MT boards

The process of performing a bone marrow differential involves the following steps:

1)Record patient and sample information. 2)Check for fragments. 3)Review stain and smear quality. 4)Scan for tumor cells, cellularity, megakaryocytes etc. 5)Add oil and perform differential. 6)Calculate M:E ratio, record cellularity, megakaryocytes 7)Send to hematopathologist for final review and interpretation.

The recommended temperature/time/pressure for routine steam sterilization of media is: 121° C for 8-10 minutes @ 10 psi 121° C for 12-15 minutes @ 15 psi 220° C for 8-10 minutes @ 10 psi 220° C for 12-15 minutes @ 15 psi

121° C for 12-15 minutes @ 15 psi

The parents' blood types were AB and O. The blood group of any of their children could ONLY be: 1)Group A only 2)Group B only 3)Group O only 4)Group A or B only 5)Group AB, A, B, or O

4 becauseIf the parents' have AB and O blood types, then the child could have only AO or BO inheritance patterns resulting in a group A or group B baby.

Expected life span of a neutrophil in the peripheral blood of an adult is: 3 days 1 day 7-8 hours 12-14 hours

7-8 hours Neutrophils reside in the peripheral circulation for only 7-8 hours ( approx. 7.5 hours) before entering the tissues and body cavities. This process is called diapedesis.

Match the clinical conditions with the most probable causative bacterial agent. A)Acute urethritis B)Scalded skin syndrome C)Septic abscesses D)Clench fist cellulitis

A)Neisseria gonorrhoeae B)Staphylococcus aureus C)Streptococcus anginosus D)Eikenella corrodens

A 47-year old man is hemorrhaging severely. He is group AB, Rho (D) negative. Ten units of packed red blood cells are requested STAT. One group-specific unit is available. Which other units that are available in the blood bank would be most appropriate to choose for crossmatch? B, Rho(D) - positive A, Rho(D) - negative A, Rho (D) - positive O, Rho (D) - positive

A, Rho(D) - negative Rh-negative recipients should receive Rh-negative Red Blood Cells. A group AB patient can receive Group A, B, or O blood. Therefore, the best choice would be units that are A negative.

A three-year-old female was seen in a local ear, nose and throat specialist for chronic ear pain. She had been treated several times for otitis media by her pediatrician with no resolution. Drainage from her ear grew an acid fast bacillus that gave the following biochemical reactions: Iron Uptake- Positive Nitrate reduction- Positive Arylsulfatase - Positive MacConkey agar growth, 5 days- Positive It should be identified as: A)Mycobacterium avium complex B)Mycobacterium fortuitum C)Mycobacterium chelonae D)Mycobacterium kansasii

B is the correct answer since only Mycobacterium fortuitum is positive for iron uptake, nitrate, arysulfatase, and growth on MacConkey agar without crystal violet in five days.

A major action of angiotensin II is: A)Increased pituitary secretion of petressin B)Increased vasoconstriction C)Increased parathormone secretion by the parathyroid D)Decreased adrenal secretion of aldosterone

B)Increased vasoconstriction

Lipemia in a serum sample is most likely caused by an increase in serum levels of: A)Cholesterol B)Triglycerides C)Protein D)Phospholipids

B)Triglycerides

Which of the following is not a component of a basic single beam spectrophotometer: Beam splitter Cuvette Prism Light source

Beam splitter

A HbA1C result for a diabetic patient is 6.0%. What conclusion can be made regarding this patient's carbohydrate management? A) The results are inconclusive and should be repeated with a different method. B) The patient is probably not following dietary recommendations. C) The patient is compliant with diet and medication.

C) The patient is compliant with diet and medication. A HbA1C result that is <7.0% indicates glycemic control for most adults with diabetes.

All of the following are characteristics of Type II diabetes mellitus EXCEPT: A)Insulin levels may or may NOT be abnormal. B)more common than Type I diabetes. C)requires insulin therapy to control hyperglycemia. D)associated with obesity and more common in persons greater than 40 years old. E)a and d

C)requires insulin therapy to control hyperglycemia.

A decrease in which of the following in an AIDS patient are associated with increased susceptibility to infection: CD4+ cells CD8+ cells HIV antigens HIV antibodies

CD4+ cells

Traditional coagulation assays are based almost solely on this technique: Chromogenic assays Clot-based assays RIA assays ELISA assays

Clot-based assays

An automated method for measuring chloride which generates silver ions in the reaction is called: Coulometry Potentiometry Chromatography Polarography Densitometry

Coulometry Coulometry operates on the principle of Faraday's law in which a silver anode releases silver ions (titration) at a constant rate when a constant potential is applied. The silver ions react with chloride in a fixed volume of solution to form silver chloride. The time it takes for the chloride in the unknown solution to react with the silver ions is proportional to the chloride activity in the sample.

