ASCP Board of Certification MLS Practice Questions

Post transfusion purpura (PTP)

A 40-year-old female receives two units of Red Blood Cells during a surgical procedure. The patient has no prior history of transfusions. Seven days later, she presents with extensive bruising of the extremities and bleeding of the gums, with no additional symptoms. Her platelet count is 5 x 109/L (reference interval 150 - 400 x 109/L). What is the most likely diagnosis?

HLA typing

A patient presents with platelet refractoriness, or poor response to platelet transfusions. What can be performed to help ensure platelet transfusions will be therapeutic?

Burkholderia cepacia

A patient with cystic fibrosis is admitted with a fulminant lung infection. A sputum culture grows a non-lactose fermenting, oxidase positive, Gram-negative bacilli. It is pyocyanin negative, nitrate reduction variable, and it is arginine dihydrolase negative.

Microcytosis, low variation of cell volume

A peripheral smear demonstrates a population of cells composed of red cells that are mostly 5 - 5.5 µm in diameter. The CBC data shows RDW of 13% (reference range 11.5-14.5%). Which morphology is consistent with these findings?

Giardia duodenalis (formerly lamblia)

A 35-year-old male presented to the local clinic complaining of abdominal cramps, severe diarrhea, and intestinal gas. A stool specimen was collected for parasite examination. It was foul-smelling and light colored in nature. The form in the attached image was recovered and measured 10 µm by 12 µm. The patient is infected with?

The tube should remain unopened and be kept at room temperature (20°-25° C).

A prothrombin time (PT) specimen was collected at an outpatient clinic and will not be picked up by the testing laboratory's courier until several hours later. How should the specimen be stored until it is picked up by the courier?

Prolonged aPTT and normal reptilase time test

A specimen drawn from an indwelling catheter that was contaminated by heparin would be indicated by:

Call the RN or physician to let them know that the specimen is unacceptable, and it should be recollected.

A swab is submitted for an influenza screen. The swab used is a cotton swab with a wooden shaft that was placed in a moist transport container. What is the most appropriate next step in this scenario?

Perform sensitivity on E. coli and list the S. epidermidis as a contaminant

A tech is working on a urine culture and finds the following isolates: Escherichia coli: >100,000 cfu/mL Staphylococcus epidermidis: 5,000 cfu/mL How should the tech continue with the culture work up?

85%

A unit of leukocyte-reduced red blood cells must retain at least what percentage of red blood cells following leukoreduction?

This represents normal kidney function

A urine concentration test was performed on a patient after a fluid intake deprivation period with the following findings: After 12 hours Urine Osmolality = 850 mOsm/KgAfter 16 hours Urine Osmolality = 850 mOsm/Kg What do these results indicate?

Prorphyrins

A urine specimen which was collected in a dark container, stored in the dark, has a pH of 7.5, and whose sample aliquot is wrapped in foil, is most likely being sent for:

Plasma cell

A white blood cell stained with Wright's stain has the following characteristics: *Round eccentric nucleus with clumped chromatin pattern *1:1 nucleus to cytoplasm ratio *Basophilic cytoplasm *Crescent-shaped clear area next to nucleus What is the MOST likely identification of this cell?

Sagebrush appearance with large hyphae; blastoconidia not characteristically present.

A yeast identification system gave a biotype number for an unknown isolate that did not differentiate between Candida tropicalis and Candida parapsilosis. This isolate could be identified as C. parapsilosis on a cornmeal agar preparation if it produced:

Patient's red cells forward types as AB with anti-A1 present in the patient's serum.

A2B is suspected when a patient's ABO typing has the results:

Osmolality

All of the following are methods employed for measuring the specific gravity of urine, EXCEPT? Refractometry Hydrometry Osmolality Urine reagent strips

Prostate Cancer

All of the following conditions would be associated with an increased level of alpha-fetoprotein, EXCEPT? Prostate Cancer Hepatocellular Carcinoma Viral Hepatitis Testicular Tumors

Variance

All of the following decrease medical errors in the clinical laboratory, EXCEPT: Accuracy Precision Variance Reduced coefficient of variation

Cortisol

All of the following hormones increase or decrease plasma glucose concentration by regulating glycogenolysis (converting glycogen to glucose) EXCEPT? Cortisol Glucagon Epinephrine Insulin

Insulin

All of the following hormones stimulate gluconeogenesis, the formation of glucose from noncarbohydrate sources such as amino acids, glycerol, and fatty acids, EXCEPT? Insulin Thyroxine (T4) Cortisol Glucagon

Amylase

All of the following laboratory tests are used to determine kidney function, EXCEPT? Creatinine Blood urea nitrogen (BUN) Amylase Phosphorus

German measles (rubella) vaccine

All of the following represent a 2 week temporary deferral from donating blood or blood products EXCEPT: Measles (rubeola) vaccine German measles (rubella) vaccine Mumps vaccine Polio vaccine

Rhizobium radiobacter

Among the non-fermenters, what is the only bacterial species to produce hydrolyze esculin?

Bordetella parapertussis

An aerobic Gram negative coccobacillus was isolated from a nasopharyngeal swab 48 hours after culture from a 6-month-old with the following culture characteristics on Bordet-Gengou agar: Small zones of beta-hemolysis Urease: positive (24 hours) Oxidase: negative Motility: negative The MOST probable identification of this isolate is:

Dehydration

An example of a cause of a "relative erythrocytosis" is:

Hepatitis B

Any health care worker who is expected to have contact with patient blood potentially infectious body fluids must be offered a vaccination for:

5 to 7

Approximately how many doses are required to obtain a steady-state oscillation allowing for peak and trough levels to be evaluated?

Hb D

At an alkaline pH, which of the following hemoglobins cannot be separated from hemoglobin S during hemoglobin electrophoresis?

Trypanosoma cruzi

Coccidia parasites are often acquired by fecal-oral routes by ingesting contaminated food or water. All of the following are coccidia parasites EXCEPT? Sarcocystis species Cryptosporidium parvum Trypanosoma cruzi Isospora belli

Beta thalassemia major

Cooley's anemia is another name for which form of beta thalassemia?

Infected indwelling devices in AIDS patients

Corynebacterium jeikeium is often associated with which condition?

Ketones

Excessive carbohydrate loss that may occur due to vomiting, or rapid weight loss may result in the presence of which of the following substances not normally contained in the urine?

5 fractions

Serum proteins can be separated by cellulose acetate electrophoresis into how many basic fractions:

Lactobacillus species

Small, smooth, gray-white, 24-hour colonies are seen growing on the surface of sheep blood agar with faint alpha-hemolysis. This isolate is most often part of the normal flora, serving in several body sites as a protection against harmful bacteria through production of lactic acid. The gram stain reveals long, slender gram-positive bacilli lying singly and in short chains. It is a non-branching, non-spore-former. From the multiple choices, select the presumptive identification of this isolate.

Ultraviolet microscopy

Smears that are appropriately stained using acridine orange should be examined using?

Cytochrome oxidase activity

Stenotrophomonas maltophilia and Burkholderia cepacia share each of the following characteristics EXCEPT: Decarboxylation of lysine Cytochrome oxidase activity Production of colonies with a yellow pigment Good growth on MacConkey agar

CREST syndrome

Suppose a patient with stiffness in her fingers has a positive antinuclear antibody (ANA) test with a centromere pattern at a 1:1280 titer. What is the most likely diagnosis?

Hereditary spherocytosis

The autohemolysis test is MOST useful in the diagnosis of which condition?

Trichoderma

The colony illustrated in the top image developed after 4 days of growth on Sabouraud's dextrose agar. Note the extension of the outer margin to the rim of the Petri dish. The bottom image 2 is a methylene-blue stained image of an inoculum obtained from the surface of the colony. From these characteristics, select the fungus genus from the multiple choices.

Plesiomonas shigelloides

The cytochrome oxidase-positive bacterial species that is DNAse negative, ornithine decarboxylase positive, and is associated with gastroenteritis in children after the ingestion of contaminated water is most likely:

Reliability

The degree in which a measure is consistent in producing the same results when measuring the same analyte is called:

Vibrio cholerae

The fastidious Gram negative bacillus featured here has been recovered from individuals in pandemic outbreaks of diarrhea after ingestion of contaminated stream, lake, or well water. In many cases, life-threatening profuse diarrhea resulting in dehydration and electrolyte loss is experienced. Smooth, entire, convex light gray-yellow colonies are observed on blood agar (left upper image). Note the yellow pigmentation of the colonies growing on TCBS agar (Thiosulfate Citrate Bile Sucrose) on the right of the composite image, indicating strong acid production from sucrose. Cytochrome oxidase is also positive. Small, curved and S-shaped, gram-negative bacilli are seen on the Gram stain. From these observations, select the correct genus/species identification of this isolate.

1-2 minute break

The laboratory workplace includes many hours of computer use. The suggested time for a break after 30 minutes of computer use is:

Affinity

The name of a reaction between a single antigenic determinant and an individual combining site is:

Efficiency

The number of patients correctly diagnosed for the disease or not having the disease is defined as:

Iodamoeba butschlii cyst

The organism illustrated on the right measures 12 µm and is found in stool. Can you identify it?

Clonorchis sinensis

The patient was a 55-year-old male immigrant from Korea. His current symptom was severe jaundice. He had had intermittent less severe bouts of jaundice in the past. During surgery, his proximal bile duct appeared to be enlarged with a nodular area of inflammation. A surgical biopsy was done and a parasite was observed in a stained tissue section residing in the lumen. Further examination revealed a collection of ova within the ovary of this fluke as see in this image (arrow). Which of the organisms listed below is most likely?

Cystic Fibrosis

The measurement of sodium and chloride in the sweat is the most useful test for the diagnosis of what condition/disease?

Streptococcus pneumoniae

The most frequent cause of bacterial meningitis in adults and in children is:

Leishmania promastigote

The suspicious form in this photograph was recovered from a bone marrow sample and measures 11 µm in length. What is the MOST likely identification of this organism?

Hb H inclusions

This image depicts a brilliant cresyl blue stained blood smear. What inclusion bodies are shown in the erythrocyte indicated by the arrow (B)?

Citrate

This member of the Enterobacteriaceae was isolated from a stool specimen and gave the following biochemical reactions: TSI: K/A, no gas, no H2S Citrate: Positive Lysine decarboxylase: Negative Ornithine decarboxylase: Positive Indole: Negative This organism agglutinated in Group D Shigella antiserum. All of the above biochemical results are consistent with this identification, EXCEPT? TSI Citrate Lysine Indole

Chrnoic inflammation

This serum protein electrophoresis scan most likely represents which condition?

Candida glabrata

This species of Candida accounts for around 20 percent of urinary yeast isolates.

Endolimax nana trophozoite

This suspicious form, found in stool, measures 10 µm. What is the identification?

False

True or False: Platelets are normally found circulating in their inactive, spiny form.

True

True or False: Pseudomonas stutzeri denitrifies nitrate

False

True or False: SCID is characterized by a deficiency of stem cells

False

True or False: Serum lead level is a good inexpensive screening test for lead toxicity

True

True or False: Vitamin D acts as a hormone in calcium regulation

False

True or False: a nonreactive screening test to either HIV-1 or HIV-2 is confirmation that a patient does not have HIV

True

True or False: alkaline phosphatase is increased in obstructive jaundice

False

True or False: hybridization cannot happen between a strand of DNA and a strand of RNA in PCR

True

True or False: pH will be elevated without an elevation of pCO2 with respect o uncompensated metabolic alkalosis

True

True or False: use of a well mixed, uncentrifuged urine sample at room temperature is the technique for urine reagent strips

False

True or false: acetaminophen is metabolized in the kidney

Monitor response to cancer therapy

Tumor markers are especially valuable when used to:

Taenia solium

Upon reviewing a fecal preparation for Ova and Parasites, a technologist thought they had just identified the egg of Taenia saginata. After a quick look, the microbiology supervisor reminded the technologist that T. saginata eggs are indistinguishable from?

Meat diet

Urine test strip positive for blood may indicate all, EXCEPT: Hematuria Hemoglobinuria Myoglobinuria Meat diet

Flocculation

VDRL and RPR are examples of which of the following types of test methodologies?

Recombinant vector

Vaccines can be divided into the following non-experimental types with the exception of: Live, attenuated Inactivated Toxoid Recombinant vector

Streptokinase

Virulence factor that cause the hydrolysis of fibrin clots

Streptolysin O

Virulence factor that is toxic to many cell types including neutrophils and monocytes

Plasma Cell

What is the cell indicated by the arrow in this illustration?

Sickle cell (drepanocyte)

What is the characteristic RBC that is uniquely associated with HbSS?

Aggregates of ribosomes

What is the composition of the granules associated with basophilic stippling?

Aldosterone decreases and norepinephrine increases

What is the effect of aging on the hormones of the endocrine system?

Observe the same organism in all cases of a given disease

What is the first step in the four steps of Koch's postulates?

Two hours

What is the maximum recommended amount of time a specimen without additive or anticoagulant should be allowed to clot before centrifugation?

Three

What is the minimum number of reactive antigen-positive and non-reactive antigen-negative panel cells that must be present in order to identify a red cell antibody with statistical confidence?

Bacillus spp.

What is the most likely organism, based on the gram stain photomicrograph?

Intravascular hemolysis

What is the most significant cause of decreased haptoglobin levels?

2:1 - 4:1

What is the normal myeloid to erythroid (M:E) ratio in the bone marrow?

Segmented neutrophil

What is the nucleated blood cell in this image?

Measures classic or terminal complement pathways

What is the purpose of the Total Complement Activity (CH50) assay?

ABO/Rh, DAT and/or antibody screening are NOT routinely performed in this scenario.

What is the recommended routine testing to be performed on a newborn of a group B Rh positive female?

Photopheresis

What procedure utilizes leukapheresis to collect the buffy coat from whole blood?

light source - monochromator - cuvette - detector - readout

What represents a diagram of a spectrophotometer?

Lymphocytosis

What term could be used to describe this picture?

Electrical equipment, motors, switches

What would be classified as a Class C fire?

Testing for antibodies to U1RNP+ and dcSSc

When a Specked Nuclear Antibody (ANA) pattern is observed, what follow-up test for antibodies related to Systemic Lupus Erythematosus (SLE) is not beneficial?

Positive because conjugated bilirubin is present and is excreted by the kidneys.

When a patient has a bile duct obstruction, the bilirubin test portion of the reagent strip is:

The recipient and donor ABO and Rh types must be identical.

When giving a whole blood donation to a patient, what consideration must be made in regards to the ABO/Rh compatibility between the recipient and the donor?

Patient has no history of clinically significant antibodies detected and the antibody screen on the current sample is negative

When is a computer crossmatch acceptable?

Fya

When performing an antibody panel, which one of the following antigens will be destroyed by enzyme treatment? Fya Jka E Lua

Allow the platelets to rest for 1-2 hours at 20-24°C.

When preparing platelet concentrates from whole blood, after the second spin and excess plasma has been expressed from the platelets, what is the next step in platelet preparation?

peripheral blood

Where is Plasmodium falciperum commonly recovered?

C in Trans to RHD

Which D variant has the best likelihood to receive D-positive RBCs without any adverse effects?

Actinomyces naeslundii

Which Gram positive bacilli will show a positive result for urease?

Plasmodium falciparum

Which Plasmodium species tends to infect any red blood cell, regardless of the age of the cell?

CDe/ce

Which Rh genotype is found with the highest frequency in the Caucasian population?

Lithium or sodium heparin

Which additive prevents clotting by inhibiting thrombin and thromboplastin?

Entamoeba coli

Which amoeba cyst measures around 25 µm?

Albumin

Which analyte measurement is used to detect early nephropathy in a diabetic patient?

Phosphorus

Which analyte shows no difference between capillary and venous values?

Kell

Which antigen is well developed on fetal cells?

There is no discernable pattern

Which antinuclear antibody (ANA) pattern is seen in the image on the right, which represents the result of an ANA test viewed using fluorescent microscopy?

Ticks

Which arthropods would be classified as Arachnida?

Factor V Leiden Mutation Assay

Which assay is commonly used to confirm the diagnosis of Activated Protein C resistance?

Category A

Which bioterrorism agent category is the easiest to spread, has the ability to cause major harm, panic, and death, and carries the highest level of risk with regard to national security?

Acid phosphatase

Which blood test is used in the determination of prostate cancer?

Amylase

Which blood test is used to determine acute pancreatitis?

Sucrose

Which carbohydrate is NOT considered a reducing sugar?

Clinical Chemistry

Which clinical laboratory department performs the most tests?

Diabetes mellitus

Which condition is associated with a positive ketone test on the urine test strip?

Post-hepatic cholestasis

Which condition would be suggested by a jaundiced patient experiencing a marked rise in alkaline phosphatase (ALP), conjugated bilirubin, and a slight rise in alanine aminotransferase (ALT)?

Pernicious anemia

Which condition would produce the results listed below in an anemic patient? MCV = 115 fL MCH = 30 pg MCHC = 34 %

Phialophora spp.

Which dematiaceous fungi affects the joints causing septic arthritis?

Aldolase

Which enzyme is associated with conditions affecting skeletal muscles?

Positive DAT

Which finding best distinguishes immune hemolytic anemia from other hemolytic anemias?

AB negative and AB positive only

Which fresh frozen plasma ABO types would be suitable for transfusion to an AB negative patient?

Heterozygous alpha thalassemia-2

Which genetic description will NOT contain Bart's hemoglobin at birth ?

IgE

Which immunoglobulin class is chiefly responsible for the degranulation of mast cells and basophils?

The study of drug disposition in the body - how and when drugs enter the circulation, how long they stay there, and how they are eliminated.

Which is the definition of pharmacokinetics?

CD19

Which marker is associated with normal mature B cell expression?

hCG (human chorionic gonadotropin)

Which marker is most useful for the detection of gestational trophoblastic disease?

ALT

Which of the following analytes would be increased due to delay in centrifugation? Bicarbonate Folate Ionized Calcium ALT

Creatinine

Which of the following analytes would be increased due to delay in centrifugation? Creatinine Ionized Calcium Folate Bicarbonate

Monitoring course of treatment

Which of the following best describes the benefits of the RPR or VDRL tests:

Bilirubin

Which of the following blood tests requires to be protected from light? Total protein Bilirubin Sodium Glucose

Myeloblast

Which of the following cells are considered abnormal and clinically significant on a CSF differential? Ependymal Myeloblast Pia arachnoid mesothelial Choroidal cells

Positive protein

Which of the following is an example of a macroscopic urinalysis abnormality? Glitter cells Positive protein Waxy casts Red blood cell casts

Cold agglutinin

Which of the following is least likely to interfere with the measurement of hemoglobin? Icteric plasma Lipemia Cold agglutinin Leukocytosis

High urine glucose

Which of the following may be associated with acidic urinary pH? Metabolic alkalosis Renal tubular acidosis Vegetarian diet High urine glucose

Pappenheimer Bodies

Which of the following red blood cell inclusions, marked by arrows, is seen on this peripheral blood smear?

Leishmania amastigote

Which of the following reside inside of macrophages, as depicted in the drawing to the right?

Alpha-fetoprotein

Which of the following tests is the BEST screening test for neural tube defects?

Le(a-b-)

Which one of the Lewis blood group system phenotypes usually produces anti-Lea?

Bacillus anthracis

Which organism displays the characteristic "Medusa head" on 5% sheep blood agar (SBA) after 18 hours of incubation at 35°C?

Schistosoma mansoni

Which parasite has the MOST complex life cycle?

CD2+ CD3- CD11b+ CD16+

Which phenotype is most indicative of a natural killer (NK) cell?

Cytoplasm appears pink-purple due to small specific granules

Which phrase best describes a segmented neutrophil?

Prostacyclin

Which potent inhibitor of platelet aggregation is released by endothelial cells?

EIA or indirect immunoflourescence

Which serological test would be used for the diagnosis of Q-fever?

Corynebacterium jeikeium

Which species of Corynebacterium is lipophilic?

M. xenopi

Which species of Mycobacterium might be associated with contamination of the hot water system in large institutions such as hospitals?

Leukocyte alkaline phosphatase (LAP)

Which stain is used to differentiate a neutrophilic leukemoid reaction from chronic myelogenous leukemia (CML)?

Color Doppler ultrasonography

Which test BEST correlates with the severity of hemolytic disease of the fetus and newborn (HDFN)?

Immunoelectrophoresis

Which test confirms the presence of Bence-Jones proteinuria:

L/S Ratio

Which test on amniotic fluid would be included when assessing fetal lung maturity:

Quantitative fecal fat

Which test requires a 72-hour stool (fecal) collection?

VDRL

Which test would you employ to examine a CSF for syphilis:

Troponin T (TnT)

Which troponin protein binds the troponin complex to tropomyosin?

Anti-A,B

Which type of antibody can cause HDFN in any pregnancy (first or subsequent), but is usually limited to less severe symptoms?

Chylomicrons

Which type of lipoprotein is the least dense?

About 11% lower

Whole blood glucose values are ____________ plasma glucose values.

have greater mobility in the endothelium and arterial wall

Why are small dense LDL molecules more atherogenic?

Its early symptoms are nonspecific and vague, and generally do not get serious until later in life.

Why is hereditary hemochromatosis (HH) thought to be underdiagnosed?

Steptococcal pyrogenic exotoxin A

virulence factor associated with the rash of scarlet fever and the pathogenesis of streptococcal toxic shock like syndrome

Streptolysin S

virulence factor is toxic to a variety of cell types including erythrocytes

Hyaluronidase

virulence factor that depolymerizes the ground substance in connective tissue

A

From the IgG molecule illustration, which region is the heavy chain?

Lactobacillus species

From the choices listed below, which organism is classified as an aerotolerant anaerobe? Clostridium novyi Staphylococcus aureus Lactobacillus species Neisseria species

Brown/black

Homogentisic acid in urine will cause urine to be which color?

Mainly by suppressing the immune response after exposure to D positive cells.

How does RhIg prevent anti-D production?

Induces increased production of HbF

How does hydroxyurea aid in the treatment of sickle cell disease?

7-8 hours

How long are healthy neutrophils expected to reside in the peripheral blood of an adult?

Antibody will react equally with labeled and unlabeled antigen

How will antibody react with antigen in competitive radioimmunoassay?

Lesions caused by deposition of antigen-antibody immune complexes

Identify a characteristic of an organ-non specific disorder that distinguishes it from an organ specific disorder.

Acid fast stain

If a Mycobacterium sp. infection is suspected on a bone marrow or body fluid, what stain should be used to detect these bacteria?

Systematic error

If a commercial lyophilized reagent is diluted using slightly more distilled water than indicated, what type of error will occur?

Leukocyte alkaline phosphatase (LAP)

If a patient has a white blood count of 40,000/µL, what would be the MOST useful staining procedure to distinguish between bacterial infection and chronic myelogenous leukemia (CML)?

Anti-Leb

If detected in antibody screen testing, which of the following antibodies is NOT considered clinically significant in prenatal patients?

Anti-Leb

If detected in antibody screen testing, which of the following antibodies is NOT considered clinically significant in prenatal patients? Anti-M Anti-N Anti-Leb Anti-Fya

Arcanobacterium haemolyticum

Illustrated growing on the surface of the blood agar plate shown in the upper left image are small distinctly beta hemolytic colonies suggestive of beta hemolytic streptococci, particularly when specimens are obtained from patients with an upper respiratory infection. Gram-positive bacilli in branching and Chinese letter formations are observed on Gram stain as illustrated in the upper right image. Observe the reverse CAMP reaction in the lower image. From these observations, select the identification of this bacterial isolate.

Alcaligenes faecalis

Illustrated in the image to the left are 3-day old colonies growing on blood agar. The colonies are gray and spreading, and a sweet, fruity odor is noted. Plump, Gram-negative coccobacilli are seen on Gram stain. This isolate belongs to the motile, non-fermenters with peritrichous flagella. Carbohydrate utilization is asaccharolytic. Nitrite reduction produces gas and citrate is positive. From the multiple choices, select the name of this isolate.

Alpha naphthol with diacetyl

Illustrated in the left tube of this photograph is a positive Voges Proskauer reaction (left tube). The red pigment is produced from the reactions of:

Immediately after waking up

Illustrated in this image is a field of view microscopically observed on a Scotch-tape preparation. Based on the morphology and presentation of these ova, an identification of Enterobius vermicularis can be made. The optimum time to obtain Scotch-tape samples of peri-anal skin to recover these ova is:

Less than 1%

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

Side scatter

In flow cytometry, the granularity of a cell is indicated by?

Phialophora verrucosa

In observing the slow-growing, 7-day-old dark brown colonies growing on Sabouraud Dextrose with Brain Heart Infusion (SABHI) agar, note that the black pigment extends to the reverse of the colony. This provides a presumptive indication of one of the fungi involved in chromoblastomycosis. The species identification of this fungus can be made by observing the distinctive fruiting heads illustrated in the bottom image. Select the identification of the fungal species.

32 grams

In order to correctly prepare a 4 M solution of NaOH, how many grams need to be added to 200 mL of solution? (GMW NaOH =40 g)

Workplace area

In the clinical laboratory, Safety Data Sheets (SDS) shall be maintained and be available to employees in the:

Prevention of Graft-Versus-Host (GVH) disease

In which situation is gamma irradiation of cellular blood components required?

Myocardial infarction

Increases in the MB fraction of CK is associated with:

Leucovorin

Methotrexate is a highly toxic medication that blocks DNA synthesis in all cells. What medication needs to be administered after methotrexate to prevent cytotoxic effects in normal cells of the body?

L-arginine

Nitric oxide is associated with the prevention of vaso-occlusion by decreasing cellular adherence to endothelium. Which amino acid is decreased in patients with sickle cell disease and is needed as a substrate to produce nitric oxide?

Estimated average glucose

Recently the American Diabetes Association (ADA) recommended reporting which of these values in order to correlate with hemoglobin A1C (HbA1C) as a further indicator of glycemic control?

False

True or False: HbD is elevated in alpha thalassemia

True

True or False: Lymphocytes may contain few azurophilic granules in the cytoplasm

Insulin dependent diabetes mellitus

A 56-year old female was taken to the emergency room in a coma by her employer's nurse. She had lost 35 pounds in 3 months; she was always thirsty; drinking a lot of water and running to the bathroom. The following are her laboratory results: Results: (indicates reference range) pH: 7.11 (7.35-7.45)pCO2: 21 mm Hg (35-45 mm Hg)Glucose: 950 mg/dL (60-110 mg/dL)Serum osmolality: 365 mOsm/Kg (275-295 mOsm/Kg)Urine ketone: strongly positive (negative)Urine glucose: strongly positive (negative) What is the MOST likely cause of this patient's symptoms?

Autoanti-P

A 9-year-old male in Alaska presents with hemolysis and hematuria. The patient history reveals that he recently recovered from a flu-like virus. The ABO type is A+, and the DAT reacts at 1+. What blood group antibody should be suspected?

D antigen

A D-positive mother with a D-negative fetus eliminates the possibility of HDFN due to the:

Delivering a Rh positive baby.

A Rh negative individual has produced an anti-D antibody. Which situation has the ability to stimulate this production of anti-D?

Tumor Cells

A cerebrospinal fluid sample was taken from an inpatient with severe neurological symptoms. The image shows a field from a cytospin preparation from this patient's fluid. What findings are present in this field?

The reduction of NAD to NADH

A chemical reaction that is utilized by many different analytical methods involves:

Lymphocytes

A college student is treated in the hospital for suspected meningitis. Which cells should be identified in the cerebrospinal fluid (CSF) report for the cytospin field that is shown?

High risk of severe sepsis/septic shock

A critically ill 86-year-old female was admitted to the intensive care unit (ICU) after arriving at the emergency department with symptoms that included shortness of breath and fever. Her temperature was 39°C (102°F) and pulse rate 110/minute. A white blood count (WBC) was ordered and was elevated at 15.0 x 109/L. The differential showed an increase in segmented and immature neutrophils. Another testing was ordered after admission to ICU, including a procalcitonin (PCT). The result was 2.15 ng/mL (The reference value for normal at the 95th percentile is <0.05 ng/mL). Given the clinical assessment and laboratory test results, what may the increased procalcitonin indicate?

Fonsecaea pedrosoi

A group of relatively slow growing fungi with distinctive dark brown to black colonies are the cause of infections of the skin known as Chromoblastomycosis. Clinically they appear as roughened multicolored verrucous vegetations, most commonly spreading over the dorsal surfaces of the lower legs and feet following penetrating injuries. A presumptive diagnosis of a fungus infection can be made on H & E - stained sections of a tissue biopsy by identifying oval/spherical bodies grouped in small clusters termed "sclerotic bodies" (more colloquial known as "copper pennies"), as illustrated in the top image. Dark gray-black pigmented mold colonies are grown in culture obtained from a biopsy specimen. The dark pigment is produced by deeply pigmented hyphae from the production of melanin, as illustrated in the bottom image. Note the branching conidiophores borne from the tips of hyphae giving rise to short chains of oval conidia. Select the presumptive species identification of this isolate.

AST, ALT, Alkaline Phosphatase, Total Protein, Albumin, Total Bilirubin, Direct Bilirubin

A hepatic function panel A consists of which of the following tests?

High risk for future CVD

A high-sensitivity C-reactive protein (hs-CRP) test result of 5 mg/L (normal = < 1 mg/L) may indicate?

Cannot report

A manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 99 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?

Increased testing volume

A new clinic in the area is sending a very large number of additional chemistry tests to the laboratory. The existing chemistry instrument is only 2 years old and works well, however, there is a need to acquire a high throughput instrument. What is the appropriate "Justification Category?"

Pseudomonas putida

A patient had a transfusion reaction to red blood cells and the remains from the unit of blood were sent to the microbiology laboratory for culture. The organism that grew was a gram-negative bacilli that was catalase and oxidase positive and was negative for gelatin hydrolysis. The organism was inoculated on a Pseudo F agar slant and incubated for 24 hours. Fluorescence was observed when using a UV light as seen in the image. This organism is most likely:

Platelet neutralization test

A patient has a history of repeated spontaneous abortion. Coagulation studies reveal an elevated APTT, normal PT, normal platelet function, and normal thrombin time. Schistocytes were seen on the peripheral blood smear. Which test should be performed to determine if the patient has lupus anticoagulant?

Microcytic, hypochromic

A patient has the following hematology test results. Classify the anemia: Hgb = 8.1 g/dL Hct = 31% RBC = 4.0 x 1012/L

Enzyme panel

After performing an antibody panel and a selected cell panel, you still can't rule out S and Fyb. It appears that the patient has anti-e and anti-Jkb, but they are only reacting microscopically. What technique would be the best way to strengthen the suspected antibodies?

A

All of the following are Lancefield carbohydrate antigens found on beta hemolytic Streptococcus species. All of the following antigens are found on organisms from the Streptococcus anginosus group EXCEPT? A B F G

Low aldosterone production

All of the following are causes of hypernatremia EXCEPT: Excess water loss Low aldosterone production Decreased water intake Increased sodium intake or retention

Amount of light present

All of the following are factors that will affect migration in gel electrophoresis, EXCEPT? Gel concentration (size of gel pores) Size of particle Voltage used Amount of light present

Staphylococcus saprophyticus

Based on the results below, what is the most likely organism? Gram stain: Positive cocci Catalase: Positive Coagulase: Negative Bacitracin susceptibility: Resistant Novobiocin susceptibility: Resistant

Allergic reactions

Basophils' primary role involves:

64.8 mg/24 hrs

Given the following information, calculate the results in mg/24 hrs for a 24-hour urine protein.Total volume for 24 hours = 2,400 mL Urine protein = 2.7 mg/dL

Kidney, bone, intestines, liver

Isoenzymes of alkaline phosphatase occur in:

Utilization of human blood agar

Isolation and detection of Gardnerella vaginalis from vaginal secretions is improved by?

Reservoir hosts

Parasitized animals that may serve as a source of infection for humans are called:

Pantoea agglomerans

Of the Enterobacteriaceae listed below, which of the following species fails to decarboxylate lysine, ornithine, and arginine? Pantoea agglomerans Enterobacter aerogenes Yersinia enterocolitica Proteus mirabilis

Coccidia

Parasites that belong to the category Sporozoa are also known as:

Diversion pouch

Platelet products will be prepared from a whole blood donation. What must be used to prevent potential contamination of the platelets with skin cells and bacteria?

Fasting blood glucose, triglycerides, HDL-C

The National Heart, Lung, and Blood Institute (NHLBI) and American Heart Association (AHA) have created a set of parameters to define the presence of metabolic syndrome. Select the set of laboratory assays that are utilized in the NHLBI and AHA criteria for metabolic syndrome diagnosis.

Chronic myelocytic leukemia (CML)

The Philadelphia chromosome is consistently associated with which of the following blood disorders?

Fisher - Race

The Rh nomenclature which uses the letters DCE is found in which of the following genetic models?

gp41 or gp160

The Western Blot for HIV-1 infection identification looks for HIV p24 and what other two protein bands to confirm HIV-1 infection?

Mycobacterium simiae

The accumulation of niacin is one of the chief characteristics to identify Mycobacterium tuberculosis. Another rarely encountered Mycobacterium species that also accumulates niacin is:

Lecithinase

The anaerobe producing the double zone of hemolysis, seen in this photograph, can be presumptively identified as Clostridium perfringens. The enzyme producing the outer zone of hemolysis is:

Cold agglutinin disorders

The arrangement of erythrocytes on this peripheral blood smear can be associated with each of the following conditions EXCEPT: Multiple myeloma Cold agglutinin disorders Chronic inflammatory disorders Lymphoplasmacytic lymphoma

Snails

The first intermediate host in all of the fluke life cycles are the:

Enrichment media

The following media contains specific nutrients that encourage the growth of a pathogen over the growth of other bacteria from a specimen. It is useful in the isolation of stool pathogens such as Salmonella and Shigella, the isolation of anaerobes, and the selective isolation of group B streptococci.

A trend where the QC data continues to increase or decrease over a period of time

The gradual deterioration of an instrument's light source would most likely be reflected in the quality control (QC) results as:

Initiators of allergic inflammation

The granules of Basophil contain?

HbAS

The hemoglobin electrophoresis patterns that are shown include controls labeled AF and ASC above and below the patient results on the alkaline electrophoresis (on the left), and above the patient results on the acid electrophoresis (on the right). Note that labels AF and ASC are simply labels for the controls and do not indicate order of migration. The patient was tested in duplicate and the results are in lanes 4 and 6. The patient samples displayed in these hemoglobin electrophoresis patterns are consistent with what diagnosis?

Paragonimus westermani egg

The image to the right was recovered from a sputum sample. The form in the image measured 112 µm by 55 µm. Which of the following is the correct identification?

Clinically insignificant cold antibodies antibodies

The immediate spin phase of an indirect antiglobulin test (antibody screen and antibody identification) could most likely lead to the detection of what?

Acetoacetic acid

The ketone component that is measured by the nitroprusside reaction is:

Reabsorption of waste products

The kidneys perform all of the following functions EXCEPT: Acid-base balance Hormone production Reabsorption of waste products Water and electrolyte balance

Direct fluorescent antibody test

The laboratory test most commonly used to establish a definitive diagnosis of primary syphilis is:

The CYP450 variants have no influence on drug metabolism.

The pharmacogenetic profiling reveals a mutation in a CYP450 enzyme that causes increased enzyme activity. Which of the statements below is incorrect?

Megaloblastic anemia

The presence of an increased number of hypersegmented neutrophils in the peripheral blood is an indication of which of the following conditions?

5-10 days

The primary antibody response takes an average of how many days?

Hydrostatic differential in glomerular tufts

The primary mechanism responsible for glomerular filtration is:

20 - 24 degrees Celsius, 24 hours

The proper storage requirements for granulocyte concentrates is:

>55%

The ratio of whole blood to anticoagulant is very important in the PT assay; at which hematocrit level should the standard anticoagulant volume be adjusted?

Phialophora verrucosa

The segmented, dark-staining grains seen in this photomicrograph are most commonly seen in cases of chromoblastomycosis. Which fungal species is known to cause this disease?

Properties of the membrane used

The selectivity of an ion-selective electrode is determined by the:

Brucella species

The small, slowly growing gray-white colonies seen on the blood agar plate were recovered from a blood culture of a 40-year-old farm worker who developed fever and chills leading to septicemia, following ingestion of contaminated milk. The Gram stain of this organism is seen in the lower image revealing small gram-negative coccobacilli in loose clusters. Key to the identification of this blood culture isolate is the rapid urease reaction. From these observations, select from the choices the presumptive identification of this isolate.

94%

The statistics for a specific laboratory test method are illustrated to the right. What is the sensitivity of this test?

False

True or False: Gastrin is primarily produced in the pancreatic islets

Mycobacterium chelonae

The tiny colonies growing on chocolate agar after 3 days incubation, as illustrated in the left plate in the upper photograph, were recovered from a skin abscess at the site of a contaminated needle injection. The colonies growing on Middlebrook 7H10 agar seen to the right in the image were larger, smooth, convex, and gray-white. Acid fast stains were positive for the appearance of slender bacilli, consistent with one of the rapidly growing Mycobacteria. Reactions for nitrate reduction and iron uptake were negative. A distinctive characteristic was the antibiotic resistance to Ciprofloxacin (left upper strip) and Polymyxin B susceptiblility (vertical strip) in the lower photograph. From these observations, select the identification of this isolate.

Type IV Cell mediated hypersensitivity (T-cell dependent)

The type of hypersensitivity reaction associated with macrophage activation, cytokine-mediated inflammation is:

Trichophyton verrucosum

The upper image to the right depicts a small circular white colony with a downy surface, recovered from a skin scraping specimen after 7 days of growth on agar supplemented with thiamine and inositol. The identification is made by observing the aerial hyphae (middle image) and the underlying chains of pigmented chlamydospores among the hyphae (lower image). Based on this information, what is the most likely identification of this dermatophyte?

Speckled

This antinuclear antibody (ANA) pattern is characterized by granular staining in the nuclei of the interphase cells (a). There is also an absence of staining in the chromosomal area of the metaphase mitotic cells (b). The slide is viewed using fluorescent microscopy. Which pattern is this?

Nucleolar

This antinuclear antibody (ANA) test is viewed using fluorescent microscopy, which pattern is this?

Blood should be drawn immediately before the next dose is given.

To assess drug concentrations during the trough phase:

False

True or False: Blood drawn into sodium citrate anticoagulant will increase ESR values

AB

What ABO phenotype will exist in an individual that inherits an A gene from one parent and a B gene from the other?

Russell bodies

What are the globular inclusions in this cell?

OA and OB

What are the possible ABO genotypes of offspring from parents whose genotypes are OO and AB:

A substitution of an amino acid in the hemoglobin chain.

What best describes a hemoglobinopathy?

Red cell membrane defects

What characteristic is common to all of these conditions: hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria?

Sodium

What contributes most to serum osmolality:

Desferrioxamine

What drug may be used to decrease iron levels in patients with iron overload?

Transfer of gamma-glutamyl peptides amino acids, water, and other peptides

What function in the body does GGT have?

A compound that is part ketone

What is a hemiacetyl?

An antibody directed against the platelet membrane

What is a mechanism known to cause platelet satellitosis (satellitism)?

Oval macrocytes

What is a sign of dyserythropoiesis that occurs in Myelodysplastic Syndromes?

Coccidiodes immitus

What is a systemic, dimorphic genus that characteristically produces barrel-shaped arthroconidia separated by dysjunctor cells:

Decreased CD4+ cells

What is associated with an increased susceptibility to infection in AIDS patients?

Retinol-binding protein

What is considered the major transport protein for vitamin A?

90 - 150 mL

What is the approximate volume of spinal fluid in an adult?

Absorption of excessive amounts of iron in the small intestine

What is the cause of iron overload in hereditary hemochromatosis?