MLT ASCP Practice Questions 3.28.16

B; Fatty casts contain refractile oval fat bodies or free fat droplets. They are derived from renal tubular cells, and may be seen in nephrotic syndrome.

Identify the urine sediment element: A. WBC cast B. Fatty cast C. Waxy cast D. Granular cast

B; Francisella is slow growing on primary isolation culture media and produces poorly-staining coccobacilli on Gram stain. Because Francisella tularensis is included on the list of bioterrorism agents, suspicious isolates should be referred immediately to a public health laboratory in lieu of attempting an in-laboratory identification.

One of the BIGGEST problems with isolating Francisella is that these organisms: A. produce wide zones of hemolysis B. grow so slowly C. overgrow other organisms D. produce greenish colonies like E. coli

1. C 2. A 3. D 4. B

Match each of the following: 1. Ratio of cellular area to total area in the bone marrow section. 2. Number of myeloid cells compared to nucleated erythroid cells. 3. Use low power to estimate their quantity and appearance. 4. Use Perls' Prussian blue stain. A. Myeloid-erythroid ratio B. Stored iron C. Overall cellularity D. Megakaryocytes

1. B 2. A 3. C Primary- Target glands (such as thymus, thyroid, parathyroid, etc.) Secondary- Pituitary gland Tertiary- Hypothalamus

Match the type of endocrine dysfunction with the appropriate organ: 1. Target gland 2. Pituitary gland 3. Hypothalamus A. Secondary B. Primary C. Tertiary

True Prominent cytoplasmic vacuolation of Burkitt lymphoma cells helps laboratorians identify these cells in a cytospin preparation of body fluids.

T/F Prominent vacuolation involving the cytoplasm of abnormal lymphoblast-like cells seen in a body fluid preparation is a distinctive feature of Burkitt Lymphoma.

C; The intended response is "transfusion dimorphism". The microcytic, hypochromic erythrocytes suggests iron deficiency anemia. Interspersed among these cells are normocytic, normochromic erythrocytes suggesting two populations of red cells following transfusion. This was a case of severe iron deficiency treated with red cell transfusions and iron supplement.

The condition most likely associated with the peripheral blood picture in the photograph is: A. Hereditary spherocytosis B. Lead poisoning C. Transfusion dimorphism D. Folic acid deficiency

A; A positive spot test shows agglutination of horse erythrocytes when added to patient serum previously absorbed with guinea pig kidney, but not when added to patient serum previously absorbed with beef erythrocyte stroma. The test is generally simple, sensitive, and specific, but false negative are common in young children with mononucleosis.

The most common rapid slide test (MONOSPOT©) for infectious mononucleosis employs: A. Horse erythrocytes B. Sheep erythrocytes C. Intact beef erythrocytes D. None of the above

C; Alkaline over acid, or K/A, in TSI reactions is associated with the fermatation of glucose alone and the utilization of peptone.

Which of the following sugars has been fermented by a gram-negative rod that has produced an alkaline slant and an acid butt on triple sugar iron agar (TSI).? A. lactose B. sucrose C. glucose D. glucose and sucrose

C; Granulocytes are the most granular population; they have the most side scatter of the cell populations that are listed.

Which of these white blood cell populations would have the MOST side scatter when analyzed using flow cytometry? A. Monocytes B. Lymphocytes C. Granulocytes

True RhIg is indicated in any circumstance in which D-positive fetal red cells may enter the circulation of an Rh-negative female, including ectopic pregnancy.

True/False Ectopic pregnancy is an indication for administering RhIg to an Rh negative woman.

D; This integrity of this specimen is compromised. The unit cannot be used.

What action should be taken if a large clot is noticed in a red blood cell unit while the product is being prepared for release to the patient? A. Issue the product as you normally would but with a filter. B. Issue the product, but note the presence of the clot in the computer records. C. Filter the product prior to issue and record the process. D. Do not issue the product.

C; The cells are plasma cells. They are larger than normal small lymphocytes with more abundant cytoplasm. The cytoplasm is more basophilic than the cytoplasm of a normal lymphocyte and a well-defined perinuclear halo (clearing in the golgi area) is noticeable. The nucleus is eccentrically placed. Plasma cells are counted in a separate category on a bone marrow differential. Hematogones are blast-like cells that are more mature than lymphoblasts. They are usually tallied with lymphocytes when performing a bone marrow differential.

What are the cells that are indicated by the red arrows in the image on the right? A. Normal lymphocytes B. Hematogones C. Plasma cells

B; Small, dense LDL is most likely to interact with arterial walls, leading to deposition of cholesterol, and initiating or worsening atherosclerosis. Small, dense LDL is associated with more than a three-fold increase in the risk of coronary heart disease. Large, buoyant LDL is less atherogenic than small, dense LDL. The LDL phenotype A is normal. It is the so called 'B' pattern that is associated with increased risk.

Which of the following is most likely to interact with arterial walls, leading to deposition of cholesterol, and initiating or worsening atherosclerosis? A. Large buoyant LDL B. Small dense LDL C. LDL phenotype 'A'

C; The combination of complement C4, C2 and C3 that binds to the antigen-antibody complex in the initial reaction step in the classical pathway of complement activation is called the activation unit.

Which of the following is the "activation unit" in the classical complement pathway? A. C1 B. C2 C. C4, C2, C3 D. C5, C6, C7, C8, C9 E. C1, C2, C9

A; The creatinine clearance for this patient is 100 mL/min. Creatinine clearance values are calculated using the following equation: Creatinine Clearance (mL / min) = (Urine Creatinine / Serum Creatinine) x Urine Volume (mL) / [ time (hr) x 60 ] For this patient Creatinine clearance (mL/min)= (120/1.5) x (1800 / [24 x 60]) 80 x 1800/1440, which is 80 x 1.25, or 100 mL/min

A 45-year-old male of average height and weight had a serum creatinine of 1.5 mg/dL and urine creatinine was 120 mg/dL; the total volume of urine collected over a 24-hour period was 1,800 mL. Calculate the creatinine clearance for this patient in mL/min. A. 100 B. 144 C. 56 D. 225 E. 177

C; The blood glucose value is critical; negative ketones is consistent with type 2 diabetes. An elderly type 2 diabetic patient is at risk for hyperosmolar non-ketotic coma and osmolality should be measured. A measurement of urine glucose would not be useful at this point.

