BOC Practice 1
Calcium-alginate swabs on wire shaft
Direct detection methods are available for Bordetella pertussis from nasopharyngeal specimens; however, caution should be used when collecting the specimen because inhibition can occur based on the type of swab that is used. Which of the following swabs have an inhibitory effect on PCR testing for Bordetella pertussis? Level-5 Microbiology
169 mg/dL
The formula for conversion of hemoglobin A1C (HbA1C) to glucose in mg/dL is eAG = (28.7 x A1C) - 46.7. The HbA1C measured on a patient is reported as 7.5%. What would be reported as the estimated average glucose (eAG) for this % A1C (rounded to the nearest whole number)? Level-2 Chemistry
Leukemia with CNS involvement
The image is a Wright-Giemsa stained smear (1000x) of cerebrospinal fluid (CSF). The arrows point to cells that may indicate which of the following conditions? Level-3 Hematology
Sepedonium
The image is a high power image of a methylene-blue stained mount prepared from the surfaces of the colony. Select the fungus genus from the multiple choices as listed. Level-8 Microbiology
Dohle bodies
The light blue-gray inclusions observed in the cytoplasm of many of the bands and segmented neutrophils of a burn patient are most likely? Level-4 Hematology
A defective X-linked recessive gene.
The most common forms of hereditary sideroblastic anemia (SA) are due to which of the following? Level-5 Hematology
Helicobacter pylori
The organism seen in the image is found in the stomach mucosa and presumptive identification is often obtained from a positive urease test. Select the organism below. Level-3 Microbiology
Red to brown
The oxidation of hemoglobin to methemoglobin in an acidic urine after several hours may cause which of the following color to produce? Level-3 Urinalysis/Body Fluids
Viral meningitis
The predominant cells seen in this CSF are from a twelve-year-old female exhibiting fever, lethargy and a stiff neck. The WBC count on the sample was 2,000/microliter. The findings most likely indicate: Level-3 Hematology
Bronchitis
The recovery of Mycoplasma hominis from the genital tract of females has been associated with all of the following clinical syndromes EXCEPT: Level-3 Microbiology
Corynebacterium diphtheriae
The serum medium and methylene blue stain originally described by Loeffler are both helpful in the identification of: Level-5 Microbiology
Vanillylmandellic acid (VMA)
The ultimate end product of both epinephrine and norepinephrine metabolism is: Level-5 Chemistry
Clozapine
Tricyclic Antidepressants (TCAs) are used to treat insomnia, depression, extreme apathy, and loss of libido. All of the following are TCAs, EXCEPT? Level-5 Chemistry
Clotting, plug formation, release of serotonin, and repair of the injured tissues.
What are function(s) of the platelet? Level-4 Hematology
Decrease in both
What changes in potassium and sodium serum results may occur with diuretic use? Level-6 Chemistry
The study of human capabilities in relation to work demands
What is ergonomics? Level-4 Lab Operation
Detect antibodies in recipient serum/plasma that react with donor red blood cells.
What is the fundamental purpose of the full, pre-transfusion crossmatch? Level-4 Blood Bank
Fetal cells present in the mother's blood smear contain fetal hemoglobin (Hgb F). When treated with acid the fetal cells are resistant and will stain pink with the counter stain.
What is the principle of the Kleihauer-Betke test? Level-2 Blood Bank
Detect small urinary concentrations of albumin before there is irreparable renal damage.
What is the role of albuminuria testing? Level-4 Chemistry
RBC cast
What type of cast is shown in the illustration? Level-4 Urinalysis/Body Fluids
Decreased serum copper
When evaluating a patient for a suspected Wilson's Disease diagnosis, low values of plasma ceruloplasmin would be expected along with: Level-5 Chemistry
Washing prevents neutralization of the anti-human globulin (AHG) serum.
