MLT ASCP Practice Questions 3.7.16

D; Pigs are the animals that served as the virus reassortment vessel for the 2009 novel influenza A H1N1 virus. Cows, deer, and horses were not the vessels for the reassortment of the 2009 H1N1 virus.

Which animal was involved in the reassortment of influenza A viruses that led to the 2009 novel influenza A H1N1 virus? A. Cows B. Deer C. Horses D. Pigs

B; Red cell membrane defects are present in each of the choices above.

What characteristic is common to all of these conditions: hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria? A. autosomal dominant inheritance B. red cell membrane defects C. positive direct antiglobulin test D. presence of hemoglobin C

C; Like malaria, Babesia is a protozoan which infects red cells and produces a febrile illness. Unlike malaria, which is spread by mosquitoes, Babesia is transmitted by ticks.

Which of the following has a life cycle that most closely resembles that of Plasmodium sp: A. Dracunculus medinensis B. Blastocystis hominis C. Babesia microti D. Toxocara canis

A; After the second spin in the preparation of platelets, the platelet bag should be allowed to rest at room temperature for 1 - 2 hours. The platelet component is placed on a rotator to resuspend the platelets that have aggregated during the centrifugation process, but should not be vigorously agitated. They should remain at room temperature, not pooled and heated in a microwave, and not frozen.

After the second spin in the preparation of platelets from whole blood, the platelet products should be: A. Allowed to rest for 1-2 hours. B. Agitated vigorously for 3 hours C. Pooled immediately and microwaved D. Frozen

B; ESR is actually increased during inflammatory conditions. Therefore choice B is the correct answer as it is a false statement.

All of the following are true concerning the Erythrocyte Sedimentation Rate EXCEPT: A. Can be used to follow the course of a disease B. ESR is decreased during inflammatory conditions C. Highest ESR values usually seen in Multiple Myeloma D. Increased in rheumatoid conditions

B; Auer rods are typically only found in myeloblasts. Therefore in lymphocytic leukemia with lymphoblasts, Auer rods would not be seen.

Auer rods may be seen in blasts of all the following conditions EXCEPT: A. Acute Myelomonocytic leukemia (M4) B. Acute lymphocytic leukemia (Ll, L2, L3) C. Acute myelocytic leukemia (M1, M2) D. Acute promyelocytic leukemia (M3)

D; Posthepatic jaundice is the result of bile duct obstruction, not impaired hepatic function. It will result in elevation of direct (conjugated) bilirubin. Crigler-Najjar syndrome, erythroblastosis fetalis and transfusion reactions are all associated with increases in unconjugated bilirubin.

Elevation in conjugated bilirubin is most likely to be found in which of the following conditions: A. Transfusion reactions B. Erythroblastosis fetalis C. Crigler-Najjar syndrome D. Biliary obstruction

B & D The presence of protein in the urine does not always indicate renal disease; benign conditions such as dehydration or orthostatic (postural) proteinuria can also produce a positive test for protein. An individual with orthostatic proteinuria will have a positive test for protein after being in an upright position for several hours, but protein will not be present in the urine if the individual has been laying down. Multiple myeloma and lupus erythematosus do not cause benign proteinuria.

Examples of conditions resulting in benign proteinuria include: (Choose ALL correct answers) A. Multiple myeloma B. Dehydration C. Lupus erythematosus D. Orthostatic proteinuria

E; Assessment of the status of amniotic fluid phospholipids has become important in determining fetal lung maturity. During pregnancy, it has been documented that the ratio of lecithin to sphingomyelin (L/S ratio), with respect to pediatric gestational age, is a reliable predictor of maturity.

Fetal lung maturity can be determined from amniotic fluid because the surfactant is PRIMARILY composed of: A. protein B. cholesterol C. glycerol D. triglycerides E. phosphatidylcholine and other phospholipids

C; Hematocrit is the percentage by volume of RBCs in a specimen of whole blood.

Hematocrit is: A. Percentage of blood made up of serum B. Concentration of serum X 100 C. Percentage of blood made up of red cells D. Concentration of red cells X 100

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

Match the viruses below with their associated diseases. 1. Epstein-Barr 2. Varicella-Zoster 3. Rhabdovirus 4. Picornavirus A. Chicken pox B. Rabies C. Infectious mononucleosis D. Polio

A; Red Cell Distribution Width (RDW) is a mathematical expression of size variation used to quantify anisocytosis. The higher the RDW, the greater the anisocytosis. RDW is increased in iron deficiency, and tends to be normal in thalassemia. Increased RDW may be an early indication of iron deficiency, where it may precede the onset of microcytosis.

RDW is an indication of which of the following: A. Variability of RBC volume B. Poikilocytosis C. Macrocytosis D. Microcytosis

B; T lymphocytes perform all of the listed functions EXCEPT synthesizing antibodies. B lymphocytes actually synthesize antibodies. T lymphocytes secrete cytokines, comprise the majority of cells in the lymphocyte pool and help regulate immune response.

T lymphocytes are characterized by all of the following functions EXCEPT which? A. Secrete cytokines B. Synthesize antibody C. Comprise majority of cells in blood lymphocyte pool D. Help regulate immune response

B; The India ink preparation is used as a presumptive test for the presence of Cryptococcus neoformans. Upon staining with India Ink, C. neoformans shows distinct, wide capsules surrounding the yeast cells. C. neoformans affects predominantly immunocompromised hosts and is the commonest cause of fungal meningitis; worldwide. In addition, 7-10% of patients with AIDS are affected.

The India ink preparation is used as a presumptive test for the presence of which organism? A. Aspergillus niger in blood B. Cryptococcus neoformans in CSF C. Histoplasma capsulatum in CSF D. Candida albicans in blood or body fluids E. Trichomonas vaginalis in vaginal secretions

Choroidal cells; a clump of choroidal cells. These are cells that line the choroid plexus and may be shed into the CSF. They are not diagnostically significant.

The arrows in the images below indicate cells that may be observed in CSF samples. Identify the cell

Lymphocytes; Chromatin is dense and the cells are normal in size.

The arrows in the images below indicate cells that may be observed in CSF samples. Identify the cell

Monomacrophages; The cells have abundant cytoplasm with a lacy appearance.

The arrows in the images below indicate cells that may be observed in CSF samples. Identify the cell

Presumptive malignant cells; Note the large size of the cells, the high nuclear:cytoplasm ratio, vacuolation, and nuclear irregularities.

The arrows in the images below indicate cells that may be observed in CSF samples. Identify the cell

B; The correct response is megaloblastic anemia. A diagnosis of megaloblastic anemia can be made on the basis of the presence of hypersegmented neutrophils and oval macrocytes in the blood or of typical megaloblasts in the marrow. These features are absent in patients with sideroblastic and iron deficiency anemias as well as those with parasitic malarial infections. In this condition, the macrocytes tend to be round and oval. Polychromatophilia and reticulocytosis may be prominent as well.

The condition which is highly associated with the oval-macrocytes and hypersegmented neutrophils found in this image is: A. Sideroblastic Anemia B. Megaloblastic Anemia C. Iron Deficiency Anemia D. Malarial Infection

C; The pH of this patient sample is alkaline (>7.45), which is indicative of alkalosis. Since the HCO3 is increased (reference range 22-26 mEq/L) and is the alkaline buffer component of the body produced by our metabolic system, the condition is called Metabolic Alkalosis.

The following results were obtained on arterial blood: pH = 7.51 pCO2= 49 mmHg HCO3 = 38.7 mEq/L pO2= 85 mmHg These results are compatible with: A. metabolic acidosis B. respiratory acidosis C. metabolic alkalosis D. respiratory alkalosis

C; Galactosemia is an inherited metabolic disorder that affects an individual's ability to metabolize the sugar galactose effectively. Infants affected by galactosemia typically present with symptoms of lethargy, vomiting, diarrhea, failure to thrive, and jaundice. The presence of galactose in the urine sample is not picked up by the glucose pad on the urine test strip, however, the clinitest result is positive since it can detect different sugars in the urine, including galactose. Diabetes mellitus, and cystic fibrosis would not be associated with the findings in this case; especially the positive clinitest result. In addition, the clinical symptoms and patient age differentiates lactose intolerance from galactosemia. True lactose intolerance will usually not become symptomatic in children until they are at least 3 years old (usually after age 7). Also, lactose intolerance is associated with diarrhea, but not closely associated with vomiting.

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: 5.0 Protein: Negative Glucose: Negative Ketones: Negative Blood: Negative Bilirubin: Negative Nitrite: Negative Urobilinogen: 0.1 EU/dL Clinitest: 2+ These results are clinically significant in which of the following disorders? A. Diabetes mellitus B. Lactose intolerance C. Galactosemia D. Cystic fibrosis

A; The protein component that surrounds the genome is called a capsid.

The protein component that surrounds the genome is called a: A. Capsid B. Spike C. Co-receptor D. Syncytia

B; Klebsiella pneumoniae is the correct answer. Enterobacter cloacae is ornithine positive and motile. Escherichia coli is ornithine positive, citrate negative and motile. Yersinia enterocolitica is lysine negative and citrate negative.

This member of the Enterobacteriacea gave these reactions: TSIA . . . . . . . . . . . . . . . . . . A/A, gas (+), no H2S Ornithine . . . . . . . . . . . . . . . Negative Lysine . . . . . . . . . . . . . . . . . Positive Citrate . . . . . . . . . . . . . . . . . Positive Urea . . . . . . . . . . . . . . . . . . Positive Phenylalanine . . . . . . . . . . Negative Motility . . . . . . . . . . . . . . . . Negative This organism is identified as: A. Enterobacter cloacae B. Klebsiella pneumoniae C. Escherichia coli D. Yersinia enterocolitica

C; The pH of freshly drawn blood decreases at a rate of 0.06 pH units/hour at 37oC, but only 0.006 pH units/hour at 4oC.

pH alteration of normal blood in a closed vessel standing at 37oC for 1 hour is approximately A. 0.01 to 0.02 pH unit B. 0.02 to 0.04 pH unit C. 0.04 to 0.08 pH unit D. 0.08 to 0.12 pH unit

D; 1/1000 ml or .001 ml

A microliter is equal to: A. 1000 ml B. 1/1000 liter C. 100 ml D. 1/1000 ml

True; Metacentric centromeres are said to be near the middle of the chromosome so that the two arms are approximately equal in length. When the centromere is located where the two arms are not equal in length, it is submetacentric. When the centromere is located close to one end of the chromosome arm, it is acrocentric.

(True/False) A centromere that is located at the point where two chromosome arms are roughly EQUAL in length is called metacentric.

C; A hs-CRP of 2.8 mg/L indicates an average risk of cardiovascular disease (1.0-3.0 mg/L).

A 45-year-old African American female has been diagnosed and treated for type 2 diabetes for the past five years. She maintains good control of her blood glucose with medication but does not exercise and has gained 12 pounds over the past year. At her next appointment, her physician orders hs-CRP along with blood assays to monitor her diabetes. Laboratory Result: hs-CRP 2.8 mg/L A. At no risk for cardiovascular disease B. Low risk for cardiovascular disease C. Average risk for cardiovascular disease D. High risk for cardiovascular disease

C; Hemochromatosis is the most common form of iron overload disease. Characteristic findings are elevations in serum iron and ferritin. Positive Prussian Blue stain indicates elevated iron (hemosiderin) stores with intensity of color being qualitative rather than quantitative for tissue iron deposits.

A 55-year-old white male had the following lab data: RBC 3.7 X 10'/uL Serum iron 220 ug/dL (N: 60-80 ug/dL) Hgb 10.0 g/dL TIBC 300 ug/dL (N: 260-400 ug/dL) Hct 32% Serum Ferritin 2,800 ng/mL (N: 10-200 ng/mL) WBC 5,800 MCV 86 fl MCH 26 pg MCHC 32% Bone marrow shows shift to left for RBC's Prussian Blue stain indicates markedly elevated iron stores These laboratory results are MOST consistent with which of the following conditions? A. Iron deficiency anemia B. Anemia of chronic disease C. Hemochromatosis D. Sideroblastic anemia E. Megaloblastic anemia

C; Cefoxitin is the disk to test for methicillin resistant staphylococci. Because it is resistant, cephalothin must not be reported as susceptible because it will not be therapeutic. Vancomycin intermediate and resistant Staphylococcus aureus have been reported and this is the drug of choice for treating many serious MRSA isolates.

A Staphylococcus aureus was recovered from a wound infection and tested for susceptibility using the CLSI guidelines for disk diffusion testing. The following results were detected: Penicillin- R Cefoxitin- R Oxacillin- S Cephalothin- S Vancomycin- S Which drug must be reported as susceptible? A. Methicillin B. Penicillin C. Vancomycin D. Cephalothin

C; In this case, the beta-hemolytic organism is most likely a Streptococcus spp. Group A Streptococcus is bacitracin-sensitive, which rules out this beta-hemolytic organism. Group D Streptococcus usually show alpha or gamma hemolysis, not beta-hemolysis, which rules out Group D. Groups B and C can be differentiated through the CAMP test, which is the correct answer for this question.

A beta-hemolytic gram-positive coccus, isolated from the CSF of an infant, grew on sheep blood agar under aerobic conditions and was resistant to a bacitracin disc. Which of the following tests should be performed for the presumptive identification of the organism? a. Oxidase production b. Catalase formation c. CAMP test d. Esculin hydrolysis e. India Ink test

D is the correct answer because the organism is susceptible to bacitracin and negative on the other tests. Beta Streptococcus, not Group A, B, or D is susceptible to SXT and resistant to bacitracin. Group B streptococci are CAMP positive and Group G strep cannot be presumptively identified.

A beta-hemolytic streptococcus was isolated from a throat culture. It gave the following biochemical reactions: Bacitracin- Susceptible Bile esculin- Negative 6.5% NaCl- No growth CAMP- Negative SXT- Resistant The presumptive identification would be: A. Beta Streptococcus, Group B B. Beta Streptococcus, not Group A, B, or D C. Beta Streptococcus, Group G D. Beta Streptococcus, Group A

C; Positive for nitrogen gas and negative for nitrite production is the correct answer. Nitrate broth is used to determine the ability of an organism to reduce nitrate (NO3) to nitrite (NO2) using the enzyme nitrate reductase or perform nitrification on nitrate and nitrite to produce molecular nitrogen. Nitrate broth is incubated and reagents containing sulfanilic acid and α-naphthylamine are added. If the organism has reduced nitrate to nitrite, a diazotized sulfanilic acid is produced. This reacts with the α-naphthylamine to form a red-ish compound. Therefore, if the medium turns red after the addition of the nitrate reagents, it is considered a positive result for nitrate reduction. If the medium does not turn red after the addition of the nitrate reagents, powdered zinc is then added. If the tube turns red after the addition of the zinc, it means that unreduced nitrate was present. If the tube turns red after the addition of the zinc, it means that unreduced nitrate was present. Therefore, a red color on the second step is a negative result. If the medium does not turn red-ish after the addition of the zinc powder, then the result is positive. If no red color forms, there was no nitrate to reduce. Since there was no nitrite present in the medium, it assumes that denitrification took place and ammonia or molecular nitrogen were formed. This answer choice was correct since the nitrate to nitrite result was negative but when zinc dust was added, no color developed. This demonstrated that no nitrate is left in the tube to be reduced; therefore, molecular nitrogen must have been produced from the nitrate.

A nitrate test is performed on a glucose nonfermenter. When the nitrate reagents were added, no color change occurred. When zinc dust was added, no color developed. This test should be reported as: A. Positive for nitrite and negative for molecular nitrogen B. Negative for molecular nitrogens and negative for nitrate production C. Positive for molecular nitrogen and negative for nitrite production D. Negative for nitrate and negative for nitrite reduction

D; Delayed hemolytic transfusion reactions (DHTR) are transfusion reactions that occurs 3 to 10 days after the transfusion. Usually, the blood appears serologically compatible at initial testing. Delayed reactions are common in patients who have been immunized to a foreign antigen from a previous transfusion or pregnancy. The antibody titers decrease over time so that the antibody was not detectable during pre-transfusion testing. Exposure to antigen causes an anamnestic response. Antibodies become detectable in the serum a few days after transfusion.

A patient transfused with two units of packed cells spiked a fever of 99.5oF and complained of chills five days after transfusion. The direct antiglobulin test (DAT) was positive with anti-IgG, but negative with anti-C3d. Compatibility testing was performed on the pre- and post-transfusion specimens. The post-transfusion specimen was incompatible with one of the donor units transfused. An antibody screen was done on both the pre- and post-transfusion specimens. An antibody was detected in the post-transfusion specimen only and identified by panel studies as anti-Jka. This transfusion reaction is most likely caused by: A. Post-transfusion purpura B. An anaphylactic response C. An acute hemolytic transfusion reaction D. A delayed hemolytic transfusion reaction

A; The stacking of red blood cells known as Rouleaux formation occurs when patients have abnormal globulins such as in Multiple Myeloma. This is most likely causing false agglutination in the ABO typing. Saline replacement should resolve these discrepancies.

A patient with Multiple Myeloma has the following reactions in the ABO typing: Anti-A= w+ Anti-B = w+ Anti-A,B = w+ Auto control = w+ A1 Cells = 4+ B cells = 4+ What is probably causing these results? A. Rouleaux B. Subgroup of A C. Patient has hypogammaglobulinemia D. Patient has selective IgA deficiency

B; In this example, we would use the standard manual WBC count equation. Cells/µL = # of cells counted x dilution / # of large squares counted x 0.1µL (chamber depth) In this case, Cells/µL = 370 x 100 / 18 x 0.1 Cells/µL = 37000 / 1.8 Cells/µL = 20556 or 2.06 x 104

A sample of cerebrospinal fluid is diluted 1:100; the standard 9 squares of a hemocytometer were counted on each side for a total of 18 large squares. Side 1- 186 cells counted Side 2- 184 cells counted total cells = 370 What is the cell count per microliter? A. 1.03 x 104 B. 2.06 x 104 C. 4.62 x 104 D. 9.25 x 104

B; Since the recommended time limit between collection and analysis is one hour, at three hours, the technologist should report the specimen as compromised on the final report.

A semen specimen was collected three hours before it was brought to the laboratory for examination. What course of action should be taken? A. Complete macroscopic and microscopic examination as quickly as possible. B. Report the specimen as compromised on the final report. C. Perform the macroscopic and morphology procedures only. D. Perform the wet mount only.

A; We can rule out answer Idiopathic thrombocytopenia since the platelet count is normal. We can also exclude lymphocytic leukemia because the WBC is normal. Thalassemia minor can be excluded because thalassemia patients usually have only mild anemia. Finally, lead poisoning cannot be the answer since this condition does not usually cause severe anemia. The RBC, Hct, and Hgb are all very low, and this fits the picture of iron deficiency anemia.

A two-year old male patient has the following hemogram results: Hgb = 6.7gms/dl Hct = 20% Platelets = 355,000/ mm3 RBC = 3.0mil/cmm WBC = 8750/cmm Differential = 6 eos 20 segs 68 lymphs 6 monos Which of the following is the MOST likely diagnosis? A. Dietary iron deficiency B. Idiopathic thrombocytopenia C. Lymphocytic leukemia D. Thalassemia minor E. Lead poisoning

D; Cornmeal agar morphology can be a valuable adjunct in separating two phenotypically, closely-related species of Candida. Observing the patterns of growth and sporulation on cornmeal agar aids in the identification of an unknown yeast if the results derived from profile numbers generated by automated or kit systems do not provide sufficient information. Candida parapsilosis produces a distinctive growth pattern on cornmeal agar with the unique formation of satelliting, sage-brush type colonies. Candida tropicalis, in contrast, produces unclustered pseudohyphae with blastoconidia irregularly spaced at points of septation. The "logs in stream" arrangement of blastoconidia is characteristic of Candida kefyr (pseudotropicalis). Neither C. tropicalis nor C. parapsilosis produce chlamydospores.

A yeast identification system gave a biotype number for an unknown isolate that did not differentiate between Candida tropicalis and Candida parapsilosis. This isolate could be identified as C. parapsilosis in a cornmeal agar preparation if it produced: A. Chlamdospores B. Dense clusters of blastoconidia regularly along the pseudohyphae C. Blastoconidia with a "logs in stream" pattern D. Satelliting "cross match stick" or "sage brush" colonies

C; Either sodium citrate or EDTA are used for ESR testing since neither will have a positive or negative effect on the rate of red blood cell sedimentation. All of the other conditions listed above can affect the ESR results.

All of the following factor(s) may increase erythrocyte sedimentation rate (ESR) values EXCEPT: a. severe anemia b. abnormal proteins (Rouleaux) c. blood drawn into sodium citrate anticoagulant d. a slanted (not perpendicular) tube e. b or d

C; The intended answer is, "The urine specimen should always be centrifuged before performing the dipstick testing." This is not the case. Urine specimens are not to be centrifuged prior to chemical reagent strip analysis.

All the following statements about the urine specimen are true EXCEPT: A. The urine specimen should be tested within two hours of collection if the specimen is stored at room temperature. B. The urine specimen should be at room temperature prior to testing. C. The urine specimen should always be centrifuged before performing the chemical reagent strip testing. D. The urine specimen must be well-mixed before performing the chemical reagent strip testing.

B; In this scenario, waist circumference, triglyceride level, and fasting blood glucose meet the criteria for diagnosis of metabolic syndrome. NCEP: ATP III criteria for diagnosis of metabolic syndrome is the presence of three or more of these components: Abdominal obesity: Increased waist circumference Men: > 40 inches Women: > 35 inches Elevated triglycerides > 150 mg/dL or drug treatment for elevated triglycerides Reduced HDL-Cholesterol (HDL-C) Men: < 40 mg/dL Women: < 50 mg/dL Elevated blood pressure > 130/85 mm Hg or drug treatment for elevated blood pressure Elevated fasting glucose > 100 mg/dL or drug treatment for elevated glucose LDL-C is not used as a determining factor in diagnosis of metabolic syndrome with the NCEP guidelines.

At medical examination, a 50-year-old Caucasian male expressed concern regarding diabetes. There is a history of type 2 diabetes, hypertension, and cardiovascular disease in his family. He has gained a few pounds each year and his physician notes abdominal obesity. His physician orders laboratory tests to evaluate his risk of cardiovascular disease. Vital Signs and Pertinent Laboratoy Results: Blood Pressure: 128/82 mm Hg Weight: 230 lbs Height: 5' 11'' Calculated BMI: 32.1 Waist Circumference: 45 inches Fasting Blood Glucose: 120 mg/dL Triglycerides: 170 mg/dL HDL-C: 42 mg/dL Which one of the following statements regarding this patient is true if the physician uses the guidlines of NCEP: ATP III Diagnostic Criteria for metabolic syndrome evaluation? A. Diagnosis of metabolic syndrome; waist circumference, HDL-C, and fasting blood glucose meet the criteria B. Diagnosis of metabolic syndrome; waist circumference, triglyceride level, and fasting blood glucose meet the criteria C. Does not meet the criteria for diagnosis of metabolic syndrome because the HDL-C is not <40 mg/dL D. Cannot make conclusion regarding metabolic syndrome because the LDL-C was not assayed

C; Sodium citrate is used for all routine coagulation procedures. Citrate binds to the calcium in the blood sample, preventing the coagulation cascade from achieving clot formation.

Choose the anticoagulant most commonly used for routine coagulation testing: A. EDTA B. Calcium binitrate C. Sodium citrate D. Sodium heparin

C; In order to diagnose acute leukemia, the FAB system requires 30% of non-erythroid blasts to be present in the bone marrow/peripheral blood, while the WHO system requires the presence of 20% non-erythroid blasts.

Classification of acute leukemia in the United States relies on two main systems, the FAB (French American British) and the WHO (World Health Organization) classifications. In order to diagnose acute leukemia, the FAB system requires ______% of non-erythroid blasts to be present in the bone marrow/peripheral blood, while the WHO system requires the presence of ________% non-erythroid blasts. A. 40%, 20% B. 30%, 20% C. 20%, 30% D. 20%, 40%

C; You must leave the tube at room temperature since refrigerating, freezing, or incubating the specimen at 56 degrees will destroy Neisseria meningitides (if present). The sample should not be thrown away.

If CSF tubes numbered #1, #2 and #3 CANNOT be analyzed within one hour, the correct procedure for the microbiology sample tube is to: A. discard it B. freeze it C. leave it at room temperature D. incubate in a 56 degree water bath E. refrigerate it

C; Ion-selective electrodes are not completely ion-specific. All are sensitive to some other ions to some extent.

Ion selective electrodes are called selective rather than specific because they actually measure the: A. activity of one ion only B. concentration of one ion C. activity of one ion much more than other ions present D. concentration and activity of one ion only

C; Beta thalassemia demonstrates problems with beta globin chain production. One or two loci that code for the beta chain may be deleted from chromosome 11. The greater the number of loci deleted or inactivated, the greater the severity of the anemia which develops.

How is beta thalassemia defined? A. The production of an abnormal form of hemoglobin due to the substitution of an amino acid in the beta chain. B. A decrease in the rate of production of Hb A due to a substitution of an amino acid in the beta chain. C. A decrease in the rate of production of beta chains due to a partial or total deletion of loci from chromosome 11 that code for the beta chain.

C; The Mean Cell Volume, or the MCV, can be calculated by dividing the hematocrit by the red blood cells and multiplying by 10. The MCV describes the volume, or size, of the red blood cell population.

How is the Mean Cell Volume calculated? A. (Hemoglobin / Red blood cells) X 10 B. (Hemoglobin / Red blood cells) X 100 C. (Hematocrit %/ Red blood cells) X 10 D. (Hematocrit % X Hemoglobin) X 100

A & C; In this cytospin sample of CSF, the cells that must be included on the report include: metamyelocytes and nucleated red blood cells (NRBCs).

