MLT BOC
The average bone marrow cellularity in a normal adult (50 years old) is
50 The overall bone marrow cellularity is estimated by comparing the amount of hematopoietic tissue with the amount of adipose (fat) tissue. An easy way to calculate it is to subtract the age from 100 and adds plus or minus 10.
Minimum volume of anticoagulant preservative for standard blood donation
63 mL
Colony forming count indicating true bacterial pneumonia
>10^4 CFU/mL
Which is the main limitation of standard PCR that is not a limitation of real-time PCR? A. Requirement of a large initial sample B. Procedure requires endpoint measurement that may not be in direct proportion to initial sample C. Ability to detect PCR product during the plateau stage D. Slow turnaround time compared to culture methods
B - The main limitation of standard PCR is the inability to accurately quantitate the DNA product due to reliance on endpoint analysis. The final yield of a product in standard PCR is not always equal to the estimated exponential growth per cycle. Therefore, quantitation is not possible with endpoint analysis.
All of the following red blood cell phenotypes will react with Anti-Fy3, EXCEPT? Fy(a+b+) Fy(a+b-) Fy(a-b+) Fy(a-b-)
Fy (a-b-) This rarely encountered immune antibody reacts with all red blood cells except those of the Fy(a-b-) phenotype. Anti-Fy3 is a rare antibody produced by Fy(a-b-) individuals lacking the Duffy glycoprotein
Purulent infection CSF
Glocuse value less 45; protein value greater than 100; WBC 800 CELLS/MM3. Glucose level is low because bacteria is using the glucose for energy.
Tuberculosis/fungi CSF
Glucose value low to normal; protein value less than 50 mg/dL; WBC 100 cells/mm3
Staining reaction for yeast
Gram positive
A distinguishing characteristic of Y. pestis:
Growth at 25C; fried egg morphology
Expected serological responses demonstrated after an HBV vaccination series
HBsAg (neg), Anti-HBc(neg,) anti-HBs (pos)
Profile of a patient who has recovered from an HBV infection.
HBsAg (neg), Anti-HBc(pos) anti-HBs (pos
Profile of a patient who is immune to HBV because of natural infection.
HBsAg (neg), Anti-HBc(pos) anti-HBs (pos)
Profile of a patient with chronic hepatitis B
HBsAg (pos), Anti-HBc(pos,) anti-HBs (neg)
MHC class I antigens
HLA-A, HLA-B, and HLA-C
MHC class II antigens
HLA-DR, HLA-DP, and HLA-DQ
CD4+ T cells
Helper T cells; destroyed by HIV
What hemoglobin do Alpha thalassemia major or Hydrops fetalis patients produce?
Hemnoglobin Barts. Gamma globin tetrads.
Hektoen Enteric Agar
Highly selective for salmonella and shigella and differentiates between them; lactose fermentors yellow/pink and nonfermentors colorless, H2S production black precipitate
Defining characteristic of M. catarrhalis:
Hockey puck appearance on agar
MEdia for isolating G. vaginalis
Human blood bilayer Tween
Upon reoxygenantion, what happens to a sickle RBC
IT will return to normal
Pharmacokinetics
What the body does to the drug
A distinguishing characteristic of F. tularensis:
Won't grow on BAP; grows on charcoal-yeast extract agar (BYCE), chocolate, and TM
Inhalation antrax
Woolsorters anthrax. Spores inhaled into lungs.
Organism most likely the cause for septic reactions asso with RBC transfusions
Y. enterocolitica
Creatinine clearance equation
[(140-age)(Ideal body weight)] / 72(Scr) multiply the answer by 0.85 for women
Specifity equation
[True Negatives/(True Negatives + False Positives)] x 100
Sensitivity equation
[True Positives/(True Positives + False Negatives)] x 100
Alpha thalassemia trait
a-/a-
Strep species with positive bile solubility
S. pneumoniae
Coefficient of variation calculation
SD / mean x 100
dilution equation
Sample volume / (sample volume + diluent volume)
Molarity equation
(Specific gravity x % assay weight x 10) / gram molecular weight
Alpha thalassemia major or Hydrops fetalis genotype
--/--
Alpha thalassemia intermedia or Hemoglobin H disease genotype
--/-a
What is the approximate time that should be allowed for samples to completely clot before centrifugation for serum samples?
