemical examination of urine is: D. Running to answer the telephone A. Reflectance photometry B. Digital imaging 29. Quality management refers to: C. Flow cytometry A. Analysis of testing controls D. Auto particle recognition B. Increased productivity C. Precise control results 2. In automated urinalysis, the specific gravity is measured by: D. Quality of specimens and patient care A. Light transmittance B. Light scattering 30. During laboratory accreditation inspections, procedure manuals are C. Refractometry examined for the presence of: D. Turbidity A. Critical values B. Procedure references 3. All of the following are true concerning fully automated urine chemistry C. Procedures for specimen preservation analyzers, except: D. All of the above A. They are designed for a high-volume urinalysis laboratory. B. The reagent strip is dipped into the well-mixed urine. 31. As the supervisor of the urinalysis laboratory, you have just adopted a C. The urine tube moves through the instrument. new procedure. You should: D. A sample probe aspirates the urine. A. Put the package insert in the procedure manual B. Put a complete, referenced procedure in the manual 4. The advantages of an automated urine microscopy analyzer over C. Notify the microbiology department manual microscopy includes: D. Put a cost analysis study in the procedure manual A. Cost-effective B. Centrifugation not required 32. Indicate whether each of the following would be considered a 1) C. Standardized results preexamination, 2) examination, or 3) postexamination factor by placing D. All of the above the appropriate number in the blank: Reagent expiration date 5. Which of the following is a complete urinalysis automated urinalysis Rejecting a contaminated specimen system? Constructing a Levy-Jennings chart A. AUTION ELEVEN AE 4022 Telephoning a positive B. Clinitek Atlas Clinitest result on a newborn C. iQ200 Automated Urine Microscopy Calibrating the centrifuge D. Clinitek AUWi Pro System Collecting a timed urine specimen 6. What two technologies are used for urine sediment analysis? A. Light scattering and refractometry D. Are disposable B. Light scattering and flow cytometry C. Flow cytometry and digital imaging 7. Labels for urine containers are: D. Digital imaging and refractometry A. Attached to the container B. Attached to the lid 7. Which automated urine particle counter combines urine flow cytometry C. Placed on the container before collection with digital image analysis? D. Not detachable A. UN-2000 B. iRICELL 8. A urine specimen may be rejected by the laboratory for all of the C. UF-1000i following reasons except the fact that the: D. iQ 200 A. Requisition form states the specimen is catheterized B. Specimen contains toilet paper 8. Which of the following urine sediment particles cannot be autovalidated C. Label and requisition form do not match but will be flagged and must be reviewed by laboratory personnel? D. Outside of the container has contamination from fecal material A. RBCs B. WBCs 9. A cloudy specimen received in the laboratory may have been preserved C. RTEs using: D. Squamous epithelial cells A. Boric acid B. Chloroform 9. Which of the automated body fluid analyzers does not need to dilute or C. Refrigeration pretreat body fluids before analysis? D. Formalin A. ADVIA 2120i B. XN Series 10. For general screening, the specimen collected most frequently is a: C. iQ 200 A. Random one D. None of the above B. First morning C. Midstream clean-catch 10. What is a disadvantage of counting body fluid cells using an D. Timed automated instrument versus a Neubauer hemocytometer? A. Less labor-intensive and time-consuming 11. The primary advantage of a first morning specimen over a random B. More precise specimen is that it: C. Unable to count low WBC numbers and malignant cells A. Is less contaminated D. Able to perform a WBC differential B. Is more concentrated C. Is less concentrated Chapter 3: Introduction to Urinalysis D. Has a higher volume 1. The primary inorganic substance found in urine is: 12. If a routine urinalysis and a culture are requested on a catheterized A. Sodium specimen, then: B. Phosphate A. Two separate containers must be collected C. Chloride B. The routine urinalysis is performed first D. Calcium C. The patient must be recatheterized D. The culture is performed first 2. An unidentified fluid is received in the laboratory with a request to determine whether the fluid is urine or another body fluid. Using routine 13. If a patient fails to discard the first specimen when collecting a timed laboratory tests, which substances would determine that the fluid is most specimen, then the: probably urine? A. Specimen must be re-collected A. Glucose and ketones B. Results will be falsely elevated B. Urea and creatinine C. Results will be falsely decreased C. Uric acid and amino acids D. Both A and B D. Protein and amino acids 14. The primary cause of unsatisfactory results in an unpreserved routine 3. The average daily output of urine is: specimen not tested for 8 hours is: A. 200 mL A. Bacterial growth B. 500 mL B. Glycolysis C. 1200 mL C. Decreased pH D. 2500 mL D. Chemical oxidation 4. A patient presenting with polyuria, nocturia, polydipsia, and a low urine 15. Prolonged exposure of a preserved urine specimen to light will cause: specific gravity is exhibiting symptoms of: A. Decreased glucose A. Diabetes insipidus B. Increased cells and casts B. Diabetes mellitus C. Decreased bilirubin C. Urinary tract infection D. Increased bacteria D. Uremia 16. Which of the following would be least affected in a specimen that has 5. A patient with oliguria might progress to having: remained unpreserved at room temperature for more than 2 hours? A. Nocturia A. Urobilinogen B. Polyuria B. Ketones C. Polydipsia C. Protein D. Anuria D. Nitrite 6. All of the following are characteristics of recommended urine containers 17. Bacterial growth in an unpreserved specimen will: except: A. Decrease clarity A. A flat bottom