Recalls-compilation-of-clinical-microscopy

CLINAL MICROSCOPY 1. HCG is produced by (Cytotrophoblast cells) 2. How many days will HCG in urine disappear after ectopic pregnancy (3-7days) 3. A animal source of anti-hCG used in home-based pregnancy test kits is (Rabbit) 4. Energy used for sperm motility is stored primarily in what part? (Midpiece) 5. Reagent used in the Apt-downey test (Apt) (1% Sodium hydroxide) 6. Bence-Jones protein coagulates at __ and dissolves at __ (40-60oC, 100C) 7. How many neutrophils per HPF are indicative of invasive diarrhea? (>3) 8. Ten(10) CaOx were seen per HPF. How do you report this finding? (Moderate) 9. What is Apatite? (Calcium Phosphate) 10. WBCs stain what color when using Sternheimer-Malbin stain? (Pale pink) 11. Glitter cells stain what color when using Sternheimer-Malbin stain? (Pale blue) 12. Approximately (9) bacteria were seen per high power field. This is reported as (Rare) 13. Urine volume required by the Irish mass gravity meter (2mL) *Irish slideless microscope (4ml) 14. In most cases, the precursor of acute glomerulonephritis is (Respiratory disease) 15. The split fat stain is composed of (36% acetic acid and Sudan III) 16. Sample used in the Diagnex tubeless test for gastric analysis (Urine) 17. PDCA stands for (Plan-Do-Check-Act) 18. A device used ti calibrate centrifuge ( Tachometer, Stop watch and Strobe light) 19. Color of Waxy Casts using KOVA stain (Pale-Pink) 20. Factors is most likely to cause a Brown-colored seminal fluid (Blood) 21. The sulkowitch test screens for urinary (Calcium) 22. Transitional epithelial cells in urine are suggestive of (Upper UTI) 23. The major responsible for egg penetration by a sperm cell (Acrosome) 24. The normal acrosomal cap should encompass (1/2 of the sperm head) 25. Sputum collection method for unconscious patients (Tracheal aspiration) 26. Which Schistosoma is seen in urine? (Schistosoma haematobium) 27. Adenosine deaminase level highly indicative of tuberculosis (>40 u/L) 28. Normal fasting gastric fluid (Pale gray and slightly mucoid) 29. Normal volume of gastric fluid of a patient in fasting state (20-50mL) 30. Positive reaction for CTAB? (White Turbidity) 31. Basal acid output in pernicious anemia (0) 32. The most important component in the handwashing procedure is (Friction) 33. Most common parasite seen in urine (Trichomonas vaginalis) 34. The E in the RACE (Extinguish or Evacuate) 35. A type of microscope that forms a halo around the specimen is (Phase contrast) 36. Preservatives for testing urinary 5-HIAA (HCL or Boric acid) 37. PASS (Pull, Aim , Squeeze , Sweep) 38. This stain used to differentiate WBCs and RTE cells in urine (Toluidine blue) 39. Neutral fat stain (95% ethanol and sudan III) 40. Earliest form of sperm cell (Spermatogonium) 41. Urine color for phenol (Blue-Green) 42. Positive color reaction in the mucopolysaccharide paper test (Blue) 43. The normal value for albumin excretion rate is (0-20 ug/min) 44. Test is least affected by standing or unpreserved urine (Protein) 45. Gold standard for glomerular filtration rate (Inulin clearance) 46. Oval fat bodies are often associated with (Nephrotic syndrome) 47. Principle utilized by home-based pregnancy testing kits (Enzyme immunoassay) 48. Epithelial cell in urine with eccentric nucleus (Renal tubular epithelial (RTE))

