Media Lab Study Qs 5/7

Pseudomonas aeruginosa

Each of the following organisms may possess extended-spectrum beta-lactamase (ESBL) activity except: Escherichia coli Klebsiella oxytoca Proteus mirabilis Pseudomonas aeruginosa

alkaline slant/alkaline deep

Pseudomonas aeruginosa is often used as a bacterial species for the quality control of Kligler Iron Agar (KIA). The expected reaction is:

increased pCO2

Respiratory acidosis is associated with:

proteus mirabilis

Shown in this photograph is a Kligler Iron Agar (KIA) slant (left) and a Christensen's urea agar slant (right) after inoculation with an unknown bacterial species and incubation for 24 hours at 35oC. The reactions shown permit a presumptive identification of:

decreased plasma pH

Storage lesion, or the biochemical changes in red blood cells during storage, will result in:

CREST syndrome

Suppose a patient with stiffness in her fingers has a positive antinuclear antibody (ANA) test with a centromere pattern at a 1:1280 titer. What is the most likely diagnosis?

albumin

The Emergency Department has collected blood test tubes for potassium, albumin, plasma hemoglobin, and acid phosphatase. Which of these test results will NOT be negatively affected if the blood tube is sent by the hospital's pneumatic tube system? Albumin Plasma hgb Potassium Acid phosphatase

galactosemia

The following urine test results were obtained from a 6-month-old African American infant who experiences vomiting and diarrhea after milk ingestion and has failed to gain weight: pH: 5.0Protein: NegativeGlucose: NegativeKetones: NegativeBlood: NegativeBilirubin: NegativeNitrite: NegativeUrobilinogen: 0.1 EU/dLClinitest: 2+ These results are clinically significant in which of the following disorders?

Candida parapsilosis

The growth of yellow-white yeast colonies with a smooth or hair-like surface within 2 - 3 days on non-selective culture media generally requires further procedures to make a presumptive identification. Microscopic observation of the subculture of colonies growing on cornmeal agar is one such approach, as illustrated in the photomicrograph. Note the spider-like colonies that appear along the streak line. From the multiple choices, select the name of the presumptive yeast identification.

Chediak-Higashi syndrome

The inclusions that are seen in the white cell indicated by the arrow in this image are characteristic of which of the following conditions?

Fc end of the molecule

The properties of an antibody class are defined by the:

Cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils.

The purpose of C3a and C5a, the split-products of the complement cascade, is to:

A positive family history

Which of the following is NOT considered necessary for making a diagnosis of hereditary hemochromatosis (HH)? Laboratory evidence of iron overload Genetic mutations associated with HH Clinical signs and symptoms consistent with HH A positive family history

Mycobacterium avium complex (MAC)

Which of the following is the most common cause of nontuberculous mycobacteria (NTM) lung disease?

2.0 mL

Which of the following represents the lower reference limit for semen volume?

L3-L4

Which of the following sites is used most often for CSF collection?

leptin

Which one of the following adipocyte products is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores?

A1 (found on red cells in greatest amount to least=O,A2, B, A2B, A1 and A1B)

Which one of the following blood groups usually reacts LEAST strongly with anti-H?

Cephalosporins

Which one of the following drugs/drug classes is the MOST COMMON cause of drug-induced immune hemolytic anemia? Levodopa Quinidine Cephalosporins Levofloxacin

Perform a direct antiglobulin test (DAT) on the incompatible unit

Which procedure should be followed when one cross-matched unit out of five is INCOMPATIBLE at the antiglobulin (AHG) phase?

AS

A 17-year old African-American male had the following laboratory results: Sickle cell screen = positiveHemoglobin Electrophoresis:Hb S = 45%Hb A = 53%HbA2 = 2% Which of the following is the PROBABLE hemoglobin genotype?

thiamine

A deficiency in which of the folowing vitamins is associated with "Beriberi"?

HLA typing

A patient presents with platelet refractoriness, or poor response to platelet transfusions. What can be performed to help ensure platelet transfusions will be therapeutic?

Burkholderia cepacia

A patient with cystic fibrosis is admitted with a fulminant lung infection. A sputum culture grows a non-lactose fermenting, oxidase positive, Gram-negative bacilli. It is pyocyanin negative, nitrate reduction variable, and it is arginine dihydrolase negative

Acid pH, dehydration, increased level of 2,3-DPG

Which group of conditions increases the risk of HbS polymerization?

aldolase

Which of the following enzymes is associated with conditions affecting skeletal muscles?

ß0/ß

Which of the following genotypes cause beta thalassemia minor?

respiratory acidosis

A young man is experiencing difficult breathing after fainting. The physician orders an arterial blood gas analysis which shows the following results: pH = 7.25 pCO2 = 62 mmHg pO2 = 70 mmHg HCO3- = 23 mmol/L Which condition is most likely afflicting this patient?

Columbia colistin-nalidixic acid agar

All of the following aerobic agars can be set up along with the anaerobic media, EXCEPT? 5% sheep blood agar Chocolate agar MacConkey agar Columbia colistin-nalidixic acid agar

Carbamazepine

All of the following are therapeutic drugs used to treat cardiac disease, EXCEPT? Carbamazepine Digoxin Procainamide Quinidine

prostate cancer

All of the following conditions would be associated with an increased level of alpha-fetoprotein, EXCEPT? Prostate Cancer Hepatocellular Carcinoma Viral Hepatitis Testicular Tumors

colon

An increase in carcinoembryonic antigen (CEA) levels is most closely associated with which of the following organs?

type IV

An obese adult with premature arteriosclerosis is seen in the clinic. When her serum is tested no chylomicrons are present, LDL levels are normal, and VLDL levels are increased. There is an increase in triglycerides and slight increase in cholesterol. Lipoprotein electrophoresis reveals a heavy pre-beta band. She has no skin rash and uric acid is increased. This patient most likely has what type of hyperlipoproteinemia?

Alcaligenes faecalis (odorans)

Bacterial colonies often emit distinct odors associated with foods. Which organism produces an odor that resembles fresh apples?

bilary duct obstruction

Given the following data, what is the most likely disease state? Total bili = 4.0 (0.5-1.5) Direct bili = 3.0 (0.2-0.5) AST = 75 (2-25) ALT = 118 (2-23) LD = 220 (< 140) ALP = 841 (28-68) GGT =150 (21-40 U)

bacitracin sensitivity

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

Cladophialophora carronii

Illustrated in the top image is a slow-growing, 8-day-old colony growing on Sabouraud Dextrose with Brain Heart Infusion (SabHI) agar obtained from a darkened superficial skin infection. Although the colony is not specific for one of the fungal species causing chromomycosis, the black outer border that extends into the reverse of the colony is consistent. The identification is made by observing the distinctive conidiation illustrated in the bottom image. Which of the following organisms is represented by the description and images shown?

K/A on Kligler's iron agar

In order to identify an isolate as Yersinia enterocolitica, it must be lysine-negative and demonstrate which of the following?

saline replacement

In the evaluation of a positive DAT result, all of the below techniques can be used to dissociate the antibody(ies) form the RBCs EXCEPT: EDTA-glycine Saline replacement Chloroquine diphosphate Murine monoclonal antibodies

30 seconds

In today's global market and competitiveness, customer service is of utmost importance in both hospital and clinical outpatient sites. The first _____ _____ of a meeting with a patient will provide the patient with a memory about the experience. The patient will share this experience with others; therefore, a positive introduction is important.

hgb H disease

In which disorder do neonates demonstrate the presence of Bart's hemoglobin that changes to beta chain tetramers in adults?

Ectopic pregnancy

In which of the following cases should Rh Immune Globulin (RhIG) be given?

diabetes insipidus

In which of the following condition(s) would an increased serum osmolality be an expected finding?