B. Increase bilirubin B. A capacity of 50 mL C. Decrease pH C. A snap-on lid D. Increase glucose 18. The most sterile specimen collected is a: B. 1.010 A. Catheterized C. 1.015 B. Midstream clean-catch D. 1.020 C. Three-glass D. Suprapubic aspiration 10. For active transport to occur, a chemical must: A. Combine with a carrier protein to create electrochemical energy 19. Which of the following would not be given to a patient before the B. Be filtered through the proximal convoluted tubule collection of a midstream clean-catch specimen? C. Be in higher concentration in the filtrate than in the blood A. Sterile container D. Be in higher concentration in the blood than in the filtrate B. Iodine cleanser C. Antiseptic towelette 11. Which of the tubules is impermeable to water? D. Instructions A. Proximal convoluted tubule B. Descending loop of Henle 20. Urine specimen collection for drug testing requires the collector to do C. Ascending loop of Henle all of the following except: D. Distal convoluted tubule A. Inspect the specimen color B. Perform reagent strip testing 12. Glucose will appear in the urine when the: C. Read the specimen temperature A. Blood level of glucose is 200 mg/dL D. Fill out a chain-of-custody form B. Tm for glucose is reached C. Renal threshold for glucose is exceeded Chapter 4: Renal Function D. All of the above 1. The type of nephron responsible for renal concentration is the: 13. Concentration of the tubular filtrate by the countercurrent mechanism A. Cortical depends on all of the following except: B. Juxtaglomerular A. High salt concentration in the medulla C. Efferent B. Water-impermeable walls of the ascending loop of Henle D. Afferent C. Reabsorption of sodium and chloride from the ascending loop of Henle D. Reabsorption of water in the descending loop of Henle 2. The function of the peritubular capillaries is: A. Reabsorption 14. ADH regulates the final urine concentration by controlling: B. Filtration A. Active reabsorption of sodium C. Secretion B. Tubular permeability D. Both A and C C. Passive reabsorption of urea D. Passive reabsorption of chloride 3. Blood flows through the nephron in the following order: A. Efferent arteriole, peritubular capillaries, vasa recta, afferent arteriole 15. Decreased production of ADH: B. Peritubular capillaries, afferent arteriole, vasa recta, efferent arteriole A. Produces a low volume of urine C. Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta B. Produces a high volume of urine D. Efferent arteriole, vasa recta, peritubular capillaries, afferent arteriole C. Increases excretion of ammonia D. Affects active transport of sodium 4. Filtration of protein is prevented in the glomerulus by: A. Hydrostatic pressure 16. Bicarbonate ions filtered by the glomerulus are returned to the blood: B. Oncotic pressure A. In the proximal convoluted tubule C. Renin B. Combined with hydrogen ions D. The glomerular filtration barrier C. By tubular secretion D. All of the above 5. The renin–angiotensin–aldosterone system is responsible for all of the following except: 17. If ammonia is not produced by the distal convoluted tubule, the urine A. Vasoconstriction of the afferent arteriole pH will be: B. Vasoconstriction of the efferent arteriole A. Acidic C. Reabsorbing sodium B. Basic D. Releasing aldosterone C. Hypothenuric D. Hypersthenuric 6. The primary chemical affected by the renin–angiotensin– aldosterone system is: 18. Place the appropriate letter in front of the following clearance A. Chloride substances: B. Sodium A. Exogenous C. Potassium B. Endogenous D. Hydrogen beta2-microglobulin creatinine 7. Secretion of renin is stimulated by: cystatin C A. Juxtaglomerular cells 125I-iothalmate B. Angiotensin I and II C. Macula densa cells 19. The largest source of error in creatinine clearance tests is: D. Circulating angiotensin-converting enzyme A. Secretion of creatinine B. Improperly timed urine specimens 8. The hormone aldosterone is responsible for: C. Refrigeration of the urine A. Hydrogen ion secretion D. Time of collecting blood specimen B. Potassium secretion C. Chloride retention 20. Given the following information, calculate the creatinine clearance: 24- D. Sodium retention hour urine volume: 1000 mL; serum creatinine: 2.0 mg/dL; urine creatinine: 200 mg/dL 9. The fluid leaving the glomerulus has a specific gravity of: 21. Clearance tests used to determine the glomerular filtration rate must A. 1.005 measure substances that are: A. Not filtered by the glomerulus D. Inability to produce an acidic urine due to increased production of B. Completely reabsorbed by the proximal convoluted tubule ammonia C. Secreted in the distal convoluted tubule D. Neither reabsorbed nor secreted by the tubules 34. Tests performed to detect renal tubular acidosis after administering an ammonium chloride load include all of the following except: 22. Performing a clearance test using radionucleotides: A. Urine ammonia A. Eliminates the need to collect urine B. Arterial pH B. Does not require an infusion C. Urine pH C. Provides visualization of the filtration D. Titratable acidity D. Both A and C Chapter 5: Physical Examination of Urine 23. Variables that are included in the MDRD-IDSM estimated calculations of creatinine clearance include all of the following except: 1. The concentration of a normal urine specimen can be estimated by A. Serum creatinine which of the following? B. Weight A. Color C. Age B. Clarity D. Gender C. Foam D. Odor 24. An advantage to using cystatin C to monitor GFR is that: A. It does not require urine collection 2. The normal yellow color of urine is produced by: B. It is not secreted by the tubules A. Bilirubin C. It can be measured by immunoassay B. Hemoglobin D. All of the above C. Urobilinogen D. Urochrome 25. Solute dissolved in solvent will: A. Raise the vapor pressure 3. The presence of bilirubin in a urine specimen produces a: B. Lower the boiling point A. Yellow foam when shaken C. Decrease the osmotic