Initial screening for PKU performed on newborns before their discharge from the hospital uses a blood sample rather than a urine sample because: Increased serum phenylalanine can be detected earlier A routine urinalysis is performed on a specimen that has turned dark after standing in the laboratory. The urine is acidic and has negative chemical tests except for the appearance of a red color on the ketone area of the reagent strip. One should suspect: Melanuria A positive Guthrie test is interpreted by observing: Bacterial growth occurs around the positive control disc and the patient disc Patients who have unusually fair complexions can be indicative for phenylketonuria because: Tyrosine is not available for conversion to melanin A reaction for urinary ketones could be present in patients who have: Melanuria A positive urine Clinitest reaction can be seen in patients with: A. Alkaptonuria Confirmation of maple syrup urine disease is made on the basis of: MS/MS A disease that causes amounts of branched-chain amino acids to be excreted in the urine is: Maple syrup urine disease Urine with the characteristic odor of “sweaty feet” and a positive ketone test indicates: Isovaleric acidemia Which of the following foods contains serotonin, which can interfere with 5-HIAA testing? Pineapples The presence of maple syrup urine disease is first suspected by the presence of abnormal urine: Odor The finding of a “blue diaper” is indicative of a defect in the metabolism of: Tryptophan Patients who produce kidney stones at an age should be tested for the presence of: Cystinuria Porphyrins are intermediary compounds in the formation of: Heme The specimen of choice when testing for protoporphyrin is: Blood The most common cause of acquired porphyria is: Lead poisoning A. Fanconi syndrome B. Neurologic C. Psychiatric D. Photosensitivity A The presence of porphobilinogen in the urine can be suspected when: Acidic urine turns a port wine color after standing Urine from a child suspected of having lead poisoning has a red fluorescence under Wood’s lamp. This finding is: Consistent with lead poisoning because coproporphyrin fluoresces under ultraviolet light The concept of vampires is associated with: Porphyrias Characteristic urine odors are associated with all of the following disorders except: A. Alkaptonuria B. PKU A
C. Maple syrup urine disease D. Isovaleric acidemia The presence of amino acids is of particular concern in which population? Newborns All of the following can be classified as metabolic rather than renal disorders except: A. Tyrosyluria B. Maple syrup urine disease C. Cystinuria D. Indicanuria C The presence of “orange sand” in an infant’s diaper is indicative of: Lesch-Nyhan disease A patient diagnosed with Lesch-Nyhan disease can have all of the following conditions, except: A. Cystinosis B. Increase in uric acid C. Self-destructive tendencies D. Severe motor defects A Mental retardation is a symptom of all of the following except: A. Hurler’s syndrome B. Galactosuria C. PKU D. Cystinuria D Melituria refers to an increase in urinary: Sugar GALT deficiency is a disorder affecting the metabolism of: Galactose Choose the characteristic odor for the following disorders: Phenylketonuria Mousy Cystinosis Sulfur Isovaleric acidemia Sweaty feet Maple syrup urine disease Sweet True/False Failure of a metabolic pathway to reach completion may be caused by an inborn error of metabolism True Persons diagnosed with PKU should avoid foods containing the chemical additive aspartame True The 2,4-dinitrophenylhydrazine reaction is the confirmatory test for syrup urine disease False Argentaffin cell tumors produce large amounts of serotonin True Both cystine and leucine crystals are present in the urine of patients with cystinuria False The free erythrocyte protoporphyrin test is the recommended screening test for lead poisoning True Uric acid crystals are frequently seen in the urine of pediatric patients. The presence of a massive amount of urinary calcium oxalate crystals is indicative of disease False A negative reagent strip test for glucose and a positive Clinitest on a pregnant woman are False
the diagnosis of esophageal rupture? A milky pleural fluid that stains strongly positive with Sudan III indicates: Thoracic duct leakage A milky, green-tinged pleural fluid: Stains weakly with III A pericardial exudate from a patient diagnosed with AIDS be tested with: An acid-fast stain The test performed on peritoneal lavage fluid is the: RBC count An ascitic absolute neutrophil count of 1000/µL is most indicative of: Bacterial peritonitis A screening test performed on a cloudy, green ascitic fluid would be a/an: Ictotest What is the significance of an ascitic fluid exudate with a positive CA 125 and a negative CEA? Ovarian malignancy What is the significance of a peritoneal fluid with an elevated creatinine level? Ruptured bladder What is the significance of a pleural fluid with a hematocrit value of 30% (blood hematocrit: 34%)? Hemothorax Increased serous fluid can be caused by all of the following except: A. Lymphatic obstruction B. Inflammation C. Increased plasma sodium D. Increased