What should be done in response to a sputum sample that has many epithelial cells in it?

(Answer to Q. 1)  ANS: D
Many epithelial cells indicate that the sample is merely saliva and should be discarded because it will not reflect the type of infection occurring in the lung.

(Answer to Q. 2)  ANS: D
In such cases, the Gram stain will demonstrate few (<25 cells.

(Answer to Q. 3)  ANS: A
The most common tests performed to evaluate kidney function are blood urea nitrogen and cre-atinine.

(Answer to Q. 4)  ANS: C
The most common CPK enzyme test is CPK-2 (CPK-MB) which is released from the heart fol-lowing myocardial infarction. Peak levels occur sometime between 12 and 24 hr following injury. Serial CPK-2 measurements are monitored in patients with suspected myocardial infarction, as well as patients with cardiac contusion from chest trauma, open-heart surgery, or myocarditis.

(Answer to Q. 5)  ANS: D
A blood glucose level above 140 mg/dl on two occasions indicates diabetes is present in most cases.

(Answer to Q. 6)  ANS: A
Prothrombin time (PT) is defined as the time in seconds required by plasma to form a fibrin clot following exposure to tissue factors. Clinically, abnormal increases in PT and PTT are found in patients with vitamin K deficiencies, and patients on anticoagulation therapy such as warfarin or heparin. PT is accompanied by an additional measurement known as the International Standard-ized Ratio (INR). The INR expresses PT relative to an established sample value. A normal INR value is 0.9 to 1.3. INR values of approximately 5.0 indicate a high likelihood for bleeding. Val-ues of 0.5 are associated with a tendency toward increased clotting.

(Answer to Q. 7)  ANS: D
The highest concentrations of AST are found in patients with liver disease, such as hepatitis, and during the second day after a myocardial infarction.

(Answer to Q. 8)  ANS: C
Elevation of the anion gap suggests that a metabolic acidosis is present, and further evaluation of the patient's acid-base status is necessary.