Adapt 1 03/11
After irradiating a unit of packed red blood cells, how is the expiration date affected?
The expiration date shortens to 28 days from the date of irradiation or the original expiration date, whichever is first.
Acetest® can be used to test for ketones in
Urine, serum, and whole blood
Where does most cerebrospinal fluid (CSF) originate?
choroid plexus
Which of the following immunoglobulin classes is chiefly responsible for the degranulation of mast cells and basophils?
IgE
has multiple functions, including opsonization of antigens for phagocytosis by macrophages and neutrophils.
IgG
The MCH normal range is
27-31 pg
Irradiated red cell units may be stored for up to
28 days
The MCHC normal range is
32-36%
Red cell units that contain CPDA-1 may be stored for up
35 days
Red cell units that contain an additive solution may be stored up to
42 days
What blood alcohol concentration has been established as the statutory limit for operation of a motor vehicle in the United States?
80 mg/dL
The MCV normal range is
80-100 fL
A 47-year old man is hemorrhaging severely. He is group AB, Rh (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?
A, Rh(D) - negative
is used as a confirmatory test for ketones and can be used to test urine, serum, and whole blood.
Acetest
Bacterial colonies often emit distinct odors associated with foods. Which organism produces an odor that resembles fresh apples?
Alcaligenes faecalis (odorans)
Basophils' primary role involves:
Allergic reactions
Why would a unit of group O blood never be administered to a Bombay patient?
Anti-H in recipient The classic Bombay phenotype (Oh) is characterized by the absence of A, B and H antigens, and the presence of anti-H, which will react from 4o to 37o C. Bombay patients must therefore be transfused only with blood from donors of the Bombay phenotype.
What is the mechanism of heparin-induced thrombocytopenia (HIT)?
Antibodies directed against platelet factor 4 (PF-4) and heparin complex.
a thick-walled yeast cell that characteristically produces a single bud attached by a broad base.
Blastomyces dermatitidis
Which of the following organisms is best visualized by use of a darkfield microscope?
Borrelia
Which of the following statements best describes the mean and median as they relate to a normal "gaussian" distribution curve?
Both are equal
The parathyroid hormone (PTH) is important in the regulation of:
Calcium and phosphate
In DNA sequencing, multiple fluorescence labeled nucleotides are commonly separated using what type of test?
Capillary electrophoresis (CE)
Different species of Neisseria can be differentiated from each other by:
Carbohydrate utilization
A patient in renal failure is seen for blood work. What would you expect the serum calcium and phosphorus levels to be in this patient?
Decreased calcium but increased phosphorus levels
In patients who have developed heparin-induced thrombocytopenia with thrombosis (HIT), which of the following should be used to prevent ischemic stroke?
Direct thrombin inhibitors
The Lutheran b antigen (Lub) is a high incidence antigen. A patient has developed an anti-Lub. All of the screening cells and antibody identification panel cells are positive at AHG. What can be used in testing so that the blood bank can determine if there are other clinically significant antibodies present in this patient?
Dithiothreitol (DTT)
What is considered the definition of allogeneic blood?
Donated by a donor for a recipient other than the donor to use
What is the BEST technique for monitoring the severity of hemolytic disease of the fetus and newborn (HDFN)?
Doppler ultrasound
When are data collected in a real-time PCR procedure?
During nucleic acid amplification
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 Southeast Asia. The patient has no recent history of sexual activity or 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 order?
ELISA testing for Hepatitis A antigens in the stool
Corneal tissue transplantation has an extremely high success rate for a variety of reasons, including all of the following Avascularity Reasonably low concentration of class I antigens An essential absence of class II antigens with the exception of:
Eccentrically place grafts
Cellulose acetate, polyacrylamide, and agarose gels are most commonly used in the clinical laboratory for
Electrophoresis
colonies on sheep blood agar are relatively small measuring 1 - 2 mm in diameter and are smooth, circular, convex, and translucent. This species may also produce large and rough colonies on sheep blood agar. Colonies show alpha hemolysis after prolonged incubation. Slender Gram positive bacilli or coccobacilli are observed microscopically, arranged singly or in short chains. In mature colonies short and long filaments may develop. Spores are not formed.
Erysipelothrix rhusiopathiae
also known as Acute Myelogenous Leukemia type M6. This type is associated with either the presence of both erythroid and myeloid precursors OR strictly erythroid precursors.
Erythroleukemia
Which of the following microorganisms is LEAST likely to produce a capsule or slime layer?
Escherichia coli
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
Bioavailability of an oral drug refers to the:
Fraction of the drug that is absorbed into systemic circulation
From the fungi listed below, which is considered to be a true pathogen that also infects immunocompromised patients?
Histoplasma capsulatum
is associated with mucosal immunity. It defends external body surfaces and is secreted into the lumens of the gastrointestinal and respiratory tracts.
IgA
Which immunoglobulin is associated with anaphylactic shock?
IgE
The yeast forms of which of the following species of dimorphic fungi (represented in the image on the right) can be described as large yeast cells with multiple buds that are attached by narrow necks, giving the appearance of a "mariner's wheel?"
