Clinical Microscopy Comprehensive Exam PDF

What department is the CSF tube labeled 3 routinely sent to? **A. Hematology** B. Chemistry C. Microbiology D. Serology 2. Which of the following findings is consistent with a subarachnoid hemorrhage rather than a traumatic tap? A. Clearing of the fluid as it is aspirated B. A clear supe...

What department is the CSF tube labeled 3 routinely sent to? **A. Hematology** B. Chemistry C. Microbiology D. Serology 2. Which of the following findings is consistent with a subarachnoid hemorrhage rather than a traumatic tap? A. Clearing of the fluid as it is aspirated B. A clear supernatant after centrifugation **C. Xanthochromia** D. Presence of a protein in the sample 3. Which of the following conditions is *most* often associated with normal CSF glucose and protein? A. Multiple sclerosis B. Malignancy C. Subarachnoid hemorrhage **D. Viral meningitis** 4. A web-like pellicle in a refrigerated CSF specimen indicates: **A. Tubercular meningitis** B. Multiple sclerosis C. Primary CNS malignancy D. Viral meningitis 5. A total CSF cell count on a clear fluid should be: A. Reported as normal B. Not reported C. Diluted with normal saline **D. Counted undiluted** 6. Which observation is *least* useful in distinguishing a hemorrhagic serous fluid from a traumatic tap? A. Clearing of fluid as it is aspirated B. Presence of xanthochromia **C. The formation of a clot** D. Diminished RBC count in successive aliquots 7. The finding of oligoclonal bands in the CSF and not in the serum is seen with: A. Multiple myeloma B. CNS malignancy **C. Multiple sclerosis** D. Viral infections 8. CSF lactate will be more consistently decreased in: A. Bacterial meningitis **B. Viral meningitis** C. Fungal meningitis D. Tubercular meningitis 9. The test of choice to detect neurosyphilis is the: A. RPR **B. VDRL** C. FAB D. ASO 10. Elevated CSF protein values can be caused by all of the following *except:* A. Meningitis B. Multiple sclerosis **C. Fluid leakage** D. CNS malignancy 11. CSF can be differentiated from serum by the presence of: A. Albumin **B. Globulin** C. Prealbumin D. Tau transferrin 12. Maturation of spermatozoa takes place in the: A. Sertoli cells B. Seminiferous tubules **C. Epididymis** D. Seminal vesicles 13. Enzymes for the coagulation and liquefaction of semen are produced by the: A. Seminal vesicles B. Bulbourethral glands C. Ductus deferens **D. Prostate gland** 14. What Temperature if you have a CSF tube 2? A. Freezing temp **B. Room temp** C. Refrigration temp D. 2 to 4 temp 15. Liquefaction of a semen specimen should take place within: **A. 1 hour** B. 2 hours C. 3 hours D. 4 hours 16. Measurement of α -glucosidase is performed to detect a disorder of the: A. Seminiferous tubules B**. Epididymis** C. Prostate gland D. Bulbourethral glands 17. Rapid, straight-line motility A. **4.0** B. 3.0 C. 2.0 D. 1.0 18. What is the *most* common cause of male infertility? A. Mumps B. Klinefelter syndrome **C. Varicocele** D. Malignancy 19. which of the following values is the lower limit of normal for sperm concentration? **A. 15 million per milliliter** B. 40 million per milliliter C. 60 million per milliliter D. 100 million per milliliter 20. Which morphological abnormality of sperm is *most* often associated with varicocele? A. **Tapering of the head** B. Cytoplasmic droplet below the neckpiece C. Lengthened neckpiece D. Acrosomal deficiency 21. Which of the following stains is used to determine sperm viability? A**. Eosin Y** B. Hematoxylin C. Papanicolaou D. Methylene blue 22. Which of the following semen analysis results is abnormal? **A. Volume 1.0 mL** B. Liquefaction 40 minutes at room temperature C. pH 7.6 D. Motility 50% progressive movement 23. When performing a seminal fluid analysis, what is the upper limit of normal for WBCs? **A. 1 × 106/mL** B. 5 × 106/mL C. 10 × 106/mL D. 20 × 106/mL 24. Which carbohydrate measurement is clinically useful when performing a seminal fluid analysis? A. Glucose B. Galactose **C. Fructose** D. Maltose 25. Which of the following stains is used to determine sperm morphology? **A. Eosin Y** B. Hematoxylin C. Papanicolaou D. Methylene blue 26. If the specimen is delay to test more than 2 hours for semenalysis what do you do to prevent fructolysis A. Stored room temp B. **Should be frozen** C. Use