Top One Review Masters

Pre Board Examination

Clinical Microscopy

1. Guthrie test is a
a. Bacterial agglutination test c. Colorimetric test
b. Bacterial inhibition test d. Fluorometric test
2. Which statement below regarding urine pH is true?
a. High protein diet makes urine alkaline
b. pH tends to decrease as urine is stored
c. Contamination should be suspected if urine pH is less than 4.5
d. Bacteriuria is most often associated with a low urine pH
3. A patient with diabetes mellitus complicated with kidney malfunction is admitted to the
hospital. His chemical urinalysis results show a glucose level of 1000 mg/dl, a protein level of
2000 mg/dl and a ketone level of 40 mg/dl. The specific gravity is 1.018 using reagent strip.
What is the patients correct specific gravity?
a. 1.007 b. 1.008 c. 1.011 d. 1.018
4. Possible cause of uniform rusty sputum without pus
a. Pneumoccal pneumonia c. Bronchogenic CA
b. Congestive Heart Failure d. Tuberculosis
5. BAO = 18.0 MAO = 25.0 Based on the above gastric acid result, one would suspect
a. Pernicious anemia c. Duodenal ulcer
b. Gastric carcinoma d. Zollinger Ellisons
6. The following results usually concern Med Tech in charge and further testing is necessary
EXCEPT
a. Tyrosine crystals with a negative bilirubin test
b. T. vaginalis in male urine specimen
c. Cholesterol crystals in urine with sp gr > 1.040
d. Waxy casts and negative protein
7. The principle of reagent strip testing for bilirubin is based on
a. Diazo rxn b. Greiss rxn c. Ehrlich rxn d. Granulocytic esterase
8. Neutral alpha glucosidase originates solely from what male reproductive part?
a. Seminal vesicle b. Epididymis c. Prostate gland d. Testis
9. Which of the following findings in sputum examination is/are correctly matched?
a. Chronic bronchitis numerous neutrophils, abundant mucus
b. Asthma numerous eosinophils, Curschmanns spirals, Charcoat Leyden
c. Specimen is saliva not sputum numerous squamous epithelial cells
d. All
10. A male patient complains of back pain. The only significant finding in his urine sediment is RBC
10-12/hpf. Which of the following conditions is most likely to associate with these findings?
a. Acute glomerulonephritis c. Renal calculi
b. Nephrotic syndrome d. Congestive heart failure
11. A urine specimen was properly collected was delivered to the information section unlabelled.
However, when it was delivered beside it was completed request form. What would the Med
Tech do?
a. Discard the specimen and demand a new one
b. Call the attention of the person who delivered the specimen and have him label it
c. Label the specimen immediately and send in for processing
d. Ask for the collector of the specimen to verify the sample and have him label it
12. These crystals are considered pathologic only when they appear in freshly voided specimen.
Their presence may indicate increased nucleoprotein metabolism
a. Calcium oxalate c. Triple phosphate
b. Uric acid d. Ammonium biurate
13. Which of the following crystals considered nonpathological?
a. Cystine b. Bilirubin c. Ammonium biurate d. Cholesterol
14. Ideal in staining eosinophils in urine
a. Papanicolau b. Sternheimer-Malbin c. Hansel d. Giemsa
15. Which of the following is true of casts in urine?
a. The high power objective is employed in a search for theseelements
b. Some kind of stain is needed to make them at all visible
c. Presence in urine is always associated with renal failure
d. They tend to accumulate near the edges of the cover slip
16. Which of the following tests can evaluate renal blood flow?
a. PAH clearance c. Creatinine clearance
b. Urine osmolarity d. Mosenthal and Fishberg
17. Yeast infection is common in patients with
a. Diabetes mellitus c. Renal failure
b. Diabetes insipidus d. Nephrotic syndrome
18. Major clinical findings seen in PKU patients
a. Bossing chicks b. Mental retardation c. Cretin d. Gigantism
19. Screening test used for MSUD
a. Nitrosonaphtol b. DNPH c. Silver nitrate d. Ehrlics
20. Normal blood glucose with positive urine glucose is indicative of
a. Diabetes mellitus c. Tubular damage
b. Diabetes insipidus d. Glomerular damage
21. Semen which fails to liquefy within 1 hour indicates
a. Low specimen count c. Inadequate prostatic secretion
b. Low fructose level d. Increase acid phosphatase
22. A urinalysis of a 3 year old revealed a positive clinitest and a negative for glucose in a reagent
strip. How would these results be interpreted?
