MediaLab ASCP Review

Iron deficiency anemia (* Found in alcohol abuse, chloramphenicol therapy, and thalassemia)

Cells, as shown in this iron-stained bone marrow preparation, are found in each of the following conditions EXCEPT:

Cylindroid

Identify the urine sediment element shown by the arrow.

Increased

Patients who develop severe sepsis or septic shock commonly have _________ plasma lactate values.

CAMP

Spinal fluid cultures on a 3-day-old infant revealed beta-hemolytic, gram-positive cocci occurring in pairs and chains. The organism was catalase-negative and bile esculin-negative. Resistance to bacitracin was noted. The other test necessary to identify this organism is a positive test by:

Acetoacetic acid

The ketone component that is measured by the nitroprusside reaction is:

Cystic fibrosis

The measurement of sodium and chloride in sweat is the most useful test for the diagnosis of what condition/disease?

Sarcocystis species

The presence of two sporocysts each containing four banana-shaped sporozoites is characteristic of this organism; however, only oocysts with one sporocyst are typically seen in patient specimens. Which of the following organisms does this represent?

Hydrostatic differential in glomerular tufts

The primary mechanism responsible for glomerular filtration is:

Speckled

This antinuclear antibody (ANA) pattern is characterized by granular staining in the nucleic of the interphase cells. There is also an absence of staining in the chromosomal area of the metaphase mitotic cells. The slide is viewed using fluorescent microscopy. Which pattern is this?

Blood should be drawn immediately before the next dose is given

To assess drug concentrations during the trough phase:

Active

What form of immunity is expected to provide long-term protection after hepatitis B vaccine (HBV) is administered to an immunocompetent person?

Permanent deferral

What is the deferral period from donating blood for someone who is or has taken Tegison for severe psoriasis?

Phosphorus

Which analyte shows no difference between capillary and venous values?

B

All of the following are Lancefield carbohydrate antigens found on beta hemolytic Streptococcus species. All of the following antigens are found on organisms from the Streptococcus anginosus group EXCEPT:

Low aldosterone production (*excess water loss, decreased water intake, increased sodium intake or retention)

All of the following are causes of hypernatremia EXCEPT:

Chronic infection

Approximately 10% of the circulating white cells were similar to the one seen in this image. The patient is 42-year-old which visited his physician because of recent bruising. Note the absence of platelets on the smear. Possible associated conditions include:

64.8 mg/24 hrs (* (2.7mg/dL)(2400mL/24hr)(1dL/100mL))

Given the following information, calculate the results in mg/24 hrs for a 24 hour urine protein. Total volume for 24 hours = 2400 mL Urine protein = 2.7 mg/dL

Beta

Hemoglobin H bodies are tetramers of which globin chain?

Induces increased production of hemoglobin F

How does hydroxyurea aid in the treatment of sickle cell disease?

The incidence of unexpected red blood cells antibodies is relatively low

In an emergency release, why do blood bankers seldom encounter patients who have experienced hemolytic transfusion reactions (HTR) from transfusion of uncrossmatched packed RBCs?

Splenectomies

In which of the following conditions would one see Pappenheimer bodies on the peripheral blood smear?

Glycolytic pathways

Many red blood cell (RBC) processes, such as binding, transporting, and releasing oxygen, do NOT require energy. Energy however, is required for cellular viability. How does the RBC obtain most of it's energy?

Coccidia

Parasites that belong to the category Sporozoa are also known as:

4(1s) (*1(2s), 1(3s) and R(4s) indicate random error)

Which of the following is a Westgard multirule that would detect systematic error only?

Hgb A1C

Which test in considered a more reliable method for monitoring long-term diabetes control?

Hemophilia A and von Willebrand's disease

Factor VIII concentrates are indicated for people with:

Steptococcus pneumoniae (*lancet shaped, gram-positive cocci, AKA "cat eyes")

Exam the gram stain illustration. The organism labeled "A" is most likely which of the following?

Hemophilia B

Recombinant Factor IX is indicated for which of the following?

A substitution of an amino acid in the hemoglobin chain

Which of the following best describes a hemoglobinopathy?

The most common alteration and a single base change

Which of the following best describes single nucleotide polymorphisms, SNPs?

Androgen production

The production of neutral 17-ketosteroids is a measure of which of the following?

Test newborn's plasma against group A1 red cells and group O antibody screen cells by IAT.

A mother is typed O positive. Her newborn types as group A positive with a (1+) positive DAT. Which of the following investigative tests would be most useful to resolve the cause of the positive DAT and should be done FIRST?

Probe

A nucleic acid used to identify a hybridization target is termed:

Urine, serum and whole blood

Acetest can be used to test ketones in:

Trichinella spiralis

Ingestion of viable larvae in improperly cooked pork could lead to human infestations with which organism?

L-arginine

Nitric oxide is associated with the prevention of vaso-occlusion by decreasing cellular adherence to endothelium. Which amino acid is decreased in patients with sickle cell disease and is needed as a substrate to produce nitric oxide?

2.5 x 10^9/L (20 x 100 x 10)/(8) = 2.5x10^3/uL (2.5 x 10^3 WBC/uL)(10^6 uL/L) = WBC/L

A 1:20 dilution is made for a manual WBC count. The four corner squares on both sides of a hemocytometer are counted. A TOTAL of 100 cells are counted (eight total squares). What is the white blood cell count in terms of a liter?

Mycobacterium fortuitum

A 3-year-old female was seen by a local ear, nose and throat specialist for chronic ear pain. She had been treated several times for otitis media by her pediatrician with no resolution. Drainage from her ear grew an acid fasts bacillus that gave the following biochemical reactions: Iron Uptake - Positive Nitrate Reduction - Positive Arysulfatase - Positive MacConkey agar growth, 5 days - Positive

Heat a suspension of the organism and then repeat the serological testing

A new tech has a presumptive Salmonella species via biochemical identification on a stool culture. to confirm, serological testing is performed. The serological testing is negative and the quality control which was run simultaneously passed. What should the tech do next?

Platelet neutralization test

A patient has a history of repeated spontaneous abortion. Coagulation studies reveal an elevated APTT, normal PT, normal platelet function, and normal thrombin time. Schistocytes were seen on the peripheral blood smear. Which test should be performed to determine if the patient has lupus anticoagulant?

The tube should remain unopened and be kept at room temperature (20 - 25C)

A prothrombin time (PT) specimen was collected at an outpatient clinic and will not be picked up by the testing laboratory's courier until several hours later. How should the specimen be stored until it is picked up by the courier?

Lithium or sodium heparin

A variety of additives are used in blood collection tubes. Which of the following additives prevents clotting by inhibiting thrombin and thromboplastin?

Factor VIII deficiency

After the physician orders a follow up for abnormal coagulation screening tests, the laboratorian completes a mixing study with the following results: Initial aPTT result: 98 seconds Initial 1:1 Mix with Normal Pooled Plasma: 28 seconds Incubated 1:1 Mix with Normal Pooled Plasma: 30 seconds Which of the choices below would most likely explain the results for this patient?

Oxidase negative (* stain faintly as gram negative coccobacilli or short rods, urea positive and non-motile)

All of the following are characteristic of Brucella EXCEPT:

Non-motile (* has been reported as the cause of lab-acquired infection, oxidase positive and catalase positive)

All of the following are characteristic of Burkholderia pseudomallei EXCEPT:

Determine the degree of immune suppression caused by HIV

All of the following are uses of nucleic acid tests for HIV infection, EXCEPT:

Immunodeficiency (* Seen in liver disease, chronic inflammation, and immune reaction)

All of the following conditions are associated with a polyclonal (broadbased) increased in gamma globulins EXCEPT:

German measles (rubella) vaccine (*Measles (rubeola) vaccine, Mumps vaccine, and Polio vaccine all have 2 weeks deferral. Rubella vaccine is a 4 week deferral)

All of the following represent a 2 week temporary deferral from donating blood or blood products EXCEPT:

Amperiometric-Coulometric Titration

An automated method for measuring chloride which generates silver ions in the reaction is called:

Hemolysis

An electrophoretic separation of lactate dehydrogenase isoenzyme that demonstrated elevation in LD-1 greater than LD-2 could be indicative of:

7.5 (*(0.4 x 1000)/(53))

How many microns are equivalent to one ocular micrometer at 40x given the following information? Stage micrometer: 0.4 Ocular micrometer: 53

Anti-Leb

If detected in antibody screen testing, which of the following antibodies is NOT considered clinically significant in prenatal patients?

Histoplasma capsulatum

Large, one-celled, smooth-to-tuberculate macroconidia, and smoother or echinulate microconidia are typical of mycelial phase growth of which organism?

LASER is an acronym for light amplified by stimulated energy radiation (*LASER = Light Amplification by Stimulated Emission of Radiation, intensity and concentration, used in flow cytometry for cell sorting and identification of cells, monochromaticity)

Laser light can be described by all of the following characteristic EXCEPT:

Proportional to concentration of solute particles

The MOST accurate observation about osmotic pressure is that is it:

Vitamin A

The deficiency in which fat soluble vitamin is associated with night blindness?

Plasmodium falciparum

The diagram indicates the banana-shaped gametocyte of the following Plasmodium species?

1 - 2 minute break

The laboratory workplace includes many hours of computer use. The suggested time for a break after 30 minutes of computer use is:

DCe

What is the most common Rh haplotype among whites?

Taenia solium scolex

What is this parasite that resides in the human intestine?

Increased platelets in the plasma sample (*platelet membranes contain a high content of lipids that can cause the antiphospholipid antibody to bind to the platelet membrane, neutralizing the antibody so that it's not detected)

What may prevent the detection of lupus anticoagulant in a plasma sample if the blood used for testing is not centrifuged for a sufficient time?

Photopheresis

What procedure utilizes leukapheresis to collect the buffy coat from whole blood?

Galactose plus fucose

What sugar configuration is necessary as a base for attachment of other sugars to produce ABO antigens?

Natural killer lymphocyte

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

Creatine kinase MB (CK-MB)

Which of the following cardiac biomarkers could detect a recent reinfarction?

Spherocytosis

Which of the following characteristic can be seen in the microcytes present in some hemolytic disorders?

Stimulates gastric acid-HCl secretion

Which of the following decsribes gastrin's role in digestion?

Aldolase

Which of the following enzymes is associated with conditions affecting skeletal muscles?

A positive family history (*Laboratory evidence of iron overload, genetic mutations associated with HH, and clinical signs and symptoms consistent with HH are all necessary for confirming a diagnosis of HH)

Which of the following is NOT considered necessary for making a diagnosis of hereditary hemochromatosis (HH)?

Retinol-binding protein

Which of the following is considered the major transport protein for vitamin A?

Is usually elevated in pediatric bacterial infections

Which of the following is correct regarding C-reactive protein (CRP)

Observe the same organism in all cases of a given disease

Which of the following is the first step in the four steps of Koch's postulates?

Fructosamine

Which of the following methods for long-term diabetic monitoring is recommended for patients with sickle cell anemia?

A 70-year-old type 2 diabetic patient (*Type 1 diabetic patients are more prone to develop ketoacidosis)

Which of the following patients is most at risk for hyperosmolar nonketotic coma?

Run samples in duplicate

Which of the following procedures would you employ to monitor the precision of an assay?

4.4 - 11.0 x 10^9/L

Which of the following represents the White Blood Cell (WBC) count reference range for adults?

Immunoelectrophoresis

Which of the following tests confirm the presence of Bence-Jones proteinuria?

Bethesda assay

Which of the following tests is used to quantify a coagulation inhibitor?

Quantitative fecal fat

Which of the following tests require a 72 hour stool (fecal) collection?

Beta hCG

Which of the following tumor markers is associated with testicular cancer?

Color Doppler ultrasonography

Which one of the following tests BEST correlates with the severity of hemolytic disease of the fetus and newborn (HDFN)?

Plasmodium malariae

Which type of Plasmodium infection has a 72-hour cycle, tends to infect old cells, and will have normal sized red blood cells?

Inhibitors with hemophilia A or B and for people with Factor VII deficiency

Factor VIIa concentrates are indicated for people with: