Media Lab Exam2
Pituitary gland These are involved: prostate, seminal vesicles, bulbourethral gland
All of the following are directly involved in the production of semen EXCEPT?
Prostate cancer
All of the following conditions would be associated with an increased level of alpha-fetoprotein EXCEPT
Regular use of multivitamins with iron
All of the following factors after a protective effect, delaying symptoms in persons with hereditary hemochromatosis EXCEPT
Erysipelothrix rhusiopathiae - usually small amount (black)
Among the gram positive bacilli, the unique species producing H2S as seen in the Kilgler Iron Agar slant illustrated in this photograph is
C, c, E, e, Fya, Fyb, Jka, Jkb, M, N, S, and s
Antigens that show dosage are
Stenotrophomonas maltophilia - on MacConkey agar colonies are small, smooth, entire and non pigmented. KIA is Alk/Alk, positive maltose and recovered from respiratory tract of cystic fibrosis patients Burkholderia cepacia - Blood agar colonies are small, entire with yellow pigmentation. Form singly, positive for oxidase, catalase, and urease Comamonas acidovorans - colonies are tiny, entire, slightly raised, smooth and distinctively light yellow. Oxidase + and nitrites are reduced, urease -, citrate +
Bacteria descriptions
37 C - should be tested within one hour of collection
For BEST results, if not tested immediately, a semen sample should remain at which of the following temperatures following collection ?
Citrate
This member of the Enterobacteriaceae was isolated from a stool specimen and gave the following biochemical reactions TSIA - K/A, no gas or H2S Citrate + Lysine - Ornithine + Indole - This organism agglutinated in Group D Shigella antiserum. Which biochemical result is NOT consistent with this identification?
Thyroid C cells
In healthy individuals, calcitonin is synthesized by which cells in the body?
Minimum energy required for the appearance of a particular fragment ion in mass spectrum
In mass spectrometry the "appearance potential" is defined as the
4.5 mL
In order to make a 1:10 dilution with 500 microliters of serum, the technologist would have to use how much saline?
Dehydration - lack of body water
In which of the following conditions would an increased serum osmolality be an expected finding?
Weak subgroup of A
What is the MOST likely cause of the ABO discrepancy when the following results were obtained from a first time 29 year old, blood donor? Forward Reverse Anti-A - A - Anti-B - B 3+
PCH is caused by an IgG antibody while CHD is usually caused by an IgM antibody
What is the common difference between paroxysmal cold hemoglobinuria (PCH) and cold hemagglutinin disease (CHD)?
Denaturation - double stranded DNA into single strands Annealing - attachment of primers to the single strand DNA Extension - creating complementary strand to produce new double strand DNA
What is the first step of the PCR reaction?
Cleaving ultra-large molecules of von Wilebrand factor to keep them out of the circulation
What is the function of ADAMTS 13 enzyme?
Increased urine copper and decreased serum copper
When evaluating a patient for a suspected Wilson's Disease diagnosis, low values of plasma ceruloplasmin would be expected along with:
False - to be significant must be a two tube increase or more example is only a one tube rise
When monitoring maternal antibody strength using a doubling dilution, an increase in titer from 16 to 32 is considered a significant rise in titer.
Adiponectin
Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity?
Metanephrines
Which assay using 24 hour urine is considered the BEST single screening test for pheochromocytoma?
HBsAg
Which is the first marker (antigen or antibody) which will become positive after exposure to Hepatitis B:
Kell
Which of the following antigen groups is closely related to the ABO antigens n the red cell membrane ?
Blastomycoses dermatitidis
Which of the following dimorphic molds produces spherical or oval conidia, each supported by an individual conidiophore "lollipop"
Outdate - can be handwritten
Which of the following is NOT required to be in a machine-readable format on a blood component label?
Hydroxyurea
Which of the following is an FDA-approved therapeutic agent for treating sickle cell patients?
Beta-hydroxybutyric acid
Which of the following ketones is NOT detected in the Acetest tablet method? These are detected: acetone, acetoacetic acid, and beta-hydroxybutyric acid and acetone
Large doses of chloropromazine
Which of the following may cause a false positive bilirubin result on a urine chemical reagent strip?
Urine protein electrophoresis or immunoelectrophoresis
Which of the following methods would be used to confirm the presence of Bence-Jones proteins in the urine?
