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AUBF Questions with answers

Medical Technology (Southwestern University PHINMA)

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Module 3

II. SEQUENCING. Assign a number to each of the following structures in order to come up with the
correct sequence of A) conducting blood (from renal artery to inferior vena cava) and B) conducting
urine (from afferent arteriole to urethra) in the kidneys. (20 points)
5 afferent arteriole 8 renal pelvis
1 arcuate arteries 7 renal pyramid
6 peritubular capillaries 1 glomerular tuft
2 Intellobar arteries 2 PCT
3 interlobular arteries 5 DCT
4 efferent arteries 10 urinary bladder
7 arcuate veins 9 ureters
9 Intellobar veins 4 Henle's ascending limb
10 renal vein 3 Henle's descending limb
8 interlobular veins 6 collecting duct

Module 4

Give three (3) answers that meet each of the following situations:
A. Types of microscopy
Brightfield, DarkfieId, Phase-contrast. Interference contrast. Polarizing, Fluorescence, & Electron
B. Special urine collection techniques.
Urethral catheterization, Ureteral Catherization, Suprapubic aspiration, & Cvstoscqpic method
C. Purposes of cytodiagnostic urinalysis.
Detection of glomerular and tubular disorders, LUT disorder detection, Finding Iithiasis (kidney stones),
& diagnosis of nonbacterial infections
D. Purposes of performing wet urinalysis.
Assessment of Diabetes, Proteinuria, Hematuria, Leucocyturia, Infections, Crystalluria, Cvlindruria
among others
E. Urine collection methods intended for bacterial culture.
Catheterized, Midstream catch early morning, & Suprapubic aspiration
F. Precautions to be observed when collecting urine samples.
Chemically clean urine containers are needed, no delays in testing (analyzed within I hour receipt in the
lab), appropriate collection technique for some tests, samples should be labeled and tightly sealed,
external genitalia is cleaned with antiseptic prior to collection, frozen samples are for chemical testing
only, among others
G. Preservatives that can be used for hormones in a 24-hour urine sample.
Refrigeration, Boric acid, & 6N HCl
H. Substances found to exceed 3.0 grams in a 24-hour urine sample.
Urea, NaCl, & Potassium
I. Substances that will yield FALSE-NEGATIVE result after delayed testing.
Glucose (utilized by microbes), Ketones (volatile), Bilirubin & Urobilinogen (light-sensitive), & Nitrite
(convened to nitrogen)
J. Urine parameters that become INCREASED in unpreserved urine
Odor, pH, Nitrite, & Bacteria

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Module 5
PARTS OF ROUTINE URINALYSIS
Column A Column B
A 1.Assessment of phenylketonuria by detecting mousy odor of urine A. Gross/Physical exam
A 2.Checking kidneys’ concentrating ability by observing urine color B. Chemical exam
B 3. Identifying uric acid as a blue product with phosphotungstic acid C. Microscopic exam
C 4. Grading casts as 0-3/lpo after scanning 10 low power microscopic fields D. Specimen evaluation
B 5. Testing urine pH using a dipstick with pads varying in color from pH 1 to 14
A&B 6. Testing urine for the presence of blood without the use of a microscope
C 7. Finding in the urine the presence of cystine crystals
A 8. Deciding whether the urine is clear, hazy, turbid or cloudy
B 9. Protein testing of the urine using heat and acetic acid
B 10. Testing of urine specific gravity using reagent strip technology
D 11. Proper labeling of the urine samples
D 12. Choosing appropriate preservative for urine
C 13. Confirming hemosiderinuria in urine by presence of blue granules in casts
B 14. Testing the presence of UTI via microbial esterase and nitrate reduction
B 15. Testing the presence of urine iron freed from hemoglobin and myoglobin

URINE PARAMETERS/COMPONENTS & ASSOCIATED CONDITIONS

Column A
H 16.Hemosiderinuria A. urate crystals, cholesterol seen as notched plates, calcium sand
B 17. Pyuria
L 18. Cylindruria
A 19. Crystalluria
K 20. Bacteriuria
E 21. Glycosuria
J 22. Chyluria
O 23. Lipiduria
D 24. Alkaptonuria
F 25. Oliguria
G 26. Isosthenuria
C 27. Hematuria
M 28. Hemoglobinuria
B 29. Leukocyturia
I 30. Myoglobinuria
Column B
B. granulocytes, lymphocytes and plasma cells
C. intact erythrocytes
D. byproducts of homogentisic acid metabolism
E. glucose, galactose and sucrose
F. low 24-hour urine volume
G. constant specific gravity
H. iron deposits in epithelial cells and casts
I. released red pigments from lysed skeletal muscles
J. presence of fatty lymphatic fluid
K. Lactobacillus acidophilus, Proteus vulgaris, Escherichia coli
L. casts described as amorphous, hyaline or mixed
M. released red pigment from lysed erythrocytes
N. bilirubin and oxidized products
O. oval fat bodies and cholesterol crystals