pressure B. White foam when shaken D. Lower the freezing point C. Cloudy specimen D. Yellow-red specimen 26. Substances that may interfere with freezing-point measurement of urine and serum osmolarity include all of the following except: 4. A urine specimen containing melanin will appear: A. Ethanol A. Pale pink B. Lactic acid B. Dark yellow C. Sodium C. Blue-green D. Lipids D. Black 27. Clinical osmometers use NaCl as a reference solution because: 5. Specimens that contain hemoglobin can be visually distinguished from A. 1 g molecular weight of NaCl will lower the freezing point 1.86°C those that contain RBCs because: B. NaCl is readily frozen A. Hemoglobin produces a clear yellow specimen C. NaCl is partially ionized, similar to the composition of urine B. Hemoglobin produces a cloudy pink specimen D. 1 g equivalent weight of NaCl will raise the freezing point 1.86°C C. RBCs produce a cloudy red specimen D. RBCs produce a clear red specimen 28. The normal serum osmolarity is: A. 50 to 100 mOsm 6. A patient with a viscous orange specimen may have been: B. 275 to 300 mOsm A. Treated for a urinary tract infection C. 400 to 500 mOsm B. Taking vitamin B pills D. 3 times the urine osmolarity C. Eating fresh carrots D. Taking antidepressants 29. After controlled fluid intake, the urine-to-serum osmolarity ratio should be at least: 7. The presence of a pink precipitate in a refrigerated specimen is caused A. 1:1 by: B. 2:1 A. Hemoglobin C. 3:1 B. Urobilin D. 4:1 C. Uroerythrin D. Beets 30. Calculate the free water clearance from the following results: urine volume in 6 hours: 720 mL; urine osmolarity: 225 mOsm; plasma 8. Microscopic examination of a clear urine that produces a white osmolarity: 300 mOsm 31. To provide an accurate measure of renal blood precipitate after refrigeration will show: flow, a test substance should be completely: A. Amorphous urates A. Filtered by the glomerulus B. Porphyrins B. Reabsorbed by the tubules C. Amorphous phosphates C. Secreted when it reaches the distal convoluted tubule D. Yeast D. Cleared on each contact with functional renal tissue 9. The color of urine containing porphyrins will be: 32. Given the following data, calculate the effective renal plasma flow: A. Yellow-brown urine volume in 2 hours: 240 mL; urine PAH: 150 mg/dL; plasma PAH: 0.5 B. Green mg/dL 33. Renal tubular acidosis can be caused by the: C. Orange A. Production of excessively acidic urine due to increased filtration of D. Port wine hydrogen ions B. Production of excessively acidic urine due to increased secretion of 10. Which of the following specific gravities would be most likely to hydrogen ions correlate with a urine that is pale yellow? C. Inability to produce an acidic urine due to impaired production of A. 1.005 ammonia B. 1.010 C. 1.020 22. The unit of osmolality measured in the clinical laboratory is the: D. 1.030 A. Osmole B. Milliosmole 11. A urine specific gravity measured by a refractometer is 1.029, and the C. Molecular weight temperature of the urine is 14°C. The specific gravity should be reported D. Ionic charge as: A. 1.023 23. In the reagent strip specific gravity reaction, the polyelectrolyte: B. 1.027 A. Combines with hydrogen ions in response to ion concentration C. 1.029 B. Releases hydrogen ions in response to ion concentration D. 1.032 C. Releases hydrogen ions in response to pH D. Combines with sodium ions in response to pH 12. The principle of refractive index is to compare: A. Light velocity in solutions with light velocity in solids 24. Which of the following will react in the reagent strip specific gravity B. Light velocity in air with light velocity in solutions test? C. Light scattering by air with light scattering by solutions A. Glucose D. Light scattering by particles in solution B. Radiographic dye C. Protein 13. A correlation exists between a specific gravity by a refractometer of D. Chloride 1.050 and a: A. 2+ glucose Chapter 6: Chemical Examination of Urine B. 2+ protein C. First morning specimen 1. Leaving excess urine on the reagent strip after removing it from the D. Radiographic dye infusion specimen will: A. Cause runover between reagent pads 14. A cloudy urine specimen turns black upon standing and has a specific B. Alter the color of the specimen gravity of 1.012. The major concern about this specimen would be: C. Cause reagents to leach from the pads A. Color D. Not affect the chemical reactions B. Turbidity C. Specific gravity 2. Failure to mix a specimen before inserting the reagent strip will primarily D. All of the above affect the: A. Glucose reading 15. A specimen with a specific gravity of 1.035 would be considered: B. Blood reading A. Isosthenuric C. Leukocyte reading B. Hyposthenuric D. Both B and C C. Hypersthenuric D. Not urine 3. Testing a refrigerated specimen that has not warmed to room temperature will adversely affect: 16. A specimen with a specific gravity of 1.001 would be considered: A. Enzymatic reactions A. Hyposthenuric B. Dye-binding reactions B. Not urine C. The sodium nitroprusside reaction C. Hypersthenuric D. Diazo reactions D. Isosthenuric 4. The reagent strip reaction that requires the longest reaction time is the: 17. A strong odor of ammonia in a urine specimen could indicate: A. Bilirubin A. Ketones B. pH B. Normalcy C. Leukocyte esterase C. Phenylketonuria D. Glucose D. An old specimen 5. Quality control of reagent strips is performed: 18. The microscopic examination of a clear red urine is reported as many A. Using positive and negative controls WBCs and epithelial cells. What does this suggest? B. When results are questionable A. Urinary tract infection C. Per laboratory policy B. Dilute random specimen D. All of the above C. Hematuria D. Possible mix-up of specimen and sediment 6. All of the following are important to protect the integrity of reagent strips except: 19. Which of the following would contribute the most to a urine osmolality? A. Removing the desiccant from the bottle A. One osmole of glucose