Master Body Fluids for your laboratory certification exam with our comprehensive collection of 182 multiple-choice questions (MCQs). Focused exclusively on Urinalysis and Other Body Fluid, these practice questions align with the latest syllabi of ASCP MLS, AMT MLT/MT, AIMS, CSMLS, IBMS, HAAD/DOH, DHA, and MOH exams. Each MCQ includes detailed explanations and references to reinforce key concepts. Sharpen your critical thinking, identify knowledge gaps, and build speed with exam-style questions—all for free. Ideal for targeted revision!
1. Physical Examination of Body Fluids
Physical characteristics such as color, clarity, viscosity, and specific gravity provide immediate diagnostic clues.
- CSF color changes, including xanthochromia (yellowish tint), may indicate subarachnoid hemorrhage or blood contamination.
- Synovial fluid viscosity, normally high due to hyaluronic acid, decreases in inflammatory and septic arthritis.
- Chylous effusions, typically milky in appearance, suggest lymphatic obstruction or malignancy.
2. Chemical Analysis of Body Fluids
Chemical testing evaluates glucose, protein, lactate, LDH, uric acid, and other analytes to differentiate between various conditions.
- Low glucose and high protein in CSF are classic findings in bacterial and tuberculous meningitis.
- Lactate levels help distinguish bacterial or fungal infections from viral causes.
- High uric acid in synovial fluid is strongly linked to gout, whereas LDH elevation in pleural or peritoneal fluids indicates cellular damage or inflammation.
- Seminal fructose testing assesses male fertility and ejaculatory duct function.
3. Microscopic Examination of Body Fluids
Microscopic analysis provides valuable information on cell counts, crystal identification, and infectious agents.
- Neutrophil predominance in CSF suggests bacterial meningitis, while lymphocyte predominance points toward viral causes.
- Monosodium urate crystals under polarized light confirm gout, whereas calcium pyrophosphate crystals indicate pseudogout.
- Malignant cells in serous fluids support a diagnosis of carcinomatosis, and yeast such as Cryptococcus neoformans in CSF suggests fungal meningitis.
4. Physiological Role of Body Fluids
Each body fluid has specific functions essential for maintaining homeostasis:
- CSF cushions the brain and spinal cord, removing metabolic waste while protecting the central nervous system.
- Pleural, peritoneal, and pericardial fluids reduce friction between organs during movement.
- Synovial fluid nourishes cartilage and lubricates joints.
- Seminal fluid supports sperm motility and fertility.
5. Disease States and Diagnostic Relevance
Abnormal findings in body fluids often indicate serious disease conditions:
- Meningitis (bacterial, viral, fungal, or parasitic) alters CSF chemistry and cell profile.
- Joint diseases, including gout, pseudogout, rheumatoid arthritis, and septic arthritis, are diagnosed using synovial fluid analysis.
- Pleural and peritoneal effusions help distinguish between transudates (e.g., cirrhosis, heart failure) and exudates (e.g., infections, malignancy).
- Hemorrhagic effusions, chylous fluids, or abnormal pH levels guide further diagnostic investigations.
182 MCQs (1110 – 1291):
Body Fluids (Physical):
- Which physical characteristic of cerebrospinal fluid (CSF) is most commonly used to detect the presence of blood contamination or subarachnoid hemorrhage?
a) Viscosity
b) Clarity
c) Color
d) Volume - Xanthochromia in cerebrospinal fluid is typically associated with which condition?
a) Bacterial meningitis
b) Subarachnoid hemorrhage
c) Traumatic tap
d) Viral encephalitis - What is the best way to distinguish a traumatic tap from a subarachnoid hemorrhage in a CSF sample?
a) Presence of bacteria in Gram stain
b) Xanthochromia after centrifugation
c) Low glucose concentration
d) Cloudy appearance - Which description best defines a chylous effusion?
a) Cloudy, pink, and containing bacteria
b) Clear with high glucose concentration
c) Milky fluid rich in triglycerides
d) Bloody fluid with low protein - Which body fluid is normally viscous due to the presence of hyaluronic acid?
a) Peritoneal fluid
b) Synovial fluid
c) Cerebrospinal fluid
d) Pleural fluid - How does a clot in synovial fluid typically form?
a) Inflammatory reaction with increased leukocytes
b) High concentration of mucin
c) Presence of fibrinogen due to joint trauma
d) Contamination with blood - Which test is most appropriate to assess synovial fluid viscosity?
a) String test
b) Refractometry
c) Gram stain
d) Osmometry - What is the typical appearance of synovial fluid in non-inflammatory joint disease?
a) Bloody and cloudy
b) Clear and colorless
c) Yellow and turbid
d) Milky and opaque - Which condition may cause cloudy or turbid synovial fluid?
a) Dehydration
b) Osteoarthritis
c) Crystal-induced arthritis
d) Hemorrhage - Which physical property of pleural fluid helps differentiate transudates from exudates?
a) Specific gravity
b) Color
c) Clarity
d) Volume - A cerebrospinal fluid with a milky appearance would most likely contain an increased amount of:
a) Lipids
b) Protein
c) Glucose
d) Bacteria - A synovial fluid that easily forms small, discrete droplets when expelled from a syringe would be associated with which of the following?
a) Gout
b) Pseudogout
c) Inflammation
d) Hypothyroidism - Ascites is collected by:
a) Paracentesis
b) Thoracentesis
c) Amniocentesis
d) Lumbar puncture - CSF should normally appear clear and:
a) Colorless
b) Opalescent
c) Pale yellow
d) Xanthochromic - Which of the following stains is commonly used to evaluate sperm viability?
a) Wright
b) Eosin-nigrosin
c) Toluidine blue
d) Papanicolaou - Amniotic fluid that is dark yellow may indicate an increased concentration of which of the following?
a) Urea
b) Glucose
c) Bilirubin
d) Creatinine - A green-colored amniotic fluid is received in the laboratory for testing. The color of this specimen indicates the presence of:
a) Blood
b) Bilirubin
c) Meconium
d) Hemoglobin - A positive amine or “whiff” test on a vaginal secretion most likely indicates:
a) Candidiasis
b) Trichomoniasis
c) Bacterial vaginosis
d) A sexually-transmitted infection - Which of the following studies is performed by aspirating seminal fluid with a Pasteur pipette and observing the formation of droplets as it is allowed to fall under only the influence of gravity?
a) Vitality
b) Motility
c) Viscosity
d) Concentration - Which of the following results would be considered abnormal for seminal fluid?
a) Liquefaction time >60 minutes
b) 65% sperm that stain with eosin-nigrosin
c) 55% sperm with normal morphology
d) 50% sperm with rapid linear progression
Body Fluids (Chemical):
- A decreased CSF glucose concentration is typically found in:
a) Viral meningitis
b) Normal aging
c) Bacterial meningitis
d) Multiple sclerosis - Which CSF analyte is most specific for the diagnosis of multiple sclerosis?
a) Protein
b) IgG index
c) Glucose
d) Lactate - Which analyte is most helpful in differentiating between bacterial and viral meningitis?
a) Protein
b) Sodium
c) Glucose
d) Lactate - Elevated CSF protein without a corresponding increase in WBC count is most consistent with:
a) Traumatic tap
b) Viral meningitis
c) Subarachnoid hemorrhage
d) Spinal blockage - Which is a common finding in tuberculous meningitis?
a) Increased CSF glucose
b) Decreased CSF protein
c) Elevated CSF lactate
d) Normal CSF chloride - A patient with traumatic CSF tap will typically have:
a) Evenly distributed blood in all tubes
b) Decreasing blood in successive tubes
c) Xanthochromia
d) Increased CSF lactate - Which test is commonly used to detect intrathecal synthesis of immunoglobulins?
a) CSF glucose
b) CSF/serum albumin index
c) Oligoclonal banding
d) Lactate dehydrogenase - Which method is used to evaluate blood-brain barrier integrity?
a) CSF protein electrophoresis
b) Albumin index
c) IgG index
d) CSF lactate - Which of the following is typically decreased in bacterial meningitis?
a) CSF chloride
b) CSF glucose
c) CSF albumin
d) CSF sodium - What is the significance of a CSF IgG index greater than 0.7?
a) Compromised blood-brain barrier
b) Normal value
c) Increased intrathecal synthesis
d) Decreased protein production - Which body fluid test helps diagnose pancreatitis?
a) CSF glucose
b) Peritoneal fluid lipase
c) Pleural fluid pH
d) Synovial fluid uric acid - Amylase levels in pleural fluid are elevated in cases of:
a) Tuberculosis
b) Pancreatitis or esophageal rupture
c) Rheumatoid arthritis
d) Congestive heart failure - Which pleural fluid finding is consistent with an exudate?
a) Protein ratio < 0.5
b) LDH ratio > 0.6
c) Glucose > 60 mg/dL
d) Clear appearance - Which fluid is analyzed for creatinine to detect urine leakage into body cavities?
a) Pericardial fluid
b) Synovial fluid
c) Pleural fluid
d) Peritoneal fluid - Ascitic fluid with a serum-ascites albumin gradient (SAAG) > 1.1 g/dL is consistent with:
a) Peritoneal carcinomatosis
b) Tuberculosis
c) Portal hypertension
d) Pancreatic ascites - Low glucose levels in pleural fluid are most often associated with:
a) Congestive heart failure
b) Cirrhosis
c) Rheumatoid pleuritis
d) Pulmonary embolism - Which synovial fluid analyte is increased in gout?
a) Cholesterol
b) Uric acid
c) Glucose
d) Sodium - Normal glucose levels in synovial fluid suggest:
a) Inflammatory arthritis
b) Gout
c) Non-inflammatory arthritis
d) Septic arthritis - Which of the following would likely show decreased glucose in synovial fluid?
a) Osteoarthritis
b) Gout
c) Rheumatoid arthritis
d) Joint trauma - What is the clinical significance of high LDH in body fluids?
a) Normal metabolism
b) Decreased permeability
c) Cellular breakdown or inflammation
d) Electrolyte imbalance - Which CSF test is best to differentiate between bacterial and viral meningitis?
a) Chloride concentration
b) Cell count
c) Lactate
d) Total protein - A peritoneal fluid to serum amylase ratio greater than 1 suggests:
a) Cirrhosis
b) Pancreatic origin of effusion
c) Bacterial peritonitis
d) Malignancy - Which is a hallmark of exudative pleural effusion?
a) Glucose > 60 mg/dL
b) LDH < 200 U/L
c) High protein content
d) SAAG > 1.1 g/dL - Which chemical parameter is evaluated in seminal fluid to assess prostate function?
a) Glucose
b) Fructose
c) Albumin
d) Uric acid - Decreased fructose levels in semen may indicate:
a) Epididymitis
b) Ejaculatory duct obstruction
c) Prostate hypertrophy
d) Hypogonadism - Which test is useful to assess sperm viability in a semen sample?
a) pH
b) Methylene blue staining
c) Fructose test
d) Leukocyte count - Which of the following normally accounts for the largest fraction of CSF total proteins?
a) Albumin
b) Fibrinogen
c) Haptoglobin
d) Transthyretin - The mucin clot test for synovial fluid is performed by adding which of the following to an aliquot of the sample?
a) Sodium chloride
b) Hydrochloric acid
c) Sodium hydroxide
d) Glacial acetic acid - The laboratory values shown in this table were obtained on an unlabeled body fluid sample:
| Test | Result |
|---|---|
| Protein | 3 g/dL (30 g/L) |
| Albumin | 2.1 g/dL (21 g/L) |
| Hyaluronate | 0.4 g/dL (4 g/L) |
| Glucose | 80 mg/dL (4.4 mmol/L) |
| Lactate | 10 mg/dL (1.1 mmol/L) |
- Based on these values, this sample is most likely:
a) Urine
b) Synovial fluid
c) Peritoneal fluid
d) Cerebrospinal fluid
- A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Addition of acetic acid results in turbidity and a clot. This indicates the fluid:
a) Is synovial fluid
b) Contains red blood cells
c) Is inappropriate for analysis
d) Must be treated with a diluent prior to testing - A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Addition of acetic acid results in turbidity and a clot. This indicates the fluid:
a) Is synovial fluid
b) Contains red blood cells
c) Is inappropriate for analysis
d) Must be treated with a diluent prior to testing - The principal mucin in synovial fluid is:
a) Pepsin
b) Albumin
c) Hyaluronate
d) Orosomucoid - False-negative results can occur for a guaiac-based fecal occult blood test due to the ingestion of:
a) Ascorbic acid
b) Horseradish
c) Blueberries
d) Acetaminophen - Which of the following compounds is used as a chromogen in fecal occult blood tests?