II.) ENUMERATION. Give three (3) examples for each of the following lettered items: (30 points)
A. Normal urinary pigments
Urochrome, uroerythrin, and urobilins
B. Properly labeled urine specimen should have these information
Patient's full name, date of collection & time of collection among others but these three (3) should be in the
label before putting other information
C. Instrumental principles used in automated urinalysis
Spectrophotometry, Flow cyometry, Microscopy & Imaging
D. Types of test for genitourinary tract cancers
Conventional urine cytometry, Flow cytometry, Image cytometry, & DNA analysis
E. Precautions in dipstick testing
See the Table on Recommendation for Reagent Strips that contains precautions on storage and testing using
reagent strips

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F. Processes involved in specimen evaluation

Checking for proper labels, appropriateness of sample for the tests, signs of deterioration, presence of
contamination, and proper preservation
G. Materials when present in urine produce cloudiness
Crystals, cells, bacteria, & lipids among others
H. Physical testing parameters
Color, odor, character/clarity, volume, specific gravity, & osmolality
I. Substances in urine that can be tested using strip technology
Glucose, Protein, Bilirubin, Ascorbic acid, Uroblinogen, Hemoglobin, Ketones, Nitrite, & Leukocyte esterase among
others (pH, specific gravity. & blood are not substances)
J. Cellular components of urinary sediment
RBC, RBC, epithelial cells, bacteria, and yeast cells

Module 6

I. TRUE OR FALSE. Write T if the statement is correct and write F if the statement is incorrect. (15 points)
T 1. The refractometer is an indirect method of measuring specific gravity.
T 2. The nitrite and leucocyte reagent strip parameters are for testing bacteriuria.
T 3. The clarity of urine also affects the color assessment of urine.
T 4. The organic solvent ether is used to confirm the presence of chyluria.
T 5. Mixing the urine sample is a must before doing clarity testing.
F 6. Before dipstick testing, mixing the urine sample is not necessary.
F 7. A dark background is necessary in order to observe the urine color.
T 8. A white background is useful in observing urine character.
F 9. The cells and crystals can be all dissolved using dilute acid.
T 10. The urine color and clarity can be correlated in the wet urinalysis.
T 11. The specific gravity and urine color can be correlated with each other.
T 12. Distilled water serves as the reference solution in both refractometry and urinometry.
F 13. pH testing is a part of the physical examination of urine.
T 14. The condenser, iris diaphragm and lamp are illuminating parts of the microscope.
F 15. Proteins in urine is diet-dependent unlike the urine pH and urine volume.

II. MATCHING TYPE: Match column A with column B. Letters only. You are not allowed to change your
answers.
PARTS OF ROUTINE URINALYSIS
Column A Column B
Urine Appearance and their Causes
C 16. Colorless A. methemoglobin, melanin
F 17. Cloudy B. hemoglobin, beets, myoglobin
J 18. Smoky C. very dilute urine, diabetes insipidus
H 19. Milky D. bilirubin-biliverdin
B 20. Red E. indicans, Pseudomonas infection
A 21. Brown-black F. bacteriuria, phosphates, urates, pus cells
E 22. Blue-green G. concentrated urine, urobilin in excess
I 23. Yellow H. fat, emulsified paraffin, pyuria
K 24. Yellow-green I. acriflavine
G 25. Yellow orange J. blood in the urine (intact RBCs)
K. None of the above
Characteristics of Urine & Associated Conditions
C 26. Sweaty feet odor A. MSUD
E 27. Odor of cabbage or hops B. Filariasis, lymph node obstruction
H 28. Mousy odor C. Isovaleric and glutaric acidemia
F 29. Rotting fish smell D. Major long bone and pelvic bones
J 30. Rancid smell E. Methionine malabsorption

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K 31. Maple syrup odor F. Trimethylaminuria

I 32. Sweetish or Fruity odor G. Alkaptonuria
G 33. Blackening upon long standing of urine H. Phenylketonuria
B 34. Chyluric urine due to leakage of lymph I. Diabetes mellitus
D 35. Lipiduria J. Tyrosinemia
K. None of the above
Module 7

MULTIPLE CHOICE. Choose the lettered choice thatcorresponds to the correct answer. Letters only.

1. Which pigment causes the production of yellow foam ?

A. uroerythrin C. bilirubin
B. hemoglobin D. indicant

2. The presence of intact red blood cells in the urine is called

A. hematuria C. hemosiderinuria
B. hemoglobinuria D. hematinuria

3. Homogentisic acid forms brown-black urine upon long standing -- a condition known as
A. porphyria C. melaninuria
B. alkaptonuria D. urobilinuria

4. Which of these urinary constituents can be cleared through acidification?

A. amorphous urates C. pus cells
B. amorphous phosphates D. bacteria

5. The dye Oil Red O is used to demonstrate the presence of

A. hematuria C. lipiduria
B. chyluria D. pyuria

6. Excretion by an adult of more than 500 mL. of urine with a specific gravity of 1.018 at night is
A. polyuria C. polydipsia
B. nocturia D. nocturnal oliguria

7. Which of the following statements is not true?

A. High volumes of urine result in a low specific gravity.
B. The aromatic odor of freshly voided urine is of undetermined source.
C. Cloudy urine is not common and not necessarily pathologic.
D. Aside from urochrome, there are other pigments that give normal urine a yellow color.

8. Which parameter cannot be measured using reagent strip technology?

A. specific gravity C. glucose
B. urinary pH D. osmolality

9. The presence of high amounts of indican will give a urine sample a

A. red-violet color C. brown-black color
B. yellow-orange color D. blue-green color

10. The average adult on a normal diet produces a 24-hour urine with a pH of about
A. 5.0 C. 7.0
B. 6.0 D. 7.4

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11. At night, during the mild respiratory acidosis of sleep, a more acidic urine is formed. The acidity is largely
due to the buildup of
A. casts and crystals C. organic acids
B. carbon dioxide D. ketone bodies

12. A diet high in meat and cranberries will

A. lower urinary pH C. increase urinary pH
B. produce neutral pH D. not affect urine pH

13. The titratable acidity of a 24-hour urine collected in ice utilizes as titrant the
A. 0.1N NaHCO3 C. 0.1N NaCl
B. 0.1N NaOH D. 0.1N NaNO3
14. The most accurate means of determining the pH of urine samples is the
A. blue and red litmus paper method
B. pH meter with a glass electrode
C. titratable acidity testing using a 24-hour urine sample (in ice)
D. reagent strip using bromthymol blue and methyl red

15. The protein uromucoid is secreted by the cells in the distal tubular cells and ascending loop of Henle. It is
highly associated with cast formation. It is also referred to as the
A. Bence Jones protein C. Retinol-binding protein
B. Tamm-Horsfall glycoprotein D. Immunoglobulin light chains

16. The presence of Bence Jones protein the urine is suggestive of

A. Overflow proteinuria C. Multiple myeloma
B. Cylindruria D. Functional proteinuria

17. A hazy urine with high protein content collected after a heavy exercise is an example of
A. Intermittent proteinuria C. Postural proteinuria
B. Persistent proteinuria D. Functional proteinuria

18. To detect the kinds of protein in the urine, what is needed is

A. Multistix 10 SG C. Electrophoresis
B. Salting-out process D. Dye-binding tests

19. The catabolic products derived from lipids which can become potentially toxic are the
A. sugar monomers C. ketone bodies
B. benzene derivatives D. fatty acids

20. When lipid is lost in the urine, many granular casts, fatty casts and oval fat bodies are found in the urine
sediment. Oval fat bodies are actually
A. hyaline casts with lipid deposits C. droplets of cholesterol esters
B. fat-laden renal tubular epithelial cells D. lipoproteins forming oval crystals

21. Tubular pattern proteinuria is seen in all of the following conditions except
A. Fanconi’s syndrome C. Wilson’s disease
B. Pyelonephritis D. Nephrotic syndrome

22. The tubular pattern proteinuria cannot be easily detected using reagent strip methods due to the type of
protein involved – the low molecular weight proteins such as alpha-1-microglobulin, light-chain

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immunoglobulins and lysozymes. On the other hand, glomerular pattern proteinuria is detected because the
protein involved is mainly
A. albumin C. medium-chain immunoglobulins
B. Bence Jones protein D. Tamm Horsfall protein

23. Which substance may largely affect urinary pH testing?

A. protein C. glucose
B. ketone bodies D. bilirubin

24. Which statement regarding protein testing is not true?

A. Reagent strips are not sensitive in measuring globulins but sensitive to albumin.
B. Both albumin and globulins can be precipitated using SSA and TCA.
C. Reagent strips can be used in assessing the degree of proteinuria.
D. Both reagent strips, SSA and TCA methods are for urine protein screening.

25. Which blood glucose level exceeds the renal threshold for glucose leading to glucosuria?
A. 100 mg/dL C. 130 mg/dL
B. 157 mg/dL D. 220 mg/dL

26. Urine glucose testing serves to check endocrine function to diagnose the disease
A. Diabetes insipids C. Diabetes mellitus
B. Hyperglycemia D. Glucosuria

27. The copper reduction tablet test for glucose is the

A. Clinistix C. Clinitest
B. Bilitest D. Chemstrip G

28. What enzyme will oxidize glucose into gluconic acid and hydrogen peroxide?
A. hexokinase C. glucokinase
B. glucose oxidase D. glucose peroxidase

29. O-toluidine is the chromogen used in which reagent strip for glucose?
A. Clinistix C. Multistix
B. Chemstrip-G D. Clinitest

30. All of the following are reducing sugars except

A. glucose C. galactose
B. fructose D. sucrose

31. What compound of copper is colored red?

A. CuOH C. CuSO4
B. Cu2O D. CuO

32. What organic substances are products of incomplete lipid metabolism?

A. free fatty acids C. bile pigments
B. ketone bodies D. porphyrins

33. The most abundant among these organic substances in the urine is
A. beta-hydroxybutyric acid C. diacetic acid
B. acetone D. urea

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34. The most abundant among these inorganic urine constituents is

A. sodium C. bicarbonate
B. chloride D. potassium

35. Ketonuria may be seen in all of the following conditions except

A. fasting C. excessive exercise
B. type I diabetes mellitus D. carbohydrate-rich diet

36. Sodium nitroferricyanide reaction (Acetest) is specific for urinary

A. urobilinogen C. bilirubin
B. diacetate D. sucrose

37. Rothera’s wet method can detect all of the following except
A. acetoacetic acid C. acetone
B. beta-hydroxybutyrate D. ketone bodies

38. Which of the following substances is an oxidizing agent?

A. ascorbic acid C. hydrogen peroxide
B. glutathione D. uric acid

39. If delay in testing for ketone bodies cannot be prevented, the urine sample should be
A. kept capped at room temperature C. discarded and replaced by a new one
B. added with preservative D. refrigerated at 2-10 degrees Celsius

40. Which of the following is not a breakdown product of hemoglobin?

A. bilirubin C. hemosiderin
B. amino acids D. haptoglobin

41. The Diazo (p-nitrobenzenediazonium p-toluene sulfonate) tablet test is for the detection of urine
A. hemoglobin C. urobilinogen
B. bilirubin D. myoglobin

42. Ehrlich’s aldehyde reaction is the formation of reddish-brown color due to

A. urobilinogen C. bilirubin
B. nitrite D. leukocyte esterase

43. Bilirubin can be detected using all of the following methods except
A. Ictotest C. Diazo reagent strip
B. Yellow foam test D. Blondheim method

44. Schwartz-Watson test differentiates between the presence of urobilinogen and

A. hemoglobin C. bilirubin
B. porphyrins D. porphobilinogen

45. Inverse Ehrlich’s reaction is also known as

A. Hecht’s test C. Hoesch’s test
B. Nitrite test D. Leukocyte esterase test

A positive nitrite test indicates ___A_(46)____ while a positive leukocyte esterase test
indicates ____C__(47)____ .
A. bacteriuria C. pyuria
B. cylindruria D. crystalluria

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48. C-Stix reagent strips are impregnated with buffered phosphomolybdates to detect
A. ascorbic acid C. citric acid
B. 5-hydroxyindoleacetic acid D. melanin

49. The 5-hydroxyindole acetic acid (5-HIAA) is a byproduct of metabolism of

A. porphyrins C. serotonin
B. indicant D. ascorbic acid

50. The most abundant among the ketone bodies which accounts 78% of the total in urine is
A. acetone C. acetoacetic acid
B. beta-hydroxybutyric acid D. urea

Module 8

I. NORMAL OR ABNORMAL FINDINGS. Tell whether the following laboratory situations or

microscopic findings are
normal or abnormal. Write N if normal and A if abnormal.
N 1) 0-2 erythrocytes per high power field
N 2) bacterial count of 1,000/mL of urine
N 3) 10 PMN per high power field of standardized slide
A 4) presence of cystine crystals
N 5) occasional amorphous urates
A 6) presence of numerous dysmorphic RBCs
A 7) moderate amount of waxy casts
A 8) presence of structures seen as Maltese crosses
A 9) passage of brown urine positive for melanin
A 10) bacteriuria (100,000/mL urine)
A 11) presence of fragmented urothelial cells
A 12) 5 renal cells per hpf
A 13) turbid uriine due to fecal contamination
A 14) albuminuria after heavy exercise
A 15) 0-2 hyaline casts per 1pf
A 16) 0-1 fatty cast per 1pf
A 17) Tumor cells found in mine sediment
A 18) Abundant mucus threads in urine
N 19) Rare appearance of renal tubular cells
N 20) 0-4 leukocytes per hpf

II. TYPES OF SEDIMENT. Identify the specific type of cell, cast, contaminant or crystal that are
referred to by each of the following: NOTE: For crystals, give chemical name.
1) refractile “Maltese cross”- Fat Globules 11) PMN- WBC
2) Lacy phosphate precipitates- Amorphous PO 12) G1 cells- dysmorphic RBC
3) Ghost cells- RBC 13) “Corkscrew” casts- waxy cast
4) Oval fat bodies- Renal cells 14) “Coffin lid” crystals- triple phosphate
5) Lemon-shaped “Whetstone”- Uric acid 15) Hexagonal laminated crystals- cystine
6) Crenated or dysmorphic structure- RBC 16) “Thorn apple” crystals- ammonium biurate

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7) Refractile “budding” forms- yeast cells 17) Renal failure casts- waxy cast
8) Glitter cells- WBC 18) Cells with endo-ecto cytoplasmic rim- Urothelial/transitional epth
9) Sheaves of wheat with eccentric binding- sulfa crystal 19) Shadow cells- RBC
10) “Envelope” crystals- Calcium oxalate 20) Brick dust- ammorphous urates

III. ENUMERATION. Enumerate the following:

1 – 4………………. Requisites for Cast Formation
High salt conc, increased acidity, high protein conc, stasis and stagnation of urine
5 – 8………………. Parameters Used in Cast Classification
Matrix, inclusion, pigments and cells
9 – 12…………….. Contaminants in Urine Microscopy
Muscle fiber, vegetable cels, spermatozoa, pollen grains, cotton fibers, wood fibers,
starch granules, oil droplets, spermatozoa, fecal materials like eggs and detritus, diaper
materials
13 – 15 ………….. Stains used in Studying Urine Sediments
Pap stain, Gram, Giemsa, Wrights, Sternheimer-Malbin, Safranin, Crystal Violet,
Toluidine Blue, Lactophenol cotton blue, Hansel, Oil Red O, Sudan III, Prussian blue
16 – 20…………… Methods of Examining Urine Sediment
Brightfield microscopy, Darkfield microscopy, PCM, EM, Polarizing microscopy,
Interference microscopy, Cytodiagnostic method, Quantitative and differential counts,
Image cytometry & DNA analysis and Flow cytometry (Automated Urinalysis)
21 – 25 …………..Conditions Affecting the Genitourinary Tract Characterized by Passage of Casts in the
Urine
Chronic glomerulonephritis (CGN), Acute glomerulonephritis (AGN), chronic
pyelonephritis, acute pyelonephritis, Nephrotic syndrome, Acute tubular necrosis (ATN),
and Acute renal allograft rejection

IV. TYPES OF CRYSTALS. Identify each of the following crystals whether they are found in
normal acid urine (write AC), normal alkaline urine (write ALK) or abnormal urine samples
(write ABN).
AC 1) Uric acid ALK 11) Calcium phosphate
ALK 2) Lacy phosphate precipitates ABN 12) Tyrosine
AC 3) Sodium urate ABN 13) Meglumine diatrizoate
ALK 4) Triple phosphate ABN 14) Ampicillin
ABN 5) Leucine ABN 15) Bilirubin needles
AC 6) Potassium urate ALK 16) Thorn apple crystals
ALK 7) Ammonium biurate ALK 17) Coffin lid crystals
ABN 8) Cystine ALK 18) Calcium carbonate
ABN 9) Sulfadiazine ALK 19) Amorphous phosphates
AC 10) Envelope crystals AC 20) Amorphous urates

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Module 9
I. ESSAY. Cite the main reason for doing each of the following: (2 points each)
1. the physician will be requesting for CSF to be collected
to diagnose meningitis and other CNS disorders
2. not allowing patients change position when collecting CSF
Materials between blood and CSF change distribution upon change in position
3. not to use tube no. 1 of collected CSF for bacterial culture purposes
Contaminated sample
4. avoiding glass tubes when doing CSF differential cell counts
Cells adhere on glass affecting count accuracy
5. determining serum glucose 2-4 hours before a CSF collection
After lumbar tap the CSF glucose tend to increase

II. MATCHING TYPE. Match column A with column B. Letters only. You cannot change your answer.
Column A Column B
Categories of SF Effusion
E 1. transparent A. Group I
E & G 2. Xanthochromic B. Group II
C &B 3. Infectious C. Group III
D 4. Red brown D. Group IV
E & G 5. 0-10 mg/dl blood/SF glucose difference E. Group I & II
F 6. Presence of erythrocytes F. Group III & IV
F 7. Opaque G. Group I & IV
B 8. 3000-75000 WBCs per mL. H. None of the above
H 9. 150 WBCs /mL
A 10. Less than 30% PMNs

Types of SF Crystal
B 11. 1-2 microns or 5-20 micron needles; rarely spherolites A. CPPD
F 12. 1-50 micron clumped spherical aggregates; isotropic B. MSU
E 13. 5-30 micron bipyramidal octahedron; birefringent C. Cholesterol
C 14. notched plates, needle, rhomboid or 1-5 micron crystals D. Corticosteroids
G 15. 1-20 micron spheres, Maltese cross appearance E. Calcium oxalate
A 16. 1-20 micron rhombic, rods or rectangles F. BCP
F 17. Stained via Alizarin Red S G. None of the above
D 18. Similar to MSU or CPPD in appearance
C 19. Ethanol or ether soluble crystals
D 20. Blunt with jagged edge without clear crystal structure

TUBE NUMBERS OF CSF with their respective INTENDED LABORATORY TESTS

C 21. Cytology for malignancy detection A. Collection tube no. 1
B 22. Bacterial culture B. Collection tube no. 2
A 23. Adenosine deaminase test C. Collection tube no. 3
A 24. Detection of viral antigens
A 25. VDRL testing
C 26. Differential cell counts

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B 27. Acid fast staining

A 28. Fibrin derivative D-dimer
A 29. Immunofixation electrophoresis
A 30. CSF Glucose/Plasma Glucose ratio

Column A Column B
TYPE OF MENINGITIS with their CHARACTERISTICS
D 31. Bacterial A. lymphocytosis; normal opening pressure, glucose & lactate; RT-PCR testing
A 32. Viral B. lymphocytosis; high protein; low glucose <45mg/dl; pellicle formation (+)
C 33. Fungal C. lymphocytosis; high protein; low glucose; Cryptococcal antigen (+)
B 34. Tuberculous D. neutrophilia; markedly high protein; glucose <40mg/dl; high opening pressure
E 35. Syphilitic E. associated with HIV infection; spirochetal meningitis

CSF PROTEINS with their associated CSF CONDITIONS

C 36. Beta- & Tau-amyloid A. Multiple sclerosis
E 37. C- reactive proteins B. Subdural hemorrhage
A 38. Myelin basic protein C. Alzheimer’s disease
D 39. Protein 14-3-3 D. Creutzfeldt-Jakob disease
B 40. Alpha2-macroglobulin E. Bacterial & viral meningitis

Module 10

ENUMERATION. Enumerate three (3) examples for each of the following about serous effusions:
(30 oints)
A. Kinds of serous effusions
Pleural fluid. pericardial fluid, and peritoneal fluid
B. Disorders producing peritoneal transudates
Congestive heart failure. hepatic cirrhosis, and nephrotic syndrome
C. Diseases related to pleural exudate formation
Infections:
Bacterial pneumonia
Tuberculosis, other granulomatous diseases (e.g., sarcoidosis, histoplasmosis)
Viral or mycoplasma pneumonia
Neoplasms:
Bronchogenic carcinoma
Metastatic carcinoma
Lymphoma Mesothehoma (increased hyaluronate content of effusion fluid)
Noninfectious inflammatory disease involving pleura:
Rheumatoid disease (low pleural fluid glucose in most cases)
Systemic lupus erythematosus (LE cells are occasionally present)
Pulmonary infarct (may be associated with hemorrhagic effusion)
D. Tests done in Gross Examination of effusions
Color, clarity, odor, and volume
E. Microbiological tests done on effusions
Acid-fast stain, Gram stain, and culture
F. Organs that are extrapleural sources of fluid
Pancreas, esophagus, and kidneys
G. Immunological tests on serous effusions
Immunocytology tests, tumor markers, VDRL, and other immunoassays like RIA, ELISA & PCR
H. Methods of collection of peritoneal fluid

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Paracentesis, peritoneal dialysis, peritoneal lavage. and peritoneal washings

