CHAPTER 4

ROUTINE URINALYSIS
1. Blood flow through a nephron of the kidney follows which of the following paths?
a. Efferent arteriole, peritubular capillaries, afferent arteriole
*b. Afferent arteriole, ureters, efferent arteriole
c. Efferent arteriole, afferent arteriole, peritubular capillaries
d. Afferent arteriole, peritubular glomerular capillaries, efferent arteriole

2. The electrolyte affected by rennin-angiotensin-aldosterone hormone is:

a. Magnesium
b. Potassium
c. Chloride
*d. Sodium

3. The daily volume of urine excreted depends would be affected by:

a. Water intake
b. Dehydration
c. Congestive heart failure
*d. All options are correct

5. Which of the following would not be a function of the renal system?

a. Filtration
b. Reabsorption
*c. Formation of blood cells
d. Secretion

6. The hormone most responsible for the regulation of sodium in the blood is:
a. Calcitriol
b. Erythropoietin
*c. Aldosterone
d. Antidiuretic hormone

7. The test used to determine the concentrating ability of the kidneys is:
a. Macroscopic evaluation
b. Creatinine clearance
*c. Osmolality
d. Measurement of daily volume

8. The three methods of determining the specific gravity of a urine sample include all the following except:
a. Refractometric measurement
b. Measurement by urinometer
*c. Weighing a given urine sample
d. Chemical measurement of ions

CHAPTER 5
1. How are body fluids other than urine and blood formed?
I- As an ultrafiltrate of blood plasma
II- By specialized cells that produce fluids in some systems
III- By the bone marrow of the body
*A. I and II
B. II and III
C. I, II and III
D. None of the options are correct
E. I only

2. Elements found in the examination of urine that have no clinical significance are:
a. Formed elements
*b. Artifacts
c. Cells of tissues and organs
d. Any chemical component

3. Body fluids include all of the following except:

a. Synovial fluid
b. Cerebrospinal fluid
c. Urine
d. Blood
*e. All options are body fluids
4. Intracellular fluid is contained:
a. Inside body cavities
b. Outside cell walls
*c. Inside cell walls
d. Only inside the nuclei of cells

5. Most of the fluids in the body are derived from:

a. Other organisms
b. Formation of fluids by body chemistry
*c. Foods and water
d. Formed in body cavities and absorbed

6. Organs and tissues that play a major role in water balance include all except:
a. Spleen
b. Kidneys
c. Liver
d. Lungs
*e. All options are correct

7. The term commonly used for the body fluid compartments of the human body are:
a. Blood and urine
*b. Intra- and extracellular fluids
c. Interstitial, transcellular
d. Serous and plasma fluids

8. The concentration of greatly influence the volume of body fluids found in various areas of the body?
a. Tissue cells
*b. Concentration of electrolytes
c. Infectious organisms
d. None of the options are correct

9. The term “osmolality” is best related to:

*a. Concentration of dissolved materials
b. Volume of fluids in the body
c. Water balance
d. Bone density

10. The term “phagocytosis” refers to:

a. Production of certain white cells
b. Displacement of red blood cells
c. A specific autoimmune disease
*d. Eating of the body’s cells

11. The disease called gout is based on the presence of:

a. Large numbers of white cells
b. Blood found in the urine specimen
c. High levels of electrolytes
*d. Presence of monosodium urate crystals

CHAPTER 7
1. The most common disorders of the urinary system are based on:
*a. Bacterial infection
b. Viral infection
c. Genetic manifestations
d. Anemia

2. The basic organs included in the urinary system include all of the following except:
a. Bladder
b. Ureters
*c. Uterus
d. Urethra

3. The kidney is responsible for a number of important functions. They normally include all of the following except: a.
Reabsorption
b. Filtration
c. Reabsorption
*d. Formation of crystals
4. The chief functional unit of the kidney is:
*a. Nephrons
b. Proximal tubule
c. Loop of Henle
d. Adrenal glands

