MLT study guide

Acidosis

<7.35

Slide coagulase test

"Clumping factor" Based on the detection of cound coagulase.

Cluster of Differentiation (CD)

-A surface marker that identifies a particular differentiation lineage recognized by a group of monoclonal antibodies.

The risk of HbS polymerization is enhanced by what 4 thing;

-Acidic pH -Dehydration -Increased level of 2,3-DPG -Increased temp (above 37C)

MCH calculation formula

(HGB) / (RBC) x 10

MCV calculation formula

(Hematocrit %) / (RBC) x 10

What formula would you use to calculate absolute cell counts?

(Total count) X (% of cells counted)

What is the formula for calculating transferrin saturation (TS)?

(serum iron/TIBC) X 100

Which of the following cells are capable of producing antibodies? -thrombocytes -macrophages -lymphocytes -neutrophils

*B lymphocytes are responsible for humoral immunity. B lymphocytes are activated and differentiate to a plasma cell. Antibodies are them made towards the antigen initiating this response.

Characteristics of transudate effusion:

*Clear-pale yellow *Serum protein < 0.5 *LD of < 0.6 *WBC of < 1,000/ mL

Characteristics of an exudate effusion:

*Cloudy *WBC of >1,000/ mL *Serum protein ratio of >0.5 *LD of >0.6

T lymphocytes are characterized by the following functions:

*Secrete cytokines *Comprise majority of cells in blood lymphocyte pool *Help regulate immune response.

What organisms require incubation in increased CO2?

-Campylobacter -Haemophilus -Helicobacter -Moraxella catarrhalis -Mycobacterium -Pathogenic Neisseriae

Enterobacteriaceae lactose fermenters;

-Citrobacter -Escherichia -Enterobacter -Klebsiella

commonly isolated Enterobacteriaceae;

-E.coli -Shigella -Edwardsiella tarda -Salmonella -Citrobacter freundii -Klebsiella pneumoniae -Enterobacter aerogenes and cloacae -Serratia marcescens -Proteus vulgaris and mirabilis Morganella morganii -Providencia -Yersinia enterocolitica

VP-positive enterics

-Enterobacter -Serratia

Enterobacteriaceae characteristics

-Gram Negative Rod -Found in GI microflora -aerobic or anaerobic growth -Oxidase Negative -Ferments Glucose -Grows on Blood Agar -Reduce nitrate to nitrite

Staphylococci characteristics

-Gram positive cocci in grape like clusters -non motile -non spore forming -catalase positive -Faculative anaerobes

indole positive organisms;

-Most strains of E. coli, P. vulgaris, M. morganii, and Providencia

Pseudomonas aeruginosa key characteristics;

-Oxidase + -Catalase - -motile -grows @ 42C -corn tortilla odor -beta hemolytic -may be mucoid -fluorescent pigment -may be mucoid

H2S-positive enterics

-Proteus -Edwardsiella -Salmonella -Citrobacter.

PD-positive enterics

-Proteus -Morganella -Providencia

Urease-positive enterics

-Proteus -Morganella -Providencia rettgeri -Klebsiella (slow)

Cycloserine cefoxitin fructose agar (CCFA)

-SELECTIVE isolation of C. diff from stool specimens. Unlike other intestinal bacterial flora, C diff is not inhibited by CCFA.

lactose-negative Enterobacteriaceae

-Shigella -Edwardsiella -Salmonella -Citrobacter (some) -Serratia -Proteus -Morganella -Providencia -Yersinia

Nonmotile @ 35C enterics

-Shigella -Klebsiella -Yersinia (motile @ 22C)

Enterobacteriaceae non-lactose fermenters;

-Shigella -Yersinia -Proteus -Salmonella

Most common VP negative organisms;

-Streptococcus mitis -Citrobacter sp. -Shigella -Yersinia -Edwardsiella -Salmonella -Vibrio furnissii

Citrobacter appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:A/A or K/A, gas, with or without H2S -MAC: colorless @ 24 hours, may become pink at 48 hours -HEK:colorless XLD:red with black center

Klebsiella appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:A/A, gas -MAC: pink -HEK:yellow XLD:yellow

Enterobacter appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:A/A, gas -MAC: pink, may be mucoid -HEK:yellow XLD:yellow

E. coli appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:A/A, gas -MAC:flat, dry pink colony with darker pink halo -HEK:yellow XLD:yellow

Yersinia appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:A/K -MAC: colorless to peach -HEK: salmon XLD:yellow or colorless

Providencia appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:K/A -MAC: colorless -HEK:yellow XLD: colorless

Serratia appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:K/A -MAC: colorless at first, turning pink. S. marcescens may have a red pigment at room temp. -HEK:colorless XLD:yellow or colorless

Shigella appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:K/A -MAC: colorless green -HEK:------ XLD:colorless

Proteus appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:K/A (mitralis), A/A (vulgaris) -MAC:colorless, may swarm -HEK:colorless XLD:yellow or colorless, with or without black center

Morganella appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:K/A, gas -MAC: colorless -HEK: colorless XLD: red or colorless

Edwardsiella appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:K/A, gas, H2S -MAC: colorless -HEK:colorless XLD:red, yellow, or colorless with or without black centers

Salmonella appearance on selected media; TSI MacConkey Hektoen Enteric XLD

-TSI:K/a, gas, H2S -MAC: colorless -HEK:green XLD:yellow

Most common VP positive organisms;

-Viridans group strep(except S. vestibularis) -Listeria -Enterobacter -Klebsiella -Serratia marcescens, Vibrio alginolyticus

Micobacterium

-aerobic -non-spore forming -non-motile rods usually straight or slightly curved -do not gram stain well

Proteus mirabilis characteristics;

-catalase pos -indole; neg -oxidase; neg

Streptococcus anginosus;

-catalase;neg -gram pos cocci -VP;pos -arginine;pos

Helicobacter pylori characteristics;

-curved, slender, gram-neg rods -oxidase and catalase positive -rapid urease reaction -grows on chocolate agar and skirrow

Campylobacter fetus characteristics;

-curved, slender, gram-negative rods "seagulls" -inhibited at 42C -hippurate hydrolysis negative -susceptible to cephalothin -resistant to nalidixic acid

Aeromonas spp. characteristics;

-gram neg coccoid in pairs or short chains -oxidase;pos -catalase;pos -reduces nitrates -urease;neg -usually arginine; pos

Escherichia coli biochemical rxns;

-gram neg rods -catalase;pos -oxidase;neg -indole; pos -lactose, and glucose fermentor

Plesiomonas shigelloides rxns;

-gram negative rods -oxidase;pos -catalase;pos -indole;pos -lipase;neg -VP;neg -lysine-, ornithine, and arginine-decarboxylase; pos -lipase;neg

Which colony features should be immediately referred to your LRN for definitive ID?

-gram stain shows large, gram-positive rods with sub-terminal or central spores(if present) -gray colonies with a ground glass appearance -non-hemolytic on SBA -tenacious or "sticky" colonies like petroleum jelly -catalase positive -non-motile

Eikenella corrodens characteristics:

-gram-neg coccobacilli -usually doesnt grow on EMB or MAC -requires increased CO2 and hemin -may corrode agar -may produce yellow pigment -oxidase positive -catalase negative -bleach like odor

Acinobacter boichemical rxns;

-gran neg cocci or coccobacilli -strict aerobe -catalase;pos -oxidase;neg -non glucose fermentor -non-motile -citrate test;pos

Campylobacter jejuni key characteristics;

-grows on Campy-blood agar @ 42C in increased CO2. -moist, runny, spreading, nonhemolytic colonies -darting corkscrew motility -oxidase and catalase positive -hippurate and hydrolysis positivie -most common cause of diarrhea

What are the three main stages of complement activation via classical pathway?

-recognition unit -activation unit -membrane attack complex

What is the incubation period for S. aureus?

1-8 hours

What three species can the indole test differentiate;

1. Klebsiella spp. -K.oxytoca is + -K. pneumoniae is - 2. Citrobacter spp. -C. Koseri is + -C. freundii is - 3. Proteus spp. -P. vulgaris is + -P. mirabilis is - **** OK VIP**** O: oxytoca K: koseri V: vulgaris IP: indole positive

What are the parameters to be diagnosed with metabolic syndrome?

1. Reduced HDL cholesterol. Women: <50 mg/dL; Men <40 mg/dL 2. Elevated waist circumference. Women =35 inches; Men=40 inches 3. Elevated trig. level (=150 mg/dL) 4. Elevated fasting glucose (100 mg/dL) 5. Elevated blood pressure (130/85 mm Hg)

What is the incubation period for Listeria monocytogenes?

16-72 hours

What is the expiration and storage temperature of rejuvenated (non-frozen) RBCs?

24 hours; 1-6C

Severe blood loss causing circulatory collapse and shock usually first occurs when what percentage of blood is lost?

30-40% -Acute blood loss of 20% or less, in many cases, doesn't cause c;iical symptoms at rest. -Acute blood loss of 50% or more is not compatible with life.

What is the incubation period for both Salmonella spp. and Vibrio spp.?

6-48 hours

Platelets that are not collected by an apheresis method must be prepared within how many hours of the collection of whole blood.

8 hours.

The ratio of whole blood to anticoagulant is very important in the PT assay; at which hematocrit level should the standard anticoagulant volume be adjusted:

>55% -At this hematocrit concentration, the plasma volume is lower and the excess citrate binds mor calcium ions required for calcium-dependent clotting assays. This created falsely prolonged clotting times affecting the PT and APTT tests.

Alkalosis

>7.45

Which of the following Staphylococcus species will produce yellow colonies on mannitol salt agar? A. S. aureus B. S. saphrophyticus C. S. epidermidis D. S. haemolyticus

A

All of the following parasites typically survive human stomach juices EXCEPT: A. Entamoeba gingivalis trophozoite B. Endolimax nana cyst C. Balantidium coli cyst D. Entamoeba histolytica cyst

A. Entamoeba gingivalis tyophozoite -These usually reside in the gingival crevices in the gums. They typically do not infect the intestines, but if they are swallowed, the stomach juices would destroy them.

How is beta thalassemia defined?

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. The greater the number of loci deleted or inactivated, the greater the severity of the anemia that develops.

What is metabolic syndrome?

A group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.

Mycobacterium fortuitum

A microscopic germ that normally exists in tap water in small numbers. Colonies are smooth, gray-white with a waxy consistency. Acid-fast staining short and filamentous bacilli are observed microscopically in acid-fast preps. M. fortuitum causes nosocomial infections, primarily of skin at sites of trauma or scratches after contact w/ contaminated H2O.

What testing method is appropriate for identifying specific allergens?

Radioallergosorbent tests (RAST)

Electrical Impedance

A process based on the electrical resistance across an aperture when a particle in a conductive liquid pass through this aperture.

What blood can AB receive?

A, B, AB, O -if AB is not available then A should be the next chosen, then B then O.

Which group of conditions increases the risk of HbS polymerization?

Acid pH, dehydration and increased levels of 2,3-DPG, as well as an increased temperature.

A gram-negative diplococcus is isolated from a throat culture. The isolate grows on Thayer-Martin agar, produces acid from maltose, lactose and glucose & is ONPG positive. What is the most likely ID of this organism? A. N. lactamica B. N. meningitidis C. N. gonorrhoeae D. N. catarrhalis

A. N. lactamica -N.lactamica is lactose and ONPG positive while the other organisms are negative. It is a lactose-fermenter, while other options are not. Allthough it is not a pathogen, it can grow on Thayer Martin agar from throat specimens.

Are these functions of the kidneys exocrine or endocrine functions? A. regulation of hormone production b. elimination of metabolic waste products C. maintenance of blood pressure D. production of RBCs

A.endo B.exo C.endo D.endo

What blood group systems are enhanced by the use of proteolytic enzymes?

ABO/H systems **Rh Lewis I **Kidd P1PK/GLOB

Which chemical substances induces platelet adhesion when there is a break in the inert epithelial lining of the vasculature?

ADP--> adenosine diphosphate and Serotonin

what is the antistreptolysin O (ASO)?

ASO is usually utilized to determine whether a previous Strep infection has caused a pose-streptococcal disease, such as rheumatic fever, scarlet fever, or glomerulonephritis.

How many doses are requires to obtain a steady-state oscillation allowing for a peak and trough levels to be evaluated?

About 5-7 doses. After the first dose, absorption and distribution occur, followed only by elimination. Before the concentration of drug drops significantly, the second dose is given and the peak of the second dose is additive to what remains of the first doses. The third through the seventh scheduled doses all have the same effect, increasing the serum concentration and the amount eliminated. By the end of the seventh dose, the amount of the drug administered is equal to the amount eliminated during the dosage period. At this point, steady state is established and peak and trough concentrations can be evaluated.

Densitometry

Absorbance measurement that uses a densitometer to ensure the absorbance of stained compounds on a support medium or electrophoretic strip.

The ketone component that is measured by the nitroprusside reaction is:

Acetoacetic acid reacts with sodium nitroprusside to produce a purple coloe.

In a standard electrophoretic separatin, what zone appears first (anodal end) on the densitometric pattern?

Albumin. -Followed by a1-globulins, a2-globulins, B-globulins and gamma-globulins.

A vegetarian diet will most likely have what kind of pH?

Alkaline urine pH. Patients on high meat diets tend to have an acidic pH

Means that there is one flagellum at both ends of the bacterium

Amphitrichous

faculative anaerobes

An organism that makes ATP by aerobic respiration if oxygen is present but that switches to fermentation under anaerobic conditions.

What is a tegument?

An outer layer of carbohydrates and proteins that make the fluke and other worms resistant to the host organism's immune system defenses and protects against digestive enzymes in the intestinal tract

Disopyramide

Antiarrhythmic agent.

What is used to determine if a person has has a recent infection with S. pyogenes?

Antistreptolysin O (ASO)

Which subset of effector lymphocytes is predominantly responsible for regulation of antibody production? A. TH1 B. TH2 C. TH17 D. CD8+

B. TH2

What is the most specific marker for adverse ventricular remodeling or volume overload of the heart?

BNP -BNP is released in response to a variety of cardiac stresses, but most particularly cardiac stretch. It is affected by changes in volume and in cardiac performance.

What markers are currently used to differentiate heart failure from lung disease?

BNP and NT-proBNP

All of the cells listed below function as a phagocyte, EXCEPT? A. neutrophil B. eosinophil C. monocyte D. macrophage

B. eosinophil -Eosinophils respond to various parasitic and allergenic antigens, and function by releasing granules that contain potentially damaging and toxic substances to these antigens.

Positive leukocyte esterase test indicates the presence in a urine specimen of which of the following? A.lymphocytes B.granulocytes C.erythrocytes D.epithelial cells

B.granulocytes -Leukocyte esterase is an enzyme present in most hranulocytic WBCs, but is not found in the lymphs, RBCs, or epi cells.

Listeria monocytogenes

Bacterial species that is widespread in nature, commonly infecting cattle and goats that forage in open fields.

Erysipelothrix rhusiopathiae

Bacterium that causes septicemia and arthritis in swine, calves, lambs, other farm animals and wild small game.

Primidone

Barbiturate used to control seizures.

Genital culture media

Blood, chocolate, MacConkey Thayer-Martin Add THIO and anaerobic media for surgical and aspirates

wound culture media;

Blood, chocolate, MacConkey. Surgical, aspirate, or tissue: add anaerobic blood, KV, Thio

Glycogenolysis

Breakdown of glycogen to glucose

What organism produced outside a bioterrorism event causes glanders disease?

Burkholderia mallei. -Glanders is a respiratory illness that forms nodular lesions in the lung tissue and can cause ulcers leading to sepsis and death.

Which of the following viral families contains DNA as nucleic acid? A. paramyxoviridaw B. phabdoviridae C. poxviridae D. orthomyxoviridae

C

In addition to antibody, what other substances can bind to complement via the classical pathway?

C-reactive protein, several viruses, mycoplasmas, some protozoa and certain gram-negative bacteria.

In order to speciate a swarming Proteus organism found on an eosin methylene blue agar plate, the BEST approach would be to: A. inoculate to a 4% agar plate and subculture to McConkey's B. determine motility and lysine decarboxylase activity C. determine Indole production, phenylalanine and urease activity D. determine utilization of sodium acetate and citrate E. inoculate a tube of thioglycolate broth

C. -Swarming Proteus species are typically P. mirabilis and P. vulgaris. P. mirabilis is indole negative and ornithine decarboxylase positive. P. vulgaris is indole positive and decarboxylase negative

Of the parasites listed, which may be recovered in sigmoidoscopic material? A. Pseudoparasite B. Entamoeba coli C. Entamoeba histolytica D. Entamoeba polecki

C.E. histolytics -Only E. histolytica may be recovered in sigmoidoscopic material.

What is the "recognition unit" of the classical complement pathway?

C1q

Tumor marker associated with ovarian cancer:

CA-125 -it is relatively more sensitive in low-stage ovarian cancer.

Normal T cells should express what CD markers?

CD2, CD3, CD5, & CD7

tumor marker associated with colon cancer:

CEA

What is the primary hepatic enzyme involved in drug metabolism?

CYP240 -They accept a variety of substrates and so are able to metabolize diverse compounds.

What four organisms is the hippurate used to ID?

Campylobacter jejuni, Listeria monocytogenes, Gardnerella vaginalis and Streptococcus agalactiae.

What does transferrin carry?

Carries iron fromextracellylar fluid to developing RBCs.

Hemoglobin

Carries oxygen that can be released in tissue.

Clonochis sinensis

Chinese liver fluke

What kind of lipoprotein is the least dense?

Chylomicrons Then VLDL, LDL and last HDL.

Class A fire

Common Combustibles such as paper, wood, furniture, clothing

Clostridium tetani

Contracted following contamination of an existing wound or puncture from an object. C. tetani produces a neurotoxic exotoxin, tetanospasim, which disrupts nerve impulses of muscles.

Lipogenesis

Conversion of carbohydrates to fatty acids.

Glycogenesis

Conversion of glucose to glycogen for storage

What is the best component to treat a patient with fibrinogen deficiency?

Cyroprecipitated AHF(antihaemophillic factor) is the only product that contains a concentrated amount of fibrinogen. Cyroprecipate contains a minimum of 150mg of gibrinogen in each unit. It is primarily used for fibrinogen replacement in patients diagnosed with a congenital fibrinogen deficiency.

Each of the following characteristics will differentiate between Listeria monocytogenes and Erysipelothrix rhusiopathiae EXCEPT: A. Hydrolysis of esculin B. Motility C. Catalase D. Fermentation of glucose

D

Which of the following statement is true regarding lymphocyte cytoplasmic granules? A. they never contain granules in the cytoplasm. B. they contain fine primary or non-specific granules in the cytoplasm. C. they contain large secondary or specific granules in the cytoplasm D. they may contain a few azurophilic granules in the cytoplasm.

D

Fluorometers are designed so that the path of the exciting light is at a right angle to the path of the emitted light. What is the purpose of this design? A. Prevent loss of emitted light B. Prevent loss of the excitation light C. Focus emitted and excitation light upon the detector D. Prevent excitation light from reaching the detector

D -The angle is set at 90 degrees in fluorometers in order to only detect the emitted light from the sample substance after it has been excited with a light beam.

Corneal tissue transplantation has an extremely high success rate for a variety of reasons, including all of the following with the exception of: A. avascularity B. reasonably low concentration of class I antigens C. an essential absence of class II antigens D. eccentrically place grafts

D. -Eccentrically placed grafts of the cornea are subject to a high rate of immunologic failure because vascularity will allow for contact with lymphocytes that can facilitate rejection of a transplant. To prevent rejection, corneal transplants are made as small as possible and the transplant is placed centrally to avoid contact with the high vascularized limbic regions.

For granulocyte concentrations, all of the following laboratory tests must be performed on the unit by the donor center EXCEPT? A. ABO and Rh B. Red Cell Antibodies C. Infectious disease markers D. Lymphocyte enumeration

D. Lymphocyte enumeration *If it is determined that greater than 2 mL of RBCs are present in the unit, then the component should be crossmatched for Rh and HLA compatibility.

What is indicative of stage 3 iron deficiency (iron deficiency anemia)?

Decreased ferritin, increased coluble transferrin receptor (sTfR), decreased serum iron, increased TIBC, and decreased saturation percent. It also presents with a decreased hemoglobin, microcytic, hypochromic RBCs.

Hemolytic anemias are diagnoed by clinical findings and laboratory test results. All of the following are lab values that are relied on to help diagnose hemolytic anemia EXCEPT? A. hemoglobin and or hematocrit B. retic count and RBC morphology C. bilirubin and haptoglobin D. fibrinogen and C-reactive protein

D. fibrinogen and C-reactive protein

Southern blotting technique is a separation technique used for the detection of:

DNA

What is the composition of Howell-Jolly bodies?

DNA. They are thought to be nuclear remnants or aggregates of chromosomes that have separated from the mitotic spindle and remain behind after the RBC nucleus is expelled.

what is effective at denaturing Luteran antigens?

DTT dithiothreitol

What changed in potassium and sodium serum results may occur with diuretic use?

Decrease in both. Diuretics can cause hypokalemia and hyponatremia in patients through renal loss.

Turbidimetry

Decrease in incident-light intensity.

The biuret reaction for the analysis of serum protein depends on the number of:

Depends on presence of >2 peptide bonds which bonds to form a purple complex with copper salts in alkaline solution.

What drug may be used to decrease iron levels in patient with iron overload?

Desferrioxamine (DFO) -It is an iron chelating agent, may be used to reduce iron overload in patients who rely on transfusions to maintain hemoglobin levels and prevent anemia.

Nephelometry

Directly measures the amount of light scattered by particles in a solution

Pathogens of Urinary Tract

E. Coli Klebsiella Enterobacter Proteus Enterococci Pseudomonas spp S. aureus S. saprophyticus Yeast

Voltammetry

Electroanalytical method that is based on the measurement of a current that develops in an eletrochemical cell under conditions of complete concentration polarization.

What values are expected with metabolic alkalosis?

Elevated pH, increased bicarbonate, normal PCO2.

Speckled ANA pattern can be followed-up with testing for antibodies to:

Extractabke nuclear antigens (ENA) which include; Smith (Sm), U1-RNP, SSA/SSB and ScI-70.

Encompasses a group of organisms that may contain multiple genera and consists of organisms with a common attribute;

Family

Gluconeogenesis

Formation of glucose-6-phosphate from non-carbohydrate sources.

Contains different species that have several important features in common;

Genus

Identify the Neisseria species according to the specific carb. utilization profile: N. sicca

Glucose, maltose and sucrose positive only

Most of the energy needed for RBC viability is obtained through what pathway?

Glycolytic pathway -About 90-95% of the cells glucose is metabolized in this pathway, which in turn, produces ATP. One glucose molecule produces a net gain of 2 moles of ATP via this pathway.

Abmornal platelet function seen in patients with Bernard-Souiler Syndrome is cause by which of the following platelet components?