A 70-year-old type 2 diabetic patient is comatose and in the emergency department. Stat blood glucose and serum ketones are ordered. Blood Glucose: 650 mg/dL Serum Ketones: Negative What is the best conclusion? A. Glucose result is acceptable for type 2 diabetic patient B. Because of the glucose and ketone result, the patient now has type 1 diabetes C. The glucose result is critical and the patient should be evaluated for hyperosmolality D. Urine glucose should be measured

B; The molecular weight of a hapten is by itself not sufficient to elicit an antibody response alone, but requires a protein to do so.

A hapten is only antigenic when it is coupled with which of the following: A. Enzymes B. Proteins C. Lymphocytes D. Lipids

A; Assuming an alpha hemolytic reaction (not well seen in the image), viridans streptococcus and S. pneumoniae are the two possible responses. However, these colonies are far too mucoid for viridans streptococci; therefore, S. pneumoniae is the most likely choice. Also, the colonies are much too large and the hemolytic reaction is wrong for S. pyogenes or S. agalactiae.

A patient was admitted to the hospital recently with an obvious infection. A sputum specimen was submitted and the microbiologist inoculated it to sheep blood agar. Based on the colony morphology and the alpha hemolysis seen in the image to the right, the most likely identification is: A. Streptococcus pneumoniae B. viridans streptococcus C. Streptococcus pyogenes D. Streptococcus agalactiae

A; The dematiaceous molds can be broadly separated into two major groups: the agents of chromomycosis that grow more slowly, maturing only after 7 days or more of incubation, and the more rapidly growing species that most commonly are clinically insignificant commensals or contaminants when recovered from clinical specimens, but in rare situations may cause opportunistic infections called phaeohyphomycosis.

Dematiaceous molds can be broadly separated into two major groups; the agents of chromomycosis and clinically insignificant commensals or contaminants. The agents of chromomycosis grow: more slowly than; more rapidly than; or generally at the same rate as the clinically insignificant commensals or contaminants? A. more slowly than B. more rapidly than C. generally at the same rate as

D; A zone of inhibition is the area around an antibiotic-infused paper disk that does not show any bacterial growth. The antibiotic impregnated on the disk will diffuse into the agar in the area surrounding the disk. If the bacteria are sensitive to the antibiotic, they cannot grow near the disk. The size of the zone is proportional to how sensitive the organism is. If the organism is resistant to the antibiotic, it will grow very closely to the disk.

The size of the zone of suppressed growth on a sensitivity plate using sensitivity disks is referred to as the zone of: A. beta hemolysis B. alpha hemolysis C. gamma hemolysis D. inhibition E. susceptibility

D; Neutrophils are typically increased in urinary bacterial infections.

What type of white blood cell is seen MOST frequently in urine sediment with infections of the urinary system? A. Eosinophil B. Lymphocyte C. Monocyte D. Neutrophil E. Plasma cell

C; Cryptococcus neoformans is the MOST likely identification of the encapsulated yeast in this question. C. neoformans is urease +, and grows brown colonies on birdseed agar. In addition, India ink stain can also be used for Cryptococus spp. identification.

What is the MOST likely identification of an encapsulated yeast in a blood culture bottle from a patient with septicemia with the following additional culture information?: Failure to produce germ tubes Urease positive Produced brown pigment on bird seed agar A. Candida albicans B. Candida pseudotropicalis C. Cryptococcus neoformans D. Torulopsis glabrata E. Saccharomyces cerevisiae

B; The body compensates for alkalosis or acidosis of the blood PRIMARILY to regain a normal pH, between 7.35 - 7.45.

When the body compensates for a respiratory or metabolic disorder, the MAIN goal is to achieve: A. correct carbonic acid level, since it is the most important system in the body B. a normal pH C. normal p02 and pCo2 for normal respiration D. correct bicarbonate level, since it is the most important system in the body

D; In radioimmunassay, a fixed concentration of labeled antigen is incubated with a constant amount of antiserum such that the concentration of antigen binding sites on the antibody is limiting. If unlabeled antigen is added to this system, there is competition between labeled antigen and unlabeled antigen for the limited and constant number of binding sites on the antibody, and thus the amount of labeled antigen bound to antibody will decrease as the concentration of unlabeled antigen increases.

Which of the following choices is correct when describing the principles of competitive radioimmunoassay procedures? A. antibody will react preferentially with the labeled antigen B. antibody will react preferentially with the unlabeled antigen C. antibody will react with labeled antigen only D. antibody will react equally with labeled and unlabeled antigen E. antibody will react directly with radioactive labeled immunoglobulin

A; Gluconeogenesis is the formation of glucose from noncarbohydrates when carbohydrate intake is absent, a fasting state. The hormone cortisol along with glucagon and epinephrine all stimulate this metabolic pathway. Insulin; however, inhibits this pathway and is therefore the correct answer.

Which of the following hormones inhibits gluconeogenesis, the formation of glucose from noncarbohydrate sources such as amino acids, glycerol, and fatty acids? A. Insulin B. Epinephrine C. Cortisol D. Glucagon

A; Leptin signals the hypothalamus that there are changes in fat stores. Resistin increases insulin resistance and enhances adhesion molecules present on endothelial cells. IL-6 responds to tissue injury. IL-6 increases insulin resistance by inhibiting insulin receptor signal transduction in liver cells. It also increases other inflammatory cytokines, interleukin-1 (IL-1) and TNF-a, and stimulates the liver to produce C-reactive protein (CRP). Adipose tissue and liver cells produce angiotensinogen, a precursor of angiotensin II. Besides increasing blood pressure, angiotensin II may stimulate adipose cell formation and thus increase adipose mass.

Which one of the following adipocyte products is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores? A. Leptin B. Resistin C. IL-6 D. Angiotensinogen

D; The e antigen is present in 98% of the Caucasian population.

Which of the following Rh antigens is found the highest frequency in the Caucasian population: A. C B. E C. c D. e

A; The Fc portion of immunoglobulin can activate the classical complement pathway, where the heavy chains, light chains, hinge regions and Fab portions cannot.

Which part of the immunoglobulin molecule is responsible for activating complement? A. Fc B. Fab C. heavy chains D. light chains E. Hinge regions

A; Gamma globulin (anti-D) is given to Rh-negative mothers to prevent any D antibody production, which could cause harmful effects in future pregnancies with an Rh-positive fetus. The administered anti-D will bind fetal Rh-positive cells that may come from the fetus in vivo; therefore the mother will not produce anti-D herself, preventing sensitization.