5. The blood flow to the kidneys includes approximately what percentage of the total volume of the blood that
nourishes the body?
a. 50%
*b. 33%
c. 25%
d. All of the arterial blood supply

6. The flow of blood within the kidney is controlled by the functions of a complex hormone system that includes all
except:
*a. Antidiuretic hormone
b. Rennin
c. Angiotensin
d. Aldosterone

7. The glomerular flow rate of water containing low-molecular-weight substances that flow through the glomeruli of the
kidneys per minute is:
a. 12 mL/min
b. 1.2 mL/min
*c. 120 mL/min
d. None of the options are correct

8. The correct pH (acidity or alkalinity) of the blood of the human body is maintained by:
I- Retention or excretion of hormones
II- Retention or excretion of hydrogen ions
III- Retention or excretion of bicarbonate ions
A. I and III
*B. II and III
C. I, II and III
D. None of the options are correct
E. I only

9. Which of the following would greatly affect the specific gravity of the urine?
I- Dehydration
II- High levels of protein
III- Glycosuria
A. I and III
B. II and III
*C. I, II and III
D. None of the options are correct
E. I only

10. Which of the following statements is true regarding the value of using the measurement of osmolality rather than
osmolarity for the measurement of non-dissociable substance?
a. Osmolality is affected by changes in temperature, atmospheric pressure
b. Osmolarity is not affected by changes in temperature, atmospheric pressure
*c. Osmolality is not affected by changes in temperature, atmospheric pressure
d. Either method of measurement is equally acceptable

11. What is the physical or colligative property used to measure the concentration of solutes in the urine, serum or
plasma?
a. Boiling point depression
*b. Freezing point depression
c. Weighing of solutions, and comparing the values with that of pure water
d. Tensile strength of the bonds between atoms of the molecule

12. The stimulation of ADH is most effectively triggered by:

*a. Changes in NaCl concentration
b. Changes in potassium concentration
c. Insulin level
d. Proteinuria

13. Which of the following is/are components of Liddle’s syndrome?

*a. Extreme hypertension
b. Extreme hypotension
c. High levels of sodium excretion
d. High levels of potassium excretion

14. A disease caused by a malfunction of ADH is that of:

a. Diabetes mellitus
*b. Diabetes insipidus
c. Polyuria
d. None of the options are correct

15. The simplest and most easily treated urinary tract infection (UTI) is called:
*a. Cystitis
b. Pyelonephritis
c. Glomerulonephritis
d. Prostatitis

16. Acute pyelonephritis will produce a positive nitrite reaction due to:
*a. Presence of certain bacteria
b. Presence of white blood cells
c. Presence of red blood cells
d. Presence of increased glucose levels

17. The kidney condition referred to as the sterile inflammatory process is:
a. Polycystic kidney disease
b. Pyelonephritis
c. Urethritis
*d. Glomerulonephritis

18. Rheumatic fever is precipitated by:

a. Recurring cystitis
*b. Post streptococcal infections
c. Injudicious use of antibiotics
d. Repeated viral infections

19. Blood tests that may be elevated during the acute stages but will return to normal along with the urinalysis results
are:
a. Bacterial cultures
*b. Blood urea nitrogen, creatinine
c. Kidney enzymes
d. Pathological examinations of tissue

20. The disease characterized by progressive kidney failure but is accompanied by lung disease is called:
a. Urethritis
*b. Goodpasture’s syndrome
c. Rheumatic fever
d. End-stage renal disease

21. A condition that is characterized by massive proteinuria and associated edema is that of:
*a. Nephrotic syndrome
b. Liddle’s syndrome
c. Diabetes mellitus
d. Rheumatic fever