Glycoprotein Ib/IX

Stenotrophomonas characteristics

Gram negative aerobic rod -decarboxylate lysine -produces smooth, glistening yellow to tan colonies -grows well on MAC -cytochrome oxidase negative

Clostriodioides difficile

Gram positive bacilli with distinctive subterminal and central spores in Gram stain mounts. Additional key identifying reactions is the absence of lipase and lecithinase and a chartreuse pigment under flourscence light. The enhancement of growth on Cycloserine-cefoxitin-fructose agar (CCFA) provides for a presumptive ID of C. diff. C. diff will produce a yellow color, due to fructose fermentation. Beta hemolysis is not observed. Long slender gram pos. bacilli.

The infectious disease process in which large number of activated macrophages and histocytes are collected at the site of inflammation is called?

Granulomatous. If many activated macrophages and histiocytes aggregate in the area, particularly with the formation of multi-nucleated giant cells, the reaction is called granulomatous.

Phialophora verrucosa

Grows slowly, producing colonies no more than 1 cm in diameter after 7 days incubation.

eye culture pathogens;

H. influenzae S. pneumoniae S. aureus Pseudomonas

The antigen marker most closely associated with transmissibility of HBV infection is:

HBeAg -high degree of infectivity

What is the first marker to appear in HBV infection?

HBsAg -indicates an active infection

Which hemoglobin will be increased in delta-beta thalassemia?

HbF is increased. -It increased to 100% in delta-beta thalassemia major.

ONPG test

Helpful in differentiating Citrobacter(pos=yellow) from most Salmonella (neg)

MCHC calculation formula

Hgb x Hct x 100

What disease is Reed-Sternberg cells associated with:

Hodgkins lymphoma

What do cestodes use to attach to the human intesting?

Hooks or suckers

Which lipid abnormality is most closely linked to heart disease?

Hypercholesterolemia -One form of the disease, which is associated with genetic abnormalities that predispose affected individuals to elevated cholesterol levels is called familial hyperchlesterolemia.

What immunoglobulin subclass is associated with severe anaphylactic reactions?

IgA

What immunoglobulin subclass is predominately associated with the secondary antibody response?

IgG

The primary immune response to a foreign antigen is characterized by a lag period and initial production of what immunoglobulin?

IgM

What immunoglobulins can activate the classical pathway?

IgM, IgG1, IgG2, and IgG3.

Cholesterol crystals appear

In acidic urine as large, flat transparent plates with notched corners. They are soluble in hot alcohol and ether.

Cystine crystals appear

In acidic urine, are typically colorless, and have characteristic hexagonal shape. Associated with cytinuria.

passive immunity

Immunity conferred by transferring antibodies from an individual who is immune to a pathogen to another individual.

Cyclosporine

Immunosuppresive drug often used to suppress graft rejection of transplanted organs.

Uric acid crystals appear

In acidic urine and resembles yellow-brown four-sided flat planes, rosettes, or wedges.

Friedewald calculation for LDL

LDL=total cholesterol-HDL-triglycerides/5 -The calculation is considered valid, IF the triglyceride value is less than 400 mg/dl

What are the risk factors of metabolic syndrome?

Increased triglycerides, decreased HDL cholesterol, obesity, hypertension and insulin resistance.

Digoxin

Increases the force of myocardial muscle contraction.

active immunity

Is acquired by natural exposure in response to an infection or a natural series of infection, or through intentional inject of an antigen.

WHy might serum ferritin (SF) alone be considered a less than optimal screening test for hereditary hemochromatosis (HH)?

It is an acute phase reactant that is frequently elevated in a variety of clinical conditions, therefore it lacks the specificity needed for a good screening test.

If a patient has a WCB would of 40,000/ul, what would be the most useful staining procedure to distinguish between bacterial infection and chronic myelogenous lukemia (CML)?

Leukocyte alkaline phosphatase (LAP) -LAP stain is used to determine if an increase of cells is due to CML or a leukemoid reaction due to infection or similar conditions. Cells from a noncancerous reaction stainpositive with many intense blye granules; cells from CML have few blue granules

Means that there is one flagellum at both ends of the bacterium

Lophotrichous

Which of the following thyroid function assay results would you expect with hyperthyroidism?

Low TSH High free T4 -The most useful test for assessing thyroid function is the TSH. Because more than 99.9% of thyroid hormone is protein bound, alteration in the thyroid hormone-binding proteins frequently leads to total T4 and T3 levels outside of the notmal range without representing true clinical thyroid dysfunction.

The addition of LISS to the testing environment when performing an indirect antiglobulin test is designed to do what?

Lower the zeta potential.

Any unknown Mycobacteriun species that accumulates niacin can be identified as;

M. tuberculosis

What are the main functions of the distal convulated tubules?

Maintain water-electrolyte and acid-base balances. These functions are controlled by antidiuretic hormone (ADH) and aldosterone.

What are proglottids?

Major portion of the body of the tapeworm that contains the reproductive organs and often the eggs.

CD5 antigen is normally found on which of the following lymphocyte populations?

Mature T cells -cluster of differentiation or CD system was developed to identify antigens on the surface of blood cells using monoclonal antibodies in flow cytometry. CD5 is a lymphoid marker present on mature T cells, but is not present on normal B cells.

What condition is highly associated with oval-macrocytes and hypersegmented neutrophils?

Megaloblastic Anemia

The presence of an increased number of hypersegmented neutrophils in the peripheral blood is an indication of what condition?

Megaloblastic anemias

Platelet specific antigens, or HPAs, are expressed on which of the following?

Membrane glycoproteins. -They are expressed on 6 different membrane glycoproteins; GPIIb, GPIIa, BPibb, GPIa, CD109

If the bicarbonate changes, it would be considered ?

Metabolic.

Glycolysis

Metabolism of glucose molecule to pyruvate or lactate for production of energy.

Pseudomonas spp.

Micro - Gram -ve rods, strictly aerobic, highly motile with flagella Diagnosis - Non-hemolytic on BA and makes MUCOID COLONIES on conventional agar, some strains produce PYCOCYANIN and FLUORESCEIN giving it a GREEN color

To determine if an elevated aPTT is caused by a factor deficiency or a factor inhibitor when the PT is normal, the FIRST step is;

Mix one part of patient plasma and one part normal pooled plasma and repeat the aPTT. **IF the specimen "corrects", a factor deficiency should be suspected. AT this point, specific factor assays should be performed to identify and quantitate the specific factor deficiency. **IF the specimen does NOT "correct", a circulating factor inhibitor should be suspected and specific tests to identify the inhibitor should be performed.

CD antigens

Molecules originally defined as being present on the cell surface of leukocytes and recognized by specific antibody molecules, but now including some intracellular molecules and molecules present on cells other than leukocytes.

Means that there is one flagellum at one end of the bacterium.

Monotrichous

Helminths

Mticellular parasitic organisms commonly called worms or flukes

Pathogens of the genital area;

N. gonorrheae C. albicans Chlamydia Gardenrella M. hominis Ureaplasma T pallidum H. ducreyi

Gram-negative cocci that occur in pairs with their adjacent sides flattened, giving them a "coffee bean" apearance are most likely;

Neisseria species

pathogens found in CSF culture;

Newborns: E. coli, group B strep Listeria Children: H influenzae Adolescents: N. meningitidis Adults: S. pneumoniae Elderly: gramnegative rods

What blood can type O receive?

O

Denaturation

Occurs when the double-stranded DNA is split into two single strands.

Leucine Crystals appear as

Oily, highly refractile yellow to brown spheroids with radial concentric laminations. They are found in acid urine in patients with maple syrup urine disease.

natural immunity

One of the ways that the body resists infection after microorganisms have penetrated the body's first line of defense of unbroken skin and mucus membranes.

Which three hormones are known to regulate serum Ca 2+ by changing their secretion rate in response to changed in ionized Ca 2+?

PTH, Vit D & calcintonin - PTH secretion in the blood is stimulated by a decrease in the ionized Ca 2+. The active form of vitamin D increases Ca2+ absorption in the intestine and enhances the effect of the PTH on bone resorption. Calcintonin is secreted when the concentration of Ca2+ in blood increases. Calcitonin exerts it Ca2+ lowering effect by inhibiting the actions of both PTH and vit D.

What adult parasites are found in the lungs and the eggs are most commonly recovered in sputum samples?

Paragonimus spp.

Factor X

Part of the common pathway, and is activated by both intrinsic and extrinsic pathways. -Stuart-prower factor

Fungal pathogen by site: VAGINAL

Possible pathogens: -Candida

Fungal pathogens by site: SPUTUM, BRONCHIAL WASHINGS, TRANSTRACHEAL ASPIRATES

Possible pathogens: -Candida -Aspergillus -Rhizopus -Mucor -Penicillium, -Blastomyces dermatitidis -Coccidioides immitis -Paracoccidioides brasilensis -Histoplasma capsulatum, -Sporothrix shenckii

Fungal pathogens by site: URINE

Possible pathogens: -Candida -Blastomyces dermatitidis -Coccidioides immitis -Histoplasma capsulatum -Cryptococcus neoformans

Fungal pathogens by site: SKIN

Possible pathogens: -Candida Trichophyton -Microsporum -Epidermophyton

Fungal pathogens by site: THROAT

Possible pathogens: -Candida albicans -Geotrichum candidum

Fungal pathogens by site: CEREBRAL SPINAL FLUID

Possible pathogens: -Cryptococcus neoformans, Coccidioides immitis -Histoplasma capsulatum -Candida spp

Fungal pathogens by site: BLOOD/BONE MARROW

Possible pathogens: -Histoplasma capsulatum -Cryptococcus neoformans -Candida albicans -Blastomyces dermatitidis -Malassezia furfur

Fungal pathogens by site: HAIR

Possible pathogens: -Trichophyton -Microsporum

Fungal pathogens by site: NAIL

Possible pathogens: -Trichophyton, -Epidermophyton -Candida -Aspergillus

Pasteurella maltocida

Prevalent bacterial species inhabiting the oropharynx of cats and dogs. Humans can become infected through bites or scratches of these animals, particularly from the scratches of cats that habitually preen themselves with their own salivary secretions.

Insulin

Primary hormone responsible for the entry of glucose into the cell. The release of insulin causes an increase in glycogenesis, an increase in glycolysis, and an increase in lipogenesis.

Radioallergosorbent test (RAST)

Procedure that detects the presence of IgE (and IgG) antibodies to allergens; a method used to measure antigen-specific IgE by means of a noncompetitive solid-phase immunoassay.

Electroosmosis

Process of the mothion of a liquid when a voltage is applied between the ends of an insulating tube that contains that liquid.

Recombination

Process that occurs when new genetic combinations are created by mixing existing genes.

Northern blotting is a separation technique used for the detection of:

RNA

Correct order of erythrocyte maturation in the bone marrow

Pronormoblast, basophilic normoblast, polychromaophilic normoblast, orthochromic normoblast, polychromatoohilic erythrocyte

Western blotting is a special separation technique used for:

Proteins

Molecules in order from most antigenic/immunogenic.

Proteins, carbs, lipids, nucleic acids. Nucleic acids are usually not antigenic.

Organisms that swarm on 5% SBA, exhibit a haracteristic odor and are oxidase negative can be presumpitively ID's as;

Proteus spp. -with further testing by spot indole, the + isolates may be presumptively reported as P. vulgaris and negative ones as P. mirabilis

Abiotrophia defectiva and Granulicatella adiacens are the names given to two specie of what were previously called nutritionally variant streptococci (NVS). What supplement must be added to blood culture medium to recover these organisms in cases of "culture negative endocarditis?"

Pyridoxyl

Which of the following abnormal WBC is most commonly found in a peripheral smear of a patient with infectious mononucleosis?

Reactive lymphs -usually starting about one week after symptoms begin.

The term TITER ( as it applies to the measurement of antibodies) is best defined as:

Reciprocal of maxium reactive dilution of the patient's serum where the antibody is still detectable.

Primary hemostasis

Refers to role of platelets in hemostasis. Platelet studies are helpful in assessing disorders of primary hemostasis.

Secondary hemostasis

Refers to the role of clotting factors to form fibrin clots. The PT and APTT are the most common screening tests used to assess secondary hemostasis.

If the carbon dioxide changes, it would be considered?

Respiratory.

wound culture pathogens;

S. aureus, betahemolytic strep, enteric, P. aeruginosa.

ear culture pathogens;

S. pneumoniae H. influenzae Group A strep M. catarrhalis

pathogens of stool

Salmonella Shigella Campylobacter Diarrheogenic E. coli Aeromonas Plesiomonas Y. enterocolitica Vibrio e

Middlebrook agar

Selective for mycobacteria

MacConkey Sorbitol Agar

Selective medium for E. coli O157:H7 does not ferment sorbitol. Colonies are colorless.

Bordet-Gengou agar

Selective medium used for the isolation of Bordetella species.

Kernicterus is associated with

Severe cases of jaundice.

Phenobarbital

Slow-acting barbiturate that effectively controls several types of seizures.

Bacteroides fragilis

Small, spherical, entire and non-spreading, gray and non-hemolytic on anaerobic blood agar. Small, gram negative coccobacilli with rounded ends. Spore production is not observed. Indole negative, bile and esculin positive, and has the ability to grown on KV anaerobic agar.

When criteria suggest that a patient is suffering from Systemic Lupus Erythematosus (SLE), the presence of which antibodies is the most important?

Smith (Sm) and SS-A/SS-B+

cytokine

Soluble proteins that regulate the innate and adaptive immmune response to an antigen. They are produced by WBCs and other cell types, and acts in conjunction with other cytokines to generate a network of interactions that influences an immune response.

Can be defined as a collection of bacterial strains that share common physiologic and genetic features and differ notable from other microbial species;

Species

In the process of thrombopoiesis, what is the order from least mature to most mature?

Stem cell, megakaryoblast, promegakarocyte, megakarocyte, thrombocyte

Estimation of hyaluronic acid for viscocity is useful in evaluating what type of body fluids?

Synovial (joint) fluid

What is the pork tapeworm. Typically the eggs are seen in the stool of infected patients.

Taenia solium

The D-dimer is useful in detecting activity in which aspect of hemostasis?

The D-dimer is a measure of fibrinolysis, or the breakdown of clots. The D-dimer is a specific fragment of the degradation of a fibrin clot.

Who should a technologist contact if an organism is isolated that cannot be ruled out as a potential agent of bioterrorism?

The Laboratory Response Network (LRN) reference labratory. -The lab should should NOT make the decision that a bioterrorism event has occured.

What is the strobila?

The body of a tapeworm, excluding the head and neck region.

Endocytosis

The cell membrane invaginates and forms vesicles to isolate foreign particles. A mechanism for viruses to enter cells.

CSF is produced in:

The choroid plexuses of the two lumbar ventricles and the third and fourth ventricles. Subarachnois is the space where CSF flows and its located between the arachnoid and pia matter.

Recognition unit

The complement component that consists of the C1 qrs complex. This must bind to at least two Fc regions to initiate the classical complement cascade.

When considering TDM, what is the definition of bioavailability?

The fraction of the administered dose that eventually reaches its site of action.

Hybridization

The pairing or annealing of two strands of DNA.

Glycosuria

The presence of glycose in the urine. It most commonly results from diabetes mellitus and impaired tubular reabsorption, ut may also occur in Fanconi's syndrome, pregnancy, and in patients taking adrenocorticosteroids among other conditions.

Glucagon

The primary hormone responsible for increasing glucose levels in the blood. Glucagon increases plasma glucose levels by increasing glycogenolysis and increasing gluconeogenesis.

Troponin I (TnI) inhibits the binding of:

actin and myosin

Amphetamine and methamphetamine are used for:

Theraputic drugs used for narcolepsy and attention deficit disorders.

Group II Discrepancies

These occur when there is an unexpected reaction in the forward grouping and is less frequent in occurrence. Diseases such as leukemia, acquired B phenomena, Hodgkins, etc. This can be resolved via incubation and cell washing.

What temperature do Bense-Jones proteins precipitate and redissolve?

They precipitate between 40 and 60 C and redissolve at 100 C.

Chloroquine diphosphate (CDP) is used for what in blood banking?

To remove IgG bound to red cells that were detected from a positive DAT. These treated RBCs can then be used to autologous adsorption and/or to determine the patient's RBC phenotype.

Normal crystals that can be found in urine include:

Tripe phosphate They are found in highly alkaline urine and look like colorless coffin lids under the scope

Which troponin protein binds the troponin complex to tropomyosin?

Troponin T (TnT)

adaptive immunity

Type of body defense. If a microorganism overwhelms the body's natural, innate resistance, a third line of defense exists, adaptive immunity.

7H10 Agar

Used for the growth of mycobacterium species

CD34

Used for the quantification of hematopoietic progenitor cells (HPC) after an APC-apheresis collection. HPC's are CD34+ and after an HPC-apheresis collection, the number of CD34+ cells are quantified to ensure that there are sufficient cells for successful engraftment.

Yersinia enterocolitica

Usually transmitted from pet feses (e.g., puppies), contaminated milk, or pork. Outbreaks are common in day-care centers. Sx can mimic Crohn's or appendicitis.

WHat factor is needed for H. parahaemolyticus?

V only

What factor is needed for H. parainfluenzae?

V only

Correct sequence of the Epstein-Barr virus (EBV) response in infectious mononucleosis? KEY: *VCA=viral capsid antigen *VCA/IgM=viral capsid antibody (IgM) *EA=early antigen *EBNA=Epstein-Barr nuclear antigen

VCA/IgM, EBNA, VCA, EA

What factor deficiency shows a normal aPTT and abnormal PT? A. IX B. VII C. VIII D. X

VII

Zero order kinetics

When the reaction rate depends only on enzyme concentration.

What percentage difference is glucose whole blood vs. plasma?

Whole blood is 11% lower than plasma.

What factor is needed for H. haemolyticus?

X AND V

What factor is needed for H. influenzae?

X AND V

What factor is needed for H. ducreyi?

X only

What platelet component causes Gray platelet syndrome?

a(alpha)-granule deficiency

Expected life span of a normal RBC?

about 120 days (3-4 months)

Phototherapy cannot reverse the red cell destruction of

anemia and edema in the newborn

Gentamicin

antibiotic from the aminoglycosides family

Lithium

antidepressant

Neutrophils in the CSF are indicative of;

bacterial infection examples include; bacterial meningitis, viral meningoencephalitis, early TB and mycotic meningitis.

Homogentisic acid

black color in alkaline urine, alkaptonuria

Urine Culture Media

blood, MAC

ear culture media

blood, MAC and chocolate

stool culture media

blood, MAC, EMP, XLD, HEK, campy

eye culture media

blood, chocolate, MAC

CSF culture media

blood, chocolate, THIO

What cancer is CA 15-3/CA 27.29 associated with:

breast cancer -CA-15-3 is a marker used to monitor patient response to treatment and recurrence of cancer after mastectomy. CA27.29 is called breast Carcinoma-Associated Antigen. This marker is not recommended for breast cancer cscreening but the marker may be helpful in conjunction with other clinical methods for predicting early recurrence of breast cancer.

Microaerophiles

can use oxygen only when it is present at levels reduced from that in air

Streptococcus characteristics

catalase-negative cocci non-motile can ferment lactose microaerophillic

Echinococcus multilocularis

causes alveolar hydatid disease.

what are the causes of acquired aplastic anemia?

certain drugs, chemical agents, ionizing radiation, viruses, and biological agents.

The immediate spin phase of an IAT could most likely lead to the detection of what;

clinically insignificant cold antibodies

Class D Fire

combustible/reactive metals, such as magnesium, sodium and potassium

what is the main purpose of the photodetector in a spec?

convert the transmitted energy to an equivalent electrical energy

What platelet componenet is seen in patients with Glanzmann thrombasthenia?

defective glocoprotein IIb/IIIa.

Hypokalemia

deficient level of potassium in the blood

Hyponatremia

deficient sodium in the blood

What platelet component is seen in patients with d-storage pool disease?

dense granuel deficiency

Class C Fire

energized electrical equipment

recombinant vector

experimental vaccines similar to DNA vaccines, but they use an attenuated virus or bacterium to introduce microbial DNA to cells of the human body. Vector refers to the virus or bacterium used as the carier.

What pathway & factor(s) does Prothrombin Time (PT) assess?

extrinsic and common factors VII, X, V, II and I (7,10,5,2,1)

Hemophilia A is associated with a deficiency of factor:

factor VIII

What medical conditions can occur in metabolic syndrome?

fatty liver disease, cholesterol gallstones, asthma, sleep apnea, osteoarthiritis, pulmonary disease, renal disease, liver disease, ocular disease, PCOS, colon, endometrial and breast cancer.

What are storage forms of iron?

ferritin and hemosiderin

Class B Fire

flammable and combustible liquids

Identify the Neisseria species according to the specific carb. utilization profile: N. meningitidis

glucose and maltose positive only

Identify the Neisseria species according to the specific carb. utilization profile: N. gonorrhoeae

glucose positive only

Identify the Neisseria species according to the specific carb. utilization profile: N. lactamica

glucose, maltose and lactose positive only

Burkholderia characteristics

gram negative rod -decarboxylate lysine -produces a yellow pigment -grows well on MAC -cytochrome oxidase positive

Stephylococcus species gram stain;

gram positive cocci in clusters

Streptococcus pneumoniae gram stain;

gram positive in pairs and chains

Which marker is most useful for detection of gestational trophoblasric disease?

hCG

AFP is often elevated in patients with:

hepatocellular carcinoma and germ cell tumors

Oxidase test

identifies bacteria that have cytochrome oxidase used to differentiate the Enterobacteriaceae family (except Plesiomas) from Pseudomonas species, which are oxidase positive.

Tacrolimus

immunosuppresive drug

What pathway & factor(s) does Partial Prothrombin Time (APTT/PTT) assess?

intrinsic and common factors XII, Fletcher, Fitzgerald, XI, IX, VIII, X, V, II and I (11, 9, 8, 10, 5, 2, 1)

absorbance is related to % transmittance in what way;

inversely and logarithmically

Cysts are noted by nature to be resistant to what body fluid;

juices in the human stomach.

Micrococcus species gram stain;

large gram positive cocci that can appear in pairs, tetrads and clusters.

HBV affects which organ;

liver

Hypobetalipoproteinemia

low levels of LDL cholesterol, Absence of lipoproteins containing Apo-b

CSF in multiple sclerosis will have an increased # of what cells;

lymphocytes

What cell is responsible for causing trasfusion associated graft-vs-host-disease?

lymphocytes -These are caused by the engrafting of immuncompetent T lymphs into a severely immunosuppressed recipient. They can be prevented by gamma irradiation of cellular blood components.

what part of the spectrometer isolates individual wavelengths of light?

monochromator.

The activity of enzymes is strongly affected by changes in

pH and temperature; which would show results lower than actual.

PSA

prostate-specific antigen

Cefsulodin-irgasan-novobiocin (CIN) agar

selective for Yersinia spp.; CIN inhibits growth of other enteric bacteria found in stool.

Fascoila hepatica

sheep liver fluke.

Platelets are produced from;

the cytoplasm of megakaryocytes

Paragonimus westermani (lung fluke)

the only helminth egg routinely recovered in sputum samples.

TIBC is an indirect measurement of

transferrin

Chloroquine Diphosphate

treats RBCs to remove IgG to identify alloantibodies

Increased # of monocytes in CSF can be seen in;

tuberculous meningitis, syphillis, subarachnois hemorrhage and viral encephalitis.

What is the most prevalent congenital bleeding disorder?

von WIllebrand disease