MLT ASCP most missed concepts and questions 2023 Solved 100% Correct

CPDA-1 expiration - ANSWER-35 Days AS-1 expiration - ANSWER-42 days 40% glycerol Freeze at - ANSWER--65 C 20% glycerol freeze at - ANSWER--120 C Leukoreduced rbcs must retain ____% of rbcs - ANSWER-85% Rejuvenated rbcs treated to restore - ANSWER-2,3 DPG and ATP up to 3 days after outdate Expiration of Irradiated rbcs - ANSWER-28 days from irradiation. prevents GVsH Transfusion date of cryoprecipitate after thawing - ANSWER-6 hrs, 4 hrs if pooled Cryo should contain how much of Factor 8 and fibrinogen - ANSWER-80IU factor 8 and 150mg fibrinogen In open system components stored at 1-6C must be used within - ANSWER-24hrs In an open system components stored at 20-24C must be used within - ANSWER-4hrs What are the changes that increased in stored blood? - ANSWER-K, NH3 ammonia, Hbg, Microaggregates What are the changes that decrease in stored blood? - ANSWER-pH, ATP, 2,3 DPG, viable rbcs, wbcs, platelets, liable coag factors Rh 0 - ANSWER-D rh' - ANSWER-C rh" - ANSWER-E hr' - ANSWER-c hr" - ANSWER-e Which procedure should be followed when one cross-matched unit out of five is INCOMPATIBLE at the antiglobulin (AHG) phase? - ANSWER-Perform a direct antiglobulin test (DAT) on the incompatible unit An acute hemolytic reaction may be caused by which of the following? Transfusion of ABO incompatible blood. Failure to irradiate cellular products. Exposure to a red cell antigen when the corresponding Leukoreduced antibody is present. - ANSWER-Transfusion of ABO incompatible blood. Exposure to a red cell antigen when the corresponding For the ANA test to be positive what must be present in the nucleus of the interphase cell? - ANSWER-clearly discernible pattern Remember, to be ANA positive there must be a clearly discernible pattern in the nucleus of the interphase cells. Lysine iron agar is a less commonly used culture medium that is most helpful in the identification of: - ANSWER-Salmonella enteritidis Lysine iron agar produces a red slant when inoculated by a bacterial species that decarboxylates lysine and a black deep by species that produce H2S. Both of these reactions are key to the identification of Salmonella species, including S. enteritidis. 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. - ANSWER-Platelet neutralization tests are one of the confirmatory tests that can be used to determine if a patient has a circulating lupus antibody, or lupus anticoagulant. The principle in this test involved the use of a freeze-thawed platelet suspension that, when mixed with the patient plasma, will neutralize the anti-phospholipid antibodies (lupus anticoagulant) present and allow for a corrected aPTT result upon re-testing. A semen sample for semen analysis should generally be received at the testing site within what period of time? - ANSWER-1 hr Which is LEAST useful in differentiating hemophilia A from hemophilia B? - ANSWER-partial thromboplastin time (aPTT) A defective clot retraction might be caused by which - ANSWER-Lack of or defect of platelet receptor Ilb/IIIa Blood samples for complete blood counts are collected on morning rounds and stored in a rack in the phlebotomist's basket. When the phlebotomist delivers the samples to your work station, the cells and plasma in the samples have separated. One of the samples has lipemic plasma. Which parameters may be affected by the lipemia? - ANSWER-MCHC MCHC may be affected by lipemia as well as hemolysis, and red cell agglutination. The photometric measurement of the hemoglobin may be affected by the lipemia, which would then impact the MCHC calculation Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity? - ANSWER-Adiponectin is a protective cytokine. This cytokine is anti-inflammatory and increases insulin sensitivity. Adiponectin is usually decreased in obesity Type I hyperlipoproteinemia - ANSWER-a form of hyperlipoproteinemia associated with deficiencies of lipoprotein lipase. Hyperlipoproteinemia type II - ANSWER-is the most common form and is classified into type IIa and type IIb, depending on whether there is elevation in the triglyceride level in addition to LDL cholesterol. Hyperlipoproteinemia type III - ANSWER-is associated with high chylomicrons and IDL Hyperlipoproteinemia type IV - ANSWER-assoicated with high triglycerides Hyperlipoproteinemia type V - ANSWER-similar to type I, but with high VLDL in addition to chylomicrons. In patients with suspected primary hypothyroidism associated with Hashimoto's thyroiditis, one would expect the following laboratory test results: T4 ___? TSH ___? TRH stimulation ___? - ANSWER-decreased, increased, increased resist acetone-alcohol decolorization - ANSWER-Gram positive organisms A 30 year old Hispanic pregnant female developed fever and signs and symptoms of meningitis following ingestion of feta cheese sent by relatives in Mexico. The colonies recovered from a positive blood culture is shown gram + rods. The most likely identification is: - ANSWER-Listeria monocytogenes soft beta hemolysis a gram positive cocco-bacillus also associated with the dairy and pickling industry and also a rare cause of meningitis and other human infections. The colonies are not beta hemolytic and the bacterial cells are more coccal in shape - ANSWER-Leuconostoc mesenteroides The clinical Gram stain taken from an endocervix revealed many WBC's with both intracellular and extracellular gram- negative diplococci. The specimen was plated onto a Modified Thayer-Martin plate and incubated. Following incubation, colonies resembling N. gonorrheae were inoculated into separate CTA tubes containing glucose, lactose, sucrose and maltose. The fluorescent monoclonal antibody test was positive as well as the CTA maltose and glucose tubes. What is the most appropriate next step? - ANSWER-Recheck the maltose tube with a known strain of N. gonorrhoeae to ensure that the test process is functioning accurately If a blood agar plate and an EMB plate are both inoculated with 0.001 ml of urine, and 90 colonies of Staph aureus grew on the blood agar plate, what should be reported? - ANSWER-If there are 90 colonies on the EMB, 90 X 1000 dilution = 90,000 colony forming units/ml of urine S. pneumoniae with MIC levels greater than ____ are considered resistant, and a beta lactam cannot be used in therapy. Strains between ______are considered relatively resistant - ANSWER-1 ug/ml 0.1 and 1 ug/ml The ONPG (ortho-nitrophenyl-Beta-D-galactopyranoside) test should be used to determine what? - ANSWER-separation late lactose fermenters from lactose negative bacteria lyophilization - ANSWER-The process of quick-freeze drying of bacteria is called: Membrane covering the brain under the skull - ANSWER-Meninges Fluid accumulation due to a malfunction of ability to form and reabsorb fluid - ANSWER-Transudate Inflammation of the pleural membranes - ANSWER-Pleurisy Excess accumulation of fluid within any of the body's serous cavities - ANSWER-Effusion What is a common early symptom of hereditary hemochromatosis (HH)? - ANSWER-Joint pain. Cirrhosis of the liver, cardiomyopathy, and diabetes are late symptoms of HH. The red blood cells are microcytic and hypochromic. Microcytes have pale or hollow centers. In contrast, spherocytes are solidly stained. - ANSWER-Iron deficiency anemia uses centrifugation to remove the liquid portion of the fluid as the cells are deposited on the slide. This introduces cytospin artifact, which can stretch the cytoplams and distort nuclear shapes as compared to the same cells in the peripheral blood. - ANSWER-Cytopspining Barr body - ANSWER-The small drumstick-like nuclear extension (Barr body) marked by the blue arrow is a chromatin mass which may represent a chromosomal remnant. These nuclear appendages are found in normal XX females, but would not be present in normal XY males. If such an appendage is found in a phenotypic male, Klinefelter's syndrome (XXY male) may be identified clinically. The appendage has a "drumstick" morphology. tests may be used to confirm screening test results for a lupus anticoagulant (or antiphospholipid antibody)? - ANSWER-Russell Viper Venom test methods could be used to differentiate between Howell-Jolly bodies and Pappenheimer bodies and what results would be noted? - ANSWER-Prussian blue stain: Pappenheimer bodies stain blue but Howell-Jolly bodies do not stain blue Acute leukemia is associated with - ANSWER-with bone pain, hepatosplenomegaly, and swollen lymph nodes. In addition, infections (causing fevers) and bleeding are common. A high white blood cell count with many blasts in the peripheral blood and bone marrow, along with a low platelet and rbc count are also highly associated with this condition. Which FAB designation is called the "true" monocytic leukemia and is characterized by monoblasts, promonocytes, and monocytes? - ANSWER-FAB M5 Which of the following is not a likely cause of an abnormal thrombin time (TT): Fibrin split products Heparin Aspirin Dysfibrinogenemia - ANSWER-Aspirin What would a number 2 on the BLUE section of the NFPA diamond indicate: - ANSWER-A potentially dangerous health hazard that can be associated with the chemical with continued exposure The term that identifies how close a set of results are to each other when running a quality control validation or similar study is called: - ANSWER-Precision You are running quality control for Hemoglobin A1C by high-pressure liquid chromatography. The high control was 2.5 standard deviations above the mean. The low control was 2.2 standard deviations below the mean. Should you continue to run patient samples? - ANSWER-No. These QC values indicate a violation of the Westgard R4S rule and are therefore cause for rejection sodium dodecyl sulfate - ANSWER-detergent added to gel media that enhances separation of solutes during electrophoresis newer types of electrophoresis - ANSWER-capillary electrophoresis (CE) occurs in a capillary tube with detection while the solutes separate and migrate in the tube Which can produce glycosuria - ANSWER-Diabetes mellitus, Impaired tubular reabsorption/advanced kidney failure Which is false about acetaminophen metabolism - ANSWER-It is metabolized in the kidney. It is largely metabolized in the liver to glucuronide and sulfonate conjugates A small amount is metabolized via cytochrome oxidase to a reactive benzoquinoneimine intermediate This intermediate becomes toxic to the liver once tissue glutathione becomes depleted 27-year-old man with Down syndrome has the following CBC results which are MOST suggestive of which condition? WBC: 27 x 103/µL HGB: 8.5 g/dl HCT: 25.0% PLT: 30 x 109/L Differential blood smear results: 8% segmented neutrophils 25% lymphocytes 67% TdT-positive blasts - ANSWER-Acute lymphocytic leukemia Enzyme-multiplied immunoassay techniques (EMIT) - ANSWER-no separation of bound and free antigen is required EMIT utilizes a technique where patient sample is incubated with antibodies directed against a drug present. After the incubation period, an enzyme labelled drug is added and binds to any available binding sites left on the antibody in the sample mixture. There is no separation step required in the EMIT procedure as the unbound labeled drug antigen portion only is measured through the reaction. This amount of free enzyme labelled drug is compared to a standard curve to obtain patient results. Which T cell expresses the CD8 marker and acts specifically to kill tumor or virally infected cells? - ANSWER-T cytotoxic Extraction of the inoculated and incubated tryptophane broth with xylene and the use of Ehrlich's reagent are necessary steps in the detection of indole production by: - ANSWER-Flavobacterium (Chryseobacterium) indologenes Flavobacterium (Chryseobacterium) indologenes is a weak indole producer. The mother is group O Rh positive with a negative antibody screen and the infant is group A Rh positive. Results are consistent with a possible case of - ANSWER-AB HDFN. useful follow-up would be to test the infant's plasma against A1 red cells and group O antibody screen cells (as a control), expecting only the A1 cells to be positive if the DAT was due to ABO incompatibility endocrine dysfunction with the appropriate organ - ANSWER-Primary- Target glands (such as thymus, thyroid, parathyroid, etc.) Secondary- Pituitary gland Tertiary- Hypothalamus What is the half-life of IgG? - ANSWER-18 - 23 days The half life of IgM and IgA are approximately - ANSWER-5-6 days. The half life of IgD and IgE are - ANSWER-2.8 and 2.3 days, What is the mechanism of heparin-induced thrombocytopenia (HIT)? - ANSWER-Antibodies directed against platelet factor 4 (PF-4) and heparin complex Which one of the following blood components would be MOST appropriate for a 9-yr old girl, with a low hemoglobin and low platelet count, who has bleeding gums? - ANSWER-Platelet Concentrate What effect may bacterial contamination have on urine pH? - ANSWER-The bacteria may make the pH more alkaline. A 2 month old infant presented with history of chronic diarrhea and failure to thrive. The child's mother also revealed that the baby has suffered from thrush (Candida infections) since birth. Preliminary findings showed lymphopenia (<2,000), hypogammaglobulinemia, and physical findings showed a small thymus, no tonsils or lymph nodes. Which of the following immune deficiencies DOES the patient present? - ANSWER-Severe combined immunodeficiency syndrome Which of the following is a bronchodilator used to treat a 39-year-old male asthmatic patient? - ANSWER-theophylline The nucleus in this cell is abnormal and appears to have divided. This finding correlates with the presence of ______ in the CSF. - ANSWER-metastasis Classification of acute leukemia in the United States relies on two main systems, the FAB (French American British) and the WHO (World Health Organization) classifications. In order to diagnose acute leukemia, the FAB system requires ______% of non-erythroid blasts to be present in the bone marrow/peripheral blood, while the WHO system requires the presence of ________% non-erythroid blasts. - ANSWER-30%, 20% transfusion reaction is MOST OFTEN associated with transfused patient's lacking IgA? - ANSWER-Anaphylaxis After experiencing extreme fatigue and polyuria, a patient's basic metabolic panel is analyzed in the laboratory. The result of the glucose is too high for the instrument to read. The laboratorian performs a dilution using 0.25 mL of patient sample to 750 microliters of diluent. The result now reads 325 mg/dL. How should the techologist report this patient's glucose result? - ANSWER-1300 mg/dL A patient suspected of a urinary tract infection has a negative nitrite test, but bacteria are present upon microscopic examination. What may have caused this discrepant result? - ANSWER-The bacteria present are not nitrate-reducers. The urine was not held in the bladder for a sufficient amount of time for nitrate to be reduced to nitrite. Which one of the following viruses requires a complex lymphoblastoid cell culture, and is rarely if ever diagnosed by culture: Varicella-Zoster Virus Herpes Simplex Virus Cytomegalovirus Epstein-Barr Virus - ANSWER-Epstein-Barr Virus What is the MOST common early abnormality observed in the lymph nodes of AIDS patients? - ANSWER-reactive lymphadenopathy Gastrin is a hormone that is produced by cells primarily in the - ANSWER-stomach Which of the following signs and symptoms may be associated with immediate transfusion reaction, but is NOT usually associated with delayed hemolytic transfusion reaction? - ANSWER-Unexplained bleeding from surgical site Which of the following can cause a false positive result for ketones? - ANSWER-L-Dopa metabolites Highly pigmented urine markedly elevated 5-hydroxyindole acetic acid (5-HIAA) determination is presumptive evidence for: - ANSWER-Carcinoid tumor Which of the following diseases is NOT associated with autoantibodies? acquired hemolytic anemia chronic thyroiditis Lupus erythematosus Hemolytic disease of the newborn Rheumatoid arthritis - ANSWER-Hemolytic disease of the newborn The McLeod phenotype is associated with which of the following antigen systems? - ANSWER-Kell C-reactive protein (CRP) is often used as a marker of inflammation. However, it has a low - ANSWER-Specificity