I. Normal cells in pleural fluid
Mesothelial cells, neutrophils, monocytes, lymphocytes, eosinophils, plasma cells, mast cells, basophils
J. Chemical tests for pericardial fluid
Protein, glucose, lipids, enzymes. pH. interferons, tumor markers. tuberculostearic acid, lactate, and
adenosine deaminase

Module 11

MATCHING TYPE. Match column A with column B. Letters only. You cannot change your answer.
Column A Column B
Transudates vs. Exudates
A 1. Usually bilateral owing to systemic conditions A. Transudate
B 2. Presence of coagulation B. Exudate
B 3. May be chylous or psuedochylous C. Both A and B
A 4. Due to decreased oncotic pressure in plasma
A 5. Due to increased hydrostatic pressure in capillaries
A 6. May be due to congestive heart failure
A 7. Retained for 7-10 days for further testing
B 8. Requires additional medical workup
B 9. Seen in SLE
B 10. Pleural LD level is equal to 2/3 the upper limit of serum LD
B 11. Pleural fluid/Serum protein ratio >25
B 12. Serum-pleural fluid albumin ratio ≤1.2 g/dL
B 13. Pleural fluid/serum cholesterol ratio of 0.45
A 14. Clear to pale yellow fluid
B 15. Feculent or putrid odor
B 16. Usually unilateral often linked to localized diseases
B 17. Presence of chylomicrons
B 18. Generally characteristic of fluids with >1000 WBC counted per uL
B 19. Seen in noninfectious inflammatory disease of the pericardium
A 20. Seen in hepatic cirrhosis
Chylous vs. Pseudochylous Effusions
A 21. Gradual onset A. Pseudochylous
A 22. <0.50 M TAG B. Chylous
A 23. Chylomicrons absent C. Both A & B
A 24. Metallic sheen
A 25. Presence of cholesterol crystals
B 26. Creamy layer on top of plasma after a Standing Plasma Test
B 27. Sudden onset
B 28. Milky to bloody turbidity
B 29. Increased lymphocyte count only
B 30. >200 TAG in mg%

Module 12
MALE REPRODUCTIVE STRUCTURES & THEIR FUNCTIONS
Column A Column B
H 1. Seminiferous tubules A. produce 60-70% of fructose-rich fluid in semem
D 2. Sertoli cells B. provides thick, alkaline mucus to the semen
C&G 3. Epididymis C. required for maturation of sperm cells
A 4. Seminal vesicles D. provides nutrients during spermatogenesis

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F 5. Prostate gland E. propel sperm to ejaculatory ducts

B 6. Bulbourethral glands F. source of proteolytic enzymes for liquefaction
E 7. Ductus deferens G. where flagellar development occurs
H. where germ cells for spermatozoa are found
SEMEN PARAMETERS & NORMAL VALUES
H 8. Volume A. >20 million/mL
I 9. Viscosity B. >40 million/ejaculate
C 10. pH C. 7.2-8.0
A 11. Sperm Concentration D. >50% within 1 hour
B 12. Sperm Count E. <1.0 million/mL
D 13. Motility F. >2.0 or a,b,c
F 14. Quality G. >30% normal forms (routine criteria)
G 15. Morphology H. 2-5 mL
E 16. Round cells I. pours in droplets
WHO CRITERIA FOR SPERM MOTILITY GRADING
A 17. slower speed, some lateral movement A. 3.0
D 18. slow forward progression, noticeable lateral movement B. 1.0
B 19. no forward progression C. 4.0
E 20. no movement D. 2.0
C 21. rapid, straight-line motility E. 0

(B) CALCULATION. Solve the following problems and show your calculation: (10 points each)

1) Using a 1:20 dilution, an average of 20 sperm are counted in the 5 RBC counting squares on both sides of
the hemocytometer. Calculate the sperm concentration per mL and the total sperm count in a specimen with
a volume of 4 mL. Interpret your result.

20 x 1,000,000 = 20 million sperms/mL. is the sperm concentration

20,000,000 x 4mL. = 80 million sperms/ejaculate is the sperm count
Interpretation: Normal

2) Using a 1:20 dilution, 200 sperm are counted in the 2 WBC counting squares of the hemocytometer.
Calculate the sperm
concentration per mL and the total sperm count in a specimen with a volume of 3.5 mL. Interpret your result.