B. Storing in an opaque bottle B. One osmole of urea C. Storing at room temperature C. One osmole of sodium chloride D. Resealing the bottle after removing a strip D. All contribute equally 7. The principle of the reagent strip test for pH is the: 20. Which of the following colligative properties is not stated correctly? A. Protein error of indicators A. The boiling point is raised by solute B. Greiss reaction B. The freezing point is raised by solute C. Dissociation of a polyelectrolyte C. The vapor pressure is lowered by solute D. Double indicator reaction D. The osmotic pressure is raised by solute 8. A urine specimen with a pH of 9.0: 21. An osmole contains: A. Indicates metabolic acidosis A. One gram molecular weight of solute dissolved in 1 liter of solvent B. Should be re-collected B. One gram molecular weight of solute dissolved in 1 kilogram of solvent C. May contain calcium oxalate crystals C. Two gram molecular weights of solute dissolved in 1 liter of solvent D. Is seen after drinking cranberry juice D. Two gram molecular weights of solute dissolved in 1 kilogram of solvent 9. In the laboratory, a primary consideration associated with pH is: A. Identifying urinary crystals D. Enzymatic reaction between albumin and dye B. Monitoring vegetarian diets C. Determining specimen acceptability 20. The principle of the creatinine reagent pad on microalbumin reagent D. Both A and C strips is the: A. Double indicator reaction 10. Indicate the source of the following proteinurias by placing a 1 for B. Diazo reaction prerenal, 2 for renal, or 3 for postrenal in front of the condition. C. Pseudoperoxidase reaction A. Microalbuminuria D. Reduction of a chromogen B. Acute-phase reactants C. Preeclampsia 21. The purpose of performing an albumin:creatinine ratio is to: D. Vaginal inflammation A. Estimate the glomerular filtration rate E. Multiple myeloma B. Correct for hydration in random specimens F. Orthostatic proteinuria C. Avoid interference for alkaline urines G. Prostatitis D. Correct for abnormally colored urines 11. The principle of the protein error of indicators reaction is that: 22. A patient with a normal blood glucose and a positive urine glucose A. Protein keeps the pH of the urine constant should be further checked for: B. Albumin accepts hydrogen ions from the indicator A. Diabetes mellitus C. The indicator accepts hydrogen ions from albumin B. Renal disease D. Albumin changes the pH of the urine C. Gestational diabetes D. Pancreatitis 12. All of the following will cause false-positive protein values on a reagent strip except: 23. The principle of the reagent strip tests for glucose is the: A. Microalbuminuria A. Peroxidase activity of glucose B. Highly buffered alkaline urines B. Glucose oxidase reaction C. Delay in removing the reagent strip from the specimen C. Double sequential enzyme reaction D. Contamination by quaternary ammonium compounds D. Dye-binding of glucose and chromogen 13. A patient with a 2+ protein reading in the afternoon is asked to submit 24. All of the following may produce false-negative glucose reactions a first morning specimen. The second specimen has a negative protein except: reading. This patient is: A. Detergent contamination A. Positive for orthostatic proteinuria B. Ascorbic acid B. Negative for orthostatic proteinuria C. Unpreserved specimens C. Positive for Bence Jones protein D. Low urine temperature D. Negative for clinical proteinuria 25. The primary reason for performing a Clinitest is to: 14. Testing for microalbuminuria is valuable for early detection of kidney A. Check for high ascorbic acid levels disease and monitoring patients with: B. Confirm a positive reagent strip glucose A. Hypertension C. Check for newborn galactosuria B. Diabetes mellitus D. Confirm a negative glucose reading C. Cardiovascular disease risk D. All of the above 26. The three intermediate products of fat metabolism include all of the following except: 15. The primary chemical on the reagent strip in the Micral Test for A. Acetoacetic acid microalbumin binds to: B. Ketoacetic acid A. Protein C. β-hydroxybutyric acid B. Antihuman albumin antibody D. Acetone C. Conjugated enzyme D. Galactoside 27. The most significant reagent strip test that is associated with a positive ketone result is: 16. All of the following are true for the ImmunoDip test for microalbumin A. Glucose except: B. Protein A. Unbound antibody migrates farther than bound antibody C. pH B. Blue latex particles are coated with antihuman albumin antibody D. Specific gravity C. Bound antibody migrates farther than unbound antibody D. It utilizes an immunochromographic principle 28. The primary reagent in the reagent strip test for ketones is: A. Glycine 17. The principle of the protein-high pad on the Multistix Pro reagent strip B. Lactose is the: C. Sodium hydroxide A. Diazo reaction D. Sodium nitroprusside B. Enzymatic dye-binding reaction C. Protein error of indicators 29. Ketonuria may be caused by all of the following except: D. Microalbumin-Micral-Test A. Bacterial infections B. Diabetic acidosis 18. Which of the following is not tested on the Multistix Pro reagent strip? C. Starvation A. Urobilinogen D. Vomiting B. Specific gravity C. Creatinine 30. Urinalysis is frequently performed on a patient with severe back and D. Protein-high abdominal pain to check for: A. Glucosuria 19. The principle of the protein-low reagent pad on the Multistix Pro is the: B. Proteinuria A. Binding of albumin to sulphonphthalein dye C. Hematuria B. Immunological binding of albumin to antibody D. Hemoglobinuria C. Reverse protein error of indicators reaction 31. Place the appropriate number or numbers in front of each of the 42. All of the following can cause a negative nitrite reading except: following statements. Use both numbers for an answer if needed. A. Gram-positive bacteria 1. Hemoglobinuria B. Gram-negative bacteria 2. Myoglobinuria C. Random urine specimens A. Associated with transfusion reactions