Q1. What is the most effective initial step c.

Timed collection
to prevent laboratory-acquired d. Random
infections? Answer: b
a. Use of gloves Rationale: Midstream clean-catch
b. Use of biosafety cabinet minimizes contamination from the urethra,
c. Handwashing ideal for culture.
d. Sterilization of equipment
Answer: c Q7. The best time to collect urine for
Rationale: Handwashing is the most pregnancy testing is:
essential and frequently used method to a. After meals
prevent transmission. b. Mid-afternoon
c. First morning specimen
Q2. The urine preservative that best d. Random specimen
preserves formed elements is: Answer: c
a. Formalin Rationale: First morning urine is most
b. Boric acid concentrated, increasing hCG detectability.
c. Toluene
d. Refrigeration Q8. What is the volume of urine typically
Answer: d required for routine urinalysis?
Rationale: Refrigeration best preserves a. 5 mL
casts, cells, and crystals without chemically b. 10 mL
altering them. c. 50 mL
d. 100 mL
Q3. Which of the following is the correct Answer: b
urine container for routine urinalysis? Rationale: A 10 mL sample is sufficient for
a. Amber sterile bottle physical, chemical, and microscopic
b. Clean, dry, plastic container with wide examination.
mouth
c. Fecal container Q9. The normal daily urine output for an
d. Blood collection tube adult ranges from:
Answer: b a. 400–600 mL
Rationale: Routine urinalysis requires a b. 600–1000 mL
clean, dry container with a wide mouth to c. 1200–1500 mL
prevent contamination. d. 2500–3000 mL
Answer: c
Q5. A fruity odor in urine is most Rationale: A healthy adult produces around
commonly associated with which of the 1200–1500 mL of urine daily.
following?
a. UTI Q10. Oliguria is defined as urine output
b. Phenylketonuria less than:
c. Diabetes mellitus a. 500 mL/day
d. Maple syrup urine disease b. 400 mL/day
Answer: c c. 1000 mL/day
Rationale: Fruity or sweet odor is often due d. 300 mL/day
to ketone bodies in diabetic ketoacidosis. Answer: b
Rationale: Oliguria is typically defined as
Q6. Which urine collection method is less than 400 mL/day output.
ideal for a bacterial culture and
sensitivity test?
a. First morning
b. Midstream clean-catch
Q11. Which urine appearance suggests Answer: c
the presence of chyluria? Rationale: The pad contains a
a. Amber and clear polyelectrolyte that changes pKa in
b. Milky white and turbid response to ionic concentration.
c. Pink and clear
d. Brown and foamy Q16. What causes a false positive
Answer: b protein test on the urine reagent strip?
Rationale: Chyluria results in milky urine a. Dilute urine
due to the presence of lymph and b. Glucose > 1 g/dL
chylomicrons. c. Alkaline pH > 9
d. Moderate ketones
Q12. A dark brown urine that turns black Answer: c
on standing is characteristic of: Rationale: Highly alkaline urine can
a. Alkaptonuria interfere with the color change on the
b. Hematuria protein pad.
c. Phenylketonuria
d. Porphyria
Answer: a Q17. Which condition results in
Rationale: Alkaptonuria involves postrenal proteinuria?
homogentisic acid, which oxidizes and a. Multiple myeloma
darkens upon standing. b. Lower UTI
c. Nephrotic syndrome
Q13. Which of the following is d. Glomerulonephritis
considered an abnormal urine color? Answer: b
a. Pale yellow Rationale: Proteinuria due to inflammation
b. Amber in the lower urinary tract is postrenal in
c. Red origin.
d. Light straw
Answer: c Q18. The glucose oxidase method on
Rationale: Red urine may suggest urine strips tests for:
hematuria, hemoglobinuria, or a. All reducing sugars
myoglobinuria and warrants investigation. b. Glucose only
c. Fructose and glucose
Q14. A urine sample with high specific d. Galactose only
gravity and high osmolality is most Answer: b
consistent with: Rationale: Glucose oxidase is specific for
a. Diabetes insipidus glucose; it does not detect other reducing
b. Glomerulonephritis sugars.
c. Dehydration
d. Overhydration Q19. Which urine test detects reducing
Answer: c substances other than glucose?
Rationale: Dehydration concentrates the a. Glucose oxidase test
urine, increasing specific gravity and b. Sulfosalicylic acid test
osmolality. c. Clinitest
d. Ictotest
Q15. The reagent strip method for Answer: c
specific gravity uses: Rationale: Clinitest is a copper reduction
a. Sodium nitroprusside method that detects all reducing sugars, not
b. Bromothymol blue just glucose.
c. pKa change of polyelectrolyte
d. Ehrlich’s reagent
Q20. Ketonuria is most frequently seen Q25. The chemical test for urobilinogen
in which condition? on reagent strips uses:​
a. Hypertension a. Ehrlich’s reagent​
b. Congestive heart failure b. Sodium nitroprusside​
c. Diabetes mellitus c. Diazo salt​
d. Urinary tract infection d. Benzidine​
Answer: c Answer: a​
Rationale: In DKA, fats are broken down Rationale: Urobilinogen reacts with
into ketone bodies, which spill into the urine. Ehrlich’s reagent to produce a pink color.

Q21. The most common ketone body Q26. Nitrite-positive urine suggests:​
found in urine is: a. Sterile pyuria​
a. Beta-hydroxybutyric acid b. E. coli infection​
b. Acetoacetic acid c. Ketone production​
c. Acetone d. High bilirubin​
d. Pyruvic acid Answer: b​
Answer: a Rationale: Many gram-negative bacteria
Rationale: β-hydroxybutyric acid is the reduce nitrate to nitrite.
predominant ketone body but not detected
by strip tests. Q27. The leukocyte esterase pad detects:​
a. Intact RBCs​
Q22. Acetoacetic acid in urine is b. Intact WBCs​
detected using:​ c. Lysed WBCs​
a. Ehrlich’s reagent​ d. Both b and c​
b. Diazo reaction​ Answer: d​
c. Sodium nitroprusside​ Rationale: It detects the enzyme esterase
d. Benedict’s reagent​ from both intact and lysed leukocytes.
Answer: c​
Rationale: Sodium nitroprusside reacts Q28. Hematuria indicates the presence
with acetoacetic acid and acetone. of:​
a. Lysed RBCs​
Q23. Bilirubin is detected on urine b. Intact RBCs​
reagent strips by:​ c. Myoglobin​
a. Gmelin’s test​ d. Hemoglobin​
b. Ehrlich’s test​ Answer: b​
c. Diazo reaction​ Rationale: Hematuria involves intact RBCs
d. Nessler’s reagent​ visible microscopically.
Answer: c​
Rationale: The diazo reaction on reagent Q29. Myoglobinuria can be distinguished
strips detects conjugated bilirubin in urine. from hemoglobinuria by:​
a. Dipstick reaction​
Q24. A positive Ictotest and negative b. Serum color​
bilirubin strip test suggest:​ c. Microscopy​
a. Hematuria​ d. Specific gravity​
b. Hemoglobinuria​ Answer: b​
c. Low levels of conjugated bilirubin​ Rationale: In myoglobinuria, serum
d. Biliary obstruction​ remains clear; in hemolysis, serum is pink
Answer: c​ or red.
Rationale: Ictotest is more sensitive and
may detect low bilirubin missed by strips.
Q30. A positive SSA test with a negative Q35. Glitter cells are:​
protein strip suggests:​ a. Swollen neutrophils​
a. Albuminuria​ b. Renal epithelial cells​
b. Bence-Jones proteins​ c. Degenerated RBCs​
c. False positive​ d. Oval fat bodies​
d. Microalbuminuria​ Answer: a​
Answer: b​ Rationale: Neutrophils with sparkling
Rationale: SSA detects all proteins granules in hypotonic urine.
including Bence-Jones; dipstick is
albumin-specific. Q36. Oval fat bodies are identified by:​
a. Phase contrast​
Q31. Which test detects all proteins in b. Polarized microscopy​
urine?​ c. Gram stain​
a. Reagent strip​ d. Sudan III​
b. SSA test​ Answer: b​
c. Clinitest​ Rationale: Show Maltese cross
d. Acetest​ appearance under polarized light.
Answer: b​
Rationale: SSA detects albumin and Q37. Normal urine does not contain:​
globulins, unlike reagent strip. a. Hyaline casts​
b. Urochrome​
Q32. The most common crystal in acidic c. Squamous cells​
urine is:​ d. RBC casts​
a. Triple phosphate​ Answer: d​
b. Calcium oxalate​ Rationale: RBC casts are always
c. Ammonium biurate​ pathologic.
d. Cholesterol​
Answer: b​ Q38. A broad cast is also called:​
Rationale: Calcium oxalate appears as a. Waxy cast​
envelopes and forms in acidic urine. b. Renal failure cast​
c. Hyaline cast​
Q33. Which cast is associated with acute d. Fatty cast​
glomerulonephritis?​ Answer: b​
a. Waxy cast​ Rationale: Broad casts form in dilated
b. Fatty cast​ nephrons, sign of ESRD.
c. RBC cast​
d. Broad cast​ Q39. Glittering neutrophils in urine are
Answer: c​ associated with:​
Rationale: RBC casts indicate glomerular a. UTI​
bleeding. b. Diabetes​
c. Fanconi syndrome​
Q34. What microscope is used for d. Biliary tract infection​
identifying crystals?​ Answer: a​
a. Bright-field​ Rationale: Common in hypotonic urine of
b. Phase-contrast​ UTI.
c. Polarizing​
d. Electron​ Q40. Which is the final step in urine
Answer: c​ formation?​
Rationale: Polarizing microscopes a. Filtration​
enhance birefringent crystals like urates. b. Secretion​
c. Reabsorption​
d. Excretion​ Rationale: Normal CSF glucose is 2/3 of
Answer: d​ blood glucose.
Rationale: Urine is excreted after
processing by the nephron. Q46. Synovial fluid is abnormal if it
appears:​
Q41. What is the hallmark of nephrotic a. Clear​
syndrome?​ b. Straw​
a. Hematuria​ c. Milky​
b. Proteinuria >3.5g/day​ d. Pale yellow​
c. Glucosuria​ Answer: c​
d. Pyuria​ Rationale: Milky synovial fluid suggests
Answer: b​ crystals or infection.
Rationale: Severe protein loss leads to
hypoalbuminemia, edema. Q47. Normal sperm motility at 1 hour
should be:​
Q42. Which finding in urine suggests a. >20%​
multiple myeloma?​ b. >30%​
a. Glucose​ c. >50%​
b. Albumin​ d. >80%​
c. Bence-Jones proteins​ Answer: c​
d. Nitrite​ Rationale: WHO guidelines require ≥50%
Answer: c​ motility.
Rationale: BJ proteins are light chains not
detected by dipstick. Q48. Amniotic fluid L/S ratio >2.0
indicates:​
Q43. In Fanconi syndrome, urine shows:​ a. Fetal lung immaturity​
a. Acidic pH​ b. Lecithin deficiency​
b. Glucose without hyperglycemia​ c. Fetal lung maturity​
c. Alkaline pH​ d. Meconium​
d. Ketones​ Answer: c​
Answer: b​ Rationale: Mature lungs produce more
Rationale: Proximal tubule defect leads to lecithin than sphingomyelin.
glucose loss despite normoglycemia.
Q49. Which crystal is pathologic?​
Q44. The confirmatory test for CSF a. Triple phosphate​
protein is:​ b. Ammonium biurate​
a. SSA​ c. Cholesterol​
b. Pandy’s test​ d. Calcium oxalate​
c. Coomassie Blue​ Answer: c​
d. Biuret test​ Rationale: Cholesterol crystals are
Answer: b​ associated with nephrotic syndrome.
Rationale: Pandy’s test is a qualitative
screen for CSF globulins. Q50. WBC cast in urine suggests:​
a. Pyelonephritis​
Q45. Normal CSF glucose is:​ b. Cystitis​
a. Equal to serum​ c. Glomerulonephritis​
b. 60–70% of plasma glucose​ d. Fanconi syndrome​
c. <40% of plasma glucose​ Answer: a​
d. >serum glucose​ Rationale: WBC casts form in upper
Answer: b​ urinary tract inflammation.
Q51. Which condition is most likely Q56. Which test detects
associated with fatty casts in urine?​ microalbuminuria earliest?​
a. Diabetes insipidus​ a. Sulfosalicylic acid test​
b. Nephrotic syndrome​ b. Reagent strip​
c. Acute pyelonephritis​ c. Immunochemical test​
d. Fanconi syndrome​ d. Heat and acetic acid test​
Answer: b​ Answer: c​
Rationale: Fatty casts containing oval fat Rationale: Immunochemical methods can
bodies are characteristic of nephrotic specifically and sensitively detect small
syndrome due to lipiduria. quantities of albumin.

Q52. Ghost cells in urine refer to:​ Q57. In which condition would you most
a. Aged epithelial cells​ likely find oval fat bodies in the urine?​
b. Swollen WBCs​ a. Pyelonephritis​
c. Lysed RBCs​ b. Nephrotic syndrome​
d. Degenerated casts​ c. Diabetes insipidus​
Answer: c​ d. Cystitis​
Rationale: Ghost cells are RBCs that have Answer: b​
lost hemoglobin in dilute urine. Rationale: Oval fat bodies are a hallmark of
lipiduria in nephrotic syndrome.
Q53. The term "isosthenuria" means:​
a. High specific gravity​ Q58. What is the primary method for
b. Constant pH​ detecting urinary ketones in reagent
c. Fixed specific gravity of 1.010​ strips?​
d. Increased osmolality​ a. Ehrlich reaction​
Answer: c​ b. Sodium nitroprusside reaction​
Rationale: Isosthenuria reflects the kidney’s c. Diazo reaction​
inability to concentrate or dilute urine, d. Acid precipitation​
maintaining SG at 1.010. Answer: b​
Rationale: Reagent strips detect
Q54. What is the function of acetoacetate and acetone using the sodium
Tamm-Horsfall protein?​ nitroprusside reaction.
a. Forming renal calculi​
b. Detecting ketones​ Q59. A positive Clinitest with a negative
c. Cast matrix formation​ glucose strip indicates:​
d. Inhibiting bacterial growth​ a. False positive on Clinitest​
Answer: c​ b. Presence of non-glucose reducing
Rationale: Tamm-Horsfall protein, secreted substances​
by renal tubular cells, forms the matrix of c. Faulty strip​
casts. d. Diabetic ketoacidosis​
Answer: b​
Q55. Which urinary cast indicates the Rationale: Clinitest detects all reducing
most severe renal pathology?​ substances; a positive result may indicate
a. Waxy cast​ galactose or fructose.
b. Hyaline cast​
c. Granular cast​ Q60. The presence of triple phosphate
d. Fatty cast​ crystals indicates:​
Answer: a​ a. Alkaline urine​
Rationale: Waxy casts are broad and rigid, b. Acidic urine​
associated with chronic renal failure. c. Normal urine​
d. Dehydration​
Answer: a​ d. Mycobacterium tuberculosis​
Rationale: Triple phosphate (coffin-lid Answer: c​
appearance) is commonly found in alkaline Rationale: E. coli and other
urine. Enterobacteriaceae convert nitrate to nitrite.

Q61. What is the primary cause of Q66. The presence of renal tubular
increased specific gravity in urine?​ epithelial cells in urine suggests:​
a. Bacteria​ a. Lower UTI​
b. Protein​ b. Renal tubular damage​
c. Glucose​ c. Vaginal contamination​
d. Ketones​ d. Bladder infection​
Answer: c​ Answer: b​
Rationale: Glucose increases urine specific Rationale: Renal tubular epithelial cells
gravity significantly in uncontrolled diabetes. originate from the nephron and indicate
tubular damage.
Q62. Which is the best indicator of early
renal disease?​ Q67. Which stain enhances visualization
a. BUN​ of urine eosinophils?​
b. Creatinine​ a. Sternheimer-Malbin​
c. Microalbuminuria​ b. Hansel stain​
d. Specific gravity​ c. Prussian blue​
Answer: c​ d. Sudan III​
Rationale: Microalbuminuria is an early Answer: b​
marker for glomerular damage, particularly Rationale: Hansel stain is specific for
in diabetics. detecting eosinophils in urine.

Q63. Which urine component is detected Q68. Which urinary finding is

using Ehrlich's reagent?​ characteristic of acute interstitial
a. Ketones​ nephritis?​
b. Urobilinogen​ a. Fatty casts​
c. Protein​ b. Waxy casts​
d. Blood​ c. Eosinophils​
Answer: b​ d. RBC casts​
Rationale: Ehrlich’s reagent reacts with Answer: c​
urobilinogen to form a red color on dipstick. Rationale: Urine eosinophils are commonly
seen in acute interstitial nephritis, especially
Q64. Which test is most sensitive for drug-induced.
detecting bilirubin in urine?​
a. SSA test​ Q69. Broad casts are most associated
b. Ictotest​ with:​
c. Reagent strip​ a. Chronic glomerulonephritis​
d. Clinitest​ b. Nephrotic syndrome​
Answer: b​ c. Renal failure​
Rationale: Ictotest is more sensitive than d. Pyelonephritis​
reagent strips for detecting bilirubin. Answer: c​
Rationale: Broad, waxy casts form in
Q65. Which organism is known to reduce dilated tubules in end-stage renal disease.
nitrate to nitrite in urine?​
a. Streptococcus​
b. Staphylococcus​
c. Escherichia coli​
Q70. What is the most common d. Urobilinogen
constituent of kidney stones?​
a. Cystine​ Answer: b Rationale: Blood detection on
b. Uric acid​ strips is based on the pseudoperoxidase
c. Calcium oxalate​ activity of hemoglobin.
d. Ammonium magnesium phosphate​
Answer: c​ Q74. Which of the following best
Rationale: Calcium oxalate is the most describes the color change of the pH pad
common type of urinary calculus. on a reagent strip?

Q71. Which condition is characterized by a. Red to blue

the presence of dysmorphic red blood
cells in urine? b. Green to yellow

a. Cystitis c. Yellow to green to blue

b. Glomerulonephritis d. Blue to red

c. Urethritis Answer: c

d. Pyelonephritis Rationale: The pH pad shows a

progressive color change from yellow
Answer: b (acidic) to blue (alkaline).

Rationale: Dysmorphic RBCs are typically Q75. What is the principle of the SSA test
associated with glomerular bleeding. for urine protein?

Q72. What is the typical appearance of a. Color change

uric acid crystals under polarized light?
a. Hexagonal plates b. Precipitation

b. Needle-shaped c. Reduction

c. Rhomboid or rosettes d. Enzyme reaction

d. Coffin-lid Answer: b

Answer: c Rationale: SSA test detects proteins by

precipitation, not by colorimetric reaction.
Rationale: Uric acid crystals appear as
rhomboid or rosette-shaped and are Q76. Which is a normal finding in
birefringent under polarized light. synovial fluid analysis?

Q73. Which reagent strip parameter uses a. Rice bodies

the peroxidase activity of hemoglobin?
b. Refringent crystals
a. Protein
c. Clear, pale yellow fluid
b. Blood
d. Cloudy and viscous fluid
c. Ketone
Answer: c
Rationale: Normal synovial fluid is clear Rationale: Kruger’s strict criteria provide
and pale yellow with good viscosity. stringent measures for sperm head,
midpiece, and tail morphology.
Q77. What is the main test used to
differentiate transudate from exudate in Q80. A sample for seminal fluid analysis
serous fluids? should be delivered to the lab within:

a. Protein concentration a. 10 minutes

b. Specific gravity b. 30 minutes

c. Light’s criteria c. 1 hour

d. Cell count d. 2 hours

Answer: c Answer: c

Rationale: Light’s criteria evaluate protein Rationale: Semen must be analyzed within
and LDH levels to differentiate transudates 1 hour to maintain motility and pH integrity.
from exudates.
Q81. What is the recommended
Q78. Which parameter is measured in abstinence period before collecting a
CSF to evaluate for subarachnoid semen sample?
hemorrhage?
a. 6–12 hours
a. Protein
b. 12–24 hours
b. Glucose
c. 2–7 days
c. Xanthochromia
d. 7–10 days
d. Cell count
Answer: c
Answer: c
Rationale: WHO recommends 2–7 days of
Rationale: Xanthochromia, a yellow sexual abstinence before semen collection
discoloration, indicates prior bleeding and for accurate assessment.
hemoglobin breakdown.
Q82. Which finding in CSF indicates
Q79. The sperm morphology criteria for bacterial meningitis?
normal sperm is based on:
a. Low protein, high glucose, lymphocytic
a. Kruger's strict criteria pleocytosis

b. WHO 1999 b. High protein, low glucose, neutrophilic

pleocytosis
c. Papanicolaou standards
c. Normal glucose, low protein, no cells
d. Modified Jones classification
d. Xanthochromia
Answer: a
Answer: b
Rationale: Bacterial meningitis is marked Rationale: Milky synovial fluid can result
by high protein, low glucose, and neutrophil from high leukocyte counts and lipids, seen
predominance. in inflammation or infection.

Q83. What is the significance of LE cells Q86. Which type of urinary crystal
in synovial fluid? appears yellow-brown and thorny
apple-shaped?
a. Diagnostic of gout
a. Cystine
b. Suggestive of SLE
b. Calcium carbonate
c. Associated with septic arthritis
c. Ammonium biurate
d.. Normal finding
d. Calcium phosphate
Answer: b
Answer: c
Rationale: LE cells are neutrophils that
have engulfed nuclear material and are Rationale: Ammonium biurate crystals are
characteristic of lupus. yellow-brown and have thorny projections.

Q84. Which test is used for detecting Q87. Which is the confirmatory test for
fructose in seminal fluid? Bence Jones proteins in urine?

a . Clinitest a. Heat test

b. Seliwanoff test b. Electrophoresis

c. Resorcinol test c. SSA test

d. Acid phosphatase test d. Reagent strip

Answer: c Answer: b

Rationale: Resorcinol test is used to detect Rationale: Electrophoresis is required to

fructose, which supports sperm motility and confirm the presence and type of Bence
metabolism. Jones proteins.

Q85. What causes the milky appearance Q88. What is the principle of the glucose
of synovial fluid? test pad on a urine strip?

a. High protein a. Glucose oxidase and peroxidase

reactions
b. Crystals
b. Reduction of copper sulfate
c. Lipids and cells
c. Acid-base reaction
d. Bacteria
d. Diazotization
Answer: c
Answer: a
Rationale: The test is based on a double Rationale: Hyaline casts can be found in
enzymatic reaction using glucose oxidase healthy individuals, especially after exercise
and peroxidase. or dehydration.

Q89. Which condition is associated with Q92. What is the function of creatinine
elevated levels of homogentisic acid in clearance?
urine?
a. To measure liver function
a. Maple syrup urine disease
b. To estimate glomerular filtration rate
b. Phenylketonuria (GFR)

c. Alkaptonuria c. To detect tubular secretion

d. Tyrosinemia d. To assess acid-base balance

Answer: c Answer: b

Rationale: Alkaptonuria is due to a Rationale: Creatinine clearance is used as

deficiency of homogentisic acid oxidase, an estimate of the GFR and overall renal
leading to dark urine. function.

Q90. What is the expected microscopic Q93. What is the predominant cell type in
finding in a patient with nephritic normal cerebrospinal fluid?
syndrome?
a. Neutrophils
a. Oval fat bodies
b. Monocytes
b. WBC casts
c. Lymphocytes
c. RBC casts
d. Erythrocytes
d. Broad casts
Answer: c
Answer: c
Rationale: In adults, lymphocytes are the
Rationale: Nephritic syndrome often predominant WBCs in normal CSF.
presents with RBC casts due to glomerular
inflammation. Q94. Which test is best for differentiating
between bacterial and viral meningitis?
Q91. Which urinary cast is considered
the least clinically significant? a. Gram stain

a. Hyaline cast b. India ink stain

b. RBC cast c. CSF glucose and protein analysis

c. Granular cast d. Latex agglutination

d. Waxy cast Answer: c

Answer: a
Rationale: Low glucose and high protein Rationale: Cyanide nitroprusside test
typically indicate bacterial, while normal detects sulfhydryl groups in cystine.
glucose and mildly increased protein
suggest viral meningitis. Q98. What is the normal range for CSF
glucose in adults?
Q95. A semen sample with low motility
but normal count suggests: a. 10–30 mg/dL

a. Obstruction b. 40–70 mg/dL

b. Asthenozoospermia c. 60–100 mg/dL

c. Oligozoospermia d. Equal to serum glucose

d. Teratozoospermia Answer: b

Answer: b Rationale: Normal CSF glucose is

approximately 2/3 of serum glucose, usually
Rationale: Asthenozoospermia refers to 40–70 mg/dL.
reduced sperm motility with normal count.
Q99. Which of the following is
Q96. What is the function of prostatic associated with a positive birefringence
fluid in semen? in synovial fluid crystals?

a. Nutrient source a. Monosodium urate

b. Coagulation factor b. Cholesterol

c. Enzymatic liquefaction c. Calcium pyrophosphate

d. Energy buffer d. Amorphous urates

Answer: c Answer: c

Rationale: Prostatic fluid contains enzymes Rationale: Calcium pyrophosphate crystals

that aid in liquefaction of the semen. seen in pseudogout are positively
birefringent.
Q97. Which of the following is a
metabolic disorder that results in a Q100. A positive nitrite result in urine
positive urine cyanide nitroprusside implies the presence of:
test?
a. Gram-positive cocci
a. Alkaptonuria
b. Mycobacterium tuberculosis
b. Cystinuria
c. Enteric gram-negative bacteria
c. Maple syrup urine disease
d. Yeast
d. Tyrosinemia
Answer: c
Answer: b
Rationale: Many enteric gram-negative Rationale: Nephrotic syndrome is
bacteria reduce nitrate to nitrite in the characterized by massive proteinuria and
urinary tract. resulting hypoproteinemia.

Q101. Which test is most specific for Q104. Which of the following is most
detecting ketone bodies in urine? commonly elevated in CSF in multiple
sclerosis?
a. Clinitest
a. Glucose
b. Ictotest
b. Chloride
c. Acetest
c. IgG index
d. SSA test
d. Albumin
Answer: c
Answer: c
Rationale: Acetest uses sodium
nitroprusside to detect ketone bodies Rationale: Increased intrathecal synthesis
(mainly acetoacetate). of IgG is common in multiple sclerosis.

Q102. The presence of calcium oxalate Q105. Which crystal is associated with
crystals is common in which type of ethylene glycol poisoning?
urine pH?
a. Ammonium biurate
a. Acidic
b. Cystine
b. Alkaline
c. Calcium oxalate (monohydrate)
c. Neutral
d. Triple phosphate
d. Basic
Answer: c
Answer: a
Rationale: Calcium oxalate monohydrate
Rationale: Calcium oxalate crystals crystals are seen in ethylene glycol toxicity.
typically appear in acidic urine.
Q106. A positive Clue cell finding in
Q103. Which of the following is a urine suggests contamination from:
hallmark of nephrotic syndrome?
a. Trichomonas vaginalis
a. Hematuria
b. Gardnerella vaginalis
b. Hypoproteinemia
c. Candida albicans
c. Proteinuria >3.5 g/day
d. Neisseria gonorrhoeae
d. B and C
Answer: b
Answer: d
Rationale: Clue cells are squamous Rationale: Rothera’s test is a qualitative
epithelial cells coated with Gardnerella test for ketone bodies in urine.
vaginalis.
Q110. Which of the following is least
Q107. What is the expected finding in a likely to cause turbid urine?
CSF sample of a patient with fungal
meningitis? a. Amorphous phosphates

a. High neutrophils, low glucose b. WBCs

b. High lymphocytes, low glucose c. Mucus

c. High eosinophils, high glucose d. Glucose

d. Normal profile Answer: d

Answer: b Rationale: Glucose does not typically

cause turbidity; phosphates, WBCs, and
Rationale: Fungal infections typically result mucus do.
in lymphocytic pleocytosis with decreased
glucose levels. Q111. What is the normal viscosity of
synovial fluid attributed to?
Q108. A urine sample smells like maple
syrup. What is the likely condition? a. Albumin concentration

a. MSUD (Maple Syrup Urine Disease) b. Mucin content

b. Cystinosis c. Water content

c. Tyrosinemia d. Crystal presence

d. Phenylketonuria Answer: b

Answer: a Rationale: Synovial fluid viscosity is

primarily due to hyaluronic acid, a mucin
Rationale: MSUD is caused by a defect in substance.
branched-chain amino acid metabolism,
producing a characteristic odor. Q112. A positive Pandy test in CSF
indicates:
Q109. Which condition is diagnosed
using the Rothera’s test? a. Elevated glucose

a. Hematuria b. Increased protein

b. Proteinuria c. Elevated chloride

c. Ketonuria d. Xanthochromia

d. Glycosuria Answer: b

Answer: c
Rationale: Pandy test detects elevated Rationale: Xanthochromia refers to a
globulin proteins in CSF, often seen in yellow discoloration of CSF due to
meningitis. hemoglobin breakdown.

Q113. Which of the following is NOT Q116. Which sperm defect is classified
normally found in semen? as a head defect?

a. Spermatozoa a. Coiled tail

b. Epithelial cells b. Tapered head

c. WBCs c. Cytoplasmic droplet

d. RBCs d. Bent neck

Answer: d Answer: b

Rationale: RBCs are not a normal Rationale: Tapered head is a morphological

constituent of semen and indicate possible abnormality of the sperm head.
pathology.
Q117. What is the purpose of acrosomal
Q114. Which CSF finding is expected in enzymes?
tuberculous meningitis?
a. Stimulate motility
a. Low protein, low glucose
b. Penetrate the zona pellucida
b. High protein, low glucose
c. Protect from acidity
c. High glucose, high protein
d. Liquefy semen
d. Normal protein, low glucose
Answer: b
Answer: b
Rationale: Acrosomal enzymes help sperm
Rationale: TB meningitis shows penetrate the ovum's protective layer.
lymphocytic predominance, high protein,
and low glucose. Q118. Which urinary crystal is hexagonal
and indicates a genetic disorder?
Q115. What is the color of CSF in
xanthochromia due to hemorrhage? a. Uric acid

a. Pink b. Triple phosphate

b. Red c. Cystine

c. Yellow d. Tyrosine

d. Clear Answer: c

Answer: c Rationale: Cystine crystals are hexagonal

and associated with cystinuria, a genetic
defect in reabsorption.
Q119. What is the best urine specimen Q122. What is the significance of a
for nitrite testing? positive CSF India ink test?

a. Random a. Detection of Cryptococcus neoformans b.

Diagnosis of bacterial meningitis
b. First morning
c. Presence of viral particles
c. Postprandial
d. Identification of xanthochromia
d. 24-hour
Answer: a
Answer: b
Rationale: India ink detects the
Rationale: First morning urine allows encapsulated yeast Cryptococcus in CSF.
sufficient time for nitrate-reducing bacteria
to act, enhancing nitrite detection. Q123. Which component of semen is
responsible for coagulation immediately
Q120. A synovial fluid with after ejaculation?
needle-shaped, negatively birefringent
crystals suggests: a. Seminal vesicle fluid

a. Pseudogout b. Prostatic fluid

b. Gout c. Epididymal secretions

c. Rheumatoid arthritis d. Bulbourethral glands

d. Septic arthritis Answer: a

Answer: b Rationale: Seminal vesicle secretions

contain fibrinogen-like proteins that
Rationale: Monosodium urate crystals in coagulate semen initially.
gout are needle-shaped and show negative
birefringence. Q124. Which type of cast is composed
entirely of Tamm-Horsfall protein?
Q121. Which test is used to detect the
presence of neutral fats in urine? a. Waxy cast

a. Sudan III stain b. Fatty cast

b. Hansel stain c. Hyaline cast

c. Prussian blue d. RBC cast

d. Gram stain Answer: c

Answer: a Rationale: Hyaline casts are composed

solely of Tamm-Horsfall protein and are
Rationale: Sudan III is a fat stain that non-specific.
detects lipids and neutral fats in urine
sediment.
Q125. In which condition are ‘Maltese Q128. What is the expected synovial fluid
cross’ formations seen under polarized WBC count in non-inflammatory joint
light microscopy? disorders?

a. Hematuria a. <200 cells/μL

b. Pyelonephritis b. 200–2,000 cells/μL

c. Nephrotic syndrome c. 2,000–50,000 cells/μL

d. UTI d. >100,000 cells/μL

Answer: c Answer: b

Rationale: Oval fat bodies containing Rationale: Non-inflammatory disorders

cholesterol show Maltese cross patterns in have mildly elevated WBC counts in
nephrotic syndrome. synovial fluid.

Q126. The normal pH of semen is: Q129. What is the clinical significance of
hemosiderin-laden macrophages in
a. 5.5–6.0 urine?

b. 6.0–6.5 a. Glomerulonephritis

c. 7.2–8.0 b. Chronic hematuria

d. 8.5–9.0 c. Acute tubular necrosis

Answer: c d. Urolithiasis

Rationale: Semen is slightly alkaline, Answer: b

helping to neutralize acidic vaginal
secretions. Rationale: These cells indicate breakdown
of RBCs over time and are found in chronic
Q127. What is the preferred specimen for bleeding.
CSF analysis?
Q130. Which of the following is a
a. 24-hour pooled CSF confirmatory test for urinary bilirubin?

b. First drop collected a. SSA test

c. Sequential tubes from lumbar puncture b. Acetest

d. Random sample c. Ictotest

Answer: c d. Ehrlich test

Rationale: Sequentially collected tubes Answer: c

help distinguish contamination versus
pathologic bleeding. Rationale: Ictotest is more specific and
sensitive than dipsticks for detecting urinary
bilirubin.
Q131. Which finding in a urine sample Q134. Which condition is associated with
most strongly suggests contamination? “glucose absent, ketones present” in
urine?
a. Hyaline casts
a. Starvation
b. Squamous epithelial cells
b. Diabetes mellitus
c. Calcium oxalate crystals
c. Pregnancy
d. Bacteria with WBCs
d. Fanconi syndrome
Answer: b
Answer: a
Rationale: Numerous squamous cells
suggest contamination from the external Rationale: In starvation, ketones increase
genitalia during collection. due to fat metabolism despite normal
glucose levels.
Q132. Which chemical is used in the
reagent strip to detect urine blood? Q135. A sperm count <15 million/mL is
referred to as:
a. Tetramethylbenzidine
a. Azoospermia
b. Sodium nitroprusside
b. Oligozoospermia
c. Potassium iodide
c. Asthenozoospermia
d. Ehrlich reagent
d. Teratozoospermia
Answer: a
Answer: b
Rationale: Tetramethylbenzidine reacts with
hemoglobin’s pseudoperoxidase activity to Rationale: Oligozoospermia refers to low
produce a color change. sperm concentration, below WHO reference
values.
Q133. Which cast is pathognomonic for
glomerulonephritis? Q136. What is the normal percentage of
motile sperm within 60 minutes of
a. Granular cast ejaculation?

b. Fatty cast a. ≥50%

c. RBC cast b. ≥40%

d. Waxy cast c. ≥30%

Answer: c d. ≥70%

Rationale: RBC casts indicate bleeding Answer: b

from glomeruli, seen in glomerulonephritis.
Rationale: WHO guidelines require ≥40%
motility within 60 minutes for normal semen
analysis.
Q137. Which of the following best Q140. The most common cause of
describes synovial fluid in rheumatoid exudative pleural effusion is:
arthritis?
a. Heart failure
a. Clear, low viscosity
b. Cirrhosis
b. Cloudy, high viscosity
c. Infection or malignancy
c. Turbid, decreased viscosity
d.. Hypoalbuminemia
d. Bloody, increased viscosity
Answer: c
Answer: c
Rationale: Infections and malignancies
Rationale: In inflammatory conditions like increase vascular permeability, resulting in
RA, synovial fluid is turbid and loses exudates.
viscosity due to hyaluronic acid degradation.
Q141. Which of the following urine
Q138. What is the normal concentration findings is most indicative of a lower
of spermatozoa in semen per WHO urinary tract infection?
guidelines? a. >5 million/mL
a. WBC casts
b. >10 million/mL
b. Granular casts
c. >15 million/mL
c. Free bacteria and WBCs
d. >20 million/mL
d. RBC casts
Answer: c
Answer: c
Rationale: WHO considers a sperm count
>15 million/mL as normal. Rationale: The presence of WBCs and
bacteria without casts typically indicates
Q139. Which urine finding is common in infection localized to the bladder or urethra.
uncontrolled diabetes mellitus?
Q142. What does the presence of
a. Bilirubin eosinophils in urine suggest?

b. Hematuria a. Pyelonephritis

c. Glucose and ketones b. Acute interstitial nephritis

d. Protein and WBCs c. Glomerulonephritis

Answer: c d. Hematuria

Rationale: Uncontrolled diabetes leads to Answer: b

glucosuria and ketonuria due to high blood
sugar and fat metabolism. Rationale: Urinary eosinophils are a
hallmark of drug-induced acute interstitial
nephritis.
Q143. Which substance may cause false Q146. The term pyuria refers to the
positive protein results in urine dipstick? presence of which element in urine?

a. Urobilinogen a. Pus cells

b. Glucose b. Erythrocytes

c. Quaternary ammonium compounds c. Protein

d. Vitamin C d. Crystals

Answer: c Answer: a

Rationale: Detergents like quaternary Rationale: Pyuria is defined as the

ammonium compounds can cause presence of WBCs (pus cells) in urine,
false-positive protein reactions. indicating infection or inflammation.

Q144. A semen sample that fails to Q147. Which urinary test result is
liquefy within 60 minutes may indicate a affected most by high doses of vitamin
disorder of: a. Testes C?

b. Epididymis a. Protein

c. Prostate b. Glucose

d. Seminal vesicle c. Ketones

Answer: c Rationale: Liquefaction is d. Urobilinogen

dependent on prostatic enzymes; failure
suggests prostate dysfunction. Answer: b

Q145. Which urine crystal appears as Rationale: Vitamin C can reduce the
colorless envelopes or dumbbells? peroxidase reaction and cause
false-negative glucose results on dipsticks.
a. Uric acid
Q148. What is the preferred method of
b. Cystine urine preservation when refrigeration is
not available?
c. Calcium oxalate
a. Freezing
d. Triple phosphate
b. Boric acid
Answer: c
c. Sodium chloride
Rationale: Calcium oxalate appears as
colorless envelopes (dihydrate) or d. Acetic acid
dumbbells (monohydrate).
Answer: b