Identify all the significant cell types in this cerebrospinal fluid cytospin. A. Nucleated red blood cells (NRBCs) B. Neutrophils C. Metamyelocyte D. Tumor cells

D; The large foamy cells in the joint fluid are synovial lining cells.

Identify the large, foamy cells in the joint fluid image shown to the right. A. Macrophage B. Bronchial lining cells C. Tumor clump D. Synovial lining cells

A; Waxy casts appear smooth and homogeneous, and highly refractile. They are present in patients with severe renal failure, and can be due to allograft rejection.

Identify the urine sediment elements shown by the arrow: A. Waxy casts B. Coarse granular casts C. Renal tubular epithelial casts D. Fine granular casts

D; Ionized calcium is important in physiologic functions such as coagulation and neuromuscular conductivity.

Which of the following forms of calcium is biologically active: A. Protein-bound calcium B. Non-ionized calcium C. Calcium carbonate D. Free ionized calcium

A; NMR (nuclear magnetic resonance) uses high energy magnetic fields and radio waves. This technology involves the absorption of electromagnetic energy (radio waves) by the nuclei of atoms placed in a strong magnetic field. The nuclei of different atoms absorb unique frequencies of radiation. By observing which frequencies are absorbed and emitted, it is possible to identify analytes like lipids. The other tests listed do not require magnetic radiation.

Exposing serum or plasma to a high magnetic field is neccessary for which of the following technologies or tests? A. NMR particle count B. LDL electrophoresis C. Immunoassay

A; The LH surge is required for ovulation. In fact, 24-36 hours after the Luteinizing Hormone surge, the follicle releases an ovum, which is called ovulation. After ovulation, the corpus luteum produces large amounts of progesterone while estrogen levels are also increased in order to prepare the uterus for a possible pregnancy.

Hormonal variation throughout the menstrual cycle typically shows: A. an abrupt rise in LH 24-36 hours prior to ovulation B. progesterone peaking at ovulation then falling C. estrogen peaking at ovulation then falling

D; Accuracy is defined as how close an assayed value is to the actual value of an analyte.

How close the assayed value of an analyte is to its actual value is a reflection of: A. Precision of the assay B. Reproducibility of the assay C. Sensitivity of the assay D. Accuracy of the assay

C; Finding compatible blood for a patient with an antibody to a low-frequency antigen would be easy since these antigens are present in less than ten percent of the population. Identification of the antibody would be difficult since most of the low-frequency antigens are not present on antibody panels. This prevents the antibodies from being detected.

If a patient has an antibody to a low-frequency antigen like Kpa or Jsa, how would this impact the ability to find compatible blood and to identify the antibody? A. Difficult to find compatible blood because everyone has the antigen and difficult to identify the antibody B. Difficult to find compatible blood but easy to identify the antibody C. Easy to find compatible blood but difficult to identify the antibody D. Easy to identify the antibody and easy to find compatible blood

D; R1R1 (DCe/DCe) cells are positive for the D antigen, which is the most immunogenic antigen of the Rh system, followed by c and E.

If an Rh negative patient is administered a unit of R1R1 packed red cells, which one of the following antibodies would be most likely to develop: A. Anti-c B. Anti-E C. Anti-e D. Anti-D

C; A simple way to calculate platelet counts on the hemacytometer is to multiply the average platelet count between the two sides of the chamber by 1,000. In this case 68 x 1,000 = 68,000 platelets. The longer derivation is as follows: The standard dilution of blood for platelet counts is 1:100; therefore the dilution factor is 100. The volume of diluted blood used is based on the area and depth of the counting area. The area counted is 1 mm2 per side (since we are using the average platelet count, we only use the area of one side) and the depth factor is 10. ((Total number of cells counted x dilution factor x depth factor(mm)) / area in mm2) = platelets per mm3

If the dilution is 1:100, and the average platelet count from both sides of the hemacytometer counting chamber in 2 mm2 is 68, what is the calculated platelet count? A. 680,000/mm3 B. 6,800/mm3 C. 68,000/mm3 D. 680/mm3 E. 34,000/mm3

D; Inadequate cell washing will lead to unbound antibody remaining in the red cell suspension. This residual unbound antibody would be available to neutralize the AHG (Coombs serum) so it will not react with red cells bound with antibody.

In performing an AHG test it is important to completely wash the red cells in order to: A. eliminate concentrations of unbound antigens B. prevent elution of cell-bound antibody C. eliminate false positive effects of Rouleaux D. avoid neutralization of the anti-human globulin serum

D; In tissues infected with Histoplasma capsulatum, the fungus is usually intracellular. Microscopic morphology of Histoplasma capsulatum can be described as large, round, single-celled macrocondidia with microconidia present on hyphae. According to the CDC, " Histoplasma capsulatum, a dimorphic fungus that causes human disease, is endemic in North and Central America, particularly in the region of the Ohio and Mississippi River valleys. Humans are infected by inhalation of the mycelial fragments and microconidia of the organism."

In tissues infected with Histoplasma capsulatum, which of the following is usually true? A. hyphae usually invade blood vessels B. encapsulated yeast cells are typical C. conidiophores with metulae and phialides are typical D. fungus is usually intracellular

A; Increased alpha-fetoprotein levels in adults is usually associated with hepatocelluar carcinoma, as it is a tumor maker in this population. Alcoholic cirrhosis, megaloblastic anemia, and mutliple myeloma would not cause an increase in serum AFP.

Increased concentration of alpha-fetoprotein (AFP) in adults are most characteristically associated with: A. Hepatocellular carcinoma B. Alcoholic cirrhosis C. Megaloblastic anemia D. Multiple myeloma

D; The isoenzyme CK-MB is fairly cardiac specific. It is elevated within 6 to 8 hours of a myocardial infarction, and remains elevated for about 2 to 3 days post infarction.

Increases in the MB fraction of CK is associated with: A. Liver disease B. Bone disease C. Kidney failure D. Myocardial infarction

A; About 5 - 10% of persons infected with M. tuberculosis, who are not treated, will develop tuberculosis disease during their lifetime.

Individuals with latent tuberculosis infections (LTBI) harbor viable Mycobacterium tuberculosis organisms, but have no symptoms of disease and are not infectious. Approximately what percentage of persons with LTBI who are not treated will develop active disease at some point? A. 5 - 10% B. 30 - 40% C. 50 - 60% D. 70 - 80%

In order for the ANA test to be positive there must be a clearly discernible pattern in the nucleus of the interphase cells. Metaphase mitotic cells are used to assist in identification of the ANA pattern. This pattern is homogeneous. This pattern is characterized by smooth staining in the nucleus of the interphase cells (a). The nucleoli may or may not stain. Notice the smooth staining in the chromosomal area of the metaphase mitotic cells (b).

Is antinuclear antibody (ANA) testing pattern shown homogeneous? Note: (a) points to the nucleus (nuclei) of the interphase cell(s), the primary consideration for discerning the ANA pattern and (b) indicates the metaphase mitotic cells. Observing the chromosomal area and cytoplasm of the metaphase cell may assist in identification of the ANA pattern.

No; this pattern has no clearly discernable pattern in the nucleus of the interphase cells (a). However, there is a discernable pattern staining in the cytoplasm (b). This pattern is characteristic of anti-golgi antibodies. In order for the ANA test to be positive there must be a clearly discernible pattern in the nucleus of the interphase cells. Metaphase mitotic cells are used to assist in identification of the ANA pattern.

Is antinuclear antibody (ANA) testing pattern shown homogeneous? Note: (a) points to the nucleus (nuclei) of the interphase cell(s), the primary consideration for discerning the ANA pattern and (b) indicates the metaphase mitotic cells. Observing the chromosomal area and cytoplasm of the metaphase cell may assist in identification of the ANA pattern.

No; this pattern is nuclear membrane. This pattern is characterized by smooth staining in the nucleus of the interphase cells (a). The nucleoli may or may not stain. Notice however the chromosomal area of the metaphase mitotic cells is negative (b). In order for the ANA test to be positive there must be a clearly discernible pattern in the nucleus of the interphase cells. Metaphase mitotic cells are used to assist in identification of the ANA pattern.

Is antinuclear antibody (ANA) testing pattern shown homogeneous? Note: (a) points to the nucleus (nuclei) of the interphase cell(s), the primary consideration for discerning the ANA pattern and (b) indicates the metaphase mitotic cells. Observing the chromosomal area and cytoplasm of the metaphase cell may assist in identification of the ANA pattern.

1. B 2. A 3. D 4. C Hemosiderin deposits would indicate a previous SAH. As red blood cells degenerate further, the breakdown products are seen in macrophages as dark, granular, iron-laden hemosiderin deposits. Neutrophilic pleocytosis may be seen with bacterial meningitis. The presence of NRBCs in the CSF would point to bone marrow contamination of the CSF sample. Bone marrow contamination of the CSF can occur if a vertebral process, which is part of the spinal column vertebra, is nicked or pierced when performing the lumbar puncture. Lymphocytic pleocytosis may indicate viral meningitis.

Match the conditions listed below with the elements that may be seen on a stained CSF smear when this condition is present. 1. Hemosiderin deposits 2. Neutrophilic pleocytosis 3. Nucleated red blood cells (NRBCs) 4. Lymphocytic pleocytosis A. Bacterial meningitis B. Previous subarachnoid hemorrhage (SAH) C. Viral meningitis D. Bone marrow contamination of the CSF

D; Diazotized sulfanilic acid (diazo reagent) reacts with bilirubin to produce colored azodipyrroles, which are measured spectrophotometrically.

Most common methods for measuring bilirubin are based on the reaction of bilirubin with: A. Methyl alcohol B. Neural salts C. Bilirubin oxidase D. Diazo reagent

A; Thawed Fresh Frozen Plasma can be stored at 1 - 6oC for 1 to 5 days. It should be relabeled as "Thawed Plasma" and used for replacement therapy only in patients requiring stable clotting factors.

Once Fresh Frozen Plasma has been thawed at 30 - 37oC, it should be stored at what temperature? A. 1-6 ºC B. 30 - 37 ºC C. 20 - 24º C D. 45- 56º C

B; The eAG for a HbA1C of 7.5% would be reported as 169 mg/dL eAG. Remember, the formula for conversion of HbA1C to glucose in mg/dL is eAG = (28.7 x A1C) - 46.7. So, in this case, the calculation is: eAG = (28.7 x 7.5) - 46.7 = 168.55 mg/dL.

The formula for conversion of HbA1C to glucose in mg/dL is eAG = (28.7 x A1C) - 46.7. The HbA1C measured on a patient is reported as 7.5%. What would be reported as the estimated average glucose (eAG) for this % A1C (rounded to the nearest whole number)? A. 142 mg/dL B. 169 mg/dL C. 200 mg/dL

D; Alpha-fetoprotein is protein that is measured in pregnant women, using maternal blood or amniotic fluid, as a screening test for a subset developmental abnormalities: it is principally increased in open neural tube defects and decreased in Down syndrome. Amniotic fluid creatinine has been used to measure fetal maturity as has the L/S ratio. The sweat chloride test is used for cystic fibrosis evaluation.

The laboratory test used to determine the presence of neural tube defects is: A. L/S ratio B. Amniotic fluid creatinine C. Sweat chloride test D. Alpha-fetoprotein

B; The purpose of C3a, C4a, C5a, the split-products, of the complement cascade is to cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils. C3a, C4a and C5a, bioactive fragments of the complement components C3, C4 and C5, respectively play a key role in mediation of immunologically provoked inflammatory responses. C4a production results from classical pathway activation while, C3a and C5a are produced by the activation of the classical pathway and/or the alternative pathway.

The purpose of C3a, C4a, C5a, the split-products of the complement cascade, is to: The correct answer is highlighted below bind with specific membrane receptors of lymphocytes and cause release of cytotoxic substances. cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils. bind with membrane receptors of macrophages to facilitate phagocytosis and the removal of debris and foreign substances. regulate and degrade membrane cofactor protein after activation by C3 convertase.

C; The mature eggs of Ascaris lumbricoides are readily visible at both 10X and 40X dry. The organism size as well as the presence of an outer albuminous coating help to identify the egg.

This suspicious form, shown below at both low (10X) and high dry (40X) power, measures 90 micro meters by 42 micro meters. It was seen in a stool sample. A. Hookworm egg B. Pseudoparasite C. Ascaris lumbricoides egg D. Diphyllobothrium latum egg

False; For some drugs, such as ampicillin, the range between the minimum effective concentration and the toxic concentration is large. These drugs are thus relatively safe. Drugs that have a very narrow therapeutic window need to be monitored by TDM.

True/False A drug that is readily cleared and has a wide therapeutic window, such as ampicillin, should always be monitored by TDM.

False; The MIC susceptibility test results obtained for penicillin also are predictive for ampicillin, cefotaxime, imipenem, and other beta-lactam antibiotics, precluding the necessity for performing specific tests against these drugs.

True/False Minimum inhibitory concentration (MIC) susceptibility tests should be performed against other beta lactam antibiotics on important S. pneumoniae isolates from blood cultures and other sterile body fluids when a MIC for penicillin is performed.

