Media Lab: Practice BOC

Serum alkaline phosphatase (ALP) activity is derived from all of the following organs EXCEPT: A. Bone B. Intestine C. Placenta D. Brain

D. Brain

The colonies illustrated in the top photograph are 48-hour-old colonies growing on the surface of blood agar that had been incubated anaerobically. The colonies are small, gray-white, and convex with irregular borders and internal flecking. Long, slender fusiform Gram-negative bacilli with tapered ends are seen in the Gram stain as observed in the bottom photomicrograph. The indole reaction is strongly positive and glucose fermentation is variable; other biochemical reactions are negative except for H2S production by some strains. This isolate is commensal in the upper respiratory tract and has been associated with hospital-acquired aspiration pneumonia, lung abscesses, and empyema in hospitalized patients. Based on these observations, select from the multiple choices the name of this isolate. A. Veillonella parvula B. Prevotella melaninogenica C. Bacteroides fragilis D. Fusobacterium nucleatum

D. Fusobacterium nucleatum

In serum protein electrophoresis all of the following proteins reside in the band closest to the anodal end EXCEPT: A. Retinol-binding protein (RBP) B. Transthyretin C. Albumin D. Haptoglobin

D. Haptoglobin

What is the primary target of HIV? A. Heart B. Neutrophils C. B-cell lymphocytes D. Helper T-cell lymphocytes

D. Helper T-cell lymphocytes

All of the following can be indications of anemia and the potential need for a transfusion of packed red cells EXCEPT? A. Pulse rate greater than 100 beats per minute B. Respiration rate greater than 30 breaths per minute C. Hemoglobin of 7 g/dL or less D. Increased haptoglobin

D. Increased haptoglobin

Which one of the following combinations of organisms would be appropriate positive and negative controls to verify the specific test functions listed? A. Beta hemolysis- Escherichia coli and Streptococcus pyogenes B. Catalase- Staphylococcus aureus and Staphylococcus epidermidis C. Hydrogen sulfide production- Proteus mirabilis and Salmonella typhi D. Indole- Escherichia coli and Klebsiella pneumonia

D. Indole- Escherichia coli and Klebsiella pneumonia (Escherichia coli is indole positive and Klebsiella pneumonia is indole negative)

The surface of a blood agar plate after 48 hours, incubated at 37oC, shows colonies with smooth, lemon yellow pigmentation. Note in the image is a Gram stain with relatively large Gram-positive cocci arranged in tetrads. Other distinguishing characteristics were the demonstration of susceptibility to bacitracin and resistance to furazolidone. Select the identification of this isolate. A. Staphylococcus aureus B. Staphylococcus epidermidis C. Staphylococcus saprophyticus D. Micrococcus luteus

D. Micrococcus luteus

A 22-year-old construction worker incurred 3rd-degree burns to the chest and arms when a boiler he was installing blew up. On the 5th hospital day, the weeping wounds became infected, exuding what was described as green pus. The image illustrates the Gram stain prepared on a direct smear of the exudate. What is the MOST likely bacterial cause of the infection? A. Chryseobacterium indologenes B. Alcaligenes faecalis C. Acinetobacter baumanii D. Pseudomonas aeruginosa

D. Pseudomonas aeruginosa

The prozone effect can be described by all of the following EXCEPT: A. Results in a false negative reaction B. The results of antibody excess C. Dilution of antibody can help prevent its occurrence. D. Results in a false positive reaction

D. Results in a false positive reaction

All of the following could explain why screening cell #2 has a stronger reaction than screening cell #1 EXCEPT: A. The patient has more than one antibody and all corresponding antigens are on screen cell #2 but not on screen cell #1. B. The patient has an antibody other than anti-D and screen cell #2 has a double dose of the antigen, whereas cell #1 has only a single dose. C. Operator variability - When dislodging the cell buttons during reading, the technologist shook screen cell #1's test more vigorously than cell #2's test. D. Screening cell #1 has homozygous antigen for the reacting antibody whereas screening cell #2 is heterozygous.

D. Screening cell #1 has homozygous antigen for the reacting antibody whereas screening cell #2 is heterozygous.

Phenotype refers to: A. The genes inerited from each parent B. Opposing antigens produced by genes C. The presence of two mor more alleles at a locus D. The expression of traits

D. The expression of traits

HLA antibodies are responsible for which of the following transfusion reactions? A. Allergic transfusion reactions B. Transfusion-associated sepsis C. Transfusion-associated circulatory overload D. Transfusion-related acute lung injury (TRALI)

D. Transfusion-related acute lung injury (TRALI)

A patient presents to the emergency room with severe headaches, nausea, and vomiting. CSF chemistry results are as follows: Protein - 74 mg/dL (15-45 mg/dL) Glucose - 53 mg/dL (40-85 mg/dL) Based on the patient's complaints and the above laboratory results what is the most probable condition? A. Fungal meningitis B. Bacterial meningitis C. Traumatic tap D. Viral meningitis

D. Viral meningitis

What is the term used to describe cardiac tissue death due to lack of oxygen caused by obstruction of circulation? A. Acute myocardial infarction (AMI) B. Angina C. Congestive heart failure (CHF) D. Myocardial ischemia

A. Acute myocardial infarction (AMI)

In which of the following cases should Rh Immune Globulin (RhIG) be given? A. Ectopic pregnancy B. Rh positive mother carrying an Rh negative fetus C. Rh positive mother carrying an Rh positive fetus D. Rh negative mother with anti-D formed from previous pregnancy

A. Ectopic pregnancy

A small portion of HIV-infected individuals are termed 'elite controllers' due to only mildly depressed CD4 T cell counts and low viral loads. The presence of which of the following genetic factors is thought to contribute to this (low viral load and mildly depressed CD4 T cell counts)? A. HLA-B57-01 and HLA-B27-05 B. T(15;17) C. T(9;22) D. JAK2 mutation

A. HLA-B57-01 and HLA-B27-05 The correct answer is HLA-B57-01 and HLA-B27-05. Their presence is thought to contribute to the mildly depressed CD4 T cells and low viral load in HIV-infected individuals (elite controllers).The t(15;17) translocation is associated with AML-M3. This is also known as Acute Promyelocytic Leukemia (APL).The t(9;22) is referred to as the Philadelphia chromosome. This is primarily associate with Chronic Myelogenous Leukemia (CML).The presence of the JAK2 mutation is most often associated to the myeloproliferative neoplasms. Polycythemia vera is an example.

In clinical genetics, the major consequence of chromosomal deletion: A. Is the loss of specific genes that are localized to the deleted chromosomal segment. B. No change in the copy numbers of genes found in these deleted chromosomal locations. C. Is the exclusion of large-scale chromosomal deletion. D. Is the inability to differentiate a chromosomal deletion from a nucleotide sequence abnormality.

A. Is the loss of specific genes that are localized to the deleted chromosomal segment.

Which term listed below refers to the process that must be followed when notification is received that a donor of a unit transfused now tests positive for an infectious disease? A. Look-back B. Donor notification C. Minor crossmatch D. Major crossmatch

A. Look-back

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

It is important to specify if a blood specimen is a capillary specimen rather than a venous specimen. How will the following laboratory results be affected if a capillary specimen is tested? A. Potassium, calcium, and total protein are lower in capillary specimens, where glucose is typically higher than in venous blood. B. Potassium, calcium, and total protein are higher in capillary specimens, where glucose is typically lower than in venous blood. C. Potassium and total protein are lower in capillary specimens, where glucose and calcium are typically higher than in venous blood. D. Potassium and total protein are higher in capillary specimens, where glucose and calcium are typically lower than in venous blood.

A. Potassium, calcium, and total protein are lower in capillary specimens, where glucose is typically higher than in venous blood.