20 minutes
The shelf life of whole blood collected with CPD, CP2D, or ACD is
21 days
A rejucednation solution may be used up to how many days follwoing epiration of a red cell unit?
3 days
What is the maximum interval during which a recipient sample may be used for compatibility testing if the patient has recently been transfused or was pregnant within the past 3 months?
3 days
The shelf-life of whole blood collected in CPDA-1 is:
35 days
Importance of irradiating blood
To prevent transfusion-associated
Chylomicrons are composed of:
Triglycerides
Correccted WBC equation
Uncorrected WBC x 100 / NRBC per 100 WBC + 100
Descriptive toxicology
Uses the results from animal experiments to predict what level of exposure will cause harm in humans.
Clinically significant antibodies for moderate to severe HDFN
Anti-FyA, anti-K, anti-D, anti-E, anti-e, anti-C, and anti-c
Type II hypersensitivity reaction
Antibody-mediated disorders
Which type of blood component is most implicated in bacterial contamination? A. Platelets B. Packed red cells C. Fresh frozen plasma D. Cryoprecipitate
A. Platelets
E. coli TSI reaction
A/A w/ gas
Clinically significant antibodies
ABO, Rh, Kell, Duffy, Kidd, SsU
Which of the following tests is the BEST screening test for neural tube defects? Placental lactogen Bilirubin Estriol Alpha-fetoprotein
AFP Alpha-fetoprotein is produced by the fetal liver. It is measured in pregnant women, using maternal blood or amniotic fluid, as a screening test for a subset developmental abnormalities. Abnormally high levels of this substance is associated with defects in the fetal neural tube, while abnormally low levels are associated with the presence of Down' syndrome
Kidneys performed what functions:
Acid-base balance, hormone production, and water and electrolyte balance
TH1 function
Activate macrophages
Which of the following organisms display the characteristic "Medusa head" on 5% sheep blood agar (SBA) after 18 hours of incubation at 35°C? A. Yersinia pestis B. Bacillus anthracis C. Francisella tularensis D. Brucella abortus
B. Bacillus anthracis
Clinical toxicology
Focuses on the relationships between xenobiotics and disease states. This area emphasizes not only diagnostic testing but also therapeutic intervention
CK-BB
Found in brain and lungs
CK-MM
Found in: skeletal muscle
Non-fastidious bacteria
Bacteria able to grow without special nutritional supplements or conditions applied to agar growth plates
Normal hemoglobin
Four heme and four globin chains
Best collection site for VRE
Rectal swb or stool specimen
Which of the following bone marrow processing procedures is best suited for a patient who had a dry tap? A. Direct differential smear B. Touch preparations C. Concentrate (buffy coat) smears D. Crush smear
B. When a patient has a dry tap, the physician was unable to collect a bone marrow aspirate. Therefore, the only remaining specimen is a bone marrow biopsy. Touch preparations, also known as imprints, are made by touching the biopsy against the slide.
In which order should the following capillary specimens be collected according to Clinical and Laboratory Standards Institute (CLSI)? Serum specimens Blood gas specimens Ethylenediaminetetraacetic acid (EDTA) specimens Other additive specimens
Blood gas specimens, EDTA, other additive specimens, serum specimens Blood gas specimens should be collected first because any delays in the collection may introduce room air and alter the values of the sample. EDTA samples are to be collected second in order to prevent the formation of platelet clumps and clotting. Other additive specimens are to be collected third and serum specimens last, since they need to clot.
Isoenzymes of CK include all of the following EXCEPT: A. MB B. MM C. MBM D. BB
C
Compared to the primary immune response, the secondary immune response typically demonstrates: A. Less antibodies produced B. A longer lag time C. More antibodies produced D. A lower affinity
C.
How many standard deviations (SD) above and below the mean is accepted as being an appropriate control limit range on a control chart utilizing the Westgard rules: A. 1 SD B. 2 SD C. 3 SD D. 4 SD
C. 3 SD
Positive acid fast
Red/Pink
TH17 function
Enhance neutrophil response
Thayer-Martin agar
Enriched and selective medium; contains colistin, vancomycin, and nystatin antibiotics; selective for N. gonorrhoeae
Chocolate Agar
Enriched medium for Haemophilus and Neisseria. Supplies X and V factors. Incubate in increased CO₂.
Enviromental toxicology
Enviromental chemical pollutants and their impact on human health
TH2 function
Regulation of antibodies
Hereditary Hemochromatosis
Excess iron deposits throughout the body; Laboratory findings of HH include increased levels of serum iron, serum ferritin, and serum transferrin.
Absolute WBC value
Relative % of each cell type x total white count
Type I hypersensitivity reaction
Results from release of histamine, heparin, leukotirenes and prostaglandins from mast cells and basophils
Ristocetin
Ristocetin causes platelets to bind to vWF via their GPIb receptor.
Leukocyte reduced blood products reduce the risk of what disease?
CMV
CREST syndrome ANA pattern
Centromere
What lipoproteins will form a creamy layer at the top of stored, non-fasting plasma specimens
Chylomicrons
Normal CSF
Clear/colorless; 45-1000 mg/dL glucose; 15-50 mg/dL protein; 0-5 cells/mm3 WBC
Causative agent of antibiotic-associated pseudomembranous colitis
Clostridium difficile
Type III hypersensitivity reaction
Complement-mediated immune complex disorders
Forensic toxicology
Concerned with medical and legal implications of toxicants
Cystine-tellurite blood agar is recommended for the isolation of what organism?
Cornyebacterium diptheriae
CK-MB
Creatine Kinase-Muscle Breakdown; found in heart
CD8+ T cells
Cytotoxic T cells; destroy viral infected cells
Which of the following describes the basis for the freezing point Osmometer? A. The freezing point depression is inversely proportional to the amount of solute in the solution. B. The freezing point depression varies as the logarithm of the concentration of solute. C. The freezing point depression is raised by an amount that is inversely proportional to the concentration of dissolved particles in the solution. D. The freezing point depression is lowered by an amount that is directly proportional to the concentration of dissolved particles in the solution.
D
Serous fluid effusions may result from all of the following EXCEPT: A. Congestive heart failure B. Infection and inflammation C. Malnutrition D. Dehydration
D - Dehydration would not result in a serous fluid effusion. Dehydration occurs when an individual loses or uses more fluid than they take in and there is not enough water or other fluids to carry out normal functions.
Recombinant vector vaccines
Experimental vaccines similar to DNA, but they use an attenuated virus or bacterium to introduce microbial DNA to cells of the human body. Vector refers to the virus or bacterium used as the carrier.
What does the PT measure?
Extrinsic and common pathways
Possible causees of false negative of IAT
Failure to adequately wash cells, high concentration of IgG paraprotein, and delay in the adding AHG reagent.
Metholody used for detecting the presence of bacteria in blood samples on the BACTEC
Fluorescent change
Southern blotting
DNA
Diuretic effect on potassium and sodium
Decreases
Kwashiorkor
Diease from protein deprivation
What procedures are performed on bone marrow aspirates?
Direct differential smears, concentrate (buffy coat) smears, and crush smears
Injectional anthrax
Direct injection of spores into tissue. The absence of an eschar, and the fact that this form is much more severe (necrotizing fasciitis, organ failure, shock, coma can occur) than cutaneous anthrax make it clinically distinct
Marasmus
Disease from calorie deprivation
Trypanisma cruzi
Does not have an egg stage and requires arthropod vector
Cutaneous anthrax
Endospores enter through a minor cut. 99% of all cases. A small pimple or papule forms at the site of inoculation 2-3 days after exposure. A small dark necrotic area known as an "eschar" forms.
Angiotensin 2 actions
Increased vasoconstriction
Gastrointestinal antrax
Ingestion of spores. Bloody diarrhea and other classic GI symptoms
Which of the following anthrax infections is also known as "woolsorter's disease"? Cutaneous anthrax Gastrointestinal anthrax Inhalation anthrax Injectional anthrax
Inhalation anthrax
Prostacyclin
Inhibits platelet aggregation and produced by endothelial cells
What does the PTT measure?
Intrinsic and common pathways
Majority of cholesterol is transported by
LDL
Where is the spine on S. mansoni
Large lateral spine
Normal ratio of plasma to CSF protein
Less than 1% or 200 to 1
Which Lutheran antibody is high frequency?
Lub; it's present on over 99% of RBCs
What hematology value sees an increase during a sickle crisis?
MCHC
A distinguishing characteristic of B. anthracis:
Medusa head; ground glass appearance and non-hemolytic
Modified acid-fast stain
Modified acid-fast stain uses carbolfuchsin as the primary stain and a surface-active detergent to help the stain penetrate the waxy material of acid-fast organisms. Acid-alcohol is the decolorizing agent and methylene blue is used as the counterstain; used to stain *Nocardia*
The property MOST responsible for the migration of proteins in an electrical field is:
Net surface charge
Viral infection CSF
Normal glucose, elevated protein, average 80 cells/mm3 with mononuclear cells
Bone Marrow Collection Procedure
Nurse prepares the patient Doctor or pathologist performs collection MLS makes slides Pathologist reads slides
Possible cause of false positive of IAT
Over-centrifugation
Enterobius
Pinworm - egg infects humans after ingestion
What test should be performed to determine if a patient has lupus anticoagulant?
Platelet neutralization
Where is the spine on S. haematobium
Pointed terminal spine
Taenia solium
Pork tapeworm - cysticerus larva infects humans after ingestion
Western blotting
Proteins
What are apolipoproteins?
Proteins that bind lipids to form lipoproteins
odium thiosulfate is often added to selective culture media to:
Provide sulfur atoms for H2S positive isolates
Northern blotting
RNA
The presence of two sporocysts each containing four banana-shaped sporozoites is characteristic of this organism; however, only oocysts with one sporocyst are typically seen in patient specimens. Which of the following organisms does this represent? Cystoisospora belli Sarcocystis species Cryptosporidium parvum Blastocystis hominis
Sarcocystis species is the correct answer because Sarcocystis species form oocysts with two mature sporocysts each containing four sporozoites. However, the oocysts of Sarcocystis species are thin-walled resulting in the release of the sporocysts. Normally, the mature oocysts will be seen with one sporocyst.
Eosin-methylene Blue Agar (EMB)
Selective and differential for isolation and differentiation of lactose fermenting and non fermenting gram negative bacillus. Lactose fermentors (E.coli) fermetns blue/black, nonfermentors (Shigella and Salmonella) ferment light purple or colorless
All of the following are types of quality and process improvement tools, EXCEPT: Six Sigma Lean Sentinel events Root-cause analysis
Sentinel events A sentinel event is any unfavorable event that is unexpected and results in death or serious injury. This is not a quality or process improvement tool.
Why might serum ferritin (SF) alone be considered a less than optimal screening test for hereditary hemochromatosis (HH)?
Serum Ferritin (SF) is an acute phase reactant that is frequently elevated in a variety of clinical conditions, therefore it lacks the specificity needed for a good screening test.
Where is the spine on S. japonicum
Small, lateral spine
Substance used to stabilize pH of RBC units during storage
Sodium biphosphate
Rheumatiod arthritis ANA pattern
Speckled
Sjogren's syndrome ANA pattern
Speckled
The fibrinolytic system may be activated by which one of the following? Streptokinase Streptolysin Fibrin EDTA
Streptokinase
TH1, TH2, TH17
Subsets of CD4+ T lymphs
Type IV hypersensitivity reaction
T-cell mediated disorders
What are the two general categories of nucleic acid amplification (NAA) techniques?
Target amplification and signal amplification
Silent carrier of alpha thalassemia
aa/a-
Streptokinase
exogenous activator produced by some bacterial species that binds and activates plasminogen, a component of the fibrinolytic system
Lupus (SLE) ANA pattern
homogenous or speckled
Streptolysin
streptococcal hemolytic exotoxin that can cause hemolysis in humans