True; The immune response to the D antigen does vary significantly among Rh negative persons. For example, some Rh-negative individuals produce anti-D after exposure to as little as 0.1 mL of D-positive red cells, yet almost one third of Rh-negative people do not produce anti-D, regardless of volume or number of exposures.

True/False: The ability to produce anti-D varies significantly among Rh negative individuals.

True; Xanthochromia may be observed in the cerebrospinal fluid of premature infants. Reasons for this include: Immaturity of the blood-brain barrier Elevated protein in CSF Elevated bilirubin in the blood

True/False: Xanthochromia in a premature infant may be due to an immature blood-brain barrier.

D; A and B subgroups, and antigen depression due to leukemia may cause unexpected negative reactions during forward typing. Hypogammaglobulinemia may cause an unexpected negative reaction during reverse typing. Acquired B antigen due to intestinal cancer is the only option listed that can cause an unexpected positive reaction during forward ABO typing.

Unexpected positive reactions encountered during forward ABO typing may be due to: A. A or B subgroups B. Antigen depression due to leukemia C. Hypogammaglobulinemia D. Acquired B antigen due to intestinal cancer

A-D; The offspring from this set of parents can yield each blood type: OO, AO, BO, AB. This can be determined by the utilization of a simple punnett square. There is a 25% chance for inheritance of each blood type.

What are the possible ABO genotypes of offspring of parents whose genotype is AO and BO: A. OO B. AO C. BO D. AB

C; Escherichia coli and Pseudomonas aeruginosa make excellent quality control choices for the oxidase production test, as P. aeruginosa is oxidase positive, while E. coli is oxidase negative.

What is the BEST stock culture for quality control testing of oxidase production? A. Escherichia coli/Klebsiella pneumoniae B. Salmonella typhimurium/Escherichia coli C. Escherichia coli/Pseudomonas aeruginosa D. Proteus mirabilis/Escherichia coli E. Bacillus anthracis/Bacillus subtilis

A; The identifying characteristic of Aureobasidium pullulans is the production of a black yeast-like colony

What is the identifying characteristic of Aureobasidium pullulans? A. The production of a black yeast-like colony B. The production of polar germ tubes C. The production of urn-shaped phialides

B; If ABO reactions are missing, repeat testing with extended incubation at room temperature or 4oC is recommended. ABO antigen expression may be weakened in some disease states.

What should be done if all forward and reverse ABO results are NEGATIVE? A. perform additional testing with anti-A1 Lectin and anti-A,B B. incubate at room temperature or 4°C to enhance weak expression C. perform testing with new reagents and retype D. perform an antibody screen E. use LISS for cell suspensions

B; RBC casts may appear as brown to almost colorless. Red cells can clearly be seen within the cast. This type of cast is diagnostic of glomerular disease or intrarenal bleeding.

What type of cast is shown in the illustration? A. WBC cast B. RBC cast C. Waxy cast D. Granular cast

D; Pilocarpine actually stimulates sweat glands, which helps to induce sweat secretion during a sweat chloride test via iontophoresis.

When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to: A. clean the skin area B. complex with chloride C. stimulate nervous system D. induce the sweat secretion

B; Most acute phase proteins are produced in the liver by hepatocytes in response to tissue damage.

Where are most acute phase proteins synthesized? A. Bone Marrow B. Hepatocytes C. Intestines D. Spleen

D; The innate immunity system is inherent and nonspecific; meaning that all pathogens are attacked similarly. The skin, mucus in respiratory tracts, acid pH, and others are all examples of the innate immunity system that the body has to prevent infection upon first exposure.

Which branch of the immune system has an immediate response on first exposure to a foreign antigenic stimulus? A. Cell Mediated B. Specific C. Humoral D. Innate

B; Both cTnI and cTnT are components of the regulation of myocyte contraction.

Which cardiac biomarker is a regulator of myocyte contraction? A. Myoglobin B. cTnT C. CK-MB D. CK-MB isoforms

A; In the US, Caucasians of Celtic descent have the highest incidence of hereditary hemochromatosis.

Which ethnic group has the highest incidence of hereditary hemochromatosis in the United States? A. Caucasians of Celtic descent B. African Americans C. Persons of Mediterranean descent D. Hispanics

D; Immunoglobulins of the IgG class are able to cross the placenta since they circulate as monomers; thus they are small in size. The other types of immunoglobulins are too large to cross the placental barrier, for example, IgM is a pentamer.

Which immunoglobulin class is able to cross the placenta from the mother to the fetus? A. IgA B. IgD C. IgE D. IgG E. IgM

D; The amplification of DNA for northern blot is not an application of real-time PCR. However, real-time PCR can be used to: diagnose infectious diseases, measure gene transcription, measure drug therapy efficacy, and more. In contrast to regular reverse transcriptase-PCR and analysis by agarose gels, real-time PCR gives quantitative results. An additional advantage of real-time PCR is the relative ease and convenience of use compared to some older methodologies

Which is not an application of real-time PCR? A. Diagnosis of infectious diseases B. Measurement of gene transcription C. Drug therapy efficacy D. Amplification of DNA for northern blot

B; Resistance to electrical current is dependent on the skin's thickness and moisture. Wet skin can reduce the contact resistance of the body. Contact with ground wires or increased CO2 in the air does not have an affect on the amount of current needed to cause an electricity-induced injury.

Which of the following can reduce the contact resistance of the body and lower the amount of current needed to cause electricity-induced injury? A. Ground wires B. Wet skin C. More carbon dioxide in the air D. All the above

D; Using capped tubes or utilizing a centrifuge with rotor covers will greatly reduce the risk of aerosol production during centrifugation.

Which of the following does the most to minimize aerosol production during centrifugation? A. using a refrigerated centrifuge B. using centrifuge tubes with tapered bottoms C. decreasing rotor speed and increasing centrifuge time D. using stoppered centrifuge tubes or a cover over the rotor chamber

C; PCR can be modified for the amplification of RNA with one additional step prior to the PCR process - the addition of a retrovirus enzyme called reverse transcriptase. The reverse transcriptase is used to create a copy of DNA using the original RNA specimen. This method is used for many viruses, such as HIV, that have an RNA genome. RT-PCR is extremely advantageous for many reasons. First, one can use a blood sample of less than 1 mL which makes it available to test and monitor neonates.Second, RT-PCR can detect infection in individuals before antibodies appear. In addition to HIV, RT-PCR is the primary mode for the detection and monitoring of hepatitis C.RT-PCR is also used for identifying Mycobacterium tuberculosis and cytomegalovirus (CMV). RT-PCR is commonly combined with real time PCR.

Which of the following is NOT true about real-time RT-PCR? The correct answer is highlighted below A. It is the most sensitive method for evaluating RNA B. It requires the least amount of initial product C. It does not require the use of reverse transcriptase D. Can detect infection before antibodies appear

A; Theophylline belongs to a class of medications called bronchodilators, used in treating asthma and other airway diseases. Digoxin is used to treat heart failure and abnormal heart rhythms (arrhythmias). Phenobarbital is a barbiturate which is used to help prevent seizures. Amitriptyline is an antidepressant medication.

Which of the following is a bronchodilator used to treat a 39-year-old male asthmatic patient? A. theophylline B. digoxin C. phenobarbital D. amitriptyline

A; In the classic Bombay phenotype, two hh genes are inherited at the H locus and there is no H antigen produced. Without H antigen, there is no way for additional sugar attachment to take place. Additional sugar attachment is necessary for the development of A and B antigens. Therefore, without H antigen, there is no development of A and B antigens.

Which of the following is true of the classic Bombay phenotype? The correct answer is highlighted below Two hh genes are inherited at the H locus H substance is present A antigen is present B antigen is present

B; After 18 hours of incubation on SBA at 35°C, the slightly undulate margin of B. anthracis may show curling, displaying a so-called "Medusa head" appearance. This characteristic is also described as comma-shaped protrusions. A distinguishing characteristic of Yersinia pestis is its preference and faster growth that occurs at 25°C. At 24 hours of incubation on SBA at 35°C, colonies are only pinpoint and translucent with a gray-white color. F. tularensis can grow poorly or not at all on SBA, producing only tiny, pin-point, translucent colonies at best after 18-24 hours. This organism prefers cystein-enriched media such as chocolate (CHOC), Thayer-Martin (TM), and buffered charcoal-yeast extract (BCYE). It would be difficult to see individual colonies on SBA growth that is less than 24 hours old.

Which of the following organisms display the characteristic "Medusa head" on sheep blood agar (SBA) after 18 hours of incubation at 35°C? The correct answer is highlighted below A. Yersinia pestis B. Bacillus anthracis C. Francisella tularensis

D; Allogenic donation is also known as homologous donation. In this procedure, donor blood products are collected for transfusion and given to a random (non-directed) patient in need.

Which of the following refers to the most common procedure for donating whole blood for use by the general population: A. Autologous donation B. Hemapheresis C. Directed donation D. Allogenic donation

D; Mueller-Hinton agar is the standard medium for Kirby Bauer testing on Staphylococcus isolates. The direct colony suspension method, utilizing a 0.5 McFarland standard, should be used to prepare the inoculum. A full 24-hour incubation is required. A 30 µg cefoxitin disk is recommended to detect mecA mediated resistance. Incubation above 35°C may not allow for the detection of resistance.

Which of the following scenarios represents appropriate detection of MRSA by the Kirby Bauer method? A. Mueller-Hinton agar (MHA); direct colony suspension; 37oC; cefoxitin disk; 24 hour incubation B. MHA; direct colony suspension; 35oC; oxacillin disk; 24 hour incubation C. MHA; direct colony suspension; 35oC; cefoxitin disk; 18 hour incubation D. MHA; direct colony suspension; 35oC; cefoxitin disk; 24 hour incubation

A,B,& E; Serum bilirubin testing would not be done as part of the immediate investigation of a possible hemolytic transfusion reaction. Peak levels of bilirubin occur 5 to 7 hours after transfusion. Gram stain would be useful if bacterial contamination of the donor blood were suspected. This would not be a hemolytic transfusion reaction.

Which of the following steps should be taken in the IMMEDIATE investigation of a potential hemolytic transfusion reaction? (choose all that apply) A. ABO and DAT on the post-transfusion patient sample B. Check for a clerical error C. Serum bilirubin test D. Gram stain the recipient's supernatant plasma E. Visual examination of the post-reaction and pre-reaction (if available) plasma for hemolysis

C; The cell indicated by the arrow is a ringed sideroblast. If siderotic granules form a ring around at least half the periphery of the nucleus of a nucleated red blood cell, the cell is referred to as a ringed sideroblast.

Which of the following terms most accurately identifies the cell indicated by the arrow in this bone marrow slide that was stained with Prussian blue iron stain? A. Siderocyte B. Sideroblast C. Ringed sideroblast

C; Turnaround time studies provide objective data and are therefore the best sources for identifying opportunities to improve timeliness of laboratory testing. Complaints from physicians, incident reports, and surveys of patient satisfaction are all subjective and may identify a trend, if there are multiple data identifying the same issue. However, turnaround times provide data that can be studied objectively to determine performance improvement.

Which of the following would be the BEST data source to identify opportunities to improve timeliness? A. Complaints from physicians B. Incident reports C. Outliers in turnaround time studies D. Surveys of patient satisfaction

C; Platelet satellitism is a rare situation in which an IgG antibody is directed against the glycoprotein IIb/IIIa complex on the platelet membrane. The antibody-coated platelets rosette around neutrophils, causing a falsely low platelet count to be recorded with automated instrumentation. Monocytes may also show some rosetting. No antibodies are formed against Factor VIII, vWF, or fibrinogen that result in platelet satellitism.

Which one of the following is the mechanism for the production of platelet satellitism? A. An IgG antibody is directed against clotting factor VIII. B. An IgG antibody is directed against von Willebrand factor (vWF). C. An IgG antibody is directed against GP IIb/IIIA on the platelet membrane. D. An IgG antibody is directed against fibrinogen.

A; A sensitive TSH assay is now considered the most cost effective method of screening for thyroid disorders. In the absence of pituitary and hypothalamic disease, TSH is decreased in hyperthroidism. and increased in hypothyroidism, with few exceptions. Diffuse toxic goiter is a cause of primary hyperthyroidism, and would be associated with decreased TSH.

Which one of the following statements about TSH is true: The correct answer is highlighted below A. It is decreased in primary hyperthyroidism B. It is decreased in primary hypothyroidism C. A sensitive TSH assay is not a good screening test for thyroid function D. Diffuse toxic goiter is associated with elevated TSH levels.

D; Glycated hemoglobin, also known as hemoglobin A1C, is hemoglobin that has a glucose group irreversibly attached. The glycated hemoglobin can detect the average levels of glucose over a 2-3 month period of time and is frequently used to monitor the glucose levels of diabetics.

Which test is performed to assess the average plasma glucose level that an individual maintained during the previous 10 week to 12 week period? A. Plasma glucose B. Two-hour postprandial glucose C. Oral glucose tolerance D. Glycated hemoglobin E. Galactose tolerance test