MLT ASCP Study Set

Which of these conditions could result in a microcytic anemia?

Iron deficiency

A small child has albino characteristics, photophobia, frequent pyogenic infections, and her blood smear shows giant dark granules in her monocytes and granulocytes. What is the probably diagnosis?

Chediak-Hegashi syndrome

Based on the evaluation of hematocrit. blood pressure, pulse, age, and gender, which of the following individuals represents and acceptable allogenic donor?

Hct is 41%, BP is 110/80, temp is 99.4, pulse is 65, age is 65, and Sex is male.

An abnormality of which of the following assays would be LEAST likely to be associated with thrombotic tendency?

APTT

Which hemoglobin, when elevated, acts as a protection against sickling in patients with HbS?

Hemoglobin F

When three tubes of cerebrospinal fluid are received in the laboratory they should be distributed to the various laboratory sections as follows:

1.) Chemistry, 2.) Microbiology. 3.) Hematology

What is the molarity of a 2.5 N solution of H2SO4 (gmw=98 g/mol, valence=2)?

1.2 mol/L H2SO4

A technologist is evaluating the red blood cell morphology on a peripheral blood smear. The image on the right is a representative field from the smear. The technologist has recorded the red cell morphology as macrocytic. Which MCV value would confirm this observation?

110 fL (reference range of 80-100 fL)

A sample of cerebrospinal fluid 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 countedSide 2- 184 cells countedtotal cells = 370What is the cell count per microliter?

2.06 x 10^4

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

24 hours; 1-6 C

Osmolality equation

2Na + glucose/18 + BUN/2.8

The radioactive method used to measure red cell survival uses which of the following isotopes?

51^Cr (Chromium 51)

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? Note: the volume correction factor if 50 microliters.

680 x 10^3/microliter

Which of the following blood tests is used in the determination of prostate cancer?

Acid phosphatase

The following stain reactions were resulted on a suspected case of leukemia: Myeloperoxidase + Sudan Black B + Chloroacetate Esterase + Nonspecific Esterases - Which of the following is the correct interpretation?

Acute Myelocytic Leukemia

Which analyte should be increased in the presence of muscular dystrophy?

Aldolase

Upon admission for thoracic surgery, a patient's physician ordered a type and screen. The patient is O positive. After a positive antibody screen was obtained, an antibody identification was performed. The results are shown on the right. Which antibodies are most likely present and causing the reactions shown?

Anti-Fya and Anti-C

Which of the following autoantibodies are found in a patient with Hashimoto's thyroiditis?

Antithyriod peroxidase (TPO)

Which of the following is responsible for the humoral immune response?

B lymphocytes

Both toxic granulation and Dohle bodies are found within:

Bacterial infections and inflammation.

Which of the following globin genes are found on Chromosome 11?

Beta, Gamma, Epsilon

What can be done to make a hapten behave like an antigen?

Bind to Protein

All cells can synthesize here, which two organs are the main sites of hemoglobin synthesis for the body?

Bone marrow and liver

Of the gram-negative bacilli listed below, which is motile with polar tufts of flagella and can produce yellow pigment?

Burkholderia cepacia

All helper cells are T cells. consequently, in a normal lymphocyte population, it is reasonable to expect all CD4-positive cells also be positive for which of the following CD markers?

CD3

In HbSS blood, an increased amount of which surfact antiens on young sickle cells (reticulocytes) many allow paltelets to forma bridge between the reticulocytes and endothelial cells, ultimately leading to vaso-occlusion?

CD36

Human dog bite infections may be caused by each of the following bacterial species except:

Capnocytophaga ochracea

A tech is workinh with a small Gram-negative coccobacillus that may be Francisella tularensis. Which of the following tests could the tech use to rule out this organism?

Catalase negative.

A representative congenital neutrophil functional disorder is:

Chédiak-Higashi syndrome

What is the function of ADAMS13 enzyme?

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

Iontophoresis is a technique used in the diagnosis of

Cystic fibrosis

Leukocyte-reduced blood products may be administered to reduce the risk o febrile reactions and what disease or condition?

Cytomegalovirus (CMV)

In patients with suspected primary hypothyroidism associated with Hashimoto's thyroiditis, one would expect the following laboratory test results:T4 ___? TSH ___? TRH stimulation ___?

Decreased, increased, increased

A hemoglobin F concentration of 100% may be seen in which beta thalassemia?

Delta-beta thalassemia major

Which of the following is the most common method for diagnosing malaria?

Demonstration of the organism in peripheral blood.

All of the following tests are useful in the diagnosis of heparin induced thrombocytopenia (HIT) EXCEPT:

Dilute partial thromboplastin time (DTT)

What is the process of monoclonal antibody production?

Fusion of antibody specific lymphocyte and myeloma cell.

What nematode egg is characteristically flattened on one side?

Enterobius vermicularis

What is the identification of this cellular clump found in CSF? Note the presence of many similar-appearing nuclei without distinct lines of demarcation between cells.

Ependymal clump

The tubes shown in this photograph reading from left to right are 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 in color. Of the bacterial species listed, the one most likely to produce the reactions observed is:

Escheria coli

All of the following statements concerning biochemical reactions are true, EXCEPT:

Escheria coli is positive for utilization of sodium citrate as depicted in tube A.

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

Folic acid deficiency

Diseases associated with a dysfunction of polymorphonuclear neutrophils include all of the following with the exception of:

Gaucher's disease

Which of the following characteristics are found within May Hegglin Anomaly?

Giant platelets

A man with an otherwise unremarkable medical history begins to bleed heavily after having his wisdom teeth removed. Which coagulation disorder would most likely be to blame?

Hemophilia C (Factor IX deficiency)

The LD (lactate dehydrogenase) molecule is made of a combination of polypeptides that can be separated into isoenzymes that help determine the location of an elevated LD. LD 3 is found primarily in the lung, lymphocytes, spleen, and pancreas- but what polypeptides make up LD3?

HHMM

cells that stain positive with acid phosphatase, and are not inhibited with tartrate, are characteristically seen in

Hairy cell leukemia

In serum protein electrophoresis, all of the following proteins reside in the band closest to the anodal end except:

Haptoglobin

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?

Hgb A = 60%, Hgb S = 38%, Hgb A2 = 2%, Hgb f = 0%

One of the most common forms of hereditary hemochromatosis has been found to result from genetic mutations of the HFE gene. This mutation causes hemochromatosis by which of the following mechanisms?

Impairs hepcidin regulation of ferroportin activity.

A medical laboratory Scientist working in Hematology was performing Myeloperoxidase staining on a suspected AML case. They found positive reactions of the segmented neutrophils. What would be the next step?

Inaccurate result, only blast cells are to be examined for reaction.

Considering all of the above information and the cells indicated by the arrows that were observed on the peripheral smear, what is the probable mechanism for the anemia that the patient is experiencing?

Increased destruction of red blood cells (RBCs) caused by an intracorpuscular abnormality.

What is the mechanism that causes megaloblastic anemia?

Interruption of DNA Synthesis

A patient grew out Mycobacterium tuberculosis (MTB) from an acid-fast bacilli (AFB) sputum culture. The physician called requesting information on which four primary drugs should be used for the treatment of MTB. Which of the following primary antitubercular agents would be recommended for treatment?

Iosinazid

Which of the following are considered two of the positive risk factors for coronary heart disease S determined by the National Cholesterol Education Program?

LDL-C concentration =100 mg/dL, HDL-C concentration < 40 mg/dL

Which of the following is most likely to interfere with the measurement of hemoglobin?

Lipemia

Which of the following is the most common condition associated with a nonmegaloblastic macrocytic anemia?

Liver disease

The peroxidase stain is useful in differentiating between which cells?

Lymphocytic and granulocytic cells

An important metallic activator of alkaline phosphatase and creatine kinase is:

Magnesium

In which age group is Type I Hereditary Hemochromatosis (HH - the most common form) most likely to be initially detected based on clinical symptoms?

Middle-aged adults

What type of cell is indicated by the arrow?

Monocyte

Which of the following conditions is most likely when an oligoclonal band is seen in CSF electrophoresis without a corresponding serum peak?

Multiple Sclerosis

Which of the following distinguishing characteristic is associated with Streptomyces species?

Musty basement odor

Which of the following cells are considered abnormal and clinically significant on a CSF differential?

Myeloblasts

A patient presents with the following test results: Total bilirubin: 3.0 mg/dL Conjugated Bilirubin: 1.2 mg/dL Urine urobilinogen: decreased Stool color: clay colored The MOST probable cause is:

Obstructive jaundice

Which parasite gives birth to live larvae known as microfilariae?

Onchocerca volvulus

On this alkaline electrophoresis gel, which patient most likely has alpha thalassemia? Lanes 5 and 6 represent controls.

Patient 3 (band far to the right).

Hyposegmented neutrophils can be seen in:

Pelger-Huet anomaly

Which of the following parasites has the longest undulating membrane?

Pentatrichomonas hominis

Plasma exchange is the current treatment for all of these conditions, EXCEPT:

Pernicious anemia (treated with monthly parenteral doses of hydroxycobalamin)

The cell in this image is known as a MOTT cell. What is the condition in which this cells are associated?

Plasma cell myeloma

Which of the following tests is expected to have a NORMAL result in a patient with type 1 von Willebrand disease?

Platelet count

Effusion fluids are classified as transudates or exudates. According to light's criteria all of the following is applicable to an exudate EXCEPT:

Pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum

Which of the following laboratory results would be seen in a patient with acute Disseminated Intravascular Coagulation (DIC)?

Prolonged PT, decreased fibrinogen. decreased platelet count, increased FDP

What is the main function of the hexose monophosphate shunt in red blood cells (RBC's)?

Provide NADPH and reduced glutathione to prevent oxidation of hemoglobin

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

RNA

What would be the next step when an EDTA specimen had an automated platelet count of 61,000/mm^3 and the platelets were surrounding the neutrophils on the differential?

Recollect a specimen for a platelet count without using EDTA.

Which of the following cells is indicative of Hodgkin's disease?

Reed-Sternberg (RS) cells

A tech receives a call from the floor regarding antimicrobial therapy. The patient culture yielded an aerobic gram-positive coccus and the physician would like to use an antibiotic that inhibits RNA synthesis. which of the following antibiotics would be the best choice?

Rifampin

Gastrointestinal infections of which of the following organisms is associated with hemolytic uremic syndrome?

Shiga toxin producing e. coli

Which of the following alpha thalassemia syndromes has the geotype -a/aa?

Silent carrier

A 49-year-old male with pneumonia was treated with high-dose intravenous penicillin. He became jaundiced with yellow sclera. The image on the right is typical of other fields that were observed on his peripheral blood smear. Since penicillin may, in some individuals, cause autoimmune hemolytic anemia, the clinician requested a direct antiglobulin test (DAT) be performed. The DAT was positive, indicating that the antibodies to the drug were produced, which were then attached to the drug on the surface of the red cells. Hemolysis occurred due to the drug-induced antibody attachment, leaving the patient with various abnormal red blood cell morphologies. Which of the following cell types would you report for this patient?

Spherocytes, nucleated red blood cells, polychromatiphylic red blood cells

In cases of suspected intestinal parasitic disease, select the name of the parasite, as illustrated by the 50 µm ovum in this image, that may be detected in upper respiratory secretions when stool specimen preparations are negative.

Strongyloides stercoralis

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.

An assessment of the myeloid to erythroid ratio is part of every bone marrow evaluation. Which of the following does not apply to the M:E ratio?

The erythroid total used in calculating the M:E ratio is the sum of all the nucleated red cell precursors.

Serum TSH levels five-times the upper limit of normal in the presence of a low T4 and low T3 uptake could mean which of the following:

The thyroid has been established as the cause of hypothyroidism

An 18-year-old patient bled profusely following a tooth extraction. She had a history of sporadically increased menstrual bleeding and nose bleeds. The laboratory tests showed: Platelet count of 350 x 10^9 PT of 12 seconds PTT of 125 seconds Factor VIII activity of 20% Factor IX activity levels 102& Platelet aggregation studies: Norma; ADP, collagen and decreased with Ristocetin. What is the most likely cause of this patient's bleeding episodes

Von Willebrand's Disease (distinguished from Hemophilia A by decrease with Ristocetin)

The ultimate end product of both epinephrine and norepinephrine metabolism is:

Vanillylmandellic acid

All of the following would be situations where you would typically find an increase in eosinophils EXCEPT?

Viral infections

The predominant cells seen in this CSF are from a twelve-year-old female exhibiting fever, lethargy, and a stiff neck. The WBC count on this sample was 2,000 per microliter. The findings most likely indicate:

Viral meningitis

Which of the following is the most common type of autoimmune hemolytic anemia?

Warm autoimmune hemolytic anemia

A yellow coloration found in fresh cerebrospinal fluid supernatant is termed:

Xanthochromia

Below are the laboratory results on a 20 year old overweight male. His waist circumference is 41 inches and blood pressure is 105/70. FBG- 130mg/dL Trig- 190 mg/dL HDL- 50 mg/dL The national Heart, Lung, and Blood Institute (NHLBI) and American Heart Association (AHA) have created a set of parameters to define the presence of the metabolic syndrome. Does this patient meet the criteria for metabolic syndrome diagnosis?

Yes, he meets the NHLBI and AHA criteria for metabolic syndrome. Waist circumference: (Male) >102 cm/40 in (Female) >88 cm/35 in Triglycerides: >/= 150 mg/dL Cholesterol: (Male) <40 mg/dL (Female) <50 mg/dL BP: (>/=130)/(>/=85) mmHg Blood glucose: >/= 110 mg/dL

What is considered to be the technique of choice for isolating the oocysts of Cystoisospora belli and Cryptosporiudium parvum?

Zinc Sulfate flotation

A 51 year old woman with type 2 Diabetes and high blood pressure has recently started noticing foaming in the toilet bowl following urination. She typically has her urine checked for abnormalities every 3 months. recently, urinalysis indicates an abnormally large concentration of protein in her urine. Given the patient's history, which of the following proteins will likely be found in her urine upon analysis in the lab?

c) Albumin, which leaks through the damaged kidney glomeruli, and appears first in the urine