LabCE practice 3
The identification of Neisseria species is most often confirmed by observing the specific carbohydrate utilization profile (glucose/dextrose; maltose; lactose; sucrose; yellow is a positive reaction). Based on the carbohydrate reactions as observed in the image, identify the organism: Image courtesy of the CDC
Neisseria meningitidis
Homogentisic acid in urine will cause urine to be which of the following colors?
Brown/black
Which type of lipoprotein is the least dense?
Chylomicrons
Following a diagnosis of tuberculosis, this physician moved to the Adirondack Mountains where he experienced an improvement in his health. He then opened a medical practice in Saranac Lake and founded the Adirondack Cottage Sanatorium where the standard of care for tuberculosis involved prolonged bed rest. Who is this physician?
Edward L. Trudeau
Which of the following specimen processing techniques is based on the principle that parasites are heavier than sample debris and will be present in the sediment after being processed?
Ethyl acetate concentration
Acute-phase proteins generally fall into which category?
Glycoproteins
Which of the following is a correct pairing of cell type in the image and a disease state associated with that type of cell? All cells are from a Wright stained peripheral blood smear.
Frame C- primary myelofibrosis
A 30-year-old man with chronic persistent hepatitis developed an abscess in the right hepatic lobe. A needle aspiration revealed purulent material. The small colonies shown in the upper photograph were isolated after 36 hours of incubation at 35°C. They emitted a butterscotch odor. The lower photomicrograph reveals the gram stain features. The antigen most likely carried by this isolate is:
Group F
A 21-year-old female developed painful swelling of the left knee along with a low-grade fever. The knee was painful to palpation, an effusion was evident, and the overlying skin was slightly erythematous. Fluid was aspirated and a gram stain was performed (as seen in the images to the right). Based on the Gram stain morphology, which of the following bacterial species is LEAST likely to serve as the etiologic agent in the case described?
Haemophilus influenzae
A variety of additives are used in blood collection tubes. Which of the following additives prevents clotting by inhibiting thrombin and thromboplastin?
Lithium or sodium heparin
Which of the following tests on amniotic fluid would be included when assessing fetal lung maturity:
L/S Ratio
All of the following are causes of hypernatremia EXCEPT:
Low aldosterone production
A 44-year-old female immigrant from Southeast Asia presented to the local clinic complaining of fever, chills, diarrhea, and weakness. Patient history revealed that the woman worked in a research laboratory in her homeland where her primary responsibility was to develop an effective insecticide for the dreaded sandfly. A bone marrow biopsy specimen was submitted to the laboratory for O & P examination. This form, measuring 14 µm, was seen. The patient is most likely suffering from:
Leishmaniasis
What is the process of monoclonal antibody production?
Fusion of antibody specific lymphocyte and myeloma cell
All of the following represent a 2 week temporary deferral from donating blood or blood products EXCEPT:
German measles (rubella) vaccine
To determine if an elevated aPTT is caused by a factor deficiency or a factor inhibitor when the PT is normal, the FIRST step would be:
Mix one part patient plasma and one part normal pooled plasma and repeat the aPTT
Which of the following tests could be used to determine whether an abnormal screening coagulation test result (PT or aPTT) is caused by a factor deficiency or an inhibitor?
Mixing studies
Which of the following is a selective medium for Campylobacter jejuni?
Skirrow agar
All of the following are true of Xanthochromia in cerebrospinal fluid, EXCEPT:
The clear appearance of CSF
Which of the following conditions would argue in favor of therapeutic drug monitoring (TDM) for a given drug?
The drug is given chronically.
Which of the following tests require a 72-hour stool (fecal) collection?
Quantitative fecal fat
Illustrated growing on the surface of the blood agar plate shown in the upper left image are small distinctly beta-hemolytic colonies suggestive of beta-hemolytic streptococci, particularly when specimens are obtained from patients with an upper respiratory infection. Gram-positive bacilli in branching and Chinese letter formations are observed on Gram stain as illustrated in the upper right image. Observe the reverse CAMP reaction in the lower image. From these observations, select the identification of this bacterial isolate.
Arcanobacterium haemolyticum
What is the identification of this organism that measures 12 µm and is found in stool?
Iodamoeba butschlii cyst
What procedure utilizes leukapheresis to collect the buffy coat from whole blood?
Photopheresis
It is essential to recognize the distinction between quality control (QC) limits and QC goals. Which is the true statement regarding these terms?
QC specifications (goals) are the criteria used to decide that a given method meets the clinical requirements.
The kidneys perform all of the following functions EXCEPT:
Reabsorption of waste products
What would be the next step when an EDTA specimen had an automated platelet count of 61,000/mm3 and the platelets were surrounding the neutrophils on the differential?
Recollect a specimen for a platelet count without using EDTA
A tech working in the laboratory receives a phone call from a doctor who is upset that his patient has a negative urine culture. The doctor indicates that the urinalysis result is positive for leukocyte esterase so the culture should be positive. The doctor feels that the urine culture was not properly handled. How can you explain the discrepancy in the urinalysis and culture to the doctor?
