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Clinical Microscopy Flashcards

6 cards from real ASCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Massive calcium oxalate crystalluria in a patient with high anion gap metabolic acidosis is most concerning for:

    Answer: Ethylene glycol poisoning

    Calcium oxalate crystals in massive amounts, combined with high anion gap metabolic acidosis, high osmol gap, and altered mental status, are characteristic of ethylene glycol (antifreeze) poisoning, where oxalic acid is a toxic metabolite.

  2. Döhle bodies in neutrophils on a peripheral blood smear are most commonly seen in:

    Answer: Severe infections, burns, or toxic states

    Döhle bodies are pale blue, oval cytoplasmic inclusions in neutrophils representing lamellar endoplasmic reticulum (aggregated ribosomes or rough ER). They indicate toxic neutrophil changes in severe infections, burns, surgery, pregnancy, or drug toxicity.

  3. Which finding on urine microscopy is pathognomonic (diagnostic) of glomerulonephritis?

    Answer: Red blood cell casts

    Red blood cell (RBC) casts are pathognomonic (diagnostic) of glomerulonephritis. They form when RBCs become trapped in the Tamm-Horsfall protein matrix within glomerular capillary loops or tubules, indicating glomerular bleeding.

  4. On a stained bone marrow aspirate, a plasma cell is identified by which morphological features?

    Answer: Eccentric nucleus with clock-face chromatin and basophilic cytoplasm with perinuclear hof (clearing)

    Plasma cells have an eccentric round nucleus with coarsely clumped chromatin in a clock-face or cartwheel pattern, deeply basophilic cytoplasm (rich in rough ER for immunoglobulin synthesis), and a clear perinuclear hof (Golgi zone).

  5. Trichomonas vaginalis on a wet prep (saline mount) is identified by:

    Answer: Motile, pear-shaped flagellated organisms with jerky tumbling motility

    Trichomonas vaginalis is a flagellated protozoan seen as a motile, pear-shaped (pyriform) organism on wet prep. The characteristic tumbling or rocking motility distinguishes it from non-motile artifacts. Flagella (4 anterior plus 1 recurrent) drive the motility.

  6. A CSF sample from a patient with suspected cryptococcal meningitis should have which test performed immediately?

    Answer: India ink preparation and cryptococcal antigen (CrAg) latex agglutination

    India ink is a rapid test where the polysaccharide capsule of Cryptococcus neoformans or gattii excludes ink particles, creating a halo around the organism. Cryptococcal antigen (CrAg) latex agglutination is more sensitive (above 90%) and is the preferred rapid test.