a) Guaiac
b) NADH
c) O-toluidine
d) p-Aminocinnamaldehyde - Normal CSF contains all of the following proteins except:
a) Transferrin
b) Transthyretin
c) Albumin
d) Fibrinogen - An increased CSF IgG index indicates:
a) A decreased antibody response
b) Increased intrathecal IgG synthesis
c) The presence of a metastatic tumor
d) Damage to the blood-brain barrier - Measurement of which of the following enzymes can be used to confirm the presence of seminal fluid?
a) Acid phosphatase
b) Alkaline phosphatase
c) Lactate dehydrogenase
d) Aspartate aminotransferase - Pilocarpine iontophoresis is used to:
a) Induce sweating
b) Separate CSF proteins
c) Measure ions in saliva
d) Determine serous fluid pH - A decreased CSF concentration of which of the following, compared to a paired serum concentration, would be associated with bacterial meningitis and pleocytosis?
a) Lactate
b) Glucose
c) Albumin
d) Total protein - Three tubes of CSF are collected, labeled, and sent to the laboratory for testing. Which tube should be used for chemical analyses, including glucose and total protein?
a) Tube 1
b) Tube 2
c) Tube 3
d) These tests should not be performed on CSF - Myelin basic protein is most commonly measured in CSF to evaluate the effectiveness of treatment for:
a) Viral encephalitis
b) Multiple sclerosis
c) Bacterial meningitis
d) Intracranial hemorrhage - pH determinations are clinically relevant for which of the following?
a) Pleural fluid
b) Synovial fluid
c) Pericardial fluid
d) Cerebrospinal fluid - An amniocentesis is performed on a 32-year-old female at 17 weeks’ gestation. The specimen is received in the laboratory and the clinician wants to confirm the specimen is amniotic fluid, not urine. Which of the following tests should be the most helpful in distinguishing these fluids?
a) Glucose, total protein, urea, and creatinine
b) Glucose, total bilirubin, urea, and creatinine
c) Albumin, potassium, sodium, and creatinine
d) Total protein, total bilirubin, albumin, and sodium - An L/S ratio of 2.4 on amniotic fluid collected at 34 weeks’ gestation indicates:
a) Fetal lung maturity
b) Fetal lung immaturity
c) Increased risk for RDS
d) Increased risk of neural tube defects - Measurement of which of the following tumor markers may be useful in evaluating both pleural and peritoneal effusions for malignancy?
a) CEA
b) JAK2
c) hCG
d) CD10 - Increased presence of fetal fibronectin (fFN) in cervicovaginal secretions from a 24-year-old female at 35 weeks’ gestation indicates an increased risk for:
a) Preterm delivery
b) Bacterial vaginosis
c) Gestational diabetes
d) Hemolytic disease of the newborn - A CSF/serum albumin index of 17 would strongly suggest which of the following?
a) Multiple myeloma
b) Multiple sclerosis
c) Bacterial meningitis
d) Damage to the blood-brain barrier - A paired fasting plasma specimen is collected at the same time an arthrocentesis is performed. The difference in glucose concentrations between the fluids is reported as 55 mg/dL. This result indicates a(an):
a) Septic condition
b) Inflammatory condition
c) Hemorrhagic condition
d) Noninflammatory condition - A phosphatidylglycerol immunochemical slide test shows no visible agglutination for an amniotic fluid collected at 30 weeks’ gestation. This should be reported as:
a) Negative
b) Low positive
c) High positive
d) Invalid - A 10 mL suspension, in water, is made from a bloody stool sample collected from a neonate. The specimen is centrifuged and the resulting pink supernatant transferred in equal volumes to 2 tubes. The first tube serves as a reference while the second tube is alkalinized with 1 mL of 0.25 M sodium hydroxide. The second tube develops a yellow color within 2 minutes. This reaction indicates the presence of:
a) Fetal hemoglobin
b) Maternal hemoglobin
c) Fetal white blood cells
d) Maternal white blood cells - The laboratory results in this table are from a 21-year-old patient with a back injury, who appears otherwise healthy:
| Test | Result |
|---|---|
| Whole blood glucose | 77 mg/dL (4.2 mmol/L) |
| Serum glucose | 88 mg/dL (4.8 mmol/L) |
| CSF glucose | 56 mg/dL (3.1 mmol/L) |
The best interpretation of these results is that:
a) The whole blood and serum values are expected but the CSF value is elevated
b) The whole blood glucose value should be higher than the serum value
c) All values are consistent with a normal healthy individual
d) The serum and whole blood values should be identical
- A healthy person with a blood glucose of 80 mg/dL (4.4 mmol/L) would have a simultaneously determined cerebrospinal fluid glucose value of:
a) 25 mg/dL (1.4 mmol/L)
b) 50 mg/dL (2.3 mmol/L)
c) 100 mg/dL (5.5 mmol/L)
d) 150 mg/dL (8.3 mmol/L) - If glucose testing cannot be performed immediately, CSF should be stored:
a) At room temperature
b) In a refrigerator
c) In a freezer
d) In an incubator
Body Fluids (Microscopic):
- Which cell type is most frequently increased in bacterial meningitis?
a) Lymphocytes
b) Eosinophils
c) Monocytes
d) Neutrophils - In viral meningitis, the predominant CSF cell type is:
a) Neutrophils
b) Basophils
c) Lymphocytes
d) Eosinophils - Which CSF cell count is considered normal in adults?
a) 0–5 WBCs/µL
b) 6–15 RBCs/µL
c) 10–50 neutrophils/µL
d) 5–10 lymphocytes/µL - Which stain is best for detecting bacteria in a CSF sample?
a) Wright-Giemsa
b) Gram stain
c) Sudan III
d) Prussian blue - Which of the following is a common artifact that may mimic cells in body fluid smears?
a) Crystals
b) Fungi
c) Bacteria
d) Talc powder - Which of the following structures can be identified by polarized light microscopy in synovial fluid?