a. A strong oxidizing reagent is present c. Clinitest is more sensitive than reagent strip
b. Galactose is present d. Glucose and galactose is present
23. Which of the following can detect the presence of Cryptococcus neoformans in CSF?
1. India ink 2. Latex agglutination 3. Limulus lysate
 a. 1 & 2 b. 1 & 3 c. 2 & 3 d. 1 only
24. Considered as the Gold Standard clearance substance
a. Urea b. Creatinine c. Inulin d. B2-microglobulin
25. This is otherwise known as the concentration test
a. Glomerular filtration c. Tubular secretion
b. Tubular reabsorption d. All
26. Extravascular pathway of RBC destruction, EXCEPT
a. Haptoglobin is used as transporter c. Transferrin is used as transporter
b. Albumin is used as transporter d. 2 of the above choices
27. Intravascular pathway of RBC destruction
a. Liver converts B1 to B2 c. Spleen converts hemoglobin to B1
b. Hemopexin can be used as transporter d. 2 of the above choices
28. True hemoglobinuria
a. Occurs in intravascular pathway
b. Occurs in extravascular pathway
c. Occurs after depletion of haptoglobin and hemopexin
d. 2 of the above choices
29. Liver disease
1. (+) bilirubin in urine 3. (+) urobilinogen in urine
2. (-) bilirubin in urine 4. (-) urobilinogen in urine
a. 1 and 3 b. 2 and 4 c. 1 and 4 d. 2 and 3
30. Billiary obstruction
1. (+) bilirubin in urine 3. (+) urobilinogen in urine
2. (-) bilirubin in urine 4. (-) urobilinogen in urine
a. 1 and 3 b. 2 and 4 c. 1 and 4 d. 2 and 3
31. Hemolytic anemia
1. (+) bilirubin in urine 3. (+) urobilinogen in urine
2. (-) bilirubin in urine 4. (-) urobilinogen in urine
a. 1 and 3 b. 2 and 4 c. 1 and 4 d. 2 and 3
32. The recommended dilution of an appropriate disinfectant for blood-borne pathogens:
a. 1:10 b. 1:100 c. 1:2 d. 1:1000
33. What is the color of the sharps container?
a. Red b. black c. green d. yellow
34. Centrifuges are calibrated ________ and disinfected _____.
a. Weekly; every 3 months c. every 3 months; weekly
b. Monthly; weekly d. weekly; monthly
35. All of the following are paired organs EXCEPT:
a. Lungs b. kidneys c. adrenal glands d. none of the above
36. Urine is stored in the ______.
a. Ureters b. urinary bladder c. renal pelvis d. urethra
37. The blood level at which tubular readsorption stops for glucose is approximately ___.
a. 110 to 140 mg/dL b.40-500 mg/dL c. 70-110 mg/dL d. 160-180 mg/dL
38. Aldosterone is involved in the reabsorption of:
a. Potassium b. sodium c. bicarbonate d. hydrogen ion
39. Rennin, secreted by the nephron, is used to:
a. Lower systemic blood pressure c. increase systemic blood pressure
b. Maintain oncotic pressure d. increase water retention
40. Specific gravity of glomerular filtrate:
a. 1.010 b. 1.015 c. 1.000 d. 1.100
41. Microscopy technique employed when identifying cholesterol in oval fat bodies, fatty casts and
crystals:
a. Interference-contrast c. phase-contrast e. dark-field
b. Bright-field d. polarizing
42. This type of microscope enhances visualization of elements with low refractive indices (hyaline
casts, mixed cellular casts, mucus threads and Trichomonas).
a. Bright-field microscope c. Phase-contrast microscope
b. Polarizing microscope d. Dark-field microscope
43. The total magnification of the high power objective is:
a. 10x b. 100x c. 1000x d. 400x
44. Which of the following match of urine specimen-purpose is INCORRECT?
a. Early afternoon urobilinogen quantitation
b. First morning orthostatic proteinuria
c. 12-hour urine Addis count
d. Suprapubic aspiration prostate infection
45. A urine specimen submitted for routine urinalysis appeared uniformly turbid and remained the
same after filtration. What could possibly cause this?
1 nonsquamous epithelial cells 2 lipids 3 RBCs 4 bacteria 5 PMNs
a. 1, 2, 3 b. 2, 3, 4 c. 1 and 4 d. 4 only
46. This is used to preserve urine specimen intended for culture when the procedure cannot be
immediately done:
a. Formalin b. sodium fluoride c. thymol d. boric acid
47. Reagent strip tests for ketone bodies use the sodium nitroprusside reaction. This test, however,
does not measure ___ which accounts for ___of the total ketone bodies.
a. beta-hydroxybutyric acid; 78% c. acetoacetic acid; 20%
b. acetone 20% d. diacetic acid; 2%
48. Positive bilirubin reactions should be confirmed by:
a. Foam Test b. Acetest c. Ictotest d. Clinitest
49. Which of the following may not be found in acidic urine?
a. Uric acid b. calcium oxalate c. cholesterol d. triple phosphate
50. Crystal/s indicating severe liver disease:
a. Tyrosine b. leucine c. bilirubin d. all of the above
51. Presence of massive amounts of monohydrate calcium oxalate crystals is a hallmark finding in:
a. Ethylene glycol poisoning c. renal calculi
b. Ingestion of ascorbic acid d. ingestion of tomatoes
52. Presence of casts in the urine is known as:
a. Casturia b. castyuria c. cylindruria d. pyuria
53. The generative form of all casts is the __and this is stained ___by supravital stains:
1. Broad cast 2. Waxy 3. Light blue 4. Dark pink
a. 1 and 3 b. 2 and 4 c. 1 and 4 d. 2 and 3
54. Which of the following results must be expected if the kidney stone present in the urine sample
is organic?
a. Does not change on ashing c. if upon heating, it coagulates
b. Entirely consumed in the flame d. no such test exists
55. Finding more than 1% of eosinophils is considered clinically significant because they are not
normally seen in urine. The presence of urinary eosinophils is primarily asscociated with drug-
induced interstitial nephritis.
a. 1st statement is true, 2nd is false c. both statements are true
st nd
b. 1 statement is false, 2 is true d. both statements are false
56. ___ are not directly stained by Sudan III.
a. Cholesterol b. neutral fats c. triglycerides d. all of the above e. none
57. Yeast cells may be commonly seen in the urine of patients with ____
a. Liver diseases b. pyelonephritis c. vaginal moniliasis d. cystitis
58. Pregnancy testing may be done by testing for the beta-human chorionic gonadotropin hormone
which rise after conception and remain elevated in pregnancy, peaking in the first trimester of
pregnancy. The most popular type of test kit for this uses which of the following principles?
a. Enzyme immunoassay b. radioimmunoassay c. coagglutination d. FISH
59. The major beta globulin present in CSF is the:
a. Transferring b. prealbumin c. IgG d. albumin
60. The finding of oligoclonal bands in the CSF and not in the serum is seen with:
a. CNS malignancy b. multiple myeloma c. multiple sclerosis d. viral infections
61. These structures in the peritoneal fluid have concentric striations of collagen-like material and
are associated with ovarian and thyroid malignancy
a. Reticulate bodies b. negri bodies c. psammoma bodies d. councilman bodies
62. _____is the stimulant of choice for routine gastric acid analysis/
a. Histamine b. histalog c. pentagastrin d. insulin
63. A renal calculi described as yellowish to brownish red in color with a moderately hard
consistency is:
a. Cystine c. Calcium oxalate
b. Phosphate d. Uric acid
64. What is the sequence of cast formation starting from the most significant?
a. Waxy, hyaline, cellular, coarsely granular, finely granular
b. Cellular, coarsely granular, finely granular, hyaline, waxy
c. Hyaline, cellular, finely granular, coarsely granular, waxy
d. Waxy, finely granular, coarsely granular, cellular, hyaline
65. Renal disease that is caused by anti-neutrophilic cytoplasmic auto-antibody (ANCA) that binds to
neutrophils in vascular walls producing damage to small vessels in the lungs and glomerulus:
 a. Alport syndrome
b. Focal segmental glomerulosclerosis
c. Wegeners granulomatosis
d. Nephrotic syndrome
66. The presence of myelin basic protein (MBP) in the CSF may indicate:
a. Multiple myeloma c. Myelin sheath destruction
b. Multiple sclerosis d. B and C
67. An amniotic fluid creatinine level of >2.0 mg/dL indicates:
a. Mature fetal lungs c. Fetal age of more than 36 weeks
b. Renal disorder d. Neutral tube defects
68. Seminal fluid viscosity graded as 4 is described as:
a. Watery b. Fair c. Friable d. Gel-like
69. SSA grading: distinct turbidity with no granulation
a. 1+ b. 2+ c. 3+ d. trace
70. A clean-catch urine is submitted to the laboratory for routine urinalysis and culture. The routine
analysis is done first, and 3 hours later, the specimen is sent to the microbiology department for
culture. The specimen should be:
a. Cultured when nitrite is positive
b. Cultured when Gram stain shows bacteria
c. Rejected
d. Autoclaved then cultured
71. The following are the recommended conditions in using and preserving reagent strips, EXCEPT:
a. Keep at room temperature c. Store in a dark container
b. Closed tingly d. Blotted on the tissue face down
72. Amniotic fluid is tested for the concentration of lamellar bodies. This test determines:
a. Fetal age c. Hemolytic disease of the newborn
b. Fetal lung maturity d. Neural tube defects
73. What is(are) the variables(s) not included in the Cockgroft and Gault formula for creatinine
clearance?
