MediaLab exams

A physician sends a bronchoalveolar lavage to the lab. What are these cells, with a rounded nuclei at one end with a column of cytoplasm?

Bronchial lining cells

Homogentisic acid will cause urine to be what color?

Brown/black

The ketone component measured by the nitroprusside reaction is:

Acetoacetic acid

Which blood test is used in the determination of prostate cancer?

Acid phosphatase

Which blood test is used in the determination of prostate cancer? Acid phosphatase Alkaline phosphatase (ALP) Alanine aminotransferase (ALT or SGPT) Creatinine

Acid phosphatase

Which Gram-positive bacilli will show a positive urease result? Lactobacillus sp. Actinomyces naeslundii Erysipelothrix sp. Cutibacterium (Propionibacterium) acnes

Actinomyces naeslundii

What white blood cell contains histamine and heparin responsible for immediate hypersensitivity reactions?

Basophil

Which disease/condition is associated with a deficiency in thiamine?

Beriberi

Hemoglobin H (HbH) bodies are tetramers of which globin chain?

Beta

What test is used to quantify a coagulation inhibitor?

Bethesda assay

Given this data, what is the most likely disease state? Total bili = 4.0 (0.5-1.5) Direct bili = 3.0 (0.2-0.5) AST = 75 (2-25) ALT = 118 (2-23) LD = 220 (<140) ALP = 841 (28-68) GGT = 150 (21-40)

Biliary duct obstruction (ALP and GGT are specific for biliary tree issues)

What urine crystals are yellow and needle-like?

Bilirubin crystals

Which of the following genotypes is found with the highest frequency in the Caucasian population? CDe/cDe cDE/ce cDE/cE CDe/ce

CDe/ce

Suppose a patient with stiffness in her fingers has a positive antinuclear antibody (ANA) test with a centromere pattern at a 1 : 1280 titer. What is the most likely diagnosis? Systemic lupus erythematosus (SLE) Rheumatoid arthritis Sjogren's syndrome CREST syndrome

CREST syndrome

What is the optimal specimen type to diagnose a Naegleria fowleri infection?

CSF (cerebrospinal fluid)

An Rh negative individual has produced an anti-D antibody. Which situation has the ability to stimulate this production of anti-D?

Delivering an Rh positive baby

Which is the most commonly used anticoagulant in the routine hematology lab?

EDTA (ethylenediaminetetraacetic acid)

For which condition / procedure may there be an increased number of megakaryocytes in the bone marrow, but a decreased number of circulating platelets? Folic acid deficiency Aplastic anemia Radiation therapy Wiskott-Aldrich syndrome

Folic acid deficiency

For which condition or procedure may have an increased number of megakaryocytes in the bone marrow, but a decreased number of circulating platelets?

Folic acid deficiency

What tests comprise the Renal Function Panel?

Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, Calcium, Albumin, Phosphorus

The alkaline hemoglobin electrophoresis pattern shows lines consistent with Hb F and either HbS or HbC. This is consistent with which diagnosis? HbSA HbSC HbSD HbS/HPFH

HbS/HPFH

Fluorometers are designed so that the path of the excitation light is at a right angle to the path of the emitted light. What is the purpose of this design?

Prevent incident light from striking the detector

All of the following are reasons for conducting compatibility testing EXCEPT: Prevent recipient alloimmunization Verify ABO and Rh Select proper blood products Detect antibodies against donor cells

Prevent recipient alloimmunization

A specimen drawn from an indwelling catheter contaminated by heparin would be indicated by:

Prolonged aPTT and normal reptilase time

What is responsible for inhibiting the tissue plasminogen activator?

Protein C

The Entamoeba histolytica trophozoite is usually characterized by the presence of what?

Small central karyosome in the nucleus, ingested RBCs

What organism has a toxin that, when released, causes profuse watery diarrhea?

Vibrio cholerae

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

Vitamin A

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

Vitamin A

Which cardiac biomarker is a regulator of myocyte contraction? Myoglobin cTnT CK-MB CK-MB isoforms

cTnT

Sudan III will confirm the presence of:

fat

Which marker is most useful for detection of gestational trophoblastic disease?

hCG (human chorionic gonadotropin)

Which is correct when describing the principles of competitive radioimmunoassay procedures? Ab will react preferentially with the labeled antigen Ab will react preferentially with the unlabeled antigen Ab will react with labeled antigen only Ab will react equally with labeled and unlabeled antigen

Ab will react equally with labeled and unlabeled antigen

All of the following conditions are consistent with this peripheral blood picture (target cells, 1 acanthocyte) EXCEPT: Abetalipoproteinemia Alcoholic cirrhosis with hemolytic anemia Hepatitis of the newborn Post-splenectomy

Abetalipoproteinemia

Schistocytes are seen in all of these conditions EXCEPT: Cardiac valve prosthesis Abetalipoproteinemia Disseminated intravascular coagulation Extensive burns

Abetalipoproteinemia

Which Rh antibody might be produced if a unit of blood with Rh genotype DCe/dce is given to a patient with Rh genotype DCe/DCe? Anti-C Anti-c Anti-D Anti-Cw

Anti-c

Acquired hemophilia A (not classic hemophilia A) may be the result of what? Anti-factor VIII inhibitor Factor VIII deficiency Warfarin therapy Thrombosis complications

Anti-factor VIII inhibitor

That portion of an enzyme which is separated from its cofactor is called a(n):

Apoenzyme

Which is the best way to identify microfilariae?

Arrangement of nuclei, presence or absence of a sheath

Which culture medium is specifically formulated to recover Salmonella typhi from stool specimens?

Bismuth sulfite agar

To assess drug concentrations during the trough phase:

Blood should be drawn immediately before the next dose is given.

Which D variant has the best likelihood to receive D-positive RBCs without any adverse effects?

C in Trans to RHD

Which of the following D variants has the best likelihood to receive D-positive RBCs without any adverse effects? D el Partial D Partial weak D C in Trans to RHD

C in Trans to RHD

MRSA is a serious health concern in the hospital environment and in the community. To control the spread of MRSA and prevent infection, it is recommended to screen patients prior to being admitted to a healthcare setting. Which antimicrobial is best for testing for methicillin resistance?

Cefoxitin (better inducer of resistance mediated by the mec A gene than oxacillin)

What antinuclear antibody (ANA) pattern shows many discrete speckles in both the nuclei of interphase cells and the chromatin of dividing cells?

Centromere

This antinuclear test pattern is characterized by discrete speckles in the nucleus of the interphase cells and also in the chromosomal area of the metaphase mitotics under fluorescent microscopy. This represents which pattern?

Centromere pattern

An adult trematode fluke that is commonly found in the distant bile ducts of the liver, is small in size (12-20mm), and is endemic in southern China could be:

Clonorchis sinensis

What is the main clinical use of the marker CEA?

Colorectal cancer

In the in vitro coagulation scheme, Factor V is primarily involved in the:

Common pathway

The renal threshold is best described as:

Concentration at which a substance in the blood spills into urine

An elevated level of which hormone will inhibit pituitary secretion of adrenocorticotropic hormone?

Cortisol

Which of the following is NOT a way hemoglobinopathies can be caused? Deletion of a globin chain Substitution of amino acids in a globin chain Deletion of amino acids in a globin chain Addition of amino acids in a globin chain

Deletion of a globin chain

Yeast might be found in the urine of a patient with what condition?

Diabetes

Most common methods for measuring bilirubin are based on the reaction of bilirubin with:

Diazo reagent (diazotized sulfanilic acid, produces azodipyrrole)

The most common eye complication in patients with candidiasis is:

Endophthalmitis

The properties of an antibody class are defined by the:

Fc end of the molecule

Which test is considered a more reliable method of monitoring long-term diabetes control?

Hgb A1c (HbA1c)

Using molecular methods to ID organisms can INCREASE specificity when compared to phenotypic methods. For which organism would molecular methods NOT be beneficial over phenotypic methods in identification? Corynebacterium and related genera Klebsiella species Nocardia and related genera Dimorphic mycologic pathogens

Klebsiella species

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? L-arginine L-glutamine L-lysine L-tyrosine

L-arginine

Which test on amniotic fluid is part of assessing fetal lung maturity?

L/S ratio

Which test on amniotic fluid would be included when assessing fetal lung maturity?

L/S ratio

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?

Platelet neutralization test

What are the primary reagent components used in the Jaffe reaction for creatinine?

Saturated picric acid and sodium hydroxide

This antinuclear (ANA) patter is characterized by granular staining in the nuclei of the interphase cells. There is an absence of staining in the chromosomal area of the metaphase mitotic cells. The interphase cells look mostly green with dark polka dots. What pattern is this?

Speckled

This antinuclear antibody (ANA) pattern is characterized by granular staining in the nuclei of the interphase cells. (Granular green staining with polka dots of negative staining) There is also an absence of staining in the chromosomal area of the metaphase mitotic cells. The slide is viewed by fluorescent microscopy. Which pattern is this?

Speckled

Deviations from Beer's Law are caused by:

Stray light

A 1:100 dilution of a patient's peripheral blood was made and a total of 136 platelets were counted in 5 squares of the RBC area of a Neubauer-ruled hemocytometer. What is the platelet count?

680 x 10^3 / uL

The most common forms of hereditary sideroblastic anemia (SA) are due to what?

A defective X-linked recessive gene

Thrombin time is:

A test used to detect heparin interference in an aPTT mixing study

Which of these tests is used to monitor therapy with unfractionated heparin? PT (Prothrombin time) APTT (Activated partial thromboplastin time) Fibrinogen assay Platelet function assay

APTT (Activated partial thromboplastin time)

Each of these tests is appropriately matched with a chemical responsible for producing a positive result EXCEPT: ONPG - Beta-galactosidase Citrate - Alpha naphthol Indole production - Dimethylaminobenzaldehyde H2S production - Sodium thiosulfate

Citrate - Alpha naphthol

Which clinical lab department performs the most tests?

Clinical chemistry

Which clinical laboratory department performs the most tests?

Clinical chemistry

A Gram stain of drainage from an open wound revealed Gram-positive bacilli with spores. This description would commonly RULE OUT which of these organisms? Clostridium perfringens Bacillus cereus Clostridium septicum Bacillus anthracis

Clostridium perfringens (produces spores, but they are RARELY seen in clinical infections)

Which test best correlates with the severity of hemolytic disease of the fetus and newborn?

Color Doppler ultrasonography

An Rh negative individual has produced an anti-D antibody. Which situation has the ability to stimulate production of anti-D? Delivering an Rh negative baby Delivering an Rh positive baby Receiving Rh negative packed RBCs Receiving Rh positive fresh frozen plasma

Delivering an Rh positive baby

What is defined as the ability of the test to detect a given disease or condition?

Diagnostic sensitivity

Which cell inclusions are characteristic of May-Hegglin anomaly?

Dohle body-like inclusions composed of precipitated myosin heavy chains

Which of the following will cause a falsely increased erythrocyte sedimentation rate (ESR)? ESR tube is slanted EDTA tube is clotted EDTA tube is 1/3 full EDTA specimen is 24 hours old

ESR tube is slanted

Following a diagnosis of tuberculosis, this physician moved to the Adirondack mountains where he then opened a medical practice in Saranac Lake and founded the Adirondack Cottage Sanatorium. Who was he?

Edward L. Trudeau (Trudeau)

The number of patients correctly diagnosed for the disease or not having the disease is defined as:

Efficiency ((correct diagnoses / total tests) x 100)

Which organism is the most common cause of acute cystitis?

Escherichia coli

The Hodge test looks for what antibiotic resistance mechanism?

KPC (Klebsiella pneumoniae Carbapenemase)

What antinuclear antibody (ANA) pattern shows prominent staining of the nucleoli in the nuclei of the interphase cells and variable staining in the chromatin of dividing cells?

Nucleolar

The American Diabetes Association (ADA) recommends performing routine oral glucose tolerance testing (OGTT):

OGTT use is discouraged for routine use

Which United States federal agency has the responsibility of enforcing the Bloodborne Pathogens Standard?

OSHA (Occupational Safety and Health Administration)

What is the main clinical use of the marker CA-125?

Ovarian cancer

A patient who recently received a transfusion of 3 units of red cells is DAT-positive with an IgG specificity. What would be the best method to identify the patient's phenotype?

PCR-based assay

The qualitative differences between A1 and A2 phenotypes include all of these EXCEPT: The formation of Anti-A1 in subgroups The amount of transferase enzymes The length of the precursor oligosaccharide chains The lack of agglutination of patient red cells with anti-A reagent

The lack of agglutination of patient red cells with anti-A reagent (both A1 and A2 react with anti-A)

The normal Myeloid-to-Erythroid ratio (M:E ratio) ranges from:

2:1 to 4:1 (1.5:1 to 3:1 if segmented neutrophils are not included)

What transferrin saturation level would indicate to investigate further for hereditary hemochromatosis (HH)?

45%

Calculate the 24-hour urine protein in mg/24 hr. Total volume / 24 hr: 2400 mL Urine protein: 2.7 mg/dL

64.8 mg/24 hr

A patient's electrolyte results are the following: Sodium=145 mmol/L Chloride=113 mmol/L Bicarbonate=24 mmol/L Calculate the anion gap for this patient.

8 mmol/L

An Rh-negative individual has produced an anti-D antibody. Which situation has the ability to stimulate this production of anti-D? Delivering an Rh-negative baby Delivering an Rh-positive baby Receiving Rh-negative packed RBCs Receiving Rh-positive fresh frozen plasma

Delivering an Rh-positive baby

A hemoglobin F concentration of 100% may be seen in which beta thalassemia? Beta thalassemia minor (B0/B) Beta thalassemia major (B0/B0) Delta-beta thalassemia minor (dB0/B) Delta-beta thalassemia major (dB0/dB0)

Delta-beta thalassemia major (dB0/dB0)

For which of these reasons would a molecular method NOT be used? Determine blood type when the DAT is positive Complex Rh genotypes (weak D expression) Donor antibody screening Type fetal blood

Donor antibody screening

A urine sample is cloudy pink. Microscopic examination reveals intact RBCs. This is described as:

Hematuria

All of these diseases are associated with autoantibodies EXCEPT: Wegener's disease Rheumatoid arthritis Systemic lupus erythematosus Hemolytic disease of the newborn

Hemolytic disease of the newborn

When quantifying glucose using an amperometric glucose electrode system, all of the following are components of the system EXCEPT: Product oxidation produces a current Hydrogen peroxide is formed Hexokinase reacts with glucose Platinum electrode

Hexokinase reacts with glucose

The Major Histocompatibility Complex (MHC) genes encode for:

Human Leukocyte Antigens (HLA)-A,B,C

Which is the most common technique used by clinical labs for therapeutic drug monitoring? Immunoassay Electrophoresis Atomic absorption Ion selective electrode voltametry

Immunoassay

A patient presents with an elevation of unconjugated bilirubin, normal serum alkaline phosphatase, normal liver enzymes, and no bilirubin in the urine. This would suggest:

Increased rate of hemolysis

All of the following stimulate gluconeogenesis EXCEPT: Insulin Thyroxine (T4) Cortisol Glucagon

Insulin

Which is true concerning alkaline phosphatase? It is optimally active at pH 5 It is decreased in bone disorders involving the osteoblasts It is increased in obstructive jaundice It is increased in myocardial infarctions

It is increased in obstructive jaundice

When a patient has a bile duct obstruction, the bilirubin test portion of the reagent strip is:

Positive because conjugated bilirubin is present and excreted by the kidneys

Which potent inhibitor of platelet aggregation is released by endothelial cells?

Prostacyclin

What is a typical regimen for long-term maintenance therapy of individuals with hereditary hemochromatosis (HH)?

Removal of 2 to 6 units of blood yearly

Which casts are characteristically associated with acute pyelonephritis?

White cell casts

Which organism causes disease by direct invasion of tissues? Clostridium botulinum Vibrio cholerae Yersinia enterocolitica Shigella sonnei

Yersinia enterocolitica

A reaction is in _______ kinetics when the reaction rate depends only on enzyme concentration.

Zero order

The gene loci for the alpha globin chains are adjacent to the locus for which other globin chain?

Zeta

In the interest of safety, it is the policy at XYZ hospital to always add one extra vial of RhIg, regardless if the dosage calculation is rounded up or down. After performing a Kleihauer-Betke test, a tech calculates the fetomaternal hemorrhage to be 45 mL of fetal whole blood. How many vials of RhIg should be administered?

3

An aerobic, gram-negative coccobacillus was isolated on Bordet-Gengou agar from a nasopharyngeal swab 48 hours after culture from a 6-month-old infant. The organism exhibited the following characteristics: Small zones of beta-hemolysis Oxidase: negative Catalase: positive Motility: negative Pasteurella multocida Bordetella pertussis Bordetella parapertussis Bordetella bronchiseptica

Bordetella parapertussis

Which statement concerning vancomycin resistance in Enterococci is true? Van A and Van C are the most clinically significant phenotypes. Van B confers intrinsic low level resistance to vancomycin only. High level vancomycin resistance is characteristic of E. gallinarum and E. casseliflavus. Both ampicillin and vancomycin resistance are found more frequently in E. faecium than in E. faecalis.

Both ampicillin and vancomycin resistance are found more frequently in E. faecium than in E. faecalis.

Which electrophoresis method first creates a pH gradient across the gel before migration of proteins?

Isoelectric focusing

What is the principle of the Kleihauer-Betke test?

It capitalizes on the resistance of fetal hemoglobin to acid treatment.

Which of these statements about urea is FALSE? It accounts for 75% of nonprotein nitrogen excreted It is elevated in a variety of glomerular, tubular, interstitial, and vascular renal diseases It is decreased in dehydration The reference range for normal individuals is 7 to 18 mg/dL when expressed as blood urea nitrogen

It is decreased in dehydration (it's actually increased)

A keyhole or clavulanate effect on a Kirby-Bauer plate would suggest what antibiotic resistance mechanism?

ESBL (extended spectrum beta lactamase)

Reactions observed reveal a motile, gas producing, lactose fermetner that produces acetyl methyl carbinol in VP broth, produces indole, and has the ability to utilize sodium citrate as its sole source of carbon. The most likely ID is:

Enterobacter aerogenes

The term Pinworm is associated with:

Enterobius vermicularis

What condition would be suspected in an asymptomatic patient with >20% atypical (reactive) lymphs on the PBS?

Epstein-Barr virus infection

Which of these organisms is Gram positive? Pasteurella Erysipelothrix Aeromonas Fusobacterium

Erysipelothrix

Which microorganism is LEAST likely to produce a capsule or slime layer? Escherichia coli Klebsiella pneumoniae Streptococcus pneumoniae Pseudomonas aeruginosa

Escherichia coli

Which of the following dematiaceous fungal species produce conidia in clusters? Alternaria species Exophiala species Cladosporium species Curvularia species

Exophiala species

Which assay is commonly used to confirm the diagnosis of Activated Protein C resistance? Factor V Leiden Mutation assay Antithrombin Activity assay Antithrombin Antigen assay Anticardiolipin Antibody immunoassay

Factor V Leiden Mutation assay

Which methods measure fetal hemoglobin or D positive red cells or both to evaluate fetomaternal hemorrhage?

Flow cytometry

Bioavailability of an oral drug refers to the:

Fraction of the drug that is absorbed into systemic circulation

Which of these antigens are well-expressed on fetal cells? Lewis ABO Kell I

Kell

In a normal CSF the protein concentration as compared to the plasma is generally:

Less than 1%

All of these are causes of hypernatremia EXCEPT: Excess water loss Low aldosterone production Decreased water intake Increased sodium intake or retention

Low aldosterone production

Which parasite migrates either to or through the lungs in their corresponding life cycle?

Paragonimus westermanni

Which virus is MOST often reported as the cause of infection leading to aplastic crisis in a patient with sickle cell disease? Adenovirus Epstein-Barr virus Parvovirus B19 Zoster-simplex virus

Parvovirus B19

A2B is suspected when a patient's ABO typing has these results:

Patient's red cells forward types as AB with anti-A1 present in the patient's serum.

A lab test which differentiates dysfibrogenemia from afibrinogenemia is:

Fibrinogen antigen assay

All of the following represent a 2-week temporary deferral from donating blood or blood products EXCEPT: Measles (rubeola) vaccine German measles (rubella) vaccine Mumps vaccine Polio vaccine

German measles (rubella) vaccine

Which lab assay is a highly specific indicator and the most sensitive assay for a diagnosis of rheumatoid arthritis? Cyclic citrullinated peptide Sensitized sheep cells Latex particle agglutination C-Reactive Protein agglutination

Cyclic citrullinated peptide

What urine crystals are colorless, with a hexagonal shape?

Cysteine crystals

Which medication is considered an antineoplastic drug? Cyclosporine Methotrexate Clozapine Tacrolimus

Methotrexate

The term Whipworm is associated with:

Trichuris trichiura

Measurement of the sodium and chloride concentration of sweat is the most useful test for the diagnosis of:

Cystic fibrosis

An organism was found in stool, oval, measuring 20 um x 15 um. It contains two round walled compartments with four smaller objects coiled inside them. What is it?

Cystoisospora belli oocyst (Isospora belli oocyst)

Which organism would show as negative with delta aminolevulinic acid disks?

Haemophilus influenzae

Rough, buff, gray-white colonies growing on Middlebrook 7H11 agar appear cracked and flaky. These are commonly recovered from expectorated or induced sputum specimens obtained from patients with signs and symptoms of pneumonia. The appearance of these colonies provide for a presumptive ID, supported by a positive yellow-pigmented niacin reaction. What is the presumptive ID of this organism?

Mycobacterium tuberculosis

Which is the most suitable specimen for isolation of Bordetella pertussis? Nasopharyngeal swab Bronchial washing Wound aspirate Throat swab

Nasopharyngeal swab (Bordetella pertussis does not reside in the lower resp. tract)

A 21-year-old visited her doctor. She mentioned dysuria, frequency and urgency of urination. Which urinalysis test would you expect to be positive?

Nitrites

Enzyme Multiplied Immunoassay Technique (EMIT) differs from other types of enzyme immunoassays in that:

No separation of bound and free antigen is required

You are running QC for Hemoglobin A1C by high-pressure liquid chromatography (HPLC). The high control was 2.5 SD above the mean. The low control was 2.2 SD below the mean. Should you continue to run patient samples, and if not, which Westgard rule is violated?

No, R4S

All of these would be represented in the usual classification of anemia EXCEPT: Microcytic, hypochromic Normocytic, normochromic Normocytic, hyperchromic Macrocytic

Normocytic, hyperchromic (hyperchromic is not a term that's used)

The kidneys perform all of the following functions EXCEPT: Acid-base balance Hormone production Reabsorption of waste products Water and electrolyte balance

Reabsorption of waste products

All of these crystals are found in normal urine EXCEPT: Triple phosphate Ammonium biurate Calcium oxalate Leucine

Leucine

Nematodes are round and elongated and typically look like an earthworm. They can be found in decaying vegetation or moist soil. Of these organisms, which is a nematode? Trichuris trichiura Diphyllobothrium latum Taenia solium Hymenolepis diminuta

Trichuris trichiura (whipworm; the others are cestodes or tapeworms)

Which Plasmodium morphologic form is considered most immature? Schizont Trophozoite Microgametocyte Macrogametocyte

Trophozoite

A diabetic woman is admitted to the hospital. It appears that she had an AMI but didn't feel the acute chest pain because of diabetic neuropathy. She has not felt well and her physician believes she possibly had an AMI 5 days ago. Assuming that the infarct was uncomplicated, which cardiac biomarker would most likely still be elevated and would assist in an AMI diagnosis? Myoglobin Creatine kinase MB (CK-MB) Troponin T All of the above

Troponin T

What is a characteristic of a person who is weak D? Types as D negative and produces anti-D when exposed to D antigen Demonstrates a reduced number of D antigen sites on the surface of the red cell Types as D positive and produces anti-D when exposed to D antigen Someone who is defined as being D negative

Demonstrates a reduced number of D antigen sites on the surface of the red cell

The MOST reliable method for determining the appropriate dosage of Rh immune globulin to give to an identified Rh immune globulin candidate after delivery is: Kleihauer-Betke Flow cytometry Rosette test Panel cells

Flow cytometry

What would be the best way to determine how much RhIg should be given to a postpartum female who received RhIg antenatally and demonstrates the anti-D antibody at delivery?

Flow cytometry

Platelets are:

Fragments of megakaryocyte cytoplasm and do not contain nuclei

What protective method should be used when working with organic solvents?

Fume hood

A boy had recent jaundice and icteric sclera after taking the medication Primaquine. Immediate lab work revealed Hct 24%, MCV 79.5 fL, RDW 13%. Blood smear showed spherocytes and supravital stain showed Heinz bodies. What condition should be considered? G6PD deficiency Pyruvate kinase deficiency Iron deficiency anemia Megaloblastic anemia

G6PD deficiency

What is a potentially negative aspect to molecular (DNA) testing for mutations of the HFE gene, the gene found in the majority of patients diagnosed with hereditary hemochromatosis (HH)?

Genetic discrimination based on knowledge of test results

All of the following represent a 2 week temporary deferral from donating blood or blood products EXCEPT: Measles (rubeola) vaccine German measles (rubella) vaccine Mumps vaccine Polio vaccine

German measles (rubella) vaccine

A 29yo pregnant woman had an outpatient glucose tolerance test. The patient was given a 100-gram dose of glucose and the following values were obtained: Fasting = 110 mg/dL 1 hr = 188 mg/dL 2 hr = 175 mg/dL 3 hr = 143 mg/dL The most likely interpretation of this glucose tolerance test would be:

Gestational diabetes mellitus

All of these conditions are associated with hereditary spherocytosis EXCEPT: Increased osmotic fragility An MCHC greater than 37% Intravascular hemolysis Extravascular hemolysis

Intravascular hemolysis

Which of the following analytes would be decreased due to delay in centrifugation? Ionized calcium Potassium ALT AST

Ionized calcium (K, ALT, AST would be increased)

Which activity would require that a label be added to the blood label indicating the name and location of a second manufacturer?

Irradiating a unit of red cells or platelets

Which of these is FALSE regarding troponin as a marker of myocardial infarction (MI)? It rises much sooner after MI than CK-MB It stays elevated much longer than CK-MB It is potentially more specific as a cardiac marker than CK-MB Troponin T is often elevated in renal failure patients

It rises much sooner after MI than CK-MB

Which characteristic is consistent with the Kidd blood group? Jk(a-b-) red cells are resistant to lysis in 2M urea Kidd antigens are destroyed by ficin Antibodies to Kidd antigens react best at immediate spin Anti-Jka activity may not react well in a LISS test system

Jk(a-b-) red cells are resistant to lysis in 2M urea (they do react well with LISS)

All of the statements about synovial fluid are correct EXCEPT: Arthrocentesis is performed as a means to evaluate arthritis and other joint disorders Synovial fluid is present only in movable joints Joint fluid resembles plasma in viscosity Joint fluid has approximately the same glucose as plasma

Joint fluid resembles plasma in viscosity (joint fluid is much more viscous)

Nocardia species can be isolated from cutaneous specimens and can produce sulfur granules. These granules can be found in tissue specimens and can aid in detecting aerobic actinomycetes. To help identify the presence of sulfur granules in tissue specimens, which method will be most beneficial? Gram stain Acid fast stain KOH mount Gomori methenamine-silver (GMS)

KOH mount

While ABO, Rh, Kell, Duffy, Kidd, SsU are clinically significant, which of these antibodies generally react ONLY at the Coombs phase (also known as the Antihuman Globulin, or AHG phase)? Rh and Kell antibodies ABO antibodies Kell, Duffy, and Kidd antibodies SsU and Kidd antibodies

Kell, Duffy, and Kidd antibodies

In a normal CSF, the protein concentration as compared to that in the plasma is generally:

Less than 1%

What urine crystals appear yellow, with concentric circles and radial striations?

Leucine crystals

What part of an immunoglobulin molecule exists as kappa or lambda chains?

Light chains

Which type of lipoprotein transports the MAJORITY of cholesterol to cells for steroid hormone synthesis or cell membrane incorporation?

Low density lipoproteins (LDL)

What are the smallest nucleated cells seen in peripheral blood?

Lymphocytes

Which cells are capable of producing antibodies?

Lymphocytes

14-day-old colonies of a Mycobacterium species develop yellow pigment after exposure to environmental light. What might it be? M. chelonae M. marinum M. scrofulaceum M. gordonae

M. marinum

Which red cell morphological classification is characteristic of megaloblastic anemia?

Macrocytic

Which of these may be seen in a CSF sample of a patient with a subarachnoid (intracranial) hemorrhage (SAH)? Macrophages containing hemoglobin Uneven distribution of blood in CSF tubes collected Clot present in CSF sample Supernatant of CSF sample does not have xanthochromia

Macrophages containing hemoglobin

A patient has a WBC count of 4,000 x 10^9/L. Giant platelets are observed on the peripheral smear. Blue-staining inclusions are seen in the cytoplasm of many neutrophils. These inclusions fit the description of: Auer rods Barr bodies Dohle bodies May-Hegglin anomaly inclusions

May-Hegglin anomaly inclusions (no other toxic changes like Dohle bodies)

The presence of an increased number of hypersegmented neutrophils in the peripheral blood is an indication of which condition?

Megaloblastic anemia

You are collecting a blood specimen for forensic (legal) alcohol testing. Which must be done before you can start the specimen collection process? Label the tubes in the presence of the patient. Must inform the patient that the blood is for alcohol testing. Seal the collection tubes in front of the patient. Collect the specimen, the patient does not need to be informed what the blood is collected for.

Must inform the patient that the blood is for alcohol testing.

Tiny colonies grew on chocolate agar after 3 days incubation, recovered from a skin abscess. Acid fast stains were positive for slender bacilli consistent with rapidly growing Mycobacteria. Reactions for nitrate reduction and iron uptake were negative. A distinctive characteristic was the antibiotic resistance to Ciprofloxacin and Polymyxin B susceptibility. What is this isolate? Mycobacterium chelonae Mycobacterium fortuitum Mycobacterium gordonae Mycobacterium scrofulaceum

Mycobacterium chelonae (M. fortuitum has reversed susceptibilities, as well as positive nitrate and iron uptake tests)

The accumulation of niacin, as shown by a yellow reaction on a test strip, is one of the chief characteristics to ID Mycobacterium tuberculosis. Another rarely encountered Mycobacterium species that also accumulates niacin is: Mycobacterium gordonae Mycobacterium simiae Mycobacterium xenopi Mycobacterium fortuitum

Mycobacterium simiae

A 30yo woman developed progressive painful swelling of the foot after getting a traumatic splinter. The wound initially healed. The Gram stain showed branching and sulfur granules. Dry yellow colonies grew in 72 hours that had a musty odor. The most likely identification is: Nocardia brasiliensis Rhodococcus equi Streptomyces anulatus (formerly griseus) Actinomyces israelii

Nocardia brasiliensis (Rhodococcus colonies are pink, Streptomyces are not yellow but glabrous and waxy, Actinomyces makes molar tooth-type colonies)

A male patient's urea nitrogen value is 15 mg/dL and his creatinine is 5 mg/dL. If this patient is not undergoing dialysis, what conclusion would you draw?

One of the values is in error.

Phagocytosis by cells of the mononuclear phagocytic system is greatly enhanced by which of these? Hemolysins Opsonins Specific antitoxins Neutralizing antibodies

Opsonins

Which of these might cause a false positive indirect antiglobulin test (IAT)? Failure to adequately wash cells Delay in the addition of antiglobulin reagent Over-centrifugation High concentration of IgG paraprotein in serum

Over-centrifugation (failure to wash and excess IgG will leave unbound IgG causing false negatives, delay may allow bound IgG to dissociate from RBCs causing false negatives)

Of these Enterobacteriaceae, which fails to decarboxylate lysine, ornithine, and arginine? Pantoea agglomerans Enterobacter aerogenes Yersinia enterocolitica Proteus mirabilis

Pantoea agglomerans

Degenerated erythrocyte cytoplasmic organelles that contain iron are called:

Pappenheimer bodies

All of these organisms are listed with a common site of recovery, EXCEPT: Giardia lamblia - duodenal contents Trichuris trichuria - stool Plasmodium falciparum - ocular secretions Paragonimus westermanni - sputum

Plasmodium falciparum - ocular secretions

There are several types of media that can be used in electrophoresis. Most methods today use a gel - cellulose acetate, agarose, or polyacrylamide gel. Which statement is TRUE regarding these gels? The compounds used to make cellulose acetate gels are carcinogenic. Polyacrylamide gels are composed of polysaccharides and acrylamides. Polyacrylamide gels have the greatest resolution or separation of solutes. Cellulose acetate and agarose gels are the more commonly used gels.

Polyacrylamide gels have the greatest resolution or separation of solutes.

Which probe technique is categorized as a target amplification technique? Polymerase chain reaction Southern blot Northern blot Sandwich hybridization

Polymerase chain reaction

A false-positive result can be observed in a rheumatoid factor latex agglutination procedure reaction due to: Poor specimen quality Antigen excess Excessive complement levels Juvenile idiopathic arthritis

Poor specimen quality (lipemia, hemolyzed, or contaminated, or test read late)

Colonies recovered from an inflammatory infection of the oral cavity of a student. Colonies grew anaerobically and are small, entire, and smooth with a light gray-yellow pigmentation. Small Gram-negative rods arranged singly and in loose clusters are observed microscopically. Spot indole and lipase reactions are positive. The bacteria are non-fermentative on Kligler Iron Agar and have a lack of fermentation in sugars. Identify this anaerobic, asaccharolytic, gram-negative isolate: Porphyromonas asaccharolytica Fusobacterium nucleatum Bacteroides fragilis Cutibacterium (Propionibacterium) acnes

Porphyromonas asaccharolytica

A peripheral blood smear contains scattered acanthocytes, echinocytes, target cells, spherocytes, schistocytes, and a Howell-Jolly body. The condition in which all of these atypical RBCs may be found in the same patient is:

Postsplenectomy syndrome

Which viral family contains DNA as its nucleic acid? Paramyxoviridae Rhabdoviridae Poxviridae Orthomyxoviridae

Poxviridae

Which is an expected or common lab finding in patients with hereditary hemochromatosis? Elevated hemoglobin and hematocrit Decreased transferrin saturation Presence of HFE mutation Decreased serum ferritin

Presence of HFE mutation (NOT high H&H)

When preparing a slide for morphologic examination, what would be the reason for adding a drop of albumin to the CSF sample prior to cytocentrifugation?

Preserve the integrity of the cells

Which of these laboratory results would you find with disseminated intravascular coagulation (DIC) but NOT with thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome (HUS)? Prolonged PT and aPTT Thrombocytopenia Schistocytes on the peripheral blood smear Elevated LDH

Prolonged PT and aPTT

Which adsorption technique removes cold (IgM) antibodies, particularly anti-I specificities? Cold autoadsorption Warm autoadsorption Differential (allogeneic) Rabbit erythrocyte stroma (RESt)

RESt (rabbit erythrocyte stroma) (autoadsorption uses pt RBCs to remove autoantibodies to determine if alloantibodies are present; allogeneic adsorption uses known phenotyped RBCs to separate specificities)

A patient had a differential diagnosis of Systemic Lupus Erythematosus (SLE). Lab results: ANA = positive (homogeneous pattern) Titer 1:320 RA = positive Complement = decreased All of the following specific laboratory tests meet the criteria for a definitive diagnosis of SLE EXCEPT: A positive antinuclear antibody (ANA) Smith (Sm) antibodies Double-stranded DNA (dsDNA) antibodies Ribonucleic protein (RNP) antibodies

RNP antibodies (Ribonucleic protein antibodies)

Which is NOT classified as a Myelodysplastic Syndrome? Refractory Lymphopenia Refractory Anemia Refractory Neutropenia Refractory Thrombocytopenia

Refractory Lymphopenia

The descriptions below refer to the appearance of inclusions found in Wright-stained or supravital-stained peripheral blood smears. Describe basophilic stippling.

Relatively evenly distributed fine or coarse granules throughout the red cell

An organism growing on anaerobic blood agar is presumptively identified as Cutibacterium (Propionibacterium) acnes. What should the next step be? Set up biochemical reactions to confirm the identification Refer the culture to a reference lab for confirmation Report with added comment Probable Contaminant Retain isolate as part of a routine stock culture collection

Report with added comment Probable Contaminant

Which disease/condition is associated with a deficiency in vitamin D?

Rickets

What physiological factor causes sedimentation in the Erythrocyte Sedimentation Rate (ESR)? Elevated levels of immunoglobulin Increased concentration of fibrinogen Rouleaux formation Tilted tube, varying from the vertical

Rouleaux formation

Which blood smear observation would support the diagnosis of Multiple Myeloma if a patient demonstrated plasma cells in his bone marrow and had an elevated serum IgG?

Rouleaux formation

All of these could explain why screen cell #2 has a stronger reaction than screen cell #1 EXCEPT: The patient has more than one antibody and all corresponding antigens are on SC2 but not on SC1 The patient has an antibody other than anti-D and SC2 has a double dose of the antigen, whereas SC1 has only a single dose Operator variability - When dislodging the cell buttons during reading, the tech shook SC1's test more vigorously than SC2's test SC1 has homozygous antigen for the reacting antibody whereas SC2 is heterozygous

SC1 has homozygous antigen for the reacting antibody whereas SC2 is heterozygous

Von Willebrand factor (vWF) multimer analyses of patient's plasma can be performed by:

SDS agarose gel electrophoresis

Which of the following Enterobacteriaceae produces H2S? Klebsiella species Escherichia species Salmonella species Yersinia species

Salmonella species

What is the proper method for examining a trichrome-stained smear using bright field microscopy? Scan the slide using fluorescent microscopy, not bright field Scan the thick areas using oil immersion (100X) only Scan the thin areas on low power (10X or 40X) only Scan the slide on low power (10X or 40X) first, then switch to oil immersion (100X) and scan the thin areas

Scan the slide on low power (10X or 40X) first, then switch to oil immersion (100X) and scan the thin areas

Which disease/condition is associated with a deficiency in vitamin C?

Scurvy

Important applications of polymerase chain reaction (PCR) include these with the general exception of: Search for mutations with large deletions Amplification of DNA Identification of a target sequence Synthesis of an anti-sense probe

Search for mutations with large deletions (generally, only short sequences can be amplified)

Which mechanism involves a series of interrelated chemical processes that lead to the formation of durable fibrin strands?

Secondary hemostasis

A 4-day-old colony on Sabaraud's Dextrose agar showed spherical to pyriform shaped, bluntly spiked conidia borne singly from slender conidiophores. They resembled the larger spiked macroconidia of Histoplasma capsulatum. What is the fungus genus?

Sepedonium

Which statement best describes small dense LDL particles that can occur in atherogenic dyslipedemia? Small dense LDL molecules are less atherogenic than larger, less dense or buoyant LDL particles because they are metabolized faster Small dense LDL molecules transport more cholesterol and thus are more atherogenic Small dense LDL molecules are more atherogenic because they can more easily move into the endothelium and vessel wall Small dense LDL molecules are just as atherogenic as the larger ones

Small dense LDL molecules are more atherogenic because they can more easily move into the endothelium and vessel wall

In which of these conditions would one see Pappenheimer bodies on the peripheral blood smear? Iron deficiency anemia Malarial infections G6PD deficiency Splenectomy

Splenectomy

Which bacterial species is most likely represented by an opaque, chalky white colony? Bacillus cereus Listeria monocytogenes Burkholderia pseudomallei Streptomyces anulatus

Streptomyces anulatus (nocardioform bacteria make those chalky types)

A nematode filariform larva has a short buccal cavity. What presumptive identification can be made?

Strongyloides stercoralis

A rhabditiform larva with a short buccal cavity was found in a diarrheal stool sample The patient also complained of persistent cough and shortness of breath. What presumptive ID can be made?

Strongyloides stercoralis

In cases of suspected intestinal parasitic disease, select the parasite ova that may be detected in upper respiratory secretions when stool specimen preparations are negative.

Strongyloides stercoralis

All of these are considered reducing sugars EXCEPT: Lactose Sucrose Glucose Ribose

Sucrose

What test can be used as a confirmatory test for proteinuria?

Sulfosalicylic acid test (acetest is ketones, Benedict's test and Fehling's test detect reducing agents)

A patient came to the ER with a swollen knee and the physician drained 20 mL of fluid from the patient's knee. What is the name of the fluid collected?

Synovial fluid

T lymphocytes are characterized by all of these EXCEPT: Secrete cytokines Synthesize antibody Comprise majority of cells in blood lymphocyte pool Help regulate immune response

Synthesize antibody (they don't)

The morphologic structures on a scolex from a cestode parasite include a rostellum, hooklets, and suckers. What species is this?

Taenia solium

All of these would be effective methods to reduce the risk of becoming infected with the H1N1 virus EXCEPT: Take an aspirin every day Receive the H1N1 vaccine Avoid touching nose and mouth Wash hands often or use an alcohol-based hand sanitizer

Take an aspirin every day

What is the predominant abnormal erythrocyte morphology associated with idiopathic myelofibrosis?

Teardrop cells (dacryocytes)

A mother's serologic results are shown below. Her newborn types as group A Rh positive with a (1+) positive direct antiglobulin test (DAT). ABO: Anti-A 0 Anti-B 0 Anti-D 3+ A1 cells 4+ B cells 4+ Maternal antibody screen: SCI (R1R1): IAT 0, CC 2+ SCII (R2R2): IAT 0, CC 2+ SCIII (rr): IAT 0, CC 2+ Which of the following investigative tests would be most useful to resolve the cause of the positive DAT and should be done FIRST? Test an eluate prepared from newborn's red cells against an antibody identification panel by IAT Test newborn's plasma against group A1 red cells and group O antibody screen cells by IAT Test newborn's plasma against mother's red cells by IAT Test newborn's plasma against father's red cells by IAT

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

When a speckled nuclear antibody (ANA) pattern is observed, what follow-up test for antibodies related to Systemic Lupus Erythematosus (SLE) is not beneficial? Testing for all antibodies to Smith (Sm) Testing for all antibodies to the extractable nuclear antigens (ENA) Testing for antibodies to SS-A/SS-B+ Testing for antibodies to U1RNP+ and dcSSc

Testing for antibodies to U1RNP+ and dcSSc (U1RNP+ is ass. with connective tissue disease; Scl-70, which must include dcSSC?, is ass. with diffuse cutaneous scleroderma)

What is the porphyrin test?

Tests whether the organism can synthesize heme (factor X)

What percentage of dietary iron is normally absorbed daily?

5-15%

Aspirin ingestion prevents the synthesis of which signaling molecule in the platelet?

Thromboxane A2

Of the following, which has the longest half-life? Carbamazepine Valproic Acid Phenytoin Phenobarbitol

Phenobarbitol

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

Photopheresis

Which of these blood components would be most appropriate for a 9yo girl suspected of having idiopathic thrombocytopenic purpura (ITP), including a low platelet count and bleeding gums? Packed RBCs Cryoprecipitate Platelets Fresh frozen plasma

Platelets

What is the group of diseases called where there is a deficiency in the enzymes involved in hemoglobin synthesis?

Porphyrias

Which cell inclusions are characteristic of Pelger-Huet anomaly?

Decreased nuclear segmentation and coarse chromatin in leukocytes

Donated red blood cells that contain the anticoagulant CPDA-1 (citrate-phosphate-dextrose-adenine) may be stored for how long?

35 days

Glitter cell is a term used to describe a specific type of:

Neutrophil

The antibody most frequently present in systemic lupus erythematosus (SLE) is directed against:

Nuclear antigen

The McFarland Comparison Card is used to:

Standardize concentrations of organisms

The normal myeloid to erythroid ratio (M:E ratio) is:

1.5 - 3.1 to 1

What test uses delta-aminolevulinic acid?

Porphyrin test

What test requires a 72-hour stool (fecal) collection?

Quantitative fecal fat

A manual white blood cell count was performed. The cell counts for each of two sides was 38 and 42 respectively. All nine large squares were counted on each side. The dilution for this kit was premeasured at 1:10. What should the tech report as the white cell count?

0.44 x 10^9/L

The radioactive method used to measure red cell survival uses which of these isotopes? I 125 51 Cr P 31 14 C

51 Cr

If detected in antibody screen testing, which antibody is NOT considered clinically significant? Anti-M Anti-N Anti-Leb Anti-Fya

Anti-Leb

If detected in antibody screen testing, which of the following antibodies is NOT considered clinically significant in prenatal patients? Anti-M Anti-N Anti-Leb Anti-Fya

Anti-Leb

If detected in antibody screen testing, which of these antibodies is NOT considered clinically significant? Anti-M Anti-N Anti-Leb Anti-Fya

Anti-Leb

The serum from an African-American patient is reactive with all screening and panel cells. Which antibody directed to a high-incidence antigen is most likely?

Anti-U

When monitoring the use of low-molecular-weight heparin, which lab test is recommended?

Anti-Xa

The term Roundworm is associated with:

Ascaris lumbricoides

A KOH mount is used to detect which microorganism? Entamoeba histolytica Pseudomonas aeruginosa Staphylococcus aureus Aspergillus fumigatus

Aspergillus fumigatus

Which fungus has spherical to pyriform conidia borne singly at the tips of long slender conidiophores, resembling the conidia of Blastomyces dermatitidis except that growth is much longer?

Chrysosporium

Which type of lipoprotein is the least dense? Chylomicrons VLDL LDL HDL

Chylomicrons

Which cell is the most common nucleated cell in normal adult bone marrow?

Metamyelocyte (reference interval 3-20%; myelocyte 6-17%; promyelocyte 1-5%; myeloblast 0-3%)

Whole blood glucose values are ____________ than plasma glucose values

About 11% lower

What is the cause of iron overload in hereditary hemochromatosis?

Absorption of excessive amounts of iron in the small intestine

Oliguria is usually correlated with:

Acute glomerulonephritis

Given these hepatitis B serology results, what is the immune status of the patient? HBsAg: positive HBeAg: positive Anti-HBc IgM: positive Anti-HBs: negative

Acute infection

Colonies were recovered from a nasal secretion of a patient with acute sinusitis. The 48-hr colonies on blood agar are small, white and non-hemolytic. Colonies on chocolate have a light yellow pigmentation. Pale-staining, Gram-negative coccobacilli are observed, with a tendency to form long narrow filaments. KIA: Acid/Acid, oxidative utilization of several carbohydrates except xylose and mannose. Nitrate reduction is positive, and ornithine and arginine decarboxylases are negative. What is this isolate? Moraxella catarrhalis Kingella kingae Aggregatibacter aphrophilus Eikenella corrodens

Aggregatibacter aphrophilus

Which statement is TRUE regarding agents of bioterrorism? The agents of bioterrorism can be manipulated on an open bench. None of the agents of bioterrorism have been known to cause lab-acquired infections. At least a class II biological safety cabinet (BSC) should be used. Agents of bioterrorism are very expensive and need very sophisticated equipment to produce.

At least a class II biological safety cabinet (BSC) should be used.

Leukocyte reduction may be performed at the same time as which step in blood component collection?

At the same time the additive solution is added

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: A B F G

B

An organism was inoculated into Kligler Iron Agar (KIA), tryptophane broth for detecting indole, and Simmon's citrate. The KIA tube shows an entirely yellow slant and butt, the indole tube shows a layer of red color, and the Simmon's citrate tube is green. The bacteria most likely to produce these reactions is: Shigella flexneri Escherichia coli Klebsiella oxytoca Enterobacter aerogenes

Escherichia coli (KIA positive - lactose fermenter, indole positive, citrate negative)

Which form of calcium is biologically active?

Free ionized calcium

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

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

A quick mathematical check to verify that hemoglobin and hematocrit on a CBC correspond would be: Hematocrit x 3 = hemoglobin Hemoglobin x 3 = hematocrit Hemoglobin / hematocrit = 3 Hemoglobin + hematocrit = 3

Hemoglobin x 3 = hematocrit

An electrophoretic separation of lactate dehydrogenase isoenzyme that demonstrates elevation in LD-1 greater than LD-2 could be indicative of: A normal LD isoenzyme pattern Hemolysis Pancreatitis Hepatic injury

Hemolysis (myocardial infarction can raise them also)

The autohemolysis test is most useful in the diagnosis of what condition? Pyruvate kinase (PK) deficiency G6PD deficiency Sickle cell anemia Hereditary spherocytosis

Hereditary spherocytosis

What antinuclear antibody (ANA) pattern shows uniform staining of the nuclei in the interphase cells and staining in the chromatin of dividing cells?

Homogeneous

What role does lipase play in the body?

Hydrolyzes fat esters to produce alcohol and fatty acids

Small beta hemolytic colonies were recovered from an induced sputum specimen from a young child with pneumonia. The colonies were slow growing, small, entire, and show soft beta hemolysis. Plump Gram-negative coccobacilli, lying singly or in pairs or short chains, are seen on Gram stain. Most strains are chemically non-reactive except for a positive oxidase reaction and acid produced from dextrose and maltose. What is the isolate? Capnocytophaga species Cardiobacterium hominis Eikenella corrodens Kingella kingae

Kingella kingae

Which site on the body is used most often for CSF collection?

L3-L4

Laser light can be described by all of these EXCEPT: Intensity and concentration Used in flow cytometry for cell sorting and identification of cells LASER is an acronym for light amplified by stimulated energy radiation Monochromaticity

LASER is an acronym for light amplified by stimulated energy radiation (it's actually Light Amplification by Stimulated Emission of Radiation)

What is the correct calculation using the Friedewald calculation for LDL?

LDL = total cholesterol - HDL - triglycerides/5 (only if trig < 400)

Which cell inclusions are characteristic of Alder-Reilly anomaly?

Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides

Which of these Lewis blood group system phenotypes usually produces anti-Lea? Le(a+b+) Le(a+b-) Le(a-b+) Le(a-b-)

Le(a-b-)

A bacterial species shows a large zone of inhibition around a novobiocin (NB) disk, a small zone around a bacitracin (A) disk, and no zone around a furazolidone (FX) disk. What is the most likely ID? Micrococcus luteus Staphylococcus saprophyticus Streptococcus pyogenes Staphylococcus epidermidis

Micrococcus luteus (Micrococcus are resistant to furazolidone, and Staph are sensitive; S. sapro is resistant to NB and sensitive to FX; S. pyogenes would have a larger zone around A; S. epi would be sens to both NB and FX)

A peripheral smear shows red cells that are mostly 5 - 5.5 micrometers in diameter, with an RDW of 13%. What correlates with these findings?

Microcytosis, low variation of cell volume

Which organism has been known to cause epidemic tinea capitis in children but almost never affects adults?

Microsporum audouinii

What describes the benefits of the RPR or VDRL tests?

Monitoring course of treatment of syphilis

Which organism will infect humans and a wide range of host animals? Mycobacterium canettii Mycobacterium microti Mycobacterium mungi Mycobacterium bovis

Mycobacterium bovis

Which disease/condition is associated with a deficiency in vitamin A?

Night blindness

All of these are responsibilities of sentinal laboratories within the Laboratory Response Network (LRN), EXCEPT: Refer samples to LRN reference labs when select bioterrorism agents cannot be ruled out. Maintain a BSL-2 facility. Perform full identification and susceptibility on all potential bioterrorism agents. Perform testing to rule out the presence of select bioterrorism agents.

Perform full identification and susceptibility on all potential bioterrorism agents. (Don't need to)

Enterococcus spp. are commonly resistant to all of these antimicrobial drug types EXCEPT: Aminoglycosides Phenicols Beta-lactams Glycopeptides

Phenicols (they usually use chloramphenicol)

Which dematiaceous fungi affects the joints causing septic arthritis? Piedraia hortae Madurella spp. Phialophora spp. Hortaea werneckii

Phialophora spp.

