Semen, CSF, body fluids and stool examination

40 Lab technician recruitment practice questions on Semen, CSF, body fluids and stool examination, part of Clinical Pathology. The first 25 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 · Easy
Which stain does the WHO semen manual recommend for assessing sperm morphology?
1. ASudan III stain
2. BPapanicolaou stain
3. CZiehl-Neelsen stain
4. DGram stain
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Answer: B · Papanicolaou stain
The modified Papanicolaou stain shows the acrosome, head, midpiece and tail clearly, so sperm can be classed as normal or abnormal by strict criteria. Shorr and Diff-Quik stains are accepted alternatives. Thin smears of liquefied semen are air-dried, fixed and stained, and at least 200 sperm are assessed. The result is reported as the percentage of normal forms.
- A: Sudan III stains neutral fat, as in faecal fat.
- C: Ziehl-Neelsen is an acid-fast stain for mycobacteria.
- D: Gram stain classifies bacteria and does not show sperm structure well.
Question 2 · Medium
A bloody pleural fluid has a haematocrit of 28% while the patient's blood haematocrit is 40%. This result indicates:
1. AA transudate
2. BA haemothorax
3. CA traumatic tap
4. DA chylothorax
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Answer: B · A haemothorax
A pleural fluid haematocrit of more than half the blood haematocrit defines a haemothorax. Here 28 ÷ 40 = 70%, well above 50%. Haemothorax usually follows chest trauma or surgery and often needs drainage. Blood-stained effusions from tumour or infarction usually have a haematocrit far below this.
- A: Transudates are clear and straw-coloured, not grossly bloody.
- C: Blood from a traumatic tap adds only a small amount of blood and does not reach half the blood haematocrit.
- D: A chylothorax is milky, from chyle rich in triglyceride.
Question 3 · Easy
Dark green peritoneal fluid obtained at paracentesis most likely contains:
1. AChyle from a lymphatic leak
2. BBile from a biliary leak
3. CUrine from a bladder injury
4. DBlood from a traumatic tap
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Answer: B · Bile from a biliary leak
A green or green-brown peritoneal fluid suggests bile, as after gallbladder perforation, bile duct injury or a perforated duodenal ulcer. It can be confirmed by a fluid bilirubin higher than the serum bilirubin. Chyle makes the fluid milky, and blood makes it red. Urine from a bladder rupture gives a pale fluid with a creatinine higher than serum.
- A: Chyle makes the fluid milky white, not green.
- C: Urine gives a pale fluid recognised by a high creatinine.
- D: Blood from a traumatic tap makes the fluid red and clears as it is drawn.
Question 4 · Medium
A raised CSF glutamine level is most useful as a pointer to:
1. AHepatic encephalopathy
2. BMultiple sclerosis
3. CBacterial meningitis
4. DSubarachnoid haemorrhage
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Answer: A · Hepatic encephalopathy
In liver failure, ammonia reaches the brain and astrocytes detoxify it by combining it with glutamate to form glutamine. CSF glutamine therefore rises with brain ammonia and correlates with the degree of coma. It is measured when hepatic encephalopathy is suspected in a confused patient. The specimen must be tested promptly because glutamine breaks down to ammonia on standing.
- B: Multiple sclerosis is shown by oligoclonal bands and a raised IgG index.
- C: Bacterial meningitis is shown by neutrophils, low glucose and raised lactate.
- D: Subarachnoid haemorrhage is shown by xanthochromia.
Question 5 · Easy
Fluid removed from the pleural cavity by needle aspiration is obtained by:
1. APericardiocentesis
2. BThoracentesis
3. CParacentesis
4. DArthrocentesis
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Answer: B · Thoracentesis
Thoracentesis (thoracocentesis) is needle aspiration of the pleural space, usually under ultrasound guidance. Paracentesis removes peritoneal (ascitic) fluid, pericardiocentesis removes pericardial fluid and arthrocentesis removes synovial fluid. All serous fluids are called effusions when they collect in excess. The sample is divided into plain, EDTA and heparin or culture containers depending on the tests.
- A: Pericardiocentesis is aspiration of the pericardial sac.
- C: Paracentesis is aspiration of peritoneal (ascitic) fluid.
- D: Arthrocentesis is aspiration of a joint for synovial fluid.
Question 6 · Medium
Many undigested meat fibres with clear cross-striations in a stool smear suggest:
1. AAmoebic dysentery
2. BUlcerative colitis
3. CGiardia infection
4. DPancreatic exocrine insufficiency
Answer and explanation in LearnFree account
Question 7 · Easy
Which reagent is used for the bench screening test for fructose in seminal fluid?
1. AResorcinol in hydrochloric acid
2. BBenedict's qualitative reagent
3. CEhrlich's aldehyde reagent
4. DSodium nitroprusside solution
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Question 8 · Easy
In the o-toluidine test for occult blood in stool, which reagent is added along with the chromogen?
1. AHydrogen peroxide
2. BSodium hydroxide
3. CSulphosalicylic acid
4. DFerric chloride
Answer and explanation in LearnFree account
Question 9 · Easy
For a guaiac card test for faecal occult blood, the patient usually collects samples from:
1. ATwo stools a week apart
2. BThree consecutive stools
3. COne stool on a single day