Rationale: Boric acid helps preserve

bacterial counts and maintain the
composition of urine.
Q149. In CSF, which condition typically Q1000. What is the principal reason for
shows increased lymphocytes and performing a urinalysis as part of a
normal glucose? routine physical exam?​
a. To confirm kidney failure​
a. Bacterial meningitis b. To monitor blood sugar levels​
c. To screen for urinary and systemic
b. Fungal meningitis disorders​
d. To assess urobilinogen​
c. Viral meningitis Answer: c​
Rationale: Urinalysis is a key non-invasive
d. Subarachnoid hemorrhage screening tool to detect both urinary tract
and systemic diseases early.
Answer: c
Q1. Which of the following is the primary
Rationale: Viral meningitis typically function of the nephron?​
presents with lymphocytic pleocytosis and a. Storage of urine​
normal glucose levels. b. Filtration of blood and formation of urine​
c. Concentration of glucose​
Q150. What is the most commonly used d. Reabsorption of bile salts​
stain for routine urine microscopy? Answer: b​
Rationale: The nephron filters blood to
a. Wright stain form urine through glomerular filtration,
tubular reabsorption, and secretion.
b. Gram stain
Q2. The major waste product excreted in
c. Sternheimer-Malbin stain urine is:​
a. Creatinine​
d. Prussian blue
b. Urea​
c. Ammonia​
Answer: c
d. Uric acid​
Answer: b​
Rationale: Sternheimer-Malbin stain
Rationale: Urea, a by-product of protein
enhances the visibility of casts and cells in
metabolism, is the major nitrogenous waste
urine microscopy.
excreted in urine.
Q999. Which of the following cells in
Q3. Which of the following is a
urine is most significant for diagnosing
pre-analytical factor that may affect urine
bladder carcinoma?​
analysis?​
a. Squamous epithelial cells​
a. Centrifuge speed​
b. Clue cells​
b. Patient hydration status​
c. Transitional epithelial cells with atypia​
c. Use of incorrect stain​
d. Renal tubular epithelial cells​
d. Improper interpretation​
Answer: c​
Answer: b​
Rationale: Transitional cells with atypical
Rationale: Hydration status influences
morphology may suggest malignancy of the
urine concentration and composition before
bladder epithelium.
analysis.
Q4. The first morning urine specimen is c. Evaluate immune status​
preferred because it is:​ d. Count platelets​
a. Diluted​ Answer: b​
b. Random​ Rationale: Clinical microscopy focuses on
c. Most concentrated​ detecting and analyzing cells and chemicals
d. Alkaline​ in urine and body fluids.
Answer: c​
Rationale: It is the most concentrated Q9. What is the maximum acceptable
specimen, useful for detecting abnormalities time for analyzing a urine sample without
like proteinuria. refrigeration?​
a. 15 minutes​
Q5. Which biosafety level is appropriate b. 30 minutes​
for handling urine and other routine c. 1 hour​
clinical specimens?​ d. 2 hours​
a. BSL-1​ Answer: c​
b. BSL-2​ Rationale: After 1 hour, unpreserved urine
c. BSL-3​ begins to deteriorate, affecting accuracy.
d. BSL-4​
Answer: b​ Q10. Which of the following best
Rationale: BSL-2 is appropriate for describes the proper disposal method
moderate-risk clinical specimens like urine, for urine samples?​
semen, and CSF. a. Flush down the sink with water​
b. Pour into the biohazard bin​
Q6. Which type of hazard is associated c. Disinfect then discard​
with exposure to pathogenic organisms d. Autoclave immediately​
in the laboratory?​ Answer: a​
a. Chemical​ Rationale: Urine can be discarded into the
b. Biological​ sink with copious running water unless
c. Physical​ contaminated with biohazards.
d. Ergonomic​
Answer: b​ Q11. The most important safety measure
Rationale: Biological hazards include when performing microscopic analysis
viruses, bacteria, and other infectious is:​
agents. a. Disinfecting centrifuges​
b. Wearing PPE and using biosafety
Q7. What is the most appropriate PPE cabinet when needed​
when handling potentially infectious c. Labeling glass slides​
body fluids?​ d. Drying specimens before staining​
a. Surgical mask only​ Answer: b​
b. Face shield, lab coat, gloves​ Rationale: Biosafety and PPE protect
c. Lab coat only​ against exposure to infectious aerosols or
d. Gloves and sandals​ contact.
Answer: b​
Rationale: Proper PPE includes gloves, Q12. Quality control in urinalysis
gown/lab coat, and eye/face protection for includes:​
exposure to fluids. a. Testing control materials​
b. Reading results within 3 hours​
Q8. The primary goal of clinical c. Using used strips​
microscopy is to:​ d. Performing tests on patients only​
a. Determine serum levels of electrolytes​ Answer: a​
b. Detect abnormal urine constituents​ Rationale: Regular quality control testing
ensures reagent strips and equipment are b. Plasma​
functioning correctly. c. Urine and other body fluids​
d. Histopathologic sections​
Q13. Which urine preservative is best for Answer: c​
maintaining cellular elements and casts?​ Rationale: Clinical microscopy
a. Boric acid​ encompasses analysis of urine, semen,
b. Formalin​ CSF, synovial, and serous fluids.
c. Toluene​
d. Refrigeration​ Q18. Which of the following may cause a
Answer: d​ falsely decreased pH reading in urine?​
Rationale: Refrigeration is the best method a. Delay in testing​
to preserve all urine constituents without b. High protein diet​
chemical interference. c. Use of preservatives​
d. Excessive exercise​
Q14. The universal precaution assumes Answer: a​
that:​ Rationale: Bacterial proliferation over time
a. Only HIV-positive samples are infectious​ increases pH, leading to falsely low
b. Only blood needs PPE​ readings if not tested promptly.
c. All body fluids are potentially infectious​
d. Gloves are optional​ Q19. Which type of urine collection is
Answer: c​ best for quantitative chemical tests?​
Rationale: Universal precautions treat all a. First morning​
body fluids as infectious to prevent b. Random​
occupational transmission. c. Timed (24-hour)​
d. Postprandial​
Q15. The color coding for biohazard Answer: c​
waste bins for infectious samples is Rationale: 24-hour urine collection is used
typically:​ to assess total excretion of substances like
a. Green​ protein or creatinine.
b. Yellow​
c. Red​ Q20. The standard precaution differs
d. Blue​ from universal precaution by:​
Answer: c​ a. Including airborne precautions​
Rationale: Red bins are designated for b. Applying to blood only​
infectious and biohazardous waste per c. Applying to all patient care settings​
safety standards. d. Being optional​
Answer: c​
Q16. Proper hand hygiene after Rationale: Standard precautions apply
specimen handling involves washing for:​ universally in healthcare, covering all body
a. 5 seconds​ fluids and patient interactions.
b. 10 seconds​
c. 15–20 seconds​ Q1. What is the first morning urine
d. 1 minute​ specimen best suited for?​
Answer: c​ a. Drug testing​
Rationale: A minimum of 15–20 seconds is b. Pregnancy testing​
required for effective handwashing per CDC c. Routine urinalysis​
guidelines. d. Microbial culture​
Answer: c​
Q17. The term "clinical microscopy" Rationale: First morning urine is most
specifically refers to the analysis of:​ concentrated, ideal for detecting formed
a. Bacteria​ elements in routine urinalysis.
Q2. Which of the following is the d. Liver disease​
principal pigment responsible for urine’s Answer: c​
yellow color?​ Rationale: Fruity or sweet odor suggests
a. Urobilin​ the presence of ketones, often due to
b. Bilirubin​ uncontrolled diabetes.
c. Urochrome​
d. Hemoglobin​ Q7. Which analyte is most unstable in
Answer: c​ urine at room temperature?​
Rationale: Urochrome is the main pigment a. Urobilinogen​
that gives urine its characteristic yellow b. Protein​
color. c. Ketones​
d. Glucose​
Q3. Which component of the nephron is Answer: a​
primarily responsible for filtration?​ Rationale: Urobilinogen is light-sensitive
a. Proximal convoluted tubule​ and rapidly oxidized to urobilin.
b. Loop of Henle​
c. Glomerulus​ Q8. What is the preferred method of
d. Collecting duct​ urine preservation for routine analysis
Answer: c​ when immediate testing is not possible?​
Rationale: The glomerulus acts as a sieve, a. Acidification​
filtering blood plasma into the Bowman’s b. Refrigeration​
capsule. c. Boric acid​
d. Freezing​
Q4. What is the most common cause of Answer: b​
cloudy urine in a fresh specimen?​ Rationale: Refrigeration slows bacterial
a. Bacteria​ growth and chemical changes in urine.
b. Protein​
c. Crystals​ Q9. Which urine pH promotes the
d. Mucus​ formation of uric acid crystals?​
Answer: c​ a. Alkaline​
Rationale: Precipitation of amorphous b. Basic​
crystals is a common cause of cloudiness in c. Neutral​
freshly voided urine. d. Acidic​
Answer: d​
Q5. Which test is used to confirm the Rationale: Uric acid crystals are more
presence of protein in urine after a likely to precipitate in acidic urine.
positive dipstick result?​
a. Clinitest​ Q10. Which renal disease is associated
b. SSA test​ with massive proteinuria and lipiduria?​
c. Benedict’s test​ a. Pyelonephritis​
d. Ictotest​ b. Acute glomerulonephritis​
Answer: b​ c. Nephrotic syndrome​
Rationale: The sulfosalicylic acid (SSA) d. Cystitis​
test precipitates proteins, confirming dipstick Answer: c​
results. Rationale: Nephrotic syndrome is
characterized by heavy protein loss and
Q6. A urine sample with fruity odor is oval fat bodies.
suggestive of which condition?​
a. UTI​
b. Starvation​
c. Diabetes mellitus​
Q11. What is the main function of the Rationale: Leukocyte esterase is released
proximal convoluted tubule?​ from WBCs, indicating pyuria (pus in urine).
a. Secretion of potassium​
b. Filtration of blood​ Q16. Which urinary abnormality is
c. Reabsorption of glucose and sodium​ commonly seen in diabetic
d. Regulation of pH​ ketoacidosis?​
Answer: c​ a. Hematuria​
Rationale: The proximal tubule reabsorbs b. Glucosuria and ketonuria​
most of the filtered sodium, glucose, and c. Proteinuria and hematuria​
water. d. Bacteriuria​
Answer: b​
Q12. The reagent strip test for blood Rationale: High blood sugar and fat
detects:​ metabolism cause glucose and ketone
a. Intact RBCs only​ excretion.
b. Free hemoglobin only​
c. Hemoglobin and myoglobin​ Q17. What is the principle behind the
d. WBCs​ Clinitest tablet test?​
Answer: c​ a. Peroxidase reaction​
Rationale: The blood pad reacts with b. Protein precipitation​
peroxidase activity in hemoglobin and c. Copper reduction​
myoglobin. d. Enzyme inhibition​
Answer: c​
Q13. Which part of the nephron is Rationale: Clinitest detects reducing
impermeable to water?​ sugars by reducing copper sulfate to
a. Descending limb of Henle​ cuprous oxide.
b. Ascending limb of Henle​
c. Proximal tubule​ Q18. What does a positive nitrite test on
d. Collecting duct​ reagent strip suggest?​
Answer: b​ a. Viral UTI​
Rationale: The ascending limb is b. Gram-positive infection​
impermeable to water but actively reabsorbs c. Gram-negative bacteria​
solutes. d. Presence of yeast​
Answer: c​
Q14. Which type of urine specimen is Rationale: Many gram-negative bacilli
best for quantitative chemical analysis?​ convert nitrate to nitrite.
a. Random​
b. First morning​ Q19. Which of the following casts is
c. Timed (24-hour)​ most associated with tubular necrosis?​
d. Clean-catch midstream​ a. Hyaline​
Answer: c​ b. Granular​
Rationale: 24-hour specimens reflect true c. Fatty​
daily excretion of analytes. d. Waxy​
Answer: b​
Q15. What is the significance of a Rationale: Granular casts, especially
positive leukocyte esterase result?​ muddy brown, indicate tubular injury.
a. Bacteriuria​
b. Hematuria​
c. Pyuria​
d. Ketonuria​
Answer: c​
Q20. The appearance of a broad, waxy Q25. Which fluid is analyzed using
cast is a sign of:​ Light’s criteria?​
a. Acute pyelonephritis​ a. CSF​
b. Acute glomerulonephritis​ b. Pleural fluid​
c. End-stage renal disease​ c. Synovial fluid​
d. Nephrotic syndrome​ d. Peritoneal fluid​
Answer: c​ Answer: b​
Rationale: Broad, waxy casts indicate Rationale: Light’s criteria distinguish
chronic tubular atrophy. exudate from transudate in pleural
effusions.
Q21. The presence of maltese cross
formations in urine sediment suggests:​ Q26. Which stain is used to identify
a. RBCs​ eosinophils in urine?​
b. WBCs​ a. Sternheimer-Malbin​
c. Oval fat bodies​ b. Prussian blue​
d. Crystals​ c. Hansel stain​
Answer: c​ d. Sudan III​
Rationale: Oval fat bodies with cholesterol Answer: c​
form birefringent crosses under polarized Rationale: Hansel stain specifically
light. highlights eosinophils, useful in interstitial
nephritis.
Q22. What is the primary cause of
ketonuria?​ Q27. What is the expected finding in CSF
a. High protein diet​ during bacterial meningitis?​
b. Diabetes mellitus​ a. Low protein, high glucose​
c. Renal failure​ b. High protein, low glucose​
d. Hemolysis​ c. Low protein, normal glucose​
Answer: b​ d. High glucose, no cells​
Rationale: In diabetes, fat metabolism Answer: b​
produces ketones excreted in urine. Rationale: Bacteria consume glucose and
raise protein via increased permeability.
Q23. Which crystal appears
yellow-brown with thorny apple shape?​ Q28. In semen analysis, liquefaction
a. Uric acid​ should occur within:​
b. Triple phosphate​ a. 10 minutes​
c. Ammonium biurate​ b. 30 minutes​
d. Cystine​ c. 60 minutes​
Answer: c​ d. 2 hours​
Rationale: Ammonium biurate crystals are Answer: c​
often seen in old specimens. Rationale: Liquefaction should be
complete within 60 minutes post-ejaculation.
Q24. What is the recommended storage
condition for CSF before analysis?​ Q29. The sperm component responsible
a. Room temperature​ for fertilizing the egg is:​
b. Freezing​ a. Head​
c. 2–8°C​ b. Midpiece​
d. Body temperature (37°C)​ c. Tail​
Answer: d​ d. Acrosome​
Rationale: CSF for microbiological testing Answer: d​
must be kept at 37°C to preserve Rationale: The acrosome contains
pathogens.
enzymes that penetrate the ovum’s by renal tubular cells, forms the matrix of
protective layer. casts.

Q30. Which type of urine sample is best Q55. Which urinary cast indicates the
for bacterial culture?​ most severe renal pathology?​
a. Random​ a. Waxy cast​
b. 24-hour​ b. Hyaline cast​
c. Clean-catch midstream​ c. Granular cast​
d. First morning​ d. Fatty cast​
Answer: c​ Answer: a​
Rationale: Clean-catch midstream avoids Rationale: Waxy casts are broad and rigid,
contamination, ideal for culture. associated with chronic renal failure.

Q51. Which condition is most likely

associated with fatty casts in urine?​
a. Diabetes insipidus​ Q56. Which test detects
b. Nephrotic syndrome​ microalbuminuria earliest?​
c. Acute pyelonephritis​ a. Sulfosalicylic acid test​
d. Fanconi syndrome​ b. Reagent strip​
Answer: b​ c. Immunochemical test​
Rationale: Fatty casts containing oval fat d. Heat and acetic acid test​
bodies are characteristic of nephrotic Answer: c​
syndrome due to lipiduria. Rationale: Immunochemical methods can
specifically and sensitively detect small
Q52. Ghost cells in urine refer to:​ quantities of albumin.
a. Aged epithelial cells​
b. Swollen WBCs​ Q57. In which condition would you most
c. Lysed RBCs​ likely find oval fat bodies in the urine?​
d. Degenerated casts​ a. Pyelonephritis​
Answer: c​ b. Nephrotic syndrome​
Rationale: Ghost cells are RBCs that have c. Diabetes insipidus​
lost hemoglobin in dilute urine. d. Cystitis​
Answer: b​
Q53. The term "isosthenuria" means:​ Rationale: Oval fat bodies are a hallmark
a. High specific gravity​ of lipiduria in nephrotic syndrome.
b. Constant pH​
c. Fixed specific gravity of 1.010​ Q58. What is the primary method for
d. Increased osmolality​ detecting urinary ketones in reagent
Answer: c​ strips?​
Rationale: Isosthenuria reflects the a. Ehrlich reaction​
kidney’s inability to concentrate or dilute b. Sodium nitroprusside reaction​
urine, maintaining SG at 1.010. c. Diazo reaction​
d. Acid precipitation​
Q54. What is the function of Answer: b​
Tamm-Horsfall protein?​ Rationale: Reagent strips detect
a. Forming renal calculi​ acetoacetate and acetone using the sodium
b. Detecting ketones​ nitroprusside reaction.
c. Cast matrix formation​
d. Inhibiting bacterial growth​
Answer: c​
Rationale: Tamm-Horsfall protein, secreted
Q59. A positive Clinitest with a negative Answer: b​
glucose strip indicates:​ Rationale: Ehrlich’s reagent reacts with
a. False positive on Clinitest​ urobilinogen to form a red color on dipstick.
b. Presence of non-glucose reducing
substances​ Q64. Which test is most sensitive for
c. Faulty strip​ detecting bilirubin in urine?​
d. Diabetic ketoacidosis​ a. SSA test​
Answer: b​ b. Ictotest​
Rationale: Clinitest detects all reducing c. Reagent strip​
substances; a positive result may indicate d. Clinitest​
galactose or fructose. Answer: b​
Rationale: Ictotest is more sensitive than
Q60. The presence of triple phosphate reagent strips for detecting bilirubin.
crystals indicates:​
a. Alkaline urine​ Q65. Which organism is known to reduce
b. Acidic urine​ nitrate to nitrite in urine?​
c. Normal urine​ a. Streptococcus​
d. Dehydration​ b. Staphylococcus​
Answer: a​ c. Escherichia coli​
Rationale: Triple phosphate (coffin-lid d. Mycobacterium tuberculosis​
appearance) is commonly found in alkaline Answer: c​
urine. Rationale: E. coli and other
Enterobacteriaceae convert nitrate to nitrite.
Q61. What is the primary cause of
increased specific gravity in urine?​ Q66. The presence of renal tubular
a. Bacteria​ epithelial cells in urine suggests:​
b. Protein​ a. Lower UTI​
c. Glucose​ b. Renal tubular damage​
d. Ketones​ c. Vaginal contamination​
Answer: c​ d. Bladder infection​
Rationale: Glucose increases urine Answer: b​
specific gravity significantly in uncontrolled Rationale: Renal tubular epithelial cells
diabetes. originate from the nephron and indicate
tubular damage.
Q62. Which is the best indicator of early
renal disease?​ Q67. Which stain enhances visualization
a. BUN​ of urine eosinophils?​
b. Creatinine​ a. Sternheimer-Malbin​
c. Microalbuminuria​ b. Hansel stain​
d. Specific gravity​ c. Prussian blue​
Answer: c​ d. Sudan III​
Rationale: Microalbuminuria is an early Answer: b​
marker for glomerular damage, particularly Rationale: Hansel stain is specific for
in diabetics. detecting eosinophils in urine.