49. What is specific gravity of distilled water when measured by refractometer (1.000) 50. What is the normal pH of the stool? (7.0 to 8.0) 51. What type of tube for gastric fluid collection is passed through the nose? (Levin tube) 52. Ideal specimen for specific gravity testing? (First morning) 53. Urine volume for testing methamphetamines? (30-45ml) 54. The sensitivity of bilirubin reagent strip is (0.4 to 0.8 mg/dL) 55. Centrifuges should be disinfected every (Week) 56. Effect of refrigeration on glucose reagent strip (False-negative) 57. Amylase in peritoneal fluid is tested for? (Pancreatitis) 58. Significance of green peritoneal fluid (Gall bladder disorder) 59. These are pieces of pigmented cartilage with a characteristics ground pepper appearance (Ochronotic shards) 60. Zone of the Liley graph that indicates moderate hemolysis and requires careful monitoring (Zone II) 61. Down syndrome is also known as (Trisomy 21) 62. Major contributor to the amniotic fluid volume after the first trimester of pregnancy (Fetal urine) 63. What anticoagulant can be used for serous fluids submitted for chemistry test? (Heparin) 64. Lack of urine odor is seen in patient with (Renal tubular necrosis) 65. Color of excess urobilinogen in urine (Orange) 66. A patient is ventilated. Best way to get specimen (Tracheal aspiration) 67. RBC cast can be easily identified due to (Color) 68. Protein seen microscopically in urine in renal disease (Tamm-Horsfall protein / Uromodulin) 69. Culture and sensitivity for urine (Suprapubic, Midstream clean catch and Catheterized) 70. AFP is usually measured around (15th – 18th weeks) 71. Numerous WBCs and Bacteria often accompanied by mild proteinuria, hematuria, increased pH and WBC cast (Acute pyelonephritis) 72. Differentiate urine for non-urine (Creatinine) 73. Homogenous blue color in reagent strip. Microscopically, 8 ghost cells were seen per field (Hematuria) 74. Increased cathecolamines (Pheochromocytoma) 75. Crystals mostly appear in urine due to (Difference in solubility) 76. What tube additive must be used for the measurement of glucose In synovial fluid (Sodium fluoride) 77. What is the amniotic fluid volume during the 3rd trimester (1000 mL) 78. Determining levels of this substance serves as an indirect measurement of excess ammonia in the CSF (Glutamine) 79. Used in the Bloom’s test for sperm viability (Eosin-Nigrosin) 80. The Refractometer is (No correction temperature) 81. In the presence of crystal in synovial fluid, the clarity of the fluid is described as (Milky) 82. Renal threshold of Glucose (160-180mg/dL) 83. Rinse hands in what position? (Downward) 84. Few particulates and Print easily seen through urine? (Hazy) 85. Principle of Bilirubin (Diazo reaction) 86. Positive color of Bilirubin in reagent strip? (Pink to Violet) 87. SSA GRADING: Turbidity with granulation but no flocculation (2+) 88. Bilirubin reagent strip detect what bilirubin fraction? (Conjugated) 89. Cause of false negative nitrite reagent strip reaction (Nitrite converted to Nitrogen gas) 90. SG of 9% sucrose (1.035) 91. Correction factor of glucose (-0.004) 92. Yellow Quadrant in the Safety Diamond (Reactivity or Stability)

93. Blue Quadrant in the Safety Diamond (Health hazard) 94. Red Quadrant in the Safety Diamond (Fire hazard) 95. Color of Health Hazard in the Safety Diamond (Blue) 96. R in RACE means? (Rescue) 97. What kind of flame hazard are flammable metals like Sodium, Magnesium, Lithium? (Type D) 98. Composition of the fire extinguisher for Type C fires (Halon, Dry chemical and Carbon dioxide) 99. Abnormalities in the sperm head morphology are associated with (Poor ovum penetration) 100. For drug testing analysis, the urine temperature within 4 minutes should be between (32.5oC to 37.7oC) 101. A protein level of 100-200 mg/dL is equivalent to a sulfosalicylic acid test grading of (2+) 102. Testing for transparency is done by (View through a newspaper print) 103. In the degree of hazards, 0 means (No hazard) 104. Slight hazard (1+) 105. Moderate hazard (2+) 106. Serious hazard (3+) 107. Diluent in sperm count (Sodium bicarbonate, Formalin, Saline, Distilled water, Cold tap water) 108. The clarity of a urine sample should be determined (Following thorough mixing of the specimen) 109. Cetyltrimethyl ammonium bromide (CTAB) for (Mucopolysaccharides (MPS) Disorder) 110. Clue cells (Gardnerella vaginalis) 111. Nucleus of sperm is located at (Head) 112. A renal disease that is caused by anti-neutrophilic cytoplasm auto-antibody (ANCA) that binds to neutrophils in vascular walls producing damage to small vessels in the lungs and glomerulus (Wegener’s granulomatosis) 113. “RACE” acronym in case of fire (Rescue, Alarm , Contain , Extinguish or Evacuate) 114. Use in measurement of Bilirubin (Spectrophotometer) 115. A urine with consistent 1.005 specific gravity is considered? (Hyposthenuria) 116. A renal calculi described as yellowish to brownish red in color with a moderately hard consistency is (Uric acid) 117. Duration of routine gastric fluid collection for basal gastric acidity (1 hour with 15 minutes interval) 118. A web-like clot or pellicle is formed in the CSF from patients with (Tubercular meningitis) 119. These are clusters of columnar cells seen in sputum of a patient with bronchial asthma (Creola bodies) 120. How will you determine if a pleural exudate is caused by a hemorrhagic effusion? (Compare to serum hematocrit) 121. Best stain for cytology in sputum analysis? (Papanicolau stain) 122. In the sputum analysis, the only clinical significance of this finding is its resemblance to blastomyces (Myelin globules) 123. A part of microscope that performs initial magnification of an object on the mechanical stage (Objectives) 124. Eosinophils and cruschmann’s spirals may be found in what condition? (Bronchial asthma) 125. (asked 3x) Positive nitrite reagent strip test with negative leukocyte esterase indicates infection with? (Gram Negative Bacilli- E.coli) 126. (asked 2x) False negative nitrite reagent strip test is caused by? (High Specific Gravity) 127. (asked 2x) A patient abstained for 2 weeks. What is the expected result of semen analysis? (Low Motility, High Count)

128. If alcohol is added to urine with tyrosine crystals, this other type of abnormal crystal may be precipitated (Leucine) 129. Metabolic disorder which lacks the gene coding for phenylalanine hydroxylase (Phenylketonuria) 130. In what metabolic disorder is melanuria associated? (Tyrosine disorder) 131. Indirect determination of ammonia in CSF (Glutamine) 132. High CSF lymphocytes or predominance of lymphocytes (Multiple sclerosis / Fungal meningitis) 133. Best stain in sputum to differentiate leukocytes (Wright’s stain) 134. False (-) Nitrite is due to (High specific gravity) 135. Melanuria is linked to (Albinism) 136. CSF protein measurement (Turbidity and Dye binding) 137. Yellow foam (Bilirubin / Phenazopyridine) 138. Anuria (Cannot produce urine in bladder) 139. Spots / Speckled in blood strip (Hematoria) 140. Normal neutral fats with increased free fatty acids (Malabsorption) 141. Acidic feces due to (Carbohydrate) 142. Increased capillary permeability would lead to (Exudate) 143. True about synovial fluid except (Clots) 144. Will cause acidic urine except (Renal tubular acidosis) *It produce (Alkaline urine) 145. Collecting specimens in containers other than the single use laboratory supplied containers would cause a pH of (8.5pH) 146. Mainly reabsorbed through passive reabsorption (Urea, Water , Sodium) 147. Not included in the 10 reagent strips (Urobilinogen) 148. Most difficult to recognize in urinalysis (RBCs) 149. Associated with glomerular bleeding (Dysmorphic RBCs) 150. Body Mass Index for Obese (>30 age) 151. Computation for Sperm per ejaculation (Sperm count= Sperm concetration x Specimen volume)

All of the following should be discarded in biohazardous waste containers except: a. Urine specimen containers b. Towels used for decontamination c. Disposable lab coats d. Blood collection tubes ____________________________________________________________ In the collection of CSF specimens, which of the following is incorrect? a. Tube 1- Chemistry and Serology- Frozen b. Tube 2- Microbiology – Room temperature c. Tube 3- Hematology - Refrigerated d. None of the above ____________________________________________________________ All of the following are causes of a false-negative nitrite test for urine except a. Insufficient contact time of bacteria and urine b. Presence of ascorbic acid c. Too much bacteria converting nitrite to nitrogen d. Improper preserved urine specimen – False positive ____________________________________________________________ A medical technologist mixed 2 mL of serum with distilled water to create 10mL solution. What is the resulting ratio of serum to water? a. 2:8 b. 2:10 c. 1:5 d. 2:12 ____________________________________________________________ If the patient fails to discard the first specimen when collecting a timed specimen the a. Specimen must be recollected b. Result will be falsely elevated c. Results will be falsely decreased d. Both A and B ____________________________________________________________ Round cells that are of concern and may be included in sperm counts and morphology analysis are: a. Leukocytes b. Spermatids c. RBCs d. Both A and B ____________________________________________________________ A clean catch urine is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hours later, the specimen is sent to 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 ____________________________________________________________ The following are the recommended condition in using and preserving reagent strip, EXCEPT: a. Keep at room temperature b. Closed tightly c. Stored in a dark container d. Blotted on the tissue face down