The patient could have another infection, such as a sexually transmitted infection (STI)
The nephron includes all of the following except:
Urethra
What would be the best way to determine how much RhIg should be given to a postpartum female who received RhIG antenatally and demonstrates the anti-D antibody at delivery?
Flow cytometry
Myelodysplastic Syndromes are characterized by cytopenias with at least one cell line decreased as well as this:
Dyspoiesis
Which of the following Mycobacterium species is positive for nitrate reduction?
Mycobacterium tuberculosis
Which marker is most useful for the detection of gestational trophoblastic disease?
hCG (human chorionic gonadotropin)
The arrangement of erythrocytes on this peripheral blood smear can be associated with each of the following conditions EXCEPT:
Cold agglutinin disorders
Which one of the following tests BEST correlates with the severity of hemolytic disease of the fetus and newborn (HDFN)?
Color Doppler ultrasonography
How many doses of RhIG should be administered if the calculated amount of fetal whole blood volume in maternal circulation was 28 mL?
2 doses
How many grams of sodium hydroxide are required to prepare a 200 ml solution of a 10% (weight per volume) solution? (Atomic weights: Na = 23; 0 = 16; H = 1)
20g
The normal Myeloid-to-erythroid ratio (M:E ratio) ranges from:
2:1 to 4:1
Which of the following represents the White Blood Cell (WBC) count reference range for adults?
4.4 - 11.0 x 109/L
From the IgG molecule illustration, which region is the heavy chain?
A
Which genotype(s) is/are possible for a mating of an AB mother and an AB father?
AB, AA, and BB
A standard is used to check the __________ of a method or instrument.
Accuracy
Which of the following blood tests is used in the determination of prostate cancer?
Acid phosphatase
Which of the following tests is used to monitor therapy with unfractionated heparin?
Activated partial thromboplastin time (aPTT)
Ion-selective electrodes, for pH determinations, are called selective rather than specific because they actually measure the:
Activity of one ion much more than other ions present
Red blood cells with a positive DAT cannot be tested accurately with blood typing reagents that require an indirect antiglobulin technique unless they have been treated with all of the following (to dissociate IgG from the RBC membrane) EXCEPT:
Albumin
Which of the following enzymes is associated with conditions affecting skeletal muscles?
Aldolase
Pseudomonas aeruginosa was isolated from a sputum specimen. Susceptibility testing was performed and the microbiologist determined that further evaluation was needed before reporting out the susceptibilities. Which of the antibiotic results would indicate a need for further evaluation?
Amikacin resistant, Gentamicin or tobramycin sensitive, Carbapenem-resistant
If detected in antibody screen testing, which of the following antibodies is NOT considered clinically significant in prenatal patients?
Anti-Leb
The following statements are true regarding the Lewis blood group EXCEPT:
Antigens are a structural component of the red cell membrane
All of the following Bacillus species would have a wide zone lecithinase reaction, EXCEPT?
Bacillus subtilis
The parasite presented here was found in a patient's urine and measured 135 µm by 50 µm. The parasite is the causative agent of which disease?
Bilharziasis
Each of the following bacterial species is commonly associated with wound infections following a dog bite except?
Bordetella bronchiseptica
Which of the following genotypes is found with the highest frequency in the Caucasian population?
CDe/ce
Which organism's natural habitat is part of the human microbiota?
Candida spp.
Which of the following consequences of severe hemolytic disease of the fetus and newborn (HDFN) is most associated with neonatal death before or shortly after birth?
Cardiac failure
Which of the following is least likely to interfere with the measurement of hemoglobin?
Cold agglutinin
The measurement of sodium and chloride in the sweat is the most useful test for the diagnosis of what condition/disease?
Cystic fibrosis
Which of the following analytes would be increased due to delay in centrifugation?
Creatinine
Which of the following phrases best describes a segmented neutrophil?
Cytoplasm appears pink-purple due to small specific granules.
A stool from a 2-year-old girl grew clear colonies on MacConkey agar, red colonies on XLD (without black centers), and green colonies on HE (without black centers). It is ornithine positive and indole negative. It should agglutinate in antisera of which serogroup of the somatic O antigen?
D
Which of the following hemoglobins is known to migrate with HbS during electrophoresis when an alkaline gel, such as cellulose acetate, is used?
D
The colonies illustrated on the blood and chocolate agar plates represent a slow-growing bacterial species that is endogenous in the oral cavity and upper respiratory tract. It may be recovered from human bite skin infections incurred during fistfights. Note the pitting of the agar surrounding the colonies growing in the chocolate agar plate. The Alk/Alk non-fermentative reaction seen in the Kligler Iron Agar tube to the left in the lower photograph indicates the non-fermentation of glucose, also indicated by the lack of carbohydrate assimilation in the individual carbohydrate reaction tubes to the right of the KIA tube. A reduction of nitrate is seen and decarboxylation of ornithine is also positive. Based on these observations, select from the multiple choices listed the correct identification of this bacterial isolate:
Eikenella corrodens
Electrophoretic separation of hemoglobin fundamentally relies on:
Electrical charge differences of molecules
Thromboelastography (TEG) is a methodology used to assess blood coagulation. The prothrombin time (PT) and activated partial thromboplastin time (APTT) are more commonly used. All of the following are things that TEG can assess that the PT and APTT cannot assess EXCEPT?
Factor deficiencies
The MOST reliable method for determining the appropriate dosage of Rh immune globulin to give to an identified Rh immune globulin candidate after delivery is:
Flow cytometry
Which of the following best describes the organisms seen in this illustration:
Gram-variable
In which disorder do neonates demonstrate the presence of Bart's hemoglobin that changes to beta chain tetramers in adults?
Hemoglobin H disease
Which situation will cause a positive DAT (direct antiglobulin test) in the newborn?
Hemolytic disease of the fetus and newborn
Which genetic description will NOT contain Bart's hemoglobin at birth ?
Heterozygous alpha thalassemia-2
A known sickle cell trait patient has a hemoglobin electrophoresis test performed. Which of the following hemoglobin percentage sets would most closely match this patient's diagnostic state?
Hgb A = 60%, Hgb S = 38%, Hgb A2 = 2%, Hgb F = 0%
Which test is considered a more reliable method of monitoring long-term diabetes control?
Hgb A1c
Which antibody class is best described with that characteristic that it is the only one capable of residing in mucosal linings?
IgA
What may prevent the detection of lupus anticoagulant in a plasma sample if the blood used for testing is not centrifuged for a sufficient time?
Increased platelets in the plasma sample
Which of the following is the most common technique that is used by clinical laboratories for therapeutic drug monitoring?
Immunoassay
Which of the following tests confirms the presence of Bence-Jones proteinuria:
Immunoelectrophoresis
Which of the following statements is FALSE regarding troponin as a marker of myocardial infarction (MI)?
It rises much sooner after a myocardial infarction than CK-MB.
Which of the following antigens are well developed on fetal cells?
Kell
What is the inside portion of the needle tube called?
Lumen
All of the terms below are a measure of central tendency, EXCEPT:
Molarity
Which of the following might cause a false positive indirect antiglobulin test (IAT)?
Over-centrifugation
All of the following conditions would be associated with an increased level of alpha-fetoprotein, EXCEPT?
Prostate Cancer
Which of the following types of molecules is most likely to be antigenic/immunogenic?
Proteins
A copper reduction method (e.g. Clinitest® or Benedict's) is performed on pediatric specimens in order to check for the presence of:
Reducing substances
Gram positive cocci isolated from a catheterized urine culture on a 76-year-old male gave the following reactions: Blood agar- creamy, white, opaque colonies with are not hemolytic Catalase- positive Slide coagulase- negative Tube coagulase- negative Novobiocin- susceptible The next action that the medical laboratory professional should take is to:
Report the isolate as coagulase negative staphylococcus
Plasma creatinine concentration is dependent on all of the following EXCEPT:
Sodium concentration
Identify the anti-nuclear antibody (ANA) pattern in this microscopic image.
Speckled
The function of the cerebrospinal fluid includes all of the following EXCEPT:
The transmittance of neurologic impulses
Which antinuclear antibody (ANA) pattern is seen in the image on the right, which represents the result of an ANA test viewed using fluorescent microscopy? Note: (a) points to the nuclei of interphase cells, the primary consideration for discerning the ANA pattern and (b) indicates a metaphase mitotic cell.
There is no discernable pattern
Obstruction of a blood vessel caused by a stationary blood clot is called:
Thrombosis
Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet?
Thromboxane A2
What are the 3 main effects of active vitamin D on the body?
To absorb calcium and phosphorus in the intestines, from bone, and in the kidneys
A pleural fluid specimen is received in the laboratory for aerobic culture. The specimen measures about 0.5 mL. How should the tech process this specimen for culture?
Use a sterile pipette and add a drop of fluid per agar plate
The type of hypersensitivity reaction associated with macrophage activation, cytokine-mediated inflammation is:
Type IV Cell mediated hypersensitivity (T-cell dependent)
The gene loci for the alpha-globin chains are adjacent to the locus for which other globin chain?
Zeta
The name of a reaction between a single antigenic determinant and an individual combining site is:
Affinity
Which of the following is a selective media recommended for the isolation of Clostridioides difficile?
Cefoxitin-cycloserine-fructose agar (CCFA)
When evaluating a patient for a suspected Wilson's Disease diagnosis, decreased concentrations of ceruloplasmin would be expected along with:
Decreased serum copper
In immunohematology, an antithetical relationship exists between M antigen and which of these antigens?
N antigen
By utilizing a Prussian Blue stain, which of the following red blood cell inclusions would be identifiable if present? Note: Upper image = Wright-Giemsa stain Lower image = Prussian Blue stain
Pappenheimer (siderotic) bodies
