ASCP Exam

hemoglobin H disease genotype

--/-a

alpha thalessemia minor genotype

--/aa, -a/-a

Which of the following represents the lower reference limit for semen volume?

1.5 mL or 2.0 mL (2-5 mL)

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 incubation at 35°C. They emitted a butter scotch odor. The lower photomicrograph reveals the gram stain features. The antigen most likely carried by this isolate is:

Group F

If a patient has three inactive alpha globin genes, which of the four alpha (a) thalassemia classifications would he/she have?

Hb H disease

Which specimen type is inoculated to media by using a quantitative isolation method?

Urine specimen

Which of the following may cause a false-positive protein reading on a urinalysis dipstick?

Urine specimen is highly pigmented alkaline urine, high specific gravity

which alpha thalassemia syndrome has the genotype -a/aa?

silent carrier

A negative glucose oxidase test and a positive test for reducing sugars in urine indicates:

presence of a non-glucose reducing sugar such as galactose

A vaginal swab for anaerobic culture is received in the laboratory. How should this specimen be handled?

The specimen should be rejected

What is the lower reference limit for sperm concentration?

15 • 10^6 spermatozoa/mL

The minimum time of retention for microbiology test reports is?

2 years

Sequence-based analysis is an alternate method used to identify bacteria and fungal isolates. This methodology uses rRNA genes (DNA) and their intergenic regions as common target sites to identify these organisms. Which of the following RNA gene target sites is used to identify fungal isolates?

28S rRNA

All of the following urinalysis findings may correlate with the presence of a yeast infection, EXCEPT:

3+ red blood cells

the radioactive method used to measure red cell survival uses which of the following isotopes?

51Cr

Which of the following statements is true about the emergence of penicillin-resistant strains of Streptococcus pneumoniae?

A zone size of = 20 mm with the oxacillin disk screen must be confirmed with an MIC method to determine if Penicillin is susceptible or resistant

Fifty percent blasts are found on a peripheral blood smear. The cells are large (3-5x the size of a lymphocyte) with a nucleus that contains homogeneous fine chromatin and two to three nucleoli. There is moderate blue-grey cytoplasm with Auer rods. What leukemia is most likely?

Acute myelogenous leukemia (AML)

All of the following viruses have RNA as their nucleic acid content, EXCEPT:

Adenovirus

A balloon-like bulge filled with blood formed due to a weakness in the wall of a blood vessel is known as:

Aneurysm

Which of the following arthropods are an important part of the life cycle of Plasmodium species?

Anopheles

a laboratory test to determine heparin levels in a patient's plasma is?

Anti-factor Xa assay

An increased reticulocyte count MAY be found in all of the following conditions, EXCEPT?

Aplastic anemia

What is the MOST likely explanation for a patient with sickle cell anemia whose hemoglobin has dropped to 4 g/dl and has a reticulocyte count of 0.1%?

Aplastic crisis

Based on the structures observed in this microscopic image, the most probable identity of the fungus recovered from an induced sputum specimen is:

Aspergillus species

What organism matches the tissue morphological features of separate hyphae, 5-10 um in diameter that exhibit dichotomous branching

Aspergillus species

Detection of a fruity odor in a fresh urine sample may be indicative of all of the following EXCEPT:

Bacterial infection

Toxic granulation is seen most frequently in:

Bacterial infections

Where is the main site of action for monocytes after diapedesis?

Body tissues

Which Brucella species has positive H,S production and may or may not need CO2 for growth?

Brucella abortus

Of the Gram-negative bacilli listed below, which is motile with polar tufts of flagella and can produce yellow

Burkholderia cepacia

which condition can be associated with macrocytes and large ovalocytes?

megaloblastic anemia

manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 99 and 164 respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the technologist report as the white cell count?

Cannot report

Which ethnic group has the highest incidence of hereditary hemochromatosis in the United States?

Caucasians

You are evaluating a potentially malignant effusion (e.g. peritoneal or pleural fluid) and you note cells that appear to be some type of tumor cells. How would you follow up/report this?

Consult a pathologist and confirm that the specimen has been sent to cytology for analysis

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 decreased serum iron levels seen in anemia of chronic disease (also referred to as anemia of chronic infection or inflammation) is caused by which of the following?

Decreased iron released from macrophages

Abnormal platelet function seen in patients with Bernard-Soulier Syndrome is caused by which of the following platelet components?

Defective glycoprotein Ib/IX

Which of the following may result in a platelet count of 230.0 X 10°/L with a bleeding time of 15 minutes.

Defective platelet function

Which of the following represent other hemoglobin gene loci that occur on the same chromosome As the beta chain loci?

