MLSC388 Review

The "recognition unit" of the classical complement pathway refers to which of the following? A. C5b, C6, C7, C8, C9 B. C1q C. C3a D. C4

B. C1q C1q is referred to as the "recognition unit" in the classical complement pathway C5b, C6, C7, C8, C9 make up the MAC C3a works as a natural substrate on C4b2a C4, along with C2, are part of the classical complement pathway

What percentage of the dietary iron is normally absorbed daily? A. 5% to 15% B. 25% to 35% C. 50% to 75% D. 75% to 100%

A. 5% to 15% Iron needs to be in ferrous state and bound to protein to be absorbed by intestinal cells. Most iron is in ferric state and must be reduced by ferric reductases before being absorbed

Which of the following statements best describes the mean and median as they relate to a normal "gaussian" distribution curve? A. Both are equal B. Median = ½ mean C. Both are variable D. Mean = ½ median

A. Both are equal A normal gaussian distribution if a symmetric distribution with a single peak at the center where the median and mean are equivalent.

Sequence-based analysis is an alternate method used to identify bacteria and fungi isolates. This methodology uses rRNA genes and their antigenic regions as common target sites to identify these organisms. Which of the following rRNA gene target sites is used to identify fungal isolates? A. 16S rRNA B. 28S rRNA C. 25S rRNA D. 14S rRNA

B. 28S rRNA 16S is a bacterial subunit 25S and 14S are not target regions for bacteria or fungi

FAB (French American British) classification of acute leukemia requires ______% non-erythroid blasts present in BM/blood while WHO system requires presence of ______% non-erythroid blasts. A. 40%, 20% B. 30%, 20% C. 20%, 30% D. 20%, 40%

B. 30%, 20%

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. A B. B C. F D. G

B. B Group B antigen is found of S. agalactiae Group A is found on S. pyogenes but can also be found on S. anginosus group. S. anginosus can be distinguished by detection of Group A, C, F and G carbohydrate group antigens Group F is most commonly found on S. anginosus. S. constellatus can also have group F antigens Group G is found on S. anginosus group, specifically S. anginosus (small colony) and S. dysagalactiae (large colony)

What is the MOST frequent disease complication of blood transfusions? A. CMV B. Syphilis C. Hepatitis D. HIV

C. Hepatitis Hep B and C are the most common diseases transmitted by blood transfusion

When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to: A. Clean the skin area B. Complex with chloride C. Stimulate nervous system D. Induce sweat secretion

D. Induce sweat secretion Pilocarpine stimulates sweat glands and helps induce secretion during sweat chloride test via iontophoresis. Sweat chloride determination are used in diagnosis of cystic fibrosis.

Albuterol is a fast acting bronchodialator used acutely during asthma attacks. All of the reasons below explain why therapeutic drug monitoring (TDM) for albuterol is not available or common, EXCEPT? A. It is not a chronically used drug so toxicity is less likely B. The half-life is short, and the drug is cleared quickly C. It has a wide therapeutic window D. It has a narrow therapeutic window

D. It has a narrow therapeutic window

The oxidase test is used to presumptively identify which of these organisms A. Escherichia B. Enterobacter C. Serratia D. Neisseria

D. Neisseria Escherichia, Enterobacter and Serratia are all oxidase negative

What is the BEST type of microscopy for performing manual platelet counts? A. Electron B. Dark-field C. Light D. Phase Contrast

D. Phase Contrast Phase contrast best defines platelets over regular light microscopy EM is used for higher magnifications Dark-field is used for refractive elements and illuminates specimen against dark background

What tribe is Morganella marganii in? A. Yersinieae B. Echerichieae C. Klebsielleae D. Proteeae

D. Proteeae Members of the family Enterobacteriaceae have been subcategorized into numerous tribes based on biochemical characteristics since 1963. M. morganii is part of the Proteeae tribe. Yersinieae contains Yersinia spp. only Escherichiea contains Echerichia spp. and Shigella spp. Klebsielleae contains Klebsiellaspp. Enterobacter spp. Pantoea agglomerans, Cronobacte sakazakii, Hafnia alvei and Serratia spp.