4. DFive stools over a fortnight
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Question 10 · Easy
About how much cerebrospinal fluid is produced each day in a healthy adult?
1. AAbout 50 mL
2. BAbout 150 mL
3. CAbout 1,500 mL
4. DAbout 500 mL
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Question 11 · Hard
Semen from a 30-year-old man: total motility 60% (progressive plus non-progressive); eosin-nigrosin vitality 45% live. How should these results be handled?
1. AReport necrozoospermia, since most sperm are dead
2. BReport asthenozoospermia from the motility result
3. CRecheck both, as live sperm cannot be fewer than motile
4. DAccept both, as the two tests measure unrelated features
Answer and explanation in LearnFree account
Question 12 · Easy
The Nonne-Apelt test, done by layering CSF with saturated ammonium sulphate, detects a raised level of CSF:
1. AAlbumin
2. BGlucose
3. CGlobulin
4. DChloride
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Question 13 · Medium
A vaginal swab is sent after a suspected sexual assault. No sperm are seen, and the accused man is known to have had a vasectomy. Which result best shows that seminal fluid is present?
1. AHigh salivary amylase activity
2. BHigh acid phosphatase activity
3. CHigh alkaline phosphatase activity
4. DHigh lactate dehydrogenase level
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Question 14 · Medium
Why is the faecal emulsion boiled before a chemical test for occult blood?
1. ATo dissolve haemoglobin out of the stool
2. BTo kill parasites and make it safe
3. CTo destroy peroxidases other than haemoglobin
4. DTo convert haemoglobin into haemin
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Question 15 · Medium
Which food, when eaten raw before a guaiac test, can give a false-positive result through its plant peroxidase?
1. AHorseradish or turnip
2. BBoiled white rice
3. CPasteurised cow's milk
4. DPlain white bread
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Question 16 · Easy
Which test on CSF is widely used in India as a supporting test for tuberculous meningitis?
1. ACreatine kinase
2. BAdenosine deaminase
3. CAlkaline phosphatase
4. DLactate dehydrogenase
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Question 17 · Medium
Why is trichloroacetic acid often preferred to sulphosalicylic acid alone for turbidimetric estimation of CSF protein?
1. AIt measures CSF glucose in the same tube
2. BIt reacts fully in a few seconds at 4 °C
3. CIt does not need any protein standard
4. DIt precipitates albumin and globulin equally
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Question 18 · Medium
Blood-stained CSF forms a small clot in the collection tube within an hour. This favours:
1. ATuberculous meningitis
2. BA traumatic lumbar tap
3. CSpinal block with Froin syndrome
4. DAn old subarachnoid haemorrhage
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Question 19 · Easy
Most of the volume of a normal ejaculate is contributed by the:
1. ASeminal vesicles
2. BProstate gland
3. CBulbourethral glands
4. DTestes and epididymis
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Question 20 · Medium
A child received oral antibiotics for two days before a lumbar puncture. CSF shows many neutrophils, but the Gram stain and culture are negative. Which CSF test can still identify the likely organism?
1. AIndia ink preparation
2. BZiehl-Neelsen stained smear
3. CPandy's globulin test
4. DBacterial antigen latex agglutination
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Question 21 · Medium
Why are oxalate and powdered EDTA avoided for synovial fluid sent for crystal examination?
1. AThey destroy the white cells quickly
2. BThey form crystals that mimic true crystals
3. CThey make the fluid clot very rapidly
4. DThey dissolve urate crystals in the sample
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Question 22 · Easy
When a sputum smear flooded with carbol fuchsin is heated in the Ziehl-Neelsen method, it should be heated until:
1. AThe glass turns too hot to touch
2. BThe stain boils vigorously
3. CThe stain dries on the slide
4. DSteam rises, without boiling
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Question 23 · Hard
A 60-year-old woman taking oral ferrous sulphate has black, formed stools. Three guaiac tests are negative, and her haemoglobin has risen steadily over a month of treatment. What best explains the stool colour?
1. AFalsely negative guaiac tests
2. BBleeding from the right colon
3. CBleeding from a gastric ulcer
4. DColouring from the oral iron
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Question 24 · Hard
Paired results: CSF IgG 6 mg/dL, serum IgG 1,000 mg/dL, CSF albumin 30 mg/dL, serum albumin 4,000 mg/dL. Taking 0.70 as the upper reference limit of the IgG index, the index and its meaning are:
1. A0.60, normal: no IgG made in the CNS
2. B0.80, raised: IgG made in the CNS
3. C0.80, normal: no IgG made in the CNS
4. D1.25, raised: IgG made in the CNS
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Question 25 · Hard
CSF from a traumatic tap has a red cell count of 14,000/µL and a white cell count of 30/µL; the blood counts are normal. Allowing 1 white cell for every 700 red cells, the corrected CSF white cell count is:
1. A20/µL
2. B30/µL
3. C10/µL
4. D50/µL
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15 more Semen, CSF, body fluids and stool examination questions

