AMT MT Set 5

When is a trough blood sample for therapeutic drug monitoring usually obtained? Just after the dose is administered Just before the next scheduled dose At the peak time calculated after a dose After one half-life of the drug

A trough blood sample for therapeutic drug monitoring is usually obtained just before the next scheduled dose as the drug level is expected to be the lowest in the body at this point. If the blood specimen was collected at one hour or later after the administration of an oral dose of the medication, the result would most likely reflect the peak level.

Which of the following is the most common method for diagnosing malaria? Serological testing Polymerase chain reaction (PCR) techniques Demonstration of the organism in peripheral blood Biochemical reactions

Diagnosis of malaria often requires thick smears to screen for the presence, as well as conventional thin blood smears to identify the species of Plasmodium. Today, Giemsa stained smears are still the specimen of choice for diagnosing malaria. Though serological testing and PCR are useful in ruling out malaria as a cause of fever of unknown origin and confirming malarial speciation, respectively, they are often not necessary. Biochemical reactions are useful for the speciation of bacteria, not sporozoa like Plasmodium.

What is the normal myeloid to erythroid (M:E) ratio in the bone marrow? 2:1 - 4:1 1:2 - 1:4 3:1 - 5:1 5:1 -10:1

In the bone marrow, the ratio of myeloid cells to erythroid cells ranges from 2:1 to 4:1 in healthy individuals (when segmented neutrophils are included in the myeloid count). If segmented neutrophils are not included in the count, the M:E reference range is between 1.5:1 to 3:1.

Which of the following RBC indices is expressed in femtoliters? RDW MCHC MCH MCV

MCV is the average volume of the RBC expressed as femtoliters or as cubic microns. The unit for RDW is %. The unit for MCHC is grams per deciliter. The unit for MCH is picograms.

Identification of intestinal microsporidial spores is usually done by using which of the listed stains? Modified trichrome stain Modified acid-fast stain Gram stain Giemsa stain

Modified trichrome stain is the stain of choice for identifying intestinal microsporidium spores. Modified acid-fast stains are primarily used in the identification of Cryptosporidium oocysts. Bacteria are usually identified by using the Gram stain. Giemsa stain is the stain of choice for the identification of malarial parasites.

All of the following are true in terms of platelet characteristics, EXCEPT? Produced in the bone marrow by megakaryocytes. Possess an inherent sticky property that aids in adhesion and aggregation. Have a lifespan of roughly 9-12 days. Are normally found circulating in their inactive, spiny form.

Platelets do not circulate in inactivated, spiny forms. The spiny, sticky form of the platelet is initiated once the platelets become activated in response to blood vessel damage. Platelets are produced in the bone marrow from megakaryocytes. Platelets do possess an inherent sticky property that aids in adhesion and aggregation. Platelets have a lifespan of about 9-12 days.

A rosette test to screen for fetomaternal hemorrhage (FMH) is indicated in all of the following situations, EXCEPT: A weak D-positive infant A D-positive infant A D-positive mother A D-negative mother

The correct answer is a D-positive mother. The mother should be D-negative and the infant should be D-positive or weak-D positive.

What is the corrected WBC if a differential count shows 20 nucleated erythrocytes per 100 leukocytes and the uncorrected leukocyte count is 12.0 X 109 1.0 X 109/L 2.0 X 109/L 10.0 X 109/L 12.0 X 109/L

The formula for correcting a white blood cell count in the presence of more than 5 nucleated red blood cells per 100 white blood cells is: (Uncorrected WBC countx100) /(# NRBCs per 100 WBCs + 100) (12.0 X 109/L X 100) / (20 + 100) = 10.0 X 109/L or 12,000/cu mm X 100 / 20 + 100 = 10,000/cu mm

Which of the following contains all the possible phenotypes that could be the result of parents who are group O and group A? Groups A or O only Group A only Group O only All possible blood groups

The group O parent can only supply an O gene to the offspring (OO), but the A parent could provide only A (AA) or either an A or an O (AO). Therefore, the only two possible combinations are OO (group O) or AO (group A).

The image is a stained smear of cerebrospinal fluid. What type of cells are the three right cells in this field? Eosinophils Macrophages Malignant cells Neutrophils

The three cells are macrophages, notice the large amount of cytoplasm and the vacuoles. These are normal cells that are not malignant. Macrophages can appear in the CSF as well as arachnoid mesothelial cells (the cell on the left). There are no eosinophils or neutrophils present in this image.

Which of these methods is used to identify prior exposure to Mycobacterium tuberculosis? Tuberculin skin test (TST) Gram stain White blood cell count Any of the above tests can be used to identify prior exposure to Mycobacterium tuberculosis.

The tuberculin skin test (TST) is traditionally used for the identification of prior exposure to Mycobacterium tuberculosis. Blood tests, collectively known as interferon-gamma release assays (IGRA), may also be used to identify prior exposure, or latent tuberculosis infection (LTBI). A Gram stain is not effective for detecting M. tuberculosis in specimens. A white blood cell count would not provide specific information related to prior M. tuberculosis exposure.

The crystals seen in these images are: Leucine crystals Bilirubin crystals Cystine crystals Cholesterol crystals

There are cystine crystals depicted in these images. Cystine crystals are present in acidic urine, are typically colorless, and have a characteristic hexagonal shape. These crystals are associated with cystinuria. Leucine crystals are associated with liver disease and are found in acid to neutral pH urine specimens. One will notice the yellow color, concentric circles, and radial striations as characteristics of leucine crystals. Bilirubin crystals are yellow, needle-like crystals that may appear in clumps. They are found in acid urine and are associated with liver disease. Cholesterol crystals appear in acid urine as large, flat, transparent plates with notched corners. They are associated with nephrotic syndrome.

Which of the following packed RBCs could be transfused to a group O patient? Group A Group B Group AB Group O

Transfusion of red cells of any ABO type other than O to a group O patient is likely to cause a hemolytic transfusion reaction. Group O individuals naturally have anti-A, anti-B, and anti-A,B. These antibodies would bind and cause hemolysis of all red blood cells that are not group O (ex. group A, group B, and group AB).

The process of pipetting 1.0 mL of plasma or serum into a tube containing 1.0 mL of saline, mixing the contents, and then repeating the same procedure into several additional tubes also containing 1.0 mL of saline is referred to as: One to one serial dilution Two-fold serial dilution Multiple dilution Decreasing serial dilution

Two-fold serial dilutions result in "halving" the amount of serum with each successive dilution. Basically, reducing the concentration of the serum in half with each dilution.

At what temperature should the urine be prior to testing with the reagent strip method? 4oC 37oC Room temperature Temperature does not affect test results

Urine should be at room temperature prior to testing with the reagent strip method. Urine strip reactivity can increase with increased urine temperature, so the optimum temperature is 22-26oC or room temperature.

Isolates of nonmotile and nonpigmented enterococci that are resistant to vancomycin can be assumed to have an acquired resistance by the transfer of which of the following genes? van A and van C genes van B and van C genes van A and van B genes mec A and van C genes

van A and van B genes is the correct answer. Vancomycin-resistant isolates of enterococci that are nonmotile and nonpigmented can be assumed to have an acquired resistance through the transfer of van A and van B genes. van A and van C genes is incorrect because van A genes are transferred to enterococci, which are nonmotile and nonpigmented, causing an acquired resistance to vancomycin. However, van C is responsible for intrinsic vancomycin resistance in motile and pigmented enterococci, such as Enterococcus gallinarium and Enterococcus casseliflavus. van B and van C genes is incorrect because van B genes are transferred to enterococci, which are nonmotile and nonpigmented, causing an acquired resistance to vancomycin. However, van C is responsible for intrinsic vancomycin resistance in motile and pigmented enterococci, such as Enterococcus gallinarium and Enterococcus casseliflavus. mec A and van C genes is incorrect because the mec A gene is found in Staphylococcus aureus, Staphylococcus lugdunensis, and coagulase negative staphylococcus that are oxacillin resistant. van C is responsible for intrinsic vancomycin resistance in motile and pigmented enterococci, such as Enterococcus gallinarium and Enterococcus casseliflavus.

Which of the following patients is most at risk for hyperosmolar nonketotic coma? A 60-year-old type 1 diabetic patient A 70-year-old type 2 diabetic patient A 15-year-old type 1 diabetic patient A 25-year-old type 2 diabetic patient

A 70-year-old type 2 diabetic patient Type 1 diabetic patients are more prone to develop ketoacidosis, whereas type 2 diabetic patients are more likely to develop nonketotic hyperosmolar coma. Elderly individuals easily become dehydrated when ill, therefore elderly type 2 diabetics are most at risk for developing hyperosmolar nonketotic coma.

Illustrated in the photograph is a bile esculin agar plate inoculated with a bacterial isolate from a urinary tract infection. The most likely identification is: Stenotrophomonas maltophilia Streptococcus mutans Enterococcus faecalis Bacteroides fragilis

A bacterial isolate recovered from the urinary tract that hydrolyzes esculin and grows in the presence of bile is most likely to be an Enterococcus species. Bacteroides fragilis also has the capability of growing in the presence of bile and hydrolyzing esculin; however, this species is an anaerobe that would not grow on the aerobic bile esculin agar used for the recovery of bacteria from urine specimens. Stenotrophomonas maltophilia hydrolyzes esculin; however, it does not grow in the presence of bile and therefore would not appear on bile esculin medium. Streptococcus mutans, one of the viridans streptococci, does not grow on bile esculin agar and does not hydrolyze esculin.

