Med Tech Review
All of the following have an impact on electrophoresis techniques in the clinical lab EXCEPT? Amount of light present in electrophoresis box Support medium pH Voltage
Amount of light present in electrophoresis box
Which of the following is not an enzyme that is used in molecular amplification methods DNA ligase Reverse transcriptase Alkaline phosphatase Amylase
Amylase
A sample has reactions occurring at immediate spin and AHG in a panel that show varying reaction strengths. There is no obvious pattern that matches a particular panel cell or single antigen profile and the auto-control was negative. Which of the following is the most likely cause?
An IgM and an IgG antibody
Using an automated cell counter analyzer, an increased Red Cell Distribution Width (RDW) should correlate with:
Anisocytosis
Which of the following is the recommended method for preparing a cerebrospinal fluid (CSF) sample for examination of cellular morphology Cytocentrifugation Concentration of cells by traditional centrifugation Manual smear methods Any of the above techniques
Cytocentrifugation
which hgb is known to migrate with hbs in alkaline electro
D
Illustrated in the photograph is a 15 X 25 um trophozoite recovered from the stool specimen of a 30 year old man with intermittent chronic diarrhea and malabsorption with onset 4 months after a camping trip to the nearby mountains. From the multiple choices listed, select the most probable presumptive identification.
Giardia duodenalis
Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes?
Glass
A patient admitted to the hospital for ongoing fever produces the following laboratory results: RBC count: 3.56 x 1012/L WBC count: 57.5 x 109/L Platelet count: 375,000/uL Differential count: 3 blasts, 10 myelocytes, 6 metamyelocytes, 12 bands, 64 segs, 4 lymphocytes, and 1 monocyte LAP score = 155. Which of the following conditions correlates closely with this patient's results?
Leukemoid Reaction
Which of the following stains is used to differentiate a neutrophilic leukemoid reaction from chronic myelogenous leukemia most accurately?
Leukocyte alkaline phosphatase (LAP)
in a motility agar, what organism has umbrella like motility
Listeria monocytogenes
The dry, chalky, indented, gray-yellow colonies growing in five days on chocolate agar as illustrated in the upper image were recovered from an expectorated sputum sample of a patient with bronchopneumonia. Illustrated in the lower image are delicate, branching, acid-fast bacilli. Key to the identification is negative hydrolysis of casein, tyrosine, and xanthine on casein agar. With these observations, what is the genus/species identification of this isolate?
Nocardia asteroides
HIV is known as a retrovirus because:
RNA is used as the template for DNA synthesis
For a substance to be immunogenic it must be
Recognized as non-self
A copper reduction method (e.g. Clinitest® or Benedict's) is performed on pediatric specimens in order to check for the presence of
Reducing substances
If an antinuclear antibody indirect immunofluorescence test shows a positive, speckled pattern, which would be the MOST appropriate additional test to perform?
Screen for Sm and RNP antibodies
What are the characteristics that should be remembered for lupus
Speckled/homo type 3 sens formation of complexes dna histones
Are normally found circulating in their inactive, spiny form. true or false
false Platelets do not circulate in inactivated, spiny forms. The spiny, sticky form of the platelet is initiated once the platelets become activated in response to blood vessel damage.
best overall picture of patients iron stores
ferritin
quantifying FMH
flow cytometry kleinhauer betke
infection of a tick bite, colonies on buffered yeast extract, tiny pale gram neg coccobacilli
francisella tularensis
In tissues infected with Histoplasma capsulatum, which of the following is usually true hyphae usually invade blood vessels encapsulated yeast cells are typical conidiophores with metulae and phialides are typical fungus is usually intracellular
fungus is usually intracellular
whiff test
gardenerella vaginalis
what does pacnreatic islets secret
glucagon insulin pancreatic polypeptide
what liver enzyme is intrumental in allowing glucose to enter the blood stream
glucose 6 phosphatase
what enzyme is responsible for conjugation of bili
glucuronyl transferase
clot retraction is apart of what
glycoprotein IIb/IIIa
the part of the immunoglobulins that is used to differentiate
heavy chains
electrophoresis separation of lactate dehydrogenase isoenzyme that demonstrates elevation in LD1 greater than LD 2 could be indicative of
hemolysis
tear drops are associated with
hepatic cirrhosis
what is associated with an increased level of alpha fetoprotein
hepatocellular carcinoma, viral hep, testicular tumors
what is found in urine after strenuous exercise
hyaline casts and granular casts
what does tamm horsfall protein do
hyaline casts are formed by this protein in DCT it acts as a coating and lubricant in the tissues produced by the tubules
monoclonal ab are usually manufactured in vitro by
hybridomas
primary mechanism responsible for glomerular filtration is
hydrostatic differential in glomerular tufts
what is commonly associated with febrile nonhemolytic transfusion rxns
immune response to leukocytes
automated blood cell counters are based on
impedance
Patients who develop severe sepsis or septic shock commonly have __________ plasma lactate values.
increased
what happens in nephrotic syndrome
increased proteinuria, decreased serum albumin, edema the kidney glomeruli are damaged, which allows proteins in the blood (albumin) to leak into urine
pt with high unconjugated bili- normal serum alkaline phosphatase- normal liver enzymes- and no bili in urine what does this suggest
increased rate of hemolysis
septicemias caused by coag neg staph are more likely to be caused by what
indwelling catheters
Enterobius vermicularis infection occurs through
ingesting or inhaling ova
cytokine most important for increased macrophage cell activity
interferon gamma
absorption of vit b12 is done by
intrinsic factor
Which of the following statements concerning C. difficile is NOT true? It is the causative agent of an inflammatory condition of the large intestine. It is an aerobic organism. It produces potent toxins. It produces spores.
it is an aerobic organism
how do you calculate the amount of ldl or hdl
ldl=total cholesterol - (HDL + trig/5)
Le sese
lea
which the development of fetal lung maturity, what phospholipid concentrations in amniotic fluid increases
lecithin
what is an important messenger in metabolism signaling the hypothalamus that there are changes in fat stores
leptin
room temp motility
listeria monocytogenes
which cell does not develop solely in the BM
lymph
Normal adult CSF may have 0-5 white blood cells (WBCs)/µL. Which of the following cell types account for 60-100% of these WBCs?
lymphs
BM cell that has highly granular basophilic cytoplasm but does not show nuclear lobation
mast cell
Most antibodies present in cord blood are of ________ origin.
maternal
cabot rings may appear in what conditions
megaloblastic anemia lead poisoning
screen best for pheochromocytoma
metanephrines
To determine if an elevated APTT is caused by a factor deficiency or a factor inhibitor when the PT is normal, the FIRST step would be:
mix 1 part patient plasma and 1 part normal reagent (pooled) plasma and repeat the APTT
nitrite portion of the test strip can be used to
monitor Ab therapy detect a bladder infection in early stage preg women screen individuals with recurrent infections
phagocytosis is performed by
monocytes
earliest biochemical marker of an MI
myoglobin
what marker is elevated first if the patient had a MI
myoglobin
certain recipients have increased risk for developing TA-GVHD they are:
neonates less than 4 months fetuses congenital or acquired immunodef recipients of donor units from a blood relative
are CKMB and myoglobin specific to cardiac muscle?
no
can specific gravity measure osmolality
no
does corisol increase glycogen to glucose conversion
no
does joint fluid resemble plasma in viscosity
no
is urea decreased in dehydration?
no
EMITS differ from all other types of immunoassays in that
no separation of bound and free antigen is requires
barr bodies are considered
non pathological
in an electrophoresis separartion, if the zones appear crescent shaped, what is the cause
overload of sample
false pos for IAT
overventrifugation
aermonas vs e coli
oxidase ecoli - aeromonas +
when doing a finger poke, do you put the lancet perpendicular or parallel with the groves of the fingers
perpendicular
FSH is produced by
pituitary
Which type of blood component is most implicated in bacterial contamination?
platelets
best method for examination of synovial crystals
polarized light
RBC formation of larger amounts of hemoglobin usually begins at what stage
polychromatic normobalst
The condition most likely to predispose a person to septicemia by viridans strep is
poor oral hygiene
would the VP test be pos or neg with klebsiella
pos
reaction when soluble antigen is mixed with its specific ab
precipitation
antimitochondrial ab
primary biliary cirrhosis
what would u find in DIC but not TTP or HUS
prolonged pt and ptt decreased fibrinogen
the selectivity of an ion selective electrode is determined by
properties of membrane used
which contributes to specific gravity but not to osmolality
proteins
A refrigerator used to store whole blood must be able to maintain a temperature in the ranges of:
1 - 6 degrees Celsius
where does tube 1, 2, 3 go for CSF
1 chem 2 micro 3 heme
brucella should be held for how long on bact alert
10-14
HPV types are most likely to be associated with cervical cancer
16 and 18
Twenty microliters (20 µL) of blood are diluted with 1.98 mL of diluent. Both sides of the hemocytometer are charged with the diluted sample and the entire ruled area of the center square is counted on both sides. A total of 356 platelets are counted (combined total of the two large squares). What is the platelet count per liter?
178 x 109/L # of platelets counted x dilution x 10 (depth) = platelets/uL number of squares counted 356 x 100 x 10 = 178 x 103 platelets/uL or 178 x 109 platelets/L 2
diluent used for sperm routine
1:20
preg female has pos ab screen due to rhogam. to be considered passive, an anti D reaction is typically equal or less than
2+
kappa/lambda ratio
2:1
Antibody identification interpretations would be considered correct 95% of the time or have a P value of 0.05 if you have:
3 positive reactions to rule in an antibody and 3 negative reactions to rule out an antibody
screen asymptomatic diabetes patients how often
3 years
troponin I will begin to increase and stay elevated for how long
3-12 hours will begin to increase 7-14 days
In order to correctly prepare a 4M solution of NaOH, how many grams need to be added to 200mL of solution? (GMW=40
32 grams Weight = Molarity x (volume needed ÷ 1000 mL/L) x Gram Equivalent weight/L Then, Weight = 4 (200mL ÷ 1000 mL/L) x 40g/L Weight = 32 grams NaOH (dissolved in 200 mL total volume will make a 4M solution)
The shelf-life of whole blood collected in CPDA-1 is
35 days
Which of the following combination of globin chains comprise Hemoglobin H
4 beta chains
lower threshold value for semen pH from fertile males
7.2
Units of A-, B-, and O-negative red blood cells are shipped to your transfusion service. What testing MUST be performed by your facility prior to placing these units into your inventory?
ABO and Rh
Which of the following best describes the direct antiglobulin test principle:
AHG detects antibody already coated to red cells
The border to border extension of the mycelium as illustrated in the top photograph is characteristic of one of the Zygomycetes. Although a light yellow green pigmentation of the mycelium is observed, the identification of the isolate depends on the presentation of the fruiting body observed in the bottom photomicrograph. From these observations, select the name of this isolate from the list of multiple choices.
Absidia species
what is the confirmatory method for ketones
Acetest® is used as a confirmtory test for ketones and can be used to test urine, serum, and whole blood
Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity?
Adiponectin
The most important bloodborne pathogens are: Hepatitis B Hepatitis C HIV All of the above
All of the above
Which alpha thalassemia shows no anemia, although a slight decrease in the MCV and MCHC may be seen
Alpha thalassemia silent carrier
In the laboratory, what biosafety level (BSL) safety equipment, practices, and facility design are recommended by the Centers for Disease Control and Prevention (CDC) for working with Mycobacterium tuberculosis if it is deemed probable that aerosols might be released?
BSL-3
Which of the following has a life cycle that most closely resembles that of Plasmodium sp:
Babesia microti
organisms display the characteristic "Medusa head" on sheep blood agar (SBA) after 18 hours of incubation at 35°C?
Bacillus anthracis
Cultures from post-abdominal cellulitis grow gram negative pleomorphic rods with the following characteristics: Grows on KV agar but does not show fluorescence Produces black colonies BBE agar Resistant to penicillin
Bacteroides fragilis
Which of the following best describes the primary function of antibodies:
Bind with antigen
Illustrated in the top photomicrograph is a 4 day old colony growing on Sabouraud's dextrose agar with a smooth dark gray to black surface surrounded by dark gray and white peripheral bands. The colony morphology is not distinctive. The identification is made by observing the septate hyphae and conidia as microscopically observed in the lactophenol stained mount obtained from the surface of the colony as illustrated in the photomicrograph. From these observations, select from the multiple choices the name of the fungus being presented.
Bipolaris species
Blood lactate concentration is an indicator of impaired circulation and tissue oxygenation in critically ill patients. If circulation and tissue oxygenation are impaired:
Blood lactate concentration will increase.
aids patients have decreased what
CD 4 cells
anticemtromere ab
CREST
The growth of yellow-white yeast colonies with a smooth or hair-like surface within 2 - 3 days on non-selective culture media generally requires further procedures to make a presumptive identification. Microscopic observation of the subculture of colonies growing on cornmeal agar is one such approach, as illustrated in the photomicrograph. Note the spider-like colonies that appear along the streak line. From the multiple choices, select the name of the presumptive yeast identification.
Candida parapsilosis
A manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 152 and 164 respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the technologist report as the white cell count?
Cells Counted (in this case the average of both sides) X dilution factor (in this case 100) / # of squares counted (in this case 9) X area of each square (1mm2) X 0.1mm (depth factor) So, in this problem: 158 x 100 / 9 x 1 x 0.1mm = 17555.55/mm3 (can be converted to 17.5 x 109/L*) *There are 1,000,000 mm3 in a liter (L). So 17555.55 X 1,000,000 = 17.5 x 109/L
Acute idiopathic thrombocytopenic purpura (ITP) is MOST OFTEN associated with which of these populations Newborns Children 1 - 7 years of age Adults 20 - 40 years of age Seniors over the age of 65
Children 1 - 7 years of age
Which of the following lipoproteins will form a creamy layer at the top of stored, non-fasting plasma specimens?
Chylomicrons
Fresh frozen plasma should be used for which of the following:
Coagulation deficiencies
Although care should be taken when working with all fungus cultures in the laboratory, personnel are particularly prone to develop laboratory acquired infections from the inhalation of airborne species of:
Coccidioides immitis
The dimorphic molds exist in both mold and yeast forms depending on the temperature of incubation. In the laboratory, when cultures are incubated at 30o C, all of the dimorphic fungi will produce mold colonies, usually with prolonged periods of growth ranging from 10 - 14 days. When cultures are incubated at 35o - 37o C, yeast colonies develop usually within 3 - 5 days, with the exception of one of the dimorphic species. From the options shown below, select the genus that does not produce yeast colonies when cultures are incubated at the higher temperature.
Coccidioides immitis
Factor V is primarily involved in the:
Common pathway
The Clinitest® reaction is based on which of the following principles?
Copper reduction
What is the corrected WBC if a differential count shows 20 nucleated erythrocytes per 100 leukocytes and the uncorrected leukocyte count is 12,000/ mm3?
Corrected WBC count = uncorrected WBC count x 100 # NRBCs (per 100 WBC) + 100
Chemicals such as sodium hydroxide and sulfuric acid should be labeled
Corrosive
Cystine-tellurite blood agar is recommended for the isolation of which organism?
Corynebacterium diphtheriae
Which one of the following organisms is commonly cultured from the nasopharynx of healthy people but is RARELY pathogenic: Beta hemolytic streptococci Corynebacterium species Haemophilus influenzae Neisseria meningitidis Staphylococcus aureus
Corynebacterium species
Which antibiotic is used to suppress or kill saprophytic molds in media?
Cycloheximide
defines specific gravity:
Density of a solution compared to density of water
What is the role of albuminuria testing?
Detect small urinary concentrations of albumin before there is irreparable renal damage.
Which of the following is NOT a common support medium used in electrophoresis technique
Dextrose
Most common methods for measuring bilirubin are based on the reaction of bilirubin with
Diazo reagent
urease neg organism
E coli
An osmometer can use any of the following principles except: Freezing point depression Vapor pressure Electrostatic charge Freezing point depression and vapor pressure
Electrostatic charge
Which of the following is NOT an expected or common laboratory finding in patients with hereditary hemochromatosis (HH)? Elevated hemoglobin and hematocrit Elevated transferrin saturation Presence of HFE mutation Elevated serum ferritin
Elevated hemoglobin and hematocrit
The prothrombin time test will detect deficiencies in which pathway
Extrinsic and common
replacement of multiple coag factor def in bleeding pts
FFP
Amylase and lipase are as predictive in chronic as in acute pancreatitis. True or False
False
The HIPAA privacy regulation prohibits faxing of PHI to other health care providers True or false
False The regulations do not prevent faxing of PHI. Covered entities must have appropriate policies, procedures and processes in place to make faxing of PHI as secure as possible.
The first time a cell containing Hb SS is deoxygenated, it forms an irreversibly sickled cell. True or False
False initially, sickling is reversible. Upon repeated sickling and unsickling, cells with Hb SS tactoids become irreversibly sickled.
Which one of the following red blood cell phenotypes will NOT react with Anti-Fy3?
Fy(a--b-)
most common method for confirmation of serum barbiturate
GLC gas liquid chrom
gamma irradiation is used to prevent what
GVHD
Which one of the following descriptions about Pasteurella is FALSE? Forms large amounts of indole. Grows well on MacConkey agar. Many infections caused by domesticated animals. Multocida is species most frequently isolated from humans. Produces an odor similar to E. coli.
Grows well on MacConkey agar. Pasteurella does not grow well on MacConkey agar. Pasteurella spp. will usually grow at 37 degrees C on blood or chocolate agar.
Which is the first marker (antigen or antibody) which will become positive after exposure to Hepatitis B
HBsAg
The satellite phenomenon on culture plates is MOST often associated with
Haemophilus influenzae
Which of the following organisms has been known to cause epidemic tinea capitis in children but almost never affects adults?
Microsporum audouinii
The absence of which clotting factor causes NO bleeding tendency
Hageman factor
hetero state of HbS that is reffered to as sickle cell trait contains which of the following hgb in combination with S
HbA
Of the dimorphic fungal species that are listed below, which has the longest time of recovery in primary culture?
Histoplasma capsulatum
The HIPAA Privacy Rule applies to covered entities. Which of the following is NOT an example of covered entities?
Hospital and laboratory accrediting agencies
Illustrated in the photograph is a close in view of a 70 um 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. Select the presumptive identification of this tapeworm ovum from the multiple choice answers.
Hymenolepis diminuta
most likely elevated in anaphylactic shock
IgE
what antigen group is closely related to the ABO antigen on the RBC membrane
Ii lewis
In skin tests for allergy, a wheal and flare development is indicative of:
Immediate hypersensitivity
In essential thrombocythemia, the platelets are usually:
In essential thrombocythemia, or ET, platelet counts are usually greater than 600 x 109/L. In ET, it is common for these platelets to be functionally abnormal
Which is the main limitation of standard PCR that is not a limitation of real-time PCR Requirement of a large initial sample Inability to quantitate DNA product due to endpoint analysis only Ability to detect PCR product during the plateau stage
Inability to quantitate DNA product due to endpoint analysis only
All of the following examples require biohazard labeling except?
Individual specimen containers
Illustrated in the photomicrograph is an amebic cyst as observed in a stool specimen obtained from a patient with low-grade, intermittent diarrhea. Observe the distinctive cytoplasmic vacuole and "ball in socket" nucleus. Select from the list of responses the species identification of this amoeba. (shows a cyst with a large vacuole)
Iodamoeba butschlii
You are working to validate a new method for the detection of C-reactive protein (CRP) in serum. To assess precision, you run a medium level control 30 times and determine the mean to be 4.0 mg/dL with a standard deviation of 0.04 mg/dL. What could be said about the precision of this run?
It is acceptable with a coefficient of variation of 1% Precision is often measured by extrapolating and evaluating the coefficient of variation, or CV. To find the percent CV, you must divide the standard deviation by the mean and multiply the result by 100. Ideal CVs are less than 3% (in a typical laboratory setting). 0.04 mg/dL divided by 4.0 mg/dL is 0.01. Multiplied by 100 = 1%, which is well below 3%. This indicates that the precision of this particular run is acceptable according to typical laboratory standards.
When the glucose result on a urine specimen from an infant is negative on the reagent strip:
It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances
what can cause a false pos with ketones
L DOPA
What is a LIS in a hospital setting?
Laboratory Information System
lele sese
Lea-b-
Le Se
Leb
what lewis will have SE LE and H
Leb
What MINIMUM level of a particular factor will cause the aPTT test to become prolonged?
Less than 40%
which mycobacterium species is associated with HIV AIDS pt
M avium
An acid-fast bacillus recovered from a post-surgery wound of a young child had the following characteristics: Rapid growth (3-5 days) on blood and chocolate agar nitrate positive; niacin negative urease positive; catalase 25/68ºC positive; iron uptake positive Which of the following is the MOST likely identification M. tuberculosis M. scrofulaceum M. kansasii M. avium-intracellulare M. fortuitum
M. fortuitum
Isoenzymes of CK include all of the following except: MB MM MBM BB
MBM
Blood samples for complete blood counts are collected on morning rounds and stored in a rack in the phlebotomist's basket. When the phlebotomist delivers the samples to your work station, the cells and plasma in the samples have separated. One of the samples has lipemic plasma. Which of the following parameters may be affected by the lipemia?
MCHC
antigen enzyme decreased
MNSs duffy
In cases where more severe symptoms may occur, particularly in progressive anemia, what additional test procedure should be performed to determine the role that hookworm infection may play when ova are detected in stool specimens?
Make a quantitative count of the number of ova present
When testing a patient with a warm autoantibody, which of the following is the most important concern? Masking of other clinically significant antibodies Interference of plasma protein with detection methods Detection of donor antibodies Interference of rouleaux
Masking of other clinically significant antibodies
In HDN which of the following antigen-antibody reactions is occurring
Maternal antibody against fetal antigen
n HDN which of the following antigen-antibody reactions is occurring:
Maternal antibody against fetal antigen
An analytical method with a low detection limit would
Measure low concentrations of analytes
Illustrated in the photograph of the surface of a blood agar plate are 48 hour old colonies incubated at 37o, with smooth, lemon yellow pigmentation. Note in the photomicrograph is a Gram stain with relatively large Gram positive cocci arranged in tetrads. Other distinguishing characteristics were the demonstration of susceptibility to bacitracin ("A disc") and resistance to furazolidone. From the list of multiple choices, select the identification of his isolate.
Micrococcus luteus
Which of the following causes schistocyte formation in disseminated intravascular coagulation (DIC)? Degranulation of promyelocytes Excessive fever in patients with DIC Microthrombi disposition in small vessels Excessive platelet size
Microthrombi disposition in small vessels Schistocytes are the result of erythrocytic membrane damage caused by sheering of red blood cells as they pass through a fibrin mesh of clot formation occurring in the blood vessels. This occurs in DIC, TTP and HUS. Therefore, schistocytes may be seen in all three of these conditions
Which specific terminal sugar causes a red cell to have A antigenic activity?
N-acetylgalactosamine
The Thayer-Martin agar plate seen in this illustration exhibits marked growth. The most likely organism found here would be:
N. gonorrhoeae
On occasion in cases of heavy infection, rhabditiform nematode larvae, measuring up to 1.5 cm long, may be observed in mounts prepared from stool specimens. A presumptive species identification can be made by microscopically observing the buccal cavity as illustrated in the photograph. Select the most likely species of nematode from the choices listed below.
Necator americanus
Which one of these characteristics distinguishes vancomycin-resistant Enterococcus faecium and Enterococcus faecalis from other Enterococcus species?
Non-motility The characteristic that distinguishes vancomycin-resistant Enterococcus faecium and Enterococcus faecalis from other Enterococcus species is their lack of motility. Enterococci are all catalase-negative. Growth on bile esculin agar and in 6.5% salt broth are two characteristics that have commonly been used to identify Enterococcus to the genus level. A positive esculin in combination with a positive PYR reaction is another approach to presumptive identification.
When can a doctor order a panel made up of tests he/she specifically wants?
Only if the laboratory ensures the ordering physician knows what tests are included in the panel or profile and has the appropriate procedure and diagnostic codes for each test
The increased resistance of MRSA strains to beta-lactam antibiotics is due to production of which of the following penicillin binding proteins (PBPs)?
PBP 2a
Warfarin-based (coumarin derivative) oral anti-coagulant therapy is commonly monitored with
PT/INR
By utilizing a Prussian Blue stain, which of the following red blood cell inclusions would be identifiable if present? Note: Upper image = Wright-Giemsa stain Lower image = Prussian Blue stain
Pappenheimer (siderotic) bodies
What should be done FIRST if a donor unit is found to be incompatible at the antiglobulin phase with several different recipients?
Perform a direct antiglobulin test (DAT) on the donor unit
In this photomicrograph are observed several background dematiaceous hyphae within which is seen a long, flask-shaped, tapered phialide (arrow) that has a flat saucer-like terminus. This feature is most characteristic of:
Phialophora richardsiae
Parasites which can be found in urinary sediment include all of the following EXCEPT: Enterobius vermicularis Trichomonas vaginalis Plasmodium malariae Schistosoma haematobium
Plasmodium malariae
Identify the parasite of a patient with suspected malaria who demonstrates the following findings on a blood smear: - Enlarged RBCs, some with fine brownish granules - > 15 parasites in some cells - Ameboid structures - Schuffner's dots
Plasmodium vivax
How should the production of a blue or purple color on the test pad of an Ictotest® be interpreted?
Positive for bilirubin
The majority of all laboratory errors occur during which phase of laboratory testing?
Preanalytic
What is the focus of both Lean and Six Sigma?
Process improvement
What is the anatomical feature of a tapeworm that possesses both male and female reproductive structures?
Proglottid
This Xylose Lysine Decarboxylase medium shown in this photograph was isolated from a stool specimen on an immunocompetent adult. Your best action would be to: (yellow colonies)
Report it as no Salmonella or Shigella isolated. D is the correct answer because this is a lactose or sucrose-fermenter. Salmonella and Shigella would appear red on XLD and Salmonella would also have black centers from production of H2S. Yersinia enterocolytica and Escherichia coli O157:H7 would appear yellow on XLD but other media such as CIN for Yersinia and Sorbitol MacConkey for E. coli O157:H7 would be more selective for these isolates. XLD is recommended only for isolation of Salmonella and Shigella.
A smear that is prepared from equal parts of methylene blue and whole blood will be used for
Reticulocyte count
Common colds are MOST often associated with which agent?
Rhinovirus
Which disease is MOST likely to show a homogenous pattern in an immunofluorescence (IF) microscopy test for ANA?
SLE
Illustrated on the photograph is a close in view of immature gray-white colonies growing on Xylose-lysine-decarboxylase (XLD) agar recovered from a stool specimen of a middle aged patient with fever and diarrhea. Note that more mature colonies have a distinctive black pigmented center surrounded by a pink halo. With these observations, select from the multiple choices the presumptive identification of this isolate.
Salmonella species
Which of the following microscopic techniques is capable of producing a 3-dimensional image
Scanning electron microscope
This non-hemolytic Streptococcus was isolated from the blood culture of a patient recently diagnosed with colon cancer. The image below demonstrates 6.5% NaCl broth (not turbid) and bile esculin agar (h2s production). With further testing, this isolate will most likely be identified as
Streptococcus bovis Streptococcus bovis is the correct answer because Group D streptococcus, not Enterococcus, is demonstrated by a negative 6.5% NaCl tube and a positive bile esculin agar. Streptococcus bovis belongs to this group and is associated with bacteremia in patients with colon cancer. Streptococcus pneumoniae and Streptococcus pyogenes are bile esculin negative. Enterococcus spp. grow in 6.5% NaCl broth.
The first time a cell containing Hb SS is deoxygenated, it forms an irreversibly sickled cell. true or false
false Initially, sickling is reversible. Upon repeated sickling and unsickling, cells with Hb SS tactoids become irreversibly sickled.
Which form of hemoglobin cannot be measured using the cyanmethemoglobin method
Sulfhemoglobin
specificity eq
TN/(TN+FP)
how to rule out heparin contamination
TT
Based on the morphologic features of this 40 um (in diameter) ovum as seen in the upper photomicrograph the accompanying scolex of the adult worm as illustrated in the lower image, select the presumptive identification of this cestode from the multiple choice answers listed below. (teeth present)
Taenia solium
What are the two general categories of nucleic acid amplification (NAA) techniques?
Target amplification and signal amplification Target amplification and signal amplification are the two general categories of amplification techniques. Polymerase chain reaction (PCR), RT-PCR, and strand displacement amplification (SDA) are specific examples of target amplification, while branched chain DNA (bDNA) is an example of signal amplification. FISH assays do not involve amplification.
Which of the following is not associated with RBC macrocytosis?
Thalassemia
A specimen from a 23-year-old female patient known to possess Bombay phenotype arrives in the blood bank. You observe the following reactions upon tube testing. Which of the following statements is true? (tubes show patient as O) Type AB red blood cells can be transfused to this patient Type O red blood cells can be transfused to this patient in an emergency Type O NEG blood can be transfused to this patient None of the Above
The correct answer is: none of the above An individual with Bombay phenotype will express as type O on the front and back types. She cannot be given type O blood, however, because she produces anti-A, anti-B and anti-H. As you may be aware, H substance (L-fucose) is present on the red cells of 99.99 percent of the population and expressed to the greatest extent on the red cells of type O individuals. Therefore, it would be very dangerous to transfuse this patient with type O blood. Such an individual can only receive blood from another person of the Bombay phenotype.
A 45-year-old male of average height and weight had a serum creatinine of 1.5 mg/dL and urine creatinine was 120 mg/dL; the total volume of urine collected over a 24-hour period was 1,800 mL. Calculate the creatinine clearance for this patient in mL/min.
The creatinine clearance for this patient is 100 mL/min. Creatinine clearance values are calculated using the following equation: Creatinine Clearance (mL / min) = (Urine Creatinine / Serum Creatinine) x Urine Volume (mL) / [ time (hr) x 60 ] For this patient Creatinine clearance (mL/min)= (120/1.5) x (1800 / [24 x 60]) 80 x 1800/1440, which is 80 x 1.25, or 100 mL/min
Which one of the following is the correct definition of isoelectric point (pI)? -Buffer formation of a positively charged ionic cloud that can affect the migration of the negative ionic cloud of the sample -The ability of a molecule to have both negatively and positively charged groups -The pH where a molecule has a net charge of zero -The movement of charged particles in an electrical field
The pH where a molecule has a net charge of zero
A phlebotomist is collecting several different tubes for a variety of laboratory tests. One of the tubes that she needs to collect is a royal blue top tube for heavy metal testing. This is a tube that is rarely used, but fortunately she finds some in the back of the phlebotomy supply cabinet. According to the order of draw, this tube is filled last. She successfully fills the light-blue, green, and lavender top tubes, but the royal-blue top tube barely fills half-way even though the blood was flowing freely throughout the blood collection. She tries another royal-blue top tube and it also begins to fill and then stops. The phlebotomist determines that the vacuum in these tubes is not adequate to fill the tubes. Which of the following is the most likely explanation for the lack of vacuum in the tubes?
The tubes are past their expiration date.
A physician discusses weight with an overweight 60-year-old female at her yearly physical appointment. The female exercises regularly and eats healthy most of the time. The physician suggests she decrease carbohydrate intake and decrease portion size at meals. Review patient vital signs and laboratory assay results to decide if a diagnosis of metabolic syndrome is appropriate using the NCEP: ATP III Diagnostic Criteria shown on the right. Height: 5' 7' Weight: 192 lbs BMI: 30.1 Waist Circumference: 37 inches Blood Pressure: 108/70 Fasting Blood Glucose: 92 mg/dL Total Cholesterol: 172 mg/dL LDL-C: 112 mg/dL HDL-C: 46 mg/dL Triglycerides: 70 mg/dL hs-CRP: <1.0 mg/L
This patient does not meet the criteria for diagnosis of metabolic syndrome.
Which of the following is not a nucleotide in RNA?
Thymine
For which of these reasons would a molecular method be used to determine a pregnant woman's Rh type?
To differentiate between weak D or partial D
An exchange transfusion has been ordered for a low birth weight infant. The physician has ordered irradiated Red Blood Cells for this purpose. Why is it necessary to irradiate the blood products for this patient?
To prevent transfusion-associated graft-versus-host disease (TA-GVHD)
Chlamydia trachomatis causes which of the following problems
Trachoma, a major cause of preventable blindness in the world
In real-time PCR procedures, fluorescence resonance energy transfer (FRET) is the process that allows for probes to emit fluorescence only after hybridization. True or false
True
The best way to evaluate single nucleotide polymorphism (SNP) is by melting curve analysis true false
True
Which of the following urine chemical reagent strip tests is based on the Ehrlich-aldehyde reaction?
Urobilinogen
which tests would u employ to examine a CSF for syph
VDRL
Which of the following are not appropriate indications for the use of fresh frozen plasma:
Volume expansion
The three main types of peripheral blood cells are:
White blood cells, red blood cells, and platelets
Illustrated in the photomicrograph is the tail portion of an adult worm of a filarial nematode. Human infections with this nematode are more commonly found among those living in Southeast Asia, but may be observed in recent travelers there and to surrounding regions. These adult worms measure up to 300 um, occupy lymphatic channels and may cause lymphatic obstruction. Varying degrees of fever and chills may be experienced. The species indicated in this exercise by the orientation of nuclei within the tail section (arrows), more commonly involves the lymphatics of the genital tract resulting in orchitis and hydrocele. From the nematode species listed below, indicate the most likely species identification.
Wuchereria bancrofti
Patient 1234 has a positive antinuclear antibody (ANA) test with a centromere pattern at a 1:1280 titer. Surprised by the result, the clinician calls and says the patient is only having mild stiffness of her fingers and asks your opinion of the result. Which is your best reply?
You point out that centromere antibodies have been known to occur years prior to the onset of the disease and the patient should be carefully examined and monitored for the development of other symptoms.
what is a hapten
a nonimmunogenic material capable of stimulating an immune response only when bound to a carrier protein
vonwillebrand dz lab results that are characteristic
abnormal plt aggregation in response to ristocetin
infection behind jaw, not acid fast
actinomyces israelii
what analyte measurement is used to detect early nephropathy in a diabetic pt
albumin
what protein is the majority of the protein that is detected by the urine reagent strip test
albumin
Thorny apple=
ammonium biurate
is bacteroides anaerobic or aerobic
anaerobic
dolichos biflorus
anti a1
12 weeks after onset of the dz, patient with uncomplicated acute hep B usually will demonstrate what in their serum
anti-HBe
mechanism of heparin induced thrombocytopenia (HIT)
antibodies directed against plt facctor 4 and heparin complex
PTP will have characteristics of
apperance of purpura plt count of less than 10,000 mucosal membrane bleeding
lecithinase production
bacillus mycoides
what abnormal hgbs may be formed in alpha thalassemia
barts and H
what test is used to quantify a coag inhibitor
bethesda assay
elevation of conjugated bili is most likely found in
biliary obstruction
budding yeast
blastomyces
best specimen for legionella
bronch wash
what cardiac biomarker is a regulator of myocyte contraction
cTnT
the purpose of C3a and C5a
cause increased vascular perm, contraction of SM, and release of histamine from baseo
bicarb leaves RBC and enters plasma in exhange for
chloride
cells with a pos DAT cannot be tested with blood typing reagents that require an IAT unless they have been treated with
chloroquine diphos zzap or ficin (dissociate IgG from the rbc membrane)
which chromosome demonstrates a partial or full gene loci deletion in various forms of beta thalassemia
chromosome 11
if the pt or ptt becomes corrected then goes back to being prolonged, it is an
coagulation inhibitor
what would u use to obtain a fetal sample to monitor severity of HDFN can also use to deliver intravenous transfusion
cordocentesis
does HIV increase or decrease lymph production
decrease
you find yeast in the urine, what is yeast commonly associated with
diabetes
Thin layer chromatography is a good tool for testing
drugs
highest rh antigen found in white
e
"hydatid sand" is what tapeworm
echinococcus sp
pos bile eschulin and pos nacl 6%
enterococcus
h2s production
erysipelothrix rhusiopathiae
what factor is not measured by the aptt and the pt
factor XIII
Cells are only capable of phagocytizing bacteria. True or false
false
hemoglobinuria and hemoglobinemia will be present in reactions where there is extravascular hemolysis true or false
false
Determining viral load is how one determines a positive diagnosis for HIV infection. true or false
false Determining viral load is a way to monitor already infected individuals with HIV and other viral diseases. The viral load can show how well treatments are working, show potential medication resistance, and also indicate relapses.
what should happen if a donor experiences numbness in the mouth during an apheresis procedure
reduce the flow rate
how can u protect, delaying symptoms, with hereditary hemochromatosis
reg blood donation pregnancy menstruation
antigen enzyme increased
rh kidd lewis I P
ab that are enhanced by enzymes
rh lewis kidd
antimyocardial ab
rheumatic fever
strep with pos bile solubility test
s pneumonia
quantitative methods for albumin
serum protein electrophoresis nephelometry colorimetric
Removal of which of these organs may be a last resort treatment for a patient whose platelet count is less than 30 x 109/L as a result of chronic idiopathic thrombocytopenic purpura (ITP)
spleen
which of the following bacteria is the MOST freq cause of prosthetic heart valve infections
staph epi
what staph does not have a positive coag test
staph lugdunensis
deviations from beers law are caused by
stray light
what would the CSF tubes look like if there was a subarachnoid hemorrhage
there would be evenly distributed blood in all tubes
serum hemolytic level (CH50) measures
total complement activity
sensitivity equation
tp/(tp+FN)
chylomicrons are composed of
triglycerides
The Kleihauer-Betke test used to quantitate FMH has poor reproducibility. true or false
true
The urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen. true or false
true
the dna strand ending with a phosphate group is the 5' end, true or false
true
The urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen. (true or false)
true Unlike the refractometry method, the reagent strip method is NOT affected by the presence of x-ray contrast media in the urine specimen. The reagent strip method is based on the relationship between ionic concentration and specific gravity. Urine specific gravity increases as ionic concentration increases. If there were no solutes present, the specific gravity of urine would be 1.000, which is the same as pure water. Since all urine has some solutes present, a urine SG of 1.000 is not really possible. The upper limit of the test pad on a chemical reagent strip, which is typically 1.035, indicates a concentrated urine, one with many solutes with a smaller amount of water. High concentration of protein increases the specific gravity readings on the reagent strip as a reasult of interations between the strip and protein anions. When using the reagent strip method, an alkaline pH (6.5 or higher) would affect the specific gravity result by decreasing the reading. The refractometer method is based on the fact that light is refracted in proportion to the amount of total solids dissolved in the urine
If a sodium citrate sample drawn for coagulation is noted to be filled an inch below the fill line (black line), then the specimen is considered:
unacceptable
blood sample is left on a phlebotomy tray for four hours before it is delivered to the laboratory. Which group of tests could still be performed glucose, Na, K, Cl, PCO2 uric acid, BUN, creatinine total and direct bilirubin CK, ALT, ALP, ACP
uric acid, BUN, creatinine
what confirms the presence of bence jones protein in urine
urine protein electrophoresis or immunoelectrophoresis
bacteria contamination effect on urine ph
urine will become more alkaline
what urine reagent will never be reported as negative
urobilinogen normal levels are .2-1.0
ultimate end product of epi and norepi metabolism is
vanillylmandellic acid
Which of the following organisms are gram negative: Bacillus Vibrio Staphylococcus Nocardia
vibrio
metabolic alkalosis
vomiting
most common type on autoimmune hemolytic anemia
warm autoimmune hemolytic anemia
antineutrophilic ab
wegeners granulomatosis
is alpha 1 antitrypsin CRP and fibrinogen all acute phase proteins?
yes
