LabCE Questions Missed

Which technique is used for the confirmation of infection with HIV-1?

Western Blot (immunoblot) assay

What is the purpose of adding citrate to donated red cell units? a) It stabilizes the pH of the unit during storage b) It is a substrate in ATP synthesis c) It supports ATP generation by the glycolytic pathway d) It prevents coagulation

d) It prevents coagulation because citrate chelates calcium

What are the main functions of the distal convoluted tubules? a) Balance hydrogen ions and keep the body's pH at 6.8 b) Control aldosterone production and ammonia reabsorption c) Excrete various antibiotics and uric acid d) Maintain water-electrolyte and acid-base balances

d) Maintain water-electrolyte and acid-base balances These functions are controlled by ADH and aldosterone

Which of the following molecules is most likely to be antigenic/immunogenic? a) Nucleic acids b) Carbohydrates c) Lipids d) Proteins

d) Proteins Carbohydrates are second most antigenic

What additive inhibits glycolysis? a) EDTA b) Gel c) Lithium or sodium heparin d) Sodium Fluoride

d) Sodium fluoride Found in grey top tubes

In which of the following conditions would one see Pappenheimer bodies on the peripheral blood smear? a) Iron Deficiency Anemia b) Malarial Infections c) G6PD Deficiency d) Splenectomies

d) Splenectomies Because the spleen will usually remove this type of inclusion

Which of the following organisms is the leading cause of bacterial meningitis in infants, young children, and adults in the US? a) Haemophilus influenzae b) Neisseria meningitidis c) Pediococcus spp. d) Streptococcus pneumoniae

d) Streptococcus pneumoniae a and b are second and third leading causes

TIBC is an indirect measure of which of the following: a) Ferritin b) Hemoglobin c) Ceruplasmin d) Transferrin

d) Transferrin TIBC measure the amount of transferrin that is available to bind with iron in the serum.

Staphylococcous morphologically arranges in... a) singly b) diplococci c) chains d) clusters

d) clusters Described as grape-like clusters

Forward Scatter

size

Specificity Calculation

true negative/(true negative + false positive)

Abnormal Urine Crystals

Includes cystine, leucine, and tyrosine

Triple Phosphate Crystals

-Coffin Lid appearance -Normal! -In highly alkaline urine

Shigella Characteristics

-Non motile -Non lactose fermenting -Gram negative rod (an enterobacteriaceae) -Causes diarrhea, stomach cramps, and fever -Oxidase negative -Does not produce urease

Tamm Horsefall Proteins

-Produced by the tubules -Acts as a coating/lubricant in the tubules -Forms hyaline casts in the tubules -Not the majority of protein that is measured by the urine reagent strip test, albumin is

Order of Draw

1) Blood culture 2) Light blue top 3) Serum (red or gold top) 4) Green Top (sodium or lithium heparin) 5) Lavender (EDTA) 6) Gray (NaF)

_____ molecules of ALA are needed to form one molecule of heme.

8

What is the blood alcohol concentration that has been established as the statutory limit to operate a motor vehicle in the US?

80 mg/dl

Type I Immediate Hypersensitivity

Allergies! Mast cell derived mediators (vasoactive amines, lipid mediators and cytokines). Cytokine mediated inflammation involves eosinophils, neutrophils, and lymphocytes. Can range from anaphylactic reactions to milder manifestations associated with food allergies.

AB negative patients can receive fresh frozen plasma from which ABO type(s)?

AB neg and AB Pos Can be given without regard to the Rh type because it doesn't contain cells with the D antigen for which the recipient can react to.

Auer rods are often seen in...

AML

Trypanosoma brucei

African sleeping sickness (tsetse fly)

Type III (Immune Complex) Hypersensitivity

Associated with complement and Fc receptor-mediatiated recruitment and activation of leukocytes and tissue damage secondary to impaired blood flow. Caused by IgG, IgM, and possibly other antibodies. Immune complexes.

Type IV Cell Mediated Hypersensitivity

Associated with macrophage activation. Characterized by direct target cell lysis and cytokine mediated inflammation. Can include delated hypersensitive against intracellular pathogens, rejection of foreign tissue grafts, elimination of tumor cells

What would cause a false positive for blood on the urine chemical reagent strip?

Bleach

The Epstein Barr Virus is associated with...

Burkitt's lymphoma and infectious nucleosis

Which cardiac markers will be elevated first if a patient had a myocardial infarction? a) LD b) CK c) Myoglobin d) Troponin

C) myoglobin Rises typically within 2-4 hours after an MI and stayed elevated for days. Troponin is the next fastest raying within 3-12 hours.

Group III Discrepancies

Cause by protein or plasma abnormalities and are associated with multiple myeloma, Wharton's Jelly, etc.

aPTT (activated partial thromboplastin time)

Commonly evaluates patients with bleeding problems to monitor anticoagulant therapy and as a pre-operative screening test.