A solution of gamma globulins containing anti-Rh (D) is given to an Rh (D) negative mother to: A. Prevent fetal cells from initially sensitizing the mother B. Neutralize any of the child's antibody that may have passed the placental barrier C. Neutralize any natural maternal antibodies present D. Prevent greater antibody response in a previously sensitized mother

C; In this case, the pH may become more alkaline, perhaps above 8.0, if the bacteria in the sample are proliferating during the extended room-temperature wait time.

A urine specimen was collected at 6:00 a.m. and remained at room temperature until it was received in the laboratory at 3:30 p.m. How may the pH of the specimen be affected by the extended time at room temperature if bacteria are present in the specimen? A. The pH may become more acidic. B. The pH may become more alkaline. C. The pH would probably not be affected.

D; The MCV is indicative of microcytosis with MCV=<80fL. The RDW is within normal limits and indicative of a homogenous cell population. If the MCV was >100 fL, this would be indicative of macrocytosis. An RDW that was outside of normal limits would be indicative of a heterogenous cell population.

An 18 year old female has a CBC as part of a routine physical exam. The following results were obtained and the physician determines she is anemic. After reviewing her CBC results shown below, which of the following would be an appropriate description of the anemia? White blood cells (WBC): 5.6 x 10^9/L (RR:4.0-10.0 x 10^9/L) Red blood cells (RBC): 3.7 x 10^12/L (RR: 4.2-5.9 x 10^12/L) Hemoglobin: 9.9 g/dL (RR:12-16 g/dL) Hematocrit: 28% (RR: 37-48%) MCV: 75 fL (80-100 fL) RDW-CV: 14% (RR: 11.0-15.0%) A. Macrocytic, heterogenous B. Macrocytic, homogenous C. Microcytic, heterogenous D. Microcytic, homogenous

C; Glucose positive, Maltose positive, Lactose negative and Sucrose negative is the correct answer since Neisseria meningitides causes Waterhouse-Friderichsen syndrome and it is positive only for glucose and maltose.

An autopsy of a 1-year-old female admitted to the emergency room 4 hours prior to her death revealed Waterhouse-Friderichsen syndrome. Blood and nasopharyngeal cultures taken prior to her death should reveal an oxidase-positive, Gram-negative diplococcus with the following biochemical reactions: A. Glucose positive, Maltose positive, ONPG positive and DNase negative B. Glucose positive, Maltose positive, Sucrose positive and Lactose negative C. Glucose positive, Maltose positive, Lactose negative and Sucrose negative D. Glucose positive, Maltose negative, Lactose negative and Sucrose negative

C; Blood plasma will contain coagulation proteins, but not in a clotted tube where serum is present.

Blood serum contains each of the following substances except: A. Water B. Sugars C. Coagulation proteins D. Electrolytes

B; Charcot-Leyden crystals in stool are thought to be created from damaged eosinophil byproducts. These crystals have a strong association, although they are rare, with parasitic infections or allergic reactions.

Charcot-Leyden crystals in stool may be associated with an immune response and are thought to be the breakdown products of: A. neutrophils B. eosinophils C. monocytes D. lymphocytes E. basophils

D; No HLA matching is performed for corneal tissue transplants as the cornea occupies a privileged site not usually seen by the immune system. This term has been coined "immune privileged".

Corneal tissue may be transplanted successfully from one patient to another because: A. Anti-corneal antibodies are easily suppressed B. Corneal antigens do not activate T cells C. The cornea is non-antigenic D. The cornea occupies a privileged site not usually seen by the immune system E. The cornea has the same DNA in everyone.

D; As maturation continues in the granulocytic series the nucleus of the metamyelocyte becomes kidney or bean shaped.

Identify the cell in this illustration indicated by the arrow: A. Monocyte B. Myeloblast C. Promonocyte D. Metamyelocyte

A; The cell shown in this image is a myelocyte. Myelocytes typically have an eccentric nucleus with cytoplasm similar to a mature neutrophils with a slightly bluer tint due to the cell's immaturity. Myelocytes have both primary and secondary granules present in the cytoplasm. The nucleus is less mature and therefore has a loose chromatin clumping pattern.

Identify the cell in this illustration indicated by the arrow: A. Myelocyte B. Monocyte C. Metamyelocyte D. Lymphocyte

A

Identify the following cell types by matching them with their respective image. A. Stromal Cells B. Osteoblast C. Macrophage with hemophagocytosis D. Megakaryocyte E. Osteoclast

B

Identify the following cell types by matching them with their respective image. A. Stromal Cells B. Osteoblast C. Macrophage with hemophagocytosis D. Megakaryocyte E. Osteoclast

C

Identify the following cell types by matching them with their respective image. A. Stromal Cells B. Osteoblast C. Macrophage with hemophagocytosis D. Megakaryocyte E. Osteoclast

C; "Universal donor", (a misnomer) is usually applied to group O, Rh negative blood. Although it may be necessary to use group O, Rh negative blood in an extreme emergency, it is preferable to use type specific blood for emergencies.

In an extreme emergency , if the ABO and Rh type are unknown which of the following should be given to the patient? A. Group O, Rh positive blood B. Group AB, Rh negative blood C. Group O, Rh negative blood D. Any blood type is OK

C; In healthy individuals, procalcitonin is only synthesized by the thyroid C cells. In bacterial infections, PCT is synthesized in various extrathyroidal neuroendocrine tissues.

In healthy individuals, procalcitonin is synthesized by which cells in the body? A. Hepatocytes B. Leukocytes C. Thyroid C cells D. Red blood cells

C; The lecithin-sphingomyelin ratio is a test for assessing fetal lung maturity that is useful in determining risk of an infant born with respiratory distress syndrome.

The Lecithin/Sphingomyelin ratio determination of amniotic fluid is useful in assessing the probability of: A. cystic fibrosis B. phenylketonuria C. respiratory distress syndrome D. chromosomal abnormalities

C; Monoclonal antibodies are monospecific antibodies that are the same because they are made by one type of immune cell which are all clones of a unique parent cell, also called a hybrid cell line, which usually arise from a hybridoma. The fusion of a specific antibody-producing lymphocyte with a myeloma cell will multiply to become a source of pure monoclonal antibody. This is often used in the manufacturing process for monoclonal antibody reagents.

Monoclonal antibodies are usually manufactured in vitro by using: A. Cultured T cells B. Human plasma cells C. Hybridomas D. Cytotoxic T cells

C; Myoglobin release is strongly associated with muscle damage; therfore, it would most closely match a diagnosis of massive muscle trauma in this question.

Myoglobinuria is MOST likely to be noted in urine specimens from patients with which of the following disorders? A. hemolytic anemia B. lower urinary tract infections C. massive muscle trauma D. paroxysmal nocturnal hemoglobinuria

B; Public health guidelines recommend that manipulation of samples for influenza testing be done inside a safety cabinet. Safety goggles could be worn if the specimen or procedure may be prone to splashes or sprays of infectious material. Utility gloves are not necessary.

Public health guidelines recommend that laboratory specimens for influenza testing must be manipulated using which of the following safety precautions? A. Safety goggles B. Safety cabinet C. Utility gloves D. None of the above

A; This Gram stain is under-decolorized

This microscopic field is representative of other fields that were observed on a Gram-stained smear. Which of the following describes the quality of the smear? A. Under-decolorized B. Over-decolorized C. Sufficiently decolorized

True This image represents a Gram stained smear that is properly prepared and stained. The host cells and background material are stained pink, the cells are evenly distributed (not clumped together), and there is no evidence of precipitated stain.

T/F Based on the picture, these statements are correct. Host cells and background material: pink Smear thickness: 1 cell thick Precipitated stain: no Would this field be appropriate for reading? yes

True; The image in this question shows a ringed sideroblast. Ringed sideroblasts are red blood cell precursors which have an abnormally increased amount of iron surrounding their nucleus. Iron stain, such as Prussian blue, is used to stain the iron in these cells. Ringed sideroblasts are associated with sideroblastic anemia, myelodysplastic syndromes, and other leukemic and genetic conditions.

T/F This Prussian Blue stain shows a ringed sideroblast.

C; Fresh frozen plasma must be thawed at a maximum of 37oC in a water bath or similar equipment that has been validated and is temperature monitored. When using a water bath, the FFP should be wrapped in a plastic liner. After thawing, it is recommended that the FFP be administered immediately, preferably within 2 hours post-thaw.

The BEST way to thaw Fresh Frozen Plasma is to thaw it by: A. leaving it at room temperature away from agitation B. refrigerating the FFP on a bottom rack C. placing the FFP in a 37º C or lower in a water bath D. placing the FFP in a 121º C or higher in a steam sterilizer

A; The DAT, or direct antiglobulin test, is used to detect antibodies coating RBC's in vivo.

The Direct Antiglobulin Test (DAT) is usually used to detect: A. Antibodies coating red cells B. Antibodies in the plasma C. Antigens coating red cells D. Antigens in the plasma E. Antibody-hapten reactions

C; May-Hegglin anomaly is a rare autosomal dominant condition in which patients are at risk for bleeding and infections. It is characterized by the presence of large Dohle body like inclusions within neutrophils, eosinophils, basophils, and monocytes.

The WBC anomaly indicated by the arrow in this illustration is: A. Alder-Reilly anomaly B. Pelger-Huet anomaly C. May-Hegglin anomaly D. Toxic granulation

C; The correct answer is Trichophyton rubrum. The tiny microconidia are lined up in a "birds on the fence" arrangement along the hyphal strand transversing the field of view (yellow arrows). Two pencil-shaped, smooth walled macroconidia are also seen in the lower left field of view (red arrows). Trichophyton verrucosum may produce microconidia in small quantities. However, they are irregularly arranged with little tendency to line up along the hyphae. Antler hyphae and string bean macroconidia are characteristic of this species. One of the key characteristics in the identification of Epidermophyton floccosum is the inability of this dermatophyte to produce microconidia. Two to four-celled, club-shaped macroconidia are produced, usually in clusters of two or three.

The profusion of tiny microconidia lining up along the hyphae in this photomicrograph is characteristic of which of the following organisms? A. Epidermophyton floccosum B. Trichophyton verrucosum C. Trichophyton rubrum

B; The liver is the primary target organ for the Hepatitis B virus (HBV). The inflammation caused by HBV can result in permanent liver damage, including cirrhosis, liver failure, and even hepatocellular carcinoma.

What is the primary target of the Hepatitis B virus? A. Heart B. Liver C. Lungs D. Blood cells

C; In combined fiscal years 2005 through 2009, transfusion-related acute lung injury (TRALI) caused the higest number of reported fatalities (48%), followed by hemolytic transfusion reactions (26%) due to non-ABO (16%) and ABO (10%) incompatibilities. Complications of microbial infection, transfusion-associated circulatory overload (TACO), and anaphylactic reactions each accounted for a smaller number of reported fatalities. Reference: U.S. Food and Drug Administration Website. Fatalities reported to FDA following blood collection and transfusion: Annual summary for fiscal year 2009. Available at: http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/ucm204763.htm. Accessed Janary 7, 2011.

Which one of the following types of transfusion reactions caused the highest number of transfusion-related fatalities that were reported to the U.S. Food and Drug Administration (FDA) from 2005 - 2009? A. Anaphylactic reactions B. Febrile non-hemolytic reactions C. Transfusion-related acute lung injury (TRALI) D. Transfusion-associated graft versus host disease (TA-GVHD)

C; Bacterial contamination of platelets is most likely because they are stored at room temperature.

Bacterial contamination is MOST likely in which of the following blood products? A. Red Blood Cells B. Red Blood Cells Frozen C. Platelets D. Fresh Frozen Plasma

D

Identify the following cell types by matching them with their respective image. A. Stromal Cells B. Osteoblast C. Macrophage with hemophagocytosis D. Megakaryocyte E. Osteoclast

1. B 2. C 3. A Granular casts are composed of plasma protein aggregates and cellular remnants. Granular casts appear as cylinders of coarse, or fine, highly refractive particles. Broad casts or "renal failure' casts are formed in the collecting ducts as the result of urinary stasis and are two to six times the size of other types of casts. Any type of cast can be a broad cast. Broad casts are typically seen in patients with advanced renal failure. Hyaline casts, the type most commonly seen in urine sediment, have a refractive index similar to the urine in which they are suspended. For this reason, hyaline casts will appear almost invisible under brightfield microscopy, but are easily of seen by phase-contrast microscopy.

Match the following descriptions of casts with their appropriate name: 1. Casts with highly refractive particles 2. "Renal failure" cast 3. Low refractive index A. Hyaline casts B. Granular Casts C. Broad Casts

C; Polyspecific antihuman globulin (AHG) reagent contains both anti-IgG and anti-C3d.