Which modified PCR technique or other method of amplification is used to detect Mycobacterium tuberculosis? A. Transcription-Mediated Amplification B. Reverse Transcriptase PCR C. Real-Time PCR D. Nucleic Acid Sequence-Based Amplification

A. Transcription-Mediated Amplification

Which of the following reagent strip tests is based on the Ehrlich-aldehyde reaction? A. Urobilinogen B. Specific gravity C. Glucose D. pH

A. Urobilinogen

Which of the following tests included on a urine reagent strip would never be reported out as negative? A. Urobilinogen B. Bilirubin C. Leukocyte esterase D. Nitrite

A. Urobilinogen

All of the following are appropriate indications for the use of fresh frozen plasma (FFP) EXCEPT? A. Volume expansion B. Severe bleeding in the presence of significantly elevated PT secondary to vitamin K deficiency C. Replacement component after plasma exchange in patients with TTP or HUS D. Dilutional coagulopathy with significant active bleeding, and PT and PTT twice normal

A. Volume expansion Since each unit of fresh frozen plasma (FFP) carries with it the risk of transmitting blood-borne pathogens, and other products (such as normal saline or albumin) which do not carry this risk are available, FFP should not be used as a volume expander.

Through the use of molecular assays, the Mycobacterium tuberculosis (MTB) complex can be detected directly from respiratory specimens without being concentrated. In addition, due to rifampin resistance strains of MTB complex occurring, a genetic marker can be detected to identify rifampin resistance. Which of the following genetic markers is linked to MTB complex rifampin resistance? A. erm gene B. rpoB gene C. mec A gene D. van A gene

B. rpoB gene

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)? A. 142 mg/dL B. 169 mg/dL C. 200 mg/dL D. 262 mg/dL

B. 169 mg/dL

A spinal fluid that is slightly hazy is briefly examined microscopically. The technologist performing the count decides to make a 1:10 dilution using 30 µL of sample. What volume of diluent should be used? A. 70 mL B. 270 mL C. 300 mL D. 30 mL

B. 270 mL

Which of the following individuals is a candidate to receive RhIg? A. An Rh positive mother upon delivery of their 3rd child. B. An Rh negative mother upon delivery of their first child. C. An Rh negative mother who had previously developed anti-D. D. An Rh positive mother who miscarried after 2 months.

B. An Rh negative mother upon delivery of their first child.

Where does most cerebrospinal fluid originate? A. Cerebral arachnoid space B. Choroid plexus C. Ventricles D. Lumbar region

B. Choroid plexus

Electrophoretic separation of hemoglobin fundamentally relies on: A. Weight differences of molecules B. Electrical charge differences of molecules C. Concentration differences of molecules D. Shape variations of molecules

B. Electrical charge differences of molecules

In which system are DR antigens are found? A. Kell system B. HLA system C. Duffy system D. ABO system

B. HLA system

The percentage of red blood cells in whole blood is called: A. Hemoglobin B. Hematocrit C. Hemostasis D. Hemopoiesis

B. Hematocrit

The regulations that are listed in the Code of Federal Regulations (CFR) should be considered: A. Optional for hospital transfusion services B. Minimum standards that a facility can exceed C. Regulations that only apply to licensed facilities D. Maximum standards that a facility could attain

B. Minimum standards that a facility can exceed

Illustrated in the upper photograph are smooth, entire, convex gray-yellow pigmented 48-hour old colonies growing on the surface of Thayer Martin medium. These isolates may be observed in cultures of specimens received from a physician's office obtained from patients with endocervicitis in females or urethral epididymitis in males. Illustrated in the lower photomicrograph is a gram stain prepared from the sediment of the specimen. These observations are enough to make a presumptive identification of Neisseria species. Further testing revealed the characteristic selective carbohydrate utilization of glucose with maltose utilization being negative. Select the identification of this isolate. A. Neisseria meningitidis B. Neisseria gonorrhoeae C. Aeromonas species D. Kingella kingae

B. Neisseria gonorrhoeae

Which patient population benefits from HLA matching to provide patients with the best outcomes? A. Transfusion recipients B. Organ transplant recipients C. Neonates D. Patients with high-incidence antibodies

B. Organ transplant recipients

Of the following anticonvulsant medications, which one does not rely solely on the liver to metabolize it for excretion? A. Valproic acid B. Phenobarbital C. Phenytoin D. Carbamazepine

B. Phenobarbital

Which of the following accurately represents reverse typing? A. Reverse typing is performed using known reagent antisera to detect ABO antigens on the patient's red blood cells. B. Reverse typing is performed using known reagent red blood cells to detect ABO antibodies in the patient's serum or plasma. C. Reverse typing is performed using known reagent screening cells to detect clinically significant antibodies in the patient's serum or plasma. D. Reverse typing is performed using known reagent antisera to phenotype donor red blood cells for clinically significant antigens.

B. Reverse typing is performed using known reagent red blood cells to detect ABO antibodies in the patient's serum or plasma.

A WBC differential count on CSF should be performed using the following technique: A. Wet mount of sample from collection tube B. Stained smear of a cytocentrifuged specimen C. Directly from hemocytometer chamber count D. Directly from stained hemocytometer count

B. Stained smear of a cytocentrifuged specimen

Jane Doe is a 30-year-old female who felt tired for several months, had pain in the joints of her fingers, and recently developed a dermatitis following exposure to the sun. The following test results were obtained on a blood sample drawn during the initial evaluation: Total Protein = 8.4 gm/dL (N = 6.0-8.0 gm/dL)ANA >1:2560; speckled patternCRP = positiveC3 = 40 mg/dL (N = 80-180 mg/dL)C4 = 5 mg/dL (N = 15-45 mg/dL) Based on the clinical and laboratory findings, what disease should be suspected? A. Rheumatoid arthritis B. Systemic Lupus Erythematosus (SLE) C. Sjogren's syndrome D. Scleroderma

B. Systemic Lupus Erythematosus (SLE)

The most likely primary site of infection represented by the Staphylococcus species growing on the surface of this agar plate with a 2 mm zone of inhibition around a 5 µg novobiocin disk is: A. The genital tract B. The urinary tract C. The respiratory tract D. The central nervous system

B. The urinary tract Staph saprophyticus is resistant to Novobiocin.

Which of the following parasites enters the human host through the ingestion of infected pork? A. Schistosoma mansoni B. Trichinella spiralis C. Necator americanus D. Ascaris lumbricoides

B. Trichinella spiralis

Lipemia in a fasting serum sample is most likely caused by an increase in serum levels of: A. Cholesterol B. Triglycerides C. Protein D. Phospholipids

B. Triglycerides

Toxic levels of lithium can cause lethargy, apathy, muscle weakness up to and including seizures and coma. What is the toxic level of lithium? A. 0.5-1.2 mmol/L B. 1.2-1.5 mmol/L C. 1.5-2 mmol/L D. >2 mmol/L

C. 1.5-2 mmol/L

A patient whose diagnosis is hepatitis may have which of the following test positive on urine test strip? A. Ketone B. Blood C. Bilirubin D. Nitrite

C. Bilirubin Hepatitis is one of the main causes of bilirubin in the urine. Because of the liver inflammation, conjugated bilirubin is unable to exit along the normal elimination tract. It reenters the circulatory system, and is then filtered through the kidneys and eliminated in the urine.

What is the identification of the organism in this image, measuring 20 µm x 15 µm, that was found in a stool specimen? A. Cyclospora cayetanensis oocyst B. Cryptosporidium parvum oocyst C. Cystoisospora belli (formerly Isospora belli) oocyst D. Toxoplasma gondii tachyzite

C. Cystoisospora belli (formerly Isospora belli) oocyst

The gel electrophoresis pattern for hemoglobin S (HbS) shows which of the following migration patterns? A. HbS migrates alone in alkaline and with HbD in acid electrophoresis. B. HbS migrates with HbD in alkaline and with HbA in acid electrophoresis. C. HbS migrates with HbD in alkaline and alone in acid electrophoresis. D. HbS migrates with HbA in alkaline and HbD in acid electrophoresis.

C. HbS migrates with HbD in alkaline and alone in acid electrophoresis.

In which disorder do neonates demonstrate the presence of Bart's hemoglobin that changes to beta chain tetramers in adults? A. Alpha thalassemia major B. Alpha thalassemia minor C. Hemoglobin H disease D. Hydrops fetalis

C. Hemoglobin H disease

Identify the object contained in the cell in this illustration indicated by the arrow: A. Cabot rings B. Malaria C. Howell-Jolly bodies D. Pelger-Huet anomaly

C. Howell-Jolly bodies

Antibodies of which of the following immunoglobulin subclasses is predominantly associated with the secondary antibody response? A. IgA B. IgD C. IgG D. IgM

C. IgG

Skin and mucous membranes are important components of what part of the immune system? A. Cell mediated immunity B. Adaptive immunity C. Innate immunity D. Acquired immunity

C. Innate immunity

The red/pink color of the colonies seen on this MacConkey agar plate is an indication of: A. Lactose-fermenting gram-positive bacilli B. Non-lactose fermenting gram-positive bacilli C. Lactose-fermenting gram-negative bacilli D. Non-lactose fermenting gram-negative bacilli

C. Lactose-fermenting gram-negative bacilli

What description applies to the cells that are indicated by the arrows? A. Normocytosis B. Microcytosis C. Macrocytosis D. Anisocytosis

C. Macrocytosis

All of the following are methods employed for measuring the specific gravity of urine, EXCEPT? A. Refractometry B. Hydrometry C. Osmolality D. Urine reagent strips

C. Osmolality Osmolality is dependent on the number of particles of solute in a unit of solution and is often measured by freezing point depression. Specific gravity is usually directly related to osmolality but is more easily measured. It provides a rough measure of the urine concentrating power of the kidney. The other methods are used to measure specific gravity in urine samples.

The measurement of total glycosylated hemoglobin A1c is an effective means of assessing the average blood glucose levels: A. Over the past few days B. Over the past 1-2 weeks C. Over the past 2-3 months D. Only the past 24 hours

C. Over the past 2-3 months

Perianal itching is the major symptom of infection for both forms of the organism pictured here. This parasite is the causative agent of what infection? A. Whipworm infection B. Roundworm infection C. Pinworm infection D. Hookworm infection

C. Pinworm infection

For which determination is the brilliant cresyl blue stain used MOST often? A. Malaria - ring forms B. Plasma cells C. Reticulocytes D. Basophilic stippling

C. Reticulocytes

Which of the following represents the best match of cell type with function? A. Eosinophils - humoral immunity B. Neutrophils - mediate inflammatory response C. T lymphocytes - cell mediated immunity D. Monocytes - protect against parasitic infections

C. T lymphocytes - cell mediated immunity

The following polypeptide chains are found in normal adult hemoglobin A: A. Alpha and gamma B. Alpha and delta C. Beta and delta D. Alpha and beta

D. Alpha and beta

During routine inspection, a unit of unexpired blood was noticed to have a black color with numerous small clots. What is the likely cause for this observation? A. The unit was frozen B. Donor had DIC C. Viral contamination D. Bacterial contamination

D. Bacterial contamination Bacterial contamination can manifest itself in several ways including: the presence of clots, darker purple-black color of blood unit, unit can appear cloudy, hemolysis may be present. A unit that was frozen inadvertently should be discarded and would be hemolyzed upon returning to normal storage temperature. A donor with DIC would not have been in adequate health to be an acceptable donor. Viral contamination of a unit would likely not demonstrate visible signs of compromise.