When performing an anti-human globulin (AHG) test, it is important to completely wash the red cells because: Level-6 Blood Bank
Candida albicans
The formation of germ tubes after 2 hours of incubation in plasma at 35° C leads to the presumptive identification of which of the following yeasts? Level-2 Microbiology
Beta hemolytic Streptococcus, Group A
A beta-hemolytic Streptococcus was isolated from a throat culture. It gave the following biochemical reactions: Bacitracin -Susceptible Bile esculin -Negative 6.5% NaCl -No growth CAMP -Negative SXT -Resistant What is the presumptive identification? Level-4 Microbiology
Vitamin K
A deficiency in which of these vitamins leads to increased clotting time and may result in hemorrhagic disease? Level-2 Chemistry
Passive anti-D from RhIG given at 28 weeks.
A maternal sample is collected 2 hours after delivery and a type and screen is performed. The screen is weakly positive and an anti-D is identified. Which of the following is the most likely cause of the positive antibody screen? Level-5 Blood Bank
Fya-; Fyb+; C-c+; K+k-
A patient has a probable anti-Fya; however, anti-c and anti-K have not been excluded. Which of the following cells would be the most useful cell to exclude both anti-c and anti-K efficiently in this patient? Level-5 Blood Bank
281 mosmol/kg
A patient has the following serum results: Na = 130 mEq/LK = 4.9 mEq/LCl = 107 mEq/LGlucose = 300 mg/dLBUN = 18 mg/dLCreatinine = 1.1 mg/dL Which osmolality result is consistent with these results?. Level-6 Chemistry
Macrophages with purple/black inclusions
A patient presents to his family doctor with respiratory issues. He has a history of being a heavy smoker for more than 20 years, so the physician orders a BAL cell count with differential. Which of the following cells would most closely correlate with the patient's medical history? Level-5 Urinalysis/Body Fluids
Leukoreduced
A patient with a documented history of febrile nonhemolytic transfusion reactions (FNHTRs) should receive __________ blood components. Level-4 Blood Bank
Dietary iron deficiency
A two-year old male patient has the following hemogram results: Hgb = 6.7g/dLHct = 20%Platelets = 355 x 109/LRBC = 3.0 x1012/LWBC = 8.75 x 109/L Level-7 Hematology
Trichomonas vaginalis
A women presents to her physician with complaint of a foul smelling vaginal discharge. The following are reported from the submitted sample of the yellow vaginal secretion: Wet prep: Many WBCs seen, no Clue cells seen, microorganism (20µm) seen with jerky motility Level-3 Microbiology
Oxidase
A wound specimen was received into the laboratory and a large Gram positive rod was isolated. The microbiologist suspected the isolate was a probable Bacillus anthracis and had to rule in/out before reporting. All of the following tests must be performed before calling the species Bacillus anthracis EXCEPT? Level-5 Microbiology
Chediak-Higashi syndrome
Abnormal granulation can be seen in the cytoplasm of leukocytes in which of the following conditions? Level-3 Hematology
Monocyte
After briefly circulating in the peripheral blood, which of the following cells becomes a tissue macrophage (or histiocyte) whose main function is phagocytosis? Level-3 Hematology
Anti-Lua
All of the following are possible causes of the positive antibody screen EXCEPT? Level-5 Blood Bank
Fy(a-b-)
All of the following red blood cell phenotypes will react with Anti-Fy3, EXCEPT? Level-3 Blood Bank
They are never seen on normal peripheral blood smears
All of the following statements are correct regarding polychromatophilic red blood cells EXCEPT? Level-5 Hematology
Dilute partial thromboplastin time (DTT)
All of the following tests are useful in the diagnosis of heparin induced thrombocytopenia (HIT) EXCEPT: Level-5 Hematology
Nephrotoxicity and ototoxicity
Aminoglycosides can cause severe toxicity including which of the following? Level-5 Chemistry
K negative; Fya negative
An 82-year-old male is a long-time resident of a local nursing facility. He has been to your hospital multiple times over the years and has historically demonstrated antibodies against the K and Fya antigens. He has returned to your hospital following a 2-year absence, and his antibody screen is as follows. Which of the following red blood cells would you crossmatch for this patient? Level-2 Blood Bank
Magnesium
An important metallic activator of alkaline phosphatase and creatine kinase is: Level-5 Chemistry
Green in both tubes with a little blue at the top of the open tube
Asaccharolytic use of glucose would be indicated by which of the following reactions in OF glucose tubes? Level-6 Microbiology
Anti-K
Based on the phenotype of the RBC screening cells, and patient results given below, Anti-Jka and what additional antibody cannot be ruled out? Level-6 Blood Bank
Congenital B-cell disorder
Bruton's agammaglobulinemia is a: Level-5 Immunology
Actinomyces israeli
Coming from a deep penetrating splinter wound. The colonies on this young culture are small, rough, gray-white, and non-hemolytic. Older larger colonies became sunken centrally having a "molar tooth" appearance. The Gram stain reveals gram-positive branching filaments. Key biochemical reactions include hydrolysis of Esculin, nitrate reduction, and negative catalase Level-4 Microbiology
Vitamin B12 deficiency
Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include Folate deficiency and which other condition? Level-3 Hematology
Kidney, bone, intestines, liver
Isoenzymes of alkaline phosphatase occur in: Level-5 Chemistry
Duschenne muscular dystrophy or cerebrovascular accident (stroke) or vigorous exercise.
Elevation of serum creatine kinase may be associated with: Level-3 Chemistry
Breast cancer
Estrogen (ERs) and progesterone (PRs) receptors used as tumor markers are most commonly employed to provide prognostic information about: Level-5 Chemistry
Ketones
Excessive carbohydrate loss that may occur due to vomiting, or rapid weight loss may result in the presence of which of following substances not normally contained in the urine? Level-2 Urinalysis/Body Fluids
20g
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) Level-4 Chemistry
3 SD
How many standard deviations (SD) above and below the mean is accepted as being an appropriate control limit range on a control chart utilizing the Westgard rules: Level-8 Lab Operation
Place it into an ice slurry.
How should an ammonia specimen be transported to prevent alteration of the ammonia level in the blood plasma? Level-1 Chemistry
Lymphocyte
Identify the nucleated blood cell that is indicated by the arrow: Level-1 Hematology
Nucleated red blood cells (NRBCs)
Identify the predominant nucleated cell this cerebrospinal fluid cytospin differential. Level-5 Hematology
The patient may experience toxic effects (high free drug fraction).
If a disease or disorder causes serum binding proteins (such as albumin) to decrease, what may occur if the dose of a highly protein-bound drug with a narrow therapeutic window is not adjusted? Level-4 Chemistry
Waldenström's disease
Immunoglobulin M (IgM) is the characteristically overproduced gene product found in: Level-5 Immunology
8
In heme synthesis, how many molecules of delta-aminolevulinic acid (ALA) are needed to form one molecule of heme? Level-5 Chemistry
Anti-Jkb
In providing crossmatch-compatible blood units, all of the following antibodies are most often clinically insignificant EXCEPT: Level-5 Blood Bank
Trichinella spiralis
Microscopic examination of peripheral blood may be diagnostic for infection with each of the following parasites EXCEPT: Level-1 Microbiology
Ureter
Name structure B from the image below: Level-2 Urinalysis/Body Fluids
Prevotella
Observation of colonies producing brick red fluorescence under long-wave ultraviolet light on KVLB agar allows for presumptive identification of which anaerobic bacterial genus? Level-9 Microbiology
PBP2a
Oxacillin resistance of MRSA is due to production of which of the following penicillin binding proteins (PBPs)? Level-4 Microbiology
Proportional to concentration of solute particles
The MOST accurate observation about osmotic pressure is that it is: Level-5 Chemistry
Microsporidium species
The acid-fast is negative with a positive Weber stain (Chromotrope 2R. Fast Green, phosphotungistic acid) confirming an identification. From the list of multiple choices, select the most probable presumptive identification. Level-5 Microbiology
Lowering the zeta potential
The addition of Low Ionic Strength Solution (LISS) to the testing environment when performing an indirect antiglobulin test is designed to do what? Level-5 Blood Bank
Cold agglutinin disorders
The arrangement of erythrocytes on this peripheral blood smear may be seen in each of the following conditions EXCEPT? Level-5 Hematology
Small lymphocyte
The cell diameter of a normal RBC is slightly smaller than the nucleus of which of the following blood cells? Level-2 Hematology
Dubin-Johnson syndrome
Which condition is caused by deficient secretion of bilirubin into the bile canaliculi? Level-6 Chemistry
Amphetamine
Which medication would be prescribed for narcolepsy? Level-5 Chemistry
Incompatible blood is transfused into a patient during surgery
Which occurrence is a medical error? Level-1 Blood Bank
AST
Which of the following analytes would be increased due to delay in centrifugation? Level-1 Chemistry
Kell
Which of the following antigens are well developed on fetal cells? Level-7 Blood Bank
Antithyroid peroxidase (TPO)
Which of the following autoantibodies would be usually found in a patient with Hashimoto's thyroiditis? Level-5 Immunology
Touch preparations