22. Acute renal failure is often characterized by:

a. Normal urine output
b. Decreased potassium levels
*c. Anuria or oliguria
d. Polyuria
23. A group of disorders called “amino acid disorders” usually refer to:
I- Enzyme deficiencies that prevent normal synthesizing of amino acids
II- Accumulation of abnormal metabolites
III- May be of the “renal” or “overflow” type
A. I and III
B. II and III
*C. I, II and III
D. None of the options are correct
E. I only

24. Various states within the US require tests at birth to detect hereditary metabolic disorders. The one required by all
states is that for:
a. Maple Syrup disease
b. Alkaptonuria
*c. Phenylketonuria
d. Diabetes mellitus

25. Fanconi’s syndrome is best described as an X-linked disease that is:

a. An acquired disease
b. A congenital disease
c. A cluster of symptoms and signs
*d. All options are correct

26. Metabolic acidosis may progress to an acute medical condition due to:
I- Hypoglycemia
II- Ketonuria
III- Increased serum ammonia levels
A. I and III
B. II and III
*C. I, II and III
D. None of the options are correct
E. I only

27. A precursor to the neurotransmitter serotonin is:

a. Niacin
*b. Tryptophan
c. Porphyrins
d. Dopamine

28. Porphyrins are the intermediate compounds in the production of:

a. Carbohydrates
b. Enzymes
c. Amino acids
*d. Heme

CHAPTER 8
1. Arguably, the most important constituent found in urine that may cause the majority of interferences with accurate
results, is that of:
a. Azo dyes
b. pH of the sample
c. Disinfectants
*d. Ascorbic acid

2. Measurement of the specific gravity of the urine is important in:

I- Determination of state of hydration
II- Concentrating ability of kidneys
III- Amount of dissolved ions in sample
A. I and III
B. II and III
*C. I, II and III
D. None of the options are correct
E. I only

3. Which of the following could affect the evaluation for protein in a urine sample?
a. Acid pH
*b. Alkaline pH
c. Ascorbic acid
d. Red blood cells

4. Which of the following may be most important in assessing kidney damage?

a. Glucose
b. Nitrites
c. Leukocyte esterase
*d. Protein

5. The presence of nitrites in a urine sample is indicative of:

a. Azo dyes
b. Presence of leukocytes
*c. Certain bacteria
d. Interfering substances

6. The test pad on the dipstick for measuring blood would be negative in the presence of:
a. Hemoglobin
b. Lysed red blood cells
c. Myoglobin
*d. Hemosiderin

7. Light chain immunoglobulins in the urine would be indicative of:

a. Myelocytic leukemia
b. Massive urinary tract infection
*c. Multiple myeloma
d. Prerenal conditions

8. Glycosuria, or glucose in the urine in abnormal amounts, would be present in:

a. Starvation
b. Diet rich in carbohydrates
c. Diabetes insipidus
*d. Diabetes mellitus

9. The finding of glucose in the urine would not be affected by:

I- Testing refrigerated urine
II- Increased bilirubin
III- Testing concentrated urine
A. I and III
B. II and III
*C. I, II and III
D. None of the options are correct
E. I only

10. The confirmatory test for bilirubin in the urine is:

a. Precipitation tests
b. Clinitest
*c. Ictotest
d. Bilirubin glucuronide

11. Which of the following is not one of the three ketone bodies?
a. Acetone
*b. Prednisone
c. Acetoacetic acid
d. Beta-hydroxybutyric acid

12. Precipitation tests are used to test for:

a. Carbohydrates
b. Ketones
c. TCA and SSA
*d. Proteins

13. A test for urobilinogen would indicate:

I- Liver disease
II- Presence of intact red blood cells
III- Destruction of red blood cells
IV- Poor kidney function
*A. I and III
B. II and IV
C. I, II and III
D. None of the options are correct
E. IV only

14. Tests for bilirubin in the urine would include evaluation for:
a. Hormone function
b. Kidney damage
*c. Liver disease
d. White blood cell destruction

