ASCP RECALLS
✔✔Stool is shiga toxin positive, but culture is shig, O157, salmonella negative. What
happened? - ✔✔Should be other shiga toxin producing strain of E. coli... (other strain of
E. coli producing shiga toxin, other enterics overgrowth...)?
✔✔Curved GNR, ox pos, ferments gluc - ✔✔Aeromonas
(enterobac all ox neg, pseudo is nonfermenter)
✔✔Picture of RBCs like bird nests (Echinocytes) with artifacts. What went wrong? -
✔✔Drying problem (slow drying leads to crenation/echinocytes)
✔✔Rapid test for legionella - ✔✔Urine ag
✔✔HbC crystals. Lysing reagent switched. HbC more susceptible or resistant to lysing?
- ✔✔Resistant to lysing reagent
✔✔Plasmodium without trophozoites or schuffner's dots on smear? - ✔✔P. falciparum
✔✔Arm lesion. Tapered cells, microconidia, etc - ✔✔Sporothrix schenckii
✔✔Define blastoconidia - ✔✔Mother and daughter budding yeast
✔✔Ox pos, nonfermentor, cystic fibrosis - ✔✔Burkholderia cepacia or Pseudomonas
aeruginosa
✔✔Catalase neg from cat scratch - ✔✔Bartonella henselae
(Pasteurella is catalase pos)
✔✔EPO decreased in what condition? - ✔✔PV
(primary: hematopoiesis despite low EPO. secondary causes would increase EPO)
✔✔Prolonged APTT not corrected by mixing. What next? - ✔✔DRVVT
(Dilute Russell viper venom test for lupus anticoagulant)
✔✔Lupus anticoagulant causes ... - ✔✔Thrombosis
✔✔ESR falsely decreased in which? (tube slanted, high plasma protein, tube vibrated,
tube sits for 8 hours) - ✔✔tube sits for 8 hours?
(all others would increase esr. EDTA stability ranges 4-24 hours at RT, so idk)
, ✔✔What happens to bilirubin metabolites in intravascular hemolysis - ✔✔Increased
urine urobilinogen and increased serum unconjugated bilirubin
(Pre-hepatic jaundice)
✔✔A pos, Le(a+b-). What is in secretions? - ✔✔Le(a)
(Nonsecretor, Le(a) secretes itself to be adsorbed onto cells.)
✔✔Antibody panel that shows possible Le(a) and Le(b) antibodies. What is responsible
for the reactions? (Allele related antigen, glycolipids adsorbed onto RBC membrane....)
- ✔✔Glycolipids adsorbed onto RBC membrane (how Lewis antigens work)
✔✔Marker for an acute and previous Hep B infection - ✔✔Anti-HBc
(Anti-HBs ONLY for immunity; Anti-HBc would not show if vaccinated. Only antibodies
would be present after full recovery; no antigens)
✔✔Passive agglutination definition - ✔✔Antigen attached to carrier particles (hapten?)
as opposed to direct agglutination on RBCs
✔✔Blood in citrate tube, hematocrit 65%. Next step? - ✔✔Redraw using less
anticoagulant
(Hematocrit >55% results in greater concentration of citrate in plasma, affecting coag
studies)
✔✔Increased PTPTT, TT, fibrinogen 150. Patient not on anticoag therapy. Cause? -
✔✔Hypofibrinogenemia
(normal fibrinogen 150-400, borderline low fib + high PTPTT/TT = hypofib)
✔✔PT and APTT results for patient, normal and abnormal controls. Controls for APTT
were out. Cause?
(Problem with thromboplastin, light bulb needs to be replaced, phospholipid injection
mechanism off...) - ✔✔Problem with thromboplastin reagent?
(Would not be light bulb, would shift all results. Injection mechanism seems unlikely?
Practically would change reagent before messing with machine)
✔✔ELISA screen for HTLV I/II positive. Next step? - ✔✔Confirm with Western blot
✔✔Dilution of patient serum against adult cells and cord blood. Reaction slowly
weakened as dilutions got higher 4+ to 2+. Weak pos of undiluted serum with cord cells,
nonreactive in higher dilution. Cause? - ✔✔Mycoplasma pneumoniae (Cold autoanti-I.