Delta and gamma

The nitrite portion of the test strip can be used to do all of the following EXCEPT:

Detect metabolic bye-products often seen in diabetic patients

All of the following tests are useful in the diagnosis of heparin induced thrombocytopenia (HIT) EXCEPT:

Dilute partial thromboplastin time (DTT)

Which of the following parasites is known to contain cytoplasmic ingested red blood cells in the trophozoite morphologic form?

E. Histolytica and E. Gingivalis

Which organism will cause amebiasis and is considered pathogenic?

Entamoeba histolytica

All of the cells listed below function as a phagocyte, EXCEPT?

Eosinophils

Which of the following assays is commonly used to confirm the diagnosis of Activated Protein C resistance?

Factor V Leiden Mutation Assay

All of the following disorders would affect the results of a Prothrombin time (PT) EXCEPT?

Factor VIII deficiency

Which of the following factors is known as Hageman factor?

Factor XII X =Stuart factor V = proaccelerin VII = proconvertin or stable factor

Which of the following processes does NOT occur during primary hemostasis?

Fibrin strands added to the newly formed clot

As one of the morphological families of parasites, a feature that characterizes various Nematode species Is:

Filariform larvae may serve as an infective form for humans.

What is the purpose of the iodine that is used in the Gram stain procedure?

Fixes the crystal violet to the cellular components of gram-positive bacteria.

All of the following information should be included in a direct microscopic examination of a Gram stained culture smear report EXCEPT:

Flattened cells

All of the following are standard methods for measuring the specific gravity of urine, EXCEPT:

Freezing point depression

All of the following tests are part of the routine semen analysis, EXCEPT:

Fructose level

Nocardia farcinica has been distinguished from other embers of the Nocardia asteroides complex because most strains are resistant to several extended spectrum antimicrobial agents and other antibiotics commonly used to treat nocardia infections, and are more commonly recovered from patients with severe underlying illness. Each of these characteristics are helpful in the identification of N. farcinica EXCEPT:

Gelatin hydrolysis

Which white blood cell population would have the MOST side scatter when analyzed using flow cytometry?

Granulocytes

Indentification

Group A Strep : bacitracin sensitive Group B strep : CAMP pos Strep pneumoniae : optochin sensitive Enterococci from other strep: hydrolysis of bile esculin

A peripheral smear demonstrates a population of cells composed of red cells that are mostly 5 - 5.5 um in diameter. The CBC data shows RDW of 13% (reference range 11.5-14.5%). Which of the following morphologies is consistent with these findings?

Microcytosis, low variation of cell volume

The INR (international normalized ratio) is calculated using the following formula:

INR=(PT patient / PT normal) raised to the ISI.

A 2-year-old girl, who had been treated with upper respiratory tract infection a few weeks ago, showed multiple bruises and had the following laboratory Findings: Hgb=13.5 g/dL RBC= 3.9•10^12/L WBC=8.0 • 10^9/L Platelets= 5•10^9/L Bone Marrow M:E ratio= 3:1 megakaryocytes= increased these results are most suggestive of which condition?

Immune (idiopathic) thrombocytopenic purpura

What is a common early laboratory marker of hereditary hemochromatosis (HH)?

Increased serum ferritin

Enterobius vermicularis infection is acquired by:

Ingestion or inhalation of egg

Streptococcus pneumoniae can be isolated from peritoneal fluid and identified by molecular testing. One method of testing used to identify Streptococcus pneumoniae is molecular hybridization. All of the following steps must be followed to ensure that false positive results do not occur when testing for Streptococcus pneumoniae EXCEPT?

Inhibitors must be removed

Why is hereditary hemochromatosis (HH) thought to be underdiagnosed?

Its early symptoms are nonspecific and vague, and generally do not get serious until later in life.

The suspicious form in this photograph was recovered from a bone marrow sample and measures 11 um in length. What is the MOST likely identification of this organism?

Leishmania promastigote

All of the following white blood cells would produce a positive leukocyte esterase test, EXCEPT?

Lymphocytes

Leucine crystals in urine

Maple syrup urine disease

Which of the following is a valid reason for evaluating red cell morphology as part of the differential procedure?

May provide diagnostic information to the physician.

Each of the cells below can be found in all types of body fluids EXCEPT:

Mesothelial cells

An example of a neoplastic proliferative disease of the plasma cells is:

Multiple myeloma (also known as plasma cell myeloma)

All of the following Mycobacterium species will cause tuberculosis, EXCEPT?

Mycobacterium leprae

All of the following represent an area in clinical microbiology using molecular detection methods a routine diagnostic tool, EXCEPT?

Mycology testing

The mutational status of Janus kinase 2 (JAK2) is most commonly used for the diagnosis Of which of the following?