unpreservative solution D. Processing it 27. Post-vasectomy semen analysis should be done \_\_\_\_ after the surgery A. 3 Months B. **2 Months** C. 6 Months D. 1 year 28. Analysis should be done A. **After liquefaction** B. Before liquefaction C. Beginning liquefaction D. During liquefaction 29. What is the significance of semenalysis if the appearance is red / brown discoloration A. Infection B. **Blood** C. Urine contamination D. Flavin 30. Semen viscosity graded as 4: A. **Gel-like** B. Lumpy C. Watery D. Ropy 31. How are specimens for FLM testing delivered to and stored in the laboratory? A. **Delivered on ice and refrigerated** B. Immediately centrifuged C. Kept at room temperature D. Delivered in a vacuum tube 32. A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte? A. **Bilirubin** B. Lecithin C. Oxyhemoglobin D. Sphingomyelin 33. Which test *best* correlates with the severity of hemolytic disease of the fetus and newborn (HDFN)? A. Rh antibody titer of the mother B. Lecithin/sphingomyelin (L/S) ratio **C. Amniotic fluid bilirubin** D. Urinary estradiol 34. Which is the reference method for determining fetal lung maturity (FLM)? A. Human placental lactogen **B. L/S ratio** C. Amniotic fluid bilirubin D. Urinary estriol 35. Which of the following statements accurately describes human chorionic gonadotropin (hCG) levels in pregnancy? A. Levels of hCG rise throughout pregnancy **B. In ectopic pregnancy, serum hCG doubling time is below expected levels** C. Molar pregnancies are associated with lower levels than expected for the time of gestation D. hCG returns to nonpregnant levels within 2 days following delivery, stillbirth, or abortion 36. Which of the following statements about alpha fetoprotein (AFP) is correct? **A. Maternal serum may be used to screen for open neural tube defects** B. Levels above 4 ng/mL are considered positive C. Elevated levels in amniotic fluid are specific for spina bifida D. AFP levels increase in pregnancies associated with Down syndrome 38\. Which of the following is incorrectly match? A. Colorless - Normal B. Yellow - Hemolytic disease of the newborn (bilirubin) C. **Dark green - streaked Traumatic tap, abdominal trauma, intra-amniotic hemorrhage** D. Dark red-brown - Fetal death 39. Purpose of detecting creatinine level in amniotic fluid: A. Evaluate Lung maturity B. Detect Polyhydramnios C. Detect Fetal death D. **Detect Maternal urine** 40. Which following conditions to determine early treatment or intervention for down syndrome of what gestation? A. **15 to 18 weeks** B. 20 to 42 weeks C. 8 to 10 weeks D. 30 to 44 weeks 41. What specimen collection for neural tubes defects A. **Amniocentesis** B. Arthiocentesis C. Peritonelcentesis D, thoracic aminocentesis 42. If the specimen is already contamined blood or meconium what alternative test or least preffered to detect phospholipids for fetal lung maturity? A. Lecithin / sphingomyelin B. **Aminostat** C. Foam stability D. Lamellar body 43. What is the refference method for fetal lung maturity? A. **Lecithin / sphingomyelin** B. Aminostat C. Foam stability D. Lamellar body 44. Which of the following the Lecithin / sphingomyelin is \> 20 of what significance? A. Hemolytic disease of the newborn B. Neural tube disorders C. **Fetal lung maturity** D. Down syndrome 45. Lamellar bodies are densely packed layers of phospholipids that represent a storage form of pulmonary surfactant. They are secreted by A. Type 1 B. **Type 2** C. Type 3 D. Type 4 46. The term *effusion* refers to: A. A chest fluid that is purulent B. A serous fluid that is chylous **C. An increased volume of serous fluid** D. An inflammatory process affecting the appearance of a serous fluid 47. Which of the following conditions is commonly associated with an exudative effusion? **A. Congestive heart failure** B. Malignancy C. Nephrotic syndrome D. Cirrhosis 48. Which of the following conditions is associated with a chylous effusion? A. Necrosis B. Pulmonary infarction or infection C. Systemic lupus erythematosus or rheumatoid arthritis (RA) **D. Lymphatic obstruction** 49. A significant cell found in pericardial or pleural fluid that should be referred to cytology is a: A. Reactive lymphocyte **B. Mesothelioma cell** C. Monocyte D. Mesothelial cell 50. Which of the following statements regarding serous fluids is true? A. The normal volume of pleural fluid is 30 to 50 mL **B. Mesothelial cells, PMNs, lymphocytes, and macrophages may be present in normal fluids** C. Radiography can detect a 10% increase in the volume of a serous fluid D. Normal serous fluids are colorless 51\.  Peritoneal lavage is performed to:\ A) remove ascitic fluid\ B) check for the presence of bile\ **C) detect intra-abdominal bleeding**\ D) provide a sufficient volume of fluid for chemical analysis 52.Which of the following is most often associated with the formation of a transudate?\ **A) Malignancy**\ B) Congestive heart failure\ C) Pancreatitis\ D) Peritonitis 53. Peritoneal fluid is collected by a procedure called: A\) thoracentesis B\) asciticentesis **C) paracentesis** D)abdominalcentesis 54.The cells lining the pleural cavities are primarily:\ A) neutrophils\ **B) mesothelial cells**\ C) lymphocytes\ D) spindle-shaped cells 55\. What type of cell is a "ragocyte"? A. Cartilage cell seen in inflammatory arthritis **B. A PMN with inclusions formed by immune complexes** C. A plasma cell seen in RA D. A macrophage containing large inclusions 56.What is the significance if the synovial fluid is turbid A. Normal B. Trumatic tap C. **WBCs** D. Crystal 57.Synovial fluid forms a string that is 6 cm long. This is considered A. Abnormal B. Poorly viscous C. **Normal** D. Highliy viscous 58.Ropes/ mucin clot test hyalurinate polymerazation test of what reagent? A. **acetic acid** B. NSS C. Turk solution D. Dacie 59.Which of the following crystals is the cause of gout? **A. Uric acid or monosodium urate** B. Calcium pyrophosphate or apatite C. Calcium oxalate D. Cholesterol 60.Which crystal causes "pseudogout"? A. Oxalic acid **B. Calcium pyrophosphate dehydrate** C. Calcium oxalate D. Cholesterol 61.A synovial fluid sample is examined by using a polarizing microscope with a red compensating filter. Crystals are seen that are yellow when the long axis of the crystal is parallel to the slow vibrating light. When the long axis of the crystal is perpendicular to the slow vibrating light, the crystals appear blue. What type of crystal is present? A. Calcium oxalate B. Calcium pyrophosphate **C. Uric acid or monosodium urate** D. Cholesterol 62.In which type of arthritis is the synovial WBC count likely to be greater than 50,000/ µL? A. **Septic arthritis** B. B. Osteoarthritis C. Rheumatoid arthritis D. Hemorrhagic arthritis 63.Pleural fluid is collected by: A. Pleurocentesis B. Paracentesis C. Pericentesis **D. Thoracentesis** 64. If you have a synovial fluid sample what are the following tubes if you choose sterile anticoagulant for chemistry test A. Plain red top B. **EDTA** C. Heparin D. Glass red top 65. Rice bodies Macroscopically resemble polished rice. Microscopically show collagen and fibrin A. 1^st^ statement is true , 2^nd^ statemenend is false B. 1^st^ statement is false, 2^nd^ state is true C. **Both statement is true** D. Both statement is false 66.Anti-intrinsic factor and anti-parietal cells causing achlorhydia and anacidity A. **Pernicous Anemia** B. Atrophic gastritis C. Cancer of the stomach D. Zollinger-Ellison (Z-E) syndrome 67.Which of the following the Secrete HCl and intrinsic factor A. **Paretial Cells** B. Chief cells C. G cells D. Foveolar cells 68.In which condition is the *highest* level of serum gastrin usually seen? A. Atrophic gastritis B. Pernicious anemia C. **Zollinger-Ellison (Z-E) syndrome** D. Cancer of the stomach 69. produce pepsinogen? A. Paretial Cells **B. Chief cells** C. G cells D. Foveolar cells 70. Secret gastrin? A. Paretial Cells B. Chief cells C. **G cells** D. Foveolar cells 71. What Gastric tube inserted through the nose? A. Rehfuss tube B. **Levine tube** C. Pentagastrin D. Azure B 72. Normal volume of gastric fluid in fasting specimens A. **20 to 50mL** B. 60 to 100mL C. 70 to 110mL D. 90 to 150mL 73. Gastric tube inserted through the mouth? A. **Rehfuss tube** B. Levine tube C. Pentagastrin D. Azure B 74. What is the gold standard for clearance test A. Urea B. **Inulin** C. Cystatin C D. Creatinine 75.What is the unit if you calculating the creatinine clearance test A. dl/min B. **mL/min** C. G/min D. kg/min 76.The principle of refractive index is to compare: A. Light velocity in solutions with light velocity in solids **B. Light velocity in air with light velocity in solutions** C. Light scattering by air with light scattering by solutions D. Light scattering by particles in solution 77. What reagent to use if you callibrating the refractometer A. Urea B. Hydrogen C. **Sodium chloride** D. Amonium biurate 78. The normal yellow color of urine is produced by: A. Bilirubin B. Hemoglobin C. Urobilinogen D. **Urochrome** 79. A correlation exists between a specific gravity by refractometer of 1.050 and a: A. 2+ glucose B. 2+ protein C. First morning specimen **D. Radiographic dye infusion** 80\. Insolube in dilute acetic acid : A. Amorphous urates, carbonates B. Amorphous phosphates, carbonates C. **WBC, bacteria, yeast, spermatozoa** D. RBC, amorphous phosphates, carbonates 81\. What boselete test if the patient deprived of fluid for up to 24 hours A. Specific gravity B. Osmolality C. Mosenthal test D. **Fishberg test** 82.Which of the follwing If you using 12-hour urine method for? A. Nitrite B. Urobilinogen C. **Addis count** D. Urea 83. What is(are) the variable(s) included in the Modification of Diet in Renal Disease formula? A. 84. Introduced urinalysis as part of doctor's routine patient examination A. Thomas addis B. **Richard bright** C. Frederik dekkers D. Anton van leuwenhoek 85. if the urine sample is more than 2 hour or delay to test what preservatives if you have a specimen protien or albumin A. Stored to the ref B. Thymol C. **Boric acid** D. Formalin 86. RTE cells originating from the collecting ducts appear as: A. Cigar-shaped B. Round C. **Cuboidal** D. Oval 87\. The following are the recommended conditions in using and preserving reagent strips, EXCEPT: a. Keep at room temperature b. Closed tightly c. Store in a dark container d. **Blotted on the tissue faced down** 88. HCG is produced by which of the following? a. **Syncytiotrophoblast cells** b. Argentaffin cells c. Endocervical glandular cells d. Type II pneumocytes 89. How many days will hCG in urine disappear after ectopic pregnancy? A. 10 days B. **3-7 days** C. 15 days D. 30 days 90. The animal source of anti-hCG used in home-based pregnancy test kits is: A. Frog B. Mouse C. **Rabbit** D. Horse **Question 91** True regarding sputum: a. Normal color is green b. Usually sterile c. Rusty with pus is due to CHF d. **Produced by the tracheobronchial tree** **Question 92** Reagent used in the Apt test: A. Potassium hydroxide B. Sulfuric acid C. **Sodium hydroxide** D. Hydrochloric acid **Question 93** Bence-Jones protein coagulates at \_\_\_\_\_\_\_\_ and dissolves at \_\_\_\_\_\_\_\_\_\_: a. **40-60 C, 100 C** b. 100 C, 40-60 C c. \200 ug/min D. 10-100 ug/min **Question 174** Which of the following tests is least affected by standing or unpreserved urine? a. Glucose b. **Protein** c. pH d. Bilirubin **Question 175** The pH buffer utilized for protein reagent strips is: A. Ascorbate, pH 3.0 B. **Citrate, pH 3.0** C. Carbonate, pH 7.0 D. Citrate, pH 5.0 **Question 176** What change in urine is an indicator of pre-eclampsia? a. **Albuminuria** b. 4+ Glucose c. Hematuria d. Positive nitrite **Question 177** The principle of protein reagent strip to produce a visible colorimetric reaction is: A. Catalytic reaction between hydrogen peroxide and a chromogen B. Polyelectrolyte ionizes, releasing hydrogen ions in proportion to the number of ions in the solution C. Double indicator system with 0.5 increments D. **Certain indicators change in color in the presence of protein because protein accepts hydrogen ions from the indicator.** **Question 178** Which of the following factors will NOT interfere with the reagent strip test for leukocytes? a. Ascorbic acid b. Formaldehyde c. Urinary protein level of 500 mg/dL d. **Nitrite** **Question 179** What is the renal threshold for glucose? A. **160-180 mg/L** B. 60-180 g/L C. 160-180 mg/dL D. 160-180 g/dL **Question 180** What is the renal threshold for potassium? a. 6.5 mmol/L b. 3.0 mmol/L c. **Potassium has no threshold** d. 120 mmol/L **Question 181** Instrument based on refractive index: A. Harmonic oscillation densitometer B. Reflectance photometer C. Hydrometer D. **Total solids meter** **Question 182** Oval fat bodies are often associated with: a. **Nephrotic syndrome** b. Acute glomerulonephritis c. Chronic renal failure d. Chronic pyelonephritis **Question 183** While processing a specimen for drug testing, you noticed that the patient's urine temperature is out of range. What is the best course of action to take? A. Report the incident to PDEA B. Tell the patient to come back tomorrow for another urine specimen collection C. **Tell the patient to repeat collection, then report the incident to the supervisor** D. Proceed to the next step and wait for the results **Question 184** A physician requested for sperm count using undiluted semen. Which of the following can be used for counting? a. Neubauer counting chamber b. Hemocytometer c. **Makler counting chamber** d. None of these **Question 185** Principle utilized by home-based pregnancy testing kits: A. Radioimmunoassay B. **Enzyme immunoassay** C. Agglutination D. Hemagglutination **Question 186** Epithelial cell in urine with eccentric nucleus: a. **Renal tubular** b. Squamous c. Transitional d. Urothelial **Question 187** What is the specific gravity of triple distilled water when measured by refractometer? A. 1.003 B. 3.000 C. **1.000** D. 1.010 **Question 188** SITUATION: A lamellar body count (LBC) was performed on an amniotic fluid sample that was slightly pink within 1 hour of specimen collection. The sample was stored at 4°C prior to analysis. The result was 25,000/μL, classified as intermediate risk of RDS. The physician waited 24 hours and collected a new sample that was counted within 2 hours of collection on the same instrument. The LBC of the new sample was 14,000/μL and the patient was reclassified as high risk for delivery. Which statement best explains these results? a. Loss of lamellar bodies occurred in the second sample because of storage b. **Blood caused a falsely elevated result for the first sample** c. The fetal status changed in 24 hours because of respiratory illness d. The difference in counts is the result of day-to-day physiological and instrument variance **Question 189** A 20-year-old pregnant woman complains of lower pelvic discomfort, fever, and pain during urination for the past 2 days. She also reports seeing blood in her urine. Which of the following is the most likely cause of hematuria in this patient? A. **Acute cystitis** B. Acute pyelonephritis C. Bladder calculi D. Postinfectious glomerulonephritis **Question 190** In the patient described in the previous question (\#129), which of the following would be the most likely etiologic agent? a. Enterobacter sp. b. **Escherichia coli** c. Proteus vulgaris d. Streptococcus pyogenes **Question 191** A 20-year-old man presents with dysuria, urgency, and urethral discharge. Physical examination shows suppurative urethritis, with redness and swelling at the urethral meatus. Which of the following is the most likely etiology of urethritis in this patient? A. Chlamydia trachomatis B. Haemophilus ducreyi C. **Neisseria gonorrhoeae** D. Treponema pallidum **Question 192** A patient with lupus erythematosus has the following urinalysis results:These results would be associated with: a. **Chronic glomerulonephritis** b. Chronic pyelonephritis c. Acute interstitial nephritis d. Acute tubular necrosis **Question 193** Identify the object pointed by the arrow:  A. Oval fat body B. **Cholesterol crystal** C. Fatty cast D. Hyaline cast **Question 194** What type of microscopy is used in the following image? IMG\_261 a. Brightfield b. Phase-contrast c. Electron d. **Interference contrast** **Question 195** Identify the cells following image:  A. Squamous epithelial cells B. Pus cells in clumps C. **Transitional epithelial cells** D. Renal tubular epithelial cells **Question 196** What type of FOBT kit is seen in the image below? IMG\_263 a. **Guaiac-based** b. Immunochemical c. Porphyrin-based d. None of these **Question 197** Identify the cell pointed in the image below:  A. Leydig cell B. Spermatocyte C. **Sertoli cell** D. Epithelial cell **Question 198** What is the clinical significance of this microscopic finding? IMG\_265 a. **Glomerular bleeding** b. Urinary tract infection c. Yeast infection d. Renal lithiasis e. **Question 199** Identify the following image (Specimen: ascitic fluid):  A. Ovarian carcinoma cells B. **Psammoma bodies** C. Leucine crystals D. Myelin globules **Question 200** The crystal in the image below is soluble in which of the following? IMG\_267 a. Ammonia b. Dilute HCl c. Ether d. **A and B**