Polyspecific antihuman globulin (AHG) reagent used in antiglobulin testing should react with which one of the following? A. IgG and IgA B. IgM and IgA C. IgG and C3d D. IgM and C3d

B; Macroamylasemia can be diagnosed by measuring amylase levels in the urine and serum. In patients with macroamylasemia, there will be high levels of amylase in the serum. However, macroamylasemia can look similar to acute pancreatitis, which also causes high levels of amylase in the blood. To help differentiate, we measure amylase levels in the urine. Urine levels of amylase are low in people with macroamylasemia, but high in patients with pancreatitis.

The results which would be MOST consistent with macro-amylasemia are? A. Normal serum amylase and elevated urine amylase values B. Increased serum amylase and normal to low urine amylase values C. Increased serum and increased urine amylase values D. Normal serum and normal urine amylase values

A; Listeria monocytogenes is the correct answer. The motility agar is showing motility at the top of the tube, but not deeper; typical of this catalase-positive, gram positive bacillus. Streptococcus agalactiae would be catalase negative and a coccus. Erysipelothrix rhusiopathiae would be H2S-positive and catalase negative. Escherichia coli is a gram negative bacillus.

This Gram-positive bacillus grew as a diffusely beta-hemolytic colony from a newborn. It was catalase positive and had tumbling motility on a hanging drop preparation. This is how it appeared on triple sugar iron agar and motility medium. What is the most likely diagnosis? A. Listeria monocytogenes B. Streptococcus agalactiae C. Erysipelothrix rhusiopathiae D. Escherichia coli

C; The ApoB/ApoA1 ratio has a positive risk marker (ApoB-100) and a negative risk marker (ApoA1). Risk diminishes as ApoA1 goes up (a negative marker) and risk increases in proportion to ApoB concentrations (a positive risk marker). This 'double-edged sword' provides good risk prediction. The other risk markers in question do not have this dual-advantage.

Which risk marker has both positive and negative cardiovascular risk integrated into its measurement? A. LpPLA2 B. Oxidized LDL C. ApoB/ApoA1 D. hs-CRP

A; Eosinophils do not have cytoplasm containing large purple/blue-staining granules. Instead, their granules are large but are orange/red in color. These granules are very distinctive for this type of cell, typically making their identification simple.

ll of the following statements describe an eosinophil EXCEPT: A. Cytoplasm contains large purple/blue-staining granules. B. May be called an "eo" C. Is a member of the granulocyte series D. Cytoplasm contains large reddish-orange granules.

A; An ultrarapid metabolizer (UM) would require a higher dose of a drug than an EM (a person with normal enzyme activity) since the UM eliminates the drug more quickly.

A CYP2D6 ultrarapid metabolizer (UM) would require ___________ dose of an active drug (non-prodrug) that is metabolized by CYP2D6 than a CYP2D6 extensive metabolizer (EM). A. a higher B. a lower C. the same

B; In reporting out Gram stains, one should not go beyond what objective observation will allow. In this case, bacterial cells are observed, which are spherical and gram-positive. Their arrangement in tetrads and clusters might be helpful to the physician, suggesting staphylococci. However, one should stop short of naming staphylococci in an official report, as the large gram-positive cocci in tetrads is also suggestive of Micrococcus species, for which human infections have not been reported.

A Gram stain of the serous exudate is shown in the image. The appropriate report would read: A. Gram-positive cocci B. Gram-positive cocci in tetrads and clusters C. Gram-positive cocci suggestive of Staphylococcus species D. Smear positive for bacteria

D; Vitamin K is needed to produce certain coagulation factors, in particular factors II, VII, IX, and X. Deficiencies in these factors can lead to increased clotting times and can cause hemorrhagic disease.

A deficiency in which of these vitamins leads to increased clotting time and may result in hemorrhagic disease? A. Riboflavin B. Pyridoxine C. Tocopherols D. Vitamin K E. Vitamin C

B; The correct set of patient data would be: Hgb A = 60%, Hgb S = 38%, Hgb A2 = 2%, Hgb F = 0% Patients with sickle cell trait commonly have Hgb A values between 40 and 60%, Hgb S values between 20 and 40% and Hgb A2 values between 2 and 3%.

A known sickle cell trait patient has a hemoglobin electrophoresis test performed. Which of the following hemoglobin percentage sets would most closely match this patient's diagnostic state? A. Hgb A = 90%, Hgb S = 8%, Hgb A2 = 2%, Hgb F = 0% B. Hgb A = 60%, Hgb S = 38%, Hgb A2 = 2%, Hgb F = 0% C. Hgb A = 40%, Hgb S = 58%, Hgb A2 = 2%, Hgb F = 0% D. Hgb A = 25%, Hgb S = 70%, Hgb A2 = 2%, Hgb F = 3%

A; 21 CFR 606.65 states, "Supplies and reagents shall be used in a manner consistent with instructions provided by the manufacturer." The correct answer is A. The reagents must be used according to the manufacturer's instructions for use. If the instructions say one or two drops may be used and the facility procedures also allow one or two drops, then there is no problem with the staff members choosing to use two drops. While equipment must be calibrated, it does not generally influence the number of drops used. Staff members often ask co-workers and colleagues from other facilities how to perform tasks, but it is the manufacturer's instructions for the operation of equipment and the use of reagents that must be followed.

A laboratory employee who is performing an internal audit of routine ABO and Rh typing procedures notes that a technologist places two drops of Anti-D in a tube, centrifuges the tube for 20 seconds, and reads the reaction using a magnifying mirror. When questioned about the procedure, the technologist indicates that most staff use two drops of Anti-D reagent because the reactions are stronger with two drops. In addition to reviewing the facility procedure manual, what should be done to ensure regulatory compliance? A. Review the anti-D manufacturer's current instructions for use. B. Check the calibration records for the centrifuge. C. Call a colleague at another institution to ask what they do.

D; Root cause analysis (RCA) is a structured study that determines the underlying causes of adverse events. RCA focuses on systems, processes, and common causes that were involved in the adverse event. It then determines ways to prevent recurrence by identifying potential improvements in systems and processes that should decrease the likelihood of repeating the event. Failure mode and effect analysis (FMEA) is used to evaluate a process prior to its implementation. Its purpose is to identify ways in which a process might possibly fail with the goal being to eliminate or reduce the likelihood of such a failure. Monitoring quality indicators is important in the maintenance of quality health care. Quality indicators should be identified to prevent medical errors from occurring or to prevent the recurrence of a quality issue. However, it is not the method that is used to evaluate an adverse event after it has occurred. A medical record audit may be a part of a root cause analysis.

A medical event occurs that results in serious injury to a patient. All systems, processes, and common causes that were involved in the adverse event should be evaluated. A method that can be implemented to effectively study the underlying causes is known as: A. Failure mode and effect analysis B. Monitoring of quality indicators C. Medical record audit D. Root cause analysis

E; The patient's BUN is within normal range (5-20 mg/dL) while the creatinine is about five times the upper normal range (0.6-1.2 mg/dL). Gross elevations in creatinine are almost always accompanied by elevations in BUN when there is kidney impairment. Either the BUN or creatinine value in this case is incorrect. Both tests should be repeated.

A patient's BUN value is 15 mg/dl and his creatinine is 5 mg/dl. If this patient is not undergoing dialysis, what conclusion would you draw from these results? A. patient is normal B. patient is in early stage of renal disease C. patient protein intake is quite low D. patient has suffered muscle deterioration E. one of the values is in error

A; Microcontainer collection order of draw differs from regular peripheral blood collection order of draw. When performing a capillary draw, the lavender top container is obtained first. This decreases the possibility of clots in the container which would invalidate the results of the complete blood count test. After the lavender is drawn, other containers with anticoagulants would be collected, and containers without anticoagulants would be collected last.

A phlebotomist must perform a skin puncture to obtain capillary specimens for a complete blood count (CBC), a plasma-based chemistry test, and a serum-based immunology test. The microcollection containers that will be used are lavender top containing EDTA anticoagulant, green top containing heparin anticoagulant, and gold top containing no anticoagulant. Which microcollection container should be collected first? A. Lavender top B. Green top C. Gold top D. The order of draw is not important.

D; Heparin contamination is characterized by an elevation in the aPTT test and can also cause an increased PT test as well. Reptilase time tests are used to elimate the effects of heparin contamination as the reagents and method are resistant to the effects of antithrombin III, unlike the PT and aPTT tests. Therefore, it would be expected that a patient sample containing pre-analytical heparin contamination will show an increased aPTT (and sometimes PT as well) while showing a normal reptilase time.

A specimen drawn from an indwelling catheter that was contaminated by heparin would be indicated by: A. normal PT and aPTT results B. abnormal PT and normal PTT results C. prolonged aPTT and prolonged reptilase time test D. prolonged aPTT and normal reptilase time test

A; There are many causes of CSF lymphocytosis. Lymphocytosis is seen in viral, fungal, and tuberculous infections, although a predominance of neutrophils may be present in the early stages of these infections. Lumbar puncture to obtain CSF samples is often contraindicated in those with a suspected brain abscess.

CSF lymphocytosis is associated with all of the following except: A. Cerebral abscess B. Viral meningitis C. Chronic fungal meningitis D. Chronic tuberculous meningitis

B & D; The intended response is Vitamin B12 and folate deficiencies. Each of these conditions lead to a megaloblastic production of the red blood cells in the bone marrow. Since vitamin B12 and folate are needed in order to produce a synchronous development of the nucleus with the cytoplasm in hematologic cells, oval-macrocytosis often occurs if these nutrients are not in adequate supply within the body. This can also affect neutrophils, allowing for the characteristic hypersegmented nucleus. The photographic field contains several oval-macrocytes and a hypersegmented neutrophil with greater than 5 nuclear segments. Oval macrocytes are most commonly associated with pernicious anemia and malabsorption syndromes leading to vitamin B12 and folic acid deficiencies. Clinical information relating to chronic infection, aplastic anemia, and other hematologic maligancies provide the context for the presence of the oval macrocyte. Macrocytic erythrocytes and hypersegmented neutrophils are not present in thalassemias or in Pelger-Huet anomaly (hyposegmented neutrophils).

Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include which of the following? A. Thalassemia B. Vitamin B12 deficiency C. Pelger-Huet anomaly D. Folate deficiency

E

Identify the following cell types by matching them with their respective image. A. Stromal Cells B. Osteoblast C. Macrophage with hemophagocytosis D. Megakaryocyte E. Osteoclast

A; A positive DAT is consistent with a diagnosis of hemolytic disease of the newborn. A hemoglobin performed on the cord blood serves as an indicator of the severity of the disease.

In order to detect the presence of antibodies fixed on the RBC's of newborns one should: A. Perform a direct antiglobulin test (DAT) on the cord blood B. Perform an indirect antiglobulin test (IAT) on the cord blood C. Test the baby's cells with typing antiserum D. Look for agglutination in a mixture of mother's serum and baby's cells

B; The proper pH for a unit of platelets must be above 6.2. According to the FDA, accurate pH measurement is time dependent, and samples should be tested within 1 hour of sampling, or as suggested by the manufacturer of the pH measurement system. It is recommended that a pH meter or gas analyzer be routinely used rather than pH (nitrazine) paper. However, if the laboratory chooses to determine pH measurements with nitrazine paper, the selected paper should read in increments of one-tenth units, or it may provide inaccurate measurements. Maintaining proper pH requires at least 35 ml, but preferably 50-70 ml of plasma per platelet unit.

In order to prevent a loss of viability in platelet concentrates during storage the pH must be maintained above: A. 7.5 B. 6.2 C. 5.0 D. 4.5

A, B, & D; Hemolytic anemia, myelodysplasia, and liver disease may each fit this peripheral blood picture. Each of these conditions can display peripheral blood macrocytosis. It is easy to observe the overall larger size of the red blood cells in this image compared to the normal lymphocyte also present. When macrocytes are present, they should be examined for their shape (round vs. oval), the hemoglobin content (central pallor), and whether or not there are any inclusions present in the cell. Iron deficiency would not be the correct answer in this case, since this condition is associated with microcytosis instead.

The complete blood count was obtained from a patient recently admitted to the emergency room. The red blood cell indices obtained revealed an MCV of 115 femtoliters (fL) (normal range 80 - 90 fL). The patient met the criteria for a peripheral blood smear examination. A representative field is shown on the right. Which of the following conditions may be indicated by the results seen on this peripheral blood smear? A. Hemolytic anemia B. Myelodysplasia C. Iron deficiency D. Liver disease

C; HCG levels rise rapidly during the first trimester, then the levels start to decline around week 16. The hCG levels slowly decrease and can level off during the remainder of the pregnancy.