D. Heavy bacterial infections B. Clear red urine and pale yellow plasma C. Clear red urine and red plasma 43. A positive nitrite test and a negative leukocyte esterase test is an D. Associated with rhabdomyolysis indication of a: E. Produces hemosiderin granules in urinary sediments A. Dilute random specimen F. Associated with acute renal failure B. Specimen with lysed leukocytes C. Vaginal yeast infection 32. The principle of the reagent strip test for blood is based on the: D. Specimen older than 2 hours A. Binding of heme and a chromogenic dye B. Peroxidase activity of heme 44. All of the following can be detected by the leukocyte esterase reaction C. Reaction of peroxide and chromogen except: D. Diazo activity of heme A. Neutrophils B. Eosinophils 33. A speckled pattern on the blood pad of the reagent strip indicates: C. Lymphocytes A. Hematuria D. Basophils B. Hemoglobinuria C. Myoglobinuria 45. Screening tests for urinary infection combine the leukocyte esterase D. All of the above test with the test for: A. pH 34. List the following products of hemoglobin degradation in the correct B. Nitrite order of metabolism by placing numbers 1 to 4 in the blank, where 1 C. Protein indicates the beginning and 4 indicates the end product. D. Blood A. Conjugated bilirubin B. Urobilinogen and stercobilinogen 46. The principle of the leukocyte esterase reagent strip test uses a: C. Urobilin A. Peroxidase reaction D. Unconjugated bilirubin B. Double indicator reaction C. Diazo reaction 35. The principle of the reagent strip test for bilirubin is the: D. Dye-binding technique A. Diazo reaction B. Ehrlich reaction 47. The principle of the reagent strip test for specific gravity uses the C. Greiss reaction dissociation constant of a(n): D. Peroxidase reaction A. Diazonium salt B. Indicator dye 36. An elevated urine bilirubin with a normal urobilinogen is indicative of: C. Polyelectrolyte A. Cirrhosis of the liver D. Enzyme substrate B. Hemolytic disease C. Hepatitis 48. A specific gravity of 1.005 would produce the reagent strip color: D. Biliary obstruction A. Blue B. Green 37. The primary cause of a false-negative bilirubin reaction is: C. Yellow A. Highly pigmented urine D. Red B. Specimen contamination C. Specimen exposure to light 49. Specific gravity readings on a reagent strip are affected by: D. Excess conjugated bilirubin A. Glucose B. Radiographic dye 38. The purpose of the special mat supplied with the Ictotest tablets is C. Alkaline urine that: D. All of the above A. Bilirubin remains on the surface of the mat B. It contains the dye needed to produce color Chapter 7: Microscopic Examination of Urine C. It removes interfering substances D. Bilirubin is absorbed into the mat 1. Macroscopic screening of urine specimens is used to: A. Provide results as soon as possible 39. The reagent in the Multistix reaction for urobilinogen is: B. Predict the type of urinary casts present A. A diazonium salt C. Increase cost-effectiveness of urinalysis B. Tetramethylbenzidine D. Decrease the need for polarized microscopy C. p-Dimethylaminobenzaldehyde D. Hoesch reagent 2. Variations in the microscopic analysis of urine include all of the following except: 40. The primary problem with urobilinogen tests using Ehrlich reagent is: A. Preparation of the urine sediment A. Positive reactions with porphobilinogen B. Amount of sediment analyzed B. Lack of specificity C. Method of reporting C. Positive reactions with Ehrlich reactive substances D. Identification of formed elements D. All of the above 3. All of the following can cause false-negative microscopic results except: 41. The reagent strip test for nitrite uses the: A. Braking the centrifuge A. Greiss reaction B. Failing to mix the specimen B. Ehrlich reaction C. Diluting alkaline urine C. Peroxidase reaction D. Using midstream clean-catch specimens D. Pseudoperoxidase reaction 4. The two factors that determine relative centrifugal force are: A. Radius of rotor head and RPM D. Lysis of RBCs by acetic acid B. Radius of rotor head and time of centrifugation C. Diameter of rotor head and RPM 16. A finding of dysmorphic RBCs is indicative of: D. RPM and time of centrifugation A. Glomerular bleeding B. Renal calculi 5. When using the glass-slide and cover-slip method, which of the C. Traumatic injury following might be missed if the cover slip is overflowed? D. Coagulation disorders A. Casts B. RBCs 17. Leukocytes that stain pale blue with Sternheimer-Malbin stain and C. WBCs exhibit brownian movement are: D. Bacteria A. Indicative of pyelonephritis B. Basophils 6. Initial screening of the urine sediment is performed using an objective C. Mononuclear leukocytes power of: D. Glitter cells A. 4× B. 10× 18. Sometimes mononuclear leukocytes are mistaken for: C. 40× A. Yeast cells D. 100× B. Squamous epithelial cells C. Pollen grains 7. Which of the following should be used to reduce light intensity in bright- D. Renal tubular cells field microscopy? A. Centering screws 19. When pyuria is detected in a urine sediment, the slide should be B. Aperture diaphragm checked carefully for the presence of: C. Rheostat A. RBCs D. Condenser aperture diaphragm B. Bacteria C. Hyaline casts 8. Which of the following are reported as number per lpf? D. Mucus A. RBCs B. WBCs 20. Transitional epithelial cells are sloughed from the: C. Crystals A. Collecting duct D. Casts B. Vagina C. Bladder 9. The Sternheimer-Malbin stain is added to urine sediments to do all of D. Proximal convoluted tubule the following except: A. Increase visibility of sediment constituents 21. The largest cells in the urine sediment are: B. Change the constituents’ refractive index A. Squamous epithelial cells C. Decrease precipitation of crystals B. Urothelial epithelial cells D. Delineate constituent structures C. Cuboidal epithelial cells D. Columnar epithelial cells 10. Nuclear detail can be enhanced by: A. Prussian blue 22. A squamous epithelial cell that is clinically significant is the: B. Toluidine blue