12 - MISC FLUIDS

Question 1

What tracheobronchial secretions contain plasma + electrolytes + mucin + water + exfoliated cells?

Answer 1

Sputum

Question 2

What is preferred sputum collection method for routine testing?

Answer 2

First morning specimen

Question 3

What sputum collection methods for pediatric + non-cooperative + debilitated patients?

Answer 3

Throat swab + sputum induction + tracheal aspiration

Question 4

What conditions cause increased sputum volume?

Answer 4

Bronchiectasis + lung abscess + edema + gangrene + TB + pulmonary hemorrhage

Question 5

What conditions cause decreased sputum volume?

Answer 5

Bronchial asthma + acute bronchitis + early pneumonia

Question 6

What sputum odors indicate lung gangrene + advanced tumors?

Answer 6

Foul or putrid odor

Question 7

What sputum odors indicate bronchiectasis + tuberculosis?

Answer 7

Sweetish odor

Question 8

What sputum odors indicate necrosis + tumors + emphysema?

Answer 8

Cheesy odor

Question 9

What sputum odors indicate liver abscess + enteric gram-negative infection?

Answer 9

Fecal odor

Question 10

What describes mucoid sputum that is colorless + translucent?

Answer 10

Made up of mucus only

Question 11

What describes serous or frothy sputum?

Answer 11

Asthma + bronchitis + lung edema

Question 12

What describes mucopurulent sputum?

Answer 12

Pus + epithelial cells present

Question 13

What are Dittrich’s plugs composed of?

Answer 13

Pus + epithelial cells

Question 14

What causes bright green sputum?

Answer 14

Pseudomonas aeruginosa + bile presence

Question 15

What causes red or bright red sputum?

Answer 15

Fresh blood + hemorrhage + TB + bronchiectasis

Question 16

What causes rusty brown + anchovy sauce + prune juice sputum?

Answer 16

Old blood + pneumonia + gangrene

Question 17

What causes olive green or grass green sputum?

Answer 17

Cancer

Question 18

What causes black sputum?

Answer 18

Dust inhalation + carbon + charcoal + anthracosis + heavy smokers

Question 19

What are bronchial casts?

Answer 19

Branching tree-like whitish or yellow casts

Question 20

What are lung stones or pneumoliths?

Answer 20

Pinhead or navy bean size calcified TB tissue + foul odor when crushed

Question 21

What are Curschmann’s spirals?

Answer 21

Whitish yellow wavy coiled threads associated with bronchial asthma

Question 22

What sputum shows layer formation with frothy top + pus bottom?

Answer 22

Layered sputum

Question 23

What are elastic fibers in sputum?

Answer 23

Slender fibrils with double contour + curled ends in abscess + gangrene + TB

Question 24

What are Charcot-Leyden crystals?

Answer 24

Colorless hexagonal double pyramid from eosinophil degeneration + asthma

Question 25

What are heart failure cells?

Answer 25

Hemosiderin-laden macrophages

Question 26

What are carbon-laden cells?

Answer 26

Angular black granules

Question 27

What are Creola bodies?

Answer 27

Clusters of columnar cells associated with bronchial asthma

Question 28

What are myelin globules?

Answer 28

Colorless round + oval + pea-shaped little clinical significance

Question 29

What yeasts seen in sputum during antibiotic treatment?

Answer 29

Candida albicans + Cryptococcus neoformans + systemic fungi

Question 30

What common parasites found in sputum?

Answer 30

Ascaris + hookworm + threadworm + E. histolytica + Paragonimus westermani

Question 31

What other stained elements seen in sputum?

Answer 31

Neoplastic cells + bacteria + leukocytes

Question 32

What does BAL evaluate in immunocompromised + interstitial lung disease?

Answer 32

Lower respiratory cellular + microbiological info

Question 33

What is BAL most important diagnostic test for?

Answer 33

Pneumocystis carinii pneumonia

Question 34

What normal BAL macrophages percentage range?

Answer 34

56-80%

Question 35

What normal BAL lymphocytes percentage range?

Answer 35

1-15%

Question 36

What normal BAL neutrophils percentage?

Answer 36

<3%

Question 37

What normal BAL eosinophils percentage?

Answer 37

<1-2%

Question 38

What normal BAL ciliated columnar epithelial cells percentage?

Answer 38

4-17%

Question 39

What viral inclusions seen in respiratory specimens?

Answer 39

Influenza A + B + RSV + Toxoplasma gondii + Legionella pneumophila + Histoplasma capsulatum

Question 40

What sweat test using Gibson-Cooke pilocarpine iontophoresis shows chloride >70 mEq/L?

Answer 40

Cystic fibrosis

Question 41

What cystic fibrosis genetic defect causes pancreatic insufficiency + respiratory distress?

Answer 41

Chloride channel defect

Question 42

What stomach cells produce HCl + intrinsic factor for vitamin B12 absorption?

Answer 42

Parietal cells

Question 43

What stomach cells produce pepsinogen converted to pepsin by HCl?

Answer 43

Chief cells

Question 44

What stomach cells produce gastrin that stimulates parietal cells?

Answer 44

G cells

Question 45

What normal gastric fasting residual volume + pH range?

Answer 45

20-100 mL + pH <2

Question 46

What normal gastric basal acid output (BAO) + maximum acid output (MAO)?

Answer 46

0-6 mmol/hr + 5-40 mmol/hr

Question 47

What gastric Levin tube inserted through + Rehfuss tube through?

Answer 47

Nose + mouth

Question 48

What describes normal fasting gastric specimen appearance?

Answer 48

Pale gray + mucus + no food particles

Question 49

What gastric analysis collects 1 hour no stimulant after 12 hour fast?

Answer 49

Basal acid output (BAO)

Question 50

What gastric analysis collects 1 hour with gastric stimulant?

Answer 50

Maximum acid output (MAO)

Question 51

What gastric test meals include Ewald's bread + water + Boas oatmeal?

Answer 51

Test meals

Question 52

What single most preferred gastric stimulant chemically resembles gastrin?

Answer 52

Pentagastrin

Question 53

What gastric stimulant injection assesses vagotomy procedure success?

Answer 53

Insulin

Question 54

What tubeless gastric test swallows azure blue resin after caffeine?

Answer 54

Diagnex Blue test

Question 55

What Diagnex Blue test stimulant releases azure blue dye?

Answer 55

Caffeine

Question 56

What color in urine confirms free HCl present in Diagnex Blue test?

Answer 56

Azure blue

Question 57

What gastric condition shows normal free HCl secretion?

Answer 57

Euchlorhydria

Question 58

What gastric condition shows increased free HCl secretion?

Answer 58

Hyperchlorhydria (peptic ulcer)

Question 59

What gastric condition has pH >3.5 that falls after stimulation?

Answer 59

Hypochlorhydria

Question 60

What gastric condition has pH >3.5 that stays high after stimulation?

Answer 60

Achlorhydria (pernicious anemia)

Question 61

What syndrome shows highest BAO/MAO ratio + elevated gastrin?

Answer 61

Zollinger-Ellison syndrome

Question 62

What Topfer's method titrates free HCl using what pH indicator?

Answer 62

Dimethylaminoazobenzol (cherry red)

Question 63

What total gastric acidity endpoint using phenolphthalein?

Answer 63

Faint pink (50-75 degrees)

Question 64

What combined HCl titration uses sodium alizarin indicator?

Answer 64

Violet endpoint (10-15 degrees)

Question 65

What Gunzberg's reagent tests free HCl turning what color?

Answer 65

Phloroglucin + vanillin = purple red

Question 66

What Boas reagent tests free HCl using resorcinol + sugar?

Answer 66

Purple red color

Question 67

What Modified Uffelman's lactic acid test reagent combination turns yellow?

Answer 67

FeCl3 + phenol

Question 68

What Strauss test for gastric lactic acid uses FeCl3 + what solvent?

Answer 68

Ether

Question 69

What Kelling's test detects lactic acid using only?

Answer 69

FeCl3

Question 70

What common endpoint color indicates positive lactic acid in all three tests?

Answer 70

Yellow

Question 71

What three FeCl3-based tests detect lactic acid in gastric analysis?

Answer 71

Uffelman's + Strauss + Kelling's