The following BEST describes serum hCG levels during pregnancy: A. Rise in levels throughout pregnancy B. Highest levels found at end of pregnancy C. Rapid rise in levels during first trimester; slow decline and possible level-off throughout remainder of pregnancy D. Slow rise in levels during first trimester; rapid rise during second trimester; slow decline during the third trimester

A; Interferon gamma serves various purposes in immunologic response, including the promotion of natural killer cell activity as well as decreased viral replication by using enzymes to decrease protein replication, both viral or host, inside of the cell.

The lymphokine most important for increased natural killer cell activity and decreased viral replication in cells is: A. Interferon gamma B. Interleukin 3 C. Interleukin 4 D. Interleukin 5

A; The lactophenol blue mount reveals tiny, ovoid microconidia, arranged in a daisy-head pattern at the tip of a straight conidiophore. This appearance is characteristic of the mold form of Sporothrix schenckii. By moving the focus up and down in a microscopic preparation, delicate hair-like attachments may be observed for each conidium. The mold form of Coccidioides immitis produces delicate hyphae that break up into arthroconidia separated by empty cells, giving an alternatively staining appearance. The mold form of Blastomyces dermatitidis is characterized by the production of single, smooth microconidia, each borne on a single, thin conidiophore ("lollipops"). The mold form of Histoplasma capsulatum is recognized by the production of large, echinulate macroconidia, appearing as a prickly surface.

The ovoid microconidia arranged in a daisy-head pattern at the tip of a a straight conidiophore, observed in the photomicrograph on the right, is characteristic of which of the following dimorphic molds? A. Sporothrix schenckii B. Coccidioides immitis C. Blastomyces dermatitidis D. Histoplasma capsulatum

C; Thin-layer chromatography has the advantage of being able to test for a large number of drugs at the same time.

Thin-layer chromatography is particularly useful as a tool in the identification of: A. Steroids B. Enzymes C. Drugs D. Hormones

B; The thrombin time (TT) involves the addition thrombin to platelet poor plasma to stimulate the clotting process. It reflects ability of the patient to convert fibrinogen to fibrin but is also sensitive to the presence of inhibitors that may be present in the plasma, like heparin. Therefore, it can be used to measure the effects of heparin on a coagulation sample.

This assay would be used to help rule-out heparin contamination in a coagulation sample: A. Protein C assay B. Thrombin time C. PT D. APTT

A; The correct answer which best fits the characteristics in this question is Mycobacterium kansasii. The remaining Mycobacterium strains can be elimated as: Mycobacterium marinum is considered a fast-grower. Mycobacterium scrofulaceum produce deep-yellow to orange pigmented colonies when grown in the either the light or dark. Mycobacterium avium grows colonies which are nonpigmented in the light and dark which do not intensify after light exposure.

What is the MOST likely identification of an acid-fast bacillus that demonstrates the following characteristics? slow growth cream to tan colored colonies when grown in the dark development of yellow pigment upon exposure to light A. Mycobacterium kansasii B. Mycobacterium marinum C. Mycobacterium avium D. Mycobacterium scrofulaceum

C; Gram positive organisms resist decolorization by ethyl alcohol. The large crystal violet-iodine complex is not able to penetrate the peptidoglycan layer, and is trapped within the cell in gram-positive organisms. Conversely, the outer membrane of gram-negative organisms is degraded and the thinner peptidoglycan layer of gram-negative cells is unable to retain the crystal violet-iodine complex and the color is lost.

What is the purpose of using ethyl alcohol or acetone in the gram stain procedure: A. Fix all gram positive organisms B. Decolorize all gram positive organisms C. Decolorize all gram negative organisms D. Fix all gram negative organisms

C; HbA1C is the recommended test for monitoring diabetic carbohydrate management. Microalbuminuria, low concentrations of urinary albumin, is measured to detect early renal impairment, at a stage where it is reversible with treatment.

What is the role of microalbuminuria testing? A. Monitor diabetic patient carbohydrate management B. Detect small-sized urinary albumin molecules in early renal disease C. Detect small urinary concentrations of albumin before there is irreparable renal damage D. Diagnose renal failure in a type 1 diabetic patient

D; HLA-DR is a class II MHC. HLA-A, HLA-B, and HLA-C are all class I MHC.

Which of the following antigens is classified as a Major Histocompatibility Complex Class II antigen (MHCII)? A. HLA-A B. HLA-B C. HLA-C D. HLA-DR

C; Thyroid-stimulating immunoglobulins, or TSI's, are IgG antibodies that can bind to thyrotropin (TSH) receptors on the thyroid gland. TSIs mimic the action of TSH, causing excess secretion of thyroxine and triiodothyronine. The TSI level is abnormally high in persons with hyperthyroidism due to Graves' disease.

Which of the following is an autoantibody that binds to TSH receptor sites on thyroid cell membranes preventing thyroid-stimulating hormone binding? A. Antithyroglobulin B. Antimicrosomal antibodies C. Thyroid-stimulating immunoglobulins D. Thyroxin-binding globulins E. Lupus erythematosus

A; Immunoassay is the most common technique that is used by clinical laboratories for therapeutic drug monitoring. Most of the drugs commonly assessed with TDM can be measured on analytical platforms which utilize antibodies (in some form) for detection. Antibodies can be developed that recognize drugs. Although most drugs are much too small to evoke an immune response, scientists can conjugate drugs to immunogenic proteins to produce antibodies that recognize drug-specific epitopes.

Which of the following is the most common technique that is used by clinical laboratories for therapeutic drug monitoring? A. Immunoassay B. Electrophoresis C. Atomic absorption D. Ion selective electrode voltimetry

C; Darkfield microscopy allows a lower limit of resolution than bright-field microscopy which helps the tiny spirochetes to be seen in patient samples. In darkfield microscpy, there is a dark background where directly transmitted light is excluded by a dark-field condenser allowing only scattered light to be focused on the specimen. With dark-field microscopy bacteria appear luminous against a dark background.

Which of the following microscopic techniques is best suited for direct examination of the infectious agent of syphilis? A. Light microscopy B. Phase microscopy C. Darkfield microscopy D. Electron microscopy

B & D; True Statements: Urine should be well mixed prior to dipping the reagent strip. Prolonged immersion may wash out test reagents. False Statements: Urine should be centrifuged prior to dipping the reagent strip. When visually reading the reagent strip, all results can be read immediately after dipping the strip in the urine specimen.