a) Cholesterol crystals
b) Bacteria
c) WBCs
d) Erythrocytes - Needle-shaped, negatively birefringent crystals in synovial fluid are characteristic of:
a) Calcium pyrophosphate
b) Cholesterol
c) Monosodium urate
d) Corticosteroid - Calcium pyrophosphate dihydrate crystals (CPPD) appear in polarized light as:
a) Needle-shaped, yellow
b) Rhomboid, blue under red compensator
c) Hexagonal, colorless
d) Round, green - A CSF sample shows a predominance of eosinophils. Which condition should be considered?
a) Bacterial meningitis
b) Parasitic infection
c) Viral meningitis
d) Traumatic tap - Which stain is best used for identifying acid-fast organisms in body fluids?
a) Wright stain
b) Gram stain
c) Ziehl-Neelsen stain
d) Sudan black - Malignant cells in serous fluids typically appear as:
a) Small round cells with uniform nuclei
b) Multinucleated with irregular nuclear borders
c) Neutrophils in clusters
d) Crystals with birefringence - Which of the following findings in synovial fluid is consistent with septic arthritis?
a) Clear appearance, few WBCs
b) Milky, high WBC count, positive Gram stain
c) Yellow, low protein, negative culture
d) High viscosity, negative Gram stain - Lipid-laden macrophages in CSF are suggestive of:
a) Hemorrhage
b) Leukemia
c) CNS trauma
d) Fungal infection - Which of the following would appear birefringent under polarized microscopy?
a) Monosodium urate crystals
b) Bacteria
c) Protein aggregates
d) Hemoglobin - Which synovial fluid characteristic supports a diagnosis of gout?
a) Presence of CPPD crystals
b) Yellow-green color
c) Presence of monosodium urate crystals
d) High viscosity - The presence of LE (lupus erythematosus) cells in body fluids is associated with:
a) Tuberculosis
b) Gout
c) Systemic lupus erythematosus
d) Bacterial infection - Which organism commonly appears as encapsulated yeast in CSF cytology?
a) Candida albicans
b) Cryptococcus neoformans
c) Histoplasma capsulatum
d) Blastomyces dermatitidis - To avoid falsely elevated cerebrospinal fluid cell counts, use an aliquot:
a) That has been centrifuged
b) From the first tube collected
c) From the last tube collected
d) Treated with glacial acetic acid - Which of the following analyses is performed on seminal fluid that has been fixed and stained with Wright, Giemsa, or Papanicolaou stain?
a) Motility
b) Viability
c) Morphology
d) Concentration - Synovial fluid analyzed with a polarizing microscope shows the presence of crystals appearing as sharp needles with strong negative birefringence. These crystals should be reported as:
a) Calcium oxalate crystals
b) Monosodium urate crystals
c) Ammonium biurate crystals
d) Calcium pyrophosphate dihydrate crystals - Seminal fluid is diluted 1:20 and loaded onto a Neubauer counting chamber. An average of 50 sperm are counted in 2 secondary squares. Sperm concentration should be reported as:
a) 5,000/mL
b) 50,000/mL
c) 500,000/mL
d) 5,000,000/mL - Monosodium urate crystals that are aligned with the slow vibration of the red compensator in a polarizing microscope will appear:
a) Blue
b) Yellow
c) Orange
d) Purple - Three tubes of cerebrospinal fluid are collected, labeled, and transported to the laboratory for immediate testing. Tube 1 is reported as light pink and clear with 50,000 RBC/μL and 48 WBC/μL. Tube 3 is reported as colorless and clear with 10 RBC/μL and 0 WBC/μL. The most likely explanation for the difference in results is that:
a) Tube 3 is QNS
b) Tube 1 is centrifuged
c) Both tubes are mislabeled
d) Tube 1 contains peripheral blood - Three tubes of CSF are collected, labeled, and sent to the laboratory for testing. All 3 tubes appear light pink and slightly hazy. The most likely explanation for the appearance of the samples is that:
a) The collection was traumatic
b) The patient has multiple sclerosis
c) They were centrifuged prior to observation
d) The patient has a subarachnoid hemorrhage - The dimensions of a standard Neubauer hemocytometer chamber are:
a) 3.0 mm × 3.0 mm × 0.1 mm
b) 2.0 mm × 2.0 mm × 0.1 mm
c) 1.0 mm × 1.0 mm × 0.1 mm
d) 0.1 mm × 0.1 mm × 0.1 mm - Motility must be observed in at least what percentage of sperm to be considered normal?
a) 10%
b) 25%
c) 50%
d) 75% - Synovial fluid is typically collected using a sterile needle and syringe and then transferred to collection tubes for testing. Which of the following anticoagulants would be appropriate to use for the aliquot sent for a manual cell count and crystal evaluation?
a) Liquid EDTA
b) Lithium heparin
c) Sodium fluoride
d) Sodium polyanethol sulfonate - Which of the following sample preparations is appropriate to use for evaluation of sperm agglutination?
a) Wet preparation
b) Smear stained with Wright stain
c) Fixed smear stained with eosin-nigrosin stain
d) Dried smear stained with Papanicolaou stain - Synovial fluid from a 68-year-old patient reveals rhombic crystals with weak positive birefringence when viewed using polarizing microscopy. These crystals can be identified as:
a) Cholesterol
b) Hydroxyapatite
c) Monosodium urate
d) Calcium pyrophosphate dihydrate - Evaluation of sperm morphology is performed by staining an air-dried smear with Wright, Giemsa, or Papanicolaou stain and evaluating 200 sperm using:
a) A 4x objective (40x magnification)
b) A 10x objective (100x magnification)
c) A 40x objective (400x magnification)
d) Oil immersion and a 100x objective (1000x magnification) - An undiluted CSF specimen is loaded onto a Neubauer hemocytometer and the results shown in this table are recorded after counting all nine 1.0 mm² quadrants on both sides: (Slide 1 = 100, Slide 2 = 50) The laboratorian should:
a) Report the sum of WBC/μL
b) Report the average WBC/μL
c) Report the difference in WBC/μL
d) Clean and reload the hemocytometer - To qualitatively aid in differentiating malabsorption and maldigestion, 2 slides are made from the stool specimen, pretreated with ethanol (slide 1) or acetic acid (slide 2), and stained with:
a) Safranin
b) Oil red O
c) Eosin-nigrosin
d) Methylene blue - In synovial fluid, the most characteristic microscopic finding for patients with gout is:
a) CPPD crystals
b) Cartilage debris
c) MSU crystals
d) Hemosiderin-laden macrophages - In synovial fluid, the most characteristic finding for patients with pseudogout is:
a) CPPD crystals
b) Cartilage debris
c) MSU crystals
d) Hemosiderin-laden macrophages
Body Fluids (Physiology):
- Which of the following best describes the function of cerebrospinal fluid (CSF)?