hydrostatic pressure C The finding of a mesothelioma cell in pericardial fluid is indicative of: Metastatic malignancy Normal values for chemistry tests on serous fluid are different from values obtained on serum. False Transudate serous fluid effusions are a complication of the nephrotic syndrome. True Additional testing is most frequently performed on transudates rather than exudates. False A significant finding in a serous effusion is an increase in mesothelial cells. False Reactive mesothelial cells indicate a malignant effusion. Pleural fluid amylase is elevated in cases of pancreatitis. True Amniotic fluid is formed by all of the following except: A. Fetal urine B. Fetal cell metabolism C. Fetal swallowing D. Transfer of water across the placenta C A dark green amniotic fluid is associated with: Meconium A primary function of amniotic fluid is to: Provide protection for the fetus The volume of amniotic fluid increases after Production of fetal urine
A fern test is performed to differentiate between: and amniotic fluid Failure of the fetus to begin swallowing will result in: Polyhydramnios The volume of amniotic fluid is regulated by fetal swallowing. True Amniotic fluid for cytogenetic analysis should be delivered to the laboratory in ice. False Meconium is composed of bowel constituents True Acetylcholinesterase testing can be performed on amniotic fluid containing blood, if the specimen is centrifuged. False Production of both lecithin and sphingomyelin increases after 35 weeks gestation. False Most laboratories detect the presence of phosphatidylglycerol using thin-layer chromatography. False When performing the foam stability index, amniotic fluid is mixed with ethanol. True Pneumocytes in the fetal lungs produce lamellar bodies. True Lamellar bodies are approximately the same size as red blood cells. False The normal brown color of the feces is produced by: Stercobilin Stools from persons with steatorrhea contain excess amounts of: Fat Which of the following pairings of stool appearance and cause does not match? Yellow-green: barium sulfate A tarry looking stool is indicative of: Upper gastrointestinal (GI) bleeding A pale, frothy looking stool is indicative of: Excess fat All of the following are secreted into the small intestine by the pancreas except: A. Bile salts B. Chymotrypsin C. Lipase D. Elastase 1 A The recommended specimen for quantitative fecal testing is a: 72-hour specimen The presence of amebic dysentery may be suspected when a Is coated with blood-streaked mucus The unpleasant odor associated with fecal analysis is caused primarily by: Bacterial metabolism Diarrhea can result from all of the following except: A. Disruption of the normal intestinal bacterial B. Addition of pathogenic organisms to the normal intestinal flora C. Increased reabsorption of intestinal water and C
undigested muscle fibers, and the inability to digest gelatin may have: A stool pH of 5.0 correlates with a: Positive Clinitest A bloody produced by a newborn should: Have an Apt test performed on it False-negative results for upper GI bleeding can be caused by: Degradation of hemoglobin to porphyrin When performing the Apt test, a pink color that remains in the supernatant during testing indicates: The presence of fetal hemoglobin What is the significance of the pale, frothy Biliary obstruction The absence of what substance most likely accounts for increased orange droplets? Bile What is the condition indicated by increased orange droplets? Steatorrhea How long should the slide for muscle fibers sit before being examined? 5 minutes An Apt test performed on a tarry stool is negative for fetal hemoglobin. Concerned; patients may not be receiving dietary instructions In the evaluation of a specimen, the results were abnormal in the trypsin test and normal in a chymotrypsin test. Not concerned; 95% retention is normal Quantitative fat testing performed on a patient maintained on a diet of 100 g of fat per day is 5 g per day. The coefficient of fat retention is reported as normal. Not concerned; 95% retention is normal An unusual number of positive occult blood tests are reported by a new employee in a satellite clinic. Concerned; patients may not be receiving dietary instructions The electrolyte content of normal feces is similar to that of plasma. True Microbial infections produce osmotic diarrhea. False A stool that appears black and tarry may be associated with bismuth ingestion True The neutral fat and split fat stains are confirmatory tests for steatorrhea. False Staphylococcal food poisoning produces secretory diarrhea and increased fecal neutrophils. The guaiac test detects both hemoglobin and porphyrin. False The Apt test should not be performed on a black, tarry stool. True True or False? The D-xylose and lactose tolerance tests are abnormal in persons with malabsorption or maldigestion disorders. True True or Steatorrhea is seen in association with decreased elastase 1 in the feces. True Which of the following is the most likely reason a physician would collect vaginal fluid for analysis? Vaginitis of the following vaginitis conditions is Chemical irritation