CHAPTER 9
MICROSCOPIC/URINARY DISORDERS
1. In the examination of urine sediment, which of the following would be the most prominent indicator of early renal
disease?
a. Red blood cells
b. Aminoaciduria
*c. White blood cells
d. Uric acid crystals

2. Which of the following statements would not be true regarding findings in urinary sediment?
a. The presence of white blood cells indicates an infectious process in most cases
*b. Bacteria is always found microscopically in cases of cystitis
c. The presence of bacteria indicated an active bacterial infection
d. The presence of nitrites indicates the presence of white blood cells

3. Those suffering from the nephritic syndrome will always exhibit:

a. Edema of tissues
b. Albumin in the urine
c. Lipids in the urine
*d. Elevated blood albumin

4. The most predictive of the severity of renal disease would be the presence of:
a. White blood cells
b. Bilirubinuria
*c. Waxy casts
d. Hyaline casts

5. For confirming the presence of fat globules in the urine, which of the following would be included in completing the
microscopic examination?
a. Phase contrast microscopy
b. Electron microscopy
*c. Staining with a Sudan stain
d. Radiography of the kidneys

6. Renal epithelial cells originate from the:

a. Bladder
b. Urethra
c. Ureters
*d. Collecting ducts

7. Urinary casts are formed in:

*a. The distal convoluted tubule and collecting ducts of nephrons
b. The ureters
c. The bladder
d. None of the options are correct

CHAPTER 10
1. Where would tests be sent for further evaluation that are not routinely performed in a routine hospital laboratory?
a. To a senior technologist
b. To the pathologist
c. To another department of the lab
*d. To a reference lab

2. One of the contraindications of using a urine preservative is:

*a. Some analytes may be destroyed
b. The materials may be too expensive
c. The specimen would become dilute
d. Urine should never be preserved

4. A urine sample is comprised primarily of:

a. Blood plasma
b. Hormones and ultrafiltrates
c. Electrolytes and food products
*d. Water

5. The most important component of the following list in the evaluation of urine is:
*a. Chemical constituents
b. Viscosity
c. Color
d. Odor

6. Which of the following would not require a confirmatory test when a positive result was obtained by dipstick
chemistry?
a. Protein
*b. Leukocyte esterase
c. Bilirubin
d. Acetone (ketones)

7. Urinary sediment would be used to determine the presence of:

a. Glucose
b. Acetone
c. Bilirubin
*d. Yeasts

8. Which of the following findings would be particularly important in diagnosing an illness related to the urinary tract?
a. Color
b. Urine chemistry results
c. Specific gravity
A. I and III
B. II and III
*C. I, II and III
D. None of the options are correct
E. I only

9. High levels of metabolism of fats for energy would give a positive result of:
a. Glucose
b. Leukocyte esterase
c. Urobilinogen
*d. Ketones

10. Musty odors of the urine may sometimes be attributed to:

a. Diabetes
*b. Phenylketonuria
c. Maple Syrup Disease
d. Alkaptonuria

11. The clarity of urine is referred to as:

*a. Turbidity
b. Viscosity
c. Mucosity
d. Concentration

12. The specific gravity of urine using the refractometer compares the sample with:
a. Water
*b. Air
c. Other urine samples
d. Standard solutions

13. Urobilinogen is formed directly from:

a. Urochrome
b. White blood cells
*c. Bilirubin
d. Hemoglobin

14. The chemistry test performed on urine that is most sensitive to sunlight is:
a. Complete urinalysis
b. Glucose
c. Ketones
*d. Bilirubin

15. The chemistry test performed on urine that is most sensitive to high alkalinity is:
a. Glucose
*b. Protein
c. Ketones
d. Bilirubin

16. A species of bacteria that is able to convert nitrates to nitrites is:

a. Staphylococcus aureus
b. Clostridium perfringens
*c. Escherichia coli
d. Streptococcus pyogenes

17. The best type of specimen for a complete urinalysis is:

*a. Fresh
b. Preserved
c. Refrigerated
d. Stored at room temperature

18. Most test results provided by urinary dipstick are:

a. Quantitative
*b. Semi-quantitative
c. Direct
d. Direct

19. The purpose of centrifuging a urine sample is to:

a. Dilute the sample results
*b. Concentrate the sample results
c. Make the results more specific
d. Make the tests easier to perform

20. The Clinitest is used to:

a. Give a true value for glucose
b. Give an accurate bilirubin level
*c. Detect reducing sugars
d. Determine the presence of acetone

CHAPTER 11 CEREBROSPINAL FLUID

1. The most common condition for which a lumbar puncture is performed is for the diagnosis of:
a. Subarachnoid hemorrhage
b. Streptococcal pharyngitis
c. Malignancy of the CNS
*d. Meningitis

2. The centrifuged supernatant from cerebrospinal fluid is pink to yellowish. The most likely cause is:
a. Clear
b. Traumatic lumbar puncture
*c. Subarachnoid hemorrhage
d. Viral meningitis

3. As a result of a traumatic spinal tap, which of the following patterns would be observed from a sequential collection
of CSF?
*a. More red color in tube #1
b. Even redness though all tubes
c. More red in tube #3 than in tube #1
d. Red color increases from #1 to #4 tubes

4. When polymorphonuclear cells are increased in a CSF sample, the likely cause is:
a. Viral meningitis
*b. Bacterial meningitis
c. Allergic reaction to povidone-iodine
d. None of the options are correct

5. Viral meningitis is usually diagnosed by:

I- Increase in lymphocytes
II- Positive antibody level for specific virus
III- Increase in neutrophils
*A. I and II
B. II and III
C. I, II and III
D. None of the options are correct
E. I only

6. Excess cerebrospinal fluid is retained in the ventricles of the brain in which of the following?
a. Hypoglycemia
*b. Hydrocephalus
c. Acute viral meningitis
d. Leakage of CSF, cerebral herniation

7. Under normal conditions, glucose and protein levels in the CSF would be:
a. Higher than that found in blood
b. Same as that found and blood
*c. Lower than that found in blood
d. Will vary, even in normal individuals

8. Which of the following is used to prevent infection of the CNS during lumbar puncture?
a. Creatine kinase
b. Sodium hypochlorite
*c. Povidone-iodine
d. 70% isopropyl alcohol

9. The most commonly diagnosed demyelinating disease of the CNS is:

a. Multiple myeloma
*b. Multiple sclerosis
c. Multisequential antibody titers
d. Viral meningitis

10. Intracranial pressure is monitored during a lumbar puncture. When the pressure drops significantly following
aspiration of a small amount of CSF, the likely reason is:
I- Spinal compression above puncture
II- Too much fluid was withdrawn
III- Presence of a cerebral herniation
IV- This is a normal occurrence
*A. I and III
B. II and IV
C. I, II and III
D. None of the options are correct
E. IV only

11. The origin of blood found in CSF can be determined by:

a. The fact that the blood clotted
*b. Test for D-Dimer Fibrin
c. Presence of C-reactive protein
d. Pus in the fluid

12. Cytocentrifugation is chiefly used for:

*a. WBC cellular differentiation
b. RBC cellular differentiation
c. Separation of viruses from bacteria
d. None of the options are correct
13. When doing a preliminary differentiation of leukocytes while using a hemocytometer, which of the following would
be used to enable an estimate of the types of cells present?
*a. Wright’s stain
b. Povidone-iodine
c. Glacial acetic acid
d. Cytological stain

14. Which of the following would be elevated following hypoxia with an impact on the brain?
a. Glucose
b. Creatine kinase
c. Lactic dehydrogenase
*d. Lactate

15. A decreased CSF protein might result from:

a. Plasma contamination
*b. Tears of the lining of the brain
c. Traumatic puncture
d. Blockages by tumors and scars

16. An increased CSF protein might result from:

I- Plasma contamination
II- Tears of the lining of the brain
III- Traumatic puncture
IV- Blockages by tumors and scars
*A. I and III
B. II and IV
C. I, II and III
D. None of the options are correct
E. IV only

17. A decreased CSF glucose may be the result of which of the following:
*a. Delay in testing
b. Bloody or traumatic spinal tap
c. Diabetic coma
d. All options are correct

18. An increased CSF glucose may be the result of which of the following:
a. Delay in testing
b. Bloody or traumatic spinal tap
*c. Diabetic coma
d. All options are correct

CHAPTER 12 SEMINAL FLUID

1. What is the most common test performed to determine causes of infertility in a couple?
a. Marital counseling
b. Evaluation of the ova of the female
c. Performing chemistry tests on semen
*d. Complete sperm count

2. Which of the following is most cost effective in determining causes of infertility?

a. In vitro fertilization
b. In vivo fertilization
*c. Complete sperm count
d. X-rays of female reproductive organs

3. Which of the following would not be a factor in determining sperm motility?

a. Infection of the prostate glands
b. Epididymitis
*c. Vasectomy
d. Antibodies against the sperm

4. Which of the following is the best way for collecting sperm samples?
a. Coitus interruptus
b. Collection from a condom
*c. Masturbation
d. None of the options are correct

5. The most important component to be considered in determining a male’s fertility status is:
a. pH of the semen
b. Volume of the semen
*c. Sperm count
d. Wife’s monthly hormone changes

6. The semen should be collected on which of the following schedules to detect a man’s fertility status that is based on a
semen analysis:
a. At least 2 samples are analyzed
b. Specimens are collected 7 days apart
c. Analysis spans 2–3 months
*d. All options are correct

7. Sperm counts are performed based on the following units of measurement:

a. Count per liter
b. Count per microliter (μL)
c. Count per deciliter (dL)
*d. Count per milliliter (mL)

8. Sperm cells that are for the most part aligned head to tail is exhibiting which of the following?
*a. Immunological response
b. Agglutination
c. Normal liquefaction
d. Molecular attraction

9. Semen should liquefy within:

a. Ten minutes
b. Not at all normally
*c. Within thirty minutes
d. After one hour

10. A more dilute semen sample would most likely show:

a. Increased count per unit
*b. Decreased count per unit
c. Same as a less dilute sample
d. Impedance of sperm motility

CHAPTER 13 SEROUS FLUID

1. Which of the following body fluids is not always considered as an ultrafiltrate of blood?
a. Synovial fluid
b. Pericardial fluid
c. Peritoneal fluid
*d. Cerebrospinal fluid

2. A chemistry test on amniotic fluid that gives information related to neural tube deficits is:
*a. Alpha-fetoprotein
b. Meconium
c. Lecithin-sphingomyelin
d. Kleihauer-Bettke

3. The “Fern test” determines the presence of:

*a. Progesterone
b. Cervical mucus
c. Meconium
d. Phagocytes

4. The most obvious difference between an exudates and a transudate would be:
*a. Elevated protein in an exudate
b. Elevated protein in a transudate
c. Protein in transudate equal to blood
d. None of the options are correct

5. The chief mechanism by which transudate effusions may accumulate in bodily cavities is
*a. Hydrostatic pressure
b. Response to infectious processes
c. Clots formation
d. Presence of crystals

6. Which of the following would be the most accurate statement?

a. Exudates form due to a disruption in the balance of filtration and reabsorption
*b. Transudates form due to a disruption in the balance of filtration and reabsorption
c. Transudates are produced by inflammatory conditions involving an organ
d. Exudates form as a result of a systemic disorder

7. Necrosis of an organ or tissue may be determined by performing:

a. Ultrasound image
b. Kleihauer-Bettke stain
*c. Lactate dehydrogenase
d. Complete blood count

8. The serous fluid that could perhaps require the most extensive group of tests would be:
a. Synovial fluid
b. Cerebrospinal fluid
*c. Amniotic fluid
d. Peritoneal transudate

9. A type of white blood cell found in nasal secretions during an allergic reaction is:
a. Basophil
b. Polymorphonuclear cell
c. Mononuclear cell
*d. Eosinophil

10. Why is differentiation of white blood cells found in body fluids important?
a. Differentiation provides information related to the severity of the disorder
*b. Differentiation provides information as to the type of infectious process present
c. Differentiation is used to differentiate exudates from transudates
d. Differentiation gives the origin of the problem as to the organ involved

11. The anticoagulant used to preserve the morphology of blood cells is:
a. Heparin
b. Methylene blue
c. Glacial acetic acid
*d. EDTA

12. The type of tube used for microbiological testing of body fluids is:
a. Sterile EDTA tube
b. Sterile clot tube
*c. Sterile heparinized tube
d. Any type is acceptable

13. Which of the following would not lead to an increase in the volume of the body fluid found in the affected site?
*a. The turbidity, odor, color of the fluid
b. Decreases or increases in hydrostatic pressure
c. Increase in capillary permeability which occurs in acute inflammatory reactions
d. Decrease in lymphatic reabsorption, or obstructions that prevent reabsorption

14. Which of the following serous fluids would normally be crystal clear?
a. Synovial fluid
b. Pericardial effusions
*c. Cerebrospinal fluid
d. Fluid from pericardial sac

15. An encapsulated yeast found in cerebrospinal fluid is often determined by:

a. Gram stain
*b. India ink prep
c. Acid fast stain
d. New methylene blue dye

16. Turk’s stain will:

a. Stain red blood cells
*b. Lyse red blood cells
c. Lyse white blood cells
d. Provide cytopathology stains

17. Inflammation of the lining of the heart is called:

*a. Endocarditis
b. Peritonitis
c. Cardiac tamponade
d. None of the options are correct

18. Oncotic pressure of the blood plasma is associated with:

a. Glucose levels
b. Numbers of blood cells
c. Body fluid volume
*d. Albumin

19. Amniotic fluid, during the second and third trimesters of pregnancy, is chiefly composed of:
a. Normal physiological saline
b. High protein plasma
*c. Urine from the fetus
d. Meconium

20. The test used to differentiate fetal cells from maternal cells is:
a. Alpha-fetoprotein
b. Lecithin-sphingomyelin
c. Fern test
*d. Kleihauer-Bettke

CHAPTER 14 SYNOVIAL FLUID

1. Synovial fluid is collect by a procedure called:
a. Lumbar puncture
b. Phlebotomy
*c. Arthrocentesis
d. Arteriocentesis

2. When red blood cells are found in synovial fluid, they are usually the result of:
I- Traumatic injury
II- Acute infection
III- Traumatic joint fluid tap
*A. I and III
B. II and III
C. I, II and III
D. None of the options are correct
E. I only

3. An effusion into the synovial cavity will:

a. Have no effect
*b. Increase volume of fluid
c. Decrease volume of fluid
d. Indicate bacterial infection

4. Crystals are best observed by:

a. Utilizing macroscopic methods
b. Using a brightfield microscope
*c. Employing phase contrast technique
d. Chemistry tests for properties

5. Synovial fluid will normally have:

a. Many white blood cells
b. Many red blood cells
*c. No red blood cells
d. High glucose level

6. Needle-like crystals that are yellow and are characteristic of acute gouty arthritis are:
a. Corticosteroid
b. Leucine
*c. Monosodium urate
d. Hydroxyapatite

7. The viscosity of synovial fluid is due to:

*a. Hyaluronic acid
b. Protein in the fluid
c. Bacterial infection
d. Cartilage debris

CHAPTER 15 FECAL ANALYSIS

1. A Gram stain of the feces is not normally important for the finding of bacteria because:
a. Feces is usually sterile
b. A Gram stain is for viruses only
*c. Thousands of species of bacteria are found in normal stool samples
d. A Gram stain is for the identification of white blood cells only

2. The presence of abnormal amounts of fats in the stool is indicative of:

*a. Pancreatic disorder
b. Diet high in fats
c. Bacterial infection
d. Viral infection

3. The odor given off by fecal samples is caused by:

a. Food breakdown
b. Viral contamination
c. Bacterial contamination
*d. Bacterial metabolism

4. Which of the following would not be considered an abnormal condition for feces?
*a. Massive numbers of bacteria
b. Large numbers of white blood cells
c. Muscle fibers
d. More than ten fat bodies/HPF

5. A large proportion of the bulk of a stool sample is accounted for by:

a. Blood products
b. Unmetabolized sugars
*c. Bacteria
d. Intestinal parasites

6. The normal brown color of feces is attributed to:

a. Mucus
b. Undigested foods
*c. Bile
d. Digestive cells

7. The term used for stools that are black in color is:
a. Hematochezia
*b. Melena
c. Jaundice
d. Urobilinogen

8. Black, tarry stools is a sign of:

*a. Bleeding from the upper gastrointestinal tract
b. Acute and current bleeding
c. Foods containing blood
d. High bilirubin levels in the blood

9. A whitish or silver color in the fecal sample is often due to:

*a. Obstructed bile duct
b. Ingestion of bismuth
c. Eating food from aluminum pots
d. Increased urobilinogen in stool
10. The guiac reaction for occult blood may yield a false positive when:
a. Peptic ulcers are bleeding
b. The common bile duct is obstructed
*c. Large amounts of meat are eaten
d. The patient is anemic

11. A condition called “ulcerative colitis” may result from:

a. Active bleeding from the intestines
b. Liver disease causing release of bilirubin
*c. Infection by Clostridium difficile
d. Increase in numbers of white blood cells in stool

12. Decreased fat absorption is due to a variety of medical conditions. Which of the following would not be a cause for
decreased fat absorption? a. Chronic pancreatitis
b. Cystic fibrosis
c. Acute pancreatitis
*d. Gastrocolic fistulas

13. A condition where the bile duct may be obstructed is called:

a. Choleliathiasis
b. Biliary cancer
c. Celiac disease
*d. All options are correct

14. Sudan III is used to:

*a. Dye lipids
b. Dye white blood cells
c. Dye undigested muscle fibers
d. Dye bacteria

CHAPTER 16 GASTRIC FLUID

1. What is the major reason that gastric juices are not considered a “major” body fluid?
I- It is an ultrafiltrate of blood
II- Does not possess significant cells
III- Not often performed
A. I and II
*B. II and III
C. I, II and III
D. None of the options are correct
E. I only

2. The organism, Helicobacter pylori, is implicated in:

a. Lack of adequate digestion
b. Food poisoning of certain types
c. Anemia from low intrinsic factor
d. High acidity
*e. Peptic ulcers

3. A condition that is rarely found when examining gastric fluids is:

*a. Presence of malignant cells
b. Extremely low acidity
c. Lack of white blood cells
d. Large amounts of mucus

4. Why would the gastric juices prevent the presence of many pathogens in the stomach?
*a. Low acidity inhibits bacterial growth
b. Most bacteria in the stomach is normal flora
c. No blood cells are found in gastric content
d. None of the options are correct

5. Which of the following would not be a hormone found in gastric juices?

a. Pepsin
b. Rennin
*c. Vitamin B12
d. Gastrin
6. Gastric glands may secrete up to mL during a meal.
a. Up to 80 mL
b. More than a liter
c. Generally none is secreted
*d. 800 mL

7. Gastric fluid is generally collected by:

a. Subcutaneous aspiration
b. Vomiting
*c. Nasal tube aspiration
d. Blood samples