1rst test stimulation

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 formula for calculating transferrin saturation (TS)?

(Serum iron/TIBC) X 100

Granulocyte Concentrates MUST be administered within ______ of collection.

24 hours

Which of the following is an FDA-approved therapeutic agent for treating sickle cell patients?

Hydroxyurea

Which of the following would be considered normal for a glucose level in cerebrospinal fluid:

60 mg/dL

Platelets that are not collected by an apheresis method must be prepared within ________ of the collection of Whole Blood.

8 hours

How many international units (IU) of IgG anti-D are in 300 µg vial of RhIg?

A 300 µg vial of RhIg contains 1500 IU of IgG anti-D. The conversion is one µg = 5 IU.

A physician needs to prescribe a drug to a patient but the drug has a narrow therapeutic window. He is concerned about possible toxic effects. To assess the upper concentration of such a drug, which time for drawing the specimen do you think makes the most sense?

Approximately one hour after an oral dose

he phenotypic property of Saccharomyces yeast species that is helpful in establishing its species identification is:

Ascospore production

The Epstein-Barr Virus is associated with which of the following conditions:

Burkitt's lymphoma

Where does most cerebrospinal fluid originate?

Choroid plexus

A 68 year old woman presents with pressure under the lower left ribs from a swollen spleen, but is not complaining of any other symptoms. Her laboratory data showed the following: Hgb = 13.5 g/dL Hct = 40% Platelets = 240 x 109/L WBC count = 46 x 109/L Differential: 45% Neutrophils, 2% Lymphocytes, 6% Eosinophils, 2% Basophils, 35% myelocytes, 10% metamyelocytes LAP score: 11

Chronic Myelogenous Leukemia

When performing bone marrow differentials it is not necessary to distinguish the precursor forms of the erythroid sequence.

False

The transmission of which of the following organisms is associated with the guano of bats?

Histoplasma capsulatum

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

lupus anticoagulant (anti-phospholipid antibody)

If reporting moxalactam, cefonicid, cefamandole, or cefoperazone for Escherichia coli, Klebsiella, or Proteus species testing positive for ESBL (Extended Spectrum Beta Lactamases), they should be reported as resistant.

true

What condition is indicated by the following blood gas results: Bicarbonate = 32 mmol/L (Normal = 22 - 26 mmol/L); pCO2 = 65 mm Hg (Normal = 35 - 45 mmHg); pH = 7.28 (normal = 7.35 - 7.45)

uncompensated respiratory acidosis

Which of the following can lower the amount of current needed to cause electricity-induced injury?

wet skin

A patient with an upper respiratory infection submits a sputum for culture. A Gram stain performed on the sputum specimen reveals gram-negative diplococci. Oxidase testing is positive and carbohydrate degradation tests are inactive. The organism may presumptively be identified as:

Moraxella catarrhalis

Tiny translucent gray colonies were recovered on blood agar from a patient with purulent conjunctivitis. Gram negative diplococci were seen on Gram stain. The preparation illustrated in this photomicrograph was obtained from colonies growing at the margin of inhibition of a 10ug/ml penicillin disk. The most likely identification is:

Moraxella lacunata

Match the names of each of the Corynebacterium species into Bucket A if it is "lipid requiring" and into Bucket B if it does not require supplemental lipids for growth.

Bucket A Corynebacterium jeikeium Bucket B Corynebacterium cystitidis Bucket A Corynebacterium ureolyticum Bucket B Corynebacterium flavescens

The McFarland Comparison Card shown in the illustration is used to:

standardize concentrations of organisms

Which form of hemoglobin cannot be measured using the cyanmethemoglobin method:

sulfhemoglobin

Which of the following are characteristics of casts?

they are cylindrical bodies they contain Tamm-Horsfall mucoprotein

Total iron-binding capacity measures the serum iron transporting capacity of:

transferrin

When the body compensates for a respiratory or metabolic disorder, the MAIN goal is to achieve

A normal pH

A lymphokine can BEST be described as:

A soluble mediator produced by lymphocytes

Which of the following best describes the direct antiglobulin test principle:

AHG detects antibody already coated to red cells

Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity?

Adiponectin

Which one of the following usually shows a decrease during an acute phase response?

Albumin

Which assay is performed to diagnose congestive heart failure (CHF)?

BNP

Group A beta-hemolytic streptococci are best characterized by which of the following:

Bacitracin Sensitivity

Which one of the following antigen markers is BEST associated with stem cells?

CD34

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 probable diagnosis?

Chediak-Hegashi syndrome

Which of the following blood components contain the most factor VIII concentration relative to the unit volume?

Cryoprecipitated AHF

Which of the following is used as a source for irradiation of blood products:

Cs137

Significantly increased levels of ketones are detected in the urine with which of the following conditions? (Choose ALL correct answers)

Diabetic acidosis Excessive carbohydrate loss Starvation

The light blue-gray inclusions observed in the cytoplasm of many of the bands and segmented neutrophils of a burn patient are MOST likely?

Dohle bodies

An osmometer can use any of the following principles except:

Electrostatic charge

Illustrated in the top photograph is a circumscribed colony with a wooly surface mycelium with a distinctive black pigmentation centrally and a ring that is yellow-brown at the periphery. The reverse of the colony would show diffusible black pigment. Although not specific for any one of the phaeohyphomyces fungal species, the bottom photomicrograph displays the muriform conidiation characteristic of this species. From the list of multiple choices, select the name of the fungus that is being represented.

Epicoccum species

A patient with atypical (reactive) lymphocytes in his peripheral blood smear should be tested for:

Epstein-Barr virus infection

A pregnant female who received RhIg at 28 weeks gestation has a positive antibody screen at delivery. If the antibody has been confirmed as anti-D alone and reacts 1+ in the indirect antiglobulin test with D+ red cells, performing a titration to investigate if the anti-D is immune is good practice.

False

The National Heart, Lung, and Blood Institute initiated the National Cholesterol Education Program (NCEP) in 1985. The goal was to reduce the number of Americans with elevated cholesterol and thus reduce illnesses and deaths in the United States due to coronary heart disease. Three adult treatment panels have been published since then with clinical practice guidelines for managing cholesterol levels in adults. The most recent panel, Adult Treatment Panel III (ATP III), was published in 2001 and updated in 2004. The NCEP: ATP III also includes criteria for the diagnosis of metabolic syndrome. Select the set of laboratory assays that are utilized in the NCEP: ATP III criteria for metabolic syndrome diagnosis.

Fasting blood glucose, triglycerides, HDL-C

Which of these could cause a sickling event?

Fluctuations in temperature

A plasma cortisol of 22 µg/dL at 8:30 a.m. and 10 µg/dL at 4:00 p.m. would be:

Found in healthy individual

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

Gestational diabetes mellitus (GDM)

Unconjugated bilirubin is conjugated in the liver with which of the following substances to become water soluble?

Glucuronic acid

The antigen marker most closely associated with transmission of HBV infections is:

HBeAg

What sero-marker is the first marker to become positive in Hepatitis B and is associated with the infective stage?

HBs antigen

Which of the following tests has been recommended by the FDA to replace the HIV-1 p24 antigen test in the screening of donated blood for infectious diseases?

HIV-1 NAT

HIPAA stands for:

Health Insurance Portability and Accountability Act

The intracellular precipitates seen in the RBCs in this illustration is termed:

Heinz bodies

Which of the following methods would be used to confirm the presence of Bence-Jones protein in the urine

Immunofixation

The results which would be MOST consistent with macro-amylasemia are?

Increased serum amylase and normal to low urine amylase values

Spectrophotometric absorbance is related to % transmittance in what way:

Inversely and logarithmically

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

LDL

A 34-year-old female was seen in the dermatology clinic for some lesions on her fingers that had not responded to topical antimicrobial therapy. Tissue was biopsied and sent for histological examination, routine, AFB and fungal cultures. There was no growth on any culture. Acid fast bacilli were seen in the histological preparations. The tissue culture for AFB had been incubated both at 35oC and 32oC, in liquid media and on media with hemoglobin added for several weeks. What is the most likely diagnosis of her skin lesions?

Leprosy

Erythema migrans, spirochetemia and chronic arthritis are three stages in the progress of:

Lyme disease

Which of the following is responsible for causing graft-versus-host reactions:

Lymphocytes

The colonies illustrated in the upper photograph, recovered from a cat bite skin lesion of a child, reveal good growth of entire, convex, gray-white, smooth colonies on blood and chocolate agars. The colonies on blood agar are non-hemolytic and growth would not be observed on MacConkey agar. Coccoid to rod-shaped gram-negative bacilli are observed in gram stains. Positive tube reactions for indole, Voges Proskauer, ornithine, arginine and strong production of esculin are observed in the lower photograph. The cytochrome oxidase reaction is also positive. With these observations, select from the multiple choices the identification of this isolate.

