Chemistry & Urinalysis and body fluids ASCP MLT Exam Final Review 100% A+ Graded Updated Correct Questions and Answers_

Chemistry & Urinalysis and body fluids ASCP MLT Exam Final Review 100% A+ Graded Updated Correct Questions and Answers_ Recently the American Diabetes Association (ADA) recommended reporting which of these values in order to correlate with hemoglobin A1C (HbA1C) as a further indicator of glycemic control? - Estimated average glucose - Blood urea nitrogen - Microalbumin - Insulin - CORRECT ANSWER-- Estimated average glucose In 2008, the ADA recommended calculating and reporting the estimated average glucose (eAG) with HbA1C measurement results. The eAG can be calculated from percent HgA1C by using the following formula: eAG (mg/dL) = 28.7 X HgA1C - 46.7 eAG HbA1C (%) 97 mg/dL 5 126 mg/dL 6 154 mg/dL 7 183 mg/dL 8 212 mg/dL 9 240 mg/dL 10 269 mg/dL 11 298 mg/dL 12 Approximately how many doses are required to obtain a steady-state oscillation allowing for peak and trough levels to be evaluated? - 1 to 2 - 3 to 4 - 5 to 7 - > 10 - CORRECT ANSWER-- 5 to 7 Approximately five to seven doses are required before a steady-state oscillation is achieved. After the first dose, absorption and distribution occur, followed only by elimination. Before the concentration of the drug drops significantly, the second dose is given and the peak of the second dose is additive to what remains of the first dose. The third through the seventh scheduled doses all have the same effect, increasing the serum concentration and the amount eliminated. By the end of the seventh dose, the amount of the drug administered is equal to the amount eliminated during the dosage period. At this point, a steady-state is established and peak and trough concentrations can be evaluated. Which of the following answer choices correctly state the use of urine reagent strips for chemical analysis? - Urine chemical reagent strips readers can utilize any manufacturer's dipsticks. - Use of a well-mixed, uncentrifuged urine sample at room temperature is the technique for urine reagent strips. - The urine reagent test strips method is very reliable and quick as the timing for chemical reactions to take place is the same. - The reagent strip can be left in the urine specimen for several minutes without causing any problem. - CORRECT ANSWER-- Use of a well-mixed, uncentrifuged urine sample at room temperature is the technique for urine reagent strips. Red cells and white cells settle to the bottom of the tube when the urine specimen is not mixed well. This can cause incorrect urine dipstick test results as these cells stay undetected during analysis. Each manufacturer will specify which urine chemical reagent strips are acceptable for use on their instrumentation. The timing for reactions to take place varies between the tests, they are read between 60 and 120 seconds. The reagents are leached from the pads when the strip remains in the urine for an extended time. Bence-Jones proteinuria is associated with all of the following conditions EXCEPT: - Macroglobulinemia - Pernicious anemia - Multiple myeloma - Amyloidosis - CORRECT ANSWER-- Pernicious anemia Macroglobulinemia, multiple myeloma, and amyloidosis are all associated with abnormal protein production and/or accumulation which can result in Bence-Jones proteins being excreted in the urine. Bence-Jones proteins are monoclonal light chains excreted in the urine, seen with multiple myeloma, and other neoplasms of lymphoid cells. Small amounts can be missed by urine dipsticks, which are more sensitive to albumin than globulins. They are best detected by urine protein electrophoresis, immunoelectrophoresis, or immunofixation. Large amounts cause renal tubular damage, resulting in myeloma kidney. Bence-Jones proteins have unusual heat solubility properties, in that they precipitate between 50 - 60 °C and redissolve at 90 - 100 °C. Historical detection methods often utilized this unusual property. Pernicious anemia is a vitamin B12 deficiency due to the lack of gastric intrinsic factor, which is, in turn, a result of autoimmune gastritis. A cerebrospinal fluid sample from a possible meningitis patient demonstrated a round, budding yeast of variable size on Gram stain. The specimen was cultured to routine fungal media without cycloheximide. The organism rapidly produced urease and demonstrated brown pigmented colonies on niger seed agar. The organism identification is: - Cryptococcus neoformans - Candida albicans - Malassezia furfur - Trichosporan species - CORRECT ANSWER-- Cryptococcus neoformans Cryptococcus neoformans is a significant human pathogen that has been associated with meningitis, pulmonary infections, and fungemia, especially in immunocompromised patients. Some of these isolates have the ability to produce a polysaccharide capsule that is visible with capsular stains or an India ink prep. The capsule may cause the colonies to be mucoid except on inhibitory mold agar. A presumptive identification may be made with a rapid positive urease test. Brown pigment colonies on niger seed agar have been sufficient for final identification. Candida albicans is a significant human pathogen as a cause of thrush, vulvovaginitis, respiratory infection, meningitis, and more. This organism produces small budding yeast with pseudohyphae and smooth, creamy, white colonies on fungal media. It produces urease but it is not rapid and it does not produce a pigment on niger seed agar. Malassezia furfur is more commonly known to cause skin infections but other infections may occur. Diagnosis is typically based on direct microscopic examination of skin scrapings. If the sample is cultured, the organism requires an over-lay with olive oil for growth. Colonies are smooth, creamy, and white but smaller than Candida albicans colonies. It does not produce brown colonies on niger seed agar. Trichosporon species cause skin infections and fungemia, especially in immunocompromised individuals. Direct examination demonstrates the presence of arthroconidia. The colonies have been described as dry, heaped, and powdery. It is also known to produce urease but it is not rapid. It does not produce brown-pigmented colonies on niger seed agar. All of the following parameters are generally considered to be a part of seminal fluid analysis, EXCEPT? - Sperm count and motility - Morphology examination - Viscosity assessment - Glucose concentration - CORRECT ANSWER-- Glucose concentration Glucose concentrations are not performed during semen analysis procedures. However, sperm count, morphologic examinations, viscosity assessments, motility, appearance, volume, and pH, assessments are usually included in a semen analysis procedure. The ketone component that is measured by the nitroprusside reaction is: - Acetoacetic acid - Beta-hydroxybutyric acid - Acetone - Glycine - CORRECT ANSWER-- Acetoacetic acid Acetoacetic acid reacts with sodium nitroprusside to produce a purple color. B-hydroxybutyrate and acetone are derived from acetoacetic acid. However, B-hydroxybutyrate is not measured and only slightly sensitive to acetone in presence of glycine. All of the following are characteristics of cast, EXCEPT? - They are cylindrical bodies. - They are formed either in the distal convoluted tubules or the collecting ducts of the kidney. - They contain Tamm-Horsfall mucoprotein. - They are formed in the urethra. - CORRECT ANSWER-- They are formed in the urethra. Casts are cylindrical bodies formed either in the distal convoluted tubules or the collecting ducts of the kidney, not the urethra.The matrix of all casts is thought to be Tamm-Horsfall protein, a glycoprotein secreted by the distal loop of Henle and the distal tubule. This protein entraps cells and granular material of tubular origin. After formation, casts are loosened from the tubules and discharged into the urine. Casts, if present, are visible in freshly voided urine.