Paracoccidioides brasiliensis
Which of the following statements is true regarding the staining protocol used for bone marrow smears compared to that for peripheral blood smear?
Longer staining time should be used to allow thorough staining
What cell population is gated in this peripheral blood sample case analyzed by flow cytometry?
Lymphocytes
What is the first line treatment for moderate to severe hemophilia A?
Lyophilized Factor VIII concentrate
Which of the following disorders is characterized by a stem cell mutation due to the PIGA gene that leads to clones of cells that bind abnormally large amounts of complement?
Paroxysmal nocturnal hemoglobinuria
How would the RBCs appear on the peripheral blood smear if the red cell indices obtained on a patient are as follows: MCV 88.5 f1 MCH 30.2 pg MCHC 33.1 %
Normocytic, normochromic
All of the following would be considered a normal part of a routine electrolyte panel (profile), EXCEPT? The electrolyte panel consists of potassium (K+), sodium (Na+), chloride (Cl-), carbon dioxide (in form of bicarbonate HCO3-).
Not magnesium
In the Coombs phase of a crossmatch, what is the proper procedure to follow if the Check Cells give a negative reaction?
Repeat procedure with new AHG reagent and check the cell washer
Which of the following best describes random error?
Results may be either above or below the mean.
The hemotoxylin and eosin (H & E) stained tissue reaction in the top photomicrograph reveals a chronic inflammatory reaction with irregular sized, non-septate fungal hyphae, suggestive of one of the Zygomycetes. In practice, a sample of the tissue specimen would be sent to the mycology laboratory to substantiate the diagnosis. What is the illustrated fungal species, recovered from the specimen, seen in the bottom, microscopic photomicrograph?
Rhizopus species
The two most commonly used antibiotics for therapy against uncomplicated tuberculosis are:
Rifampin and Isoniazid
Which physician is known for their discovery of Bacillus anthracis and Mycobacterium tuberculosis?
Robert Koch
A routine serum protein electrophoresis with normal proteins results in _____ zones or bands.
Five
eggs are round and the organism is small and often obscured.
Schistosoma japonicum
presence of an obvious lateral spine, which can be seen in the image. Humans are infected by direct penetration from the cercariae, which enters the circulation and travels to the veins of the large colon where eggs are formed and passed in feces. This condition is often called "swimmer's itch" due to the dermatitis caused by the site of penetration.
Schistosoma mansoni
What is the formula for calculating transferrin saturation (TS)?
Serum iron/TIBC) X 100
On a Cytospin preparation from a pleural fluid, 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") How should these cells be classified?
mesothelial cells
Which of the following answer choices correctly state the use of urine reagent strips for chemical analysis?
Use of a well-mixed, uncentrifuged urine sample at room temperature is the technique for urine reagent strips.
The most significant class of microbial targets for Natural Killer (NK) cells is:
Viruses
Which of the following will impact platelet aggregation when it becomes deficient?
Fibrinogen
In which section of the safety data sheet (SDS) would you find information about whether a specific chemical is a carcinogen?
Toxocological information section
Which one of the following is the MOST specific biochemical marker of myocardial infarction?
Troponin
Which of the following kappa / lambda ratios are found in normal B cells?
2 : 1
What is the proper storage temperature for thawed cryoprecipitate?
20 - 24 ºC.
Red blood cell units that contain CPD (citrate-phosphate-dextrose) can be stored for up to how many days?
21 days
How many white blood cells (WBCs) would be considered normal for adult cerebrospinal fluid?
0-5 WBCs/µL
How would one prepare 3 mL of a 5% albumin working solution from a stock 30% albumin solution?
0.5 mL stock 30% albumin + 2.5 mL diluent
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?
1-10C
Which of the following may associated with acidic urinary pH?
High urine glucose
In most cases of Fanconi anemia, which of the following types of anemia develops?
Aplastic
Which risk marker has both positive and negative cardiovascular risk integrated into its measurement?
Apo B-100/Apo A-1
has a bumpy appearance.
Ascaris lumbricoides
Illustrated in the upper blood agar plate are large, spreading, gray white colonies with a buttery consistency and fimbriated edges. Each colony is surrounded by broad zones of beta hemolysis. The Gram stain in the lower image reveals long, box-car shaped, spore-forming Gram-positive bacilli. Lecithinase is produced on egg yolk agar. These findings are most consistent with a presumptive identification of which of the following?
Bacillus cereus
A 65-year-old Asian female presented to the emergency room exhibiting severe abdominal pain, fever and diarrhea. Examination revealed an enlarged liver that was tender to the touch. Patient history revealed that the woman worked in a fish processing plant for years prior to moving to the United States. Her diet was heavy in raw fish. Stool and duodenal contents were collected and sent to the laboratory for cultures and parasite examination. The cultures were unremarkable. This suspicious form was seen in both specimen types. It measures 27 µm by 14 µm. What is the most likely cause for this patient's symptoms?
Clonorchiasis
A recto-sigmoidoscopy revealed pseudomembranes in a patient with severe diarrhea following prolonged treatment with ampicillin. Which of the following organisms is MOST likely to be isolated?
Clostridium difficile
An elevated level of which of the following hormones will inhibit pituitary secretion of adrenocorticotropic hormone (ACTH)?
Cortisol
colonies on sheep blood agar are small, 0.5 - 1.0 mm, gray to white, convex, and non-hemolytic. The bacterial species is pleomorphic and is observed as small Gram-positive bacilli arranged in V-forms or in picket fence like palisades. Spores are not produced.
Corynebacterium jeikeium
Which statement about bacterial culture for Clostridioides (Clostridium) difficile is TRUE?
Culture on appropriate media provides an effective means of recovering the organism.
The illustration demonstrates a dematiaceous mold that is known to cause phaeohyphomycoses and sinusitis. It produces septate hyphae, geniculate conidiophores and multi-celled, curved conidia with a swollen central cell. The most likely identification is:
Curvularia species
Blood cultures are collected from a septic patient with a history of chronic urinary tract infections. The sheep blood agar and the chocolate agar grow a creamy colony that has feet like or star like projections from the colony. The Gram stain of the colony demonstrates a budding yeast with pseudohyphae. What would be the next step in identifying the organism?
Germ tube
A large number of antigen detection procedures and assays are available to diagnose clinically suspected parasitic diseases in the absence of finding ova or other forms of parasites in stool preparations or other body fluids. Illustrated in the photograph are antigen positive-staining green dots at sites where small drops of duodenal aspirated fluid had been applied to the test reagents. Trophozoites of this protozoan occupy the upper gastrointestinal tract and the excreted ova may not find the way down the long stretch of bowel to be excreted in stool specimens. From the list of multiple choice selections, indicate the genus/species in which antigen detection may be required to make a diagnosis.
Giardia duodenalis
Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes?
Glass
Which of the following best describes the organisms seen in this illustration:
Gram-variable
What is a major reason why there is no viable HIV vaccine available on the market
HIV has a high mutation rate due to the lack of proofreading ability by reverse transcriptase
The accuracy of an immunoassay is its ability to discriminate between results that are true positive and results that are true negative. Two parameters of test accuracy are specificity and sensitivity. Which of these statements apply to an immunoassay with low sensitivity?
Has many false-negative results
When considering therapeutic drug monitoring, which two organ systems are associated with drug elimination?
Hepatic and renal
False-positive tests for protein on a urine reagent strip may be caused by the following conditions, EXCEPT: Blood presence in the specimen High amounts of bilirubin Alkaline medication
High protein diet
Which of the following is necessary for the absorption of Vitamin B12:
Intrinsic factor
The glucose result on a urine specimen from an infant is negative on the urine chemical reagent strip, what is the next step?
It must be followed by the copper reduction test (Clinitest®) to check for other reducing substances.
Antibodies within which of the following blood group systems are known to result in severe hemolytic transfusion reactions, but are not always detected during pre-transfusion testing in the blood bank?
Kidd
grow on sheep blood agar as small, pinpoint, alpha hemolytic colonies that may resemble streptococci or rough, gray colonies. Lactobacillus shows a pleomorphic morphology in stained smears, occurring as Gram positive bacilli in long, thin chaining bacilli, coccobacilli or spiral forms. Spores are not produced.
Lactobacillus species
The measurement of light scatter is characteristic of:
Nephelometry
What morphologically abnormal red blood cell is associated with "hyperchromia"?
Spherocyte
cigar bodies."
Sporothrix schenckii
Observe the Optochin "P" disc reaction Illustrated in the upper left photograph on the surface of blood agar. Heavy growth of tiny, alpha hemolytic colonies are observed growing on the agar surface that extend to the outer margins of the paper disc. The Gram stain presented in the lower photomicrograph reveals small Gram positive cocci lying singly, in small clusters, and more typically in long chains. This isolate has been recovered from blood cultures in cases of post-valvular endocarditis. Select the presumptive identification of this isolate.
Streptococcus viridans
What is an appropriate use for molecular (DNA) tests for mutations of the HFE gene, the gene found in the majority of patients diagnosed with hereditary hemochromatosis (HH)?
Testing family members of persons with HH
Which of the following best defines "sensitivity"
The percentage of patients with a disease who will have a positive test result.
Which listed transfusion reaction is MOST OFTEN associated with transfused patient's lacking IgA?
anaphylaxis
Streptococcus are typically round or oval shaped and, when grown in broth, will show gram positive cocci along with the characteristic of growing in chains when viewed on the
brightfield microscope.
Spirochetes such as Borrelia and Treponema are best visualized using
darkfield microscopy.
Zinc deficiency in the elderly is often caused by:
decreased intake/absorption
Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes?
glass
Poxviridae are the largest are the largest and the most common of all viruses. The virions appear as oval or brick-shaped structures 200 to 400 nm in length. Because of their large size, poxvirus virions may be visualized through a
light microscope.
Which of the following represents a diagram of a spectrophotometer?
light source - monochromator - cuvette - detector - readout
In an adult, 0 - 5 WBC/µL is considered normal. Children will have
slightly higher cell counts. Up to 30 WBC/µL is within normal limits for newborns. Lymphocytes account for 60 - 100% of these cells.