Clinical pathology: semen analysis

18 Kerala PSC Lab Technician Gr II practice questions on Clinical pathology: semen analysis, part of Pathology. The first 18 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
How is the motility of sperm that beat their tails but make no forward progress graded?
1. ARapid progressive motility
2. BNon-progressive motility
3. CImmotile
4. DSlow progressive motility
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Answer: B · Non-progressive motility
WHO grades sperm motility as progressive (moving forward, in a line or a large circle), non-progressive (moving without forward travel, such as a tail beat only or swimming in small circles) and immotile. The 2021 manual again splits progressive motility into rapid and slow. Motility is assessed on at least 200 sperm in a fresh, liquefied sample, ideally at 37 °C. Poor progressive motility is called asthenozoospermia.
- A: Rapid progressive sperm move forward quickly, at 25 µm/s or more.
- C: Immotile sperm show no movement at all.
- D: Slow progressive sperm still move forward, only slowly.
Question 2 · Hard
Semen from a 32-year-old man is diluted 1 in 20, and 52 sperm are counted in five medium squares (each 0.04 mm²) of a Neubauer chamber (depth 0.1 mm). The sperm concentration is:
1. A52,000/mL
2. B52 million/mL
3. C520 million/mL
4. D5.2 million/mL
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Answer: B · 52 million/mL
Volume counted = 5 × 0.04 mm² × 0.1 mm = 0.02 mm³ (µL). Sperm per µL = 52 × 20 ÷ 0.02 = 52,000, and since 1 mL = 1,000 µL this is 52 million/mL. This is above the WHO 2021 lower reference limit of 16 million/mL. The diluent, for example sodium bicarbonate with formalin, immobilises the sperm so that they can be counted.
- A: 52,000/mL is the count per µL wrongly reported per mL.
- C: 520 million/mL uses a dilution of 200 instead of 20.
- D: 5.2 million/mL leaves out the depth of 0.1 mm.
Question 3 · Easy
Normal semen kept at room temperature or 37 °C usually liquefies within:
1. A1-2 minutes
2. B24 hours
3. C3-4 hours
4. D15-60 minutes
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Answer: D · 15-60 minutes
Semen coagulates on ejaculation through proteins from the seminal vesicles (semenogelins) and then liquefies as prostatic enzymes, mainly PSA, break the coagulum down. Liquefaction is usually complete within 15 minutes and should be by 60 minutes. Analysis starts after liquefaction, ideally within 30-60 minutes of collection. Failure to liquefy by 60 minutes suggests poor prostatic secretion.
- A: Normal semen is still a coagulum in the first few minutes.
- B: Waiting 24 hours would destroy motility; normal semen liquefies far sooner.
- C: Liquefaction taking hours is abnormal and suggests prostatic dysfunction.
Question 4 · Medium
Low seminal zinc, citric acid and acid phosphatase point to poor function of the:
1. AEpididymis
2. BProstate
3. CSeminal vesicles
4. DBulbourethral glands
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Answer: B · Prostate
The prostate secretes zinc, citric acid and acid phosphatase, and its enzymes liquefy the semen. The seminal vesicles provide most of the volume and the fructose, while the epididymis is marked by neutral alpha-glucosidase. Measuring these markers helps locate a problem in the male accessory glands. Prostatic acid phosphatase is also used as a marker of semen in forensic work.
- A: The epididymis is marked by neutral alpha-glucosidase.
- C: The seminal vesicles are marked by fructose, not zinc or citric acid.
- D: Bulbourethral glands add a small amount of mucus and have no routine marker.
Question 5 · Easy
What is the complete absence of spermatozoa in the ejaculate called?
1. AAzoospermia
2. BAspermia
3. COligozoospermia
4. DAsthenozoospermia
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Answer: A · Azoospermia
Azoospermia means no spermatozoa in the ejaculate, confirmed by examining the centrifuged pellet. Aspermia means no ejaculate at all, oligozoospermia a low sperm count, and asthenozoospermia poor motility. Azoospermia may be obstructive (blocked ducts) or non-obstructive (testicular failure). Seminal fructose and hormone tests help to separate the two.
- B: Aspermia means that no ejaculate is produced at all.
- C: Oligozoospermia means sperm are present but in low numbers.
- D: Asthenozoospermia means poor sperm motility.
Question 6 · Easy
After vasectomy, the semen result that most clearly shows the operation has worked is:
1. ASemen volume under 1.5 mL
2. BNo sperm seen (azoospermia)
3. CProgressive motility under 32%
4. DUnder 15 million sperm per mL
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Question 7 · Easy
How long should a man abstain from ejaculation before semen collection, according to the WHO manual (6th edition)?
1. A2 to 7 days
2. B3 to 4 weeks
3. CLess than 24 hours
4. D10 to 14 days
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Question 8 · Hard
A 30-year-old man's semen: volume 2.5 mL, 12 million sperm/mL; of 200 sperm, 76 progressive, 30 non-progressive, 94 immotile; 10 of 200 have normal forms. Lower reference limits: 16 million/mL, total 39 million, progressive motility 30%, normal forms 4%. What does the sample show?
1. AOligozoospermia
2. BOligoasthenozoospermia
3. CTeratozoospermia
4. DNormozoospermia
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Question 9 · Medium
In the eosin-nigrosin test for sperm vitality, live spermatozoa:
1. AStain blue in the head
2. BStain uniformly black
3. CStain pink or red
4. DRemain unstained (white)
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Question 10 · Medium
Semen of 0.8 mL with an acidic pH, no sperm and no fructose most likely indicates:
1. ARetrograde ejaculation into the bladder
2. BFailure of sperm production in the testes
3. CAbsent or blocked seminal vesicles
4. DChronic infection of the prostate
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Question 11 · Medium
A semen sample from a 34-year-old man is still thick and gel-like after 60 minutes at 37 °C. Poor function of which gland is most likely?
1. AProstate
2. BEpididymis
3. CTestes
4. DSeminal vesicles
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Question 12 · Easy
A normal semen sample, once it has liquefied, looks:
1. AClear and colourless
2. BGrey and opalescent
3. CYellow-green and cloudy
4. DReddish-brown
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Question 13 · Medium
Why should semen for analysis not be collected in an ordinary latex condom?
1. AIt can kill or damage sperm
2. BIt lowers the pH of semen
3. CIt prevents liquefaction
4. DIt adds fructose to the sample
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Question 14 · Easy
Seminal fructose is secreted mainly by the:
1. ABulbourethral glands
2. BProstate
3. CTestes
4. DSeminal vesicles
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Question 15 · Medium
A sperm concentration below the lower reference limit is called:
1. AOligozoospermia
2. BTeratozoospermia
3. CAsthenozoospermia
4. DNecrozoospermia
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Question 16 · Medium
With Papanicolaou staining and strict criteria, the WHO lower reference limit for normal sperm forms is:
1. A30%
2. B50%
3. C14%
4. D4%
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Question 17 · Hard
WHO lower limits: 16 million/mL, progressive motility 30%, total motility 42%, vitality 54%, normal forms 4%. An infertile husband, 35, gives 3.0 mL with 40 million/mL; progressive motility is 12%, total motility 25%, vitality 75% and normal forms 6%. Which term fits?
1. AAsthenozoospermia
2. BOligoasthenozoospermia
3. CNecrozoospermia
4. DTeratozoospermia
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Question 18 · Easy
A semen sample collected at home should reach the laboratory within:
1. A24 hours
2. B6 hours
3. C12 hours
4. D1 hour
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Clinical pathology: semen analysis