Which of the following bone marrow processing procedures is best suited for a patient who had a dry tap? Level-5 Hematology
Lymphocytes
Which of the following cells are capable of producing antibodies? Level-3 Blood Bank
8 to 32
Which of the following changes in titers would be considered significant when monitoring maternal antibodies using a doubling dilution? Level-4 Blood Bank
Antibody will react equally with labeled and unlabeled antigen
Which of the following choices is correct when describing the principles of competitive radioimmunoassay procedures? Level-5 Chemistry
Thrombotic thrombocytopenic purpura (TTP)
Which of the following conditions is characterized by small clots made up of platelets and large forms of von Willebrand factor? Level-5 Hematology
Sodium
Which of the following contributes most to serum osmolality: Level-4 Chemistry
Stimulates gastric acid-HCl secretion
Which of the following describes gastrin's role in digestion? Level-5 Chemistry
BACTEC
Which of the following instrument-based systems are considered a continuous monitoring system? Level-5 Microbiology
Frame C- primary myelofibrosis
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. Level-8 Hematology
Overtime pay
Which of the following is considered to be a variable cost in the clinical laboratory? Level-5 Lab Operation
Amastigote
Which of the following is the first stage in the life cycle of a hemoflagellate? Level-9 Microbiology
Immunoassay
Which of the following is the most common technique that is used by clinical laboratories for therapeutic drug monitoring? Level-4 Chemistry
Prolonged PT and aPTT
Which of the following laboratory results would you find with disseminated intravascular coagulation (DIC) but NOT with thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome (HUS)? Level-6 Hematology
Dark-field microscopy
Which of the following microscopic techniques is best suited for direct examination of the infectious agent of syphilis? Level-4 Immunology
Peptostreptococcus anaerobius
Which of the following organisms appear Gram positive when using the Gram Stain? Level-4 Microbiology
Inflammatory cytokines, synthesized and released by adipose tissue, contribute to the development of cardiovascular disease
Which of the following statements is true regarding cardiovascular disease and adipose tissue? Level-3 Chemistry
Hemoglobin electrophoresis for the presence of Hb S
Which of the following tests are necessary to confirm the condition suggested by the morphology? Level-3 Hematology
Meat-filled diet
Which of the following will cause an acidic urine pH? Level-5 Lab Operation
Haptoglobin
Which of these blood levels will decrease during intravascular hemolysis? Level-4 Chemistry
Prussian blue stain: Pappenheimer bodies stain blue but Howell-Jolly bodies do not stain blue
Which of these methods could be used to differentiate between Howell-Jolly bodies and Pappenheimer bodies and what results would be noted? Level-4 Hematology
Proto-oncogenes
Which one of the following are normal genes that induce DNA synthesis, promote cell division, and inhibit cell death? Level-5 Immunology
A diastolic blood pressure of 110 mm Hg
Which one of these physical exam results would cause a donor to be deferred? Level-5 Blood Bank
CEA
Which tumor marker is used for colorectal cancer? Level-5 Chemistry
Mycobacterium tuberculosis has a waxy coating on its surface which prevents gram stain penetration.
Why is Mycobacterium tuberculosis not seen on gram stained smears? Level-3 Microbiology
450 mg/dL
You are working in a clinical chemistry laboratory and are analyzing a plasma glucose sample. The sample is flagged by the analyzer for being "outside of linear range." You manually dilute the sample 1:2 and rerun it. Again, you receive an "outside linear range" alert. You decide to perform a different manual dilution. This time you manually dilute the original sample again; this time using a 1:3 dilution. The instrument gives you a glucose value of 150 mg/dL from this diluted sample. What is the actual patient glucose result that you should report to the physician? Level-3 Chemistry