Q63. Which urine component is detected Q68. Which urinary finding is

using Ehrlich's reagent?​ characteristic of acute interstitial
a. Ketones​ nephritis?​
b. Urobilinogen​ a. Fatty casts​
c. Protein​ b. Waxy casts​
d. Blood​ c. Eosinophils​
 d. RBC casts​ b. Blood​
Answer: c​ c. Ketone​
Rationale: Urine eosinophils are commonly d. Urobilinogen​
seen in acute interstitial nephritis, especially Answer: b​
drug-induced. Rationale: Blood detection on strips is
based on the pseudoperoxidase activity of
Q69. Broad casts are most associated hemoglobin.
with:​
a. Chronic glomerulonephritis​ Q74. Which of the following best
b. Nephrotic syndrome​ describes the color change of the pH pad
c. Renal failure​ on a reagent strip?​
d. Pyelonephritis​ a. Red to blue​
Answer: c​ b. Green to yellow​
Rationale: Broad, waxy casts form in c. Yellow to green to blue​
dilated tubules in end-stage renal disease. d. Blue to red​
Answer: c​
Q70. What is the most common Rationale: The pH pad shows a
constituent of kidney stones?​ progressive color change from yellow
a. Cystine​ (acidic) to blue (alkaline).
b. Uric acid​
c. Calcium oxalate​ Q75. What is the principle of the SSA test
d. Ammonium magnesium phosphate​ for urine protein?​
Answer: c​ a. Color change​
Rationale: Calcium oxalate is the most b. Precipitation​
common type of urinary calculus. c. Reduction​
d. Enzyme reaction​
Q71. Which condition is characterized by Answer: b​
the presence of dysmorphic red blood Rationale: SSA test detects proteins by
cells in urine?​ precipitation, not by colorimetric reaction.
a. Cystitis​
b. Glomerulonephritis​ Q76. Which is a normal finding in
c. Urethritis​ synovial fluid analysis?​
d. Pyelonephritis​ a. Rice bodies​
Answer: b​ b. Refringent crystals​
Rationale: Dysmorphic RBCs are typically c. Clear, pale yellow fluid​
associated with glomerular bleeding. d. Cloudy and viscous fluid​
Answer: c​
Q72. What is the typical appearance of Rationale: Normal synovial fluid is clear
uric acid crystals under polarized light?​ and pale yellow with good viscosity.
a. Hexagonal plates​
b. Needle-shaped​ Q77. What is the main test used to
c. Rhomboid or rosettes​ differentiate transudate from exudate in
d. Coffin-lid​ serous fluids?​
Answer: c​ a. Protein concentration​
Rationale: Uric acid crystals appear as b. Specific gravity​
rhomboid or rosette-shaped and are c. Light’s criteria​
birefringent under polarized light. d. Cell count​
Answer: c​
Q73. Which reagent strip parameter uses Rationale: Light’s criteria evaluate protein
the peroxidase activity of hemoglobin?​ and LDH levels to differentiate transudates
a. Protein​ from exudates.
Q78. Which parameter is measured in c. Normal glucose, low protein, no cells​
CSF to evaluate for subarachnoid d. Xanthochromia​
hemorrhage?​ Answer: b​
a. Protein​ Rationale: Bacterial meningitis is marked
b. Glucose​ by high protein, low glucose, and neutrophil
c. Xanthochromia​ predominance.
d. Cell count​
Answer: c​ Q83. What is the significance of LE cells
Rationale: Xanthochromia, a yellow in synovial fluid?​
discoloration, indicates prior bleeding and a. Diagnostic of gout​
hemoglobin breakdown. b. Suggestive of SLE​
c. Associated with septic arthritis​
Q79. The sperm morphology criteria for d. Normal finding​
normal sperm is based on:​ Answer: b​
a. Kruger's strict criteria​ Rationale: LE cells are neutrophils that
b. WHO 1999​ have engulfed nuclear material and are
c. Papanicolaou standards​ characteristic of lupus.
d. Modified Jones classification​
Answer: a​ Q84. Which test is used for detecting
Rationale: Kruger’s strict criteria provide fructose in seminal fluid?​
stringent measures for sperm head, a. Clinitest​
midpiece, and tail morphology. b. Seliwanoff test​
c. Resorcinol test​
Q80. A sample for seminal fluid analysis d. Acid phosphatase test​
should be delivered to the lab within:​ Answer: c​
a. 10 minutes​ Rationale: Resorcinol test is used to detect
b. 30 minutes​ fructose, which supports sperm motility and
c. 1 hour​ metabolism.
d. 2 hours​
Answer: c​ Q85. What causes the milky appearance
Rationale: Semen must be analyzed within of synovial fluid?​
1 hour to maintain motility and pH integrity. a. High protein​
b. Crystals​
Q81. What is the recommended c. Lipids and cells​
abstinence period before collecting a d. Bacteria​
semen sample?​ Answer: c​
a. 6–12 hours​ Rationale: Milky synovial fluid can result
b. 12–24 hours​ from high leukocyte counts and lipids, seen
c. 2–7 days​ in inflammation or infection.
d. 7–10 days​
Answer: c​ Q86. Which type of urinary crystal
Rationale: WHO recommends 2–7 days of appears yellow-brown and thorny
sexual abstinence before semen collection apple-shaped?​
for accurate assessment. a. Cystine​
b. Calcium carbonate​
Q82. Which finding in CSF indicates c. Ammonium biurate​
bacterial meningitis?​ d. Calcium phosphate​
a. Low protein, high glucose, lymphocytic Answer: c​
pleocytosis​ Rationale: Ammonium biurate crystals are
b. High protein, low glucose, neutrophilic yellow-brown and have thorny projections.
pleocytosis​
Q87. Which is the confirmatory test for c. Granular cast​
Bence Jones proteins in urine?​ d. Waxy cast​
a. Heat test​ Answer: a​
b. Electrophoresis​ Rationale: Hyaline casts can be found in
c. SSA test​ healthy individuals, especially after exercise
d. Reagent strip​ or dehydration.
Answer: b​
Rationale: Electrophoresis is required to Q92. What is the function of creatinine
confirm the presence and type of Bence clearance?​
Jones proteins. a. To measure liver function​
b. To estimate glomerular filtration rate
Q88. What is the principle of the glucose (GFR)​
test pad on a urine strip?​ c. To detect tubular secretion​
a. Glucose oxidase and peroxidase d. To assess acid-base balance​
reactions​ Answer: b​
b. Reduction of copper sulfate​ Rationale: Creatinine clearance is used as
c. Acid-base reaction​ an estimate of the GFR and overall renal
d. Diazotization​ function.
Answer: a​
Rationale: The test is based on a double Q93. What is the predominant cell type in
enzymatic reaction using glucose oxidase normal cerebrospinal fluid?​
and peroxidase. a. Neutrophils​
b. Monocytes​
Q89. Which condition is associated with c. Lymphocytes​
elevated levels of homogentisic acid in d. Erythrocytes​
urine?​ Answer: c​
a. Maple syrup urine disease​ Rationale: In adults, lymphocytes are the
b. Phenylketonuria​ predominant WBCs in normal CSF.
c. Alkaptonuria​
d. Tyrosinemia​ Q94. Which test is best for differentiating
Answer: c​ between bacterial and viral meningitis?​
Rationale: Alkaptonuria is due to a a. Gram stain​
deficiency of homogentisic acid oxidase, b. India ink stain​
leading to dark urine. c. CSF glucose and protein analysis​
d. Latex agglutination​
Q90. What is the expected microscopic Answer: c​
finding in a patient with nephritic Rationale: Low glucose and high protein
syndrome?​ typically indicate bacteria, while normal
a. Oval fat bodies​ glucose and mildly increased protein
b. WBC casts​ suggest viral meningitis.
c. RBC casts​
d. Broad casts​ Q95. A semen sample with low motility
Answer: c​ but normal count suggests:​
Rationale: Nephritic syndrome often a. Obstruction​
presents with RBC casts due to glomerular b. Asthenozoospermia​
inflammation. c. Oligozoospermia​
d. Teratozoospermia​
Q91. Which urinary cast is considered Answer: b​
the least clinically significant?​ Rationale: Asthenozoospermia refers to
a. Hyaline cast​ reduced sperm motility with normal count.
b. RBC cast​
Q96. What is the function of prostatic d. Yeast​
fluid in semen?​ Answer: c​
a. Nutrient source​ Rationale: Many enteric gram-negative
b. Coagulation factor​ bacteria reduce nitrate to nitrite in the
c. Enzymatic liquefaction​ urinary tract.
d. Energy buffer​
Answer: c​ Q101. Which test is most specific for
Rationale: Prostatic fluid contains detecting ketone bodies in urine?​
enzymes that aid in liquefaction of the a. Clinitest​
semen. b. Ictotest​
c. Acetest​
Q97. Which of the following is a d. SSA test​
metabolic disorder that results in a Answer: c​
positive urine cyanide nitroprusside Rationale: Acetest uses sodium
test?​ nitroprusside to detect ketone bodies
a. Alkaptonuria​ (mainly acetoacetate).
b. Cystinuria​
c. Maple syrup urine disease​ Q102. The presence of calcium oxalate
d. Tyrosinemia​ crystals is common in which type of
Answer: b​ urine pH?​
Rationale: Cyanide nitroprusside test a. Acidic​
detects sulfhydryl groups in cystine. b. Alkaline​
c. Neutral​
Q98. What is the normal range for CSF d. Basic​
glucose in adults?​ Answer: a​
a. 10–30 mg/dL​ Rationale: Calcium oxalate crystals
b. 40–70 mg/dL​ typically appear in acidic urine.
c. 60–100 mg/dL​
d. Equal to serum glucose​ Q103. Which of the following is a
Answer: b​ hallmark of nephrotic syndrome?​
Rationale: Normal CSF glucose is a. Hematuria​
approximately 2/3 of serum glucose, usually b. Hypoproteinemia​
40–70 mg/dL. c. Proteinuria >3.5 g/day​
d. B and C​
Q99. Which of the following is Answer: d​
associated with a positive birefringence Rationale: Nephrotic syndrome is
in synovial fluid crystals?​ characterized by massive proteinuria and
a. Monosodium urate​ resulting hypoproteinemia.
b. Cholesterol​
c. Calcium pyrophosphate​ Q104. Which of the following is most
d. Amorphous urates​ commonly elevated in CSF in multiple
Answer: c​ sclerosis?​
Rationale: Calcium pyrophosphate crystals a. Glucose​
seen in pseudogout are positively b. Chloride​
birefringent. c. IgG index​
d. Albumin​
Q100. A positive nitrite result in urine Answer: c​
implies the presence of:​ Rationale: Increased intrathecal synthesis
a. Gram-positive cocci​ of IgG is common in multiple sclerosis.
b. Mycobacterium tuberculosis​
c. Enteric gram-negative bacteria​
Q105. Which crystal is associated with Rationale: Rothera’s test is a qualitative
ethylene glycol poisoning?​ test for ketone bodies in urine.
a. Ammonium biurate​
b. Cystine​
c. Calcium oxalate (monohydrate)​
d. Triple phosphate​ Q110. Which of the following is least
Answer: c​ likely to cause turbid urine?​
Rationale: Calcium oxalate monohydrate a. Amorphous phosphates​
crystals are seen in ethylene glycol toxicity. b. WBCs​
c. Mucus​
Q106. A positive Clue cell finding in d. Glucose​
urine suggests contamination from:​ Answer: d​
a. Trichomonas vaginalis​ Rationale: Glucose does not typically
b. Gardnerella vaginalis​ cause turbidity; phosphates, WBCs, and
c. Candida albicans​ mucus do.
d. Neisseria gonorrhoeae​
Answer: b​ Q111. What is the normal viscosity of
Rationale: Clue cells are squamous synovial fluid attributed to?​
epithelial cells coated with Gardnerella a. Albumin concentration​
vaginalis. b. Mucin content​
c. Water content​
Q107. What is the expected finding in a d. Crystal presence​
CSF sample of a patient with fungal Answer: b​
meningitis?​ Rationale: Synovial fluid viscosity is
a. High neutrophils, low glucose​ primarily due to hyaluronic acid, a mucin
b. High lymphocytes, low glucose​ substance.
c. High eosinophils, high glucose​
d. Normal profile​ Q112. A positive Pandy test in CSF
Answer: b​ indicates:​
Rationale: Fungal infections typically result a. Elevated glucose​
in lymphocytic pleocytosis with decreased b. Increased protein​
glucose levels. c. Elevated chloride​
d. Xanthochromia​
Q108. A urine sample smells like maple Answer: b​
syrup. What is the likely condition?​ Rationale: Pandy test detects elevated
a. MSUD (Maple Syrup Urine Disease)​ globulin proteins in CSF, often seen in
b. Cystinosis​ meningitis.
c. Tyrosinemia​
d. Phenylketonuria​ Q113. Which of the following is NOT
Answer: a​ normally found in semen?​
Rationale: MSUD is caused by a defect in a. Spermatozoa​
branched-chain amino acid metabolism, b. Epithelial cells​
producing a characteristic odor. c. WBCs​
d. RBCs​
Q109. Which condition is diagnosed Answer: d​
using the Rothera’s test?​ Rationale: RBCs are not a normal
a. Hematuria​ constituent of semen and indicate possible
b. Proteinuria​ pathology.
c. Ketonuria​
d. Glycosuria​
Answer: c​
Q114. Which CSF finding is expected in and associated with cystinuria, a genetic
tuberculous meningitis?​ defect in reabsorption.
a. Low protein, low glucose​
b. High protein, low glucose​ Q119. What is the best urine specimen
c. High glucose, high protein​ for nitrite testing?​
d. Normal protein, low glucose​ a. Random​
Answer: b​ b. First morning​
Rationale: TB meningitis shows c. Postprandial​
lymphocytic predominance, high protein, d. 24-hour​
and low glucose. Answer: b​
Rationale: First morning urine allows
Q115. What is the color of CSF in sufficient time for nitrate-reducing bacteria
xanthochromia due to hemorrhage?​ to act, enhancing nitrite detection.
a. Pink​
b. Red​ Q120. A synovial fluid with