Inflammatory cytokines, synthesized and released by adipose tissue, contribute to the development of cardiovascular disease
Which of the following statement is true regarding cardiovascular disease and adipose tissue?
The reagent strip method is based on the relationship between ionic concentration and specific gravity
Which of the following statements is TRUE for specific gravity measured by the reagent strip method?
Urobilinogen
Which of the following urine chemical reagent strip tests is based on the Ehrlich-aldehyde reaction ?
Thymine RNA contains Uracil
Which of these nitrogenous bases is present in deoxyribonucleic acid (DNA), but not in ribonucleic acid (RNA)?
A1
Which on of the following blood groups usually reacts LEAST strongly with anti-H?
Lewis
Which one of the following blood group systems may show a cell typing change during pregnancy?
It is a strict anaerobe
Which one of the following comments about Francisella is not true?
It is decreased in hyperthyroidism
Which one of the following statements about thyroid-stimulating hormone (TSH) is true?
Endocytosis us the process by which phagosomes are released by the cell to expel the macromolecules inside (this is exocytosis)
Which one of the following statements concerning endocytosis (process by which cells absorb molecules by engulfing them) is NOT TRUE?
CA 15-3 and CA 549
While serum elevations are NOT generally seen in early stages, which of the following tumor markers are elevated in more advance stages of breast cancer?
Tyrosine - acidic urine
Name the crystals present on this slide. Contains fine needles clumps or rosettes
Nocardia
Patterns of hydrolysis of tyrosine, xanthine, and casein are characteristics helpful in making identifications within the genera:
Binds with factor H to initiate alternate complement pathway
All of the following statements are characteristic of the role of C-reactive protein (CRP) (activated complement, exhibits inflammatory characteristics, initiates opsonization) except?
Amylase and lipase are predictive in chronic as in acute pancreatitis
All of the statements below regarding amylase and lipase in pancreatitis are true EXCEPT:
False - free hemoglobin is not released in extravascular hemolysis
Hemoglobinuria and hemoglobinemia will be present in reactions where there is extravascular hemolysis
Histoplasma capsulatum
Large, one-celled, smooth-to-tuberculate macroconidia and smooth or echinulate microconidia are typical of mycelial phase growth of which organism?
False - also predictive for ampicillin, cefotaxime, imipenem, and other beta lactam antibiotics
Minimum inhibitory concentration (MIC) suseptability tests should be performed against other beta lactam antibiotics on important S. pneumoniae isolates from blood cultures and other sterile body fluids when a MIC for penicillin is performed.
Thrombin time
This assay would be used to help rule-out heparin contamination in a coagulation sample
what the drug does to the body
The term pharmacodynamics BEST describes
What the body does to the drug
The term pharmacokinetic BEST describes
rapid and immediate vascular dilation occurs
Primary hemostatic processes resulting from vascular damage include all of the following EXCEPT:
TISA acid over acid, H2S negative, lysine negative, indole variable, urea positive - case typical of Yersinia enterocolitica
A 6 year old girl was seen in the emergency room with pain and tenderness in her lower right quadrant. A CBC showed a high white blood cell count with increased segmented neutrophils and bands. The child was admitted to surgery with a diagnosis of appendicitis. During surgery the appendix appeared normal, but an enlarged node was removed and cultured. A diagnosis of mesenteric lymphadenitis was made. Gram-negative rods were isolated. Which of the following biochemical results are most likely produced by the suspect organism?
Pappenheimer bodies - iron and protein and found in sideroblastic anemia
A few dark blue staining granular inclusions located near the periphery of an erythrocyte are most likely:
Proteins (carrier)
A hapten is only antigenic when it is coupled with which of the following:
A soluble mediator produced by lymphocytes - usually T cells
A lymphokine can BEST be described as
Carcinoid tumor
A markedly elevated 5-HIAA determination in presumptive evidence for
96.4 - 103.6 : 2 standard deviations which is 3.6
A mean value of 100 mg/dL and a standard deviation of 1.8 mg/dL were obtained from a set of glucose measurement on a control solution. The 95% confidence interval in mg/dL would be:
Leukemoid Reaction
A patient admitted to the hospital for ongoing fever produces the following laboratory results RBC - 3.56 WBC - 57.5 Platelet - 375 Blasts - 3 Myelocytes - 10 Metamyelocytes - 6 Bands - 12 Segs - 64 Lymphs - 4 Mono - 1 LAP score: 155 Which of the following conditions correlates closely with this patient's results?
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 clotting time. Schistocytes were seen on the peripheral blood smear. Which test should be performed to determine if the patient has lupus anticoagulant?
An IgM and an IgG antibody
A sample has reactions occurring at immediate spin and AHG in a panel that shows varying reaction strengths. There is no obvious pattern that matches a particular panel cell or single antigen profile and the auto-control was negative. Which of the following is the most likely cause?
All of them
A technologist has 500 microliters of serum and needs to make a 1:2 dilution for a glucose determination. How should he/she do it?
Plasma cell
A white blood cell stained with Wright's stain has the following characteristics: Round eccentric nucleus 1:1 nucleus to cytoplasm ratio Basophilic cytoplasm Crescent-shaped clear area next to the nucleus What is the MOST likely identification of this cell?
leukemia, anemias, thrombocytopenia
Bone marrow examinations may aid in the diagnosis of:
Yes, he meets the NHLBI and AHA criteria for metabolic syndrome
Below are the laboratory results on a 20 year old overweight male. His waist circumference is 41 inches and blood pressure is 105/70. Fast glucose: 130 mg/dL Triglycerides: 190 mg/dL HDL: 50 mg/dL The National Heart, Lung, and Blood Institute and American Heart Association have created a set of parameters to define the presence of metabolic syndrome. Does this patient meet the criteria for metabolic syndrome diagnosis?
Acetyl-CoA - breakdown of carbs, lipids and protein
Beta-hydroxybutyric acid is formed as the result of an accumulation of which of the following ?
False - laboratories develop their own policies
Blood safety standards such as AABB Standards specify that a computer crossmatch is acceptable when an Rh negative woman has an anti-D consistent with antenatal RhIg administration.
Microsporum gypseum - mature in 3-5 days with a granular surface, microscopically they are multi-segmented, large conidia, nonbranching hyphae Triphophyton tonsurans - granular buff-colored surface with radial rugae, microscopically they are club shaped and spherical conidia, non branching hyphae Epidermophyton floccosum - colonies have a khaki-green pigment with hyphal strands, microscopically they are large club shaped conidia with 3-5 cells
Dermatophye decriptions
Assess the risk of Down's Syndrome
Estriol levels in conjunction with hCG, inhibin A and alpha-fetoprotein can be obtained during pregnancy to
90%
Hemophilia A (80%)and B and von Willebrand's disease together constitutes approximately what percentage of all hereditary coagulation disorders:
Streptococcus agalactiae - Group B beta hemolytic hydrolyzes hippurate to benzoic acid and glycine (purple)
Hippurate hydrolysis is an important characteristic in the definitive laboratory identification of streptococci. The positive ninhydrin reaction, seen in the left tube in the photograph, is produced by:
10 - area of each square is 1 mm2 and the depth is 0.1
How many large hemocytometer squares contain a total volume of 1 microliter of fluid?
Plasmodium vivax
Identify the parasite of a patient with suspected malaria who demonstrates the following findings on a blood smear. Enlarged RBCs, some with fine brownish granules >15 parasites in some cells Ameboid structures Schuffner's dots
31 K (1-0.09)=0.91 Fya (1-.66)=0.34 100x(0.91x0.34)=31
If the antigen frequencies for K=0.09 and Fya=0.66, what precent of the type-specific units would be compatible for a patient with anti-K and anti-Fya?
Trichophyton verrucosum - antler like under microscope, branching hyphae
Illustrated in the top photograph is a small circular white colony with a downy surface, recovered from a skin scraping specimen after 7 days growth on agar supplemented with thiamine and inositol. The identification is made by observing the aerial hyphae and the underlying chains of pigmented chlamydospores among the hyphae as seen in this composite image. With these observations, select the identification of this dermatophyte.
Roseomonas
Illustrated in the upper photograph are small, entire, raised colonies with a distinctive pink-red pigmentation shown here growing on MacConkey agar after 48 hours incubation. The Gram stain shows distinctive Gram-negative plump coccoid rods arranged in loose pairs, some with internal vacuoles. Key biochemical reactions that were performed include positive reactions for oxidase, catalase, and urease. From these observations, select the genus/species name of the isolate.
Mary should take frequent stretch breaks and May, Jane, and Pam could alternate or share tasks
Mary, Jane, and Pam work in the specimen processing area. Mary sits at the computer station and logs in specimens. Jane's task is to centrifuge and aliquot samples to prepare them for testing. Pam delivers specimens to the testing department. Mary is having frequent mild pain in her neck, shoulders, and wrists. What ergonomic corrective action could be taken to help Mary ?
B - basophil
Select the letter representing the cell that can be seen in increased concentrations in the peripheral blood smear during immediate hypersensitivity reactions
False - the cell is a monocyte, not an atypical lymphocyte
The white blood cell indicated by the arrow is representative of an atypical white blood cell associated with infectious mononucleosis.
small central karyosome in the nucleus, ingested RBCs
The Entamoeba histolytica trophozoite is usually characterized by the presence of the following
usually increased
The Red cell distribution width (RDW) in alpha thalassemia is
HBeAg
The antigen marker most closely associated with transmission of HBV infections is:
Polyacrylamide gels have the greatest resolution or separation of solutes
There are several different types of media that can be used in electrophoresis. Most methods today use a gel cellulose acetate, agarose , or polyacrylamide gel. Which one of the following statements is true regarding these gels?
Alpha thalassemia intermedia (Hemoglobin H Disease)
This drawing depicts which alpha chain genotype? --/alpha-
Severe burns
The cell containing the inclusions (dohle bodies) indicated by the arrows are often associated with which of the following conditions?
Bismuth sulfite agar
The culture medium that is specifically formulated to recover Salmonella typhi from stool specimens is:
Reliability
The degree in which a measure is consistent in producing the same results when measuring the same analyte is called:
Synovial
The estimation of hyaluronic acid concentration by measurement of viscosity is useful in evaluating which type of fluid?
Endogenous triglycerides Chylomicrons - exogenous lipids HDL and LDL transports cholesterol
The function of the very low density lipoprotein is to transport
Zeta - Chromosome 16 Zeta, Alpha 2, Alpha 1
The gene loci for the alpha globin chains are adjacent to the locus for which other globin chain?
Histrogram with normal width
The image on the right is a representative field from a peripheral blood smear. What characteristics would describe the red cell distribution curve that you would expect to see?
Anti-proliferating cell nuclear antigen (anti-PCNA)
The image represents the results of an antinuclear antibody (ANA) test that is viewed using fluorescent microscopy. The speckled staining within these positive cells varies between coarse speckled and smooth speckled. Cells are also present that are negative because these cells are not expressing the antigen that the antibodies are directed against.
Cysts protozoans - trophozoites and cysts, not larvae or eggs saline mounts help to look for motility
The iodine prep method is used to detect which of the following protozoan stages?
Testes and adrenal cortex
The measurement of 17-ketosteroids in urine is performed to assess PRIMARILY which organs
Streptococcus pneumoniae
The most frequent cause of bacterial meningitis in older adults is
Bordetella bronchiseptica (motile) and Acinetobacter baumannii (nonmotile)
The pair of nonfermentative gram negative bacilli producing the motility reaction illustrated and non motile tubes respectively shown in the photograph are
Staphylococcus lugdnensis All of these are coagulase + - intermedius, schleiferi ssp. coagulans, and aureus ssp aureus
The photograph illustrates a positive tube coagulase test as compared to the fluid, uncoagulated appearance of the negative control. Each of the following Staphylococcus species may produce the reaction seen in Tube A except:
a minimum of 20-30 analytes of control serum over a period of 20-30 days
The preparation of a Levey-Jennings quality control chart for any constituent of serum requires:
Glucose oxidizer
The reactions in the tubes illustrated in this exercise (KIA Alk/Alk, Pseudosel +, OF glucose, closed green and open yellow) indicate that the bacterial species in question is a:
Properties of the membrane used
The selectivity of an ion-selective electrode is determined by:
ABO and Rh
Units of A-, B-, and O negative red blood cells are shipped to your transfusion service. What testing must be performed by your facility prior to placing these units into your inventory?
Target amplification and signal amplification
What are the two general categories of nucleic acid amplification techniques?
Anemia, splenomegaly
What characteristics are often associated with alpha thalassemia intermedia?