a) Promotes immune responses in the brain
b) Delivers nutrients to the spinal cord only
c) Provides mechanical cushioning and removes metabolic waste
d) Maintains blood glucose concentration - Where is cerebrospinal fluid primarily produced?
a) Subarachnoid space
b) Ependymal lining
c) Choroid plexus
d) Spinal cord - What is the normal total volume of CSF in an adult?
a) 50–70 mL
b) 90–120 mL
c) 140–170 mL
d) 200–250 mL - Which of the following best explains the blood-brain barrier’s role in CSF composition?
a) Allows passive diffusion of all substances
b) Prevents water from entering the brain
c) Regulates the entry of large molecules and cells
d) Facilitates protein entry into the brain - Which body cavity is associated with the production and circulation of pleural fluid?
a) Abdominal cavity
b) Pericardial cavity
c) Thoracic cavity
d) Pelvic cavity - Which of the following fluids functions to reduce friction between organs during movement?
a) CSF
b) Pleural fluid
c) Synovial fluid
d) Seminal fluid - Synovial fluid is secreted by which of the following structures?
a) Bone marrow
b) Cartilage
c) Synovial membrane
d) Joint capsule - What is the primary physiological role of synovial fluid?
a) Provides nutrients to the cartilage and acts as a lubricant
b) Delivers oxygen to muscles
c) Breaks down glucose in joints
d) Regulates sodium concentration in plasma - Which mechanism ensures the continuous production and reabsorption of CSF?
a) Active filtration
b) Osmotic pressure
c) Hydrostatic balance in the choroid plexus
d) Passive diffusion - What is the typical rate of cerebrospinal fluid production in adults?
a) 20–25 mL/hour
b) 10–15 mL/hour
c) 5–8 mL/hour
d) 0.5–1.0 mL/hour - Pericardial fluid accumulation is normally prevented by:
a) Constant lymphatic drainage
b) High vascular pressure
c) Fluid secretion by the myocardium
d) Reabsorption by red blood cells - Which of the following body fluids is directly involved in male fertility?
a) Pleural fluid
b) Peritoneal fluid
c) Seminal fluid
d) Synovial fluid - Which fluid plays a key role in cushioning the brain and spinal cord?
a) Synovial fluid
b) Seminal fluid
c) Cerebrospinal fluid
d) Pericardial fluid - The tau isoform of transferrin is a carbohydrate-deficient protein found only in:
a) CSF
b) Sweat
c) Seminal fluid
d) Amniotic fluid - Which of the following results reported for a seminal fluid would be considered abnormal?
a) pH of 7.5
b) Total volume of 1.2 mL
c) Complete liquefaction in 30 minutes
d) Gray-white, translucent appearance - What substance gives feces its normal color?
a) Uroerythrin
b) Urochrome
c) Urobilin
d) Urobilinogen - Which of the following calculations may be useful in determining if there is a breach in the blood-brain barrier?
a) CSF IgG index
b) Total protein ratio
c) CSF/serum albumin index
d) Lactate dehydrogenase ratio - Results from a yellow, cloudy pleural fluid collected from a 56-year-old male are listed in the table:
| Test | Result |
|---|---|
| Fluid WBC count | 1550/μL (neutrophils predominate) |
| Fluid glucose | 45 mg/dL |
| Fluid/serum total protein | 0.9 |
| Fluid/serum LD | 0.7 |
These results indicate the fluid is:
a) Chylous
b) An exudate
c) A transudate
d) Pseudochylous
- Which of the following seminal fluid results would be evidence of a successful vasectomy?
a) pH of 7.8
b) 50% motility
c) Azoospermia
d) Negative agglutination - If amniotic fluid is to be collected for fetal lung maturity testing, amniocentesis should be performed at:
a) 1-5 weeks’ gestation
b) 6-10 weeks’ gestation
c) 14-18 weeks’ gestation
d) 30-42 weeks’ gestation - The opening pressure for a CSF collection is low, so only 1 mL of fluid is collected into a labeled, sterile tube and sent to the laboratory. Which of the following tests should be performed first?
a) Glucose
b) Total protein
c) Manual cell count
d) Gram stain and culture - Results from a milky peritoneal fluid demonstrate an elevated triglyceride content and the presence of chylomicrons. These results indicate the fluid is:
a) Chylous
b) An exudate
c) A transudate
d) Pseudochylous - Amniotic fluid is collected from a 24-year-old female at 33 weeks’ gestation and sent to the laboratory for analysis. The specimen arrives in a clear, plastic container that has been exposed to light for over an hour. Which of the following analyses may be affected by this error in specimen transport?
a) Lamellar body count
b) Alpha-fetoprotein
c) ΔA450 determination
d) Foam stability index - A xanthochromic CSF specimen is centrifuged resulting in a pink-colored supernatant. This indicates presence of:
a) Bilirubin
b) Hemoglobin
c) Red blood cells
d) Methemoglobin - The presence of which of the following may result in a CSF specimen with an oily appearance?
a) White blood cells
b) Neutral triglycerides
c) Increased total proteins
d) Radiographic contrast media
Body Fluids (Disease States):
- Which condition is most commonly associated with increased neutrophils in CSF?
a) Viral meningitis
b) Bacterial meningitis
c) Multiple sclerosis
d) Subarachnoid hemorrhage - Xanthochromia is most commonly associated with which condition?
a) Traumatic tap
b) Viral meningitis
c) Subarachnoid hemorrhage
d) Encephalitis - Which disorder is best diagnosed with the presence of oligoclonal bands in CSF?