____________________________________________________________ A nurse arrived from the ward with a urine specimen and left immediately. You checked the specimen right after the nurse left. Upon checking the specimen, there is no label attached to is. As a medical technologist, what is the best course of action to take? a. Reject the specimen b. Call the nurse who delivered the specimen and ask to label it c. Call the nurse and tell that the specimen is QNS and reject it d. Tell the nurse to inform the patient to recollect a new urine sample ____________________________________________________________ Prior to testing urinary nitrite, the patient should a. Wast urethral opening before collection b. Abstain from coitus c. Undergo 8-10 hours of fasting d. Eat vegetables the night before collection Note*: Vegetables is reach in nitrite ____________________________________________________________ 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 ____________________________________________________________ How do you report bladder cells Transitional cells a. Average number per LPF – Abnormal crystal and cast b. Average number per HPF – RTE cell and Oval fat bodies c. Rare, Few, Moderate or Many per LPF – Squamous epithelial cell d. Rare, Few, Moderate or Many per HPF ____________________________________________________________ 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 ____________________________________________________________ A physician requested for sperm count using undiluted semen. Which of the following can be used for counting? a. Nuebauer counting chamber b. Hemocytometer c. Makler counting chamber d. None of these ____________________________________________________________ Which is part of the Lens system of the microscope? 1. Oculars 2. Objectives 3. Coarse Adjustment Screw 4. Fine Adjustment Screw A. 1, 2 B. 1, 2, 3, 4 C. 3, 4

____________________________________________________________ A very faint line was seen in the HCG test kit. What would you do as a medical technologist? a. Report as Positive b. Report as Negative c. Report as Invalid d. Re-test after 48 hours ____________________________________________________________ In HCG testing for pregnancy, why is called as indirect? a. HCG is non-specific b. HCG is non-specific, but sensitive c. What the test detects is not the fetus itself ____________________________________________________________ What is the proper container for urobilinogen testing? a. Screw-cap plastic container b. Amber bottle c. Glass container ____________________________________________________________ What condition is being tested if urine will be tested for fluorescence under Wood’s lamp? a. Acute Intermittent Porphyria b. Lead Poisoning c. Porphyria Cutanea Tarda d. Arsenic Poisoning ____________________________________________________________ Crystal seen in Alkaline urine a. Calcium Oxalate b. Calcium Phosphate c. Triple Ammonium Phosphate d. B and C ____________________________________________________________ Crystals that are seen as wheat that are tied together at the center? a. Bilirubin b. Tyrosine c. Ampicillin d. Sulfonamide ____________________________________________________________ Multiple urine samples are acquired from the same patient. Which will have the highest specific gravity among the samples if the patient has normal kidney function? a. 100 mL b. 30 mL c. All will have the same d. 50 mL ____________________________________________________________ Which specimen can be collected in an unsterile container? a. Wound Discharge b. Sputum ____________________________________________________________ When collecting stool specimens, which is the appropriate container? a. Wax-lined container b. Unsterile container ____________________________________________________________

Common cause of calculi formation a. Alkaline urine b. Acidic urine c. High specific gravity ____________________________________________________________ Renal calculi are commonly composed of: a. Calcium oxalate b. Uric acid c. Calcium carbonate ____________________________________________________________ Microalbuminuria is definitive of what condition? a. Diabetes Mellitus b. Diabetes Insipidus c. AGN (Acute glomerulonephritis) d. Pyelonephritis ____________________________________________________________ Clear red color of urine: a. Hematuria b. Hemoglobin c. Myoglobin d. All of the above ____________________________________________________________ Brown,Black color of urine a. Methemoglobin b. Homogentisic acid c. Melanin d. All of the above ____________________________________________________________

Clarity / Transparency / Turbidity / Character Clear Hazy Cloudy Turbid Milky

= No visible particulates, transparent = Few particulates, print easily seen through urine = Many particulates, print blurred through urine = Print cannot be seen through urine = May precipitate or be clotted

Urine odor Aromatic Odorless Foul, ammoniacal Fruit, sweet Caramelized sugar, curry maple syrup Mousy, musty Rancid butter Sweaty feet, acrid Cabbage, hops Bleach Sulfur Rotting fish (Galunggong fish) Pungent Swimming pool Cat urine Tomcat urine

= Normal = Acute tubular necrosis = UTI (Ex. Protues vulgaris) = Ketones (DM, Starvation , Vomitting) = Maple syrup urine disease = Phenylketonuria (PKU) = Tyrosinemia = Isovaleric acidemia, glutaric acedimia = Methionine malabsorption = Contamination = Cystine disorder = Trimethylaminuria = Ingestion of onions, garlic and asparagus = Hawkinsinuria = 3-hyroxy-3-methylglutaric aciduria = Multiple carboxylase deficiency

Correlation in urine turbidity Acidic urine Alkaline urine Soluble in heat Soluble in dilute acetic acid Insoluble in dilute acetic acid Soluble in Ether

= Amorphous urates , Radiographic contrast media = Amorphous phosphates, Carbonates = Amorphous urates, Uric acid crystal = RBCs, Amorphous phosphates, Carbonates = WBCs, Bacteria , Yeast , Spermatozoa = Lipids, Lymphatic fluid , Chyle

Chemical examination of urine Glucose Bilirubin Ketones S.G Protein pH Blood Urobilinogen Nitirite Leukocytes

= Double sequential enzyme reaction = Diazo reaction = Sodium nitroprusside reaction (Legal’s test) = pKa change of a polyelectrolytes = Protein (Sorensen’s) error of indicator = Double indicator system = Pseudoperoxidase activity of hemoglobin = Ehrlich reaction = Greiss reaction = Leukocyte esterase

=Green to brown =Tan or Pink to Violet =Purple =Blue to Yellow =Blue =Orange to Blue =Uniform green/Blue =Red =Uniform Pink =Purple

Increased when unpreserved urine (PBaON) -pH -Bacteria -Odor -Nitrite Ascorbic acid can produce False negative (BBLNG) -Blood -Bilirubin -Leukocytes -Nitrite -Glucose 60 seconds reading time in Reagent strip (PPBUN) -Protein -pH -Blood -Urobilinogen -Nitrite Reagent use Specific gravity PH Protein Blood Bilirubin Nitrite Leukocytes

= Bromthymol blue , Bromthymol blue = Methyl red, Bromthymol blue = Tetrabrom , Tetrabrom = Tetramethylbenzidine , Tetramethylbenzidine = Dichloro , Dichloro = Quinoline , Quinoline = Ester , Ester

Crystal reporting HPF 0-2 Rare 2-5 Few 5-20 Moderate >20 Many Bacteria reporting HPF 0-10 Rare 10-50 Few 50-200 Moderate >200 Many Mucus threads LPF 0-1 Rare 1-3 Few 3-10 Moderate >10 Many

Epithelial cells LPF 0-5 Rare 5-20 Few 20-100 Moderate >100 Many

Zone of Liley graph Zone I None/mild Zone II Moderate hemolysis , requires careful monitoring Zone III Severe, requires intervention

Grading for SSA precipitation test Negative Trace 1+ 2+ 3+ 4+

= No increase in turbidity = Noticeable turbidity = Distinct turbidity with no granulation = Turbidity with granulation but NO flocculation = Turbidity with granulation AND flocculation = Clumps in protein

3 CSF tubes Tube 1 = Chemistry / Serology Tube 2 = Microbiology Tube 3 = Hematology Tube 4 = Microbiology / Serology

= Freezing temperature = Room temperature = Refrigeration temperature

CSF tubes: Microbiology > Hematology > Chemistry / Serology Sperm motility grading 4.0 / a = Rapid, stright-line motility 3.0 / b = Slower speed, some lateral movement 2.0 / b = Slow forward progression, noticeable lateral movement 1.0 / c = No forward progression 0 / d = No movement

= <6 = 6-30 = 30-100 = 100-200 = 200-400 = >400

Yellow quadrant (Reactivity / Stability Hazard) (SUV-SM) 0= Stable 1= Unstable if heated 2= Violent chemical change 3= Shock & heat may deteriorate 4= May deteriorate White quadrant (Specific hazard) OXY ACID ALK COR W R

= Oxidizer = Acid = Alkali = Corrosive = Use no Water = Radiation

Blue quadrant (Health hazard) (N-SHED) 0 = Normal material 1 = Slightly hazardous 2 = Hazardous 3 = Extreme danger 4 = Deadly Red quadrant (Flammability hazard) 0 = Will not burn 1 = Above 200F 2 = Below 200F 3 = Below 100F 4 = Below 73F Degree of HAZARDS (No SMS Ex) 0 = No / Minimal hazard 1 = Slightly hazard 2 = Moderate hazard 3 = Serious hazard 4 = Extreme / Severe hazard Types of fire Type A – Ordinary combustible: Paper, Cloth , Ruddish , Plastic , Wood Type B – Flammable liquids: Grease, Gasoline, Paints, Oil Type C – Electrical equipment and Motor switches Type D – Flammable metals: Mercury, Magnesium, Sodium, Lithium Type E – Detonation (Arsenal fire) Type K – Cooking media: Grease, Oil, Fats

Types of Extinguisher Type A – Water, Dry chemical, Loaded steam Type B – Dry chemical, Carbon dioxide, Halon foam Type C – Dry chemical, Carbon dioxide, Halon Type D – Metal X, Sand: Fought by fire fighter only Type E – Allowed to burn out and nearby materials protected Type K – Liquid designed to prevent splashing and cool the fire Water (A), Dry chemicals (ABC), Carbon dioxide (BC), Halon (BC)