c. Yellow​ needle-shaped, negatively birefringent
d. Clear​ crystals suggests:​
Answer: c​ a. Pseudogout​
Rationale: Xanthochromia refers to a b. Gout​
yellow discoloration of CSF due to c. Rheumatoid arthritis​
hemoglobin breakdown. d. Septic arthritis​
Answer: b​
Q116. Which sperm defect is classified Rationale: Monosodium urate crystals in
as a head defect?​ gout are needle-shaped and show negative
a. Coiled tail​ birefringence.
b. Tapered head​
c. Cytoplasmic droplet​ Q121. Which test is used to detect the
d. Bent neck​ presence of neutral fats in urine?​
Answer: b​ a. Sudan III stain​
Rationale: Tapered head is a b. Hansel stain​
morphological abnormality of the sperm c. Prussian blue​
head. d. Gram stain​
Answer: a​
Q117. What is the purpose of acrosomal Rationale: Sudan III is a fat stain that
enzymes?​ detects lipids and neutral fats in urine
a. Stimulate motility​ sediment.
b. Penetrate the zona pellucida​
c. Protect from acidity​ Q122. What is the significance of a
d. Liquefy semen​ positive CSF India ink test?​
Answer: b​ a. Detection of Cryptococcus neoformans​
Rationale: Acrosomal enzymes help sperm b. Diagnosis of bacterial meningitis​
penetrate the ovum's protective layer. c. Presence of viral particles​
d. Identification of xanthochromia​
Q118. Which urinary crystal is hexagonal Answer: a​
and indicates a genetic disorder?​ Rationale: India ink detects the
a. Uric acid​ encapsulated yeast Cryptococcus in CSF.
b. Triple phosphate​
c. Cystine​
d. Tyrosine​
Answer: c​
Rationale: Cystine crystals are hexagonal
Q123. Which component of semen is Answer: c​
responsible for coagulation immediately Rationale: Sequentially collected tubes
after ejaculation?​ help distinguish contamination versus
a. Seminal vesicle fluid​ pathologic bleeding.
b. Prostatic fluid​
c. Epididymal secretions​ Q128. What is the expected synovial fluid
d. Bulbourethral glands​ WBC count in non-inflammatory joint
Answer: a​ disorders?​
Rationale: Seminal vesicle secretions a. <200 cells/μL​
contain fibrinogen-like proteins that b. 200–2,000 cells/μL​
coagulate semen initially. c. 2,000–50,000 cells/μL​
d. >100,000 cells/μL​
Q124. Which type of cast is composed Answer: b​
entirely of Tamm-Horsfall protein?​ Rationale: Non-inflammatory disorders
a. Waxy cast​ have mildly elevated WBC counts in
b. Fatty cast​ synovial fluid.
c. Hyaline cast​
d. RBC cast​ Q129. What is the clinical significance of
Answer: c​ hemosiderin-laden macrophages in
Rationale: Hyaline casts are composed urine?​
solely of Tamm-Horsfall protein and are a. Glomerulonephritis​
non-specific. b. Chronic hematuria​
c. Acute tubular necrosis​
Q125. In which condition are ‘Maltese d. Urolithiasis​
cross’ formations seen under polarized Answer: b​
light microscopy?​ Rationale: These cells indicate breakdown
a. Hematuria​ of RBCs over time and are found in chronic
b. Pyelonephritis​ bleeding.
c. Nephrotic syndrome​
d. UTI​ Q130. Which of the following is a
Answer: c​ confirmatory test for urinary bilirubin?​
Rationale: Oval fat bodies containing a. SSA test​
cholesterol show Maltese cross patterns in b. Acetest​
nephrotic syndrome. c. Ictotest​
d. Ehrlich test​
Q126. The normal pH of semen is:​ Answer: c​
a. 5.5–6.0​ Rationale: Ictotest is more specific and
b. 6.0–6.5​ sensitive than dipsticks for detecting urinary
c. 7.2–8.0​ bilirubin.
d. 8.5–9.0​
Answer: c​ Q131. Which finding in a urine sample
Rationale: Semen is slightly alkaline, most strongly suggests contamination?​
helping to neutralize acidic vaginal a. Hyaline casts​
secretions. b. Squamous epithelial cells​
c. Calcium oxalate crystals​
Q127. What is the preferred specimen for d. Bacteria with WBCs​
CSF analysis?​ Answer: b​
a. 24-hour pooled CSF​ Rationale: Numerous squamous cells
b. First drop collected​ suggest contamination from the external
c. Sequential tubes from lumbar puncture​ genitalia during collection.
d. Random sample​
Q132. Which chemical is used in the Answer: b​
reagent strip to detect urine blood?​ Rationale: WHO guidelines require ≥40%
a. Tetramethylbenzidine​ motility within 60 minutes for normal semen
b. Sodium nitroprusside​ analysis.
c. Potassium iodide​
d. Ehrlich reagent​ Q137. Which of the following best
Answer: a​ describes synovial fluid in rheumatoid
Rationale: Tetramethylbenzidine reacts arthritis?​
with hemoglobin’s pseudoperoxidase a. Clear, low viscosity​
activity to produce a color change. b. Cloudy, high viscosity​
c. Turbid, decreased viscosity​
Q133. Which cast is pathognomonic for d. Bloody, increased viscosity​
glomerulonephritis?​ Answer: c​
a. Granular cast​ Rationale: In inflammatory conditions like
b. Fatty cast​ RA, synovial fluid is turbid and loses
c. RBC cast​ viscosity due to hyaluronic acid degradation.
d. Waxy cast​
Answer: c​ Q138. What is the normal concentration
Rationale: RBC casts indicate bleeding of spermatozoa in semen per WHO
from glomeruli, seen in glomerulonephritis. guidelines?​
a. >5 million/mL​
Q134. Which condition is associated with b. >10 million/mL​
“glucose absent, ketones present” in c. >15 million/mL​
urine?​ d. >20 million/mL​
a. Starvation​ Answer: c​
b. Diabetes mellitus​ Rationale: WHO considers a sperm count
c. Pregnancy​ >15 million/mL as normal.
d. Fanconi syndrome​
Answer: a​ Q139. Which urine finding is common in
Rationale: In starvation, ketones increase uncontrolled diabetes mellitus?​
due to fat metabolism despite normal a. Bilirubin​
glucose levels. b. Hematuria​
c. Glucose and ketones​
Q135. A sperm count <15 million/mL is d. Protein and WBCs​
referred to as:​ Answer: c​
a. Azoospermia​ Rationale: Uncontrolled diabetes leads to
b. Oligozoospermia​ glucosuria and ketonuria due to high blood
c. Asthenozoospermia​ sugar and fat metabolism.
d. Teratozoospermia​
Answer: b​ Q140. The most common cause of
Rationale: Oligozoospermia refers to low exudative pleural effusion is:​
sperm concentration, below WHO reference a. Heart failure​
values. b. Cirrhosis​
c. Infection or malignancy​
Q136. What is the normal percentage of d. Hypoalbuminemia​
motile sperm within 60 minutes of Answer: c​
ejaculation?​ Rationale: Infections and malignancies
a. ≥50%​ increase vascular permeability, resulting in
b. ≥40%​ exudates.
c. ≥30%​
d. ≥70%​
Q141. Which of the following urine d. Triple phosphate​
findings is most indicative of a lower Answer: c​
urinary tract infection?​ Rationale: Calcium oxalate appears as
a. WBC casts​ colorless envelopes (dihydrate) or
b. Granular casts​ dumbbells (monohydrate).
c. Free bacteria and WBCs​
d. RBC casts​ Q146. The term pyuria refers to the
Answer: c​ presence of which element in urine?​
Rationale: The presence of WBCs and a. Pus cells​
bacteria without casts typically indicates b. Erythrocytes​
infection localized to the bladder or urethra. c. Protein​
d. Crystals​
Q142. What does the presence of Answer: a​
eosinophils in urine suggest?​ Rationale: Pyuria is defined as the
a. Pyelonephritis​ presence of WBCs (pus cells) in urine,
b. Acute interstitial nephritis​ indicating infection or inflammation.
c. Glomerulonephritis​
d. Hematuria​ Q147. Which urinary test result is
Answer: b​ affected most by high doses of vitamin
Rationale: Urinary eosinophils are a C?​
hallmark of drug-induced acute interstitial a. Protein​
nephritis. b. Glucose​
c. Ketones​
Q143. Which substance may cause false d. Urobilinogen​
positive protein results in urine dipstick?​ Answer: b​
a. Urobilinogen​ Rationale: Vitamin C can reduce the
b. Glucose​ peroxidase reaction and cause
c. Quaternary ammonium compounds​ false-negative glucose results on dipsticks.
d. Vitamin C​
Answer: c​ Q148. What is the preferred method of
Rationale: Detergents like quaternary urine preservation when refrigeration is
ammonium compounds can cause not available?​
false-positive protein reactions. a. Freezing​
b. Boric acid​
Q144. A semen sample that fails to c. Sodium chloride​
liquefy within 60 minutes may indicate a d. Acetic acid​
disorder of:​ Answer: b​
a. Testes​ Rationale: Boric acid helps preserve
b. Epididymis​ bacterial counts and maintain the
c. Prostate​ composition of urine.
d. Seminal vesicle​
Answer: c​ Q149. In CSF, which condition typically
Rationale: Liquefaction is dependent on shows increased lymphocytes and
prostatic enzymes; failure suggests prostate normal glucose?​
dysfunction. a. Bacterial meningitis​
b. Fungal meningitis​
Q145. Which urine crystal appears as c. Viral meningitis​
colorless envelopes or dumbbells?​ d. Subarachnoid hemorrhage​
a. Uric acid​ Answer: c​
b. Cystine​ Rationale: Viral meningitis typically
c. Calcium oxalate​
presents with lymphocytic pleocytosis and Urine with an SG consistently between 1.002
normal glucose levels. and 1.003 indicates:
A. Acute glomerulonephritis
Q150. What is the most commonly used B. Renal tubular failure
stain for routine urine microscopy?​ C. Diabetes insipidus
D. Addison's disease
a. Wright stain​
b. Gram stain​ C. Diabetes insipidus
c. Sternheimer-Malbin stain​
d. Prussian blue​ All of the following statements are true about
Answer: c​ Cryptoccocal meningitis, except:
Rationale: Sternheimer-Malbin stain A. An India Ink preparation is positive
enhances the visibility of casts and cells in B. A starburst pattern is seen on Gram stain
urine microscopy. C. The Lymphocyte count is over 2000
D. A confirmatory immunology test is available
Q999. Which of the following cells in
C. The Lymphocyte count is over 2000
urine is most significant for diagnosing
bladder carcinoma?​ Grossly bloody pericardial fluid is caused by
a. Squamous epithelial cells​ which of the following?
b. Clue cells​ A. Increased WBCs
c. Transitional epithelial cells with atypia​ B. Misuse of anticoagulant medications
d. Renal tubular epithelial cells​ C. Chylous
Answer: c​ D. (+) Crystals
Rationale: Transitional cells with atypical
morphology may suggest malignancy of the B. Misuse of anticoagulant medications
bladder epithelium.
SITUATION: What is the most likely cause of
the following CSF results?
Q1000. What is the principal reason for
CSF glucose 20 mg/dL
performing a urinalysis as part of a CSF protein 200 mg/dL
routine physical exam?​ CSF lactate 50 mg/dL
a. To confirm kidney failure​
b. To monitor blood sugar levels​ A. Viral meningitis
c. To screen for urinary and systemic B. Viral encephalitis
disorders​ C. Cryptococcal meningitis
d. To assess urobilinogen​ D. Acute bacterial meningitis
Answer: c​
Rationale: Urinalysis is a key non-invasive D. Acute bacterial meningitis
screening tool to detect both urinary tract
Normal for synovial fluid, except:
and systemic diseases early. A. Uric acid = equal to blood value
B. >50,000 WBC/μL
C. Total protein = <3 mg/dL
A discrepancy between the urine SG D. Both a and c
determined by measuring refractive index
and urine osmolality would be most likely to B. >50,000 WBC/μL
occur in:
A broad spectrum of reactive and
A. After catheterization of the urinary tract nonreactive lymphocytes in the CSF is
B. In diabetes mellitus associated with:
C. After an intravenous pyelogram (IVP) A. Bacterial meningitis
D. In uremia B. Fungal meningitis
C. Tubercular meningitis
C. After an intravenous pyelogram (IVP) D. Viral meningitis
D. Viral meningitis D. Calcium pyrophosphate showing (-)
birefringence
True about synovial fluid:
1. Surrounds all movable joints in the body B. Monosodium urate showing (-) birefringence
2. Found only in the knee
3. Acts as lubricant Effusions produced by conditions that
4. Supplies nourishment to cartilage directly affect the serous membranes are
termed:
A. 1 and 3
B. 1, 3 and 4 A. Transudates
C. 2, 3 and 4 B. Exudates
D. 1, 2 and 3 C. Both of these
D. None of these
B. 1, 3 and 4
B. Exudates
Correct matches regarding synovial fluid:
1. Normal= clear, pale yellow A milky pleural fluid becomes clear after
2. Crystals= milky extraction with ether. This fluid contained:
3. Traumatic tap= blood streaks
4. Sepsis= uniform blood A. Chylous material from thoracic duct leakage
B. Pseudochylous material from thoracic duct
A. 1 and 3 leakage
B. 1, 3, and 4 C. Chylous material inflammation
C. 1, 2, and 3 D. Pseudochylous material from inflammation
D. All of the above
A. Chylous material from thoracic duct leakage
C. 1, 2, and 3
These crystals are rare, occurring as yellow,
In the ropes, or mucin clot, test, normal oily-appearing spheres with radial and
synovial fluid: concentric striations. They are soluble in
A. Forms as a solid clot when added to both acids and alkalis.
hyaluronidase
B. Forms a solid clot when added to glacial A. Tyrosine
acetic acid B. Cholesterol
C. Forms a friable clot when added to C. Cysteine
hydrochloric acid D. Leucine
D. Does not form a clot when added to glacial
acetic acid D. Leucine