Cord cells are strong i-pos and weak I-pos)
✔✔Band anodal to the albumin peak of a CSF specimen. Next step? - ✔✔Report it
(Prealbumin band is anodal to - closer to positive electrode or before - albumin)
✔✔Stool is shiga toxin positive, but culture is shig, O157, salmonella negative. What
happened? - ✔✔Should be other shiga toxin producing strain of E. coli... (other strain of
E. coli producing shiga toxin, other enterics overgrowth...)?
✔✔Curved GNR, ox pos, ferments gluc - ✔✔Aeromonas
(enterobac all ox neg, pseudo is nonfermenter)
✔✔Picture of RBCs like bird nests (Echinocytes) with artifacts. What went wrong? -
✔✔Drying problem (slow drying leads to crenation/echinocytes)
✔✔Rapid test for legionella - ✔✔Urine ag
✔✔HbC crystals. Lysing reagent switched. HbC more susceptible or resistant to lysing?
- ✔✔Resistant to lysing reagent
✔✔Plasmodium without trophozoites or schuffner's dots on smear? - ✔✔P. falciparum
✔✔Arm lesion. Tapered cells, microconidia, etc - ✔✔Sporothrix schenckii
✔✔Define blastoconidia - ✔✔Mother and daughter budding yeast
✔✔Ox pos, nonfermentor, cystic fibrosis - ✔✔Burkholderia cepacia or Pseudomonas
aeruginosa
✔✔Catalase neg from cat scratch - ✔✔Bartonella henselae
(Pasteurella is catalase pos)
✔✔EPO decreased in what condition? - ✔✔PV
(primary: hematopoiesis despite low EPO. secondary causes would increase EPO)
✔✔Prolonged APTT not corrected by mixing. What next? - ✔✔DRVVT
(Dilute Russell viper venom test for lupus anticoagulant)
✔✔Lupus anticoagulant causes ... - ✔✔Thrombosis
✔✔ESR falsely decreased in which? (tube slanted, high plasma protein, tube vibrated,
tube sits for 8 hours) - ✔✔tube sits for 8 hours?
(all others would increase esr. EDTA stability ranges 4-24 hours at RT, so idk)
, ✔✔What happens to bilirubin metabolites in intravascular hemolysis - ✔✔Increased
urine urobilinogen and increased serum unconjugated bilirubin
(Pre-hepatic jaundice)
✔✔A pos, Le(a+b-). What is in secretions? - ✔✔Le(a)
(Nonsecretor, Le(a) secretes itself to be adsorbed onto cells.)
✔✔Antibody panel that shows possible Le(a) and Le(b) antibodies. What is responsible
for the reactions? (Allele related antigen, glycolipids adsorbed onto RBC membrane....)
- ✔✔Glycolipids adsorbed onto RBC membrane (how Lewis antigens work)
✔✔Marker for an acute and previous Hep B infection - ✔✔Anti-HBc
(Anti-HBs ONLY for immunity; Anti-HBc would not show if vaccinated. Only antibodies
would be present after full recovery; no antigens)
✔✔Passive agglutination definition - ✔✔Antigen attached to carrier particles (hapten?)
as opposed to direct agglutination on RBCs
✔✔Blood in citrate tube, hematocrit 65%. Next step? - ✔✔Redraw using less
anticoagulant
(Hematocrit >55% results in greater concentration of citrate in plasma, affecting coag
studies)
✔✔Increased PTPTT, TT, fibrinogen 150. Patient not on anticoag therapy. Cause? -
✔✔Hypofibrinogenemia
(normal fibrinogen 150-400, borderline low fib + high PTPTT/TT = hypofib)
✔✔PT and APTT results for patient, normal and abnormal controls. Controls for APTT
were out. Cause?
(Problem with thromboplastin, light bulb needs to be replaced, phospholipid injection
mechanism off...) - ✔✔Problem with thromboplastin reagent?
(Would not be light bulb, would shift all results. Injection mechanism seems unlikely?
Practically would change reagent before messing with machine)
✔✔ELISA screen for HTLV I/II positive. Next step? - ✔✔Confirm with Western blot
✔✔Dilution of patient serum against adult cells and cord blood. Reaction slowly
weakened as dilutions got higher 4+ to 2+. Weak pos of undiluted serum with cord cells,
nonreactive in higher dilution. Cause? - ✔✔Mycoplasma pneumoniae (Cold autoanti-I.
Cord cells are strong i-pos and weak I-pos)
✔✔Band anodal to the albumin peak of a CSF specimen. Next step? - ✔✔Report it
(Prealbumin band is anodal to - closer to positive electrode or before - albumin)