What transferrin saturation level would be indicative to investigate further for hereditary hemochromatosis (HH)? 40% 45% 35% 25%

A persistent transferrin saturation level of 45% or greater is often recommended as the value that indicates further investigation. This is a progressive iron overload and in addition, other iron studies should be evaluated, any value under 45% would be considered normal range.

Which of the following is used to determine if a person has had a recent infection with Strep pyogenes? Antistreptolysin O (ASO) Hyaluronidase M-protein Streptococcal pyrogenic exotoxin

ASO (antistreptolysin O titer) is a test that can be used to detect a recent infection with Strep pyogenes. The ASO is usually utilized to determine whether a previous Strep infection has caused a post-streptococcal disease, such as rheumatic fever, scarlet fever, or glomerulonephritis. Hyaluronidase, or spreading factor, is an enzyme present in Strep pyogenes that solubilizes the ground substance of connective tissues. Formerly, it was thought that it helped spread infection, but no evidence has been found to support this hypothesis. M-protein is attached to the cell wall of Strep pyogenes, and is essential for its virulence. Streptococcal pyrogenic exotoxins, formerly called erythrogenic toxins, are present in some strains of Strep pyogenes, and cause a red spreading rash, referred to as scarlet fever.

A 41-year-old male arrived at the clinic with complaints of fatigue, malaise, and overall discomfort. Upon testing, the patient's CBC results were notably abnormal with 30% blasts present along with anemia and thrombocytopenia. Bone marrow and cytochemical staining were subsequently performed. The cytochemical stains noted negative reactions to Myeloperoxidase and Sudan Black B but a positive reaction to alpha-naphthyl acetate. Which of the following conditions is most likely seen? Acute Erythroleukemia Acute Monocytic Leukemia Acute Promyelocytic Leukemia Acute Lymphocytic Leukemia

Acute Monocytic Leukemia is most likely present due to the positive reaction of alpha-naphthyl acetate stain. This is a type of nonspecific esterase stain which are known to positively identify monoblastic cells. Specific esterase stains would stain myelocytic cells positively. Both Acute Erythroleukemia and Acute Lymphocytic Leukemia would stain negative with all three stains mentioned in the case. Acute Promyelocytic Leukemia would stain positive with Myeloperoxidase and Sudan Black B but would stain negatively with alpha-naphthyl acetate.

Illustrated in the image to the left are 3-day old colonies growing on blood agar. The colonies are gray and spreading, and a sweet, fruity odor is noted. Plump, Gram-negative coccobacilli are seen on Gram stain. This isolate belongs to the motile, non-fermenters with peritrichous flagella. Carbohydrate utilization is asaccharolytic. Nitrite reduction produces gas and citrate is positive. From the multiple choices, select the name of this isolate. Bordetella bronchiseptica Alcaligenes faecalis Moraxella catarrhalis Acinetobacter baumannii

Alcaligenes faecalis is the correct response. Colonies on blood agar are gray and spreading. Plump Gram-negative coccobacilli are seen on Gram stain. Peritrichous flagella are seen on the flagellar stain. A fruity odor of apples or strawberries may be noted. Carbohydrate utilization is asaccharolytic, oxidase is positive, nitrites are reduced with the production of gas, citrate utilization is positive and urease is negative. A. faecalis exists in soil and water. Most human infections are opportunistic and are acquired from contact with moist items such as contaminated nebulizers, respirators, and lavage fluids. Bordetella bronchiseptica colonies on blood agar are small, non-hemolytic, and smooth with a "mercury droplet" appearance, translucent, and non-pigmented. On Gram stain, non-discriminatory small Gram-negative coccobacilli are observed. Motility is positive also with peritrichous flagella. Nitrates are not reduced. Distinctive for the identification of B. bronchiseptica is the rapid production of urea, often visible within 4 hours of incubation. Moraxella catarrhalis colonies growing on blood agar are small, initially pinpoint in size after 24 hours incubation, and non-pigmented. Small, Gram-negative coccobacilli in pairs and short chains are observed in Gram stains. M. catarrhalis is non-motile; therefore, flagellae are not observed in flagella stains. Acid also is not produced from carbohydrates (asaccharolytic), nitrates are reduced and urease is also negative. Acinetobacter baumannii colonies growing on blood agar are relatively large, white, entire, convex, and opaque. Gram-negative coccobacilli are distinctive for appearing as diplococci and even Gram-positive. Peritrichous flagellae are not observed. Distinctive is the oxidative utilization of glucose and lactose on OF culture media. Oxidase is negative and nitrates are not reduced.

What part of an immunoglobulin (Ig) molecule exists as kappa or lambda chains? Fc Fab Heavy chains Light chains

All immunoglobulins have a common, basic polypeptide structure with a three-dimensional configuration. The polypeptide chains are linked by covalent and noncovalent bonds, which produce a unit composed of a four-chain structure based on pairs of identical heavy and light chains. There are two types of light (L) chains: kappa (?)or lambda (?), which are common to all Ig classes. The L chain subtypes have different amino acid sequences and are antigenically different. In human beings, about 65% of Ig molecules have kappa chains, and about 35% have lambda chains. The larger H chains extend the full length of the molecules. IgG, IgD, and IgE occur only as monomers of the four-chain unit; IgA occurs in both monomeric and polymeric forms, and IgM occurs as a pentamer with five four-chain subunits linked together. Fc is the third fragment formed in addition to the two Fab fragments if a typical monomeric IgG is digested with a proteolytic enzyme. This fragment is relatively homogeneous and sometimes crystallizable. The Fc receptor is the portion of the Ig molecule responsible for binding to antibody receptors on cells and the C1q component of complement. Fab fragments are two of the three fragments formed if a typical monomeric IgG is digested with a proteolytic enzyme. These fragments retain the ability to bind antigens, specific receptors on cells, and are called antigen-binding fragments. Fab is composed of two light chains, and portions of two heavy chains joined by disulfide bonds in the hinge region of Ig. Heavy (H) chains extend the full length of an immunoglobulin (Ig) molecule. In addition, each monomer of an immunoglobulin consists of two heavy chains paired with two light chains. the first 110 to 120 amino acids of both L and H chains a variable sequence that forms the V region of the Ig. The remaining portion of the H chain is constant for each type of Ig. The class and subclass of an immunoglobulin molecule are determined by its H-chain type.

These illustrations are of parasites. Which of the following does Illustration A represent? Flagellate Hemoflagellate Sporozoa Amoeba

Amoeba is the correct answer because of the nuclear and cytoplasmic features. The illustration shows a nucleus with a centrally located karyosome with evenly distributed chromatin, which represents a possible Entamoeba histolytica trophozoite. Illustration D represents a Chilomastix mesnili cyst due to its lemon or pear shape with an anterior hyaline knob, which is an example of a flagellate. Illustration B represents a Trypanosoma species due to its kinetoplast, nucleus, undulating membrane, and flagellum, which is an example of a hemoflagellate. Illustration C represents a ring form typically seen in Plasmodium species which is a sporozoa.

The lecithin to sphingomyelin ratio (L/S) is used to assess: Fetal neurological development Fetal lung maturity Fetal viability Fetal liver development

An L/S ratio above 2:1 indicates mature lung development, whereas a ratio below 1.5:1 indicates pulmonary immaturity. 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. Until about 32-33 weeks of gestation, the concentration of these two substances are quite similar; thereafter the concentration of lecithin increases significantly compared with the relatively constant concentration of sphingomyelin. In the absence of complications, the ratio of these two components reaches 2.0 at about 35 weeks gestation. Infants delivered after attaining an L/S ratio of 2.0 or higher rarely develop respiratory distress syndrome (RDS). This value of 2.0 has become the commonly accepted standard value indicating maturity in the fetus of a non-diabetic woman.

HLA antibodies are responsible for which of the following transfusion reactions? Allergic transfusion reactions Transfusion-associated sepsis Transfusion-associated circulatory overload Transfusion-related acute lung injury (TRALI)

Antibodies to human leukocyte antigens (HLA) are responsible for transfusion-related acute lung injury (TRALI). The pathogenesis of this transfusion reaction is not fully understood, but there are two accepted mechanisms. The first involves antibodies to human leukocyte antigens or human neutrophil antigens transfused into a recipient. The antibodies bind and activate the recipient's leukocytes. The second mechanism involves a patient undergoing some event that primes their leukocytes. This includes a disease state, infection, or trauma). The patient is then transfused with a product that contains cytokines or anti-leukocyte antibodies, which then activate the already primed leukocytes. Both mechanisms cause leukocytes (especially neutrophils) to aggregate in the lungs. As a result, there is damage to the endothelium, which leads to an increase in pulmonary capillary permeability and noncardiogenic pulmonary edema. Allergic reactions are due to a recipient having an antibody (usually IgE) to a protein in the donor's plasma. They can also be caused by donor antibodies to a protein present in the recipient's plasma. Transfusion-associated sepsis is caused by bacterial contamination of a transfused product. Transfusion-associated circulatory overload is caused by the inability of a patient's circulatory system to handle the additional workload from the transfused product. It occurs when the volume or rate of transfusion is too high.

Antibodies to the Kidd blood group system are MOST commonly associated with: Delayed hemolytic transfusion reactions Postpartum depression Hives and rashes Immediate spin, cold antibody reactions

Antibodies to the Kidd blood group typically cause delayed hemolytic transfusion reactions. Delayed hemolytic transfusion reactions occur 24 hours or longer after a transfusion with symptoms that include pallor, jaundice, and flu-like symptoms. Kidd antibodies have a reputation of disappearing, causing dosage, and being weak in nature. They are IgG and some are able to fix complement. Kidd antibodies have not been shown to be linked to postpartum depression or reactions involving hives and rashes (allergic reactions). Lastly, they are IgG in nature so they are not cold antibodies that show up at immediate spin.

The photograph here is of a peripheral smear sent for hematologic review. No clinical information for the patient was sent with the slide. What is the first course of action that the reviewer should take to assist him/her in interpreting the findings on this blood smear? Perform hemoglobin electrophoresis Request a repeat smear preparation Perform lipid electrophoresis assay Request additional medical information

Any of the four responses may be acceptable, yet perhaps a review of the clinical situation is the clearest and most direct way to begin to work through the problem. The patient's age, gender, ethnicity, and other variables are key to help in the diagnosis. Hemoglobin electrophoresis allows the separation of abnormal hemoglobin variants and should be performed when hemoglobinopathy is suspected or after a screening test (sickle cell, for example) is positive or questionable. Erythrocytes in the photograph are normocytic with mild hypochromia. Echinocytes (burr cells), a few acanthocytes (spur cells), and scattered ovalocytes (elliptocytes) are recognized. Another smear to verify the presence of true burr cells is an easy first step, but the presence of other abnormal red cells suggests that the burr cells are not the result of poor slide preparation. A few ovalocytes in a peripheral smear may be insignificant or may, in context, point to other situations such as post-splenectomy, liver disease, or perhaps a response to hemorrhage or hemolysis.

Which of the following leukocytes is most directly associated with antibody production? B-Cell T-Cell Neutrophil NK Cell

B-Cells are directly involved in humoral immunity through the production of antibodies. T-Cells are involved in cellular immunity because they attack foreign cells/organisms directly. NK cells are part of the innate immune system and are cable of attacking damaged or diseased cells without prior sensitization. Neutrophils are part of the innate immune system, which is not antigen-specific. Hence, neutrophils are not directly involved in humoral immunity.

The top image shows a 5-day old entire colony with distinct outer borders that was incubated at 30° C. The surface is a delicate silky, light gray-white mycelium. The reverse of the colony appears white. This appearance is non-specific. The bottom image is a photomicrograph of a lacto-phenol blue stained mount of a small inoculum taken from the surface of the colony. What is the most likely identification? Chrysosporium Sepedonium Beauveria Scedosporium

Beauveria is the correct selection. This is a rare human pathogen. This fungus is known worldwide as an insect pathogen. Identification is made by the microscopic observation of abundant single-celled, tear-shaped conidia on conidiophores which taper from a swollen base. Conidiophores may sometimes cluster to form radial tufts. Chrysosporium colonies have a moderate growth rate with a gray, wooly surface. Microscopically simple, wide-based single-celled conidia are produced, the conidiophores disintegrate or break to release conidia. Sepedonium colonies are gray white with a cottony surface that is non-specific. Microscopically, large spherical, bluntly spiked macroconidia are borne singly and not in clusters from long, delicate conidiophores. They may resemble the macroconidia of Histoplasma. Scedosporium grows rapidly to produce white to dark gray colonies. Microscopically, large smooth-walled ovoid conidia are borne singly at the tips of unbranched conidiophores called annelides.

Which of the following conditions should be suspected if a healthy patient presents with an elevated potassium level while all other chemistry results are normal? The sample is turbid. The sample is hemolyzed. The sample is clotted. The sample is lipemic.

Because the concentration of potassium within red blood cells is markedly higher than the concentration outside of red blood cells, and hemolysis in a sample may increase the potassium result without affecting or while minimally affecting other analytes. Because of this, a sample with these results should be examined for hemolysis before reporting. Turbid samples may be due to excess protein. If this is the case, the protein can interfere with ion-selective electrode (ISE) function, but it would most likely affect all electrolytes that are tested by ISE. Since only the potassium level is affected, that does not seem likely. Most chemistry analytes, including potassium, are present in the serum, so a clotted sample will not alter the results. Lipemia has minimal effect on potassium levels.

Which of the following is true about Bence-Jones protein when performing the heat precipitation test? Precipitates between 40° and 60°C but redissolves at 100°C Precipitates between 60° and 80°C but redissolves at 100°C Is dissolved between 40° and 60°C but precipitates around 100°C Is dissolved between 60° and 80°C but precipitates around 100°C

Bence-Jones protein is a protein that is excreted by persons with multiple myeloma, a myeloproliferative disorder of the immunoglobulin-producing plasma cells or Waldenstrom's macroglobulinemia. The protein, which is markedly elevated in blood serum, is filtered through the kidneys in quantities that exceed the tubular reabsorption capacity. Consequently, it is excreted in the urine. All suspected cases should have protein and immunoelectrophoresis performed on both serum and urine. The sulfosalicylic acid and dipstick methods are semiquantitative tests that are not specific for Bence-Jones proteins when tested individually. If the dipstick is negative but the sulfosalicylic acid test is positive, Bence-Jones proteins are suspected. The next step is to perform the heat precipitation test, Bence-Jones proteins precipitate between 40° and 60°C but redissolve at 100°C.

Nucleated RBCs are most likely to be seen in the peripheral blood of which type of beta thalassemia? Beta thalassemia minima Beta thalassemia minor Beta thalassemia intermedia Beta thalassemia major

Beta thalassemia major is the correct answer. Due to the severity of the anemia, nucleated RBCs are almost always seen in cases of beta thalassemia major. Beta thalassemia minima is a form of asymptomatic beta thalassemia with no major laboratory abnormalities. Beta thalassemia minor is mild with hemoglobin values typically between 9 - 14 g/dL, thus nucleated RBCs are usually not found Beta thalassemia intermedia is a moderate anemia with hemoglobin values typically between 7 - 10 g/dL, whether or not nucleated RBCs are seen depends on the severity of the anemia.

Which of the following would be the most characteristic finding in synovial fluid in a case of pseudogout? Monosodium urate crystals Calcium pyrophosphate crystals Macrophage infiltration Mixed RBC/WBC infiltration

Calcium pyrophosphate crystals are characteristic of pseudogout. Pseudogout is a result of endocrine disorders that produce high levels of calcium in serum. It can also be a result of degenerative arthritis producing cartilage calcification. Monosodium urate crystals are the causative agent for gout. Macrophages can be normal in synovial fluid, but large quantities may be associated with viral infections. RBCs are not usually seen and WBCs are usually seen in viral or bacterial infections. None of then cause pseudogout.

The smooth and pasty appearing 72-hour yeast colonies growing on blood agar shown in the upper image are non-specific and further studies must be performed to make the identification. One of these studies is a cornmeal agar preparation as illustrated in the bottom photomicrograph in which tiny, uniform, spherical cells are arranged in tight clusters. This yeast is commonly recovered from urinary tract infections. Select the most likely yeast isolate. Candida glabrata Candida albicans Cryptococcus neoformans Candida parapsilosis

Candida glabrata is the correct response. Although growth on blood agar is somewhat slower, identification cannot be made from the morphology alone. On cornmeal agar preparations observed microscopically, the uniform, small, regular-sized cells of C. glabrata are arranged in relatively tight, compact clusters, in contrast to those of Cryptococcus neoformans that are irregular in size and separated by capsular material. The identification can be confirmed by demonstrating the assimilation of both glucose and trehalose in carbohydrate test reactions. Among the yeast, C. glabrata is a common isolate from urinary tract infections. Candida parapsilosis produce delicate radiating conidiophores that produce tiny conidia in a pattern colloquially referred to as "sagebrush" or "cross matchstick". The compact, tight clusters of small, regular-sized yeast cells of C. glabrata are not observed. Candida albicans is distinctive for the production of pseudohyphae along the sides of which clusters of small blastoconidia are produced, with the production of relatively large, spherical chlamydospores. Cryptococcus neoformans yeast cells observed in cornmeal agar preparations are spherical, vary in size, and are widely separated by capsular material, rather than the close, compact arrangement of small, regular-sized cells C. glabrata that are arranged in tight clusters.

Charcot-Leyden crystals in stool may be associated with an immune response and are thought to be the breakdown products of: Neutrophils Eosinophils Monocytes Lymphocytes

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.

Materials such as strong acids and bases are classified as: Mutagens Chemical irritants Flammable liquids Carcinogens

Chemical irritants are any liquid or solid that causes visible destruction or irreversible alteration in human skin tissue at the site of contact, or a liquid that has a severe corrosion rate on steel. A mutagen is any agent that causes genetic mutations. Flammable liquids are liquids with a flashpoint below 37ºC (100ºF). Combustible liquids have a flashpoint at or above 37.8ºC (100ºF) and below 93.3ºC (200ºF). Carcinogens are any substances that cause the development of cancerous growths in living tissue.

Which of the following media contains the X and V factors necessary for the growth of Haemophilus influenzae? Thayer-Martin agar Xylose lysine deoxycholate agar Chocolate agar Thiosulfate citrate-bile salts agar

Chocolate agar contains both the X factor (hemin) and V factor (coenzyme nicotine adenine dinucleotide) which are necessary for growth of H. influenzae. Chocolate agar is essentially the same as blood agar except that during preparation the red blood cells are lysed when added to molten agar base. Thayer-Martin agar is selective for N. gonorrhoeae and N. meningitidis. It supports the growth of Francisella and Brucella spp. Xylose lysine deoxycholate agar is used for the isolation and differentiation of Salmonella and Shigella spp. from other gram negative enteric bacilli. Thiosulfate citrate-bile salts agar is selective and differential for Vibrio spp.