B. Forms a solid clot when added to glacial A Watson- Scwartz test is performed on a
acetic acid urine specimen. The following results are
seen:
Examination of synovial fluid under direct
polarized light reveals intracellular -Chloroform tube: red color in the bottom
needle-shaped crystals that appear white layer
against the black background. When a red -Butanol tube: red color in the top layer
compensator is added and the crystals are These result indicate the presence of:
aligned with the slow vibration, they appear
yellow against the red background. These A. Urobilinogen
crystals are: B. Urobilinogen and other Ehrlich-reactive
substances
A. Monosodium urate showing (+) birefringence C. Phorphobilinogen and other Ehrlich-reactive
B. Monosodium urate showing (-) birefringence substances
C. Calcium pyrophosphate showing (+) D. Phorphobilinogen
birefringence
A. Urobilinogen
What is the most common parasite Class K fire extinguisher:
contaminant in urine? A. Electrical
A. Bladder fluke B. Wood, paper, clothing
B. Pinworm C. Flammable chemicals
C. Threadworm D. Grease fats and oils
D. AOTA
D. Grease fats and oils
B. Pinworm
A blood-tainted pleural fluid is submitted for
Which of the following vaginal secretion culture. Which test result would be most
findings is diagnostic for bacterial conclusive in classifying the pleural fluid as
vaginosis? an exudate?
A. Presence of clue cells A. LD fluid/serum = 0.65
B. Vaginal secretions may appear as an B. Total protein = 3.2 g/dL
increased C. RBC count = 10,000/UL
Thin, homogeneous white-to-gray discharge or D. WBC count = 1,500/UL
white "cottage-cheese "-like
C. pH 5.0 A. LD fluid/serum = 0.65
D. AOTA
A medical technologist performed a STAT
A. Presence of clue cells microscopic analysis and report the
following:
Three tubes of CSF labeled 1, 2, and 3 are WBC: 12-15
received in the laboratory. They should be RBC: 4-6
distributed as follows: Hyaline cast: 6-8
A. Hematology #1, chemistry #2, and Bacteria: 1+
microbiology #3
B. Hematology #2, chemistry #3, and The centrifuged tube was discarded and the
microbiology #1 urine sediment was reevaluated
C. Hematology #3, chemistry #1, and microscopically 5hrs after the above results
microbiology #2 were reported. A second medical
D. Hematology #1, chemistry #3, and technologist reported the same results,
microbiology #2 except 2+ bacteria and no hyaline casts. The
most probable explanation for the second
C. Hematology #3, chemistry #1, and technologist's findings is:
microbiology #2
A. Sediment was not agitated before preparing
Performing bronchoalveolar lavage is the microscopic slide
important in the diagnosis of _______ in B. Casts dissolved due to decrease urine pH
immunocompromised patients: C. Casts dissolved due to increase urine pH
A. Paragonimiasis D. Casts were never present in this specimen
B. Pneumocystis jiroveci pneumonia
C. Primary atypical pneumonia C. Casts dissolved due to increase urine pH
D. Tuberculosis

B. Pneumocystis jiroveci pneumonia

Failure to mix a specimen prior to inserting

the reagent strip will primarily affect the:
A. Blood reading
B. Nitrite reading
C. Glucose reading
D. pH reading

A. Blood reading
All of the following statements regarding C. Blastomyces
peritoneal fluid are true, except:
A. Lavage of the peritoneum revealing visible It is used as a safer alternative for testing
blood indicates abnormal bleeding vagal stimulation of gastric acid secretion.
B. Patients with acute pancreatitis have a high The procedure also requires gastric
LD level in peritoneal fluid intubation, however, instead of administering
C. High ALP in ascitic fluid is associated with insulin, patients are given a sandwich to
cancer and bowel perforation chew and spit out.
D. A green color in peritoneal fluid is associated A. Secretin test
with gallbladder leakage B. Sham feeding
C. Sweat test
B. Patients with acute pancreatitis have a high D. Breath test
LD level in peritoneal fluid
B. Sham feeding
Elevated levels of 5-HIAA are associated
with: Creatinine is a good substance to use for a
A. Carcinoid tumors renal clearance test because it:
B. Cystinuria A. Is affected by fluid intake
C. Isovaleric acidemia B. Is reabsorbed
D. Platelet disorders C. Is exogenous
D. Has a constant plasma concentration
A. Carcinoid tumors
D. Has a constant plasma concentration
Attachment of cytotoxic antibody formed
during viral respiratory infections to Which observation is least useful in
glomerular and alveolar basement distinguishing a hemorrhagic serous fluid
membranes: from a traumatic tap?
A. Goodpasture syndrome A. Clearing of fluid as it is aspirated.
B. Wegener granulomatosis B. Presence of xanthochromia
C. Acute glomerulonephritis C. The formation of a clot
D. Henoch-Schonlein purpura D. Diminished RBC count in successive aliquots

A. Goodpasture syndrome C. The formation of a clot

Slides for muscle fiber detection are The glucose renal threshold is 160-180 mg/
prepared by emulsifying a small amount of dl. This represents the:
stool in 10% alcoholic eosin, which A. Plasma level at the commencement of
enhances the muscle fiber striations. The glucose reabsorption in the nephron
entire slide is examined for exactly 5mins. B. Maximum rate of glucose reabsorption in the
Only undigested fibers are counted, and the renal tubule
presence of ________ is reported as C. Plasma concentration above which glucose is
increased. excreted in the urine
A. More than 8 D. Concentration of glucose in vasa recta
B. More than 3
C. More than 5 B. Maximum rate of glucose reabsorption in the
D. More than 10 renal tubule

D. More than 10 All of the following should be discarded in

biohazardous containers except:
Myelin globules have little to no significance A. Urine specimen containers
in sputum except it resembles: B. Towels used for decontamination
A. Cooccidiodes C. Blood collection tubes
B. Histoplasma D. Disposable lab coats
C. Blastomyces
D. Aspergillus A. Urine specimen containers
To distinguish between a clump of WBC and CSF/ Serum IgG index of less than 0.77 is
a WBC cast, it is important to observe: indicative of:
A. Presence of free floating WBCs A. Damage to the blood brain barrier
B. Positive leukocyte reaction B. Multiple sclerosis
C. Positive nitrite reaction C. Multiple myeloma
D. Presence of cast matrix D. Normal condition

D. Presence of cast matrix D. Normal condition

A milky pleural fluid becomes clear after A black, tarry stool maybe indicative of:
extraction with ether. This fluid contained: A. Hematochezia
A. Chylous material from thoracic duct leakage B. Upper GI bleeding
B. Pseudochylous material from thoracic duct C. Melena
leakage D. B and C
C. Chylous material from inflammation
D. Pseudochylous material from inflammation D. B and C

A. Chylous material from thoracic duct leakage Best single indicator of renal disease is:
A. Pyuria
Renin released by the kidney is stimulated B. Polyuria
by: C. Proteinuria
A. A decrease in extracellular fluid volume or D. Glycosuria
pressure
B. Renal tubular reabsorption C. Proteinuria
C. Increased dietary sodium
D. Increased plasma sodium concentration Which of the following crystals may be
usually found in acidic urine?
A. A decrease in extracellular fluid volume or A. Struvite
pressure B. Leucine
C. Ammonium biurate
Reagent strip tests use the sodium D. Apatite
nitroprusside reaction to measure ketones.
In this reaction, ketone in an alkaline medium B. Leucine
reacts with sodium nitroprusside to produce
a: A. Renal lithiasis
A. Red color B. Cystitis
B. Yellow color C. Interstitial nephritis
C. Blue color D. Fanconi syndrome
D. Purple color
A. Renal lithiasis
D. Purple color
A 13-year-old boy is awakened with severe
Granular, dirty brown casts: back and abdominal pain and is taken to the
A. Must be present in conjunction with other emergency department by his parents. A
pathologic findings such as RTE cells and a complete blood count is normal. Family
positive reagent strip for blood history shows that both his father and uncle
B. They are associated with acute tubular are chronic kidney stone formers. Results of
necrosis often caused by the toxic effect a urinalysis are as follows:
hemoglobinuria that can lead to renal failure COLOR: Yellow
C. Represents hemoglobin degradation products KETONES: Negative
such as methemoglobin APPEARANCE: Hazy
D. All of these BLOOD: Moderate
SP. GRAVITY: 1.025
D. All of these BILIRUBIN: Negative
pH: 6.0
UROBILINOGEN: Normal
PROTEIN: Negative B. 0- 1, 200/ul within 12hr urine
NITRITE: Negative C. 0- 1, 200, 000/ hpf
GLUCOSE: Negative D. 0-1,200, 000/ul within 12hr urine
LEUKOCYTE: Negative
Microscopic: D. 0-1,200, 000/ul within 12hr urine
>15-20 RBCs/hpf
Few squamous epithelial cells Type 3 tyrosinemia is negative in the gene
0-3 WBCs/hpf that codes for:
Many cystine crystals A. Tyrosine aminotransferase
What is the physiologic abnormality causing B. p-hydroxyphenylpyruvic acid dioxygenase
this condition? C. Fumarylacetoacetate hydrolase (FAH)
A. Impaired renal tubular secretion of cystine D. Aminolevulinic acid synthetase
B. Impaired renal tubular reabsorption of cystine
C. Inability of the renal tubules to respond to B. p-hydroxyphenylpyruvic acid dioxygenase
ADH
D. Impaired cysteine metabolism Stain used to identify urinary eosinophils:
A. Hansel stain
B. Impaired renal tubular reabsorption of cystine B. Prussian blue
C. Sternheimer-malbin
A 13-year-old boy is awakened with severe D. Toluidine blue
back and abdominal pain and is taken to the
emergency department by his parents. A A. Hansel stain
complete blood count is normal. Family
history shows that both his father and uncle Hemolyzed RBC will produce what type of
are chronic kidney stone formers. Results of cell in the urine?
a urinalysis are as follows: A. Glitter cells
COLOR: Yellow B. Fragmented cells
KETONES: Negative C. Ghost cell
APPEARANCE: Hazy D. Psammoma bodies
BLOOD: Moderate
SP. GRAVITY: 1.025 C. Ghost cell
BILIRUBIN: Negative
pH: 6.0 What microscopic technique is used to
UROBILINOGEN: Normal enhance the visualization of elements with
PROTEIN: Negative low refractive indices?
NITRITE: Negative A. Bright-field
GLUCOSE: Negative B. Phase-contrast
LEUKOCYTE: Negative C. Fluorescence
Microscopic: D. Interference-contrast
>15-20 RBCs/hpf
Few squamous epithelial cells B. Phase-contrast
0-3 WBCs/hpf Third stage in the formation of casts
Many cystine crystals A. Aggregation of Tamm-Horsfall protein into
If amino acid chromatography was individual protein fibrils
performed on this specimen, what additional B. Possible attachment of urinary constituents to
amino acids could be present? the solid matrix
A. Lysine, arginine, ornithine C. Further protein fibril interweaving to form a
B. Thymine, guanine, cytosine solid structure
C. Lysine, alanine, guanine D. Detachment of protein fibrils from the
D. Arginine, ornithine, guanine epithelial cells

A. Lysine, arginine, ornithine C. Further protein fibril interweaving to form a

solid structure
What is the normal WBC count in Addis
count? Presence of this cast indicates destruction
A. 0- 1, 200/hpf or widening of the tubular walls
A. Waxy cast D. Parasitism
B. Granular cast
C. Fatty cast B. Bowel obstruction
D. Broad cast
Why is pregnancy tested as an indirect test?
D. Broad cast A. Sensitive but not specific for HCG
B. Two colored bands are used
Which is not an acceptable specimen for C. it detects the fetus
drug testing? D. it only detects maternal hCG
A. pH 5
B. Urine creatinine 2 mg/dL; specific gravity D. it only detects maternal hCG
1.002
C. pH 8 Which of the following is difficult to
D. Urine creatinine 20 mg/dL; specific gravity differentiate with WBC?
1.010 A. RBC
B. RTE
B. Urine creatinine 2 mg/dL; specific gravity C. Transitional
1.002 D. Urothelial

The specific gravity of a urine sample left B. RTE

standing at 29°C was measured using a
urinometer. The readings showed 1.025. What is the color of waxy cast in KOVA
What is the corrected specific gravity of the stain?
urine? A. Blue
A. 1.028 B. Green
B. 1.022 C. Brown
C. 1.034 D. Pink
D. 1.025
D. Pink
A. 1.028
What is the reagent used in leukocyte
What is the effect on the appearance of urine esterase reagent strip?
of a patient taking medications for UTI? A. Indoxylcarbonic acid ester
A. Cloudy and red B. methylene blue
B. Clear and red C. p-arsinilic
C. Clear and orange D. NOTA
D. Cloudy and orange
A. Indoxylcarbonic acid ester
D. Cloudy and orange

Light reflected in the reagent strip Eating vegetables can cause urine to be:
__________ in proportion to the intensity of A. Acid
the color that reacts with the substances B. Alkaline
present. C. Dilute
A. Decreases D. Neutral
B. Compares
C. Increases B. Alkaline
D. Reflects
Associated with black pleural fluid:
A. Decreases A. Microbial infection
B. amoebic liver abscess
Associated with noodle-like appearance of C. Aspergillosis
stool D. Malignancy
A. Bladder obstruction
B. Bowel obstruction C. Aspergillosis
C. Constipation
What is the positive reaction in Resorcinol Which of the following has the greatest
test? contribution to urine specific gravity?
A. Orange A. Sodium
B. Blue B. Chloride
C. Purple C. Calcium
D. Green D. Urea

A. Orange D. Urea

After a three-glass collection, the physician Which of the following stimulates secretion
requested for additional urinalysis testing, of hydrochloric acid?
what specimen should be used? A. G cells
A. First B. Pepsin
B. Second C. Chief cells
C. Third D. Parietal Cells
D. Last
A. G cells
B. Second
CSF tube samples for microbiological
What anticoagulant is appropriate to use for analysis should be stored in:
identification of crystals in synovial fluid? A. Freezer
A. Powdered EDTA B. Room Temperature
B. Heparinized syringe C. Refrigerator
C. Liquid EDTA D. Incubator
D. SPS
B. Room Temperature
C. Liquid EDTA
Which of the following hormones regulate
What is the characteristic appearance of the water excretion in the tubules?
stool of a patient having a pancreatic A. ADH
disorder? B. Aldosterone
A. Bloody C. Renin
B. Watery D. Angiotensin
C. Tarry
D. Frothy A. ADH

D. Frothy

Which of the following is the stain used to

Which of the following provides initial demonstrate sperm morphology?
magnification for the microscope? A. Papanicolau
A. Objectives B. Trichrome
B. Lens C. Hematoxylin stain
C. Diaphragm D. Sternheimber malbin
D. Condenser
A. Papanicolau
A. Objectives
Normal viscosity of synovial fluid
What does BAO mean? A. 4-6 cm
A. Bases acid outcome B. 2-3 cm
B. Basic Acid Output C. 5-7 cm
C. Basal Acid Output D 3-6 cm
D. Basal acid outcome
A. 4-6 cm
C. Basal Acid Output
Which of the following provides energy to
the tail for motility? C. 3 days
A. Acrosome
B. Nucleus The term melituria pertains to the increase
C. Midpiece urinary excretion of what substance?
D. Neckpiece A. Sugar
B. Protein
C. Midpiece C. Melanin
D. Amino acids
Which is the predominant cells seen in
bronchoalveolar lavage specimen of A. Sugar
cigarette smokers?
A. Neutrophil Which of the following are tests for MPS?
B. Monocyte I. Acid albumin
C. Lymphocyte II. CTAB
D. Eosinophil III. Metachromatic staining
A. 1 and 2
A. Neutrophil B. 2 and 3
C. 1, 2, 3
A symbol that has skull with crossbones D. 3 only
below:
A. Acute toxicity C. 1, 2, 3
B. Hazardous
C. Acute death Urine specimen preferred for crystal
D. Radioactive identification:
A. First-Morning urine
A. Acute toxicity B. Random
C. 4 hour
It preserves protein and formed elements D. Catheterized
well:
A. Boric Acid A. First-Morning urine
B. Thymol
C. Toluene Glitter cells are:
D. Phenol A. Crenated RBC
B. Infected tubular cells
A. Boric Acid C. Macrophages with inclusion
D. Swollen leukocytes

If the patient's serum uric acid is 10mg/dL. D. Swollen leukocytes

What is the corresponding synovial fluid uric
acid? Liley graph indicates moderate hemolysis
A. 80 mg/dL and require careful monitoring anticipating
B. 10 mg/dL an early delivery or exchange transfusion
C. 12 mg/dL upon delivery
D. 14 mg/dl A. Zone 1
B. Zone 2
B. 10 mg/dL C. Zone 3
D. None of these
Fruits such as banana, avocados, and kiwi
should be avoided for how many days before B. Zone 2
the patient should be tested for urinary
5-HIAA levels? Which of the following terms is another
A. 1 day name for peritoneal fluid?
B. 2 days A. Synovial
C. 3 days B. Ascetic
D. 1 week C. Pelvic
D. Abdominal C. 2
D. 10
B. Ascetic
B. 0

Which of the following substances is NOT a Which of the following food is associated
component of "normal" feces? with urinary excretion of calcium oxalate?
A. RBCs I. Tomatoes
B. Bacteria II. Cabbage
C. Electrolytes III. Asparagus
D. Water IV. Orange
A. 1, 2
A. RBCs B. 1, 2, 3
C. 1 and 4
Which blood vessel supplies blood to the D. 1, 2, 3, 4
kidney?
A. Collecting ducts D. 1, 2, 3, 4
B. Renal vein
C. Renal artery Number of orange fat droplets per high
D. Glomerular tuft power field that is considered as normal:
A. 150
C. Renal artery B. 60
C. 20
Which of the following is/are principles D. 100
applied in the mechanism of the slide less
automated machine for microscopy? C. 20
A. Fluorescence
B. Impedance and reflectance photometry The earliest form of spermatogenesis:
C. Fluorescence, impedance and light scatter A. Spermatid
D. Light scatter B. Spermatozoa
C. Spermatocyte
C. Fluorescence, impedance and light scatter D. Spermatogonia

A decrease in sperm motility and presence of D. Spermatogonia

clumping is an indication of _____.
A. Male antisperm antibodies
B. Low level of fructose
C. Female antisperm antibodies SITUATION A 3ml semen sample was
D. Low volume of acid phosphatase delivered to the laboratory and a sperm
counting using Neubauer was performed.
A. Male antisperm antibodies There were 80 sperm cells counted in the
5RBC squares using a 1:20 dilution. Five
In slideless microscopy, which of the spermatids were also noted. What is the
following can be used in conjunction with DC sperm concentration?
that can serve as AC? A. 80 million sperm/ul
A. RF B. 80,000 sperm/ul
B. High voltage C. 80 million sperm/ml
C. Impedance D. NOTA
D. Optical light scatter
C. 80 million sperm/ml
A. RF
SITUATION A 3ml semen sample was
What viscosity grade is appropriate if the delivered to the laboratory and a sperm
semen is described as "watery"? counting using Neubauer was performed.
A. 5 There were 80 sperm cells counted in the
B. 0 5RBC squares using a 1:20 dilution. Five
spermatids were also noted. What is the c.​ Type E fire
sperm count? d.​ Type F fire
A. 9.6 million sperm/ejaculate
B. 240,000 sperm/ejaculate Urine samples should be examined within one
C. 240 million sperm/ejaculate hour of voiding because:
D. NOTA a.​ RBC, leukocytes and casts agglutinate
on standing for several hours at room
C. 240 million sperm/ejaculate temperature
b.​ Urobilinogen and bilirubin increased
Compute for the total number of round cells: after prolonged exposure to light
*10 WBC was noted c.​ Bacterial contamination will cause
*80sperm cells counted using 1:20 dilution in alkalinization of urine
the 5 RBC central squares d.​ Ketones will increased due to bacterial
A. 240 million/ml and cellular metaboliam
B. 4 million/ml
C. 80 million/ml The urine volume of a patient with oliguria is
D. 8 million/ml usually:
a.​ 1,200-1,500 mL
D. 8 million/ml b.​ > 2,500 mL
c.​ < 400 mL
Describe the appearance of a staghorn d.​ < 700 ml
calculi:
A. Spiky thorns The clarity of a urine sample should be
B. Coffin shaped determined:
C. Hexagonal plates a.​ Using glass tubes only, never plastic
D. Hard branching and resembles the shape of b.​ Following thorough mixing of the
renal pelvis specimen
c.​ After addition of salicylic acid
D. Hard branching and resembles the shape of d.​ After the specimen cools to room
renal pelvis temperature
.

Urine clarity grading: “Few particulates, print

Nomarski and Hoffman are example of what easily seen through urine”
microscopy? a.​ Clear
a.​ Phase contrast microscopy b.​ Hazy
b.​ Darkfield microscopy c.​ Cloudy
c.​ Brightfield microscopy d.​ Turbid
d.​ Fluorescent microscopy Which method for the determination of urine
specific gravity is based on refractive index?
Degree of Hazard: 3 a.​ Total solids meter
a.​ Slight Hazard b.​ Hydrometer
b.​ Moderate Hazard c.​ Reagent strip
c.​ Extreme Hazard d.​ Harmonic oscillation densitometry
d.​ Serious Hazard
Urine reagent strips should be stored in a/an:
The best aid for chemical spills is flushing the a.​ Incubator
area with large amounts of water for at least ___ b.​ Cool dry place
minutes then seek medical attention. c.​ Refrigerator
a.​ 15 d.​ Freezer
b.​ 20
c.​ 25 Reading time: 30 seconds
d.​ 30 a.​ Bilirubin
e.​ b.​ Ketones
Arsenal fire: c.​ Specific gravity
a.​ Type A fire d.​ pH
b.​ Type C fire
The protein section of urine reagent strip is most a.​ Waxy-hyaline-coarsely granular-finely
sensitive to: granular-cellular
a.​ Albumin b.​ Coarsely granular-finely
b.​ Bence Jones protein granular-hyaline-waxy-cellular
c.​ Mucoprotein c.​ Hyaline-cellular-coarsely granular-finely
d.​ Globulin granular-waxy
d.​ Cellular-hyaline-finely granular-coarsely
Bence Jones Protein is characterized by its granular-waxy
unique ability to coagulate at ___ and dissolve at Normal urinary crystal which is colorless,
___. resembling flat plates or thin prisms often in
a.​ 30-50 : 80-100 degrees Celcius rosette form:
b.​ 40-50 : 80-90 degrees Celcius a.​ Amorphous phosphates
c.​ 50-60 : 90-100 degrees Celcius b.​ Struvite
d.​ 40-50 : 80-100 degrees Celcius c.​ Apatite
d.​ Calcium carbonate
SSA turbidity: “Turbidity with granulation, no
flocculation” If alcohol is added to urine with tyrosine crystals,
a.​ 1+ this other type of abnormal crystal may be
b.​ 2+ precipitated:
c.​ 3+ a.​ Bilirubin
d.​ 4+ b.​ Sulfonamide
c.​ Leucine
The parameter in the reagent strip which utilizes d.​ Cystine
Ehrlich units is:
a.​ Bilirubin Manner of reporting for RTE cells:
b.​ Urobilinogen a.​ Average number per LPF
c.​ Glucose b.​ Average number per HPF
d.​ Leukocytes c.​ Average number per OIO
d.​ 1+, 2+, 3+, 4+
Convert 0.4 mg/dL urobilinogen to Ehrlich units.
a.​ 0.4 Transitional epithelial cells seen in urine
b.​ 4 specimens may be reported using
c.​ 40 rare/few/moderate/many by using the:
d.​ 400 a.​ Scanner field
e.​ b.​ Low power field
c.​ High power field
Ascorbic acid causes false negative reactions in d.​ Oil immersion field
what urine reagent strip?
a.​ Blood In a urine specimen, ten calcium oxalate crystals
b.​ Bilirubin were seen per high power field (HPF). How do
c.​ Leukocytes you report the findings?
d.​ All of the choices a.​ Rare
b.​ Few
Soluble in ether, except: c.​ Moderate
a.​ Red blood cells d.​ Many
b.​ Lipids
c.​ Chyle In a urine specimen, nine bacteria were seen
d.​ Lymphatic fluid per high power field (HPF). How do you report
the finding?
Soluble in dilute acetic acid, except: a.​ Rare
a.​ Red blood cells b.​ Few
b.​ Amorphous phosphates c.​ Moderate
c.​ Calcium carbonates d.​ Many
d.​ White blood cells
Most frequent parasite encountered in the urine:
Ascending sequence of casts: a.​ Schistosoma haematobium
 b.​ Enterobius vermicularis
c.​ Trichomonas vaginalis Pellicle clot formation after 12-24 hours
d.​ Giardia lamblia refrigeration of cerebrospinal fluid:
a.​ Bacterial meningitis
A renal calculi described as very hard, dark in b.​ Viral meningitis
color with rough surface: c.​ Tubercular meningitis
a.​ Calcium oxalate d.​ Fungal meningitis
b.​ Uric acid
c.​ Cystine Oligoclonal banding in cerebrospinal fluid but not
d.​ Phosphate in serum, except:
a.​ Multiple myeloma
Renal disease whose etiology is the deposition
b.​ aEncephalitis
of anti-glomerular basement membrane antibody
c.​ Neurosyphilis
to glomerular and alveolar basement
d.​ Guillain-Barre disease
membranes:
a.​ Berger’s disease
b.​ Wagener’s granulomatosis Normal synovial fluid glucose should not be
c.​ Goodpasture syndrome more than ___ mg/dL lower than the blood
d.​ Membranous glomerulonephritis value.
a.​ 5
The sperm acrosomal cap should encompass b.​ 10
approximately ___ of the head and covers c.​ 15
approximately ___ of the nucleus. d.​ 20
a.​ One half, two-thirds
b.​ One third, one half Cell which could be seen in synovial fluid
c.​ Two-thirds, one fourth resembles polished rice macroscopically:
d.​ One fourth, one third a.​ Ragocytes
b.​ Cartilage cells
Sperm motility grading: “Slower speed, some c.​ Rice bodies
lateral movement” d.​ Reiter cell
a.​ 4.0
b.​ 3.0 The normal color of gastric fluid is
c.​ 2.0 a.​ Colorless
d.​ 1.0 b.​ Green
c.​ White
Reagent/s used for the assessment of sperm d.​ Gray
viability:
a.​ Papanicolau What reagent is used for the APT test?
b.​ Wright’s a.​ Hydrochloric acid
c.​ Giemsa b.​ Sodium hydroxide
d.​ Eosin-Nigrosin c.​ Sulfuric acid

Computer-Assisted Semen Analysis (CASA) is

used to determine sperm cell:
a.​ Vertical movement
b.​ Lateral movement
c.​ Circular movement
d.​ Velocity and trajectory

Florence test, which choline, uses which

reagent?
a.​ Potassium iodide
b.​ Picric acid
c.​ Trichloroacetic acid
d.​ Silver nitroprusside