example ASCP
All of the following serological test results may occur in a patient experiencing a hemolytic transfusion reaction due to the presence of a clinically significant Rh antibody such as anti-c EXCEPT:
-Optimal reaction at 37°C or AHG phase. -Preference to react with RBCs possessing a double-dose of Rh antigen. ***-Binding complement. -Positive DAT result.
Determine the molarity of a solution of KOH that is contained in a Class A 1-L volumetric flask filled to the calibration mark. The content label reads 18 g KOH. The gmw of KOH=56.1 g/mol.
0.32 mol/L The equation is: (18 g KOH/ L) X (1 mol/ 56.1 g HCl) = 0.32 mol/L The correct answer is 0.32 mol/L
Whole blood or red blood cell units will be shipped from the American Red Cross to the transfusion facility. At what temperature should the units be kept during transportation?
1-10 °C
One standard 300 µg vial of RhIg contains enough anti-D to protect against what amount of whole blood exposure?
30 mL
Which of the following represents the percent population of T-helper cells in this sample data? absolute lymphocyte count= 2.4 x 109/L %CD3 = 60 %CD4 = 40 %CD8 = 20
40% T-helper cells are CD4 positive. The flow results reflected 40% CD4.
What are the expected lab results in the condition known as "Afibrinogenemia"?
Elevated PT, elevated aPTT, elevated thrombin time (TT) and elevated reptilase time
The 20 µm in diameter cyst illustrated in the photograph had been observed microscopically in a trichrome stained mount prepared from a stool specimen of a patient with low grade, intermittent diarrhea. What is the presumptive identification?
Entamoeba coli
All of the following factors are involved in the intrinsic pathway, EXCEPT?
Factor XII ***Factor VII Factor IX Factor XI
Which classification is defined as encompassing a group of organisms that may contain multiple genera and consists of organisms with a common attribute?
Family
Which of the following is the principle for the biuret method for total protein analysis?
Formation of violet-colored chelate between Cu2+ ions and peptide bonds
A normal hemoglobin molecule is comprised of the following:
Four heme and four globin chains
Which blood component is the most commonly used component for the replacement of multiple coagulation factor deficiencies in bleeding patients?
Fresh Frozen Plasma
What sugar configuration is necessary as a base for attachment of other sugars to produce ABO antigens?
Galactose plus fucose
In rapid carbohydrate fermentation testing, Neisseria gonorrhoeae ferments the following sugar(s):
Glucose only
Observations that can be made based on the Gram stain examination include all of the following, EXCEPT:
Gram stain reaction Shape of the organism Cellular arrangement ***Age of the organism
What is the expected serological response in an immunocompetent patient who has been vaccinated for hepatitis B?
HBsAg (neg), Anti-HBc(neg), anti-HBs (pos)
A patient presents with platelet refractoriness, or poor response to platelet transfusions. What can be performed to help ensure platelet transfusions will be therapeutic?
HLA typing
All of the following are characteristic of Burkholderia pseudomallei EXCEPT?
Has been reported as the cause of laboratory-acquired infection Oxidase positive ***(Non-motile) Catalase positive
Examples of cytokines originating from activated T-cells include:
IL-2, IL-3
Which of the following methods may be employed to definitively identify Bence-Jones proteins?
Immunoelectrophoresis
Which of the following hormones is mainly responsible for the entry of glucose into the cell for energy production?
Insulin
An error is a verified and reported result on a patient that is later determined to be inaccurate. To identify an error, reports can be reviewed, other microbiologists may locate the error through testing, or nurses and physicians may come across the error when evaluating laboratory results. If an error is detected by repetitive quality control testing, which may indicate probable erroneous patient results, this is an example of which type of error detection?
Laboratory detection
A defective clot retraction might be caused by which one of these?
Lack of or defect of platelet receptor IIb/IIIa
Which Lewis antigen(s) would be detected when phenotyping the red cells of an adult who has the Le, Se, and H genes?
Leb
All of the following would be included in a hemolytic transfusion reaction investigation, EXCEPT:
Leukocyte antigen studies
Which organ is the primary target of the hepatitis B virus?
Liver
The late steps of complement activation and formation of the "membrane attack" complex (MAC) results in:
Lysis of cells
Which of the following viruses or diseases is screened for in blood donors only using questions asked during the donor screening and selection process?
Malaria
Serum calcitonin is typically elevated in which of the following conditions?
Medullary carcinoma of the thyroid
On a Cytospin preparation from a pleural fluid specimen, 50% of the cells have the following characteristics: - uniform, regular arrangement- some cells resemble a "fried egg"- multiple nuclei- smooth nuclear outline and homogeneous chromatin- when present in clumps, there are clear spaces between the cells ("windows")
Mesothelial cells
Identify the nucleated blood cell:
Monocyte
Which of the following media is commonly used when performing the Kirby-Bauer disk diffusion?
Mueller-Hinton agar
The entire, smooth, convex Mycobacterium species colonies growing on 7H10 agar were observed to be dark yellow pigmented early in culture even before having been exposed to light. This isolate was found to be Tween-80 positive as seen in the reaction tubes in the bottom photograph. Select from the multiple choices the presumptive identification of this isolate:
Mycobacterium gordonae
Can you use an alcohol wipe to cleanse the venipuncture site prior to obtaining a sample for ethanol?
No, alcohol wipes must be avoided when testing for ethanol levels
Which of the following organisms is a cause of cutaneous infections?
Nocardia brasiliensis
An MCV is reported by the instrument as 82 fL. The MCV is flagged with a delta check alert as the previous MCV reported on this patient 12 hours earlier was 97 fL. What is a possible cause for this discrepancy?
The specimens are not from the same patient
Koch's postulates include all of the following EXCEPT for which statement?
This microorganism can be isolated from specimens associated with the given disease. Inoculation of the isolate into a susceptible experimental animal will produce the disease. The organism can subsequently be recovered from an experimentally infected animal. ***The isolated organism, when injected into a human host, will produce the disease.
What is the purpose of the sweat chloride test?
To help diagnose cystic fibrosis.
Chloroquine diphosphate can be used in blood banking for which of the following methodologies?
To remove antibody bound to red cells so that cells can be further tested
Which of the following formulas would you use to calculate absolute cell counts?
Total count X % of cells counted
Nematodes are round and elongated and typically look like an earthworm. Nematodes can be found in decaying vegetation or moist soil. Of the following organisms listed, which one is considered a nematode?
Trichuris trichiura
Which of these methods are used to identify prior exposure to Mycobacterium tuberculosis?
Tuberculin skin test (TST)
What causes polyacrylamide gels to have greater resolution of proteins than agarose gels?
Varying pore size in each polyacrylamide layer
Using the initial screen cell antigram below, which antibodies have not been eliminated? Be sure to include all potential clinically significant antibodies not excluded by the antibody identification process. Screen CellDonorRh-HrKellDuffyKiddMNSsPLewisResultsCellCDEceKkFyaFybJkaJkbMNSsP1LeaLebGelIAT1R1R1++00+0+++0++00++002+12R2R20+++0++0++++++++0+3+23rr000++0++00+0++0+S+003Auto0Auto
anti-C, D, E, K, Fyb, Jka, M, s, Leb
Based on the following results obtained against a patient's red cells, what will the genotype look like in this example? Anti-C = 4+Anti-c = 4+Anti-E = 0Anti-e = 4+Anti-D = 0
r'r
When three tubes of cerebrospinal fluid are received in the laboratory they should be distributed to the various laboratory sections as follows:
#1 Chemistry, #2 Microbiology, #3 Hematology
All of the following methods can be used to transport carbon dioxide to the lungs EXCEPT:
- Blood plasma - ***Attached to neutrophils - Bound to hemoglobin in the RBC - In solution within the RBC
All of the following are indications for administering Rh immune globulin (RhIg) to an Rh negative woman, EXCEPT?
- Therapeutic abortion - Ectopic pregnancy - Rh positive fetus -***Rh negative fetus
All of the following are collected from sterile sites, EXCEPT:
- Urine - Pleural Fluid - ***Abscess fluid - Cerebrospinal fluid (CSF)
All of the following are uses of nucleic acid tests for HIV infection, EXCEPT?
-Monitor the effectiveness of antiretroviral therapy -Obtain a baseline value prior to the start of antiretroviral therapy -Diagnose HIV infection -***Determine the degree of immune suppression caused by HIV
Leukocyte-reduced blood products may be administered to reduce the risk of febrile reactions and what disease or condition?
Cytomegalovirus
When AHG or Coombs serum is used to demonstrate that red blood cells are antibody coated in vivo, the procedure is termed:
Direct technique
Which condition is caused by deficient secretion of bilirubin into the bile canaliculi?
Dubin-Johnson syndrome
It's a busy Friday evening in the blood bank, and you have been receiving a steady stream of Type & Screen specimens from the emergency room. Several of them have positive antibody screens, which require further workup. One of these patients is a 46-year-old male whose hemoglobin has dropped from 8.4 g/dL to 4.6 g/dL in the previous 8 hours (normal Hgb for this patient demographic would be ~14 g/dL). Your workup reveals a group O patient with the following antibodies: anti-K, anti-Fya. The prevalence of K negative donors in your donor population is 91%, while the prevalence of Fya negative donors is 37%. Two units of cross-matched RBCs are requested by the physician. How many units of group O RBC units should you phenotype in order to fulfill the request for two cross-matched units?
6 units of type O RBC units
A technologist performed a STAT spinal fluid count by pipetting undiluted spinal fluid in a Neubauer Counting Chamber and counting both sides of the chamber (4 large WBC squares on each side). A total of 54 White Cells were counted. How many White Cells would there be per cubic millimeter?
67.5 First, determine the number of WBC's from the hemacytometer as follows: WBC/µL= Avg # cells counted /(# squares counted x 0.1 µL) WBC = 54 / (8 squares x 0.1 µL) = 67.5/µL Since 1 µL = 1 cubic millimeter, then the answer is 67.5/µL.
A CSF glucose value is 62 mg/dL. What would you estimate the serum glucose?
93 mg/dL CSF glucose is roughly estimated to be about 2/3 of the serum glucose level in mg/dL. Therefore: 62 mg/dL = 2/3 x serum glucose serum glucose = 62 mg/dL x 3/2 serum glucose = 93 mg/dL
amplification curve Looking at the amplification curve on the right, which sample has the highest nucleic acid concentration - A, B or C?
A
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.
Which of the following statements is true regarding cardiovascular disease and adipose tissue?
A state of abnormal lipids and lipid levels found in metabolic syndrome contribute to the development of cardiovascular disease
Which of the following blood tests is used in the determination of prostate cancer?
Acid phosphatase
What is the term used to describe cardiac tissue death due to lack of oxygen caused by obstruction of circulation?
Acute myocardial infarction (AMI)
Which of the following describes a cestode?
Adults are ribbonlike and contain segments
Which of the following tests would be employed in order to detect neural tube defects?
Alpha fetoprotein
Which of the following tests is the BEST screening test for neural tube defects?
Alpha-fetoprotein
Identify the crystal indicated by the arrow in this alkaline urine:
Ammonium biurate crystal
An automated method for measuring chloride which generates silver ions in the reaction is called:
Amperometric-coulometric titration
Which of the following apolipoproteins contributes the greatest mass to the structure of high-density lipoprotein (HDL)?
Apo A
That portion of an enzyme which when separated from its cofactor is called a(n):
Apoenzyme
Which of the following is the immediate precursor of the mature neutrophil?
Band
A mother brings in her 6-year-old son to the clinic with concerns of learning difficulties from his school and also states he seems very tired all the time. The family has been staying in an old, run down motel recently as they try to find housing with no other significant family history. Testing was ordered to include a CBC. The CBC shows a microcytic anemia but otherwise normal results. Which of the following would be present upon manual differential review?
Basophilic stippling
Which of the following tumor markers is associated with testicular cancer?
Beta hCG
The avoidance of laboratory diagnosis techniques that utilize water is recommended for the identification of which of these parasites?
Blastocystis hominis
Identify the inclusion indicated by the arrow:
Cabot ring
8-Hydroxyquinoline and Ortho-Cresolphthalein complexone (CPC) reagent is commonly used in the determination of:
Calcium
A markedly elevated 5-hydroxyindoleacetic acid (5-HIAA) determination is presumptive evidence for:
Carcinoid tumor
The fluid that surrounds and protects the spinal cord and brain is called:
Cerebrospinal fluid
In the clinical laboratory, after correctly matching the blood collection tube(s) with the appropriate test requisition and patient identification labels, the laboratorian will ascertain if the sample is acceptable for further processing. What is NOT part of this criteria?
Checking for hemolysis.
A white blood cell (WBC) count is performed on a blood specimen from a newborn using a hematology analyzer that does not have the capability to detect and quantify nucleated red blood cells (NRBCs). The WBC count that is reported by the analyzer is 28.2 x 109/L and it is flagged for a manual differential. Upon review of the blood film, more than 6 nucleated cells that resemble the cells shown in the image were identified in the 100 WBC differential. What action should be taken?
Count the number of cells that resemble the cells in this image (per 100 WBCs) and compute for the corrected WBC count using the formula, Total WBCs x100 / 100+ number of NRBCs
A patient's coagulation mixing study results are shown below after an initially prolonged aPTT result. Initial aPTT: 63 sec. (normal range 21-34 seconds) Immediate aPTT mixing study: 26 sec. Incubated aPTT mixing study; 65 sec. Has the aPTT been corrected by the mix? Is a factor deficiency or a coagulation inhibitor the more likely cause of the patient's prolonged aPTT?
Not Corrected, Coagulation Inhibitor
This antinuclear antibody (ANA) test is viewed using fluorescent microscopy, which pattern is this?
Nucleolar
To determine if xanthochromia is present in a cerebrospinal fluid sample, the sample must be centrifuged within:
One hour
All of the following are methods employed for measuring the specific gravity of urine, EXCEPT?
Osmolality
A specimen from a 23-year-old female patient who is a Bombay phenotype arrives in the blood bank. You observe the following reactions upon tube testing. Which of the following statements is true?
Patient can receive only Bombay phenotype blood
What is the BEST type of microscopy for performing manual platelet counts?
Phase contrast
How should an ammonia specimen be transported to prevent alteration of the ammonia level in the blood plasma?
Place it into an ice slurry.
What is a corrective action that can be used to obtain a valid platelet count from a patient specimen that exhibits platelet satellitism on the manual differential?
Recollect the blood specimen in a blue top tube containing sodium citrate.
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?
Reject the specimen, the potassium test results will be increased.
This peripheral smear is demonstrating:
Rouleaux
The presence of two sporocysts each containing four banana-shaped sporozoites is characteristic of this organism; however, only oocysts with one sporocyst are typically seen in patient specimens. Which of the following organisms does this represent?
Sarcocystis species
Which of the following is most likely to interact with arterial walls, leading to deposition of cholesterol, and initiating or worsening atherosclerosis?
Small dense LDL
The cell diameter of a normal RBC is slightly smaller than the nucleus of which of the following blood cells?
Small lymphocyte
Which of the following cells is characterized by a thin rim of cytoplasm around the nucleus?
Small lymphocyte
Please see the image. Which illustration corresponds with the classification of bacteria seen in section A?
Spiral (spirochetes)
The class of protozoa with no apparent organelles for locomotion is known as:
Sporozoa
All of the following are functions of cerebrospinal fluid, EXCEPT?
Supply nutrients to nervous system tissue. ***Regulate body metabolism. Protect the spinal cord from injury. Remove waste products from cerebral metabolism
The arrows in the image point to Heinz bodies in erythrocytes. Which of the following stains was used to confirm the presence of these inclusions?
Supravital stain
What is the principle of the Kleihauer-Betke test?
The Kleihauer-Betke test capitalizes on the resistance of fetal hemoglobin to acid treatment.
An assessment of the myeloid to erythroid (M:E) ratio is part of every bone marrow evaluation. Which of the following does not apply to the M:E ratio?
The M:E should always be interpreted in context with the overall bone marrow cellularity.
What conclusion can be made if a person has a cardiovascular risk marker that is abnormal?
The person has an increased probability of developing cardiovascular disease.
Which of the following statements is true regarding the Gram-stained smear that is represented by this image?
The smear is underdecolorized and shows precipitated and crystallized stain.