200 sperm x20 dilution = 20.000

2 WBC squares x 0.1uL
20,000 x 1,000 = 20 million sperms/ml. is the sperm concentration
20,000,000 x 3,5 mL = 70 million sperms/ejaculate is the sperm count
Interpretation: Normal

C. TEST INTERPRETATION. Write N if the given test result done on semen/amniotic fluid is normal and write
A if the result interpretation is abnormal.
A 1. amniotic fluid with light yellow color
A 2. blood-streaked amniotic fluid
N 3. the Rh blood group compatibility of a Rh(+) mother and a Rh(-) fetus
N 4. alpha-feto protein at 1.5 MoM
N 5. L/S ratio of 4.0
N 6. negative result in Amniostat for FLM

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A 7. foam stability index of 47

N 8. microviscosity test of amniotic fluid at 35 mg/g
A 9. change in OD at 650nm of 1.5
A 10. lamellar body count of 40,000/mL
N 11. acid phosphatase level of 400 units/semen ejaculate
N 12. zinc level of 3 umol/semen ejaculate
N 13. positive result in hamster egg penetration test
N 14. sperm is able to penetrate the wife’s cervical mucus
A 15. WHO sperm grading of 2.0

Module 13

MATCHING TYPE. Match column A with column B. Letters only. You cannot change your answer.
Column A Column B
Body Fluids & their Associated Terms
C 1. Obtained vaginally or transabdominally A. Sputum
A 2. Dittrich plugs & Curschmann spirals may be present B. Hair & Nails
B 3. Needed in testing for drugs in chronic abuse C. Amniotic fluid
A 4. Obtained via cough plate method D. Saliva
B 5. Clippings and trimmings are obtained usually 100 grams E. All of the above
B 6. Skin outgrowths made into clinical samples F. Both A & D
D 7. Used to detect Cushing’s syndrome G. A, B, & D
A 8. Can be described as mucopurulent or seropurulent
A 9. Used in detecting lobar pneumonia
A 10. Commonly rich in histiocytes during infection
C 11. Used to detect polyhydramnios
A 12. Consistency may be dependent on the sialic acid content
C 13. Specimen of choice for L/S ratio determination
C 14. Best sample to diagnose HDN
C 15. Can be used to detect neural tube defects
A 16. Contaminated if 25 squamous cells are found under LPO
C 17. Detected by a positive Fern Test in vaginal fluid
G 18. Collected by noninvasive means
E 19. Regarded as nonstandard samples by CLSI
D 20. Normally rich in buccal epithelia and food debris
A 21. Represents portion of the lower respiratory tract
D 22. Drug testing with drugs still present for a number hours only
B 23. Drug testing with drugs detectable even after a year
D 24. Collected via drool technique
A 25. Normally mucoid and clear exudates

TERMS ASSOCIATED WITH GASTRIC JUICE ANALYSIS

Column A Column B
CC 26. Ewald test meal A. results in appearance of food residues
H 27. Hollander Test B. indicator in Topfer’s titration of free HCl
L 28. Levin tube C. test for free HCl, total acids and protein-bound acids
Z 29. Uffelman test D. analog for histamine
F 30. Histamine E. colorless to yellow to greenish
M 31. Pentagastrin F. chemical stimulant that erodes gastric epithelium
W 32. Gastrin G. bacterium capable of lactate production

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R 33. Pepsinogen H. test for completenesss of vagotomy

X 34. Achylia
BB 35. Achlorhydria
A 36. Pyloric obstruction
V 37. Normal gastric juice Ph
G 38. Boas-Oppler bacillus
Q 39. Schilling test
C 40. Topfer test
J 41. Alizarin sulfonate
AA 42. Azure A
T 43. Phenolphthalein
B 44. Dimethylaminoazobenzene
N 45. Titrant for gastric juice
Y 46. Boa test
P 47. Ewald tube
D 48. Histalog
I 49. Riegel test meal
S 50. Alcohol test meal
DD 51. Grunzberg test
E 52. Normal color of gastric juice
K 53. Normal volume of gastric residue
O 54. Normal consistency of gastric juice
U 55. Zollinger-Ellison syndrome
I. test meal for achlorhydria detection
J. indicator in Topfer’s titration of protein-bound acids
K. less than 50 ml.
L. smallest nasogastric tube
M.most widely used synthetic gastric HCl stimulant
N. 0.1N NaOH
O. fluid like water
P. largest oral gastric tube
Q. test for presence of intrinsic factor
R. inactive precursor of pepsin
S. test meal for detection of regurgitation
T. indicator used in Topfer’s titration of total acids
U. disease with increased gastric secretion
V. 1.5-1.9
W. produced by G cells of the stomach
X. absence of all gastric acid
Y. quali test for free HCl using resublimed resorcinol
Z. phenol-utilizing test for lactic acid; (+) yellow
AA.the blue dye used in Diagnex test
BB.absence of free HCl after gastric stimulation
CC.test meal of toasted bread and tea
DD. Quali test for free HCl using phloroglucinol

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