A. Cuboidal cell C. Acetic acid B. Clue cell D. Both B and C C. Caudate cell D. Columnar cell 11. Which of the following lipids is/are stained by Sudan III? A. Cholesterol 23. Forms of transitional epithelial cells include all of the following except: B. Neutral fats A. Spherical C. Triglycerides B. Caudate D. Both B and C C. Convoluted D. Polyhedral 12. Which of the following lipids is/are capable of polarizing light? A. Cholesterol 24. Increased transitional cells are indicative of: B. Neutral fats A. Catheterization C. Triglycerides B. Malignancy D. Both A and B C. Pyelonephritis D. Both A and B 13. The purpose of the Hansel stain is to identify: A. Neutrophils 25. A primary characteristic used to identify renal tubular epithelial cells is: B. Renal tubular cells A. Elongated structure C. Eosinophils B. Centrally located nucleus D. Monocytes C. Spherical appearance D. Eccentrically located nucleus 14. Crenated RBCs are seen in urine that is: A. Hyposthenuric 26. After an episode of hemoglobinuria, RTE cells may contain: B. Hypersthenuric A. Bilirubin C. Highly acidic B. Hemosiderin granules D. Highly alkaline C. Porphobilinogen D. Myoglobin 15. Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except: 27. The predecessor of the oval fat body is the: A. Observation of budding in yeast cells A. Histiocyte B. Increased refractility of oil droplets B. Urothelial cell C. Lysis of yeast cells by acetic acid C. Monocyte D. Renal tubular cell B. Degenerated cells C. Protein aggregates 28. A structure believed to be an oval fat body produced a Maltese cross D. Gram-positive cocci formation under polarized light but does not stain with Sudan III. The structure: 40. All of the following are true about waxy casts except they: A. Contains cholesterol A. Represent extreme urine stasis B. Is not an oval fat body B. May have a brittle consistency C. Contains neutral fats C. Require staining to be visualized D. Is contaminated with immersion oil D. Contain degenerated granules 29. The finding of yeast cells in the urine is commonly associated with: 41. Observation of broad casts represents: A. Cystitis A. Destruction of tubular walls B. Diabetes mellitus B. Dehydration and high fever C. Pyelonephritis C. Formation in the collecting ducts D. Liver disorders D. Both A and C 30. The primary component of urinary mucus is: 42. All of the following contribute to urinary crystals formation except: A. Bence Jones protein A. Protein concentration B. Microalbumin B. pH C. Uromodulin C. Solute concentration D. Orthostatic protein D. Temperature 31. The majority of casts are formed in the: 43. The most valuable initial aid for identifying crystals in a urine specimen A. Proximal convoluted tubules is: B. Ascending loop of Henle A. pH C. Distal convoluted tubules B. Solubility D. Collecting ducts C. Staining D. Polarized microscopy 32. Cylindruria refers to the presence of: A. Cylindrical renal tubular cells 44. Crystals associated with severe liver disease include all of the B. Mucus-resembling casts following except: C. Hyaline and waxy casts A. Bilirubin D. All types of casts B. Leucine C. Cystine 33. A person submitting a urine specimen after a strenuous exercise D. Tyrosine routine normally can have all of the following in the sediment except: A. Hyaline casts 45. All of the following crystals routinely polarize except: B. Granular casts A. Uric acid C. RBC casts B. Cholesterol D. WBC casts C. Radiographic dye D. Cystine 34. Before identifying an RBC cast, all of the following should be observed: 46. Casts and fibers usually can be differentiated using: A. Free-floating RBCs A. Solubility characteristics B. Intact RBCs in the cast matrix B. Patient history C. A positive reagent strip blood reaction C. Polarized light D. All of the above D. Fluorescent light 35. WBC casts are associated primarily with: 47. Match the following crystals seen in acidic urine with their A. Pyelonephritis description/identifying characteristics: B. Cystitis Amorphous urates 1. Envelopes C. Glomerulonephritis Uric acid 2. Thin needles D. Viral infections Calcium oxalate 3. Yellow-brown, monohydrate whetstone 36. The shape of the RTE cell associated with RTE casts is primarily: Calcium oxalate 4. Pink sediment A. Elongated dihydrate 5. Ovoid B. Cuboidal C. Round 48. Match the following crystals seen in alkaline urine with their D. Columnar description/identifying characteristics: Triple phosphate 1. Yellow granules 37. When observing RTE casts, the cells are primarily: Amorphous PO4 2. Thin prisms A. Embedded in a clear matrix Calcium phosphate 3. “Coffin lids” B. Embedded in a granular matrix Ammonium biurate 4. Dumbbell shape C. Attached to the surface of a matrix Calcium carbonate 5. White precipitate D. Stained by components of the urine filtrate 6. Thorny apple 38. The presence of fatty casts is associated with: 49. Match the following abnormal crystals with their description/identifying A. Nephrotic syndrome characteristics: B. Crush injuries Cystine 1. Bundles after refrigeration C. Diabetes mellitus Tyrosine 2. Highly alkaline pH D. All of the above Cholesterol 3. Bright yellow clumps Leucine 4. Hexagonal plates 39. Nonpathogenic granular casts contain: Ampicillin 5. Flat plates, high specific gravity A. Cellular lysosomes Radiographic 6. Concentric circles, radial  Dye striations Bilirubin 7. Notched corners 9. Ischemia frequently produces: 8. Fine needles seen in liver A. Acute renal tubular necrosis disease B. MCD C. Renal glycosuria 50. Match the following types of microscopy with their descriptions: D. Goodpasture syndrome Bright-field 1. Indirect light is reflected off the object 10. A disorder associated with polyuria and low specific gravity is: Phase 2. Objects split light into two A. Renal glucosuria beams B. MCD Polarized 3. Low-refractive-index objects may be C. Nephrogenic DI overlooked D. FSGS Dark-field 4. Three-dimensional images Fluorescent 5. Forms halo of light around 11. An inherited disorder producing a generalized defect in tubular object reabsorption is: Interference 6. Detects electrons emitted A. Alport syndrome contrast from objects B. AIN 7. Detects specific C. Fanconi syndrome wavelengths of light emitted D. Renal glycosuria from objects 12. A teenage boy who develops gout in his big toe and has a high serum uric acid should be monitored for: Chapter 8: Renal Disease A. Fanconi syndrome B. Renal calculi 1. Most glomerular disorders are caused by: C. Uromodulin-associated kidney disease A. Sudden drops in blood pressure D. Chronic interstitial nephritis B. Immunologic disorders C. Exposure to toxic substances 13. The only protein produced by the kidney is: D. Bacterial infections A. Albumin B. Uromodulin 2. Dysmorphic RBC casts would be a significant finding with all of the C. Uroprotein following except: D. Globulin A. Goodpasture syndrome B. AGN 14. The presence of RTE cells and casts is an indication of: C. Chronic pyelonephritis A. AIN D. Henoch-Schönlein purpura B. CGN C. MCD 3. Occasional episodes of macroscopic hematuria over periods of 20 or D. ATN more years are seen in patients with: A. Crescentic glomerulonephritis 15. Differentiation between cystitis and pyelonephritis is aided by the B. IgA nephropathy presence of: C. Nephrotic syndrome A. WBC casts D. GPA B. RBC casts C. Bacteria 4. Antiglomerular basement membrane antibody is seen with: D. Granular casts A. GPA B. IgA nephropathy 16. The presence of WBCs and WBC casts with no bacteria is indicative C. Goodpasture syndrome of: D. Diabetic nephropathy A. Chronic pyelonephritis B. ATN 5. ANCA is diagnostic for: C. AIN A. IgA nephropathy D. Both B and C B. GPA C. Henoch-Schönlein purpura 17. ESRD is characterized by all of the following except: D. Goodpasture syndrome A. Hypersthenuria B. Isosthenuria 6. Respiratory and renal symptoms are associated with all of the following C. Azotemia except: D. Electrolyte imbalance A. IgA nephropathy B. GPA 18. Prerenal acute renal failure could be caused by: C. Henoch-Schönlein purpura A. Massive hemorrhage D. Goodpasture syndrome B. ATN C. AIN 7. The presence of fatty casts is associated with all of the following except: D. Malignant tumors A. Nephrotic syndrome B. FSGS 19. The most common component of renal calculi is: C. Nephrogenic DI A. Calcium oxalate D. MCD B. Magnesium ammonium phosphate C. Cystine 8. The highest levels of proteinuria are seen with: D. Uric acid A. Alport syndrome B. Diabetic nephropathy 20. Urinalysis on a patient with severe back pain being evaluated for renal C. IgA nephropathy calculi would be most beneficial if it showed: D. NS A. Heavy proteinuria B. Low specific gravity 11. Urine from a newborn with MSUD will have a significant: C. Uric acid crystals A. Pale color D. Microscopic hematuria B. Yellow precipitate C. Milky appearance D. Sweet odor Chapter 9: Urine Screening for Metabolic Disorders 12. Hartnup disease is a disorder associated with the metabolism of: A. Organic acids 1. Abnormal urine screening tests categorized as an overflow disorder B. Tryptophan include all of the following except: C. Cystine A. Alkaptonuria D. Phenylalanine B. Galactosemia C. Melanuria 13. 5-HIAA is a degradation product of: D. Cystinuria A. Heme B. Indole 2. All states require newborn screening for PKU for early: C. Serotonin A. Modifications of the diet D. Melanin B. Administration of antibiotics C. Detection of diabetes 14. Elevated urinary levels of 5-HIAA are associated with: D. Initiation of gene therapy A. Carcinoid tumors B. Hartnup disease 3. All of the following disorders can be detected by newborn screening C. Cystinuria except: D. Platelet disorders A. Tyrosyluria B. MSUD 15. False-positive levels of 5-HIAA can be caused by a diet high in: C. Melanuria A. Meat D. Galactosemia B. Carbohydrates C. Starch 4. The best specimen for early newborn screening is a: D. Bananas A. Timed urine specimen B. Blood specimen 16. Place the appropriate letter in front of the following statements. C. First morning urine specimen A. Cystinuria D. Fecal specimen B. Cystinosis IEM 5. Which of the following disorders is not associated with the Inherited disorder of tubular reabsorption phenylalanine–tyrosine pathway? Fanconi syndrome A. MSUD Cystine deposits in the cornea B. Alkaptonuria Early renal calculi formation C. Albinism D. Tyrosinemia 17. Blue diaper syndrome is associated with: A. Lesch-Nyhan syndrome 6. The least serious form of tyrosylemia is: B. Phenylketonuria A. Immature liver function C. Cystinuria B. Type 1 D. Hartnup disease C. Type 2 D. Type 3 18. Homocystinuria is caused by failure to metabolize: A. Lysine 7. An overflow disorder of the phenylalanine–tyrosine pathway that would B. Methionine produce a positive reaction with the reagent strip test for ketones is: C. Arginine A. Alkaptonuria D. Cystine B. Melanuria C. MSUD 19. The Ehrlich reaction will detect only the presence of: D. Tyrosyluria A. Uroporphyrin B. Porphobilinogen 8. An overflow disorder that could produce a false-positive reaction with C. Coproporphyrin the Clinitest procedure is: D. Protoporphyrin A. Cystinuria B. Alkaptonuria 20. Acetyl acetone is added to the urine before performing the Ehrlich test C. Indicanuria when checking for: D. Porphyrinuria A. Aminolevulinic acid B. Porphobilinogen 9. A urine that turns black after sitting by the sink for several hours could C. Uroporphyrin be indicative of: D. Coproporphyrin A. Alkaptonuria B. MSUD 21. The classic urine color associated with porphyria is: C. Melanuria A. Dark yellow D. Both A and C B. Indigo blue C. Pink 10. Ketonuria in a newborn is an indication of: D. Port wine A. MSUD B. Isovaleric acidemia 22. Which of the following specimens can be used for porphyrin testing? C. Methylmalonic acidemia A. Urine D. All of the above B. Blood C. Feces D. All of the above A. Tube 1 B. Tube 2 23. The two stages of heme formation affected by lead poisoning are: C. Tube 3 A. Porphobilinogen and uroporphyrin D. Tube 4 B. Aminolevulinic acid