How is the motility of sperm that beat their tails but make no forward progress graded?

Semen from a 32-year-old man is diluted 1 in 20, and 52 sperm are counted in five medium squares (each 0.04 mm²) of a Neubauer chamber (depth 0.1 mm). The sperm concentration is:

Normal semen kept at room temperature or 37 °C usually liquefies within:

Low seminal zinc, citric acid and acid phosphatase point to poor function of the:

What is the complete absence of spermatozoa in the ejaculate called?

After vasectomy, the semen result that most clearly shows the operation has worked is:

How long should a man abstain from ejaculation before semen collection, according to the WHO manual (6th edition)?

A 30-year-old man's semen: volume 2.5 mL, 12 million sperm/mL; of 200 sperm, 76 progressive, 30 non-progressive, 94 immotile; 10 of 200 have normal forms. Lower reference limits: 16 million/mL, total 39 million, progressive motility 30%, normal forms 4%. What does the sample show?

In the eosin-nigrosin test for sperm vitality, live spermatozoa:

Semen of 0.8 mL with an acidic pH, no sperm and no fructose most likely indicates:

A semen sample from a 34-year-old man is still thick and gel-like after 60 minutes at 37 °C. Poor function of which gland is most likely?

A normal semen sample, once it has liquefied, looks:

Why should semen for analysis not be collected in an ordinary latex condom?

Seminal fructose is secreted mainly by the:

A sperm concentration below the lower reference limit is called:

With Papanicolaou staining and strict criteria, the WHO lower reference limit for normal sperm forms is:

WHO lower limits: 16 million/mL, progressive motility 30%, total motility 42%, vitality 54%, normal forms 4%. An infertile husband, 35, gives 3.0 mL with 40 million/mL; progressive motility is 12%, total motility 25%, vitality 75% and normal forms 6%. Which term fits?

A semen sample collected at home should reach the laboratory within: