MLT ASCP UA, Immunology, Body Fluids, and Lab Operation

What is the lower reference limit for semen volume according to the World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen, 5th edition?

1.5 mL The typical ejaculate contains usually between 2-5 mL. Volumes above or below the reference intervals are associated with infertility.

An average adult would excrete approximately what volume of urine per 24 hours

1200-1500 mL

A dilution commonly used for a routine sperm count is:

1:20

Safety data sheets shall be maintained and be available to employees in the ______________

Workplace area

Xanthochromia CSF

Xanthochromia is an abnormal color, usually yellow, orange, or pink, in the supernatant of the CSF sample. It may indicate that a subarachnoid hemorrhage (SAH) has occurred. Jaundice and icterus both describe a yellowing of the skin, mucous membrane, and eyes. Blood plasma/serum that is deeply yellow is also described as icteric.

adenine (A), guanine (G), cytosine (C) and thymine (T) in DNA

adenine (A), guanine (G), cytosine (C), and uracil (U) in RNA

Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes? a. Silver b. Glass c. Platinum d. Platinum-lactate

b. Glass

A patient who has a primarily vegetarian diet will most likely have

An alkaline urine pH

An India Ink preparation is used to identify: A. Crystals in synovial fluid B. Cryptococcus neoformans in CSF C. Bacteria in CSF D. WBCs in synovial fluid

B. Cryptococcus neoformans in CSF India Ink preparation performed on spinal fluid is used to demonstrate the polysaccaride capsule of Cryptococcus neoformans by negative staining.

Which of the following are indicators of sepsis? (more than one is correct) A. Erythrocytosis B. Increased heart rate C. Leukocytosis D. Increased body temperature

B. Increased heart rate C. Leukocytosis D. Increased body temperature Sepsis results in an immune response by the body. This response includes increasing body temperature and leukocytes in order to help fight off the infection, and increased heart rate in order to get more blood and oxygen to the tissues. Erythrocytosis is not part of the immune response.

HLA-A and HLA-B antigens can be detected using which of the following techniques? A. Standard crossmatch B. Lymphocyte cytotoxicity C. Immunofluorescent staining D. Mixed lymphocyte cultures

B. Lymphocyte cytotoxicity HLA-A and B antigens are detected by mixing the lymphocytes being tested with known HLA antisera and complement and then measuring the cell lysis (leukocytoxicity) that occurs.

Three main functions of cerebrospinal fluid?

1. protect brain and spinal cord from trauma 2. supply nutrients to nervous system tissue 3. remove waste products from cerebral metabolism.

What is the first step in PCR reaction?

1. Denaturation 2. Annealing/Hybridization 3. Extension

Use of extension cords in a health care facility

1. extension cord should only be used in an emergency situation 2. should be tested for physical integrity, polarity, and continuity of grounding before it is used 3. Must be a three-pronged cord 4. Mist contain a ground wire.

What is the optimal time to begin initial microscopic examination of a semen specimen, assuming liquefaction is complete?

30 minutes. According to the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen, the analysis should begin at 30 minutes (if liquifaction is complete), but no longer than one hour after ejaculation. Occasionally a specimen does not liquify. If this occurs, mechanical mixing or enzyme treatment may be necessary in order for the sperm count, motility analysis and other microscopic aspects of semen analysis to be performed.

What is the lower reference limit for progressive motility of spermatozoa when performing a semen analysis?

32%

Urine pH values can normally vary between:

4.5-8.0

According to the lower normal reference limit stated by WHO what sperm concentration would be considered abnormally low?

5*10^6 spermatozoa/mL

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 er cubic millimeter?

67.5 WBC/microL = Avg # cells counted /(# squared counted * 0.1 microL) WBC = 54 / (8squares * 0.1 microL) = 67.5/microL

What is generally accepted as the lower threshold value for semen pH from fertile males?

7.2

A CSF glucose value is 62 mg/dl. what would you estimate the serum glucose

93 mg/dL CSF glucose - 2/3 * serum glucose

Which of the following statements about phagocytosis is FALSE? A. Cells are only capable of phagocytizing bacteria B. Membrane "reaches" out and surrounds the material to be internalized. C. Once internalized the material is surrounded by phagosomes. D. Only specialized cells are capable of phagocytosis E. Whole pathogenic organisms can be ingested.

A. Cells are only capable of phagocytizing bacteria Cells can also phagocytize other cells, cellular remnants, and other waste products as well.

A nucleic acid used to identify a hybridization target is termed: A. Probe B. Oligonucleotide C. Amplicon

A. Probe A probe is a nucleic acid that is used to identify a hybridization target. An oligonucleotide is a short single stranded nucleic acid. Amplicon is the product of amplification.

A patient suspected of a urinary tract infection has a negative nitrite test, but bacteria are present upon microscopic examination. What may have caused this discrepant result? A. The bacteria present are not nitrate-reducers. B. The urine specimen may have been tested too soon after collection. C. There was a tech error when the test was performed. D. The urine was in the bladder for more than 4 hours.

A. The bacteria present are not nitrate-reducers. Other causes could be: 1. the urine was in the bladder for insufficient amount of time (less than 4 hours) for nitrate to be reduced to nitrite 2. lack of dietary nitrate resulting in inadequate nitrate levels in urine 3. nitrate was further reduced to nitrogen interfering with the diazo reaction 4. bacterial metabolism is inhibited by the presence of antibiotics 5. large amounts of ascorbic acid present in urine, interfering with the diazo reaction

Which of the following is not a standard method for measuring the specific gravity of urine: A. Urine reagent strips B. Osmolality C. Refractometry D. Hydrometry

B. Osmolality Osmolality is dependent on the number of particles of solute in a unit of solution and is often measured by freezing point depression. Specific gravity is usually directly related to osmolality, but is more easily measured. It provides a rough measure of the urine concentration power of the kidney. The other methods are used to measure specific gravity in urine samples.

A blood collection system that has a retractable needle malfunctions and causes an injury to a patient. Which TWO of the following actions must be taken? A. The phlebotomist must be retained. B. The manufacturer of the device must be notified. C. An incident report must be completed D. The patient must be given a Hep B vaccine.

B. The manufacturer of the device must be notified. C. An incident report must be completed

Fecal uronobilinogen level may be markedly decreased because of:

Biliary obstruction

Which laboratory is regulated by the FDA?

Blood Bank

All of the statements below about synovial fluid are true EXCEPT: A. arthrocentesis is performed as a means to evaluate arthritis and other joint disorders B. synovial fluid is present only in movable joints C. joint fluid resembles plasma in viscosity D. joint fluid has approximately the same glucose as plasma

C. Synovial fluid is actually quite viscous and does not have the same consistency as plasma. The reason for its thicker consistency is to provide cushion and reduce friction between the articular cartilage of synovial joints during movement.

Which of the following is responsible for humoral response: A. neutrophil B. basophil C. B lymphocyte D. monocytes

C. B lymphocyte In the humoral response, B-lymph are stimulated to when an antigen binds to its surface receptors. This sensitizes or primes the B cell and it undergoes clonal selection, where it reproduces asexually by mitosis. Most of the family of clones become plasma cells. These cells produce antibodies while other B cells become long-lived memory cells.

Parasites which can be found in urinary sediment include all of the following EXCEPT: A. Enterobius vermicularis B. Trichomonas vaginalis C. Plasmodium malariae D. Schistosoma hamatobium

C. Plasmodium malariae Plasmodium is a blood parasite. Both Enterobius vermicularis and Trichomonas vaginalis could potentially arrive in the urine as contaminants from other sources; Enterobius from fecal contamination and Trichomonas from vagial secretion. Only Schistosoma haematobium is a true urinary tract parasite.

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

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

Which of the following statement is FALSE? A. fever can have a direct effect on the growth or death of pathogenic microorganisms B. low pH of stomach, skin, and vagina can inhibit microbial growth. C. secretory cells of the innate system are antigen specific. D. oxygen tension can result in the death of microorganisms due to oxidation

C. secretory cells of the innate system are antigen specific

Which of the following reagent strip tests is based on the Ehrlich- aldehyde reaction. A. pH B. glucose C. urobilinogen D. specific gravity

C. urobilinogen Urobilinogen reacts with p-dimethylaminobezaldehyde (Ehrlich reagent). A pink-red color forms in proportion to the amount of urobilinogen present.

A decrease in ______________ in an aids patient are associated with increased susceptibility

CD4+ cells CD4 positive lymphocytes, or T helper cells, are infected and destroyed by the HIV virus

Which of the following would be the most characteristic finding in synovial fluid in a case of pseudogout:

Calcium pyrophosphate crystals

Enzyme

Can be combined with fluorescence or dyes and uses standard chemical reactions

The purpose of C3a, C4a, C5a, the split-products of the complement cascade, is to:

Cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils.

Homogeneous ANA pattern

Characterized by smooth staining in the nuclei of the interphase cells and smooth staining in the chromosomal areas of the metaphase mitotic cells.

Where does most cerebrospinal fluid (CSF) originate?

Choroid plexus

The Clinitest reaction is based on what principles?

Copper reduction

Which of the following tests would be used in the assessment of glomerular filtration:

Creatinine clearance Creatinine is filtered by the glomerulus and is not reabsorbed; therefore it can be used to estimate the GFR (glomerular filtration rate).

Which of the following is the recommended for preparing a CSF sample for examination of cellular morphology?

Cytocentrifugation

Xanthochromia in a premature infants may be due to: A. An immature blood-brain barrier B. Elevated protein CSF C. Elevated bilirubin in the blood D. All of the above

D. All of the above Xanthochromia is the pink, yellowish, or orange discorloration of the CSF mostly due to the presence of RBC degradation.

Which of the following are characteristics of casts? (Choose all that apply.) A. They are cylindrical bodies. B. They are formed either in the distal convoluted tubules or the collecting ducts of the kidney C. They contain Tamm-Horsfall mucoprotein. D. All of the above.

D. All of the above.

Which of the following tests confirms the presence of Bence-Jones proteinuria: A. protein electrophoresis B. sulfosalicylic acid precipitation C. cryoprecipitation D. immunoelectrophoresis

D. Immunoelectrophoresis Immunoelectrophoresis is used to detect the presence of Bence-Jones proteins. Immunoelectrophoresis is used to help detect, diagnose, and monitor the course and treatment of conditions associated with abnormal proteins, including Multiple Myeloma, Waldenstrom's macroglobulinemia, and a few other related diseases.

The vast MAJORITY of would-be invaders are killed or inactivated primarily by which part of the immune system? A. Cell Mediated B. Specific C. Humoral D. Innate

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

Which of the following white blood cells would NOT produce a positive leukocyte esterase test on the urine chemical reagent strip? A. Neutrophils B. Eosinophils C. Basophils D. Lymphocytes

D. Lymphocytes The presence of lymphocytes will not produce a positive leukocyte esterase test since lymphocytes do not contain leukocyte esterase.

A 2 month old infant presented with history of chronic diarrhea and failure to thrive. The child's mother also revealed that the baby has suffered from thrush (Candida infections) since birth. Preliminary findings showed lymphopenia (<2,000), hypogammaglobulinemia, and physical findings showed a small thymus, no tonsils or lymph nodes. Which of the following immune deficiencies DOES the patient present? A. T-cell activation deficiency B. MCH deficiency C. Deficiency in immunoglobin production D. Severe combined immunodeficiency syndrome

D. Severe combined immunodeficiency syndrome (SCID) It is a group of congenital disorders in which both the humoral and cell-mediated portions of a patient's immune system are dysfunctional. Children with SCID are vulnerable to recurrent severe infections, retarded growth, and early death.

Normal crystals that can be found in urine include: A. Leucine B. Tyrosine C. Cystine D. Triple phosphate

D. Triple phosphate Triple phosphate crystals are found in highly alkaline urine and look like colorless coffin lids under the microscope. If the crystals are from solutes that are not normally in the urine, they are considered "abnormal". Abnormal crystals include: bilirubin, cholesterol, cysteine, leucine, tyrosine, and sulfa.

Which of the following is not a common support medium used in electrophoresis: A. cellular acetate B. agarose gel C. polyacrylamide gel D. dextrose

D. dextrose

Which of the following is responsible for causing graft-versus-host reactions? A. platelet B. granulocytes C. monocytes D. lymphocytes

D. lymphocytes Graft-versus-host reactions are caused by the engrafting of immunocompetent T lymphocytes into a severely immunosuppressed recipient. They can be prevented by gamma irradiation of cellular blood components.

Which is the best method for examination of synovial crystals: A. Phase contrast B. Darkfield microscopy C. Brightfield microscopy D. Polarized light

D. polarized light

During which stage in real-time PCR can the fluorescent signal start to be recorded?

Exponential stage

Clots in specimen

Failure to mix a specimen containing an anticoagulant by inverting the sealed specimen container several times after collection of the specimen

An adapter can be used to increase the number of available outlets in a laboratory area. T/F

False. Adapters designed to increase the number of outlets should NOT be used in the laboratory.

To analyze the current process as part of the Lean technique of value stream mapping, only include value-added activities. T/F

False. Include all these activities: 1. value-added activities 2. value enabling 3. non-value added

Nitrates in urine are reduce to nitrites by:

Gram-negative bacteria

The antigen marker most closely associated with transmission of HBV infections is:

HBeAg The presence of HbeAg can notes active replication of Hep B virus.

A traveler is being evaluated at a local hospital for gastrointestinal pain, fever and diarrhea. The patient has recently returned from a month-long visit to South Asia. The patient has no recent history of sexual activity of IV drug use but did describe conditions of poor sanitation where they were visiting. If liver function test results were elevated and bilirubinuria was noted, which of the following would be the next logical test to oder? A: ELISA for HBsAg B. Recombinant Immunoblot Assay (RIBA) for Hep C C. Western Blot test for HIV D. ELISA for Hep A antigens in the stool

Hep B, C, and HIV are spread primarily through sexual contact or IV drug use and needle sharing. While it is possible to contact these viruses through other means, the patient history of visiting areas of low sanitation in Asia is more indicative of an fecal-oral transmitted organism like Hep A.

Decreased blood flow

Holding the hand from which blood is being collected in an upward position during collection of the specimen.

What is the most common combination of ANA patterns?

Homogeneous and speckled

Lymphocyte pleocytosis refers to a(n) ______________ in a CSF when compared to a normal sample.

Increased number of lymphocytes Typically, majority of cells seen in a normal adult CSF specimen are lymphocytes and monocytes (70:30 ratio).

Which one of the following statements regarding factors that affect the mobility or rate of migration in electrophoresis is correct?

Increasing the heat increases the mobility of the solutes

Which electrophoresis method first created a pH gradient across the gel before migration?

Isoelectric focusing

Analytical sensitivity of a method generally refers to:

Its ability to measure low concentrations of analytes

Many red cells in urine microscopy?

Kidney disease (glomerulonephritis)

White blood cell casts are most likely to indicate disease of the:

Kidney. WBC casts are found often in pyelonephritis cases involving the kidney. However, they may also be present in glomerulonephritis, interstitial nephritis, and lupus nephritis.

In a normal CSF the protein concentration as compared to that in the serum is generally:

Less than 1% Normal ratio of serum to CSF Protein is about 200 to 1, or less than 1%. Elevation of CSF total protein is a nonspecific finding, but usually indicates some type of disease involving the brain or meninges.

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?

Lymphocytes

Fluorescence

Molecules emit light at a longer wavelength when excited at a shorter wavelength and can be stained as well as labeled

Which of the following situation suggest a traumatic tap occurred?

More blood is in tube 1 than tubes 2, 3, 4

Electrophoresis

Movement in a gel matrix caused by an electrical field

The measurement of light scatter is characteristic of:

Nephelometry Nephelometry is based on the measurement of the intensity of scattered light emanating from an illuminated volume of sample. Fluorometry is based on the principle of measured light emission that fluoresces after stimulation from ultra-violet light. Atomic absorption measures atomic particles of a sample for determining the concentration of a particular metal element present. Chemiluminescence is the emission of light when an electron returns from a state of high energy to a state of low energy.

Specimen contaminated or diluted with tissue fluid

Not wiping away the first drop of blood prior to specimen collection

What is the most likely cause when clinical signs indicate HIV infection but antibody tests are negative?

Patients is in the "window phase" before antibody production

The primary site of reabsorption of glomerular filtrate is the:

Proximal convoluted tubule

Hemolysis

Puncture of the cleansed site before alcohol is completely dry

Given the following results, what is the immune status of the patient? HBsAg: negative HBeAg: negative Anti-NBc: positive Anti-HBs: positive

Recovery

Chemiluminescence

Release of light energy as the product of a chemical reaction

The quality of a test to show a positive result in the presence of the disease it was designed to detect is known as:

Sensitivity. Sensitivity is the degree to which a laboratory test can correctly identify the presence of a disease in a patient who actually has it. A test with high sensitivity accurately identifies the presence of disease; it has false-negative. A test with high specificity accurately detects the absence of disease; it has few false-positives

"Gold standard" for ANA detection

Slide-based immunofluorescent assay (IFA)

Patients with antibody to the following antigen are immune to Hep B:

Surface antigen The principle behind Hep B vaccinations as proteins associated with the Hep B surface antigen are administered to an individual, who then produces an immune response against the surface antigen. the antibodies produces through through this process allows for the immunization against the Hep B virus.

Contact dermatitis is mediated by:

T lymphocytes When an antigen comes in contact with the skin, the antigen is processed by cells in the epidermis and come in contact with T lymphocytes. T lymphocytes recognize the antigen as foreign and circulate the bloodstream back to the epidermis and produce an inflammatory response to eliminate the antigen, but this immune response can produce a characterized rash in the skin called contact dermatitis.

The DNA strand ending with a phosphate group is the 5' end. T/F

True

Radioactivity

Uses a scintillation counter to detect dacay