Which analyte shows no difference between capillary and venous values? Glucose Phosphorus Bilirubin Calcium

Phosphorus (and urea)

Follicle-stimulating hormone (FSH) is produced by:

Pituitary gland

Which cells show a perinuclear hof effect when Wright-stained?

Plasma cells

Which of these animals is a likely source of human tularemia infections?

Rabbits

Edwardsiella tarda is known to be associated with which animals?

Reptiles (snakes, turtles, toads, fish)

All of these should be done when centrifuging specimens EXCEPT: Specimens without anticoagulant should sit for 30 minutes before centrifugation Specimens with anticoagulant should sit for 20 minutes before centrifugation Cap all tubes for centrifugation Allow the centrifuge to come to a complete stop by itself before opening

Specimens with anticoagulant should sit for 20 minutes before centrifugation (centrifuge immediately)

A mixture of Gram positive and Gram negative bacteria may be present within the same field of a slide in all of these EXCEPT: Mixed wound infections Urine sediment from a mid-stream clean-catch specimen Expectorated sputum specimen Sterile cerebrospinal fluid

Sterile cerebrospinal fluid

A 67yo man in the ER was complaining of cough, fever, and piercing right posterior chest pain. X-ray of the chest revealed consolidation of the right middle lobe of the lung. A sputum culture grew wet, mucoid, alpha hemolytic colonies. The Gram stain showed gram positive diplococci. The most likely cause of the pneumonia is:

Streptococcus pneumoniae

The body of a cestode is known as its

Strobila

A jaundiced newborn's bilirubin values are: 12/28/2015, 7:45am: 14 mg/dL 12/29/2015, 7:15am: 13 mg/dL 12/30/2015, 8:00am: 4 mg/dL What is the explanation for these results? This is a case of diurnal variation The ultraviolet light placed on the baby broke down the bilirubin The specimen was not protected from light and bilirubin broke down resulting in a falsely decreased value These are normal test values and there should be no concern

The specimen was not protected from light and bilirubin broke down resulting in a falsely decreased value

A prothrombin time (PT) specimen was collected at an outpatient clinic and will not be picked up for several hours. How should the specimen be stored?

The tube should remain unopened and be kept at room temperature.

Which drug is used to treat asthma and COPD in patients with nocturnal symptoms or problems with inhalers?

Theophylline

Following the treatment of an IgG molecule with papain, which will remain? Two Fab fragments, each with a light chain and a partial heavy chain attached with a disulfide bond Four separate light chains and two separate heavy chains One unit that consist of two partial heavy chains and two light chains, all attached with a disulfide bond Eight units, two complete light chains and two heavy chains split in half

Two Fab fragments, each with a light chain and a partial heavy chain attached with a disulfide bond

The type of hypersensitivity reaction associated with macrophage activation, cytokine-mediated inflammation is: Type I Anaphylactic Type II Cytotoxic Type III Immune complex mediated Type IV Cell mediated

Type IV Cell mediated

Which amino acid is the precursor for catecholamines as well as thyroid hormones?

Tyrosine

What describes the direct antiglobulin test (DAT) principle?

AHG (anti-human globulin) detects antibody already sensitized to red cells.

A 40-year-old man with a prosthetic valve developed intermittent bouts of low-grade fever. A changing cardiac murmur suggested the possibility of endocarditis; however, repeart blood cultures over a 2-week period were negative. GPC in chains were finally seen in a Gram stain of a positive bottle. Colonies were recovered when broth was subcultured to a blood agar plate with a Staph streak, showing tiny colonies satelliting around the Staph. What is the most likely bacterial species? Streptococcus mitis group Enterococcus faecalis Abiotrophia defectiva Streptococcus bovis

Abiotrophia defectiva

Which statement applies to an immunoassay with high specificity? Accurately identifies the presence of disease Accurately identifies the absence of disease Has many false-positives Has few false-negatives

Accurately identifies the absence of disease

All of these lab tests are used to determine kidney function EXCEPT: Creatinine Blood Urea Nitrogen (BUN) Amylase Phosphorus

Amylase

Prothrombin time is:

An initial screening procedure for bleeding disorders and a test to monitor anticoagulant therapy

The eggs of Necator americanus are basically indistinguishable from those of:

Ancyclostoma duodenale

If detected in antibody screen testing, which antibody is NOT considered clinically significant in prenatal patients? Anti-M Anti-N Anti-Leb Anti-Fya

Anti-Leb

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

B

All of the following normal urine crystals are most often found in a urine that has a pH > 7 EXCEPT: Calcium oxalate Triple phosphate Ammonium biurate Calcium carbonate

Calcium oxalate

Measurement of sodium and chloride in sweat is the most useful test for the diagnosis of:

Cystic fibrosis

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

Lithium or sodium heparin

Which source of error will give a false negative result in antihuman globulin testing? Low pH of saline Dirty glassware Samples collected in gel separator tubes Refrigerated specimen

Low pH of saline

Which of the following is true regarding the Lutheran blood group? Anti-Lua most often is IgG Anti-Lub is always IgM Lua is a high-frequency antigen Lub is a high-frequency antigen

Lub is a high-frequency antigen

The positive predictive value of a Borrelia burgdorferi antibody assay depends on the likelihood of ______ being present?

Lyme disease

A baby is born. 30 min later, you receive a cord blood specimen that you ID as O positive. You previously typed the mother as O negative with a negative antibody screen. What is the next action?

Perform a fetal blood screen

How does RhIg prevent anti-D production?

Mainly by suppressing the immune response after exposure to D positive cells

A newborn presents with neonatal alloimmune thrombocytopenia. What is the most likely cause of this condition?

Maternal antibodies to neonatal platelet antigens

Cytospin from pleural fluid: identify the cells to report. (round pale pink cells, larger cells with darker pink, oddly shaped bits, larger purple cells with round pink nuclei)

Mesothelial cells, neutrophils, and red blood cells

An Rh negative pregnant woman has produced anti-D and the physician has decided to use molecular typing to determine if the fetus is at risk. Which test results make fetal DNA testing a recommended second step?

Molecular genotyping demonstrates that the father is heterozygous for the RHD allele.

A culture was taken of a conjunctival exudate. The bacterial species, represented by tiny colonies on a chocolate agar plate, were recovered after 48 hour incubation at 35 degrees C. The isolate was cytochrome oxidase positive and highly susceptible to penicillin. What is the most likely identification of this organism? Moraxella lacunata Moraxella catarrhalis Neisseria subflava Haemophilus aphrophilus

Moraxella lacunata

These Mycobacterium colonies are dark yellow pigmented early in culture without being exposed to light:

Mycobacterium gordonae, scrofulaceum, xenopi, szulgai

What best describes the relation of nephelometry to turbidimetry?

Nephelometry directly measures the amount of light scattered by particles in solution, and turbidimetry measures the decrease in incident-light intensity.

Which urinalysis test detects bacteria that produce enzymes to reduce nitrate?

Nitrate reduction test

Which organism is both a transient colonizer of skin and the most common cause of bacterial skin infections?

Staphylococcus aureus

The qualitative differences between A1 and A2 phenotypes include all EXCEPT: The formation of anti-A1 in A subgroups The amount of transferase enzymes The length of the precursor oligosaccharide chains The lack of agglutination of patient RBCs with anti-A reagent

The lack of agglutination of patient RBCs with anti-A reagent

A prothrombin time (PT) specimen was collected at an outpatient clinic and will not be picked up until several hours later. How should the specimen be stored?

The tube should remain unopened and be kept at room temperature.

Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet:

Thromboxane A2

A slow progressive drift of values away from the mean is:

Trend

A small circular white colony with a downy surface, from a skin scraping specimen after 7 days growth on agar supplemented with thiamine and inositol. Aerial hyphae show branching hyphae with small stalks with one teardrop apiece. Underlying are chains of pigmented chlamydospores among the hyphae. What is the most likely ID of this dermatophyte?

Trichophyton verrucosum

The principle behind the diagnosis of Paroxysmal Nocturnal Hemoglobinuria (PNH) by flow cytometry is:

Using a fluorescein labeled proaerolysin variant to selectively bind to GPI anchor proteins

In heme synthesis, how many molecules of delta-aminolevulinic acid (ALA) are needed to form one molecule of heme?

8

A markedly elevated 5-hydroxyindole acetic acid (5-HIAA) determination is presumptive evidence for:

Carcinoid tumor

Which clinical finding characterizes post-transfusion purpura (PTP)? Increased hemoglobin Pancytopenia High ferritin levels Thrombocytopenia

Thrombocytopenia

How many grams of CaCl2 is needed to prepare 500mL of a 0.5M solution?

27.5 g (need molecular weight of CaCl2: 111 g/mol. Grams needed = (mol wt) x (M) x (volume in L)

What is the proper storage temperature for thawed cryoprecipitate?

20-24 C

Regarding hemoglobin synthesis, which constitutes the alpha globin chain coding? How many gene loci, on which chromosome?

4 gene loci, 2 each on chromosome 16

An Rh negative mother gave birth to an Rh positive baby. Her rosette test was positive. The Kleihauer-Betke stain procedure showed the percentage of fetal cells to be 1.9%. The mother's total blood volume is 5000 mL. What dose of RhIg (RhoGam) should be administered to the mother?

4 vials (KB% x mat. blood = fetal blood; 30 mL fetal blood per vial of RhIg; round up or down, then add 1 more vial)

Significant risk factors for potential development of graft-vs-host disease (GVHD) include these factors EXCEPT: Source of immunocompetent lymphocytes Human leukocyte antigen (HLA) differences Inability to reject donor lymphocytes A strong ability of the host to destroy foreign lymphocytes

A strong ability of the host to destroy foreign lymphocytes

Which best describes a hemoglobinopathy? Any problem involving hemoglobin destruction Any problem associated with hemoglobin production A deletion of the loci of one or more hemoglobin chains A substitution of an amino acid in the hemoglobin chain

A substitution of an amino acid in the hemoglobin chain

All of the following affect hybridization EXCEPT G:C content A:T content pH Temperature

A:T content (This is a stupid question. G:C and A:T content give the same information.)

Which genotypes are possible with an AB mother and an AB father?

AB, AA, BB

Which is the most important factor in determining the immediate outcomes of kidney transplants? ABO compatibility HLA compatibility Rh compatibility Other blood group system compatibility (Kell, Kidd, Duffy)

ABO compatibility

An abnormality of which of these assays would be LEAST likely to be associated with thrombotic tendency? AT III Protein C APTT Protein S

APTT (deficiencies of Antithrombin III, Protein C, and Protein S all cause hypercoagulability)

Which of these analytes would be increased due to delay in centrifugation? AST Folate Glucose Ionized calcium

AST (folate, glucose, ionized Ca would be decreased)

A hepatic function panel A consists of which tests?

AST, ALT, Alkaline Phosphatase, Total Protein, Albumin, Total Bilirubin, Direct Bilirubin

A hepatic function panel A consists of which tests? AST, ALT, Alkaline Phosphatase, total protein, albumin, total bilirubin, direct bilirubin Glucose, BUN, creatinine, sodium, potassium, chloride, CO2, calcium Cholesterol, Lipoprotein, HDL, triglycerides Potassium, sodium, chloride, CO2

AST, ALT, Alkaline Phosphatase, total protein, albumin, total bilirubin, direct bilirubin

What usually shows a decrease during an acute phase response?

Albumin, transferrin, transthyretin

Which enzyme is associated with conditions affecting skeletal muscles? Aldolase Alkaline phosphatase (ALP) Gamma-glutamyltransferase 5'-nucleotidase

Aldolase (aids in the glycolytic breakdown of glucose to lactate for energy)

What is the effect of aging on the hormones of the endocrine system, aldosterone and norephinephrine?

Aldosterone decreases and norepinephrine increases.

Which alpha thalassemia shows no anemia, although a slight decrease in the MCV and MCHC may be seen?

Alpha thalassemia silent carrier

Which is the first stage in the life cycle of a hemoflagellate? Amastigote Trypomastigote Promastigote Epimastigote

Amastigote

A suspicious form measuring 25 micrometers was recovered in an eye sample. It is associated with which disease?

Amebic keratitis (Acanthamoeba cyst)

Which is a true statement about aminoglycoside antibiotics? Aminoglycosides have a half-life of 1-2 hours and are metabolized by the liver. Aminoglycosides are antibiotics used to treat only Gram-negative bacterial infections. Aminoglycosides are antibiotics used to treat only Gram-positive bacterial infections. Aminoglycosides can be toxic antibiotics that are used to treat bacterial infections when such bacteria are resistant to less-toxic antibiotics.

Aminoglycosides can be toxic antibiotics that are used to treat bacterial infections when such bacteria are resistant to less-toxic antibiotics.

Which blood test needs to be placed on ice immediately after collection?

Ammonia

All of these are factors that will affect migration in gel electrophoresis EXCEPT: Gel concentration (size of gel pores) Size of particle Voltage used Amount of light present

Amount of light present

All of these tests are used to determine kidney function EXCEPT: Creatinine Blood urea nitrogen (BUN) Amylase Phosphorus

Amylase

Which is a true statement concerning the Category A agents of bioterrorism? Category A agents carry the third highest priority Category A agents are difficult to disseminate Category A agents cause high mortality and the potential for major public health impact Category A agents would not cause public panic

Category A agents cause high mortality and the potential for major public health impact (they have the highest priority, can be easily disseminated and can cause panic)

All of these life stages of schistosome worms are appropriately matched with the host they're found in, EXCEPT: Cercaria - cow Sporocysts - snail Adult worm - human Egg - human

Cercaria - cow

All of the following agencies directly regulate clinical labs EXCEPT: Centers for Medicare and Medicaid Services Chemical Safety Board College of American Pathologists Joint Commission

Chemical Safety Board

Which organism is considered nonpathogenic? Dientamoeba fragilis Balantidium coli Blastocystis hominis Chilomastix mesnii

Chilomastix mesnii

What urine crystals form flat transparent plates with notched corners?

Cholesterol crystals

It is necessary to use xylene extraction and Ehrlich's reagent rather than the conventional Kovac's reagent when detecting indole production by which of the following organisms: Pasteurella multocida Chryseobacterium (Flavobacterium) meningosepticum Shigella sonnei Klebsiella oxytoca

Chryseobacterium (Flavobacterium) meningosepticum

This is a spore-forming anaerobe associated with neutropenic enterocolitis: Clostridium septicum Porphyromonas spp. Bacteroides fragilis Fusobacterium nucleatum

Clostridium septicum

The dimorphic molds exist in both mold and yeast forms depending on the temperature of incubation. Select the genus that does not produce yeast colonies when incubated at a higher temperature. Blastomyces dermatitidis Coccidioides immitis Histoplasma capsulatum Sporothrix schenckii

Coccidioides immitis

Rouleaux on a peripheral blood smear can be associated with each of these conditions EXCEPT: Multiple myeloma Cold agglutinin disorders Chronic inflammatory disorders Lymphoplasmacytic lymphoma

Cold agglutinin disorders

Which component can be shipped with fresh frozen plasma? Cryoprecipitate Platelets Packed RBCs Whole blood

Cryoprecipitate

A patient with truncal obesity, hypertension, a ruddy/striated complexion, and mood swings has multiple elevated glucose values. A fasting ACTH sample is also elevated. The physician orders a dexamethasone test, which shows an elevated cortisol level (no suppression). What is the most likely cause?

Cushing Syndrome

Which finding best distinguishes immune hemolytic anemia from other hemolytic anemias?

Positive DAT

What is the most likely genotype for a white male with these Rh antigens: C,c,D,E,e

R1R2

The ability of an instrument or testing method to provide a negative result for patients who do not have the disease or condition is known as:

Specificity

The beta-hemolytic, chaining GPC is referred to in the quote below. Identify the bacteria. "If a pregnant woman be attacked by erysipelas of the womb, it is fatal." -Hippocrates

Streptococcus pyogenes

Contact dermatitis is mediated by:

T lymphocytes

A patient suffering from celiac disease and Crohn's disease (both inflammatory conditions of the GI tract) is given a new oral medication that has a narrow therapeutic window. Which would be true? An oral medication is never effective for a patient with these diseases; the drug must be given through IV. Toxicity in this patient is not likely since most of the drug will not be absorbed. Therapeutic drug monitoring (TDM) would be helpful to see how much drug has been absorbed. Serum drug levels obtained 15 min after the oral dose should confirm the drug was absorbed.

Therapeutic drug monitoring (TDM) would be helpful to see how much drug has been absorbed.

Which antinuclear antibody (ANA) pattern is seen in the image, showing a vague granular-looking pattern throughout the cell, with an odd-looking oval in the metaphase mitotic cell.

There is no discernible pattern

An 18-year-old immigrant from the Philippines presented complaining of chills and fever. Examination revealed large lymph nodes. Blood culture was negative. A suspicious form was seen on the blood smear. It measures 225 micrometers in length, and has a sheath, with nuclei that do not extend to the tip of the tail. The patient is most likely infected with:

Wuchereria bancrofti

Human infections with this nematode are more commonly found in Southeast Asia, but may be observed in travelers and surrounding regions. These adult worms measure up to 300 micrometers, occupy lymphatic channels and may cause lymphatic obstruction, particularly in the genital tract resulting in orchitis and hydrocele. Fever and chills may be experienced. This worm has no sheath, and nuclei extending continuously, but not all the way to the end of the tail.

Wucheria bancrofti

How long are healthy neutrophils expected to reside in the peripheral blood of an adult?

7-8 hours

What temperature is considered optimal for Taq polymerase activity?

70 C

Which change in titers would be considered significant when monitoring maternal antibodies? 16 to 32 4 to 8 8 to 32 8 to 16

8 to 32

All of the following conditions would be associated with an increased level of alpha-fetoprotein EXCEPT: Prostate cancer Hepatocellular carcinoma Viral hepatitis Testicular tumors

Prostate cancer

Each of these bacterial species may be associated with culture-negative endocarditis EXCEPT: Cardiobacterium hominis Streptococcus abiotropha Brucella abortis Staphylococcus epidermidis

Staphylococcus epidermidis

The observation of darkly pigmented colonies on agar is something of a surprise. The colonies of each of the following may have a dark appearance EXCEPT: Prevotella melaninogenica Stenotrophomonas maltophilia Chromobacterium violaceum Pseudomonas aeruginosa

Stenotrophomonas maltophilia

The most frequent cause of bacterial meningitis in adults and children is:

Streptococcus pneumoniae

All of these carbohydrates are reducing sugars EXCEPT: Lactose Sucrose Glucose Ribose

Sucrose

The addition of Low Ionic Strength Solution (LISS) to the testing environment when performing an indirect antiglobulin test is designed to do what?

Lower the zeta potential

A deficiency in which vitamin is associated with "Beriberi?"

Thiamine

Which signs and symptoms may be associated with immediate transfusion reaction but is NOT usually associated with delayed hemolytic transfusion reaction? Fever & chills Unexplained bleeding from surgical site Unexplained drop in hemoglobin Transient jaundice

Unexplained bleeding from surgical site

Acetest can be used to test for ketones in: Urine Urine and serum Urine, serum, and whole blood Urine, serum, whole blood, and CSF

Urine, serum, and whole blood

What is the name of the colorless end product of bilirubin catabolism?

Urobilinogen

Which of these is correct concerning Vitamin D? Vitamin D deficiency is a cause of scurvy Vitamin D acts as a hormone in calcium regulation Vitamin D functions in part to aid in optic nerve transmission One form of vitamin D is referred to as pyridoxal phosphate

Vitamin D acts as a hormone in calcium regulation (scurvy is Vit C, optic nerve is Vit A, pyridoxal phosphate is Vit B6)

A patient who demonstrates a history of an allergic reaction from RBC transfusions will benefit from receiving which red cell component?

Washed RBCs

Which organism is MOST likely responsible for septic reactions associated with RBC transfusions? Yersinia enterocolitica Escherichia coli Enterobacter species Streptococcus species

Yersinia enterocolitica (can thrive at 4 degrees C in storage - the other 3 have been linked to platelets stored at RT)

Which organism is MOST likely responsible for septic reactions associated with red blood cell transfusions? Yersinia enterocolitica Escherichia coli Enterobacter species Streptococcus species

Yersinia enterocolitica (thrives at 4 degrees C; the others would not)

Which antibody is present in the blood of an individual with the Bombay phenotype that will cause agglutination with any non-Bombay individual's blood?

Anti-H

Which condition would argue in favor of therapeutic drug monitoring (TDM) for a given drug?

The drug is given chronically.

Which microscopic technique is best suited for direct examination of the infectious agent of syphilis?

Dark-field microscopy

A refrigerator used to store whole blood must be able to maintain a temperature in the ranges of:

1-6 C

How many microns are equivalent to one ocular micrometer unit at 100X given the following information? ocular micrometer units: 50 stage micrometer units: 0.05

1.0 um ((#stage micrometer units x 1000) / (#ocular micrometer units))

The purpose of a recovery study is to determine how much of the analyte can be detected (recovered) in the presence of all the other compounds in the patient sample (matrix). In a recovery experiment, a small aliquot of concentrated analyte is added (spiked) into the patient sample. In order for the physiological (biological and protein components) matrix to be minimally affected, the original patient sample should not be diluted by more than what percentage?

10%

What is the half-life of immunosuppressive drugs cyclosporine and tacrolimus?

10-12 hours

The recommended temperature/time/pressure for routine steam sterilization of media is:

121 C for 12-15 minutes at 15 psi

Approximately what percent of the Caucasian population is Rh negative?

15%

20 uL of blood are diluted with 1.98 mL of diluent. Both sides of the hemocytometer are charged with the diluted sample and the entire center square is counted on both sides. A combined total of 356 platelets are counted. What is the platelet count per liter?

178 x 10^9/L

What is the maximum recommended amount of time a specimen without additive or anticoagulant should be allowed to clot before centrifugation?

2 hours

When collecting specimens for viral studies, samples should be collected within how many days of symptom onset for best sensitivity?

2-3 days

What is the increase in risk percentage for developing antibodies against red cell antigens (RBC alloimmunization) for patients who are characterized as chronically transfused patients?

2-8%

A sample of CSF is diluted 1:100; the standard 9 squares of a hemocytometer were counted on each side for a total of 18 large squares. Side 1 - 186 cells counted Side 2 - 184 cells counted What is the cell count?

2.06 x 10^4 / uL

The proper storage requirements for granulocyte concentrates is:

20-24 degrees C, 24 hours

Unless an alternative has been approved by the FDA, what is the expiration and storage temperature of rejuvenated (non-frozen) RBCs?

24 hours, 1-6 degrees C

How many milliliters of Rh positive whole blood is one dose of Rh immune globulin capable of neutralizing?

30

What is currently recommended as a routine temperature of incubation for the lab recovery of fungi from culture specimens, being both successful and cost-effective?

30 degrees C

What is the lower reference limit for progressive motility of spermatozoa when performing a semen analysis?

32%

What transferrin saturation level would be indicative to investigate further for hereditary hemochromatosis (HH)?

45%

Approximately how many doses are required to obtain a steady-state oscillation allowing for peak and trough levels to be evaluated?

5-7

A platelet component prepared from a unit of whole blood (random donor platelet) must contain at least how many platelets?

5.5 x 10^10 platelets/unit

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

64.8 mg/24hrs

Which enzyme is associated with conditions affecting skeletal muscles? Aldolase Alkaline phosphatase (ALP) Gamma-glutamyltranferase (GGT) 5'-nucleotidase

Aldolase (glycolytic breakdown of glucose to lactate) (ALP is hepatobiliary disease assoc with biliary obstruction and bone disease; GGT is liver disease affecting the biliary system esp in heavy drinkers; 5'-nucleotidase or 5NT is also hepatobiliary disease)

Which blood test is used to determine acute pancreatitis? Acid phosphatase Uric acid Amylase Alkaline phosphatase (ALP)

Amylase

All of these lab tests are used to determine kidney function EXCEPT: Creatinine Blood urea nitrogen (BUN) Amylase Phosphorus

Amylase (pancreatic)

All of these statements regarding amylase and lipase in pancreatitis are true EXCEPT: Amylase and lipase are as predictive in chronic as in acute pancreatitis Diagnostic sensitivity is increased by assaying both amylase and lipase Urinary amylase : creatinine ratio is the most sensitive test for acute pancreatitis Serum lipase peaks at 24 hours after an episode of acute pancreatitis and remains high for 7-8 days

Amylase and lipase are as predictive in chronic as in acute pancreatitis (they're only slightly elevated in chronic pancreatitis)

Hormonal variation throughout the menstrual cycle typically shows:

An abrupt rise in luteinizing hormone (LH) 3-36 hours prior to ovulation

For which of these antibodies is the DAT most likely to be NEGATIVE when testing a newborn for possible HDFN? Anti-A,B Anti-c Anti-D Anti-K

Anti-A,B (washing done as part of the DAT may break the bonds between anti-A,B and the baby's poorly developed A or B antigens)

A gram-positive bacillus that has a rod-coccus cycle (short, thin rods in young cultures and cocci in older cultures) and an odor resembling cheese is: Rothia spp. Corynebacterium diphtheriae Brevibacterium spp. Dermabacter hominis

Brevibacterium spp.

Which of the following is the "activation unit" in the classical complement pathway? C1qrs Factors B and D C4, C2, C3 C5, C6, C7, C8, C9

C4, C2, C3

Patients with AIDS often have oropharyngeal thrush. Specimens grow yeast colonies within 2-3 days. They have rough colonies with extending "feet" from the outer margins. It may be potentially resistant to commonly used anti-fungal agents. What is the species?

Candida dubliniensis

This species of Candida accounts for around 20% of urinary yeast isolates.

Candida glabrata

A manual white blood cell count was performed, and the cell counts for both sides wer 99 and 164 respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the tech report as the WBC count?

Cannot report

A 21yo male presented in the ER with symptoms resembling a liver infection. He complained of abdominal pain, fever, cough, nausea, vomiting, and constipation alternating with diarrhea. Further examination revealed a hepatic abscess. A 20um round form with a single nucleus with a centrally located karyosome was found in the abscess. What condition is the man suffering from? Intestinal amebiasis Meningoencephalitis Giardiasis Extraintestinal amebiasis

Extraintestinal amebiasis

Which FAB designation is called the "true" monocytic leukemia and is characterized by monoblasts, promonocytes, and monocytes?

FAB M5 (M5 is true monocytic leukemia; M1 is acute myeloblastic leukemia without maturation; M3 is acute promyelocytic; M4 is acute myelomonocytic)

IgG coated red cells are added to negative antiglobulin tests to detect which of the following sources of error?

Failure to add AHG

Which cell inclusions are characteristic of Chediak-Higashi syndrome?

Giant, dysfunctional lysosomal cytoplasmic granules

Which stain is used specifically to detect Histoplasma capsulatum in blood and bone marrow?

Giemsa

What is the expected serological response in an immunocompetent patient who has been vaccinated for hepatitis B?

HBsAg neg, Anti-HBc neg, Anti-Hbs pos

Current CDC (2014) recommendations for initial HIV screening include FDA-approved immunoassay for detection of: HIV-1 p31 antigen HIV-1 and HIV-2 antibody, HIV-1 p24 antigen HIV-1 antibody and HIV-1 gp41 antigen HIV-1 and HIV-2 antibody

HIV-1 and HIV-2 antibody, HIV-1 p24 antigen

The Major Histocompatibility Complex (MHC) I genes encode for:

HLA-A,B,C

The Major Histocompatibility Complex (MHC) II genes encode for:

HLA-DR,DQ,DP

The primary mechanism responsible for glomerular filtration is:

Hydrostatic differential in glomerular tufts

To assess drug concentrations during the trough phase, blood should be drawn:

Immediately before the next dose is given

Which test confirms the presence of Bence-Jones proteinuria? Protein electrophoresis Sulfosalicylic acid precipitation Cryoprecipitation Immunoelectrophoresis

Immunoelectrophoresis

Which test result will be normal in a patient with dysfibrinogenemia? Thrombin time APTT Fibrinogen assay Immunologic fibrinogen level

Immunologic fibrinogen level

A 46yo known alcoholic with liver damage is brought into the ER unconscious. One would expect his lipid values to be affected in what way?

Increased

Why is it dangerous to transfuse a blood group O person with a unit of blood group A?

The patient's anti-A would destroy the donor's cells with severe consequences to the patient.

Which is true for specific gravity measured by the urine chemical reagent strip method? High concentrations of protein do not increase the readings. An alkaline pH would not affect the specific gravity result. The reagent strip method is not affected by x-ray contrast media. The reagent strip method is based on the fact that light is refracted in proportion to the amount of total solids dissolved in the urine.

The reagent strip method is not affected by x-ray contrast media.

When collecting a urine specimen for workplace drug testing, which situation may indicate that the specimen has been tampered with or adulterated? The temperature is 34 degrees C. The specific gravity is 1.001. The color is amber. The specific gravity is 1.020.

The specific gravity is 1.001.

Which of these statements about directed donations is true? They are safer than random donor units They will never cause graft-versus-host disease They do not cause logistical problems for blood banks They are often perceived by the recipient as safer than random donor units

They are often perceived by the recipient as safer than random donor units

What type of chromatography is commonly used for screening tests for drugs of abuse in urine?

Thin-layer chromatography

The clot-based assay that is most specific for measuring fibrinogen function is the:

Thrombin time (TT)

Which of these may lead to a HIPAA violation lawsuit? Faxing patient health information (PHI) to the patient's physician who orders the lab tests Throwing lab test results into the regular trash Discussing patient information with a patient's family member with the patient's permission Logging off the computer after entering blood collection updates

Throwing lab test results into the regular trash

Which autoantibodies are found in Graves disease but not in Hashimoto's thyroiditis?

Thyroid-stimulating hormone receptor antibodies (TRAbs)

All of these specimen processing examples are considered processing errors that can have a negative impact on the test results EXCEPT: Transporting an ammonia specimen to the lab in an ice slurry Centrifuging a plasma specimen 4 hours after collection Rimming the clot in a serum collection tube prior to centrifugation A blood specimen that is frozen and thawed a few times before testing

Transporting an ammonia specimen to the lab in an ice slurry

A scavenger that lives in the mouth, measures about 10 um, has flagella on the rounded end, and the other end is pointed: Trichomonas hominis cyst Entamoeba gingivalis trophozoite Trichomonas vaginalis cyst Trichomonas tenax trophozoite

Trichomonas tenax trophozoite

A respiratory culture is submitted to the microbiology lab for testing. An organism is recovered with the following characteristics: Fat Gram-negative rods that may demonstrate bipolar staining Faster growth at 25 degrees C Gray-white translucent colonies on blood agar at 24 hours that turn slightly yellow and opaque at 48 hours Irregular colonies with a "fried egg" or "hammered copper" appearance after 48-72 hours Catalase positive Oxidase negative Urea negative Indole negative What is the most likely organism based on these results? Yersinia pestis Acinetobacter spp. Shigella spp. Escherichia coli

Yersinia pestis