Lab + Diagnostic Test 1 (Based on Class of 2019 Quizlet)

Which of the following is true? A) Children and infants have higher WBC counts than adults B) WBC count is not helpful in evaluating a patient with infection, allergy, or immunosuppression C) WBC count can't be used to determine stages of a disease without additional diagnostic tests

A

All of the following are true EXCEPT: A) preanalytical phase is the least common place for errors to occur B) in analytical phase errors are less common because of high level of automation of instruments C) errors in the postanalytical phase include delay in time to enter a completed result

A) Errors are MOST common in the pre-analytical phase

You run a CBC on your patient and notice that the RDW is increased. This could be indicitative of all diseases EXCEPT A) Thalessemia B) Sickle cell disease C) Hemolytic anemia D) Iron deficiency anemia E) B12 or folate deficiency anemia F) Anisocytosis

A) Thalessemia doesn't cause changes in RDW

You are working in the ER and a patient comes in with a large scalp wound that he states happened about an hour ago and has been bleeding steadily ever since. You manage to get the bleeding under control and determine that he doesn't need a transfusion. What type of anemia would you see if you did a CBC? A) Normocytic normochromic anemia B) Microcytic hypochromic anemia C) Microcytic normochromic anemia D) Macrocytic normochromic anemia

A) The patient will probably have normocytic normochromic anemia from the acute blood loss

All of the following are true about the reference range EXCEPT: A) Reference range depends of the instrument and reagent used to perform the test B) being outside the reference range always reflects the presence of disease C) 5% of healthy individuals fall outside the reference range D) patients with values in the reference range may have subclinical diseases

B - There are 5% that fall outside of the reference range normally that do not have disease

All of the following are true about the thereapeutic range EXCEPT: A) it is used for certain medications to provide a target range B) values outside the therapeutic range are subtherapeutic or toxic C) this may reflect a therapeutic effect produced by a drug instead of an actual level D) all of the above are true

B - Values outside the therapeutic range are POTENTIALLY subtherapeutic or toxic

Which of the following is NOT true about the Absolute Neutrophil Count (ANC)? A) The ANC includes bands B) The ANC has to reach 0 before the patient is at risk for infection C) The ANC is a measure of the proportion of neutrophils and bands in the blood

B) If the ANC is under 1,000 then the patient is at risk for infection

Which of the following is FALSE: A) blood and body fluid precautions should be used for all patients B) If healthcare worker gets a needlestick they must immediately cover it with a band-aid and go about their day C) saliva is considered infectious

B) If you get a needlestick, wash it immediately and report it to Employee Heath/your manager!!

Which of the following is FALSE: A) sensitivity focuses on identifying those with a disease B) specificity focuses on identifying those without a disease C) Positive predictive and negative predictive value are test driven D) Positive predictive value has nothing to do with prevalence of disease

D - Positive predictive value is highly dependent on the prevalence of a disease

Which of the following is FALSE: A) for serious treatable diseases, it's important to maximize sensitivity B) for serious non-treatable diseases, it's important to maximize specificity C) For serious treatable diseases, we want to minimize false positives D) For serious un-treatable diseases, we want to minimize false positives

C - for serious treatable diseases we want to minimize false NEGATIVES (ie we don't want to miss people that we could potentially treat)

Which of the following is NOT true? A) pregnancy can cause decreased RBCs B) Women tend to have less RBCs than men C) intravascular trauma and enlarged spleen may lengthen RBC life span D) dehydration may factitiously increase RBC count E) drugs may increase or decrease RBC count

C) INtravascular trauma and enlarged spleen (hypersplenism) will shorten the RBC lifespan

Which of the following is correct? A) when the MCV is decreased the RBC is hypochromic B) when the MCHC is decreased the RBC is microcytic C) when the MCV is increased the RBC is macrocytic D) when the MCHC is increased the RBC is macrocytic

C) Increased MCV = macrocytic Remember that MVC has to do with size (ie cytic) micro - small, macro - big MCHC has to do with hemoglobin (ie chromic) hypo - too little hyper - too much

Which of the following is FALSE about WBC count? A) drugs may increase or decrease the WBC count B) Pregnancy and labor can increase the WBC count C) patients with a splenectomy have a persistent mild to moderate depression of WBC count