Which of the following statements are TRUE regarding the reagent strip test procedure? (Choose ALL of the correct answers) A. Urine should be centrifuged prior to dipping the reagent strip. B. Urine should be well mixed prior to dipping the reagent strip. C. When visually reading the reagent strip, all results can be read immediately after dipping the strip in the urine specimen. D. Prolonged immersion may wash out test reagents.

A; L/S ratio <2.0 indicates an increased risk of respiratory distress syndrome (RDS) at delivery. L/S ratio <1.5 indicates a very high risk of developing RDS.

Which of the following statements regarding the L/S ratio is TRUE? The correct answer is highlighted below A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent respiratory distress syndrome (RDS) A ratio of 1.5:1 indicates fetal lung maturity in pregnancies associated with diabetes mellitus. Sphingomyelin levels increase during the 3rd trimester causing the L/S ratio to fall slightly during the last two weeks of gestation. A phosphatidylglycerol (PG) spot indicates the presence of meconium in the amniotic fluid Lecithin is in direct ratio with sphingomyelin

D; Transfusion of red cells of any ABO type other than O to a group O patient is of course likely to cause a hemolytic transfusion reaction.

Which of the following types of packed RBCs could be transfused to a group O patient: A. Group A B. Group B C. Group AB D. None of the above

C; Vitamin K dependent factors are those that require Vitamin K for their synthesis in the liver. Vitamin K is an important factor to gamma-glutamyl carboxylase which adds a carboxyl group to glutamic acid residues on factors II, VII, IX and X, as well as Protein S, Protein C. In adding the gamma-carboxyl group to glutamate residues on the immature clotting factors Vitamin K is itself oxidized. Deficiency of Vitamin K due to malabsorption, liver disease, etc. may contribute to bleeding disorders because clotting factor maturation depends on Vitamin K.

Which of these coagulation factors are referred to as "vitamin-K dependent?" A. I, V, VIII, XIII B. II, V, IX, XII C. II, VII, IX, X D. XI, XII, Fletcher, Fitzgerald

D; CD34, a cell surface marker, presents on undifferentiated pluripotential hemopoietic stem cells. CD34 is a cell surface glycoprotein and functions as a cell-cell adhesion factor.

Which one of the following antigen markers is BEST associated with stem cells? A. CD3 B. CD10 C. CD18 D. CD34 E. CDC007

D; Following an AMI, elevated CK-MB returns to normal ranges in 48-72 hours. If a patient has a second AMI in this time period, a second rise in concentrations of CK-MB would be seen. This is not true for the cardiac troponins since they remain elevated 7-14 days following an AMI.

Which one of the following cardiac biomarkers could detect a reinfarction? A. cTnI B. cTnT C. TnC D. CK-MB

D; Calcium oxalates can be found in normal urine in varying pH levels. Ammonium biurate and triple phosphate can be found in normal alkaline urine. Leucine crystals are always abnormal, and can be found in maple syrup urine disease.

Which one of the following crystals is NOT found in normal urine? A. Triple phosphate B. Ammonium biurate C. Calcium oxalate D. Leucine

C; Each of the drugs/drug classes listed above have been known to cause drug-induced hemolytic anemia, although cephalosporins are the MOST COMMON cause. Cephalosporins can cause drug-induced hemolytic anemia when a patient produces antibodies to the particular cephalosporin drug in the presence of red blood cells. The drugs can alter the membrane appearance of the red blood cells, causing the body to mistake them as foreign. Complement becomes activated due to these antibodies; red cells are then destroyed causing hemolytic anemia. Dark urine, caused by intravascular hemolysis, is one of the most common symptoms associated with this condition.

Which one of the following drugs/drug classes is the MOST COMMON cause of drug-induced hemolytic anemia? A. Levodopa B. Quinidine C. Cephalosporins D. Levofloxacin E. Nonsteroidal anti-inflammatory drugs (NSAIDs)

D; AHG must be added to the cells immediately following washing. Antibodies may elute from the cells if the cells are allowed to sit in saline without the addition of AHG.

Which one of the following may cause a FALSE-NEGATIVE result with antiglobulin techniques? A. Red cell/AHG test sample is over-centrifuged B. Patient's blood specimen was collected in silicone gel tubes C. Saline used for washing the test sample has been stored in squirt bottles D. Addition of AHG is delayed for 40 minutes or more after final saline wash E. Patient's red cells have an antibody coating them

B; The characteristic that distinguishes vancomycin-resistant Enterococcus faecium and Enterococcus faecalis from other Enterococcus species is their lack of motility. Enterococci are all catalase-negative. Growth on bile esculin agar and in 6.5% salt broth are two characteristics that have commonly been used to identify Enterococcus to the genus level. A positive esculin in combination with a positive PYR reaction is another approach to presumptive identification.

Which one of these characteristics distinguishes vancomycin-resistant Enterococcus faecium and Enterococcus faecalis from other Enterococcus species? A. PYR positive reaction B. Non-motility C. Catalase negative D. Growth on bile esculin agar

B; The second choice is correct. Standard Precautions means to treat blood, all body fluids, all secretions (except sweat), all excretions, non-intact skin, and mucous membranes as if they were infectious. The purpose of this rule is to ensure the safety of and to protect those who come into contact with potentially infectious material.

Which one statement about Standard Precautions is most correct? A. Standard Precautions means to treat all patients as if they were infectious. B. Standard Precautions means to treat blood, all body fluids, all secretions (except sweat), all excretions, non-intact skin, and mucous membranes as if they were infectious. C. Standard Precautions do not apply to feces or urine. D. Standard Precautions do not apply to pleural fluid or semen.

C; Caffeine benzoate solution is used to split the unconjugated bilirubin protein complex releasing the bilirubin so that it can react with diazotised sulphanilic acid. The tartrate buffer creates an alkaline solution and converts the red acid bilirubin to a green coloured compound which can be measured spectrophotometrically.

Which substance is used in the Jendrassik-Grof method to accelerate the reaction of unconjugated bilirubin with the diazo reagent? A. NADH B. N-butanol C. caffeine D. acetic acid

B; The results of this PT and aPTT are in normal range. These results can be reported and are not indicative of the need to: order a mixing study or request a redraw.

You have just performed stat PT and aPTT tests on your coagulation instrument. Your results are as follows: PT = 12 seconds (normal range 10-13 seconds) aPTT = 24 seconds (normal range 21-34 seconds) What would be your next step? A. Perform a mixing study B. Report the results C. Request a redraw of the specimen