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Semen, CSF, body fluids and stool examination

Which stain does the WHO semen manual recommend for assessing sperm morphology?

A bloody pleural fluid has a haematocrit of 28% while the patient's blood haematocrit is 40%. This result indicates:

Dark green peritoneal fluid obtained at paracentesis most likely contains:

A raised CSF glutamine level is most useful as a pointer to:

Fluid removed from the pleural cavity by needle aspiration is obtained by:

Many undigested meat fibres with clear cross-striations in a stool smear suggest:

Which reagent is used for the bench screening test for fructose in seminal fluid?

In the o-toluidine test for occult blood in stool, which reagent is added along with the chromogen?

For a guaiac card test for faecal occult blood, the patient usually collects samples from:

About how much cerebrospinal fluid is produced each day in a healthy adult?

Semen from a 30-year-old man: total motility 60% (progressive plus non-progressive); eosin-nigrosin vitality 45% live. How should these results be handled?

The Nonne-Apelt test, done by layering CSF with saturated ammonium sulphate, detects a raised level of CSF:

A vaginal swab is sent after a suspected sexual assault. No sperm are seen, and the accused man is known to have had a vasectomy. Which result best shows that seminal fluid is present?

Why is the faecal emulsion boiled before a chemical test for occult blood?

Which food, when eaten raw before a guaiac test, can give a false-positive result through its plant peroxidase?

Which test on CSF is widely used in India as a supporting test for tuberculous meningitis?

Why is trichloroacetic acid often preferred to sulphosalicylic acid alone for turbidimetric estimation of CSF protein?

Blood-stained CSF forms a small clot in the collection tube within an hour. This favours:

Most of the volume of a normal ejaculate is contributed by the:

A child received oral antibiotics for two days before a lumbar puncture. CSF shows many neutrophils, but the Gram stain and culture are negative. Which CSF test can still identify the likely organism?

Why are oxalate and powdered EDTA avoided for synovial fluid sent for crystal examination?

When a sputum smear flooded with carbol fuchsin is heated in the Ziehl-Neelsen method, it should be heated until:

A 60-year-old woman taking oral ferrous sulphate has black, formed stools. Three guaiac tests are negative, and her haemoglobin has risen steadily over a month of treatment. What best explains the stool colour?

Paired results: CSF IgG 6 mg/dL, serum IgG 1,000 mg/dL, CSF albumin 30 mg/dL, serum albumin 4,000 mg/dL. Taking 0.70 as the upper reference limit of the IgG index, the index and its meaning are:

CSF from a traumatic tap has a red cell count of 14,000/µL and a white cell count of 30/µL; the blood counts are normal. Allowing 1 white cell for every 700 red cells, the corrected CSF white cell count is: