MedLab

A patient has a sweat conductivity result of 60 mmol/L. What would be the estimated corresponding sweat chloride concentration?

45 conductivity is 15 mmol/L higher than chloride concentration

Which of the following are considered among the classic symptoms of hyperthyroidism?

Among the classic symptoms of hyperthyroidism are: Weight loss Exophthalamos (bulging eyes) Heat intolerance Nervousness Anxiety Feeling jittery

In the thyroid hormone feedback mechanism, what is the normal effect of T4 on thyroid-stimulating hormone (TSH) production?

Elevated T4 provides a negative feedback on TSH production.

Which of the following are considered among the classic symptoms of hypothyroidism?

Experiencing chronic fatigue and a lack of energy

When would a myeloproliferative neoplasm be classified as "myeloproliferative neoplasm, unclassifiable (MPN-u)"?

Patient does not meet all required diagnostic criteria for a specific MPN. Patient demonstrates features of more than one specific MPN.

This antinuclar antibody (ANA) pattern is characterized by granular/speckled staining in the nucleus of the interphase cells (a). The nucleoli do not stain. There is also an absence of staining in the chromosomal area of the metaphase mitotic cells (b). The slide is viewed using fluorescent microscopy. Which pattern is this?

speckled

Platelet adhesion involves the absorption of this factor between receptors on the exposed subendothelial tissue, and by receptors on the platelets themselves?

vWF

What causes polyacrylamide gels to have greater resolution of proteins than agarose gels?

varying pore size in each polyacrylamide layer

The product administered to treat Von Willebrands Disease is?

Cryoprecipitate

Which of the following is NOT one of the published indications for FFP transfusion?

Volume replacement

If a commercial lyophilized reagent is diluted using slightly more water than indicated, what type of error will occur?

systematic

A thrombin time will detect heparin in a patient's plasma so that heparin does not produce a false-positive aPTT mixing study result.

true

Molecular diagnostics utilizes blotting techniques to separate nucleic acids; northern blotting separates RNA.

true

Routine serum protein electrophoresis with normal proteins results in five zones or bands.

true

True or false? Insulin is the main regulatory hormone produced and secreted by the pancreatic beta cells. It stimulates the uptake of glucose and the movement of glucose from the blood to cells for energy production.

true

True or false? One of the ADA's option for diagnosis of diabetes is the use of a 2 hour plasma glucose (PG) ≥200 mg/dL during oral glucose tolerance test (OGTT) (75 g). Moreover, the definitive diagnosis of gestational diabetes is made with a glucose challenge test of 100 g or 75 g glucose and timed blood glucose measurements (OGTT).

true

The American Thyroid Association (ATA) recommends the use of which laboratory test in screening all adults for thyroid disease, starting at age 35?

tsh

What is the mechanism of heparin-induced thrombocytopenia (HIT)?

Antibodies directed against platelet factor 4 (PF-4) and heparin complex

Which of the following types of controls can be used to measure accuracy of a laboratory's methods?

Assayed commercially prepared control and unassayed commercially prepared control

Which of the conditions listed below must be met before a unit of Red Blood Cells that has been issued and returned can be reissued?

B. The container has a tamper-proof seal and the seal remains unbroken.

A staff technologist is receiving a shipment of reagents. The technologist logs the date received and the number of vials in the shipment. Two of the vials are contaminated. The manufacturer wants the vials back. Which of the following must be done to comply with the 606.160 Records section of the Code of Federal Regulations (CFR)?

B. The final disposition of the unsuitable reagents must be recorded.

If an allogenic blood component is shipped from the donor center with infectious disease testing incomplete the units must be labeled with:

B. The phrase "For Emergency Use Only By ____(specific patient)"

The antinuclear antibody (ANA) is used to screen for the presence of autoantibodies that are directed toward components in the nucleus of the cell. Which of the following choices are true regarding the ANA test? (Select all that apply.)

Because early presentation for many of the SARDs are nonspecific, the result of the ANA test alone are not diagnostic for SARD. The utility of the ANA test is to detect the antibodies early in the disease process.

Which statement about samples or specimens for electrophoresis is correct?

DNA fragments and RNA are isolated and purified before electrophoresis

Which of the following is true for a normal distribution curve?

Data are more likely to fall closer to the mean.

What is the cause of neonatal alloimmune thrombocytopenia (NAIT)?

Destruction of a neonate's platelets by alloantibodies crossing the placenta from the mother.

Which statement about diabetes is FALSE?

Diabetes can produce weight loss as a result of the excess buildup and storage of protein.

What is the function of ADAMTS13 enzyme?

Cleaving ultra-large molecules of von Willebrand factor to keep them out of the circulation.

Which of the following is a disadvantage of using the Hb A1C test over blood glucose measurement for diabetes screening?

Conditions that shorten red blood cell (RBC) survival will reduce exposure of RBCs to glucose, thereby lowering the Hb A1C test value

Alpha thalassemia is defined as:

The decrease in the rate of production of alpha chains due to a partial or total deletion of the genetic code.

The difference between the coagulation disorders Hemophilia A, and Hemophilia B, lies in:

The deficient factor, and the products used in treatment.

What conclusion can be made if a person has a cardiovascular risk marker that is abnormal?

The person has an increased probability of developing cardiovascular disease.

What marker is important to measure in conjunction with determining thyroglobulin (Tg) levels with an immunoassay?

Thyroglobulin antibody (TgAb)

If a patient experiences an acute transfusion reaction and TRALI is suspected, who must be notified immediately

Trasfusion service, donor center, and patients physician

The primary WHO criteria for diagnosis of polycythemia vera are bone marrow morphology (hypercellularity with prominent erythroid, granulocytic, and megakaryocytic proliferation), along with JAK2(V617F) or exon 12 mutation.

True

What peripheral blood findings shown below are MOST consistent with the chronic phase of chronic myeloid leukemia (CML)?

WBC >100 x 109/L, left shift with <20% blasts

Which statement relative to the treatment and management of diabetes is FALSE?

A combination of insulin injections and anti-diabetic drugs should not be used together.

Which of the following is NOT a common manifestation of cystic fibrosis (CF)?

renal disease

The minimum acceptable sweat yield for a valid sweat test using 2X2 inch gauze is 75 mg. What is the minimum acceptable sweat yield for a valid test collected in 30 minutes using the Macroduct® coil method?

15 µL

Chronic eosinophilic leukemia is associated with a clonal proliferation of eosinophils in the bone marrow. Which of the following eosinophil percentage ranges is typically demonstrated in the peripheral blood of these patients?

30-70%

Which of the following peripheral blood findings is consistent with the onset of the accelerated phase of chronic myeloid leukemia (CML)?

> 20% basophils

Following the surgical removal of the thyroid in thyroid carcinoma, which of the following proteins may be used as an indicator of cancerous regrowth of thyroid tissue?

Tg

Sweat testing for diagnosis of cystic fibrosis (CF) would be appropriate for which one of the following patients?

A 4-day-old infant with a positive newborn screening test result who is not acutely ill

Which of the following statements best describe Hb A1C?

A glycated protein that is an index of carbohydrate management over 2 - 3 months

Which of the following would be acceptable as the "normal" plasma reagent to use in a mixing study?

A pooled plasma from at least 20 healthy donors having normal PT/aPTT results

Which of the following tests is appropriate to CONFIRM the diagnosis of cystic fibrosis (CF)?

A quantitative sweat chloride test

We know that hemostatic events are triggered by a break in the inert epithelial lining of the vasculature, but what specific product(s) act as initiators?

ADP or Serotonin

Which of the following is not a consequence associated with deficiencies in coagulation factors?

ALL OF THE ABOVE Coagulation proceeds at a much slower rate than normal. Activation of subsequent factors may be delayed or inhibited all together. The time required for the clot to form is prolonged. The breach may not seal, and free bleeding could continue.

Which one of the statements below is a correct description of one of the newer types of electrophoresis?

Capillary electrophoresis (CE) occurs in a capillary tube with detection while the solutes separate and migrate in the tube.

Which of the following statements is true regarding adverse event reporting to the FDA (Director, Office of Compliance and Biologics Quality, CBER)?

C. The initial notification to the FDA of a transfusion-related death must be made as soon as possible after the death is confirmed to be associated with the transfusion.

A 67-year-old man visits his primary care physician due to some abdominal discomfort. The physician notes that the man has also experienced malaise lately that has prevented him from completing his daily exercise routine. A CBC and chemistry panel are ordered. The chemistry panel results were relatively normal, but the CBC was abnormal and triggered a manual differential. The image to the right represents a typical field of this patient's peripheral blood smear. The CBC and differential revealed the following results: Analyte Value Reference Interval WBC 72 x 109/L 3.8-9.8 x 109/L RBC 3.1 x 1012/L 4.5-5.9 x 1012/L Platelet 500 x 109/L 140-440 x 109/L Manual Differential: Blasts - 2%, Promyelocytes - 2%, Myelocytes - 8%, Metamyelocytes - 13%, Bands - 28%, Neutrophils - 26%, Lymphocytes - 17%, Monocytes - 4% Which of the following myeloproliferative neoplasms is MOST consistent with these results?

CML

Which statement is TRUE concerning C-reactive protein (CRP)?

CRP is the same analyte as that measured in the high-sensitivity CRP (hsCRP) assay.

All transfusion reaction initial workups must include which of the following?

Checking records and labels for identification errors

Which of the following is considered one of the most common coagulation inhibitors?

Lupus anticoagulant (anti-phospholipid antibody)

What causes a decrease in digestive enzyme secretion from the pancreas into the intestines in patients with cystic fibrosis (CF)?

Mucus blockage of the pancreatic duct

Which two of the following laboratory blood test results are associated with chronic neutrophilic leukemia (CNL)?

Neutrophils/bands >80% Hypercellular bone marrow

Below are the laboratory results and chief clinical findings in a 31 year-old woman. Laboratory Results: Thyroid-stimulating hormone (TSH): 0.02 µIU/mL (ref range 0.4 - 4.12 µIU/mL) Free T3 (FT3):6.8 pg/mL (ref range 2.5 - 3.9 pg/mL) Free T4 (FT4): 1.3 ng/dL (ref range 0.6 - 1.3 ng/dL) Thyroperoxidase antibody (TPOAb): 212 IU/mL (ref range <9.0 IU/mL) Thyroglobulin antibody (TgAb): 2.5 IU/mL (ref range <4.0 IU/mL) Clinical Findings: Bulging eyes Hand tremors Extreme weight loss Accelerated heartbeat Which of the options below is most likely the diagnosis of this patient?

Hyperthyroidism, possibly due to Graves' disease

Following a radical prostatectomy (the removal of the prostate in men with prostate cancer), what should the patient's PSA level be?

Non-detectable, since only the prostate gland produces PSA.

The 2015 American Diabetes Association (ADA) updated guidelines include which of the following recommendations for diabetes screening/diagnosis? (Select all that apply.)

If test results are normal, testing should be repeated in ≥3 year intervals. A1C ≥6.5% is one of 4 screening options for diabetes diagnosis.

What is the goal of physiotherapy with inhaled medications in the treatment of CF?

Improve lung function and decrease lung infections

Which statement best describes ketones and their involvement in ketoacidosis?

Increased ketones can result in a metabolic acidosis referred to as ketoacidosis. Type 1 diabetic patients are especially at risk.

Which one of the following statements regarding factors that affect the mobility or rate of migration in electrophoresis is correct?

Increasing the heat increases the mobility of the solutes

Match each of the following definitions associated with heart disease and heart failure to the term that it defines.

Infarction- An area of tissue death that occurs due to lack of oxygen. Angina- Chest pain caused by inadequate supply of oxygen to heart myocardium. Congestive heart failure- A left ventricular dysfunction resulting from aging, hypertension, atherosclerosis or muscle damage from an AMI or repeated AMIs. Ischemia- An inadequate blood supply that decreases availability of oxygen.

Why is it important to screen expectant mothers for thyroid disorders early in pregnancy?

Insufficient levels of maternal thyroid hormones are associated with increased incidence of mental retardation in newborns.

A laboratory developing a new testing procedure runs the test on 1,000 patients. Later confirmation shows that the experimental procedure produced remarkably few false-negative results, but many false-positive results. Which of the following statements is true regarding the experimental procedure?

It has high sensitivity.

Historical methods for determining the free thyroxine index (FTI) have been largely replaced with more sensitive and automated immunoassay methods for determining which hormone?

Free T4 (FT4)

Which of the following statements related to Graves' disease is TRUE?

Graves' disease is an autoimmune condition where the body produces increased amounts of thyroid hormone.

What common thyroid condition is associated with the production of the highest levels of thyroperoxidase antibody (TPOAb)?

Hashimoto's thyroiditis

Which of the following statements about anticoagulant therapy is false?

Heparin dosage is monitored by the clinician using the PT test. aPTT is correct

Which of the following components would MOST LIKELY be associated with TRALI?

FFP from a female donor with a history of one full term pregnancy

With which of these conditions or procedures may there be an increased number of megakaryocytes in the bone marrow, but a decreased number of circulating platelets?

Folic Acid Deficiency

A patient suspected of having a myeloproliferative disorder is undergoing a bone marrow aspiration to confirm the diagnosis. The physician was unable to collect the sample and reported a "dry tap." Which myeloproliferative disorder is commonly associated with failure to aspirate bone marrow successfully (known as dry tap)?

Primary myelofibrosis

The image represents the results of an antinuclear antibody (ANA) test that is viewed using fluorescent microscopy. The speckled staining within these positive cells varies between coarse speckled (a) and smooth speckled (b). Cells are also present that are negative (c) because these cells are not expressing the antigen that the antibodies are directed against. This image represents which of the following ANA testing patterns?