The renal threshold is best described as:

Concentration at which a substance in the blood spills into urine. Also the max amount of a substance the kidney can prevent from going into the urine. An example is glucose where the renal threshold is 160-180mg/dl, after this glucose will no longer be reabsorbed and it will appear in the urine.

Which blood antigens are denatured by enzymes?

Duffy (Fya and Fyb) and MNSs

PT (Prothrombin Time)

Evalutes the generation of thrombin and the formation of a fibrin clot via the extrinsic and common pathways

What is the most common fungal and bacterial cause of swimmers ear?

Fungal- Aspergillus niger Bacterial- Pseudomonas aeruginosa

Which analytes can be falsely decreased if there is delayed centrifugation (>2hrs)?

Glucose, ionized calcium, folate, bicarbonate, etc. as they get used by cellular consumption

Uric acid is used to evaluate what?

Gout

Side Scatter

Granularity

How can you tell group D strep from enterococcus?

Group D strep is PYR negative, while enterococcus is PYR positive.

Which bacteria is largely attributed to causing Pinkeye?

Haemophilus aegyptius

Group II Discrepancies

Unexpected FORWARD reactions. Due to weakly reacting or missing antigens.

Group I Discrepancies

Unexpected REVERSE reactions due to weakly reacting or missing antibodies.

Vitamin K dependent factors

II, VII, IX, X, protein C and S

What factors are vitamin K dependent?

II, VII, IX, X. Also for protein C, protein S, and protein Z

Anti-i is associated with

Infectious mononucleosis, lymphoproliferative disease, and sometimes cold hemagglutinin disease

CRP is a marker for

Inflammation and tissue damage. It is increase in cardiovascular disease but isn't specific to it.

Thrombin Time (TT)

Involves the addition of thrombin to platelet poor plasma to stimulate the clotting process. It reflects the ability of the patient to convert fibrinogen to fibrin. Also sensitive to inhibitors such as heparin.

___________ is used to prevent donor T-cells from multiplying and and causing transfusion associated graft vs host disease.

Irradiation

Enzymes enhance the activity of what antigens/antibodies of what systems?

Kidd, Rh

Which blood antigens are enhanced by enzymes?

Kidd, Rh, Lewis

ALP/alkaline phosphatase is used to evaluate __________ function.

Liver

Enzymes destroy which antigens?

M, N, S, s, Fya, Fyb

Which bacteria has colonies that are smooth with a distinct lemon yellow, on a gram stain has TETRAD FORMATION of gram positive cocci, is susceptible t bacitracin and resistant to furazolidone?

Micrococcus luteus

Anti-I is associated with

Mycoplasma pneumoniae and cold hemagglutinin disease

Anion Gap Equation

Na- (Cl +HCO3)

Vitamin A deficiency is associate with...

Night blindness

Primary hyperparathyroidism

Overactive parathyroid glands secrete too much PTH which triggers the release of too much calcium in the bloodstream. PTH also lowers blood phosphorus by increasing excretion of it into the urine.

Waldenstrom's Primary Macroglobunemia is characterized by...

Overproduction of IgM antibodies due to uncontrolled proliferation of B lymphocytes and plasma cells

Patients with hemophilia A have a factor _______ deficiency.

VIII

Anti-P is associated with what?

PCH (Donath-Landsteiner Biphasic Hemolysin)

Paroxysmal Cold Hemoglobinuria differs from Cold Hemagglutinin disease by...

PCH has IgG biphasic antibodies, while CHD has IgM anti-I and anti-i antibodies. They are both acquired autoimmune hemolytic anemias.

Salmonella and Shigella appearance on XLD agar

Red colonies, salmonella would have black centers

Vitamin D deficiency is associated with...

Rickets

Vitamin C defieicny is associated with...

Scurvy

Which organisms in gastrointestinal infections cause an increased number of fecal leukocytes?

Shigella, Salmonella, Campyobacter, Yersinia, and E. coli

Most Mycobacterium species grow very....

Slowly! (Including tuberculosis and malmoense) The exception is fortuitum/chelonae which grows in 72 hours and leprae which doesn't grow on artificial media.

Protein in urine can be confirmed using...

Sulfosalicylic acid (SSAP Precipitation

Sensitivity Calculation

TP / (TP + FN)

Which parasite is transmitted by the kissing bug or triatomic bug?

Trypanomosa cruzi

The mediator cell type that binds to IgE antibodies is the... a) Basophil b) Eosinophil c) Polymorphonuclear neutrophil d) Macrophage

a) Basophil They have high concentrations of heparin and histamine and degranulation occurs when an antigen binds to IgE on the surface of mast cells

A protein that plays a role in both coagulation and platelet aggregation is a) Factor I b) Factor VIII c) Factor IX d) Factor XI

a) Factor I/ fibrinogen is necessary for platelet aggregation with the glycoprotein IIB complex

What medication is primarily used in the treatment of bipolar disorder? a) Lithium b) Imipramine c) Amitriptyline d) Doxepin

a) Lithium It is a mood altering drug used to treat bipolar disorder, recurrent depression, migraines, and aggressive behavior

CD5 antigen is normally found on which of the following lymphocyte populations? a) Mature T cells b) Normal B cells c) Both mature T cells and normal B cells d) None of the above, CD5 is not a lymphoid marker

a) Mature T cells

MacConkey agar contains all of the following except: a) Penicillin b) Bile salts c) Lactose d) Crystal violet

a) Penicillin

Which molecular technique is appropriate for HIV-1 genotyping? a) Reverse Transcriptase PCR b) Multiplex PCR c) Real-time PCR d) Strand Displacement Amplification

a) Reverse Transcriptase PCR Useful in identifying RNA viral agents such as HIV

Humans are infected with _____ through the ingestion of cystericerci in raw or undercooked beef. a) Taenia saginata b) Trichinella spiralis c) Hymenolepis diminuta d) Strongyloides stercoralis

a) Taenia saginata

Which of the following common laboratory analyses is most often increased in newborns due to crying violently? a) WBC b) Potassium c) RBC d) Sodium

a) WBC

Patients on high meat diets tend to have more ____________ urine. a) acidic b) alkaline c) Neutral d) pH is not affected

a) acidic

Which of the following analytes would be increased due to delay in centrifugation? a) Creatinine b) Ionized calcium c) Folate d) Bicarbonate

a) creatinine Potassium, ALT and AST can also be falsely increased because they will released out of the cell over time

Amylase is used to determine...

acute pancreatitis

Type II (antibody mediated) hypersensitivity

antibodies against antigens present on cell surfaces or other tissue components. Normal or altered cell surface antigen -> binding of antibody -> opsonization and phagocytosis -OR- alteration of cell function -OR- complement and Fc receptor mediated inflammation (inflammation and tissue injury)

Primary immunodeficiencies are most commonly... a) T-cell disorders b) B-cell disorders c) Complement Disorders d) Platelet disorders

b) B cell disorders

A patient experiences a mild allergic reaction to a transfusion, including skin redness, urticaria, and itching. What is the most likely source of the allergen? a) IgA on mast cells b) Drugs or food consumed by the blood donor c) Insoluble allergens d) Donor Red Cells

b) Drugs or food consumed by the donor. The blood recipient can form antibodies to these allergens that are bound to IgE on mast cells and cause the release of histamines

Which one of the following RBC inclusions can be visualized with Supravital stain but CANNOT be detected on a Wright stained blood smear? a) Basophilic stippling b) Heinz bodies c) Howell Jolly bodies d) Pappenheimer bodies

b) Heinz bodies

Which of the following red cell inclusions are often found in peripheral blood smears of patients with sideroblastic anemia? a) Howell jolly bodies b) Pappenheimer bodies c) Heinz bodies d) Cabot rings

b) Pappenheimer bodies Made of iron

Ingestion of viable larvae in improperly cooked pork could lead to human infestations with which organisms? a) Taenia saginata b) Trichinella spiralis c) Hymenolepis diminuta d) Strongyloides stercoralis

b) Trichinella spirali

A standard is used to test the _________ of an instrument. a) Precision b) accuracy c) variance d) stability

b) accuracy Precision is values measuring close to each other, stability is evaluated with QC.

The epstein barr virus (which causes infectious mono) primarily targets a) Monocytes b) T-cells c) B-cells d) Neutrophils

c) B-cells Can be atypical in patients with infectious mono

If a patient is suffering from DIC and her CBC is normal, what would be the best blood product for them to receive? a) Platelets b) RBCs c) Cryoprecipitate d) FFP

c) Cryoprecipitate because the coagulation factors are concentrated and does not risk circulatory overload.

Which of the following is an FDA approved therapeutic agent for treating sickle cell patients? a) Butyric acid b) Erythropoietin c) Hydroxyurea d) Nitric oxide

c) Hydroxyurea HU elevates hemoglobin F in most cells containing HgS

What additive prevents clotting by inhibiting thrombin and thromboplastin? a) EDTA b) Gel c) Lithium or sodium heparin d) Sodium fluoride

c) Lithium of sodium heparin Found in green and light green tubues

Which of the following organisms is considered universally susceptible to penicillin? a) Haemophilus influenzae b) Neisseria gonorrhea c) Streptococcus pyogenes d) Corynebacterium diptheriae

c) Streptococcus pyogenes

In which of the following circumstances is it acceptable to change a physician's testing orders without contacting the physician first? a) When it is obvious they have ordered the wrong test b) The physician ordered individual tests that would fit an approved panel c) It is ok to change an order if you know the physician office will be called the next day to confirm the change d) It is the sole responsibility of the physician to change the test order

d) it is the sole responsibility of the physician to change the test order

Aldosterone function

decreases sodium and water loss in urine by returning sodium and water to the blood. Works in the distal tubule of the nephron

Group IV Discrepancies

due to miscellaneous problems. cold reactive abtibodies more than one ABO group due to RBC transfusion or marrow transplant Unexpected ABO isoagglutinins Unexpected non-ABO alloantibodies