a) Guillain-Barré syndrome
b) Tuberculosis
c) Multiple sclerosis
d) Cryptococcal meningitis - What CSF finding is most indicative of tuberculous meningitis?
a) Decreased protein and increased glucose
b) Increased chloride and decreased WBCs
c) High protein and low glucose
d) Normal glucose and low WBCs - Which of the following is most likely to produce a chylous pleural effusion?
a) Pulmonary embolism
b) Malignancy involving lymphatic obstruction
c) Bacterial infection
d) Tuberculosis - Which of the following is a feature of exudative effusions?
a) Low protein concentration
b) SAAG >1.1 g/dL
c) High lactate dehydrogenase (LDH)
d) Clear, straw-colored fluid - What type of peritoneal fluid is typically found in cirrhosis-related ascites?
a) Exudate
b) Chylous fluid
c) Transudate
d) Bloody effusion - A pleural fluid pH less than 7.2 is commonly seen in:
a) Malignancy
b) Pancreatitis
c) Bacterial pneumonia with empyema
d) Congestive heart failure - Which condition is associated with the presence of monosodium urate crystals in synovial fluid?
a) Pseudogout
b) Gout
c) Osteoarthritis
d) Septic arthritis - Calcium pyrophosphate dihydrate (CPPD) crystals in synovial fluid are characteristic of:
a) Gout
b) Rheumatoid arthritis
c) Pseudogout
d) Septic arthritis - A milky appearance of synovial fluid may indicate:
a) Septic arthritis
b) Fungal infection
c) Crystal-induced arthritis
d) Hemorrhagic effusion - What is the typical CSF glucose finding in viral meningitis?
a) Markedly low
b) Normal or mildly decreased
c) Very high
d) Undetectable - Which condition is associated with the presence of malignant cells in pleural fluid?
a) Congestive heart failure
b) Liver cirrhosis
c) Carcinomatosis
d) Tuberculosis - Which disorder can cause an increased number of eosinophils in CSF?
a) Fungal meningitis
b) Parasitic infection
c) Multiple sclerosis
d) Traumatic tap - A low CSF chloride level is typically associated with:
a) Bacterial meningitis
b) Viral encephalitis
c) Tuberculous meningitis
d) Multiple sclerosis - Which of the following diseases is associated with elevated IgG index in CSF?
a) Guillain-Barré syndrome
b) Multiple sclerosis
c) Viral meningitis
d) Tuberculosis - Which of the following CSF findings is consistent with cryptococcal meningitis?
a) Low glucose, high protein, positive India ink
b) High glucose, low protein, positive culture
c) Normal glucose and protein, negative stains
d) High glucose, low WBC - Increased CSF lactate concentration is most indicative of:
a) Viral infection
b) Bacterial or fungal infection
c) Traumatic tap
d) Normal physiology - Hemorrhagic synovial fluid is most commonly associated with:
a) Gout
b) Rheumatoid arthritis
c) Hemophilia
d) Osteoarthritis - A patient has cloudy synovial fluid with decreased viscosity and positive Gram stain. This is most consistent with:
a) Osteoarthritis
b) Gout
c) Septic arthritis
d) Pseudogout - Which of the following diseases may cause an exudative pericardial effusion?
a) Congestive heart failure
b) Nephrotic syndrome
c) Bacterial infection
d) Cirrhosis - A high synovial fluid WBC count (>50,000/μL) is most indicative of:
a) Non-inflammatory arthritis
b) Gout
c) Septic arthritis
d) Pseudogout - Which condition is associated with decreased glucose in peritoneal fluid?
a) Cirrhosis
b) Peritonitis
c) Congestive heart failure
d) Hepatitis - Increased LDH levels in serous fluids typically suggest:
a) Transudate
b) Cellular breakdown or inflammation
c) Electrolyte imbalance
d) Dehydration - What is the diagnostic significance of the serum-ascites albumin gradient (SAAG)?
a) Differentiates cirrhosis from tuberculosis
b) Determines glucose imbalance
c) Measures protein leakage
d) Assesses hemolysis - Pleural transudates differ from pleural exudates in that transudates have:
a) Fluid:serum LD ratio >0.6
b) Fluid:serum protein ratio >0.5
c) A white blood cell count <1000/μL
d) Fluid:serum glucose difference >30 mg/dL - Pleural fluid from a patient with congestive heart failure would be expected to:
a) Contain >1000 WBC/μL
b) Appear clear and pale yellow
c) Have a fluid:serum LD ratio >0.6
d) Have a fluid:serum protein ratio >0.5 - An accumulation of fluid in a body cavity is referred to as a(an):
a) Effusion
b) Exudate
c) Transudate
d) Metastasis - A fluid sample is collected by thoracentesis and a paired serum sample is collected immediately afterward. The fluid-to-serum LD ratio is determined to be 0.9. This fluid would be categorized as a:
a) Pleural exudate
b) Pleural transudate
c) Pericardial exudate
d) Peritoneal transudate - Amniotic fluid may be tested to determine the concentration of lamellar bodies to evaluate for:
a) Fetal lung maturity
b) Neural tube defects
c) Erythroblastosis fetalis
d) Congenital birth defects - Amniocentesis should be performed to:
a) Determine the gestational age
b) Confirm a high maternal serum AFP
c) Measure bilirubin levels for an Rh-positive mother
d) Determine the folic acid concentration in fetal circulation - An elevated sweat chloride is associated with:
a) Multiple sclerosis
b) Muscular dystrophy
c) Multiple myeloma
d) Cystic fibrosis - The most common genetic defect associated with cystic fibrosis is called:
a) Fragile X
b) Trisomy 21
c) CFTR delta-F508
d) Philadelphia chromosome - The presence of oligoclonal bands in a CSF specimen but not in the paired serum sample is associated with:
a) Spina bifida
b) Hydrocephalus
c) Reye syndrome
d) Multiple sclerosis - The presence of macrophages in CSF is associated with a:
a) Viral infection
b) Bacterial infection
c) Subarachnoid hemorrhage
d) Traumatic lumbar puncture - Which CSF results are most consistent with bacterial meningitis?