1. Age 3. Urine creatinine
2. Sex 4. Body weight
a. 1, 2 and 3 c. 1, 2 and 4
b. 1 and 3 d. 3 only
74. A tea-colored urine may be caused by:
a. Drinking green tea c. Rifampin
b. Bilirubin d. Clorets
75. To avoid needle stick injuries, what procedure should one always follow?
a. Dispose needles in biohazard red-bag waste
b. Recap contaminated needles before disposing into sharps container
c. Place contaminated sharps into appropriate puncture-resistant, leak-proof container
immediately after use
d. Break and bend contaminated needles before disposing into sharps container
76. Eosinophils and Curschmanns spirals may be found in which of the following conditions?
a. Bronchiectasis c. Lobar pneumonia
b. Chronic bronchitis d. Bronchial asthma
77. Rice-watery stool is seen in:
a. Cholera c. Constipation
b. Typhoid fever d. Cystic fibrosis
78. The total renal plasma flow is approximately:
a. 60 mL/min b. 120 mL/min c. 600 mL/min d. 1200 mL/min
79. A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to
digest gelatin may have:
a. Bacterial dysentery c. Cystic fibrosis
b. Duodenal ulcer d. Lactose intolerance
80. Correct procedure for handwashing, EXCEPT:
a. Wet hands with boiling water
b. Clean between fingers for at least 15 seconds
c. Rinse hands in a downward position
d. Turn off faucets with a clean paper towel
81. Use of a refractometer over a urinometer is preferred due to the fact that the refractometer
uses:
a. Small urine volume and compensates for temperature
b. Small urine volume and compensates for protein
c. Large urine volume and compensates for temperature
d. Small urine volume and compensates for glucose
82. Post-stimulation specimens from persons with pernicious anemia will show:
a. No increased acidity and a pH above 6.0
b. No increased acidity and a pH below 6.0
c. Increased acidity and a pH below 6.0
d. Increased acidity and a pH below 3.5
83. The advantage to using phase-contrast microscopy in urinalysis is to:
a. Enhance constituents with a low refractive index
b. Provide higher magnification
c. Provide a larger field of view
d. Allow constituents to stain more clearly
84. Which of the following are indications of a traumatic tap?
1. Even distribution of blood on 3 tubes
2. Clear supernatant after centrifugation
3. Xanthochromia
a. 1 and 2 c. 2 only
b. 2 and 3 d. 1 only
85. Select the renal function test used to measure renal blood flow:
1. Creatinine 3. Specific gravity
2. Urea 4. p-aminohippuric acid
 a. 1 and 2 b. 3 only c. 4 only d. 1 and 3
86. Which of the following cells is most likely to be seen in the urine sediment following a
catheterization procedure?
a. Urothelial cell c. White blood cell
b. Squamous epithelial cell d. Renal tubular epithelial cell
87. A medical technologist is having trouble differentiating between RBCs, oil droplets and yeast
cells on a urine microscopy. Acetic acid should be added to the sediment to:
a. Lyse the yeast cells
b. Dissolve the oil droplets
c. Enhance the nuclear detail of the red blood cells
d. Lyse the red blood cells
88. Which of the following tests is least affected by standing or unpreserved urine?
a. Glucose b. Protein c. pH d. Bilirubin
89. A fire involving heavy metals is classified as a:
a. Class C fire c. Class E fire
b. Class B fire d. Class D fire
90. NFPA Health Hazard classification: Deadly
a. 1 b. 2 c. 3 d. 4
91. When combining acid and water, ensure that:
a. Acid is added to water c. They are added simultaneously
b. Water is added to acid d. water is slowly added to acid
92. Bacteria and yeasts are considered significant in the urine sediment when:
a. Nitrite is positive c. Specimen is cloudy
b. Protein is positive d. Leukocytes is positive
93. Gold standard for glomerular filtration rate:
a. Creatinine clearance c. Inulin clearance
b. Cystatin C clearance d. Urea clearance
94. The reading of distilled water by the refractometer is 1.003. What should you do?
a. Subtract 1.003 from each specimen reading
b. Add 1.003 to each specimen reading
c. Use a new refractometer
d. Adjust the set screw
95. Oval fat bodies are often associated with:
a. Nephrotic syndrome c. Chronic renal failure
b. Acute glomerulonephritis d. Chronic pyelonephritis
96. Preferred urine sample for pregnancy testing:
a. Random c. First morning
b. Fasting d. Midstream clean-catch
97. Which marker can be used to identify a blood fluid as semen?
a. Zinc c. PSA
b. Hyaluronic acid d. Alkaline phosphatase
98. Animal used in Hogben bioassay test for hCG:
 a. Female rabbit c. Male rats
b. Female toad d. Male frog
99. To alkalinize the urine, tell the patient to
a. Eat high meat protein diet c. Eat citrus fruits
b. Take methionine or ammonium chloride d. Eat fruits such as cranberries
100. In suspected cases Reyes syndrome, it is used to measure CSF?
a. Glucose b. Ammonia c. Lactic acid d. Glutamine