and porphobilinogen C. Coproporphyrin and protoporphyrin 7. Place the appropriate letter in front of the statement that best describes D. Aminolevulinic acid and protoporphyrin CSF specimens in these two conditions: A. Traumatic tap 24. Hurler, Hunter, and Sanfilippo syndromes are hereditary disorders B. Intracranial hemorrhage affecting the metabolism of: Even distribution of blood in all tubes A. Porphyrins Xanthochromic supernatant B. Purines Concentration of blood in Tube 1 is greater than in Tube 3 C. Mucopolysaccharides Specimen contains clots D. Tryptophan 8. The presence of xanthochromia can be caused by all of the following 25. Many uric acid crystals in a pediatric urine specimen may indicate: 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 26. Deficiency of the GALT enzyme will produce a: 9. A web-like pellicle in a refrigerated CSF specimen indicates: A. Positive Clinitest A. Tubercular meningitis B. Glycosuria B. Multiple sclerosis C. Galactosemia C. Primary CNS malignancy D. Both A and C D. Viral meningitis 27. Match the metabolic urine disorders with their classic urine 10. Given the following information, calculate the CSF WBC count: cells abnormalities. counted, 80; dilution, 1:10; large Neubauer squares counted, 10. PKU A. Sulfur odor A. 8 Indicanuria B. Sweaty feet odor B. 80 Cystinuria C. Orange sand in diaper C. 800 Alkaptonuria D. Mousy odor D. 8000 Lesch-Nyhan E. Black color disease 11. A CSF WBC count is diluted with: Isovaleric F. Blue color A. Distilled water acidemia B. Normal saline C. Acetic acid D. Hypotonic saline OTHER BODY FLUIDS 12. A total CSF cell count on a clear fluid should be: Chapter 10: Cerebrospinal Fluid A. Reported as normal B. Not reported 1. CSF is produced mainly in the: C. Diluted with normal saline A. Bone marrow D. Counted undiluted B. Peripheral blood C. Choroid plexuses 13. The purpose of adding albumin to CSF before cytocentrifugation is to: D. Subarachnoid space A. Increase the cell yield B. Decrease the cellular distortion 2. The functions of the CSF include all of the following except: C. Improve the cellular staining A. Removing metabolic wastes D. Both A and B B. Producing an ultrafiltrate of plasma C. Supplying nutrients to the CNS 14. The primary concern when pleocytosis of neutrophils and lymphocytes D. Protecting the brain and spinal cord is found in the CSF is: A. Meningitis 3. The CSF flows through the: B. CNS malignancy A. Choroid plexus C. Multiple sclerosis B. Pia mater D. Hemorrhage C. Subarachnoid space D. Dura mater 15. Neutrophils with pyknotic nuclei may be mistaken for: A. Lymphocytes 4. Substances present in the CSF are controlled by the: B. Nucleated RBCs A. Arachnoid granulations C. Malignant cells B. Blood–brain barrier D. Spindle-shaped cells C. Presence of one-way valves D. Blood–CSF barrier 16. The presence of which of the following cells is increased in a parasitic infection? 5. What department is the CSF tube labeled 3 routinely sent to? A. Neutrophils A. Hematology B. Macrophages B. Chemistry C. Eosinophils C. Microbiology D. Lymphocytes D. Serology 17. Macrophages appear in the CSF after: 6. The CSF tube that should be kept at room temperature is: A. Hemorrhage B. Repeated spinal taps D. 2.8 C. Diagnostic procedures D. All of the above 29. The CSF IgG index calculated in Study Question 28 indicates: A. Synthesis of IgG in the CNS 18. Nucleated RBCs are seen in the CSF as a result of: B. Damage to the blood–brain barrier A. Elevated blood RBCs C. Cerebral hemorrhage B. Treatment of anemia D. Lymphoma infiltration C. Severe hemorrhage D. Bone marrow contamination 30. The finding of oligoclonal bands in the CSF and not in the serum is seen with: 19. After a CNS diagnostic procedure, which of the following might be A. Multiple myeloma seen in the CSF? B. CNS malignancy A. Choroidal cells C. Multiple sclerosis B. Ependymal cells D. Viral infections C. Spindle-shaped cells D. All of the above 31. Which condition is suggested by the following results: a CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 20. Hemosiderin granules and hematoidin crystals are seen in: mg/dL? A. Lymphocytes A. Fungal meningitis B. Macrophages B. Viral meningitis C. Ependymal cells C. Tubercular meningitis D. Neutrophils D. Bacterial meningitis 21. Myeloblasts are seen in the CSF: 32. A patient with a blood glucose of 120 mg/dL would have a normal CSF A. In bacterial infections glucose of: B. In conjunction with CNS malignancy A. 20 mg/dL C. After cerebral hemorrhage B. 60 mg/dL D. As a complication of acute leukemia C. 80 mg/dL D. 120 mg/dL 22. Cells resembling large and small lymphocytes with cleaved nuclei represent: 33. CSF lactate will be more consistently decreased in: A. Lymphoma cells A. Bacterial meningitis B. Choroid cells B. Viral meningitis C. Melanoma cells C. Fungal meningitis D. Medulloblastoma cells D. Tubercular meningitis 23. The reference range for CSF protein is: 34. Measurement of which of the following can be replaced by CSF A. 6 to 8 g/dL glutamine analysis in children with Reye syndrome? B. 15 to 45 g/dL A. Ammonia C. 6 to 8 mg/dL B. Lactate D. 15 to 45 mg/dL C. Glucose D. a-Ketoglutarate 24. CSF can be differentiated from serum by the presence of: A. Albumin 35. Before performing a Gram stain on CSF, the specimen must be: B. Globulin A. Filtered C. Transthyretin B. Warmed to 37°C D. Tau transferrin C. Centrifuged D. Mixed 25. In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is: 36. All of the following statements are true about cryptococcal meningitis A. Transferrin except: B. Transthyretin A. An India ink preparation is positive C. Prealbumin B. A starburst pattern is seen on Gram stain D. Ceruloplasmin C. The WBC count is over 2000 D. A confirmatory immunology test is available 26. Elevated values for CSF protein can be caused by all of the following except: 37. The most sensitive and specific method to detect the causative A. Meningitis organism in meningitis is: B. Multiple sclerosis