Increased concentration of alpha-fetoprotein (AFP) in adults are most characteristically associated with: The correct answer is highlighted below Hepatocellular carcinoma Alcoholic cirrhosis Megaloblastic anemia Multiple myeloma AFP is one of the oncofeta

Increased concentration of alpha-fetoprotein (AFP) in adults are most characteristically associated with: The correct answer is highlighted below Hepatocellular carcinoma Alcoholic cirrhosis Megaloblastic anemia Multiple myeloma AFP is one of the oncofetal proteins which are produced in high concentration during fetal life. AFP is produced by the fetal yolk sac and liver. Oncofetal proteins usually disappear or are reduced to very low concentrations after birth. Increased alpha-fetoprotein levels in adults is usually associated with hepatocelluar carcinoma, as it is a tumor maker in this population. Alcoholic cirrhosis, megaloblastic anemia, and multiple myeloma would not cause an increase in serum AFP. Which test is NOT used as a screen for retroviruses in donated blood? The correct answer is highlighted below Antibody to HIV type 1 or type 2 Nucleic acid testing to detect HIV-1 RNA Antibody to HTLV types I and II Nucleic acid testing for HCV Three tests are currently used as a screen for retroviruses in donated blood: antibody to HIV type 1 or type 2 (anti-HIV-1/2), nucleic acid testing (NAT) to detect HIV-1 RNA, and antibody to HTLV types I and II (anti-HTLV-I/II). Positive results using NAT for HCV are approved by the FDA to confirm a reactive HCV antibody test. Also, hepatitis C is not considered a retrovirus. What are the MAIN functions of the distal convoluted tubules? The correct answer is highlighted below Balance hydrogen ions and keep the body pH at 6.8 Control aldosterone production and ammonia reabsorption Excrete various antibiotics and uric acid Maintain water-electrolyte and acid-base balances The main functions of the distal convoluted tubules are to maintain water-electrolyte and acid-base balances. These functions are controlled by antidiuretic hormone (ADH) and aldosterone. Six months ago, a 55-year-old female had a fasting plasma glucose (FPG) greater than 200 mg/dL on two occasions. She was diagnosed as having type 2 diabetes and treatment was started. Along with routine FPG's which of the following tests would most likely be used to monitor glycemic control? The correct answer is highlighted below HbA1C Insulin C-peptide Urine glucose FPG is performed to monitor diabetes, often weekly or even daily. The ADA also recommends that a HbA1C be tested at least twice a year to monitor long-term glycemic control. HbA1C reflects long-term blood glucose concentration for a patient, it provides the clinician with a picture of glucose concentration over the past 120 days. A level of HbA1C =6.5% is indicative of diabetes mellitus. Individuals with levels between 5.7% to 6.4% are considered at high risk for developing diabetes. In healthy individuals, calcitonin is synthesized by which cells in the body? The correct answer is highlighted below Hepatocytes Leukocytes Thyroid C cells Red blood cells In healthy individuals, calcitonin is only synthesized by the thyroid C cells. Calcitonin is released as a response to increased serum calcium. It inhibits bones from releasing further calcium and thus reducing serum calcium concentration. What is the International Normalized Ratio (INR) calculation used for? The correct answer is highlighted below Standardize PT and aPTT results Standardize PT results between different reagent sensitivities Standardize aPTT results between different reagent sensitivities Calibrate coagulation instruments for all coagulation testing Standardize PT results between different reagent sensitivities The primary mechanism responsible for glomerular filtration is: The correct answer is highlighted below Osmotic gradient Concentration of blood components Rate of blood flow through the kidneys Hydrostatic differential in glomerular tufts The hydrostatic pressure in the capillaries of the glomerular tuft drives the filtrate across their semipermeable membrane. The normal glomerular filtrate is similar in composition to the plasma, with the exception that molecules with a molecular weight of greater than about 70,000 daltons are not filtered. Why is Weak D testing not performed on pregnant women? The correct answer is highlighted below Weak D testing should be performed on pregnant women. Weak D testing is not required as part of a prenatal evaluation, as it is not possible to differentiate weak D from partial D serologically. Weak D testing is no longer used in blood banking. Weak D testing is not reliable in pregnant women. The correct answer is weak D testing is not required as part of a prenatal evaluation, as it is not possible to differentiate weak D from partial D serologically. Weak D testing is still used in blood banking, especially in donor testing. Weak D testing is reliable in all patients with a negative DAT. Which analyte is MOST useful for monitoring long-term (~12 weeks) stability of blood glucose? The correct answer is highlighted below Lactic acid Urinary ketone bodies Insulin Glycosylated hemoglobin (HbA1C) Hemoglobin A1C (HbA1C), also known as glycosylated hemoglobin, has the ability to measure an approximate 3 month period of glucose control. HbA1c is the nonenzymatic addition of a glucose molecule to HbA. After a rearrangement, the addition is irreversible. HbA1c reflects long-term blood glucose concentration for a patient and it provides the clinican with a picture of a patient's average glucose concentration over the past 120 days. A level of HbA1c =6.5% is indicative of diabetes mellitus. Individuals with levels between 5.7% to 6.4% are considered at high risk for developing diabetes. What is the shelf-life of whole blood collected in CPDA-1? The correct answer is highlighted below 21 days 28 days 35 days 48 days Whole blood collected with CPDA-1, or citrate-phosphate-dextrose-adenine, has a storage (shelf) life of 35 days from the date of collection. Whole blood collected with CPD (citrate-phosphate-dextrose), CP2D (citrate-phosphate-dextrose-dextrose), or ACD (acid-citrate-dextrose) has a storage (shelf) life of 21 days from the date of collection. Which of the following organisms are aerobic, Gram negative diplococci that do not ferment sugars and is DNAse positive? The correct answer is highlighted below Neisseria lactamica Moraxella catarrhalis Kingella kingae Veillonella parvula Moraxella catarrhalis is a common laboratory isolate that is distinguished from other Gram negative diplococci, including Neisseria species and Kingella species, by not fermenting any of the commonly tested carbohydrates and is DNAse positive. It is also aerobic. N. lactamica is a Gram negative diplococci but ferments glucose, maltose lactose, while K. kingae is a Gram negative coccobacilli that ferments glucose and maltose. Veillonella parvula is an infrequently recovered anaerobic Gram negative diplococcus that also has the properties of being asaccharolytic and failing to hydrolyze DNA. The most frequently encountered immunoglobulin demonstrated in patients with Multiple Myeloma is: The correct answer is highlighted below IgM Ig G Ig A IgE The most commonly encountered form of immunoglobin in patient suffering from Multiple Myeloma is Ig G at 52%. Four subtypes of IgG heavy chains are known to exist among patients with IgG myeloma (IgG1, IgG2, IgG3, IgG4). The subclasses of cases of IgG myeloma are distributed as follows: 65% gamma G1, 23%IgG2, 8% IgG3, 4% IgG IgM occurs in 12% of patients with Multiple Myeloma. Ig A occurs in 22% of patients with Multiple Myeloma. IgE is rarely detected in patients with Multiple Myeloma. A CSF specimen was sent to the laboratory for analysis. A glucose, protein, and cell count were performed. Based on the following results, what would be the probable cause? Analyte Result Glucose 15 mg/dL Protein 150 mg/dL Leukocytes 1,000 cells/mm3 neutrophils The correct answer is highlighted below Normal CSF Viral infection Purulent infection Tuberculosis or fungal infection Purulent infection is correct. For a CSF to be considered purulent, the glucose value should be <45 mg/dL, the protein value should be >100 mg/dL, and the leukocyte count should average 800 cells/mm3 (range 5-20,000 cells/mm3) with polymorphonuclear cells predominating. The glucose value is low because bacterial organisms are using the glucose as an energy source for growth and the protein value is elevated due an increase in cellular presence. Normal CSF is incorrect. To be considered normal, the glucose value must be within 45-100 mg/dL, the protein must be within 15-50 mg/dL, and the leukocyte count must be within 0-5 cells/mm3 with no predominant cell line. Viral infection is the incorrect answer. In a viral infection, the spinal fluid will have a normal glucose value (range 45-100 mg/dL), a slightly elevated protein value (range 15-50 mg/dL), and an average leukocyte count of 80 cells/mm3 (range 0-5 cells/mm3) with mononuclear cells predominating. Tuberculosis or fungi infection is incorrect. In this type of infection, the glucose value is low to normal, the protein value is >50 mg/dL, and the leukocyte count is around 100 cells/mm3 with mononuclear cells predominating. What is the mechanism of heparin-induced thrombocytopenia (HIT)? The correct answer is highlighted below Antibodies directed against platelet factor 4 (PF-4) and heparin complex. Administration of toxic doses of heparin that destroy platelets. Abrupt cessation of heparin therapy. Purposeful destruction of platelets by heparin administration. The correct answer is antibodies directed against platelet factor 4 (PF-4) and heparin complex. HIT is a complication that may occur in some patients receiving heparin therapy. When heparin is administered to these patients, it forms an immune complex with platelet factor 4 (PF-4) that is released from the alpha granules in platelets. The body's immune system recognizes this complex as a foreign substance and forms an antibody against it. The antibody binds to this complex and the platelets are destroyed. HIT is not the result of administration of toxic doses of heparin. The dosing is correct; the thrombocytopenia is the result of the patient's immune response to the heparin. Abrupt cessation of heparin therapy will not cause thrombocytopenia. If a patient is diagnosed with HIT, heparin therapy should be stopped immediately and replaced with a different anticoagulant therapy if necessary. The mechanism by which heparin prevents clotting is not due to platelet destruction. Contact dermatitis is mediated by: The correct answer is highlighted below B lymphocytes Mast cells Polymorphonuclear cells T lymphocytes Contact dermatitis is an example of a cell-mediated (Type IV) hypersensitivity reaction that involves macrophages and T lymphocytes. When an antigen comes in contact with the