TIBC (total iron-binding capacity) is an indirect measurement of which of the following: A)Ferritin B)Hemoglobin C)Ceruloplasmin D)Transferrin

D)Transferrin

When should blood samples for trough drug levels be collected? A)30 minutes after peak levels B)45 minutes before the next dose C)1-2 hours after the last dose D)immediately before the next dose is given

D)immediately before the next dose is given

Which of the following laboratory test results indicates that a sickle cell patient may be in aplastic crisis? A) Decreased reticulocyte count B) Decreased haptoglobin level C)Increased bilirubin level D)Increased lactate dehydrogenase (LDH)

Decreased reticulocyte count

Hemophilia B or Christmas disease is the result of a hereditary deficiency in which coagulation factor: Factor X Factor VIII Factor VII Factor IX

Factor IX

Acute phase proteins generally fall into which category? Glycoproteins Immunoglobulins Lipoproteins Microglobulins

Glycoproteins

What analyte which should be increased in the presence of these associated diseases? Gout? Muscular Dystrophy? Glomerulonephritis? Pancreatitis

Gout = Uric acid Muscular dystrophy = Aldolase Glomerulonephritis = BUN Pancreatitis = Amylase

All of the following cellular antigens are important to an immunohematologist except: Blood group antigens Histocompatibility antigens Haptens Autoantigens

HAPTENS: A hapten is an incomplete antigen.

The antigen marker most closely associated with transmission of HBV infections is: HBsAg HBeAg HBcAg HBiAg

HBeAg

Which abnormal hemoglobins may be formed in alpha thalassemia? (more than one is correct) Hb Bart's Hb Lepore Hb E Hb H Hb O

Hb Bart's and Hb H In alpha thalassemia intermedia or Hemoglobin H disease, insufficient alpha chains are produced. The remaining globin chains often form tetramers. In neonates the gamma chain is present in high amounts, forming tetramers known as Bart's hemoglobin. As gamma chain production decreases, beta chain production increases. Adults form beta chain tetramers -Hemoglobin H.

Which of the following parts of the body synthesizes and secretes BNP? Kidney Liver Heart Adrenal gland

Heart

Low values of plasma ceruloplasmin are MOST associated with: Hepatolenticular regeneration High plasma copper values Hypoparathyroidism Kidney stones

High plasma copper values

Large, one-celled, smooth-to-tuberculate macroconidia, and smooth or echinulate microconidia are typical of mycelial phase growth of which organism? Blastomyces dermatitidis Coccidioides immitis Histoplasma capsulatum Paracoccidioides brasiliensis Sporothrix schenckii

Histoplasma capsulatum characteristically shows large, one-celled, smooth-to-tuberculate macroconidia, and smooth or echinulate microconidia. H. capsulatum is a dimorphic fungus which is known to cause histoplasmosis, a lung disease. H. capsulatum can grow in soil and material contaminated with bat or bird droppings. Spores are introduced into the air when contaminated soil is moved or displaced. When spores produced by this fungus are breathed in, the pathogen grows in the lungs as a yeast.

Which of the following would be considered the definitive host of a parasite: Humans Insect vector First host infected by the parasite Host in which mature parasites develop

Host in which mature parasites develop

Which one of the following immunoglobulins is MOST likely to be elevated in anaphylactic shock? IgA IgD IgE IgG IgM

IgE anaphylaxis is caused by degranulation of mast cells or basophils mediated by IgE, and pseudo-anaphylaxis occurs without IgE mediation.

The rheumatoid factor in rheumatoid arthritis is PRIMARILY which type of immunoglobulin? IgM IgA IgG IgE Incomplete

IgM Rheumatoid Factor (RF) is an antibody against the Fc portion of IgG molecules. It is primarily, of the IgM class and can less commonly be IgG or IgA. These circulating antibody complexes are found in the synovial tissue and synovial fluid and tend to cause systemic problems. In the laboratory, routine latex agglutination test would typically detect only IgM RF since most IgG and IgA antibodies are non-agglutinating.

Which of the following methods may be employed to definitively identify Bence-Jones proteins: Immunoelectrophoresis Sulfosalicyclic acid precipitation Heat precipitation at 40-60oC Urine dipstick

Immunoelectrophoresis

What is the most significant cause of decreased haptoglobin levels? Acute infection Intravascular hemolysis Liver disease Myoglobinuria

Intravascular hemolysis

Which of the following antigens are well developed on fetal cells? Lewis ABO Kell

Kell :Antigens develop at various rates both in utero and after birth. Kell is an antigen that is well-developed on fetal cells, ABO is slightly weaker, and Lewis is either poorly developed or not present at all on fetal cells.

An 87-year old patient had a foot wound that grew gram-negative rods on McConkey agar as pink to dark pink oxidase-negative colonies along with the following results: TSI: A/A Indole: neg. MR: neg. VP: pos. Citrate: pos. H2S: neg. Urea: pos. Motility: neg. Ornithine: neg. Antibiotic susceptibility: Carboxicillin and ampicillin resistant, all others sensitive. What is the MOST likely organism? Serratia marcescens Proteus vulgaris E. coli Klebsiella pneumonia

Klebsiella pneumonia Serratia marcescens can be eliminated by the fact that it is motility + and urea negative, as well as ornithine +. Proteus vulgaris can be eliminated due to its production of H2S, the fact that it is indole +, the MR/VP reaction is positive/negative, it is citrate +, and motility +. E. coli can be eliminated due to its production of gas on the tsi slant. E. coli is also indole +, MR/VP = positive/negative, citrate negative, urea negative, motility +, ornithine +.

This member of the Enterobacteriacea gave these reactions: TSIA . . . . . . . . . . . . . . . . A/A, gas (+), no H2S Ornithine . . . . . . . . . . . . . . . Negative Lysine . . . . . . . . . . . . . . . . . Positive Citrate . . . . . . . . . . . . . . . . . Positive Urea . . . . . . . . . . . . . . . . . . Positive Phenylalanine . . . . . . . . . . Negative Motility . . . . . . . . . . . . . . . . Negative This organism is identified as: A)Enterobacter cloacae B)Klebsiella pneumoniae C)Escherichia coli D)Yersinia enterocolitica

Klebsiella pneumoniae

Which of the following is responsible for causing graft-versus-host reactions: Platelets Granulocytes Monocytes Lymphocytes

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.

The precursor of the platelet which is commonly only found in the bone marrow is: Myeloblast Metakarocyte Megakaryocyte Erythroblast

Megakaryocyte:Platelets are formed by the fragmentation of megakaryocyte cytoplasm

A sputum sample from a patient with pulmonary abscesses is received in the laboratory, and after several days of incubation the following are noted: Yellow, irregular colonies grow on BAP under aerobic conditions. Acid-fast stain shows that the organisms are partially acid-fast. Which of the following organisms should be suspected? Nocardia asteroides Streptococcus pneumoniae Actinomyces israelii Actinomadura madurae Mycobacterium avium

Nocardia asteroides Nocardia stain partially acid-fast which is the biggest clue to the answer in this case. In pulmonary nocardiosis, the lesions contain N. asteroides though the abscesses in the form of tangled, branching filaments. N. asteroides typically shows a colony morphology of yellow, irregular colonies that grow on BAP under aerobic conditions.

Bence-Jones proteinuria is associated with all of the following conditions except: Macroglobulinemia Pernicious anemia Multiple myeloma Amyloidosis

Pernicious anemia Macroglobulinemia, Multiple Myeloma, and Amyloidosis are all associated with abnormal protein production and/or accumulation which can result in Bence-Jones proteins being excreted in the urine.

What is the anatomical feature of a tapeworm that possesses both male and female reproductive structures? Brood capsule Proglottid Rostellum Scolex

Proglottid

Which one of the following determinations is MOST reliable for evaluating bone marrow activity? Hemoglobin Reticulocyte count Platelet count Hemolytic index

Reticulocyte count Reticulocyte counts evaluate the activity of the bone marrow; as the bone marrow is attempting to recover from an abnormal hematological state, there are more reticulocytes produced. Retic counts are often used to evaluate the effectiveness of therapy for stimulating the bone marrow.

All helper cells are T cells. Consequently, in a normal lymphocyte population, it is reasonable to expect all CD4-positive cells to be CD3-positive as well. True or False? True False

TURE: If CD3 marks all normal mature T cells and if CD4 marks T-helper cells (which are mature T cells), then one would expect all CD4 positive cells in the gated lymphocyte population to also be CD3 positive.

A sample has reactions occuring at immediate spin and AHG with varying strengths and no true pattern that matches a panel cell . Which of the following is the most likely cause? An IgM and an IgG antibody A warm autoantibody An antibody to a low-frequency antigen An antibody to a high-frequency antigen

The cause would be the presence of both an IgM and an IgG antibody. Antibodies to high-frequency antigens would be positive with all of the panel cells in the AHG phase. Reactions would be the same strength. If the antibody is a warm autoantibody, then reactions would all be positive at AHG at the same strength and the auto control would also be positive. Antibodies to low-frequency antigens would probably not be detected at immediate spin and there would be very few if any reactions at AHG due to low-frequency antigens not being present on panel cells. Think multiple antibodies when reactions are occurring at two different phases (IS and AHG), varying strengths in reactions and no definite pattern.

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

An acid-fast bacillus recovered from a cervical lymph node of a young child had the following characteristics: yellow pigmentation in the dark turns deeper yellow-orange after two weeks of light exposure nitrate negative; niacin negative urease negative; catalase 25/68ºC positive, optimal growth 42o Which of the following is the MOST likely identification? M. tuberculosis M. scrofulaceum M. kansasii M. avium-intracellulare M. xenopi

The organism is M. xenopi since it demonstrates scotochromogenic activity, is nitrate, niacin, and urease negative, while growing best at 42 degrees.

Match each common name of the helminth groups with its respective scientific name: Tissue roundworms Flukes Roundworms Tapeworms

Tissue roundworms = Filariae Flukes = Trematodes Roundworms = Nematodes Tapeworms = Cestodes

What condition is indicated by the following blood gas results: Bicarbonate = 32 mmol/L (Normal = 22 - 26 mmol/L); pCO2 = 65 mm Hg (Normal = 35 - 45 mmHg); pH = 7.28 (normal = 7.35 - 7.45) Healthy condition Uncompensated metabolic acidosis Compensated metabolic acidosis Uncompensated respiratory acidosis

Uncompensated respiratory acidosis The normal pH of blood is 7.40. In order for most metabolic processes to take place, the pH must remain within a narrow range close to this value. The range is usually defined in adults as 7.35-7.45. If blood pH falls below 7.35, the blood becomes too acidic (acidosis). If blood rises above 7.45, the blood is too alkaline (alkalosis). As blood pH decreases, the kidneys will retain bicarbonate (HCO3-) from the glomerular filtrate; therefore, bicarbonate is increased. However, in this case, the increased HCO3- could not compensate for the markedly elevated pCO2 (the respiratory component) and the condition that results is uncompensated respiratory acidosis.

Which of the following tests included on a urine chemical reagent strip would never be reported out as negative? Urobilinogen Bilirubin Leukocyte esterase Blood Nitrite

Urobilinogen is reported as normal, not negative. A normal urobilinogen result is approximately: 0.2-1.0 Ehr U/dL

Match each parasite listed here with its corresponding optimal specimen type from which it may be recovered: a) Onchocerca volvulus b) Trichinella spiralis c) Dracunculus medinensis d) Brugia malayi

a) Nodule b) Muscle c) Skin Blister d) Blood

False-positive tests for protein on a urine reagent strip may be caused by what? More than one is correct a) Bacterial contamination b) Urine that has remained at room temperature for an extended period of time c) Alkaline medication d) Ascorbic acid

a, b, c. Bacterial contamination, urine that has remained at room temperature for an extended period of time, and the presence of alkaline medication are all factors which can cause false positives on the protein pad of a urine reagent strip.

A specimen for potassium was drawn in a tube without anticoagulant at 6 AM during a traumatic patient stick. The results were 6.0 mmol/L. Why are the results elevated? a) Specimen should have been drawn with anticoagulant b) Exposure to light c) Hemolysis of the RBC's d) Specimen should have been frozen e) Analyzer systematic error

c) Hemolysis of the RBC's

Patients with Cushing syndrome exhibit: a) Decreased plasma 17-hydroxysteroid concentration b) Decreased urinary 17-hydroxysteroid excretion c) Serum cortisol concentrations greater than 15 mg/dL d) Decreased cortisol secretion rate e)Decreased ACTH levels

c) Serum cortisol concentrations greater than 15 mg/dL Cushing syndrome is a hormone disorder caused by exposure to high levels of cortisol for a prolonged period. Serum cortisol may be greater than 15 mg/dL. The serum reference range for cortisol is approximately 0.006 - 0.023 mg/dL, which is usually expressed as 6 - 23 micrograms per deciliter (µg/dL).

Select the statement that best describes hs-CRP? a) hs-CRP is a measurement of acute inflammation and is used to monitor these conditions b) hs-CRP is an anti-inflammatory adipokine synthesized by adipocytes c) hs-CRP is a marker of chronic inflammation and measured to predict the risk of cardiovascular disease d) hs-CRP is decreased in inflammatory conditions and measured to predict a return of inflammation

c) hs-CRP is a marker of chronic inflammation and measured to predict the risk of cardiovascular disease

Which of the following major cellular elements does not develop solely in the bone marrow: a)Monocyte b)Neutrophil c)Lymphocyte d)Macrophage

c)Lymphocyte

When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to: clean the skin area complex with chloride stimulate nervous system induce the sweat secretion

induce the sweat secretion

The part of the immunoglobulin molecule that may be kappa or lambda chains is: Fc Fab heavy chains light chains Hinge regions

light chains