| Sample | Glucose | Protein | Lactate |
|---|---|---|---|
| A | 20 mg/dL | 200 mg/dL | 40 mg/dL |
| B | 75 mg/dL | 35 mg/dL | 15 mg/dL |
| C | 75 mg/dL | 45 mg/dL | 30 mg/dL |
| D | 20 mg/dL | 90 mg/dL | 10 mg/dL |
a) Sample A
b) Sample B
c) Sample C
d) Sample D
- The presence of small, dark, pepper-like granules in a synovial fluid is strongly associated with:
a) Alkaptonuria
b) Rheumatoid arthritis
c) Traumatic collection
d) Hemorrhagic arthritis - Which of the following results would be associated with malabsorption syndrome?
a) Increased fecal fat
b) Positive fecal lactoferrin
c) Positive fecal occult blood
d) Negative fecal calprotectin - Amniotic fluid may be measured spectrophotometrically to determine the change in absorbance at 450 nm in order to monitor progression of which of the following?
a) Fetal lung maturity
b) Open neural tube defects
c) Respiratory distress syndrome
d) Hemolytic disease of the newborn - Acetylcholinesterase activity may be measured on amniotic fluid when a positive alpha-fetoprotein result is obtained to evaluate for:
a) Fetal lung maturity
b) Open neural tube defects
c) Respiratory distress syndrome
d) Hemolytic disease of the newborn - Qualitative methods used as screening tests for cystic fibrosis employ:
a) Chloridometry
b) Immunoassay
c) Nephelometry
d) Spectrophotometry - A mildly increased CSF lactate (25-30 mg/dL) is generally associated with:
a) Fungal meningitis
b) Multiple sclerosis
c) Multiple myeloma
d) Bacterial meningitis - A decreased CSF total protein concentration may indicate the occurrence of which of the following?
a) Meningitis
b) Carcinoma
c) Hemorrhage
d) CSF leakage - An acholic or pale/clay-colored stool is characteristic of:
a) Steatorrhea
b) Maldigestion
c) Malabsorption syndrome
d) A post-hepatobiliary obstruction - Results from a CSF cell differential for an adult patient suspected of having meningitis are listed in the table:
| Test | Result |
|---|---|
| Neutrophils | 3% |
| Lymphocytes | 62% |
| Monocytes | 23% |
| Eosinophils | 12% |
These results suggest:
a) Viral meningitis
b) Fungal meningitis
c) Bacterial meningitis
d) Tubercular meningitis
- A vaginal swab is received in the laboratory for testing and immediately placed in sterile physiological saline to prepare a suspension. A wet mount is prepared and the laboratorian reports the presence of numerous clue cells. This most likely indicates the patient has:
a) Candidiasis
b) Trichomoniasis
c) Atrophic vaginitis
d) Bacterial vaginosis - A wet preparation is made from a fresh fecal specimen and stained with Wright stain. The laboratorian reports the presence of 3-5 WBC per high power field, noting that the cells are neutrophils. These results may indicate the patient has:
a) Gallstones
b) Maldigestion
c) Ulcerative colitis
d) Malabsorption - A white blood cell differential is performed on CSF from an adolescent patient suspected of having meningitis. The results shown in this table are reported:
| Test | Result |
|---|---|
| Neutrophils | 89% |
| Lymphocytes | 7% |
| Monocytes | 3% |
| Eosinophils | <1% |
These results suggest:
a) Viral meningitis
b) Fungal meningitis
c) Bacterial meningitis
d) Tubercular meningitis
- The presence of rice bodies in a synovial fluid is strongly associated with:
a) Gouty arthritis
b) Rheumatoid arthritis
c) Traumatic collection
d) Infection with S. aureus - A stool specimen that appears black and tarlike should be tested for the presence of:
a) Occult blood
b) Fecal fat
c) Trypsin
d) Excess mucus
Answer Key
Answer Key:
Body Fluids (Physical):
- c) Color
- b) Subarachnoid hemorrhage
- b) Xanthochromia after centrifugation
- c) Milky fluid rich in triglycerides
- b) Synovial fluid
- c) Presence of fibrinogen due to joint trauma
- a) String test
- b) Clear and colorless
- c) Crystal-induced arthritis
- a) Specific gravity
- a) Lipids
- c) Inflammation
- a) Paracentesis
- a) Colorless
- b) Eosin-nigrosin
- c) Bilirubin
- c) Meconium
- c) Bacterial vaginosis
- c) Viscosity
- a) Liquefaction time >60 minutes
Body Fluids (Chemical):
- c) Bacterial meningitis
- b) IgG index
- d) Lactate
- d) Spinal blockage
- c) Elevated CSF lactate
- b) Decreasing blood in successive tubes
- c) Oligoclonal banding
- b) Albumin index
- b) CSF glucose
- c) Increased intrathecal synthesis
- b) Peritoneal fluid lipase
- b) Pancreatitis or esophageal rupture
- b) LDH ratio > 0.6
- d) Peritoneal fluid
- c) Portal hypertension
- c) Rheumatoid pleuritis
- b) Uric acid
- c) Non-inflammatory arthritis
- c) Rheumatoid arthritis
- c) Cellular breakdown or inflammation
- c) Lactate
- b) Pancreatic origin of effusion
- c) High protein content
- b) Fructose
- b) Ejaculatory duct obstruction
- b) Methylene blue staining
- a) Albumin
- d) Glacial acetic acid
- b) Synovial fluid
- a) Is synovial fluid
- a) Is synovial fluid
- c) Hyaluronate
- a) Ascorbic acid
- a) Guaiac
- d) Fibrinogen
- b) Increased intrathecal IgG synthesis
- a) Acid phosphatase
- a) Induce sweating
- b) Glucose
- b) Tube 2
- b) Multiple sclerosis
- a) Pleural fluid
- a) Glucose, total protein, urea, and creatinine
- a) Fetal lung maturity
- a) CEA
- a) Preterm delivery
- d) Damage to the blood-brain barrier
- b) Inflammatory condition
- a) Negative
- b) Maternal hemoglobin
- c) All values are consistent with a normal healthy individual
- b) 50 mg/dL (2.3 mmol/L)
- b) In a refrigerator
Body Fluids (Microscopic):
- d) Neutrophils
- c) Lymphocytes
- a) 0–5 WBCs/µL
- b) Gram stain
- d) Talc powder
- a) Cholesterol crystals
- c) Monosodium urate
- b) Rhomboid, blue under red compensator
- b) Parasitic infection
- c) Ziehl-Neelsen stain
- b) Multinucleated with irregular nuclear borders
- b) Milky, high WBC count, positive Gram stain
- a) Hemorrhage
- a) Monosodium urate crystals
- c) Presence of monosodium urate crystals
- c) Systemic lupus erythematosus
- b) Cryptococcus neoformans
- c) From the last tube collected
- c) Morphology
- b) Monosodium urate crystals
- d) 5,000,000/mL
- b) Yellow
- d) Tube 1 contains peripheral blood
- d) The patient has a subarachnoid hemorrhage
- a) 3.0 mm × 3.0 mm × 0.1 mm
- c) 50%
- b) Lithium heparin
- a) Wet preparation
- d) Calcium pyrophosphate dihydrate
- d) Oil immersion and a 100x objective (1000x magnification)
- b) Report the average WBC/μL
- b) Oil red O
- c) MSU crystals
- a) CPPD crystals
Body Fluids (Physiology):
- c) Provides mechanical cushioning and removes metabolic waste
- c) Choroid plexus
- c) 140–170 mL
- c) Regulates the entry of large molecules and cells
- c) Thoracic cavity
- b) Pleural fluid
- c) Synovial membrane
- a) Provides nutrients to the cartilage and acts as a lubricant
- c) Hydrostatic balance in the choroid plexus
- a) 20–25 mL/hour
- a) Constant lymphatic drainage
- c) Seminal fluid
- c) Cerebrospinal fluid
- a) CSF
- b) Total volume of 1.2 mL
- c) Urobilin
- c) CSF/serum albumin index
- b) An exudate
- c) Azoospermia
- d) 30-42 weeks’ gestation
- d) Gram stain and culture
- a) Chylous
- c) ΔA450 determination
- b) Hemoglobin
- d) Radiographic contrast media
Body Fluids (Disease States):
- b) Bacterial meningitis
- c) Subarachnoid hemorrhage
- c) Multiple sclerosis
- c) High protein and low glucose
- b) Malignancy involving lymphatic obstruction
- c) High lactate dehydrogenase (LDH)
- c) Transudate
- c) Bacterial pneumonia with empyema
- b) Gout
- ) Pseudogout
- c) Crystal-induced arthritis
- b) Normal or mildly decreased
- c) Carcinomatosis
- b) Parasitic infection
- c) Tuberculous meningitis
- b) Multiple sclerosis
- a) Low glucose, high protein, positive India ink
- b) Bacterial or fungal infection
- c) Hemophilia
- c) Septic arthritis
- c) Bacterial infection
- c) Septic arthritis
- b) Peritonitis
- b) Cellular breakdown or inflammation
- a) Differentiates cirrhosis from tuberculosis
- c) A white blood cell count <1000/μL
- b) Appear clear and pale yellow
- a) Effusion
- a) Pleural exudate
- a) Fetal lung maturity
- b) Confirm a high maternal serum AFP
- d) Cystic fibrosis
- c) CFTR delta-F508
- d) Multiple sclerosis
- c) Subarachnoid hemorrhage
- a) Sample A
- a) Alkaptonuria
- a) Increased fecal fat
- d) Hemolytic disease of the newborn
- b) Open neural tube defects
- a) Chloridometry
- a) Fungal meningitis
- d) CSF leakage
- d) A post-hepatobiliary obstruction
- b) Fungal meningitis
- d) Bacterial vaginosis
- c) Ulcerative colitis
- c) Bacterial meningitis
- b) Rheumatoid arthritis
- a) Occult blood
Top 8 Medical Laboratory Scientist (MLS) Exams:
Top 8 Medical Laboratory Scientist (MLS) Exams that are recognized globally and can help professionals validate their credentials and enhance their career opportunities:
1. ASCP – American Society for Clinical Pathology (USA)
- Exam Name: MLS(ASCP)
- Eligibility: Bachelor’s degree with clinical laboratory experience.
- Global Recognition: High
- Purpose: Certifies Medical Laboratory Scientists in the United States and internationally.
2. AMT – American Medical Technologists (USA)
- Exam Name: MLT(AMT) or MT(AMT)
- Eligibility: Academic and/or work experience in medical laboratory technology.
- Global Recognition: Moderate
- Purpose: Credentialing for medical technologists and technicians.
3. AIMS – Australian Institute of Medical and Clinical Scientists
- Exam Name: AIMS Certification Exam
- Eligibility: Assessment of qualifications and work experience.
- Recognition: Required for practice in Australia.
- Purpose: Certification and registration in Australia.
4. CSMLS – Canadian Society for Medical Laboratory Science
- Exam Name: CSMLS General or Subject-specific Exams
- Eligibility: Graduation from a CSMLS-accredited program or equivalent.
- Recognition: Canada
- Purpose: Entry-to-practice certification in Canada.
5. IBMS – Institute of Biomedical Science (UK)
- Exam Name: Registration and Specialist Portfolio Assessment
- Eligibility: Accredited degree and lab experience.
- Recognition: UK and some Commonwealth countries.
- Purpose: Biomedical Scientist registration with the HCPC (UK).
6. HAAD / DOH – Department of Health, Abu Dhabi (UAE)
- Exam Name: DOH/HAAD License Exam
- Eligibility: Degree in medical laboratory science and experience.
- Recognition: UAE (Abu Dhabi)
- Purpose: Licensure for medical laboratory practice in Abu Dhabi.
7. DHA – Dubai Health Authority (UAE)
- Exam Name: DHA License Exam for Medical Laboratory Technologists
- Eligibility: Relevant degree and experience.
- Recognition: Dubai, UAE
- Purpose: Professional license for clinical laboratory practice in Dubai.
8. MOH – Ministry of Health (Gulf Countries like UAE, Saudi Arabia, Kuwait)
- Exam Name: MOH License Exam
- Eligibility: BSc/Diploma in Medical Laboratory + experience.
- Recognition: Varies by country.
- Purpose: Required for practicing in public and private sector labs.
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#ASCPMLS #MLSexam #LabTech #MedicalLaboratory #BOCexam #FreePracticeQuestions #QualityControl #LaboratorySafety