What are function(s) of the platelet? Clotting and plug formation Maintain vascular integrity Release serotonin Clotting, plug formation, release of serotonin, and repair of the injured tissues.

Clotting, plug formation, release of serotonin, and repair of the injured tissues. Platelets maintain vascular integrity, form the primary and secondary hemostatic plug. They also release serotonin and ADP from their granules that act as an agonist for stimulating additional membrane receptors on additional platelets. Platelets are involved in hemostasis by maintaining vascular integrity even in the absence of physical trauma. They also form the primary hemostatic plug. They first stick to exposed collagen and then to each other. Platelet's shape change, and their granule contents (serotonin)are released in the surroundings.During secondary hemostasis, fibrin forms between and around the aggregated platelets.

In the clinical laboratory, compliance training is mandatory for: The phlebotomy department only. The laboratory safety officer only. Laboratory managers and supervisors only. All laboratory employees regardless of their job title or status.

Compliance training is always mandatory for all employees regardless of their job title or status. All persons working in the laboratory setting must be trained and fully aware of the importance of compliance with legal operating regulations. This includes: the phlebotomy department, safety officer, technologists, and managers and supervisors. All laboratory personnel must be aware of these regulatory considerations, but the management/supervisors is responsible for ensuring that this information is communicated to everyone who needs to know. Compliance programs help laboratories achieve the highest standards of excellence to positively impact patient care.

A computer monitor should be set approximately how many inches away from the eyes? 1 - 3 inches 5 - 10 inches 10 - 15 inches 20 - 40 inches

Computer monitors should be approximately 20 - 40 inches away from the eyes. The top of the monitor is best set at eye level so that the eyes gravitate toward the center of the screen. OSHA recommends: Ensuring adequate desk space between the user and the monitor (table depth). If there is not enough desk space, consider doing the following:Make more room for the back of the monitor by pulling the desk away from the wall or divider; orProvide a flat-panel display, which is not as deep as a conventional monitor and requires less desk space, orPlace monitor in the corner of a work area. Corners often provide more desk depth than a straight run of desk top. Move back and install an adjustable keyboard tray to create a deeper working surface.

Contact dermatitis is mediated by: B lymphocytes Mast cells Polymorphonuclear cells T lymphocytes

Contact dermatitis is an example of a cell-mediated (type IV) hypersensitivity reaction that involves macrophages and T lymphocytes. When an antigen comes in contact with the skin, the antigen is processed by cells in the epidermis and comes in contact with T lymphocytes. T lymphocytes recognize the antigen as foreign and circulate through the bloodstream back to the epidermis. There, they release cytokines that produce an inflammatory response, causing a characteristic rash in the skin called contact dermatitis. B lymphocytes produce antibodies, and these are not involved in contact dermatitis. Mast cells are a key component of Type I hypersensitivity reactions, not cell-mediated hypersensitivity. Polymorphonuclear cells are recruited to the sites where immune complexes have formed in Type III hypersensitivity reactions.

Coombs control check cells used to verify negative reactions at the anti-globulin (IAT) phase are coated with: Anti-P1 Anti-M IgM antibodies IgG antibodies

Coombs' control cells are Rh-positive cells that are coated with anti-D. These cells will agglutinate when added to the negative test due to the anti-IgG present in the AHG reagent. Anti-P1 is an IgM antibody that would not react in the IAT phase with the antiglobulin (anti-IgG) reagent. Anti-M is an IgM antibody that would not react in the IAT phase with the antiglobulin (anti-IgG) reagent. IgM antibodies would not react in the IAT phase with antiglobulin (anti-IgG) reagent.

Which of the following tests would be useful in the assessment of glomerular filtration: 24 hour urine protein Creatinine clearance PSP test Urea clearance

Creatinine clearance tests are utilized to estimate the glomerular function of the kidney. The creatinine clearance calculation is defined as the volume of plasma that is cleared of creatinine by the kidney per unit of time and uses the following formula:Creatinine clearance = (Urine creatinine conc x Urine Volume) / Plamsa creatinine conc.Creatinine clearance measurements have a recommended specimen requirement = 24-hour urine collection.

Critical values not reported or not reported in a timely manner is an example of a laboratory error made during which phase of laboratory testing? Centrifugation Analytic Postanalytic Preanalytic

Critical values not reported or not reported in a timely manner is an example of a postanalytic error. A centrifugation error is an error that occurs during centrifugation of a specimen such as spinning the sample for the wrong amount of time. An analytic error is an error associated with tasks that occur during testing, an example would be using the wrong testing method. A preanalytical error is an error associated with tasks that occur before testing beginnings. An example of a preanalytical error is improperly labeling a specimen.

What drug may be used to decrease iron levels in patients with iron overload? Desferrioxamine Cobalamin Antibiotics Eculizumab

Desferrioxamine (DFO), an iron-chelating agent, may be used to reduce iron overload in patients who rely on transfusions to maintain hemoglobin levels and prevent anemia. Cobalamin is the chemical name for Vitamin B12 and is the treatment of choice in megaloblastic anemia related to B12 deficiency. Antibiotics would be of no use in the treatment of iron overload. Eculizumab is the drug of choice in the treatment of classic PNH. It is a humanized monoclonal antibody that inhibits complement lysis.

The nitrite portion of the test strip can be used to do all of the following EXCEPT: Monitor antibiotic therapy Detect a bladder infection in an early stage in pregnant women Screen individuals with recurrent infections Detect metabolic by-products often seen in diabetic patients

Detect metabolic by-products often seen in diabetic patients The nitrite portion of the test strip can be used to monitor antibiotic therapy, detect a bladder infection in an early stage in pregnant women, screen individuals with recurrent infections, and other conditions such as the presence of cystitis.The test reaction on the urine chemical reagent strip pad for nitrite works by detecting when nitrite in the urine reacts with para-arsanilic acid to form a diazonium compound. This diazonium compound in turn couples with 1,2,3,4-tetrahydrobenzo(h)quinoline-3-ol to produce a pink color.The ketone portion of the reagent strip can be used to determine the presence of acetoacetate, a by-product of fat and/or protein metabolism. The presence of ketones in the urine is often associated with diabetes.

What condition would be suspected in an asymptomatic patient with greater than 20% atypical (reactive) lymphocytes on their peripheral blood smear? Herpes simplex virus infection Epstein-Barr virus infection Bacterial meningitis Acute leukemia

Epstein-Barr virus causes infectious mononucleosis, which is associated with atypical (reactive) lymphocytosis. The peripheral blood smear may show 5%to 30% atypical lymphocytes. Patients are often asymptomatic, however, they can present with fatigue, malaise, fever, sore throat and cervical lymphadenopathy. Herpes simplex virus infection does produce atypical lymphocytosis, however, the percentage of atypical lymphocytes will be less than 20%. Bacterial meningitis would present as an increase in neutrophils, which help fight bacterial infections. Acute leukemias generally present with many immature cells in the bone marrow and/or the peripheral blood. The types of immature cells present will depend upon the cell like affected, myelogenous, monocytic or lymphocytic.

The acid/acid reaction shown in the photograph of a Triple Sugar Iron (TSI) Agar reaction tube indicates the recovery of a bacterial species that ferments both glucose and lactose. Also, the absence of the formation of any black pigment indicates one of the Enterobacteriaceae that does not produce hydrogen sulfide (H2S). Select the species producing this acid/acid, H2S negative reaction. Proteus mirabilis Escherichia coli Providencia stuartii Salmonella species

Escherichia coli is the correct response. The acid/acid reaction (yellow/yellow) with the absence of H2S pigmentation as observed in TSI agar is distinctive for providing a presumptive identification of E. coli from the multiple choices as listed. Proteus mirabilis produces H2S and a black pigment would be observed either in the but of the tube or at its interface with the slant. P.mirabilis is also lactose negative and the slant would appear alkaline or red. Salmonella species also produces H2S. The black pigment would be observed either throughout the but of the tube or at its interface with the slant. Salmonella species are also lactose negative and the slant would appear alkaline or red. Providencia stuartii does not ferment lactose and in contrast to E. coli, an Alk/Acid KIA reaction would be observed. Production of H2S is also negative.

Which of the following best describes the methodology for FISH? Uses directly labeled fluorescent nucleotides or probes with reporter molecules that are indirectly detected by fluorescent antibodies or affinity molecules Signal amplification test that uses signal amplification and alkaline phosphatase Target amplification test that uses thermal cycling and DNA polymerase Target amplification test using thermal cycling and DNA ligase

FISH, fluorescent in situ hybridization, uses directly labeled fluorescent nucleotides or probes with reporter molecules that are indirectly detected by fluorescent antibodies or affinity molecules. Branched DNA (bDNA) uses signal amplification by measuring nucleic acid directly by signal amplification with alkaline phosphatase labels. Polymerase chain reaction (PCR) is a test amplification procedure with thermal cycling and DNA polymerase as the enzyme for amplifying the desired sequence. Ligase chain reaction (LCR) is similar to PCR, however, it uses DNA ligase to enhance amplification of the sequence using thermal cycling instead of polymerase like PCR.

In hemoglobin synthesis, which enzyme is responsible for adding iron in the last step? ALA Synthase Ferrochelatase PBG Synthase Protoporphyrinogen oxidase

Ferrochelatase is the enzyme responsible for adding iron into the porphyrin ring in the final step of heme synthesis. ALA synthase is the enzyme used in the first step to create delta-aminolevulinic acid (ALA); PBG synthase is used in the second step to condense two ALA molecules into porphobilinogen; protoporphyrinogen oxidase catalyzes the second to last step to create protoporphyrin.

A bacterium was isolated as the cause of a urinary tract infection. The organism showed no lactose fermentation on MacConkey agar (MAC). On triple sugar iron (TSI) media, the organism produced an A/A with H2S. What organism is most likely observed? Enterobacter aerogenes Proteus mirabilis Proteus vulgaris Edwardsiella tarda

From the information given, the organism in question does not ferment lactose but does ferment sucrose and glucose as determined from the MAC agar and TSI. The organism is also H2S positive. From the list of organisms, only Proteus vulgaris produces these reactions. Enterobacter aerogenes ferments lactose, sucrose, and glucose, but does not produce H2S. Proteus mirabilis is negative for lactose and sucrose fermentation, positive for glucose fermentation, and is H2S positive. Edwardsiella tarda is negative for lactose and sucrose fermentation, positive for glucose fermentation, and is H2S positive.

All of the following hormones are produced primarily in the pancreatic islets EXCEPT which one? Gastrin Glucagon Insulin Pancreatic polypeptide

Gastrin is a hormone produced by cells primarily in the gastrointestinal tract and it stimulates the secretion of gastric acid and gastric mucosal growth. The other hormones listed are all produced by the pancreas.

Hemoglobin H (HbH) bodies are tetramers of which globin chain? Alpha Beta Delta Gamma

Hemoglobin H is comprised of beta chain tetramers that form when insufficient alpha chains are produced. These tetramers (Hemoglobin H) are seen in alpha thalassemia intermedia or Hemoglobin H disease. HbH bodies are demonstrable by supravital staining with brilliant cresyl blue. HbH is also detectable by Hb electrophoresis (fast migrating). Tetramers of alpha globins are not seen, although they are thought by some investigators to be a cause of cell membrane damage in beta thalassemia. Tetramers of delta globins are not seen. Tetramers of gamma globin is called Hb Bart, which is seen in alpha thalassemia major.

Which of the following additives should be used for the collection of a sample for blood gas analysis? Sodium citrate EDTA Sodium oxalate Heparin

Heparin is the additive of choice for arterial, capillary, or venous blood gas collection as it has the least amount of interference with the blood gas analytes measured. Arterial and venous specimens are collected anaerobically, using lyophilized heparin anticoagulant in 1- to 3- mL sterile syringes.

Blood lactate concentration is an indicator of impaired circulation and tissue oxygenation in critically ill patients. If circulation and tissue oxygenation are impaired: Blood lactate concentration will decrease below the lower end of the established reference range. Blood lactate concentration will increase. Blood lactate will not be affected. Blood lactate will be slightly decreased.

In this case, lactate levels will increase. When cells do not receive enough oxygen due to reduced blood flow to the tissues, they release excess lactate into the bloodstream as a byproduct of anaerobic metabolism. Organ failure as a result of septic shock may be indicated by unexplained metabolic acidosis (low blood pH and low bicarbonate level) and extremely elevated lactate, where blood pH is <7.30 and plasma lactate is >1.5 times the upper limit of the laboratory's established reference values.

You are working to validate a new method for detecting C-reactive protein (CRP) in serum. To assess precision, you run a medium-level control 30 times and determine the mean to be 4.0 mg/dL with a standard deviation of 0.04 mg/dL. What could be said about the precision of this run, assuming a CV less than 3% is acceptable? It is not acceptable, with a coefficient of variation of 100%. It is not acceptable, with a coefficient of variation of 10%. It is acceptable, with a coefficient of variation of 0.1%. It is acceptable, with a coefficient of variation of 1%.

It is acceptable with a coefficient of variation of 1%. Precision is often measured by extrapolating and evaluating the coefficient of variation, or CV. To find the percent CV, you must divide the standard deviation by the mean and multiply the result by 100. 0.04 mg/dL divided by 4.0 mg/dL is 0.01. Multiplied by 100 = 1%, which is well below 3%. This indicates that the precision of this particular run is acceptable according to the parameters given.

If a patient's WBC is 50,000/mm3, what test should be ordered to determine if this is a leukemoid reaction or a chronic myelocytic leukemia? Peroxidase stain Sternheimer stain Leukocyte alkaline phosphatase stain Sudan Black B stain

Leukocyte alkaline phosphatase (LAP) stain is used to differentiate chronic myelocytic (myelogenous) leukemia (CML) from leukemoid reactions. The LAP score is calculated and is high in reactive states, such as leukemoid reactions, but is low in CML. Peroxidase stain is used to differentiate lymphoid cells from granulocytes and their precursors and monocytes. Sternheimer stain is a supravital stain used in Urinalysis to stain cellular structures and other formed elements. Sudan Black B stain is used to help identify myelogenous and myelomonocytic leukemia.

Which of the following cells have pale blue cytoplasm with a few azurophilic granules and an oval or indented nucleus? Monocyte Segmented neutrophil Eosinophil Lymphocyte

Lymphocyte: Pale blue cytoplasm with a few azurophilic granules. The nucleus may be oval or indented. Monocyte: Blue-gray opaque cytoplasm. The nucleus may have convolutions. Segmented neutrophil: Light pink cytoplasm with fine granules. Nucleus with 2-5 lobes. Eosinophil: Colorless cytoplasm with large red-orange refractile granules. The nucleus is usually bi-lobed.

What is the primary oxygen-carrying protein found in muscle? Hemoglobin Troponin Myoglobin BNP

Myoglobin is the main oxygen-carrying protein in the muscle, accounting for about 2% of muscle protein. Hemoglobin is the main oxygen protein in circulation; troponin is a set of regulatory proteins found in muscle, especially cardiac muscle but does not carry oxygen; BNP is brain (or B-type) natriuretic peptide, a set of hormones that affect body fluid homeostasis and blood pressure.

Ninety-nine percent of lead absorbed in the body is taken up by what after absorption? Lungs Gastrointestinal tract Heart Erythrocytes

Ninety-nine percent of lead is taken up first by the erythrocytes which causes interference with heme synthesis. Lead is mostly absorbed through the lungs (respiration) and gastrointestinal tract but is not taken up by these organs, nor the heart. It is taken up by the erythrocytes before being distributed into soft tissue and bone.

A ten-year-old boy came to a physician's attention because of recent jaundice and icteric sclera after taking the medication Primaquine before a trip to Africa. The immediate laboratory work revealed: Hct 24% (normal 36%-47%), MCV 79.5 fL (normal 78-95fL), RDW 13% (normal 11.5-15.0%). His blood smear findings are reflected in the images to the right. The upper image is a Wright-Giemsa stained smear, while the lower is a supravital-stained smear. Which condition should be considered for this patient when analyzing his symptoms, history, and laboratory results? G6PD deficiency Pyruvate kinase deficiency Iron deficiency anemia Megaloblastic anemia

Note the spherocytes in the upper image to the right. Some resemble a half-blister, with the other half of the cell containing solidly-staining hemoglobin. These are called eccentrocytes. When present, along with a suspicious patient history, they should trigger an evaluation for G6PD deficiency. Upper image: The blue arrows in the upper photomicrograph are directed toward solid-staining spherocytes in which the cell membrane is beaded by inclusions wrapped within the cell membrane, suggesting the remains of denatured hemoglobin. Included in the smear are a target cell, several acanthocytes, a smudge cell, and a few schistocytes. Lower image: This is a supravital staining of the affected red blood cells, confirming the presence of Heinz bodies, a key diagnostic feature of this condition. Pyruvate kinase deficiency is associated with a normocytic, normochromic anemia with poikilocytosis and anisocytosis, but Heinz bodies are not found in this condition. Iron deficiency anemia is associated with a microcytic, hypochromic anemia and is not associated with the presence of Heinz bodies. Finally, megaloblastic anemia is considered a macrocytic, normochromic anemia associated with abnormal red blood cell development. This condition is also not associated with the presence of Heinz body inclusions.

The statement, "The student will perform direct antiglobulin tests with 100% accuracy," is an example of a(n)? Goal Objective Course description Competency statement

Objectives are statements that describe the general knowledge, attitude, and skill a learner will demonstrate at the completion of a learning activity. Objectives are measurable, have conditions, standards, and terminal behaviors. Goals are statements that describe the general knowledge, attitude, and skill a learner will possess at the completion of a learning activity. Goals are general, not measurable, and usually do not have conditions for success. A course description provides an overview of the educational course in which the student is enrolled. A competency statement describes how an individual's skills and experience meet specific criteria for their job.

All of the following are methods employed for measuring the specific gravity of urine, EXCEPT? Refractometry Hydrometry Osmolality Urine reagent strips

Osmolality is dependent on the number of particles of solute in a unit of solution and is often measured by freezing point depression. Specific gravity is usually directly related to osmolality but is more easily measured. It provides a rough measure of the urine concentrating power of the kidney. The other methods are used to measure specific gravity in urine samples.

Which of the following types of automated chemistry analyzers allows for all specimens to be analyzed at the same time? Discrete analyzer Random access analyzer Multi-channel analyzer Parallel analyzer

Parallel = All specimens analyzed at the same time Discrete = Each specimen and accompanying reagents have their own space Random Access = Specimens can be analyzed out of sequence Multi-channel = Each specimen may be subjected to multiple analyses

The fever and chills syndrome associated with malaria is known as: Recrudescence Periodicity A paroxysm Relapsing Fever

Paroxysm is the correct answer. A paroxysm is the onset or periodic recurrence of fever, chills and sweats associated with malaria. Many malarial organisms are circulating in the blood of an infected human in between paroxysms. Typically, examination of multiple samples is necessary to conclude that a patient is not infected with Plasmodium species. Recrudescence is the reappearance or recurrence of a disease and its associated symptoms after a quiescent stage. Although periodicity is also associated with Plasmodium species, this term specifically refers to the actual timing of the paroxysm. For example, a paroxysm that occurs every 72 hours is known as a quartan periodicity as it would occur on the fourth day. Relapsing Fever is caused by Borrelia recurrentis and other species of Borrelia and is transmitted through infected lice or tick bites. Infected individuals have a rapid onset of fever, headache, and muscle pain that lasts for up to ten days. As the host mounts an antibody response to the microorganism, it becomes sequestered during an afebrile period and subsequently reemerges with modified antigens, creating another febrile episode. Subsequent relapses are generally milder and shorter in length.

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

Qualitative differences for A1 and A2 phenotypes include the following: differences in the precursor oligosaccharide chains (in length and complexity of branching), small differences in transferase enzymes (decreased in A2 subgroup), and the formation of anti-A1 in the serum of A2 phenotype individuals. Both A1 and A2 patient red cells react with the anti-A reagent. Dolichos biflorus or anti-A1 lectin reagent is used to differentiate between A1 and A2 phenotypes. This lectin reagent agglutinates with A1 patient red cells but does NOT agglutinate with A2 patient red cells.

Which of the following statements is true regarding primary hemostatic process resulting from vascular damage? Inhibition of platelet function by interaction with collagen. Platelet adhesion through Weibel-Palade bodies. Platelet aggregation through interaction of von Willebrand factor and glycoprotein IIb/IIIa. Rapid and immediate vasoconstriction by contraction of smooth muscles.

Rapid and immediate vasoconstriction by contraction of smooth muscles. Rapid vascular constriction, not dilation, immediately occurs when there is vascular injury in order to constrict the amount of blood that escapes the vessels, ultimately preventing massive loss of blood. Collagen is a powerful stimulator of platelet aggregation. Platelet adhesion occurs by von Willebrand factors (produced in Weibel-Palade bodies) bridging glycoprotein Ib and the exposed collagen. Platelet aggregation requires fibrinogen and glycoprotein IIb/IIIa.

A red blood cell on the smear that was stained with Wright stain shows numerous fine purple-blue inclusions that are distributed throughout the cell. It should be reported as: Howell-Jolly bodies Basophilic stippling Heinz bodies Siderotic granules

Residual RNA (ribosomes) precipitate as coarse basophilic stippling, which should be reported. Basophilic stippling may be fine or coarse. Howell-Jolly bodies are dense purple bodies composed of DNA. Heinz bodies are precipitated unstable hemoglobin that is visualized with supravital stain. Siderotic granules are iron deposits visualized with iron stain (Prussian blue).

All of the adult forms of the following worms are hermaphroditic, EXCEPT: Hymenolepis Taenia Schistosoma Clonorchis

Schistosoma spp. are blood flukes. They differ from all other flukes (trematodes) in that both male and female forms exist. The female lives in an involuted chamber, the gynecophoral canal, which extends the length of the male. Since both male and female forms exist, Schistosoma are not hermaphroditic. Hymenolepis spp. and Taenia spp. are tapeworms (cestodes) containing both male and female reproductive organs, therefore they are hermaphroditic. Clonorchis spp. are flukes (trematodes) that contains both male and female reproductive organs, therefore they are hermaphroditic.

The viscous fluid found in the joint cavities is called: Pleural fluid Peritoneal fluid Amniotic fluid. Synovial fluid

Synovial fluid is the viscous fluid found in joint cavities. Pleural fluid is the fluid found in the cavity surrounding the lungs. Peritoneal fluid is fluid created in the abdominal cavity. Amniotic fluid is the protective fluid found within the membranes that hold and surround an embryo or fetus.

What temperature is considered optimal for Taq polymerase activity? 4oC 50oC 70oC 95oC

Taq polymerase is a type of DNA polymerase enzyme used in PCR to lengthen the DNA sequence during the extension step. This enzyme has its optimal activity between 68°C and 72°C. A temperature of approximately 95°C is used in the first step of the PCR, to denature the double-stranded DNA into two strands. A temperature between 50°C and 70°C can be used in the second step of the PCR, to allow hybridization of the primers to occur. A temperature of 4°C is not used in the PCR itself but may be used to store PCR products after the amplification process is completed until they are analyzed.

Which subset of effector lymphocytes is predominantly responsible for regulation of antibody production? TH1 TH2 TH17 CD8+

The TH2 subset of CD4+ effector T lymphocytes (Helper T type 2) plays a significant role in the regulation of antibody production. This subset secretes IL-4, IL-5 and IL-13. IL-4 and IL-13 act on B cells to stimulate production of antibodies that bind to mast cells, such as IgE. TH2< cells mediate host defense against extracellular parasites, including helminths. They are important in the induction and persistence of asthma and other allergic inflammatory disorders. TH2 cells produce Il-4, Il-5, IL-9, IL-10, IL-13, IL-25 and amphiregulin, a protein member of the epidermal growth factor (EGF) family. The TH1subset of CD4+ effector T lymphocytes secrete interferon (IFN-?) that acts on macrophages to increase phagocytosis and killing of microbes, and on B lymphocytes to stimulate production of IgG antibodies that opsonize microbes for phagocytosis. But help for antibody production may be provided, not by classical TH1 cells most of which migrate out of lymphoid organs to sites of infection and inflammation, but by follicular helper T cells that remain in lymphoid organs and produce(IFN-?).The role of IFN-? has been established in mice but not in human beings. The TH17subset of CD4+ effector T lymphocytes mediate immune responses against extracellular bacteria and fungi. These cells are also responsible for, or participate in, the induction of many organ-specific autoimmune disorders. TH17 cells produce IL-17a, IL-17f, IL-21 and IL-22. Both IL-17a and IL-17f recruit and activate neutrophils during an immune response against extracellular bacteria and fungi. The CD8+ subset of effector T lymphocytes (Cytotoxic, Tc) are effector cells found in the peripheral blood that are capable of directly destroying virally infected target cells. After clearance of the virus, most effector CD8+ T cells contract due to apoptosis, but a small number of these CD8+ cells form a memory T-cell pool.

All of the following affect the relative centrifugal force of a centrifuge, EXCEPT? Revolutions per minute (RPM) Time Radius of centrifuge A constant of 1.12 x10-5

The amount of time a sample is spun does not affect the relative centrifugal force. The Relative Centrifugal Force (RCF) is equal to (1.12 x 10-5 )(radius of centrifuge)(revolutions per minute).

The bioavailability of an oral drug refers to the: Availability for therapeutic administration The ratio of protein-bound to free drug Amount of drug transformation Fraction of the drug that is absorbed into the systemic circulation

The bioavailability of an oral drug is the fraction of the drug that is absorbed into the systemic circulation. The bioavailability of a drug is calculated by comparing the area under the plasma concentration-time curve of an equivalent dose of the intravenous form and the oral form of the drug. For oral drugs to be effective, bioavailability typically should be greater than 70%.

Which substance is used in the Jendrassik-Grof method to accelerate the reaction of unconjugated bilirubin with the diazo reagent? NADH N-butanol Caffeine-benzoate Acetic acid

The caffeine-benzoate solution is used to split the unconjugated bilirubin protein complex releasing the bilirubin so that it can react with diazotized sulphanilic acid. The tartrate buffer creates an alkaline solution and converts the red acid bilirubin to a blue-colored compound which can be measured spectrophotometrically at 600nm.

What are the cells that are indicated by the red arrows in the image on the right? Normal lymphocytes Hematogones Plasma cells Monocytes

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. Monocytes have lobular (horseshoe) nuclei with a loose chromatin pattern giving the nucleus a brainy or lacy appearance.

Which complement pathway and related initiator can activate complement? Classic pathway; antigen-IgG antibody complexes Classic pathway; tumor cells Alternative pathway; certain viruses and gram-negative bacteria Mannose-Lectin pathway; apoptotic cells

The classic complement pathway is initiated by the binding of complement protein (C1) complex to antibodies bound to an antigen immune (antigen-IgG antibody) complex on the surface of a bacterial cell, apoptotic cells, certain viruses, and gram-negative bacteria, or C-reactive protein bound to ligand . Although the sequence of events is similar in all three pathways of complement activation, the pathways differ in their pathway initiators and early stages of complement component reactivity. The three pathways do converge at the point of cleavage of C3 to C3b, the central event of the common final pathway, which in turn leads to activation of the lytic complement sequence, C5-C9, and cell destruction. The Classic complement pathway is not initiated by tumor cells. Tumor cells can be an initiator associated with the Alternative complement pathway. The Alternative pathway initiators are not restricted to just certain viruses and gram-negative bacteria. Initiators can include various bacteria, fungi, viruses, or tumor cells. The alternative pathway is initiated by contact with a foreign surface, e.g. polysaccharide coating of a microbial cell wall, and the covalent binding of a small amount of C3b in plasma to hydroxyl groups on these cell surface carbohydrates and proteins. The Mannose-Lectin pathway is initiated by microbes with terminal mannose groups not apoptotic cells. Mannose-binding lectin is a pattern recognition molecule of the innate immune system. The binding of mannose-binding lectin to mannose residues terminal mannose groups on a variety of bacteria can initiate complement activation.

What percentage of glycerol is most commonly used when freezing red blood cell units? 70% 40% 10% 20%

The correct answer is 40%. This is called the high glycerol method, and it is often used because the equipment is fairly simple, and frozen products require less delicate handling. The use of 70% glycerol is not a method that is commonly used to freeze red blood cell units. The use of 10% glycerol is not a method that is commonly used to freeze red blood cell units. The use of 20% glycerol (low glycerol method) is a method that can be used to freeze red blood cell units but is less commonly used because of the need for liquid nitrogen for initial freezing and the propensity of the red blood cells to degrade with temperature fluctuations.

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

The correct answer is A:T content. A:T bonds only utilize two hydrogen bonds, where G:C bonds utilize three hydrogen bonds. Thus, A:T bonds are easier to separate than G:C bonds and do not affect hybridization. Hybridization is the pairing or annealing of two strands of DNA. Several environmental factors can influence this process: Temperature: If the temperature is too high, the strands melt. If it is too low, they might be forced together. The pH: A pH that is too alkaline will cause the strands to separate; too acidic and they are forced together. The guanine to cytosine ratio (G:C ratio): Since this bond is stronger than the other nucleotide bonds, if the G:C ratio in the desired target strand is high, the separation process may take longer.

This parasite is found in blood, is sheathed, and measures 200 µm. From the parasites listed, what is the correct identification? Brugia malayi microfilaria Loa loa microfilaria Wuchereria bancrofti microfilaria Onchocerca volvulus microfilaria

The correct answer is Brugia malayi. B. malayi ranges in length from 200-280 µm and is typically found in blood. They possess a sheath, rounded anterior end, and numerous nuclei. The two distinct nuclei present in the tip of the tail, distinguish this organism from other microfilariae. These two nuclei are separated and distinct from the other nuclei present in the body of the organism. Loa loa is also sheathed but typically 248-300 µm in length. Loa loa can also be found in the blood but not until years after the initial infection. The organism resides in the subcutaneous tissue after initial infection by the bite of an infected Chrysops fly. The differentiating characteristic is the nuclei in the tip of the tail. Loa loa have nuclei that are continuous and fill the tip of the tail. Wuchereria bancrofti is also sheathed but typically measures 240-300 µm in length. W. bancrofti has an anterior end that is blunt and round. The tip of the tail is free of nuclei, which differentiates it from the other microfilariae. Onchocerca volvulus ranges in length from 150-355 µm. The main characteristic that differentiates this organism is that it does not contain a sheath. The body contains numerous nuclei that extend almost down to the entire tip. This organism is also only found in subcutaneous tissue, it is not found in blood smears.

On sheep blood agar, Haemophilus influenzae may exhibit satellitism around all of the following bacteria, EXCEPT: Pseudomonas spp. Neisseria spp. Staphylococcus spp. Streptococcus pneumoniae

The correct answer is Pseudomonas spp. Neisseria, Staphylococcus, and Streptococcus pneumoniae produce enough V factor to allow H. influenzae to grow on blood agar near their colonies; however, Pseudomonas does not. This property is utilized in the "satellite test" technique whereby minute colonies of Haemophilus are seen in the hemolytic zone surrounding a streak of S. aureus on sheep blood agar, providing a presumptive identification of Haemophilus.

With regards to identifying resistance in Enterococcus species, all of the statements below are true, EXCEPT: Both disk diffusion and broth microdilution tests should be incubated for a full 24 hours to detect vancomycin resistance. BHI agar with 6 µg/mL vancomycin can be employed as a screening methodology for vancomycin resistance. All antibiotics on a gram-positive panel should be reported. Methodologies employed should also address the detection of high-level resistance to gentamicin and streptomycin.

The correct answer is all antibiotics on a gram-positive panel should be reported. CLSI criteria for reporting antibiotics should be strictly adhered to. Since enterococci possess many intrinsic resistance factors, there are many antibiotics that should not be included in the final report. CLSI provides the definitive guidelines for the detection of resistance in Enterococci. BHI with 6 µg/mL vancomycin can be employed as a screening methodology for vancomycin resistance; the presence of >1 colony indicates the need for further testing to confirm potential resistance. All screening and susceptibility tests require a full 24 hours incubation. Since the standard approach for treating systemic infections with enterococci is a combination of a cell wall drug with an aminoglycoside, testing protocols should also address the detection of high-level resistance to gentamicin and streptomycin.

What is this suspicious form seen in a stool sample that measures 10 µm in diameter? Iodamoeba butschlii trophozoite Artifact Entamoeba histolytica trophozoite Entamoeba coli trophozoite

The correct answer is artifact. Although its size may indicate an ameba, this suspicious form does not contain the typical amebic nuclear structures commonly seen and cytoplasmic material is absent. Iodamoeba butschlii is an appropriate size match for this suspicious form, but its nucleus would exhibit a "ball-in-socket" appearance. Entamoeba histolytica is also an appropriate size match for this suspicious form but has centrally placed intra-nuclear karyosomes with a ring of evenly dispersed nuclear chromatin. Entamoeba coli are generally larger than the size of the suspicious form in this photo and have a visible eccentrically placed karyosome surrounded by blotchy nuclear chromatin.

Which of the following activities would require that a label be added to the blood label indicating the name and location of a second manufacturer? Irradiating a unit of red cells or platelets Shipping a unit to another facility Thawing a unit of plasma Receiving a unit from another facility

The correct answer is irradiating a unit of red cells or platelets. Irradiating a unit is considered manufacturing and the second manufacturer (name of the facility performing the irradiation) must be listed on the label. Shipping components, thawing plasma, and receiving components are not considered manufacturing and an additional label would not be required.

When assessing the RBC morphology on a peripheral blood smear, which would be an expected finding on a patient with thrombotic thrombocytopenic purpura (TTP)? Schistocytes Target cells Acanthocytes Echinocytes

The correct answer is schistocytes. In TTP, microthrombi made up of platelets and large forms of von Willebrand's factor (VWF) are formed. Because of a deficiency in the enzyme ADAMTS13, the ultra-large multimers of VWF remain attached to endothelium and cause platelets to adhere. RBC's pass by these multimers with platelets adhered to them and cause RBC damage, resulting in hemolysis and the presence of schistocytes.Target cells, acanthocytes, and echinocytes are not a key finding when assessing RBC morphology in patients with TTP.

All of the following statements about blood cultures are correct, EXCEPT: The volume of blood collected is important. Short draws will reduce the likelihood of successfully growing out bacteria. If two separate sets of blood cultures are requested, do not draw them both from the same site at the same time. Be sure to allow the iodine prep to dry on the patient's skin prior to performing the blood culture. Since all gloves are sterile, you may use your gloved finger without further preparation to feel the vein on a prepped arm before making the stick.

The correct answer is since all gloves are sterile, you may use your gloved finger without further preparation to feel the vein on a prepped arm before making the stick. This statement is false since you may not touch a prepped area for a sterile phlebotomy draw with your finger (whether you have gloves on or not). This may cause contamination of the cleansed area and can negatively affect the quality of the culture result. The volume of blood collected is important. Short draws will reduce the likelihood of successfully growing out bacteria. If two separate sets of blood cultures are requested, do not draw them both from the same site at the same time. Be sure to allow the iodine prep to dry on the patient's skin prior to performing the blood culture.

What are the two general categories of nucleic acid amplification (NAA) techniques? Polymerase chain reaction (PCR) and branched-chain DNA (bDNA) Fluorescence in situ hybridization (FISH) and strand displacement amplification (SDA) Target amplification and signal amplification PCR and reverse transcriptase PCR (RT-PCR)

The correct answer is target amplification and signal amplification. Target amplification and signal amplification are two general categories of amplification techniques. Target amplification involves making copies of a target sequence to such a level that they can be detected in vitro. Signal amplification does not increase the number of target or probe sequences but does increase the amount of signal bound to target sequences. Polymerase chain reaction (PCR), RT-PCR, and strand displacement amplification (SDA) are specific examples of target amplification, while branched-chain DNA (bDNA) is an example of signal amplification. FISH assays do not involve amplification.

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

The correct answer is: demonstrates a reduced number of D antigen sites on the surface of the red cell. The weak D individual has a reduced number of D antigen sites on the surface of the red cell. The first answer option is incorrect because this defines a D Negative person. The third answer option is incorrect because this could occur with the individual with a partial D antigen. Partial D = a person who types as D positive but is capable of producing anti-D when exposed to D antigen. This person demonstrates certain epitopes of the D antigen on the red cell surface, but other epitopes are not demonstrated. Thus, while this person types as D positive, they are capable of producing antibodies against the D epitopes they do not demonstrate. The last answer option is incorrect because as a recipient, the weak D individual would be considered D negative, but as a donor, this person would be considered D positive.

A 56-year-old woman with a history of high blood pressure and cardiovascular disease is evaluated by her physician due to her recent loss of appetite. The doctor reviews the following test results: Plasma creatinine = 2.4 mg/dL Urine creatinine = 65 mg/dL Urine volume (24 hrs) = 1400 ml What is the estimated glomerular filtration rate for this patient? 65 mL/min 26.32 mL/min 51.69 mL/min 37,916 mL/min

The general glomerular filtration rate calculation is as follows: (Urine creatinine/plasma creatinine) x (volume / minute) = glomerular filtration rate (mL/min) *in order to solve this problem, the 24-hour urine must be converted into minutes. 1440 minutes should be used as the denominator in the volume component. So...for this patient, the calculation would be: ( 65 mg/dL / 2.4 mg/dL ) X ( 1400 mL / 1440 min ) = (27.083) X (0.972 mL/min) = = 26.32 mL/min

What is the condition most likely associated with the peripheral blood picture shown in the image on the right? Artifact of staining Congenital spherocytosis Iron deficiency anemia Autoimmune hemolytic anemia

The intended response is iron-deficiency anemia. The red blood cells in the image are microcytic and hypochromic, which are typical findings in iron-deficiency anemia. Hypochromic RBCs have pale or hollow centers. In contrast, spherocytes are solidly stained as they lack a central pallor. Both congenital spherocytosis and autoimmune hemolytic anemia present with spherocytes, therefore, can be ruled out. There are no artifacts of staining present. Additional testing, such as iron studies and a complete medical history and/or repeat smears, may be indicated for clarification. Note the absence of polychromasia in any red cells. This is further evidence of iron deficiency.

A blood collection system that has a retractable needle malfunctions and causes an injury to a patient. Which of the following actions must be taken? The phlebotomist must be reprimanded The phlebotomist must be retrained The manufacturer of the device must be notified. The patient must be given a Hepatitis C vaccine.

The manufacturer of the device must be notified. One of the primary laboratory-related areas in the Safe Medical Devices Act of 1990 entails devices used during phlebotomy procedures. If it appears that a device has caused injury, it is important that the device and packaging be saved and any serial or lot numbers noted. An incident report should also be completed within 24 hours. The incident report must then be handled by the institution's "Risk Management" department (if applicable), which will file a report to the manufacturer. The problem was not related to the phlebotomist's competency to do his or her job. Retraining or reprimanding is not the required action for a medical device that malfunctions. The patient would not be given a Hepatitis C vaccine as a result of the incident.

The image on the right is a cytospin preparation of cerebrospinal fluid viewed at 1000X magnification. What is the identity of the primary blood cell type observed in this microscopic field? Monocytes Macrophages Mesothelial cells Lymphocytes

This is the normal range of variation for lymphocytes in a cytospin. There are no monocytes, macrophages, or mesothelial cells present in this image. Lymphocytes typically have condensed chromatin and scant blue cytoplasm. Small numbers are normal, but Increased numbers can be associated with viral infections, meningitis, and others. Monocytes are large cells, often with convoluted nuclei and large cytoplasms, and are infrequently seen in CSF. Sometimes they can be seen in meningitis or other conditions. Macrophages are not seen in normal CSF but can be seen in meningitis and other conditions. They are large cells with abundant cytoplasm. Mesothelial cells are not found in normal CSF. If present, the distinction from macrophages is sometimes difficult.

Identify the urine sediments present in this image observed using brightfield microscopy. White blood cells Red blood cells Squamous epithelial cells Yeast

This slide shows many red blood cells. Red blood cells (RBCs) are slightly smaller than WBCs and have a smooth, non-nucleated appearance. White blood cells have a rough appearance and contain granules and multilobed nuclei which fill out the cytoplasm of the cell. Squamous epithelial cells are the largest cells found in the urine sediment and can even be seen under low-power field. They may appear as clumps of cells and have a very large irregular-shaped cytoplasm with a prominent centrally located nucleus. Yeast cells can appear very similar to red blood cells in the urine at times. Yeast cells are usually oval and a bit smaller than red blood cells and can have a "budding" appearance. This morphology can aid in the differentiation between red cells and yeast. Acetic acid can be added to urine samples in order to lyse red blood cells and leave the remaining sediment intact. This is useful when attempting to differentiate between red cells and yeast.

Which of the following is responsible for causing transfusion associated graft-versus-host disease? Platelets Granulocytes Monocytes Lymphocytes

Transfusion associated graft-versus-host reactions are caused by the engrafting of immunocompetent T lymphocytes into a severely immunosuppressed recipient. They can be prevented by gamma irradiation of cellular blood components. Platelets, monocytes, and granulocytes are not involved in transfusion associated graft-versus-host disease.

Two CSF specimens were sent to the Lab with the following results:Tube #1 = 11,200 rbc/µLTube #2 = 300 rbc/µLThe results on these CSF specimens are indicative of: An infection A recent subarachnoid hemorrhage A traumatic tap An old intracranial bleeding episode

Traumatic taps are described as spinal fluid taps where blood vessels are pierced with the needle during aspiration, causing a contamination of the spinal fluid sample with blood or bone marrow. Traumatic taps are easily differentiated from true hemmorhages as each subsequent container of spinal fluid drawn will have a smaller amount of red and white cells present. In a true hemorrhage, the red and white cell counts will remain steady in each subsequent tube of spinal fluid drawn.

The type of hypersensitivity reaction associated with macrophage activation, cytokine-mediated inflammation is: Type I Anaphylactic (Immediate hypersensitivity) Type II Cytotoxic (Antibody mediated and antibody dependent, complement mediated hypersensitivity) Type III Immune complex mediated hypersensitivity Type IV Cell mediated hypersensitivity (T-cell dependent)

Type IV Cell-mediated hypersensitivity is associated with macrophage activation. Type IV is characterized by direct target cell lysis and cytokine-mediate inflammation. There are three defining characteristics of type IV hypersensitivity reactions: (1)Type IV delayed-type hypersensitivity involving antigen-sensitized T cells or particles that remain phagocytized in a macrophage and are encountered by previously activated T cells for a second or subsequent time. Delayed hypersensitivity is a major defense mechanism again various intracellular pathogens, including mycobacteria, fungi, and certain parasites. (2) Rejection of foreign tissue grafts, elimination of tumor cells bearing neoantigens. (3) Formation of chronic granulomas. Type I Immediate hypersensitivity is mast cell-derived mediators (vasoactive amines, lipid mediators, and cytokines). Cytokine-mediated inflammation involves eosinophils, neutrophils, and lymphocytes. Type I reactions can range from life-threatening anaphylactic reactions to milder manifestations associated with food allergies. Type II Antibody-mediated hypersensitivity is associated with complement and Fc receptor-mediated recruitment and activation of leukocytes (neutrophils and macrophages). Opsonization and phagocytosis of cells. Abnormalities in cellular function, e.g., hormone or neurotransmitter receptor signaling. Types II and III are initiated by the interaction between antibodies, except IgE and antigen. Three different mechanisms of antibody-mediated injury exist in type II reactions: (1) Antibody-dependent, complement-mediated cytotoxic reactions characterized by the interaction of IgG or IgM antibody with the cell-bound antigen. (2) Antibody-dependent, cell-mediated cytotoxicity that depends on the initial binding of specific antibodies to target cell surface antigens. (3) Antireceptor antibodies that disturb the functioning of receptors. Transfusion reactions are an example of an antibody-dependent, complement-mediated cytotoxic reaction. Hyperacute graft rejection is also an example of a Type II hypersensitivity reaction. Type III Immune complex-mediated hypersensitivity is associated with complement and Fc receptor-mediated recruitment and activation of leukocytes and tissue damage secondary to impaired blood flow. Type III reactions are caused by IgG, IgM, and possibly other antibody types. Immune complexes can cover a spectrum of biological activities, including suppression or augmentation of the immune response by interacting with T and B cells; inhibition of tumor cell destruction; and deposition in blood vessel walls, glomerular membranes, and other sites. These deposits interrupt normal physiologic processes because of tissue damage secondary to the activation of complement and resulting activities.

Illustrated in this photograph is the surface of a thiosulfate citrate bile sucrose (TCBS) agar plate which are growing colonies of an unknown bacterial species from a diarrheal stool specimen. The most likely identification is: Vibrio cholerae Vibro parahemolyticus Plesiomonas shigelloides Vibrio vulnificus

Vibrio cholerae is correct because Vibrio cholerae ferments sucrose, resulting in the yellow, acid pH colonies. Bacterial species that can grow on TCBS agar, but do not ferment sucrose are semitransparent and will appear green. Vibrio parahemolyticus is incorrect because V. parahemolyticus is unable to ferment sucrose and will produce blue-green colonies on TCBS agar. Plesiomonas shigelloides is incorrect because this species will not grow on TCBS agar. Vibrio vulnificus is incorrect because this species is unable to ferment sucrose and will produce blue-green colonies on TCBS agar.

A test used to evaluate the abnormalities in the intrinsic coagulation pathway and to monitor heparin therapy is called: Platelet function assay (PFA) Prothrombin time (PT) Activated partial thrombloplastin time (aPTT or PTT) Erythrocyte sedimentation rate (ESR)

aPTT is test used to evaluate abnormalities in the intrinsic coagulation pathway and to monitor heparin therapy. PFA test used to evaluate bleeding problems and monitor antiplatelet medication. PT is a test used to evaluate abnormalities in the extrinsic coagulation pathway and to monitor coumarin therapy. ESR is a common hematology test that measures the rate a which the red blood cells fall and settle in a period of one hour.

Which marker is most useful for the detection of gestational trophoblastic disease? CEA (Carcinoembryonic antigen) AFP (a-fetoprotein) hCG (human chorionic gonadotropin) CA-125 (cancer antigen 125)

hCG is used for pregnancy testing, but it is also the most useful marker for the detection of gestational trophoblastic disease.The main clinical use of CEA is a marker for colorectal cancer.AFP is often elevated in patients with hepatocellular carcinoma and germ cell tumors.CA-125 is a serological marker of ovarian cancer.