Proliferating cell nuclear antigen (PCNA)

What is the function of BNP?

Promote diuresis

Which of the following components would be suitable for a patient with a history of severe anaphylactic reactions to Red Blood Cell transfusion associated with haptoglobin antibodies?

Red Blood Cells, Saline Washed

Which of the following components is NOT addressed by the AABB TRALI mitigation standard 5.4.1.2

Red blood cells

Which of the following best describes random error?

Results may be either above or below the mean.

What form of triiodothyronine (T3) is formed in circulation under the influence of high stress?

Reverse T3 (RT3)

An MCV is reported by the instrument as 82 fL. The MCV is flagged with a delta check alert as the previous MCV reported on this patient 12 hours earlier was 97 fL. What is a possible cause for this discrepancy?

Specimens may not be from the same patient

You are performing a sweat test using the Macroduct® system. At the end of 30 minutes, you observe that the patient is not producing very much sweat in the Macroduct® coil. Visually, you estimate it is between 5-10 µL. What should you do?

Stop the collection and quantitate the volume collected with a micropipet. If it is less than 15 µL report out the result as "quantity not sufficient" (QNS).

Below are the laboratory results and chief clinical findings in a 58 year-old woman. Laboratory Results: Thyroid-stimulating hormone (TSH): 4.21µIU/mL (ref range 0.4 - 4.12 µIU/mL) Free T3 (FT3): 2.5 pg/mL (ref range 2.5 - 3.9 pg/mL) Free T4(FT4): 1.0 ng/dL (ref range 0.6 - 1.3 ng/dL) Thyroperoxidase antibody (TPOAb): <1.0 IU/mL (ref range <9.0 IU/mL) Thyroglobulin antibody (TgAb): <0.5 IU/mL (ref range <4.0 IU/mL) Clinical Findings: Inability to lose weight Constipation Of the options below, what is the most likely diagnosis of this patient?

Subclinical hypothyroidism

Which of the following practices would NOT be in conformance with the AABB TRALI mitigation standard 5.4.1.2?

Taking female donor pregnancy histories at the initial donation only and using those with no history of pregnancy for FFP production at all subsequent donations. must be re-evaluated at each donation to determine pregnancy status.

Which statements are TRUE regarding the testing and diagnosis of gestational diabetes (GDM)? (Select all that apply.)

Testing typically occurs during a woman's first prenatal visit in those with risk factors. Women with GDM are typically screened for persistent diabetes at 6-12 weeks postpartum.

The reagent strip method for protein primarily tests for which type of protein?

albumin

Which of the following is NOT a category of clonal hypereosinophilic syndrome (HES)?

allergic

A complete blood count is performed on a post-surgical, post-transfusion patient. The red cell distribution width (RDW) reported with the automated cell count is 16.5%. The reference interval in this laboratory is 11-15%. What would be demonstrated on the peripheral smear that relates directly to the RDW value?

anisocytosis

Approximately 47% of individuals with cystic fibrosis are homozygous for the F508del mutation of cystic fibrosis transmembrane conductance regulator (CFTR). How does this mutation affect CFTR?

block in processing

Which cardiac protein is part of the myocyte contraction mechanism?

cTnT

Which of these factors may be deficient if both the PT and aPTT are prolonged?

factor II

High levels of LpPLA2 are associated with DECREASED cardiovascular risk.

false

Electroendosmosis is the movement of buffer into the medium due to heat generation and ensuing drying of that medium.

false Wick flow is caused by the movement of buffer into the medium due to heat generation and ensuing drying of that medium. The bands of separated proteins where wick flow occurs will be distorted and atypical in appearance.

Which of the following organs synthesizes and secretes b-type natriuretic peptide (BNP)?

heart

Which coagulation pathway is initiated when collagen is exposed, and involves the substances HMWK, Fletcher Factor, and Hageman Factor?

intrinsic pathway

Which element is essential for the production of thyroid hormone?

iodine

Which of these conditions could result in a microcytic anemia?

iron deficiency

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

isoelectric focusing

What is TRUE regarding the pulmonary disease associated with cystic fibrosis (CF)?

its progressive

Proteins in a buffer that sets the pH at 8.6 will become ___________ charged and migrate to the ____________.

negatively, anode.

Following a complete removal of the thyroid gland due to an advanced malignancy, one must be concerned with the level of _____________ as the ___________________ may also be removed or damaged secondary to this surgical procedure.

parathyroid hormone (PTH) ; parathyroid glands