Pasteurella multocida

Which of the following conditions would NOT be associated with an increased level of alpha-fetoprotein?

Prostate Cancer

Jane Doe is a 39-year-old female who felt tired for several months, had pain in the joints of her fingers, and recently developed a dermatitis following exposure to the sun. The following test results were obtained on a blood sample drawn during the initial evaluation: Total Protein = 8.4 gm/dL (N = 6.0-8.0 gm/dL) ANA >1:2560; speckled pattern CRP = positive C3 = 40 mg/dL (N = 80-180 mg/dL) C4 = 5 mg/dL (N = 15-45 mg/dL) Based on the clinical and laboratory findings, what disease should be suspected?

SLE

Which one of the following statements is FALSE?

Secretory cells of the innate immune system are antigen specific.

Among the nonfermenters, the only bacterial species to produce H2S is

Shewanella putrifaciens

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

Which one of the following bacteria is the MOST frequent cause of prosthetic heart valve infections occurring after heart surgery?

Sthapylococcus epidermis

Patients with antibody to the following antigen are immune to Hepatitis B:

Surface antigen

A mother's serologic results are shown above. Her newborn types as group A Rh positive with a (1+) positive direct antiglobulin test (DAT). Which of the following investigative tests would be most useful to resolve the cause of the positive DAT and should be done FIRST?

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

A patient who previously had an hs-CRP of 4 mg/L was put on statin and daily aspirin medication. She returns to the laboratory a month later, and her repeat hs-CRP is 2.3 mg/L. Which of the following is the most likely reason for the decrease in the test value?

The medications lowered the hs-CRP value.

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

In healthy individuals, procalcitonin is synthesized by which cells in the body?

Thyroid C Cells

A technologist performed a STAT spinal fluid count by pipetting undiluted spinal fluid in a Neubauer Counting Chamber and counting both sides of the chamber (4 large WBC squares on each side). A total of 54 White Cells were counted. How many White Cells would there be per cubic millimeter?

WBC/µL= Avg # cells counted (# squares counted x 0.1/µL) WBC = 54 / (8 squares x 0.1) = 67.5 Since 1 uL = 1 cubic millimeter, then the answer is 67.5

The immunoassay procedure for serum hCG utilizes antisera against which subunit of hCG?

beta

MOST of the carbon dioxide present in the blood is in the form of:

bicarbonate

The stool specimen from a patient admitted to the hospital with symptoms of appendicitis has a culture with the following characteristics: Gram-negative bacillus Catalase positive Urease positive Weakly fermentative TSI Slant is A/A These reactions suggest that the organism is MOST likely:

Yersinia enterocolitica

Given the following results, what is the immune status of the patient? HbsAg: positive HbeAg: positive Anti-HBc IgM: positive Anti-HBs: negative

acute infection

@ pH 8.6 proteins are charged and will migrate toward the:

anode

Which of the following substances can cause a false positive result for blood on the urine chemical reagent strip?

bleach in the collecting bottle

The bacterial species represented by the positive test illustrated in the photograph of a 5% sheep blood agar plate cross streaked with a hemolytic strain of Staphylococcus aureus has been associated with each of the following conditions except:

carcinoma of the colon

Select the morphologic structure that identifies Candida albicans and distinguishes it from most other Candida species.

chlamydospore

The infective stage for the majority of all intestinal amoebae is the:

cyst

Iontophoresis is a technique used in the diagnosis of:

cystic fibrosis

Which two of the following crystalline elements are found in acid urine:

cystine Tyrosine

The life span of RBCs containing Hemoglobin H is typically:

decrease

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

factor II

Hemoglobinuria and hemoglobinemia will be present in reactions where there is extravascular hemolysis.

false

The prozone effect ( when performing a screening titer) is most likely to result in:

false negative

Which of the following is TRUE of a fully compensated metabolic acidosis?

pH will be normal with a decrease in PCO2

The BEST way to thaw Fresh Frozen Plasma is to thaw it by:

placing the FFP in a 37º C or lower in a water bath

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

prolonged aPTT and normal reptilase time test

Based on the following results obtained against a patient's red cells, what will the genotype look like in this example? Anti-C = 4+ Anti-c = 4+ Anti-E = 0 Anti-e = 4+ Anti-D = 0

r'r

Which of the following is/are NOT associated with immediate hypersensitivity?

serum sickness arthus reaction tuberculin reaction