An iodine prep is least helpful in identification of which parasitic stage? A. Larvae B. Eggs C. Cysts D. Trophozoites

D. Trophozoites Iodine kills trophozoites The other stages, iodine emphasizes nuclear material and glycogen masses which makes identifying distinguishing characteristics easier

An automated method for measuring chloride which generates silver ions in the reaction is called: A. Amperiometric-coulometric titration B. Potentiometry C. Chromatography D. Polarography

A. Amperiometric-coulometric titration A-C titration operates on the Faraday law in which a silver anode releases silver ions 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.

CSF lymphocytosis is associated with all of the following EXCEPT: A. Cerebral abscess B. Viral meningitis C. Chronic fungal meningitis D. Chronic tuberculous meningitis

A. Cerebral abscess CSF lymphocytosis is seen in viral, fungal and tuberculous infection, although a predominance of neutrophils may be present in early stages of these infections. CSF lymphocytosis is NOT associated with cerebral abscess and is often contraindicated in those with suspected brain abscess

Which of these parasites are hermaphroditic in their adult phase? A. Chlonorchis sinensis B. Schistosoma haematobium C. Wuchereria bancrofti D. Trichuris trichiura

A. Chlonorchis sinensis Hermaphroditic = self-fertilization. Of the listed species, Chlonorchis sinensis is the only one with this ability. The other choices all have separate male and female adults for reproduction. Schistosoma haematobium (fluke) Wuchereria bancrofti (filariae) Trichuris trichiura (nematode)

What changes in potassium and sodium serum results may occur with diuretic use: A. Decrease in both B. Increase in both C. Increase in potassium and decrease in sodium D. Decrease in potassium and increase in sodium

A. Decrease in both Drugs can affect various analytes. Both K+ and Na+ are decreased through renal loss.

What sugar configuration is necessary as a base for attachment of other sugars to produce ABO antigens A. Galactose plus fucose B. Glucose plus fucose C. N-acetylgalatosamine plus fucose D. D-galactose plus fucose

A. Galactose plus fucose Fucose must to attached to galactose in a specific configuration for further antigen development to take place. This configuration is called "H" and acts as a building block for additional sugars Galactose and glucose act as a base for the oligosaccharide to attach to the cell membrane N-acetylgalatosamine attached to the "H" base form A antigen D-galactose attached to the "H" base forms B antigen

Many RBC processes, such as binding, transporting and releasing oxygen do NOT require energy. Energy however is required for cellular viability. How does the RBC obtain most of its energy? A. Glycolytic pathways B. Hexome-monophhosphate shunt C. Papaport-Luebering pathway D. Methemoglobin reductase pathway

A. Glycolytic pathways One glucose produces two molecules of ATP HMS reduces oxidants RLP controls amount of 2,3 BPG that gets produced Methemoglobin pathway reduces methemoglobin

All of the following are considered to be important protein regulators of ion metabolism, EXCEPT? A. Hemosiderin B. Hepcidin C. Transferrin receptor D. Ferroportin

A. Hemosiderin Hemosiderin is an iron rich brown pigment and although it is considered stored iron, it does not perform a regulatory function in iron metabolism. Hepcidin is produced in the liver in response to inflammation. Its function is to block iron release or absorption. atients who have anemia of inflammation often have elevated hepcidin levels. Transferrin receptor is a membrane bound protein which captures transferrin. Transferrin carries iron from ECF to developing RBCs Ferroportin is a transmembrane iron transport protein which transports iron from inside the cell to the outside. It is important in iron release from macrophages and thus important for iron recycling.

Which of the following is NOT classified as a MDS? A. Refractory Lymphopenia B. Refractory Anemia C. Refractory Neutropenia D. Refractory Thrombocytopenia

A. Refractory Lymphopenia Only MYELOID lines. Derp MDS are hematopoietic neoplasms characterized by cytopenias and dysplastic cells

Which statement applies to high specificity and low sensitivity? A. Accurately identifies the presence of disease B. Accurately identifies the absence of disease and has few false positives C. Has few false positives and accurately identifies the presence of disease D. Has few false negatives and accurately identifies the presence of disease

Accurately identifies the absence of disease and has few false positives High specificity detects absence of disease, fewer false positives

All of the following are examples of antiseptics commonly used in blood collection, EXCEPT? A. 70% ethyl alcohol B. 70% isopropyl alcohol C. 5.25% sodium hyperchlorite D. Hydrogen peroxide

C. 5.25% sodium hyperchlorite 5.25% Sodium hypperchlorite is a disinfectant, not an antiseptic. Disinfectants are stronger, used to kill microorganism. Disinfectants are not safe o use on human skin and are typically used on medical instruments and counter-tops. Antiseptics are used to clean human skin by inhibiting microbial growth. The other three choices are examples of commonly used antiseptics used in blood collection.

A high-sensitivity CRP test of 5 mg/L (normal = <1 mg/L) may indicate which of the following? A. Low risk or CVD B. High risk for future CVD C. Acute inflammatory condition D. No risk for future CVD

B. High risk for future CVD Hs-CRP is used for CVD risk. > 10 mg/L should be assessed for acute inflammatory condition

Normal adult CSF ay have 0-5 WBCs/uL. Which of the following cell types account for 60-70% of these WBCs? A. Neutrophils B. Lymphocytes C. Monocytes D. Eosinophils

B. Lymphocytes Typically, the majority of cells seen in normal adult CSF specimens are lymphocytes and monocytes (70:30). This ratio is reversed in children.

The segmented, dark staining grains seen in this photograph are most commonly seen in cases of chromoblastomycosis. Which of the fungal species listed below is known to cause this disease? A. Trichophyton schoenleinii B. Phialophora verrucose C. Sporothrix schenckii D. Tinea pedis

B. Phialophora verrucose Of the fungal species listed, Phialophora verrucose is associated with chromoblastomycosis and has the capability of producing the grains seen in the photograph. Trichophyton schoenleinii is mycosis of the hair follicle Sporothrix schenckii is the agent of lymphocutaneous sporotrichosis. Biopsy may reveal small, cigar-shaped yeast. Culture produces this hyphae with rosette conidia, making it dimorphic. Tinea pedis is the causative agent of athlete's foot that generally affects the soles of the feet and toe webs.

A WBC sstained with Wright's stain has the following characterstics: -round eccentric nucleus -1:1 nucleus to cytoplasm ratio -basophillic cytoplasm -crescent-shaped clear area next to nucleus A. Myeloblast B. Plasma cell C. Reactive lymphocyte D. Polychromatic normoblast

B. Plasma cell Plasma cells have characteristic "halo" next to nucleus

Which potent inhibitor of platelet aggregation is released by endothelial cells? A. Epinephrine B. Prostacyclin C. Ristocetin D. Thromboxane A2

B. Prostacyclin Prostacyclin is produced by endothelial cells and prevents formation of platelet plug by preventing platelet activation and aggregation as well as inducing vasodilation Epinephrine and Ristocetin are an agonists used in platelet aggregation studies Thromboxane A2 is a platelet activator not produced by endothelial cells

Which one of these test can be used to evaluate the adequacy of fibrinogen in heparinized patients? A. D-Dimer B. Reptilase Time C. Thrombin Time D. Prothrombin Time

B. Reptilase Time (RT) is a blood test used to detect deficiency or abnormalities in fibrinogen, especially in cases of heparin contamination. Reptilase, an enzyme found in the venom of Bothrops snakes, has activity similar to thrombin. Unlike thrombin, reptilase is resistant to inhibition by antithrombin III. Thus, the reptilase time is not prolonged in blood samples containing heparin, hirudin, or direct thrombin inhibitors, whereas the thrombin time will be prolonged in these samples. D-Dimer testing is affected by heparin causing decreased sensitivity TT is similar to reptilase time testing but uses thrombin rather than snake venom and therefore is sensitive to the presence of inhibitors such as heparin PT is used to assess extrinsic and common pathways

What is indicated by the number 3 in the BLUE section of the NFPA diamond? A. No health hazard associated with this chemical B. A slight health hazard associated with the chemical, such as irritation or minor residual injury C. A potentially dangerous health hazard that can be associated with the chemical with continued exposure D. A deadly health hazard associated with the chemical; short exposure could cause death

C. A potentially dangerous health hazard that can be associated with the chemical with continued exposure

All of the following are coagulation assays that employ low reagent phospholipids and thus are sensitive to Lupus Anticoagulant (LA) EXCEPT: A. Kaolin Clotting Time (KCT) B. Dilute Russell viper venom time (DRVVT) C. Activated partial thromboplastim time (aPTT) D. Dilute partial thromboplastin time (DTT)

C. Activated partial thromboplastim time (aPTT) aPTT does not use low phospholipid reagents and thus is not as sensitive to the antiphospholipid antibodies. A modified version of the aPTT can be performed by using a low phospholipid reagent instead. The other choices use low reagent phospholipid reagents

Cyclosporine and tacrolimus (immunosuppressive drugs) have multiple therapeutic ranges, why? A. There is no therapeutic range established for either B. Because the slow uptake of the medications by tissues C. Because both drugs have ranges dependent on the organ transplanted and the time after transplantation D. Because of the short half-lives of the drugs

C. Because both drugs have ranges dependent on the organ transplanted and the time after transplantation Dose dependent on organ transplanted Multiple therapeutic ranges due to pharmacokinetics and pharmacodynamics Each patient is different

Clinical laboratories follow recommendation requirement for instrument calibration frequency established by whom? A. CLIA requirements only B. Manufacturer's requirements only C. CLIA or Manufacturer's requirements, whichever is more stringent D. A combination of CLIA and Manufacturer requirements to meet the preference of the laboratory

C. CLIA or Manufacturer's requirements, whichever is more stringent

A large container of peritoneal fluid is received in the lab (abut 50 mL). How should the tech process the sample for aerobic culture? A.Use a sterile pipette and add a drop of fluid per agar plate B. Insert a swab into the specimen container and inoculate all agar plates C. Centrifuge the specimen and use the sediment to inoculate the agar plates D. Add 1 mL of saline to 1 mL of fluid, vortex, and inoculate plates

C. Centrifuge the specimen and use the sediment to inoculate the agar plates Because it is such a large volume, centrifugation is required and the sediment is then used for inoculation of agar plates. Concentration helps recover bacteria present in sample. Spin for 20 mins at 3000 g.

Which of the following is NOT a way hemoglobinopathies can be caused? A. Deletion of a globin chain B. Substitution of amino acids is globin chain C. Deletion of amino acid in globin D. Addition of an amino acid in a globin

C. Deletion of amino acid in globin*

What organisms are the appropriate stock culture for QC testing of oxidase production? A. Escherichia coli/Klebsiella pneumonia B. Salmonella typhimurium/ Escherichia coli C. Escherichia coli/Pseudomonas aeruginosa D. Proteus mirabilis/ Escherichia coli

C. Escherichia coli/Pseudomonas aeruginosa Want +/- reaction for QC Oxidase test is used to differentiate Enterobacteriaceae family (all oxidase negative) from Pseudomonas species which are all oxidase positive K. pneumoniae, S. typhimurium and P. mirabilis are all part of Enterobacteriaceae family and are all oxidase negative

A patient presents to his family doctor with respiratory issues. He has a history of being a heavy smoker for more than 20 years, so the physician orders a BAL cell count with differential. Which of the following cells would most closely correlate with the patient's medical history? A. Macrophages with phagocytized RBCs B. Macrophages with phagocytized bacteria C. Macrophages with purple/black inclusions D. Macrophages without any inclusions

C. Macrophages with purple/black inclusions These cells contain hemosiderin and are also known as siderophages RBCs correlates with normal removal of old RBCs from circulation by spleen Bacteria would correlate to a bacterial infection No inclusions would indicate no disease state

In the life cycle of the intestinal trematodes, Faschiolopsis/Fasciola and Heterphyes, which of the following is known to infect snails? A. Coracidium B. Onchosphere C. Miracidium D. Rhabditiform

C. Miracidium Miracidium larvae will liberate from eggs once the eggs come in contact with water. The liberated larvae will then penetrate snails and develop into other larval forms, such as cercariae. Coracidium is incorrect because this is part of D. latum life cycle. After the eggs icubate in freshwater for two weeks, the mature eggs will release tthe first larval stage, the coracidium. Oncosphere is incorrect because Hymeolepis species will have an oncosphere that surrounds the eggshell of this species. Polar filaments are seen between the oncosphere and the eggshell. Rhabditiform is incorrect because they are seen in Strongyloides stercoralis life cycle and are considered the noninfective stage of larvae

Which of the following analytical techniques measures scattered light? A. Spectrophotometry B. Colorimetry C. Nephelometry D. Chemiluminescence

C. Nephelometry Nephelometry measures scattered light, generally speaking the more light that is scattered in the solution, the more concentrated it is Spectrophotometry uses transmittance to derive the concentration of an analyte Colorimetry measures color intensity Chemiluminescence can be described as the emission of light by molecules in an excite state

All of the following are responsibilities of sentinel laboratories within the Laboratory Response Network (LRN), EXCEPT? A. Refer samples to LRN reference laboratory when select bioterrorism agents canot be ruled out B. Maintain a BSL-2 facility C. Perform full identification and susceptibility on all potential bioterrorism agents D Perform testing to rule out the presence of select bioterrorism agents

C. Perform full identification and susceptibility on all potential bioterrorism agents Sentinel labs should refer samples when select bioterrorism agents cannot be ruled out.

A bacterium was isolated as the cause of a UTI. The organism showed no LAC fermentation on MAC agar. On TSI media, the organism procuced A/A with H2S. What organism is most likely observed? A. Enterobacter aerogenes B. Proteus mirabilis C. Proteus vulgaris D. Edwardsiella tarda

C. Proteus vulgaris The organism ferments sucrose and glucose and is H2S positive. Only P. vulgaris produces these reactions. E. aerogenes ferments all three sugars but does not produce H2S P. mirabilis is NEG for LAC and SUC fermentation and POS for GLU E. tarda is NEG for LAC and SUC fermentation and POS for GLU

Some strains of Group F Strep can carry the group A antigen, potentially leading to false positive identification of group A, S. pyogenes. A spot test that is helpful in differentiating these two species and thus preventing a false report is: A. Catalase B. Bile solubility C. Pyrrolidonyl-b-naphthylamide (PYR) D. Cytochrome oxidase

C. Pyrrolidonyl-b-naphthylamide (PYR) Most strains of S. pyogenes are PYR positive and this will differentiate them from other beta hemolytic streptococci, all of which are negative. All strep are catalase negative Bile solubility helps distinguish S. pneumoniae (bile soluble) from other streptococci (bile resistant) The streptococci do not process cytochrome oxidase activity

In which of the following sections of CFR Title 21, Good manufacturing practices, would you find requirements for quality control testing of donor platelets? A. 21 CFR 211.22 Responsibilities of a Quality Control Unit B. 21 CFR 211.80 Control of components, Drug Product Container and Closures C. 21 CFR 606,140 Laboratory Controls D. 21 CFR 640.25 Platelets - General Requirements

D. 21 CFR 640.25 Platelets - General Requirements* This section contains the requirements to test a minimum of 4 units per month. The pH must be at least 6.2 at the end of the dating period. The plasma volume and the platelet count must also be measured. Minimum plt count from whole blood derived platelets is 5.5 x 10^10 in 75% of units tested There is no QC requirements in the other sections

The organism Acinetobacter baumannii is known to have caused which of the following outbreaks? A. Berry outbreak B. Camper/hiker outbreak C. Milwaukee water outbreak D. Afghanistan and Iraq U.S. soldiers outbreak

D. Afghanistan and Iraq U.S. soldier outbreak Acinetobacter baumannii is nicknmedIraqibacter because this organism is commonly isolated from soldiers injured in Afghanistan and Iraq. Beryy outbreak occurred due to berries being contaminated with E. coli H157:H7 and/or Hep A virus Camper/hiker outbreak occurred due to campers coming into contact with deer mice scant and developing Hantavirus or campers being bitten by Ixodes tick and developing Lyme disease Milwaukee water outbreak occurred dur to the consumption of water contaminated with Cryptosporidium species.

A balloon-like bulge filled with blood formed due to weakness in the wall of a blood vessel is known as: A. Phlebitis B. Embolism C. Thrombosis D. Aneurysm

D. Aneurysm As aneurysms increase, there is a risk of blood vessel rupture causing internal bleeding and subsequent hypovolemic shock leading to death. Phlebitis is the inflammation of the vein, usually in the legs Embolism is the moving and lodging of an embolus which could be a blood clot, gas bubble, fat globule or other foreign material , through the bloodstream. This can cause a blockage of a vessel away from original embolus site. Thrombosis is the obstruction of a blood vessel caused by a stationary blood clot.

The following morphologic structure identifies Candida albicans and distinguishes it from most of the other Candida species: A. Hypha B. Blastoconidia C. Mycelium D. Chlamydospore

D. Chlamydospore* Hyphae are tubular structures that are part of the vegetative mycelium of mold. Pseudohyphae are elongated budding yeast that fail to dissociate Blastoconidia are buds of daughter cells that form from a larger cell. It is a yeast's metho of asexual reproduction and is produced by most yeast. Mycelium is a mass of vegetative hyphae that is produced by molds. Yeast produce bacteria-like colonies but not mycelium that gives mold colonies texture such as woolly, granular, fluffy, cottony

Which of the following is the most commonly encountered enterococcal species? A. Enterococcus gallinarum B. Enterococcus faecium C. Enterococcus casseliflavis D. Enterococcus faecalis

D. Enterococcus faecalis Enterococcus faecalis and Enterococcus faecium are the top two encountered species but faecalis is the most commonly isolated The other two are not as common

Nitrate reduction is the process by which nitrate is reduced to nitrite. In denitrification, nitrate is COMPLETELY reduced to nitrogen gas. Which of the following species denitrifies nitrate? A. Yersinia entercolotica B. Enterobacter cloascae C. Citrobacter amalonaticus D. Pseudomonas stutzeri

D. Pseudomonas stutzeri Most Pseuodmonas species are capable of reducing nitrate ro nitrogen gas. The ramaining species are of the family Enterobacteriaceae and are only capable of reducing nitrate to nitrite.

The generalized basic steps in Next-Generation sequencing include all of the following EXCEPT: A. Template preparation and data analysis B. Template preparation and sequencing C. Template amplification and imaging D. Sequencing of the entire genome and data analysis

D. Sequencing of the entire genome and data analysis Generalized steps are: template preparation, sequencing and imaging, and data analysis. Sequencing of the entire genome is not generally done Physicians are generally interested in the protein coding regions, the exome (1%) Template preparation: building DNA or cDNA library and amplification of that library. This is done by fragmenting the DNA or cDNA specimen and attaching adapter sequences to the ends of the DNA fragments. Constructed library is clonally amplified in preparation for sequencing. Raw data undergoes several analysis steps.

Which two crystalline elements are found in acid urine: A. Cystine and calcium carbonate B. Triple phosphate and calcium carbonate C. Calcium phosphate and uric acid D. Tyrosine and cystine

D. Tyrosine and cystine Crystals and sediment found in acid urine: cystine, leucine, calcium oxalate, sodium urate, sulfonamide, tyrosine, uric acid and amorphous crystals