Myeloproliferative neoplasms

What type of lymphocyte appears as a large cell with abundant cytoplasm and a few azurophilic granules?

Natural killer lymphocytes

MCV normal range: 80-100fl MCH normal range: 27-31pg MCHC normal range: 32-36%

Normal ranges

illustrated in the image to the right is a tube of tryptophane agar with a positive indole reaction, as seen by the red ring top of the medium. It is necessary to use xylene extraction and Ehrlich's reagent rather than the conventional Kovac's when detecting indole production by which of the following organisms:

O Chryseobacterium (Flavobacterium) meningosepticum

Enterococcus faecium is:

Often vancomycin resistant

A few dark blue staining granular inclusions located near the periphery of an erythrocyte are most likely:

Pappenheimer bodies

Degenerated erythrocyte cytoplasmic organelles that contain iron are called:

Pappenheimer bodies

Which of the following red cell inclusions are often found in peripheral blood smears of patients with sideroblastic anemia?

Pappenheimer bodies

The adult fluke related to the 100 um ovum, as illustrated in the image shown, most commonly inhabits the lung parenchyma. The ovum, as may be observed in a sputum specimen, has a smooth, slightly thickened shell with a prominent shouldered operculum as seen at the left lower end. A developing larvae is observed within, retracting from the inner marginof the shell leaving a clear space. Infections with this fluke are endemic in the orient, in West Africa, in South and Central America and may be observed in patients elsewhere after travel to one of these regions. Humans become infected after ingestion of poorly cooked crab meat or crayfish contaminated with metacercariae. Intermittent chest pain, and cough with occasional spitting up of blood (hemoptysis) may be experienced after infection. From the choices below, select the trematode species related to this ovum.

Parogonimus westermani

Which of the following is a clinical symptom that is associated with thrombocytopenia?

Petechiae

The cells which release von Willebrand's Factor (vWF) are:

Platelets and endothelial cells

A patient has a hypercellular bone marrow and is suspected of having a myeloproliferative disorder. Laboratory features include: excess megakaryocyte proliferation and atypia, marked marrow fibrosis, and the JAK2 mutation. The most likely diagnosis is:

Primary Myelofibrosis (PMF)

Which potent inhibitor of platelet aggregation is released by endothelial cells?

Prostacyclin

All of the following methods are used in the diagnosis and classification of acute leukemia, EXCEPT?

Reticulocyte count

In the hookworm life cycle, which of the following is considered the noninfective larval form?:

Rhabditiform

Ristocetin is used in certain von Willebrand Factor (VWF) functional assays. The reason it is used is because:

Ristocetin enhances binding of vWF to platelet GPIb.

An acid-fast bacillus is isolated and produces an orange pigment when grown in either the light or the dark. Which type of organism has most likely been isolated?

Scotochromogen

Which of the following is an important technique consideration in order to obtain consistently high quality bone marrow smears?

Select or concentrate bone marrow spicules, ensuring they are transferred to the slide.

A peripheral blood smear with many myeloid cells was presented for morphology review (see image on the right). Toxic granulation and vacuoles in the neutrophil most likely represent which of the following conditions?

Septicemia

All of the following information should be included in a direct microscopic examination of a Gram stained culture smear report EXCEPT:

Size of bacteria

Methylene blue stain works by:

Staining cellular components that have an acidic pH such as ribosomes, DNA, and RNA

This image shows a gram-positive, catalase negative coccus on sheep blood agar (beta- hemolytic). Please note the reactions with bacitracin (A) and trimethoprim sulfamethoxazole (SXT) disks seen on the right side of the agar plate. On the left side of the agar, a beta lysin-producing Staphylococcus aureus is streaked perpendicular to the unknown organism. What is the presumptive identification of this organism?

Streptococcus pyogenes

Fluids

Synovial fluid: joint cavities pleural fluid: lungs peritoneal fluid: abdominal cavity amniotic fluid: embryo or fetus

What specimen type should be gently minced before inoculating fungal media?

Tissue

Complaints of pain from a patient with sickle cell disease are most likely associated with which of the following conditions/events?

Vaso-occlusive crisis

All of the following can cause erroneously decreased automated platelet counts EXCEPT?

WBC fragmentation

In a patient with acute glomerulonephritis you would expect to find all of the following in the urine EXCEPT:

Yeast

What bacteria is responsible for the bubonic plaque?

Yersinia pestis

a small child has albino characteristics, photophobia, frequent pyogenic infection, and her blood smear shows giant dark granules in her monocytes and granulocytes. what is the diagnosis?

chediak hegashi syndrome pelger heut is associated with bi-lobed neutrophil alder rielly is associated with genetic mucopoly saccharidoses