CMV

Infections with all of the following viruses could cause malignant disease, except: Human papillomavirus (HPV) Epstein-Barr Virus (EBV) Human Herpesvirus 8 (HHV-8) Cytomegalovirus (CMV)

Le(a+ b-)

Lewis Blood Group System is a human blood group unlike most others. The antigen is produced and secreted by exocrine glands, eventually adsorbing to the surface of red blood cells. Its expression is based on the genetic expression of the Lewis and Secretor genes. Based on the following genotype (Le) (sese), what would you predict the Lewis antigen phenotypic expression to be?

Paragonimus westermani

The relatively large ovum (100 µm), as illustrated in the high-power photomicrograph, may be most commonly recovered in stool specimens from people with low grade abdominal pain and diarrhea. Ova may also be recovered from sputum specimens as the adult worms may reside within lung pseudocysts. During periods of coughing, ova may be released into the bronchi and observed in sputum samples. Based on the distinct features of the ova as presented in the photomicrograph, what is the presumptive identification?

Corynebacterium diphtheriae

The serum medium and methylene blue stain originally described by Loeffler are both helpful in the identification of:

Haemophilus influenzae

The term "HACEK" is often associated with infective endocarditis. All of the following organisms are included in the "HACEK" group, EXCEPT? Kingella kingae Cardiobacterium hominis Haemophilus influenzae Eikenella corrodens

What the body does to the drug

The term pharmacokinetics BEST describes:

protozoa

The trichrome stain is most commonly used to identify which class of parasites?

pentatrichomonas hominis

The trophozoite is the only morphologic form in the life cycle of:

1.5-2 mmol/L

Toxic levels of lithium can cause lethargy, apathy, muscle weakness up to and including seizures and coma. What is the toxic level of lithium?

Clotting, plug formation, release of serotonin, and repair of the injured tissues.

What are function(s) of the platelet?

prozone reaction prozone=too much antibody postzone=too much antigen

What has happened in an antibody titer, if tubes #5-7 show a stronger reaction than tubes #1-4?

phase contrast

What is the BEST type of microscopy for performing manual platelet counts?

These discrepancies between forward and reverse groupings are due to weakly reacting or missing antigens.

What is the correct description for Group II discrepancies?

VCA, EBNA, VCA/IgM, EA

What is the correct sequence of the immunologic Epstein-Barr virus (EBV) response in infectious mononucleosis? Key:VCA= viral capsid antigenVCA/IgM =viral capsid antibody (IgM)EA=early antigenEBNA=Epstein-Barr nuclear antigen

Interconversion of lactate and pyruvate

What is the function of LD in the body?

Detect small urinary concentrations of albumin before there is irreparable renal damage

What is the role of albuminuria testing?

Testing for antibodies to U1RNP+ and dcSSc

When a Specked Nuclear Antibody (ANA) pattern is observed, what follow-up test for antibodies related to Systemic Lupus Erythematosus (SLE) is not beneficial?

Positive because conjugated bilirubin is present and is excreted by the kidneys.

When a patient has a bile duct obstruction, the bilirubin test portion of the reagent strip is:

M:E = 2.5:1

When assessing a bone marrow aspirate smear of an adult, a normal M/E ratio (myeloid to erythroid cells) would be?

Testing for weak D on potential transfusion recipient samples

When is testing for weak D optional (not required)?

you have not run a PT and aPTT on the new mix before incubating

When performing your mixing study, you aliquot your sample plasma and the pooled normal plasma to create your "mix". You then place the sample in a water bath to incubate for 90 minutes before running your new mixed sample. What is the problem with the steps involved in the procedure above?

#1 Chemistry, #2 Microbiology, #3 Hematology

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

gastrin

Zollinger-Ellison syndrome is characterized by a large (usually 20-fold) elevation of: