ASCP study guide
mol solute= molar concentration X L solution =2.00 M X 0.475 L =0.950 mol The moles of HCl then need to be converted to grams using the molecular weight. g HCl = 0.950 mol X (36.46 g/1 mol) =34.6 g The correct answer is 34.6 g.
An aqueous 2.00 M HCl solution is prepared with a total volume of 0.475 L. The molecular weight of HCl is 36.46 g/mol. What mass of hydrochloric acid (in grams) is needed for the solution?
Staphylococcus aureus
An infective agent of skin wound infections and an agent of toxic shock syndrome, the large, entire, golden-yellow, smooth convex colonies on blood agar were recovered from a swab specimen after 48 hours incubation at 37° C. In the photomicrograph, clusters of Gram positive cocci were observed microscopically in a Gram stain prepared from one of the colonies. The coagulase reactions are pictured in the lower images. With these observations, select the name of this isolate.
Stronger reactions are seen with homozygous cells
Antibodies are ruled out using panel cells that are homozygous for the corresponding antigen because:
dosage
Antibodies do react with heterozygous cells, but with a weaker reaction. Heterozygous cells can be used for rule outs, especially for antibodies that do not exhibit _____.
Granulocytes
Antibodies to which of the following blood components is the most frequent cause of febrile nonhemolytic transfusion reactions?
3 positive reactions to rule in an antibody and 3 negative reactions to rule out an antibody
Antibody identification interpretations would be considered correct 95% of the time or have a P value of 0.05 (5% probability that the result is due to chance) if you have:
Kell
Antigens develop at various rates both in utero and after birth. _____ blood group antigens can be detected on fetal cells at 10 weeks gestation and are well developed at birth.
blood-brain barrier
Any condition that causes damage to the _____ mostly likely will cause elevated protein levels in the CSF.
swimmer's ear
Aspergillus niger is the most common fungal cause of _____.
Platelets
Bacterial contamination is MOST likely in which blood product?
histamine and heparin
Basophils contain substances such as _____ and _____ which are important in inflammatory and allergic responses. Many of the basophil's granules are water soluble, and thus could wash out or get lighter if the rinsing step during the staining process is prolonged.
red blood cells or hemoglobin
Bleach can trigger the color change normally associated with the presence of _____ or _____. It is important to follow up with a microscopic analysis for confirmation of a true positive result.
urine; fecal; vaginal
Both Enterobius vermicularis and Trichomonas vaginalis could potentially arrive in the _____ as contaminants from other sources; Enterobius from _____ contamination and Trichomonas from _____ secretions.
Acute hemolytic transfusion reactions
Both hemoglobinuria and hemoglobinemia will be present in what type of reactions?
brain; lungs
CK-BB is found mainly in the _____ and _____.
heart
CK-MB is found mainly in the _____.
skeletal muscle
CK-MM is found mainly in _____ _____.
acid or neutral
Calcium oxalate crystals have a refractile square envelope shape and can be seen in _____ urine. They characteristically occur as octahedral or envelope shapes. Calcium oxalate crystals can also be viewed as having a Maltese cross when one focuses up and down through the crystal.
apple green or blue-white
Calcofluor white binds to the polysaccharides in the chitin of fungus causing fungal elements to appear _____ or _____ depending on the combination of filters used on a fluorescent microscope.
arterioles; venules
Capillaries are the smallest blood vessels. They are the connection between _____ and _____. They are the only vessel that allows for the exchange of O2 and CO2.
River Blindness
Caused by Onchocerca volvulus. It is called such because of the ocular involvement that leads to varying degrees of loss of sight. Microfilariae are found in the nodule following the bite of a fly and may cause localized infection or wander to infect other tissues, including the eye.
East African Sleeping Sickness
Caused by Trypanosoma brucei subspecies rhodesiense. It is transmitted to humans by the bite of an infected tse tse fly transmitting epimastigotes.
Elephantiasis
Caused by three different microfilariae: Wucheria bancrofti, Brugia malayi or Loa loa. All three are introduced to humans by larvae that are transmitted by the bite of an infected insect.
homozygous
Cells in the _____ state have a double dose of the antigen on the red cell so reactions are stronger.
lipid
Chylomicron particles are 98% _____, 90% of which are exogenous triglycerides, which means the triglycerides originate from sources outside the body (i.e., food sources). They are the least dense of the lipoprotein particles; therefore, when a non-fasting plasma is stored, chylomicrons will rise to the top.
granulation
Chédiak-Higashi syndrome represents a qualitative disorder of neutrophils. It is a rare disorder that is expressed as an abnormal _____ of neutrophils. Neutrophils with giant granules display impaired chemotaxis and delayed killing of ingested bacteria.
S. intermedius
Coagulase positive staphylococcal isolates from dog bite wounds should be tested for _____, some strains of which can be positive.
basophilic stippling
Coarse _____ _____ may be observed on the Wright-stained peripheral blood smear in cases of thalassemia or lead poisoning.
glomerulus
Creatinine is filtered by the _____ and is not reabsorbed; therefore it can be used to estimate the GFR.
jaundice and hemoglobinuria
For delayed hemolytic transfusion reactions, the clinical signs and symptoms include _____ and _____.
macrophages
Gaucher's disease is a rare genetic defect of _____. In this disorder there is a deficiency of ß-glucocerebrosidase, the enzyme that normally splits glucose from its parent sphingolipid, glucosylceramide. As a result of the enzyme deficiency, cerebroside accumulates in macrophage. Gaucher's cells are rarely seen in circulating blood but are found in the bone marrow, spleen, and other organs of mononuclear phagocyte system.
incompatible
If donor cells are coated with antibody from a positive DAT the AHG will crosslink the donor cells and the crossmatch with be _____. ABO grouping does not need to be repeated since ABO incompatibility would be seen at immediate spin.
antiglobulin testing
If the patient or donor has a positive DAT, antibody coating the patient or donor RBCs can interfere with _____, for instance, phenotyping with antisera requiring an antiglobulin phase of testing.
hemophilia
A Factor VIII, IX, or XI deficiency are all types of _____, which are inherited hemorrhagic disorders caused by a genetic mutation of the gene coding for the coagulation factor.
Lying or reclining body, face up on his/her back.
A body in "Supine Position" is referred to as?
Malignant infiltration of the bone marrow
A cause of thrombocytopenia due to decreased production of platelets is:
The computer hardware and software which provide the means to manage data used in laboratory operations.
A laboratory information system (LIS) consists of:
Flow cytometry
A laboratory test which can detect the specific decrease in the platelet surface membrane receptor glycoprotein Ib and thus lead to a diagnosis of Bernard Soulier Syndrome (BSS) is:
Centrifuge the specimen and use the sediment to inoculate the agar plates
A large container of peritoneal fluid is received in the laboratory (about 50 mL). How should the tech process this sample for aerobic culture?
water
A normal cerebral spinal fluid is clear and colorless with a consistency similar to _____.
operculum
A number of helminth eggs (primarily cestode & trematode eggs) each have an _____. This lid structure under the appropriate conditions opens and allows the egg contents (larva) to escape and continue its development. This structure does not aid in the organism's attachment to the intestinal lining.
Primary Myelofibrosis (PMF)
A patient has a hypercellular bone marrow and is suspected of having a myeloproliferative disorder. Laboratory features include: excess megakaryocyte proliferation and atypia, marked marrow fibrosis, and the JAK2 mutation. The most likely diagnosis is:
non-diabetic
All _____ pregnant women should be screened at 24 to 28 weeks of gestation. Screening is done using the 50 g OGTT. A plasma glucose = 140 mg/mL (7.7 mmlo/L) at an hour after the glucose ingestion, indicates definitive testing is needed using 100 g, 3 hour OGTT.
SLE
Although Lupus Anticoagulant can be found in some patients with _____, it can be associated with many other diseases as well, including AIDS, malignancies, and others.
phospholipids
Although Lupus Anticoagulant prolongs coagulation times in laboratory testing, in vivo the antibodies can attach to_____ and induce coagulation.
hemophiliacs
Although _____ may be at risk for developing certain antibody inhibitors to Factor VIII products, these are not the same as the antiphospholipid antibody of Lupus Anticoagulant.
liver
Ammonia levels in the blood rise when the _____ is not able to convert ammonia to urea, such as in end-stage cirrhosis.
Scotochromogen
An acid-fast bacillus is isolated and produces an orange pigment when grown in either the light or the dark. Which type of organism has most likely been isolated?
osmolality
Increase serum _____ occurs with increase in solute which is directly proportional to the freezing point depression.
End stage cirrhosis
Increases in blood ammonia levels would be expected in which of the following conditions:
Babesia spp.
Like Plasmodium spp., _____ _____ is a protozoan which infects red blood cells and produces a febrile illness. It also has sexual and asexual reproduction stages in the life cycle. Unlike the causative agents of malaria, which are spread by mosquitoes, this organism is transmitted by ticks.
Mycobacterium fortuitum
MacConkey agar without crystal violet is a culture medium useful in the presumptive identification of:
alcoholism
Macrocytosis occurs in _____ due to decreased levels of folate from a folate deficient diet. Folate like Vitamin B12 is necessary for synthesis of DNA.
autoimmune hypothyroidism
Macrocytosis occurs in patients with _____ due to production of antibodies which inhibit intrinsic factor production in the gastric mucosa. Intrinsic factor is necessary for Vitamin B12 absorption.
negative charge
Major serum proteins carry a _____ and when a current is applied to the medium, the proteins move towards the anode (positive electrode).
influenza
Matrix protein (M) and nucleoprotein (NP) are major structural proteins in the _____ viruses.
protein
Meningitis, multiple sclerosis, and hemorrhage would all result in elevated _____ levels in the CSF.
Diazo reagent
Most common methods for measuring bilirubin are based on the reaction of bilirubin with:
crystal violet
Mycobacterium fortuitum has the capability of growing on modified MacConkey agar without _____, in contrast to other Mycobacterium species that do not grow. This media is helpful in the identification of rapidly growing mycobacteria.
Myeloperoxidase
Myeloperoxidase deficiency is a congenital neutrophil abnormality. _____ is an iron containing heme protein responsible for the peroxidase activity characteristic of azurophilic granules in neutrophils. Human neutrophils contain many granules of various sizes that are morphologically, biochemically and functionally distinct. The azurophilic granules normally contain this.
MRSA
Nasal, Groin, and Throat are most appropriate for _____ screening.
Cystoisospora belli
Oocysts are oval in outline and have a smooth, thin outer shell. Internally, a single spherical sporocyst may be observed, but more typically mature oocysts are noted which contain two sporocysts. One is advised to search further in a smear preparation for detection of oocysts with double sporocysts to ensure an accurate identification.
Taenia saginata
Ova identical to those of Taenia solium and are suggestive of the ova of Hymenolepis species by also possessing three pairs of internal hooklets. The lack of an inner hexicanth membrane and an outer shell that is thick with distinctive radial striations are the exclusive characteristics.
Hymenolepis nana
Ova may appear similar to those of H. diminuta, but are smaller in size, averaging 35 µm, and more distinctly possess a pair of bipolar filaments extending from each side of the inner hexacanth membrane.
anaerobic conditions
Oxygen labile hemolysin, or streptolysin O (SLO) is observed only under _____; therefore, will appear in the stab areas, accentuating the intensity of the hemolytic reaction.
Trichuris species
Polar plugs are characteristic features that aid in identifying the _____. The ends and the oval shape give the organism a lemon-drop appearance. These structures do not aid in the organism's attachment to the intestinal lining.
Hymenolepis species
Polar thickenings are characteristic features that aid in identifying the _____. These thickenings do not aid in the organism's attachment to the intestinal lining.
reverse transcriptase
Retroviruses such as HIV are viruses that use RNA as the template for DNA synthesis. They are unique viruses because they require a _____ that synthesizes the DNA from the RNA strand of the virus.
motile
Salmonella is a _____ bacteria.
light; dark
Scotochromogens are slow growing nontuberculous mycobacteria (NTM) that produce deep yellow to orange pigmented colonies when grown in either the _____ or _____.
rinsing
Segmented neutrophils, eosinophils, and banded neutrophils all contain cytoplasmic granules, but they are not as susceptible to fading during the _____ step of the Wright's stain procedure.
Systemic inflammatory response syndrome (SIRS)
Sepsis, severe sepsis, and septic shock are progressively severe stages of _____. Sepsis begins when the innate immune system responds aggressively to the presence of bacteria. Toll-like receptors cause the antigen-presenting cell to produce proinflammatory cytokines.
defects; errors
Six Sigma strategies seek to identify and eliminate causes of _____ and _____.
reading times
Some tests on the reagent strip require specified _____ _____. If you are visually reading the results, it is important to adhere to the timing recommended by the reagent strip manufacturer.
pulmonary TB
Specialized masks and respirators are required measures for use by persons who are occupationally exposed to patients with suspected or confirmed cases of _____. This requirement is mandated by OSHA.
Heparin
Specimens for blood gas determination should be drawn into a syringe containing:
Inversely and logarithmically
Spectrophotometric absorbance is related to % transmittance in what way:
optical density (OD)
Spectrophotometric analysis of amniotic fluid measures the change in _____ of bilirubin. The absorbance difference at 450 nm is plotted on a Liley graph to determine the severity of fetal distress in hemolytic disease of the newborn (HDN).
cocci
Staphylococcus aureus are gram positive _____ found in irregular clusters.
Streptococcus pyogenes
Streptolysin S (SLS) is the oxygen stable form of hemolysis seen around colonies when incubated aerobicaly. SLO and SLS are produced by _____, the causative agent of strep throat.
migration rates
The ionic charge of the sample proteins in protein electrophoresis is a paramount factor in establishing the _____ for the proteins being analyzed.
Lysis of cells
The late steps of complement activation and formation of the "membrane attack" complex (MAC) results in:
Ionic charge on the proteins
The migration rate of proteins on cellulose acetate is primarily the result of:
Hooklets
The morphologic structure of select tapeworms that is most likely responsible for piercing the human intestinal wall is/are called:
cytotoxic antibodies; leukoagglutinins (leukocyte antibodies)
The most common type of febrile nonhemolytic transfusion reaction (FNHTR) occurs as the result of _____ or _____formed against the white blood cells present in the donor unit.
Trichuris trichiura
The ova are easy to recognize with their barrel-shape and a distinctive protruding, convex, hyaline polar plug at each end. The shell is smooth but relatively thick and the internal developing embryo reaches the inner lining of the shell without leaving an open space.
Necator americanus
The ova are oval in outline, but are not flattened on one side and the outer shell is thin and transparent. Although the inner yolk sac retreats, leaving a clear space beneath the shell, further development into an embryo is not observed.
Red to brown
The oxidation of hemoglobin to methemoglobin in an acidic urine after several hours may cause which color to be produced?
Streptolysin O
The photograph on the right is of a 5% sheep blood agar plate inoculated with a throat culture. It is common practice to stab the agar with the inoculating needle, as seen at the tip of the arrow, in order to detect or accentuate the reaction of:
stabbing the agar
The practice of _____ in areas of inoculation has the effect of submerging the growing bacteria under the surface of the agar, where conditions are relatively anaerobic.
Bacterial meningitis
The predominant cells seen on the CSF smear in this illustration are indicative of:
bacteria
The presence of _____ can be indicative of either lower or upper urinary tract infection (UTI).
bleach
The presence of _____ in the urine collection container can lead to a false positive blood result on the chemical reagent strip.
d-dimer
The presence of thromboembolisms in a patient can be detected by assays such as _____.
Hemopoiesis
The production of and development of blood cells is called:
Net surface charge
The property MOST responsible for the migration of proteins in an electrical field is:
121° C for 12-15 minutes @ 15 psi
The recommended temperature/time/pressure for routine steam sterilization of media is:
lancet
The skin puncturing device is typically a retractable _____ while for venipuncture a needle is used.
two hours
The specimen should not be delayed for more than _____ prior to centrifugation because some of the analyte levels (such as glucose, ionized calcium, bicarbonate, folate, etc.) may be falsely decreased due to cellular consumption or falsely increased (such as potassium, ALT, AST, creatinine, etc.) because they are released over time from cells into serum or plasma.
Type IV Cell mediated hypersensitivity (T-cell dependent)
The type of hypersensitivity reaction associated with macrophage activation, cytokine-mediated inflammation is:
electrophoresis
The type of support media, type of stains used, and voltage settings all have an impact on _____ techniques; however, the amount of light present in an electrophoresis box does not.
Ehrlich-aldehyde reaction
The urobilinogen urine chemical reagent strip test is based on the _____ in which urobilinogen reacts with p-dimethylaminobezaldehyde (Ehrlich reagent). In this test, a pink-red color forms in proportion to the amount of urobilinogen present.
Chronic Myelogenous Leukemia (CML)
The use of molecular and cytogenetic techniques to detect the translocation between chromosomes 9 and 22 (resulting in the formation of the BCR-ABL1 gene) are currently the favored tests to diagnose a suspected case of _____ _____ _____.
skin puncture
The volume for the specimen collected by _____ _____ is much smaller (250-500 µL) compared to the blood volume collected by venipuncture (usually 3.5-10 mL).
Hematocrit
The volume percentage of red blood cells in whole blood is called:
femoral
The_____ artery is located in the groin area and brings oxygenated blood to the lower extremities.
wet mounts
Thick iodine stains are not used on blood smears. This stain is typically used on _____ of fecal material for the detection of protozoan inclusions.
protozoa
Thin and thick Trichrome stains are used for the detection and identification of _____ from stool samples. This stain is not used to stain blood smears for Plasmodium species.
Anti-A,B
This antibody is frequently implicated in HDFN, but the disease is generally mild, often subclinical.
Anti-I
This antibody is not implicated in HDFN because it is IgM in nature and the antigens are not well-developed at birth.
Anti-N
This antibody is not usually implicated in HDFN because it is IgM. When cases of HDFN have occurred they are very mild.
Anti-D
This antibody is the most common cause of severe HDFN.
Trichinella spiralis
This organism is an intestinal-tissue nematode whose larvae encyst by coiling in muscle tissue. Humans are an accidental host that becomes infected when encysted larvae are ingested through poorly cooked pork.
Trichinosis
This parasite, found in striated muscle, is responsible for which of the following conditions?
Brucella
This species are facultative, intracellular organisms that can live in neutrophils, monocytes, and macrophages. As a result, this organism can circulate throughout the blood stream and invade other organs such as spleen, liver, and bone marrow. People who have this infection can be asymptomatic or symptomatic and those who are asymptomatic have a delay in medical treatment. This delay in treatment can result in possibly further complications of the disease. Complications that can occur are arthritis, spondylitis, and endocarditis.
Amebiasis
This suspicious form measures 15 µm and was recovered in stool. What condition is associated with the presence of this form?
Vancomyin-Resistant Enterococci (VRE)
To screen for _____, rectal or stool swabs will provide the best sensitivity. Open skin lesions and mucosal surfaces can be sampled, but the sensitivity is low. Nasal swabs are not recommended for this screening.
non-motile
Yersinia and Pasturella, while _____, do not have a distinct polysaccharide capsule.
Reject the specimen, the potassium test results will be increased.
You are processing specimens for your laboratory when you receive a potassium test specimen in a tube that looks like the one in the image. What should you do?
Plasmodium falciparum
_____ , a causative agent of malaria, is characterized by fever and chills.
Gaucher cells
_____ , typically a large cell with one to three eccentric nuclei and a characteristically wrinkled cytoplasm, are found in the bone marrow, spleen, and other organs of the mononuclear phagocyte system. They are rarely seen in the circulating blood.
Common Pathway
_____ Factors- X, V, II, I (assessed by PT and aPTT).
Döhle bodies
_____ _____ are blue-gray in color. They are typically found in band and segmented neutrophils.
Neisseria sicca
_____ _____ are large, nonpigmented, wrinkled, coarse, dry, adherent colonies.
Moraxella catarrhalis
_____ _____ are large, pinkish to brown opaque colonies that can be moved over the agar intact with a loop, similar to a hockey puck on ice.
Neisseria subflava
_____ _____ are medium greenish yellow to yellow smooth colonies.
Lymphoma cells
_____ _____ are medium to large cells with blue cytoplasm that may or may not contain vacuoles. The chromatin is less condensed than resting B and T lymphocytes. These are not frequently seen phagocytizing bacteria.
Allergic reactions
_____ _____ are not associated with acute hemolytic transfusion reactions (AHTR) because the etiology is either immune-mediated or nonimmune-mediated by origin.
Mesothelial cells
_____ _____ are not found in normal CSF. If present, the distinction from macrophages is sometimes difficult.
Auer rods
_____ _____ are red-purple in color. They are composed of fused primary granules. One or more may be observed in the cytoplasm of myeloblasts. Myeloblasts have between 0-20 primary granules.
Neisseria lactamica
_____ _____ are small, nonpigmented to yellowish, smooth, and transparent colonies.
Plasma components
_____ _____ do not contain enough white blood cells to warrant the use of a leukocyte reduction filter. Therefore, there is minimal risk for a FNHTR to occur.
Lean principles
_____ _____ focus on reducing waste, such as streamlining a process to reduce wait times.
Intracellular microorganisms
_____ _____ in the CSF cytospin are indicative of infection such as bacterial meningitis.
Expiration dates
_____ _____ indicate the ensured reactivity of the reagent strips. Even though controls may be accurate, it does not guarantee that patient results will be accurate if the reagents are beyond this.
Dracunculus medinensis
_____ _____ infection occurs when humans ingest copepods containing infective parasite larva. Once the larva is released in the intestine, it will penetrate the intestinal wall and migrate to a body cavity where the male and female parasites mature. A mature, gravid female will migrate through subcutaneous tissue to release liveborn larvae into water when the human comes into contact with the water.
Acinetobacter species
_____ _____ is a non-lactose fermenter and grows easily on sheep blood, chocolate, and MacConkey agar. They are gram negative coccobacilli and can often be mistaken for Neisseria species. This is commonly found in genitourinary tract, respiratory tract, and in wound infections.
Toxoplasma gondii
_____ _____ is an obligate intracellular parasite found in mammals. Humans will acquire infection either by ingesting or inhaling the oocyst or by ingesting bradyzoites in undercooked meat. The organism will invade cells in various organs, not red blood cells.
Bacillus anthracis
_____ _____ is commonly encountered through direct contact of sheep, goats, horses, and cattle. Infections occur through direct contact with wool or hair of infected animals, inhalation of spores, and ingestion of contaminated meat. In addition, they are large Gram positive rods that grow within 24 hours on sheep blood and chocolate agar.
Moraxella species
_____ _____ is considered normal flora of the respiratory tract. Even though it is considered part of the respiratory tract normal flora, it commonly causes respiratory, eye, ear, and sinus infections. They are large, pink to brown colonies in color and produces a hockey puck type colony that easily glides across the surface of chocolate media.
Clostridium difficile
_____ _____ is the causative agent of antibiotic-associated pseudomembranous colitis. The diagnosis of this infection is based on clinical symptoms and the detection of the cytotoxin.
Prolonged immersion
_____ _____ of the reagent strip in the specimen may wash out reagents and affect test results.
Campylobacter jejuni
_____ _____ produces a characteristic bloody diarrhea with white blood cells after the consumption of infected food sources. Culture detection is sufficient for diagnosis.
Shigella dysenteriae
_____ _____ produces dysentery with white blood cells. It is associated with contaminated water.
Bacillus cereus
_____ _____ produces watery diarrhea with white blood cells and vomiting. The infection is associated with the consumption of a pre-formed toxin from a food source such as meats, vegetables, and rice.
Loa loa
_____ adult worms are distinctive for having a sheath and an uninterrupted column of nuclei extending to the tip of the tail (continuous row). The disease caused by this species results from the migration of adult worms through sub-cutaneous tissue. The thin skin below the conjunctival lining of the eye is one of the more common infections, resulting in a condition known as "Calabar swelling".
Brugia malayi
_____ adult worms characteristically have a sheath and two nuclei extending into the tip of the tail (not continuous), separated by an open space measuring 10 µm. A common clinical presentation in human infections with this species is tissue swelling known as elephantiasis, primarily involving the legs below the knee.
Erythromycin; Rifampin
_____ and _____ are both used in the treatment of Rhodococcus, Gordonia, and Tsuamurella species infections.
Lewis; I
_____ antigens and the _____ antigen are all poorly developed on fetal cells.
ABO
_____ antigens are present on fetal cells but expression is only 25%-50% of that we see on adult RBCs.
Triple phosphate crystals
_____ appear as colorless prisms with 3 to 6 sides and oblique ends, or as "feathery sleeves". The have been described as "coffin lid shaped", and can occur normally in alkaline urine. They may indicate the presence of an infection.
Uric acid crystals
_____ appear in acid urine and resemble yellow-brown four-sided flat planes, rosettes, or wedges.
Cholesterol crystals
_____ appear in acid urine as large, flat, transparent plates with notched corners. They are soluble in hot alcohol and ether.
Fusobacterium
_____ are Gram negative bacilli with tapered or pointed ends.
Plasmodium malariae
_____ causes quartan malaria and the infective stage of the organism is the sporozoite stage. The sporozoite is contained in the salivary glands of the Anopheles mosquito and is discharged into the puncture wound when the mosquito takes a blood meal.
Exophiala species
_____ colonies are slow growing but are more flat and velvety in consistency at maturity. Sporulation is of the genus-type in which long and narrow phialides end each with a distinctive sharply pointed terminal end, from which clusters of elongated pigmented conidia are produced.
Cladophialophora carrionii
_____ colonies are slow growing with a smooth, olive-gray surface mycelium and black pigmentation of the reverse side. Being non-specific, the identification is made by observing the distinctive genus type sporulation in which long unbranched chains of elliptical conidia are produced, with each pair separated by a scar-like dysjunctor.
Micrococcus luteus
_____ colonies are slow growing, small, and gray-white with a matte appearance. Hemolysis is absent. Small Gram positive cocci are observed in Gram stains and are arranged singly, in pairs, in short chains, and not in grape-like clusters. Slide coagulation and latex agglutination tests are negative. Recovery in clinical specimens are considered to be commensals or contaminants and rarely of clinical significance.
Phialophora verrucosa
_____ colonies are slow-growing with a nondistinctive olive brown to gray-black mycelium. Identification is made by the elongated narrow bottle-like phialides with collarettes from which loose clusters of conidia are produced.
Kingella kingae
_____ colonies grow well on blood agar with distinctive soft beta hemolysis. Short, plump, gram-negative coccobacillli in pairs and short chains are observed in gram stains. Distinctive is the production of acid from both glucose and maltose, in contrast to production from glucose alone. Also distinctive from Neisseria species, the catalase reaction for this is negative.
Neisseria meningitidis
_____ colonies growing on selective agar with the observation of intra-cellular small gram-negative cocci as observed in mounts prepared from liquid specimens provide for a presumptive identification of Neisseria species.
Staphylococcus epidermidis
_____ colonies on blood agar are entire, convex, smooth, gray white, and non-beta hemolytic. It is observed as Gram positive cocci, arranged individually, in tetrads, or short chains. Slide coagulation and latex agglutination tests are negative. When recovered in culture. It is most commonly considered a commensal or contaminant. Infections are related to IV-catheters, intravenous lines, bone following post-prosthesis implantations, ocular following lens implantations, and cataract surgery.
Sensitivity
_____ does not directly affect assay time and throughput.
Mansonella perstans
_____ does not have a sheath and has nuclei in the tail that extends to the tip. These are typically found in the pericardial, pleural, and peritoneal cavities.
CML (chronic myelogenous leukemia)
_____ does not have the JAK 2 mutation and has excess proliferation in many of the myelocytic lines.
Fasciola hepatica
_____ eggs are operculated and range in size from 130 to 150 µm x 60 to 90 µm. The eggs are typically found in stool.The attached image has no operculum.
Schistosoma japonicum
_____ eggs are round, have a small curved rudimentary spine which may be obscured and range in size from 60 to 90 µm x 40 to 60 µm. The eggs are typically found in stool. The attached image is too large, has a large lateral spine, and is the wrong shape.
Schistosoma mansoni
_____ eggs are yellowish, elongated, have a prominent lateral spine and range in size from 115 to 175 µm x 45 to 75 µm. The size, shape and lateral spine identify the parasite as Schistosoma mansoni. The eggs are typically found in stool.
Schistosoma japonicum
_____ eggs typically measure around 80 µm and exhibit an oval to spherical shape. A small knob extending from the side of the outer thin, smooth shell is distinctive for S. japonicum. The adult fluke resides in the small intestine and may invade the intestinal wall. A heavy proliferation of eggs is most commonly detected in the microscopic examination of fecal specimens.
Three-prong
_____ electrical plugs should be used for all equipment.
Cellulose acetate
_____ electrophoresis separate serum proteins into 5 fractions: albumin, a1-globulins, a2-globulins, ß-globulins, and ?-globulins.
Creatinine
_____ excretion is related to muscle mass and is fairly constant from day to day for a given individual.
Transfusion-associated graft-versus-host disease
_____ falls under the category of a delayed hemolytic transfusion reaction.
Polar
_____ flagella are flagella that extend from one end of the bacterium.
Peritrichous
_____ flagella are flagella that occur on all sides of the bacterium.
Lophotrichous
_____ flagella are polar flagella that multiply in tufts at one end or the other.
ET (essential thrombocythemia)
_____ has excess megakaryocyte proliferation and the JAK2 mutation, but platelet counts are higher. Also, though there can be some fibrosis, it is not as characteristic or excessive as in PMF.
Opsonization
_____ in phagocytosis is facilitated by covalently bonded fragments of C3 and C4.
Actinomyces israelii
_____ infections can be seen in intrauterine infections associated with long term implantation of intrauterine devices.
AST
_____ intracellular concentration is approximately 7000 times higher than the extracellular concentration.
Secondary hemostasis
_____ involves the activation of coagulation proteins to form a fibrin clot.
Trichophyton rubrum
_____ is a dermatophyte that commonly causes an itching, scaling skin infection of the feet, known as tinea pedis.
Sulfonamides
_____ is a drug of choice in the treatment of Norcadia species infections. Other agents that can be used are amikacin, ceftriaxone, cefotaxime, linezolid, imipenem, and minocyline. The combination of a sulfa-containing agent and one of the primary agents is recommended for serious systemic Norcardia infections.
Pinkeye
_____ is a general term for acute infection of the conjunctiva, but classically has been attributed to Haemophilus aegyptius, thought by most microbiologists to be a variant of Haemophilus influenzae.
Melioidosis
_____ is a glanders-like infection (fever, malaise, cutaneous cellulitis, ulceration, and abscess formation) that affects animals and humans. It is caused by the bacterium, Burkholderia pseudomallei, which is endemic in regions of Thailand, Vietnam, and Southeast Asia.
Glycosylated Hemoglobin (HbA1c)
_____ is a hemoglobin compound formed when glucose binds to the hemoglobin protein. It is a useful measurement to monitor a diabetic patient's average blood glucose over the last 120 days.
Bacteroides fragilis
_____ is a major component of the large bowel flora and is often associated with enteric abscesses, including those involving the appendix.
Gaucher's disease
_____ is a monocyte-macrophage disorder caused by a rare genetic defect. There is a high incidence of this disease in Ashkenazi Jews. There are two types of the disease: neuronopathic and nonneuronopathic depending on symptoms. The disorder represents a deficiency of B-glucocerebrosidase, the enzyme that normally splits glucose from its parent sphingolipid, glucosylceramide. As a result of this enzyme deficiency, cerebroside accumulates in histiocytes (macrophages).
Thromboelastography
_____ is a point of care test which can assess the entire coagulation status of the patient, and gives a functional and holistic perspective of their ability to clot. The elasticity of the patient's vessels is not determined by this test.
Neisseria gonorrhoeae
_____ is a sexually transmitted infection that can cause acute urethritis in males and cervicitis in females, as well as pharyngitis, conjunctivitis, anorectal infections and some disseminated infections as well. This organism is not part of the normal human flora.
Pasteurella
_____ is a small, Gram negative bacillus with bipolar staining.
Streptolysin
_____ is a streptococcal hemolytic exotoxin that can cause hemolysis in humans.
Uric acid
_____ is a test used to diagnose gout in a patient. It should be collected in a gel-barrier serum tube (red or gold top). Serum should be separated from cells within 45 minutes and stored at room temperature.
Fontana-Masson
_____ is a tissue stain used to identify the presence of phaeoid fungi.
Black lung
_____ is actually caused by long term exposure to coal dust, not a microorganism.
Staphylococcus lugdunensis
_____ is always tube coagulase negative. It should be noted, however, that it can produce a slide coagulase positive result (bound coagulase, or clumping factor). However, the slide test is considered obsolete.
Serum Ferritin (SF)
_____ 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. In hereditary hemochromatosis, signs and symptoms usually don't present until mid-life and include joint pain, fatigue, and bronze discoloration of the skin. As the disease advances, hepatomegaly develops which can lead to cirrhosis of the liver.
EDTA
_____ is an anticoagulant used in specimen collection tubes, which does not activate the fibrinolytic system.
Lecithinase
_____ is an enzyme that can cause the hemolytic breakdown of erythrocytes in blood agar; however, appears as a broader zone of faint hemolysis concentric to the beta hemolytic zone, producing the so called double zone of hemolysis.
ELISA
_____ is an enzyme-linked immunosorbent assay in which an antibody that contains an enzyme gives a visually discerning end product as the enzyme catalyzes a given reaction.
Streptokinase
_____ is an exogenous activator produced by some bacterial species that binds and activates plasminogen, a component of the fibrinolytic system.
Factor VII
_____ is an extrinsic factor and is assessed by the PT assay only.
Lupus Anticoagulant
_____ is an immunoglobulin, which acts as an inhbiitor of phospholipid-dependent coagulation in vitro, but causes a tendency to thrombosis in vivo.
Entamoeba hartmanni
_____ is an intestinal ameba and cysts serve as its infective stage. Transmission occurs through the digestion of mature cysts from contaminated food or water.
Dientamoeba fragilis
_____ is an intestinal flagellate and the trophozoite is its infective stage, there is no known no cyst stage. The life cycle and mode of transmission are unknown.
H. diminuta
_____ is an uncommon tapeworm in humans and is typically found in rodents. It can infect humans after contamination of grains or flours with rat feces. Symptoms may include diarrhea, anorexia, nausea, headache, and dizziness.
Clostridium botulinum
_____ is associated with "floppy infant" syndrome, due to a botulinum toxin released from ingested organisms replicating in the bowel causing neurological effects.
Type II Antibody mediated hypersensitivity
_____ is associated with complement and Fc receptor-mediated recruitment and activation of leukocytes (neutrophils and macrophages). Opsonization and phagocytosis of cells. Abnormalities in cellular function, e.g. hormone or neutrotransmitter receptor signaling. Types II and III are initiated by the interaction between antibody, except IgE, and antigen. Three different mechanisms of antibody-mediated injury exist in these reactions: (1) Antibody-dependent, complement-mediated cytotoxic reactions characterized by the interaction of IgG or IgM antibody with cell-bound antigen. (2) Antibody-dependent, cell-mediated cytotoxicity that depends on the initial binding of specific antibodies to target cell surface antigens. (3) Antireceptor antibodies that disturb the functioning of receptors. Transfusion reactions are an example of an antibody-dependent, complement-mediated cytotoxic reaction. Hyperacute graft rejection is also an example of a this type of reaction.
Type III Immune complex mediated hypersensitivity
_____ is associated with complement and Fc receptor-mediated recruitment and activation of leukocytes and tissue damage secondary to impaired blood flow. These reactions are caused by IgG, IgM and possibly other antibody types. Immune complexes can cover a spectrum of biological activities, including suppression or augmentation of the immune response by interacting with T and B cells; inhibition of tumor cell destruction; and deposition in blood vessel walls, glomerular membranes, and other sites. These deposits interrupt normal physiologic processes because of tissue damage secondary to the activation of complement and resulting activities.
Creatinine clearance
_____ is based on the serum creatinine level and is used to measure glomerular filtration rate, or GFR.
Vibrio parahemolyticus
_____ is best isolated from the medium thiosulfate citrate bile sucrose (TCBS) agar.
Filiariasis
_____ is caused by any of the microfilariae (nematodes) and is spread by blood-feeding black flies and mosquitoes.
Nephrotic syndrome
_____ is caused by damage to the kidneys, especially the basement membrane of the glomerulus; which causes abnormal excretion of protein and red blood cells in the urine. Fats are also present in the urine in most cases. A foamy appearance of the urine is a key characteristic of this condition. Clinical symptoms include: -Swelling -Weight gain from fluid retention -Poor appetite -High blood pressure
CNL (Chronic Neutrophilic Leukemia)
_____ is characterized by neutrophilia and the CSFR mutation.
Scedosporium apiospermum
_____ is commonly associated with sinusitis.
Blood
_____ is filtered in the kidney. Nutrients, water, and salts are reabsorbed while waste products are eliminated from the body by the urinary system. The kidney also helps regulate the acid-base balance in the body.
Staphylococcus saprophyticus
_____ is incorrect. S. saprophyticus colonies on blood agar are entire, convex, smooth, devoid of yellow pigmentation, and non-hemolytic. On Gram stains, small Gram positive cocci are arranged in loose clusters and tetrads. Both slide and tube coagulation tests are negative. Latex agglutination tests are also negative. Most infections are of the lower urinary tract in women. Most strains are novobiocin resistant.
Mobiluncus species
_____ is known to cause bacterial vaginosis and can be found growing along with Gardnerella vaginalis. It is rarely encountered in infections outside of the female genital tract.
Type I Immediate hypersensitivity
_____ is mast cell-derived mediators (vasoactive amines, lipid mediators and cytokines). Cytokine-mediated inflammation involves eosinophils, neutrophils and lymphocytes. These reactions can range from life-threatening anaphylactic reactions to milder manifestations associated with food allergies.
Trichomonas vaginalis
_____ is most commonly associated with vaginal discomfort, a green frothy discharge, odor, pain, itching, and irritation.
Campylobacter jejuni
_____ is mostly seen in gastrointestinal infections, not commonly in blood cultures. This species requires a microaerophilic environment as well as incubation at 42 degrees.
Eikenella corrodens
_____ is normal flora of the mouth, and those that have been in an altercation and have punched someone in the mouth can often become infected with this bacteria.
Endolimax nana
_____ is not considered to be a pathogen, according to the CDC.
Cobalamin
_____ is the chemical name for Vitamin B12 and is the treatment of choice in megaloblastic anemia related to B12 deficiency.
Hemagglutination
_____ is the clumping of red blood cells.
Eculizumab
_____ is the drug of choice in the treatment of classic PNH. It is a humanized monoclonal antibody that inhibits complement lysis.
Fibrin
_____ is the end product of the coagulation cascade in which the fibrinolytic system acts upon.
ALA synthase
_____ is the enzyme used in the first step of hemoglobin synthesis to create delta-aminolevulinic acid (ALA)
Microbiology
_____ is the laboratory department that cultures and identifies the presence of microorganisms from body fluids and tissues.
Clinical Chemistry
_____ is the laboratory department that performs most laboratory tests, which include quantitative analytical procedures on various body fluids.
Hematology
_____ is the laboratory department which performs tests that identify diseases associated with blood and blood-forming tissues.
Potassium
_____ is the major intracellular cation in the body, with a concentration 20 times greater inside the cells than outside.
Sodium
_____ is the most abundant cation in the extracellular fluid (ECF) and largely determines the osmolality of the plasma. This concentration in the ECF is much larger than inside the cells. Higher levels in the blood could occur with excess water loss or decreased water intake.
Pseudomonas aeruginosa
_____ is the most common bacterial cause of "swimmer's ear". This occurs when water is retained in the outer ear canal, giving the perfect habitat for bacteria (or fungi) to grow.
Fusarium species
_____ is the most likely associated with mycotic keratitis (fungal infection of the cornea).
Cryoprecipitate
_____ is the only concentrated fibrinogen product available and is used to treat patients with congenital or acquired fibrinogen defects.
Good manufacturing practices
_____ is the part of quality assurance that ensures that reagents, tissue, blood, and other products are produced and controlled according to quality standards appropriate for its use. It does not apply to laboratory waste as it will not be use on/or for humans, animals, etc. This does apply to the production of blood, progenitor cells, and tissue.
Lockout
_____ is the physical placement of a device on the breaker or the placement of the plug into a canister to prevent its use.
Tagout
_____ is the placement of a tag on the energy-isolating device notifying staff: "Do Not Operate this Equipment."
Diapedesis
_____ is the process in which blood cells pass through capillary walls. Monocytes function in the immune system by responding to inflammation signals and moving to sites of infection in the tissues. There, monocytes divide and differentiate into macrophages and dendritic cells to elicit an immune response.
Hemoglobin
_____ is the red blood cell protein responsible for binding oxygen and carbon dioxide. One molecule can bind four oxygen molecules for transport.
Alkaline phosphatase (ALP)
_____ is the test used to evaluate liver function. It requires to be a fasting collection and collected in a gel-barrier tube. Serum / plasma should be separated from cells immediately and refrigerated for storage.
PBG synthase
_____ is used in the second step of hemoglobin synthesis to condense two ALA molecules into porphobilinogen
Streptomycin
_____ is used in the treatment of Streptomyces species infections.
India ink
_____ is used to examine cerebrospinal fluid (CSF) samples for the presence of Cryptococcus neoformans.
Whole blood
_____ is used to increase red cells mass and plasma volume.
Fresh frozen plasma
_____ is used to replace stable and labile coagulation factors.
Thalassemia
_____ is usually associated with microcytosis.
Osmolality
_____ measures particles in solution, such as sodium and chloride, and is used for evaluation of renal concentrating ability.
Macrocytosis
_____ occurs in vitamin B12 deficiency due to defective synthesis of DNA. In B12 deficiency nucleated red cells do not undergo normal mitotic divisions due to thymidine deficiency.
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 highly vascularized limbic regions.
Alpha prime hemolysis
_____ refers to a small zone of intact erythrocytes and non-hemolysis immediately adjacent to the colony, with the hemolytic zone outside this zone of intact erythrocytes, somewhat resembling a bulls eye.
Primary hemostasis
_____ refers to the role of blood vessels and platelets in response to vascular injury. Blood vessels contract to seal the wound and reduce the blood flow (vasoconstriction). Platelets become activated, adhere to the site of injury, secrete the contents of their granules, and aggregate with other platelets to form a platelet plug.
Chediak-Higashi
_____ syndrome is a congenital neutrophil abnormality. Because of an abnormal granulation of neutrophils, it results in a qualitative neutrophil disorder of neutrophils. The neutrophils with giant granules display impaired chemotaxis and delayed killing of ingested bacteria.
Amylase
_____ test helps to determine acute pancreatitis. It should be collected in a gel-barrier serum tube (red or gold top). Hemolysis and lipemia should be avoided. Serum should be separated from cells immediately and refrigerated for storage.
Immunofluorescence
_____ testing uses immobilized antigens from the test sample and mono- or polyclonal antibodies that bind and fluoresce if antigens are present.
Flocculation
_____ tests are antigen-antibody tests in which the final product is a precipitin whose visible clumps can be seen either microscopically (VDRL) or macroscopically (RPR). Both VDRL and RPR are serologic screening tests for syphilis.
Class II
_____ transplantation antigens are essentially absent in the cornea.
Class I
_____ transplantation antigens are present in the cornea in a low concentration.
Aspergillus niger
_____ typically causes otitis externa and can also be associated with sinusitis.
Enterobius vermicularis
_____ typically causes perianal itching due to the female worms laying their eggs in this region
Desferrioxamine (DFO)
_____, an iron chelating agent, may be used to reduce iron overload in patients who rely on transfusions to maintain hemoglobin levels and prevent anemia.
Pseudomonas aeruginosa
_____, and others of the species, are motile via a single polar flagellum.
Vasoconstriction
_____, rerouting of blood flow, and platelet adhesion to exposed collagen at the site of the injury all occur during primary hemostasis.
Streptococcus anginosus group
_____, while part of the normal oral and GI flora, are viridans streptococci. This group may group with Lancefield groups A, C, F, G or L and have been associated with abscesses and bacteremia caused by invasive pyogenic infections.
Staphylococcus aureus
_____, while part of the normal skin flora of many individuals, does not cause clenched-fist cellulitis. It has been isolated from other cellulitis infections and is also the causative organism in scalded skin syndrome, can cause toxic shock syndrome, bacteremia and many other infections.
Alpha-naphthyl acetate
_____-_____ _____is a nonspecific esterase that is used to distinguish immature monocytic cells from myeloblasts.
anuria
no urine output
Taenia solium
ova possess three pairs of internal hooklets but the lack of an inner hexicanth membrane and an outer shell that is thick with distinctive radial striations are the exclusive characteristics.
protoporphyrin
protoporphyrinogen oxidase catalyzes the second to last step of hemoglobin synthesis to create _____.
Mycoplasma pneumoniae
the culture medium for the presumptive identification of _____ is methylene blue-glucose biphasic medium (New York City Medium). Stuart's medium, trypticase soy broth supplemented with 0.5% bovine serum albumin, Mycotrans, and A3B broth are all additional media that can be used for the isolation of this bacteria.
Legionella pneumophila
the preferred media for the isolation of _____ is buffered charcoal yeast extract agar (BCYE).
Brucella suis
A patient was admitted to the hospital for fever, chills, weight loss, headaches, and fatigue. The patient mentioned that he had cut his hand while hunting wild boar a couple of weeks ago. Blood cultures were received in the microbiology laboratory and several days later a bone marrow specimen on the patient was received. The blood culture was positive after 5 days and the bone marrow grew a small, convex, smooth colony after 48 hours on sheep blood and chocolate agar. A gram stain was performed and demonstrated small Gram negative coccobacilli organisms. What organisms is the cause of infection for this patient?
Atypical lymphocyte
A patient with an infectious mononucleosis infection presents in the emergency room. Physicians order a spinal tap, which is immediately sent to the laboratory for review. What is the cell in the image below from this patient's cerebrospinal fluid sample?
basophilic stippling
A possible finding on the peripheral blood smear in a case of lead poisoning is _____. In some instances, lead poisoning may also present with a microcytic, hypochromic anemia, however, many children with high levels of lead do not have microcytic, hypochromic anemia.
Chédiak-Higashi syndrome
A representative congenital neutrophil functional disorder is:
2.06 x 10^4
A sample of cerebrospinal fluid is diluted 1:100; the standard 9 squares of a hemocytometer are counted on each side for a total of 18 large squares. Side 1-- 186 nucleated cells counted Side 2-- 184 nucleated cells counted Total nucleated cells = 370 Using the standard hemocytometer formula shown here, what is the nucleated cell count per microliter (µL)?
Klebsiella
A sputum specimen submitted for culture is brick red in color. The organism causing this sputum color, also has a distinct polysaccharide capsule and is non motile. What organism can be associated with this sputum?
Hepatitis
A virus that infects the liver is known as a _____ virus. Some have DNA genomes and others contain an RNA genome, but they cause similar clinical symptoms such as fatigue, nausea, vomiting, abdominal pain, dark urine, and jaundice.
polymorphonuclear (PMN)
Activation of _____ leukocytes is facilitated by C5a, C3a, and C4a.
thrombin
Activation of coagulation proteins results in the formation of _____, an enzyme which converts fibrinogen to fibrin.
8-12 hours
After an AMI, myoglobin is released into the blood stream and peaks at about _____. Since myoglobin is a small molecule that is filtered by the kidneys, levels return to normal at about 18-30 hours.
18-30 hours
After an acute myocardial infarction (AMI), myoglobin levels will rise within 3 hours and peak at 8-12 hours. When will they return to normal?
Mesothelial cells, neutrophils and red blood cells
After reviewing this cytospin from a pleural fluid, identify the cells that would be the appropriate to report?
Francisella tularensis; Sub blood culture bottle to a media with cysteine for optimal growth
Agar plates on a positive blood culture are incubated for 48 hours and no growth is visible on the agar plates. The tech reviews the initial Gram stain from the blood culture bottle, which reveals tiny pleomorphic Gram-negative coccobacilli. What organism should the tech suspect and what should the tech do next?
microscopic urinalysis
Crystals, yeast, and casts are identified by performing _____ which is considered a moderate complexity test and must be performed by a medical laboratory thechnician (MLT) or a medical laboratory scientist (MLS).
Glass
Hydrogen ion concentration (pH) in blood is usually determined by means of what electrode?
Wuchereria bancrofti
Distinctive is the sheath presence and the absence of nuclei extending into the tip of the tail of the adult worm. The common clinical diseases produced by this worm, residing in the lymphatics of the genital tract, are folliculitis, orchitis, and hydrocele.
transfusion
During _____ related acute lung injury and anaphylactic transfusion reactions, there is no visible hemolysis.
pre-analytical phase
During which phase of testing are MOST laboratory errors known to occur?
pinworm infections
Enterobius vermicularis causes _____. The eggs are typically not found in stool and they are flattened on one side.
bacillus
Escherichia coli is a gram negative _____.
Intrinsic Factors
Factor VIII, Factor IX, and Factor XI are all part of the _____, which also includes Factor XII. These are assessed by aPTT only, and would not affect the PT assay.
clotting
Factor XII, or Hageman factor, may cause prolonged _____ in the specimen tubes, but does not cause abnormal coagulation symptoms or complications in vivo.
dust or dirt
False positive reactions can result from _____ or _____ in the glassware used for testing (clumping could occur that is mistaken for agglutination).
silicone gel
False positive reactions can result from the use of samples collected in _____ tubes due to complement attachment.
neutropenia
Granulocyte concentrates are collected white blood cells used in the treatment of patients diagnosed with severe _____.
RNA is used as the template for DNA synthesis
HIV is known as a retrovirus because:
hemoglobinemia; hemoglobinuria
Hallmark signs of intravascular hemolysis include _____ and _____.
Alpha Thalassemia
Hemoglobin D (HbD) is NOT elevated in:
weaker
Homozygous cells should be used for rule outs when possible so that _____ reacting antibodies present in the heterozygous state aren't accidentally ruled out.
tapeworms
Hooklets are structures attached to the rostellum of _____ (Cestodes). These hooklets are used to aid in attachment of the worm to the host's intestinal lining. An example of a cestode that has hooklets is Taenia solium.
3-5 minutes
How long should a heel warmer be placed on an infant's heel before a capillary collection is to be performed?
0-5 WBCs/µL
How many white blood cells (WBCs) would be considered normal for adult cerebrospinal fluid?
Should be tested in 20 separate runs
Ideally, what testing should be done prior to starting a new lot of control material in order to establish its mean and standard deviation?
Synovial lining cells
Identify the large, foamy cells in the joint fluid image shown to the right.
Lymphocyte
Identify the nucleated blood cell:
Hyaline cast
Identify the urine sediment element indicated by the arrow in the illustration:
Leucine crystals
Identify the urine sediment elements shown by the arrow: Appears 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.
DAT
If a donor unit of red blood cells is found to be incompatible at the antiglobulin phase with several recipients, the possibility of antibody coating the red blood cells is likely. A _____ should be performed on the donor unit. The antiglobulin phase of a crossmatch involves the addition of anti-human globulin (AHG).
Leukocyte alkaline phosphatase (LAP)
If a patient has a white blood count of 40,000/µL, what would be the MOST useful staining procedure to distinguish between bacterial infection and chronic myelogenous leukemia (CML)?
Hymenolepis diminuta
Illustrated in the photograph is a close in view of a 70 µm oval ovum with a thin, smooth outer shell and an inner membrane containing three pairs of hooklets (hexacanth embryo). This ovum is indigenous primarily in rats and mice and only rarely found in human feces. When found, the infected person usually has minimal symptoms; however, in heavy infections, particularly in those who are immune-suppressed, abdominal pain, diarrhea and anal pruritis may be experienced. What is the best presumptive identification of this tapeworm ovum?
Rapid Urease
Illustrated in this photomicrograph of a gastric biopsy specimen are a few thin, curved and S-shaped bacteria (arrows). This picture is suspicious for Helicobacter pylori. An additional test helpful in confirming this identification is:
Dipylidium caninum
Image A represents the egg of _____ _____, the egg packets are large and irregular and contain 15-25 globular eggs, with an onchosphere and 6 hooklets.
Dipylidium caninum
Image A represents the egg of _____. The egg packets are large and irregular and contain 15-25 globular eggs, with an onchosphere and 6 hooklets.
Diphyllobothrium latum
Image B shows the egg of _____ _____ which is unembryonated, with a thin shell and indistinct operculum. Cleavage fills the entire egg.
Diphyllobothrium latum
Image B shows the egg of _____ which is unembryonated, with a thin shell and indistinct operculum. Cleavage fills the entire egg.
Hymenolepis nana
Image C represents the egg of _____ _____, which is hexacanth or lancet-shaped with six hooklets. It is round to oval with a thin, smooth membrane and an outer shell. There is a clear space between the membrane and shell and 4-8 filaments emerge from its inner membrane.
Hymenolepis nana
Image C represents the egg of _____, which is hexacanth or lancet-shaped with six hooklets. It is round to oval with a thin, smooth membrane and an outer shell. There is a clear space between the membrane and shell and 4-8 filaments emerge from its inner membrane.
Taenia species, T. solium and T. saginata
Image D represents the eggs of _____ _____, __. _____ and __. _____ as the eggs are indistinguishable. The eggs have a dark brown shell which surround the oncosphere with a radially striated shell and 6 hooklets. The gravid proglottids must be examined to distinguish these two.
multiple myeloma
In _____ _____ the peripheral blood smears commonly have rouleuax formation. No other red blood cell abnormalities are typically noted.
hemolytic anemias
In _____ _____, a hallmark abnormality seen on the Wright-stained peripheral blood smear are spherocytes.
viral meningitis
In _____ _____, reactive lymphocytosis is present.
sideroblastic anemia
In _____ _____, the Wright-stained peripheral blood smear will reveal microcytic, hypochromic red blood cells.
partial D and partial weak D
In _____ and _____ individuals, they can produce Rh antibodies to the portion of the RhD gene that is missing. There is a risk for potential adverse effects to occur when these individuals are recipients of D-positive RBCs.
folic acid deficiency
In _____, the RBC's are macrocytic.
hereditary spherocytosis
In _____, up to 25% of the RBC population may appear as microspherocytes.
Increased in number and function abnormally
In essential thrombocythemia, the platelets are usually:
cholesterol
In excess triglycerides, the triglycerides reduce the amount of _____ in LDL particles producing small dense LDL molecules. Because of size and density, these molecules more easily enter damaged endothelium and vessel walls and are more easily incorporated as plaque is formed.
Ferrochelatase
In hemoglobin synthesis, which enzyme is responsible for adding iron in the last step?
Common pathway
In the in vitro coagulation scheme, factor V is primarily involved in the:
Providing learning activities
In the instructional sequence, the evaluation component follows directly after:
protein electrophoresis
In the serum _____, the gamma globulins travel the least toward the anode and will be closest to the cathode.
Staphylococcus aureus
In the vast majority of clinical settings, a Staphylococcus species that is coagulase positive can be identified as _____. However, microbiologists should remember that other Staphylococcus species may produce a positive coagulase test.
lead poisoning
In which disorders would you probably observe coarse basophilic stippling on a Wright-stained peripheral blood smear?
Blood gas -> EDTA -> Other additives -> Serum
In which order should the following capillary specimens be collected according to Clinical and Laboratory Standards Institute (CLSI)? -Ethylenediaminetetraacetic acid (EDTA) specimens -Serum (non-additive) specimens -Blood gas specimens -Other additive specimens
D-positive RBCs
Individuals with C in Trans to RHD possess complete D antigen structures. The allele that carries C is in trans (or opposite position) from the allele carrying RHD. As a result, the position of the C antigen in relationship to the D antigen interferes with the expression of D antigen. This can be a weakened expression of D antigen; however, D antigen is still present. These patients can receive _____ without implication of a Rh-mediated transfusion reaction.
Del phenotype
Individuals with _____ possess a low number of D antigen sites that can go undetected in routine serological testing. This testing discrepancy can lead to misclassification of Rh type for the recipient (i.e. classified RhD-negative but may be RhD-positive). Molecular studies are needed to detect mutant the RHD gene responsible for altering the expression of the RhD protein.
Activity of one ion much more than other ions present
Ion selective electrodes, for pH determinations, are called selective rather than specific because they actually measure the:
necrotizing pneumonia
Klebsiella is the bacterial species that causes a _____ characterized by the production of a brick red sputum and offers a distinct polysaccharide capsule.
hereditary hemochromatosis
Laboratory findings of hereditary hemochromatosis include increased levels of serum iron, serum ferritin, and serum transferrin.
bacterial meningitis
Neisseria meningitidis is a gram negative diplococci but more likely seen in CSF as a cause of _____ _____.
diplococci
Neisseria species are characterized by gram negative _____.
glitter cells
Neutrophils are the most predominant WBC found in the urine sediment. Neutrophils exposed to hypotonic urine absorb water and swell, and the granules exhibit Brownian motion resulting in a sparkling appearance which referred to as _____.
lipid metabolism
Niemann-Pick Disease is similar to Gaucher's disease as an inherited abnormality of _____. It is characterized by massive accumulation of sphingomyelin in the mononuclear phagocytes.
nonpigmented
Nonphotochromogens are slow growing NTM that produce _____ colonies when grown in the light or dark.
acellular
Normal CSF should be mostly _____ by the manual chamber count.
chylomicrons
Normally absent in fasting specimens, _____ will form a creamy layer at the top of stored, non-fasting plasma specimens.
Acute glomerulonephritis
Oliguria is usually correlated with:
mononuclear
On the cytocentrifuged smear, a normal CSF will have less than 5 _____ cells/µL in adults.
leukocyte reduction
One approach to preventing a FNHTR is to perform a prestorage _____ _____ for whole blood, platelet, and packed red blood cell components.
Arteries
_____ carry oxygen rich blood away from the heart.
light
Photochromogens are slow growing NTM that produce pigmented colonies after _____ exposure.
renal function
Plasma concentrations of creatinine are used to assess _____.
antigenic
Proteins are complex molecules with a high molecular weight and are more _____ than the other types of molecules.
Six Sigma
Quality control would be a _____ _____ focus, as would reducing variation.
7
Rapid growers are NTM that grow within _____ days; however, some can be pigmented, but the rate of growth will separate this group from a scotochromogen or photochromogen.
Enterobius vermicularis
The 30 X 50 µm ovum illustrated in the image are most commonly observed by microscopic examination of transparent adhesive tape mounts of perianal skin of children who have complained of nocturnal anal pruritus. What is the most likely presumptive identification? The eggs are collected using a sticky paddle or a piece of clear cellophane tape pressed against the perianal region. The ova are oval in outline with flattening along one margin, simulating a deflated football.
washing
The AHG reagent must be added to the cells immediately following _____. Antibodies may elute from the cells if the cells are allowed to sit in saline without the addition of the AHG reagent. The AHG reagent can be neutralized by the presence of the antibodies now present in the saline causing a false negative result, or too little IgG antibody remains attached to the cells for detection by the AHG reagent.
infection
The LAP stain is used to determine if an increase of cells is due to chronic myelogenous leukemia or a leukemoid reaction due to _____ or similar conditions. Cells from a noncancerous reaction stain positive with many intense blue granules; cells from chronic myelogenous leukemia have few blue granules.
pulmonary
The _____ artery brings carbon dioxide and oxygen poor blood from the heart to the lungs.
carotid
The _____ artery is found on the side of the neck and brings oxygenated blood to the head and brain area.
aorta
The _____ is the largest artery in the human body. It splits into smaller arteries which distribute oxygenated blood throughout the body.
urine reagent strip
The _____ is used to determine the presence of bacteria, blood bilirubin, leukocytes, protein, urobilinogen, pH, and specific gravity.
myeloperoxidase
The _____ stain is used to distinguish between the immature cells in acute myeloblastic leukemia (cells stain positive) and those in acute lymphoblastic leukemia (cells stain negative).
amine (Whiff)
The _____ test uses KOH and saline vaginal fluid suspension to detect the presence of a "fishy" odor due to volatilization of amines produced by anaerobic bacteria in bacterial vaginosis (BV).
urobilinogen
The _____ urine chemical reagent strip test is based on the Ehrlich-aldehyde reaction in which urobilinogen reacts with p-dimethylaminobezaldehyde (Ehrlich reagent).
platelet aggregation studies
The ability of platelets to change shape in response to certain stimuli can be reflected in functional platelet tests such as _____.
Increased red cell production
The abnormalities that are seen on this slide are probably associated with what condition?
Hageman factor (XII)
The absence of which clotting factor causes NO bleeding tendency?
Fonsecaea pedrosoi
The colony morphology is not species specific but with the dark brown to black mycelium, an agent of chromomycosis can be presumptively suspected. Microscopically is shown the branching phialides giving rise to small clusters of elliptical conidia. This represents the acrotheca-type sporulation, most consistent with this bacteria. There is considerable strain variation within the genus, and other species may produce sporulation as seen with Cladosporium or Rhinocladiella species, at times making a definitive identification somewhat difficult.
avascular
The cornea is _____. Subsequently, no HLA matching is performed for corneal tissue transplants.
Balantidium coli
The disease balantidiasis is caused by ingesting the ova of the ciliate _____ and is transmitted by the ingestion of fecally contaminated food or water.
Giardia lamblia/intestinalis
The disease giardiasis is caused by ingesting the ova of the flagellate _____ and is transmitted by the ingestion of fecally contaminated food or water.
Ascaris lumbricoides
The disease process associated with _____ may be termed as roundworm infection after the common name of the worm. Patient's roundworm infection experience symptoms corresponding with the migration of the worm within the human body.
blotted
The edge of the strip should be run along the lip of the specimen container or touched to absorbent toweling, but should not be _____ with a paper towel.
E. granulosus
The eggs of __. _____ are hexacanth and resemble those of Taenia spp.
Normal cells
The erythrocytes seen in this illustration are indicative of:
directly proportional
The freezing point depression is lowered by an amount that is _____ to the concentration of dissolved particles in the solution.
It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances.
The glucose result on a urine specimen from an infant is negative on the urine chemical reagent strip, what is the next step?
Blast with Auer rod
The hematology analyzer reported an elevated white blood cell count and flagged for manual review due to the suspected presence of immature cells. What is the arrowed cell's identity, and what name is given to its inclusion?
LDH
The highest levels of total _____ are seen in pernicious anemia and hemolytic disorders.
Metastasis
The image is a stained smear of cerebrospinal fluid. The cell in this slide could be caused by what condition?
Lymphocytes
The image on the right is a cytospin preparation of cerebrospinal fluid viewed at 1000X magnification. What is the identity of the primary blood cell type observed in this microscopic field?
Ascaris lumbricoides
The intestinal parasite pictured was found in stool and measures 170 µm by 63 µm. What is the most likely organism?
whipworm infections
Trichuris trichiura causes _____. The eggs appear as brown barrel-shaped structures with hyaline polar plugs at each end.
8.6
Using standard SPE methods, all major serum proteins carry a net negative charge at pH _____ and migrate toward the positive terminal (anode) with albumin travelling the farthest, then the alpha-1 globulins, alpha-2 globulins, beta globulins, and the last set are the gamma globulins.
West Nile Virus
Virus that is transmitted from birds to humans through a mosquito vector.
RNA synthesis
Viruses that use DNA as the template for _____ are common for virus with a DNA genome. The virus releases its DNA genome into the cell nucleus, which the host cell uses to make viral proteins.
Binds with antigen
What best describes the primary function of antibodies?
Transfusion dimorphism
What condition/situation is associated with the peripheral blood picture in the image on the right? Microcytic, hypochromic erythrocytes suggests iron deficiency anemia. Interspersed among these cells are normocytic, normochromic erythrocytes suggesting two populations of red cells following transfusion. This was a case of severe iron deficiency treated with red cell transfusions and iron supplement.
Specificity
What does the equation in parenthesis measure? (TN/TN+FP)
Total count X % of cells counted
What formula would you use to calculate absolute cell counts?
VCA, EBNA, VCA/IgM, EA
What is the correct sequence of the immunologic Epstein-Barr virus (EBV) response in infectious mononucleosis? Key: VCA= viral capsid antigen VCA/IgM =viral capsid antibody (IgM) EA=early antigen EBNA=Epstein-Barr nuclear antigen
10.0 X 10^9/L The formula for correcting a white blood cell count in the presence of more than 5 nucleated red blood cells per 100 white blood cells is: (Uncorrected WBC count x 100) /(# NRBCs per 100 WBCs + 100) (12.0 X 109/L X 100) / (20 + 100) = 10.0 X 109/L or 12,000/cu mm X 100 / 20 + 100 = 10,000/cu mm
What is the corrected WBC if a differential count shows 20 nucleated erythrocytes per 100 leukocytes and the uncorrected leukocyte count is 12.0 X 10^9?
Lyophilized Factor VIII concentrate
What is the first line treatment for moderate to severe hemophilia A?
Process improvement
What is the focus of both Lean principles and the Six Sigma methodology?
Calcium oxalate
What is the identification of these crystals seen in a urine with an acid pH?
Nasopharyngeal swab
What is the most suitable specimen for the isolation of Bordetella pertussis?
Capillaries
What is the only vessel that allows for the exchange of oxygen (O2) and carbon dioxide (CO2)?
Comparison of two means from matched groups
What is the purpose of a t-test?
It binds to the polysaccharides in the chitin of the fungus.
What is the purpose of calcofluor white in the direct examination of patient specimens for fungal elements?
The maximum level of a chemical to which a worker can be exposed without causing adverse health effects.
What is the threshold limit value?
The sample must cross the threshold and peak within the target temperature range
What two components must be true in order to call a positive sample using real-time PCR and melt curve analysis?
heterozygous
When cells are in the _____ state, there are less antigen sites to bind with so reactions are weaker.
About 10 degrees
When collecting blood from the back of the hand using the winged infusion/butterfly system, what should the insertion angle be for the needle?
hour
When evaluating specimen throughput, one would focus on processes and issues that may affect the number of tests that can be performed per _____.
Sensitivity of technique
When evaluating the throughput of a particular method you should consider all of the following except:
8-10 hours after an oral dose
When should a peak digoxin level be drawn?
Body tissues
Where is the main site of action for monocytes after diapedesis?
Roundworm infection
Which condition is associated with this stool parasite with large, broadly oval and bile stained eggs (see photomicrograph)?
Gamma
Which represents peak 1 (closest to the cathode) in this serum protein electrophoresis (SPE) scan?
Fern test
Which test uses a vaginal fluid specimen to differentiate amniotic fluid from urine and other body fluids?
Basophils
Which type of granulocyte has water soluble granules which may fade during the rinsing phase of the staining process using the Wright's stain?
Thin-stained Giemsa smears
Which type of stain is recommended to speciate Plasmodium species?
Blastocystis hominis
While the life cycle of _____ _____ is not completely known, it is most likely that the infective cyst is ingested and exocysts in the large intestine where it will transform into a central vacuolar form.
classification
Wright stain does not provide any differential information other than possible cell _____.
Chronic granulomatous diseases(CGDs)
_____ are a congenital neutrophil abnormality. They are a genetically heterogeneous group of disorders of oxidative metabolism affecting the cascade of events required for H2O2 production by phagocytes during phagocytosis. Life-threatening infections can result. Patients with autosomal-recessive form may have a less severe clinical course than patient with X-linked forms of the disease.
Calcium carbonate crystals
_____ are colorless with dumbbell or spherical appearance and are found in alkaline urine.
Hospital and laboratory accrediting agencies
_____ are considered business associates and not HIPAA covered entities. Business associates provide services to covered entities.
Eosinophils
_____ are granulocytic white blood cells which are identified by their large orange/red granules and a dark purple nucleus usually segmented into two lobes.
Reticulocytes
_____ are immature red blood cells.
Ketones
_____ are intermediate products of fat metabolism. Significantly increased levels are detected in the urine in diabetic acidosis, excessive carbohydrate loss, and starvation, among other conditions.
Monocytes
_____ are large cells, often with convoluted nuclei and large cytoplasms, and are infrequently seen in CSF. Sometimes they can be seen in meningitis, or other conditions.
Microfilariae
_____ are larvae (not eggs) from blood and tissue filarial nematodes and would not be found in the stool.
Oval fat bodies
_____ are lipids containing renal tubular epithelial cells(RTE).
Cryptosporidium species
_____ are members of the sporozoa and the infective stage is the oocyst. Humans can acquire infection through direct contact with infected people or animals or by consuming contaminated water or food.
Acute hemolytic transfusion reactions (AHTR)
_____ are most commonly due to ABO-incompatible blood being transfused to a recipient with naturally occurring ABO alloantibodies (anti-A, anti-B, anti A,B). This is different from passively transfused antibodies to HLA antigens. Typically, the interaction occurs between donor red blood cell antigens and preformed antibodies in the recipient.
Monocytes
_____ are nongranular and the largest white blood cell by size. They have a folded nucleus and an irregular cellular shape. The cytoplasm stains gray-blue and often contains vacuoles.
Lymphocytes
_____ are nongranular white cells with a large dark staining nucleus and very little cytoplasm which stains light blue. They are the smallest white cells by size and typically second most numerous after neutrophils.
Fibrin strands
_____ are not added to the newly formed clot during primary hemostasis as this is the basis of secondary hemostasis.
Macrophages
_____ are not seen in normal CSF, but can be seen in meningitis and other conditions. They are large cells with abundant cytoplasm.
Promyelocytes
_____ are often slightly larger than myeloblasts but they have fewer and less prominent nucleoli and slightly coarser chromatin. They have more than 20 primary granules.
Cystine crystals
_____ are present in acidic urine, are typically colorless, and have a characteristic hexagonal shape (also described as appearing similar to a benzene ring). These crystals are associated with cystinuria.
Neutrophils
_____ are the most numerous granulocytic white blood cells. The cytoplasm stains pink, with bluish/lavender granules, and they have multilobulated nuclei which stains dark blue/purple.
Erysipelothrix
_____ are thin Gram positive bacilli.
Platelets
_____ are used to treat bleeding caused by thrombocytopenia or thrombocytopathy.
Uric acid crystals
_____ are variably shaped: they occur as flat diamond (four-sized), rhombic, lemon-shaped, or rarely hexagonal shapes with a yellowish or yellowish brown coloration. They are present in acid urine. They are polarizable and show various colors when polarized. They may be present in normal urine.
Arterioles
_____ are vessels that connect arteries and capillaries. They are an extension of arteries that carry oxygen rich blood to capillaries. It is in the capillaries where oxygen can be released to tissues.
Potassium hydroxide (KOH)
_____ breaks down the keratin and skin layers to more clearly reveal fungal elements. Nail scrapings, hair, or skin scales are placed on a slide and one drop of this is added, then coverslipped. The slide can then be heated to expedite the breakdown or left to sit for 15-30 minutes. A bright field microscope can then be used to look for fungal elements. This can be used in conjunction with calcuofluor white to make the fluorescent observation clearer.
Ketones
_____ can be positive in urine when your cells don't get enough carbohydrates and use non-carbohydrate compounds such as fats and proteins for energy.
Aeromonas species
_____ can be seen as colonies that are small, opaque, gray-white and beta-hemolytic on blood agar. Bacilli instead of cocci are observed in gram stains. Distinctive is the production of acid also from sucrose and lactose in addition to glucose and maltose. Infections associated with skin wounds and lacerations exposed in water sports. Septicemia is commonly associated with these infections.
Yersinia pestis
_____ can be seen in blood cultures but is more common in respiratory cultures or aspirates from lesions.
Streptococcus pneumoniae
_____ can be seen in blood cultures but is more common in respiratory cultures. This organism does have an autolytic property, which is used with the bile solubility test for identification.
pH
_____ can change the charge of the analyte and thus affect the mobility. It can also denature the analyte (protein).
Veins
_____ carry oxygen deficient blood and carbon dioxide back to the lungs and heart.
Biosafety Level 4
agents not routinely found in a clinical lab, pose a high risk of aerosol transmission, are frequently fatal, and have no treatment or vaccine (Ebola, a filovirus, and other arboviruses and arenaviruses). All work is confined to a biosafety cabinet that with engineering features that prevent air flow. Full PPE as specified by the type of infectious agent must be worn at all times. Special disposal of used PPE and decontamination protocols may be required.
Biosafety Level 3
agents not usually encountered in the clinical lab on a regular basis (many highly infectious viruses (certain arboviruses and arenaviruses, cultures of TB, and some systemic fungi). Use of a biosafety cabinet is required. gloves, gown, and eye protection should be worn. Respirators or face shields should be used depending on specimen type.
Biosafety Level 1
agents of relative low risk for causing disease in healthy adults (agents used for lab instructions such as Bacillus subtilis). Standard PPE includes gown, gloves, and goggles with proper hand washing practices.
Biosafety Level 2
agents that pose a moderate threat to a healthy adult (most patient specimens encountered in routine clinical laboratory settings, including common agents of infectious diseases; i.e. Salmonella spp. and Shigella spp.) Safety equipment and PPE can vary depending on the type of specimen and possible infectious agent. Tuberculosis would require respiratory protection. Specimens that could be a splash hazard require a face shield. Samples that could become aerosols are required to be used under a biosafety cabinet.
oliguria
decreased urine output
underlying acute inflammation
hsCRP values >10 mg/L usually signify an _____ such as infection.
Neisseria gonorrhoeae
identify the most likely species based on this image of a gram stain from a male urethral swab.
lymphocytes
increased number of _____ are associated with fungal, tuberculous, and parasitic infections.