C) Patients with a splenectomy (removal of spleen) will have a presistant mild to moderate ELEVATION of WBC count

Which of the following statements is NOT true about WBC count? A) In sepsis, the WBC count can reach levels similar to leukemia B) A dramatic decrease in WBC count below normal range may indicate marrow failure C) Eating, physical activity, and stress can decrease WBC count D) a WBC count that in continually worsening may indicate worsening of an infectious process

C) Physical activity, eating, and stress can INCREASE the WBC count

You have a patient presenting with fatigue, weakness, and easy bruising. Being the awesome primary care provider that you are, you decide to order a CBC. When the results come back, you notice that the patient's RBC count is higher than normal, which is not what you were expecting. What is next appropriate step? A) Just ignore it B) refer the patient to an oncologist for a possible blood disorder C) Redraw the specimen and retest it D) call the lab and have them re-run the sample they already have

C) Redraw the specimen and retest it

A patient presents to your office after returning from working in the slums of India. He states that he "doesn't feel good" and that he didn't have time to get any vaccines or anti-parasitic medications before he left. What would you expect to see elevated on his CBC with Diff? A) Macrophages B) Monocytes C) Eosinophils D) Lymphocytes

C) The most likely elevation would be eosinophils because this patient probably has a parasite

All of the following is true about factors that effect lab results except: A) you may have different normal ranges for pts of different ages B) muscle mass can affect levels of certain compounds C) blood glucose may differ in capillary samples from venous or arterial blood D) The years of experience of the person taking the sample can affect the lab results

D) As long as you follow proper protocol, years of experience won't have an effect!!

Which of the following would NOT cause leukocytosis? A) Infection B) Trauma or stress C) Removal of spleen D) Bone marrow failure E) B12 or folate deficiency

D) Bone marrow failure would result in leukopenia (less WBCs) instead of leukocytosis (increased WBCs)

Which WBC produces interferon? A) Neutrophils B) Lymphocytes C) Basophils D) Monocytes

D) Monocytes

Which of the following is the most common cause of macrocytic anemia? A) vit B12 deficiency B) iron deficiency C) folic acid deficiency D) A and C

D) Vit B12 and folic acid deficiency

Increased RDW is caused by all of the following except: A) posthemorrhagic anemias B) B12 or folate deficiency anemia C) hemoglobinopathies D) hemolytic anemias E) All of the above can cause increased RDW

E

Lymphocytes fight A) chronic bacterial infections B) acute viral infections C) allergic reactions D) parasitic infections E) A + B

E

Which of the following is true: A) prevalence is the number of existing cases in a pouplation B) incidence is the number of new cases occuring within a period of time C) sore throat has a low prevalence but high incidence D) A and B only E) all of the above

E) All are true

Which of the following can cause leukopenia? A) drug overdose B) bone marrow infiltration C) autoimmune diseases D) hypersplenism E) All of the above

E) All of the above

Which of the following are causes of leukocytosis? A) leukemic neoplasias B) non-marrow malignancies C) hemorrhage D) A and B E) all of the above

E) All of these can cause leukocytosis

You have a patient that has a long history of chronic illness. What type(s) of anemia would you expect to see? A) Normocytic normochromic anemia B) Microcytic hypochromic anemia C) Microcytic normochromic anemia D) Macrocytic normochromic anemia E) A + C

E) Both types of anemia can be found in chronic illness

Which is TRUE about serum vs plasma: A) serum is the blood minus RBCs, WBCs, and platelets B) serum is what is left behind after blood clots C) plasma is blood minus RBCs, WBCs, plateltes, fibrinoben, and prothrombin D) plasma is what's left behind after blood clots

Plasma is blood without WBCs, RBCs, + platelets Serum is blood without WBCs, RBCs, platelets, fibrinogen, and prothrombin (ie what's left behind after the blood clots) B is the correct answer

What signs and symptoms are indications for a CBC? What diseases/conditions is it useful for diagnosing?

Weakness, fatigue, fever, bruising are all good reasons to do a CBC. A CBC is useful for diagnosing anemia, infectionm or leukemia.