MLS PROGRAM COMPREHENSIVE EXAM | 206 QUESTIONS | WITH SCORED A+ SOLUTIONS!!

What antibody is most associated with delayed hemolytic transfusion reactions? - ANS-Anti-Jka What antibody is associated with Mycoplasma pneumonia? - ANS-Anti-I What class of antibodies cause extravascular hemolysis from sequestration by spleen? - ANS-IgG Enzyme panel will not react with which antibodes? - ANS-Duffy (Fya or Fyb) What can cause a mother to have a low titer anti-D? - ANS-RhIg at 28 weeks (T/F) Blood from mom to child must be irradiated. - ANS-True What kind of errors can room temp cross match detect? - ANS-ABO What is the main reason premature infants need transfusions? - ANS-Blood loss from lab tests (aka iatrogenic blood loss) What type of positive control should be used when phenotyping? - ANS-Heterozyous What could make the auto control positive? - ANS-Rouleaux or cold agglutinin How would you correct rouleaux? - ANS-Saline replacement How would you fix cold agglutinin results? - ANS-Prewarm Cryoprecipitate is used today mostly to replace what? - ANS-Fibrinogen What type of plasma can an AB = patient receive? - ANS-only AB What are the requirements for intrauterine transfusions? - ANS-Fresh, O neg, CMV neg, irradiated, collected with CPDA When is FFP used? - ANS-When PT and PTT are prolonged What temperature do Lewis antibodies react? - ANS-RT and sometimes 37 What affect can Lewis antibodies have on samples? - ANS-Can cause in vitro hemolysis How long would a sexual partner of an IV drug user be deferred from donating? - ANS-One year What can make the Rh control positive when doing a weak D test? - ANS-Positive DAT What medication does PT monitor? - ANS-Coumadin (Warfarin) Protein C deficiency causes what? - ANS-Thrombosis What factor deficiency causes thrombosis instead of bleeding? - ANS-XII What parameter does a cold agglutinin NOT affect? - ANS-Hemoglobin What will the cells of an aged sample look like? - ANS-crenated red cells and vacuoles in white cells What two RBC morphologies will lower a sed rate? - ANS-Sickle cells and spherocytes What changes should be made to a PT or PTT sample collected on a patient with polcythemia? - ANS-Anticoagulant should be adjusted to correct for less plasma Megaloblastic anemia is associated with what? - ANS-Hypersegmented neutrophils, pancytopenia, and macrocytes What are Dohle bodies? - ANS-Blue oblong inclusions located near the periphery of seg What are Dohle bodies composed of and when are they seen? - ANS-RNA or rough endoplasmic reticulum; Bacterial infection, inflammation, or burns What are Howell-Jolly bodies composed of and when are they seen? - ANS-DNA; megaloblastic anemia, splenomegaly or splenectomy, thalassemia, sickle cell, or hemolytic anemia What is basophilic stippling and what does it indicate/when is it seen? - ANS-Denatured RNA; altered or impaired hemoglobin synthesis/lead poisoning, thalassemia What are Pappenheimer bodies called when Prussian blue stain is used? - ANS-Siderocytes What are Pappenheimer bodies composed of and when are they seen? - ANS-Iron; sideroblastic anemia (iron overload), thalassemia, splenectomy What stain is used for Heinz bodies? - ANS-Supravital (crystal violet or new methylene blue) What are Heinz bodies composed of and when are they seen? - ANS-Denatured or precipitated hemoglobin; G6Pd deficiency, unstable hemoglobin causing iron to be unprotected, oxidizing drugs, alpha thalassemia What are cabot rings composed of and when are they seen? - ANS-Remnants of spindle fibers; severe anemias, pernicious anemia, dyserythropoiesis Describe hemoglobin C crystals - ANS-Oblong dark crystal in Hemoglobin C disease What hgb electrophoresis results are seen in hgb C disease? - ANS-90% of the hemoglobin is hgb C and the rest is A2 and F Lab results in multiple myeloma - ANS-Monoclonal M spike on protein electrophoresis, Bence Jones proteins in urine, norm/norm anemia, pancytopenia in advanced stages, rouleaux, "sheets" of plasma cells in bone marrow (usually 30% plasma cells) How is osmotic fragility affected in hereditary spherocytosis? - ANS-Increased What is the osmotic fragility results in normal cells vs hereditary spherocytosis? - ANS-Normal = 0.45 HS = 0.65 ALL cytochemical stain results - ANS-PAS + and all others = M5 (monoblastic) cytochemical stain results - ANS-Non specific esterase + and all others = M4 (myelomonoblastic) cytochemical stain results - ANS-Specific and nonspecific esterase + M1 cytochemical stain results - ANS-Peroxidase/Sudan black and specific esterase + Myelofibrosis stain results - ANS-Reticulin and silver stain + Key features of CML - ANS-Decreased LAP score (13) and + Philadelphia chromosome Hairy cell leukemia cells - ANS-Tartrate resistant acid phosphatase (TRAP) How to distinguish Hemophilia A from von Willibrands - ANS-Normal bleeding time What result is affected by lipemia in hematology automation? - ANS-Hemoglobin, MCH, and MCHC How to fix lipemia issue in hematology automation - ANS-Saline replacement and multiply results by 1.1 Hemocytometer dimensions - ANS-Each grid is 9mm squared and the depth is 0.1 mm for a volume of 0.9 mm cubed. Each 'big' square is 1X1 mm or 1 sq mm and 0.1 depth for a volume of 0.1 mm cubed. White cell calculation on hemocytometer - ANS-(cells counted X dilution factor X depth factor (10)) / (area counted aka how many large squares counted) Define sensitivity - ANS-The ability of a test to correctly identify patients with a disease Define specificity - ANS-The ability of a test to correctly identify patients without a disease The most significant disease associated with red blood cell casts is - ANS-Acute glomerulonephritis The most significant disease associated with white blood cell casts is - ANS-Pyelonephritis Where do broad casts form and what do they indicate? - ANS-In the collecting duct; severe urine stasis The most significant disease associated with fatty casts is - ANS-Nephrotic syndrome Hemolytic anemia urine bilirubin and urobilinogen results - ANS-Neg; +++ Liver disease urine bilirubin and urobilinogen results - ANS-++ ; + Bile duct obstruction urine bilirubin and urobilinogen results - ANS-+++ ; Normal or decreased What element in urine is most indicative of renal disease? - ANS-Protein What would cause a urine dipstick glucose to be negative, but the clinitest to be positive? - ANS-Other reducing sugars present What could galactose in urine of a child indicate? - ANS-Congenital enzyme defect, failure to thrive, retardation CSF bacterial meningitis results - ANS-Decreased glucose, increased protein, increased lactate; predominate segs CSF viral meningitis results - ANS-Normal glucose, increased protein, normal lactate CSF tubercular/fungal meningitis results - ANS-Decreased glucose, increased protein, increased lactate; predominate lymphs/monos CSF traumatic tap results - ANS-Clot may be present (fibrinogen), decline in blood from tube 1 to 3, xanthochromia only if sample sits too long CSF hemorrhage results - ANS-No clots, even distribution of blood in all tubes, xanthochromia within 2 hours of bleed, microscopic evidence When would you expect to see erythrophagocytosis after a cerebral hemorrhage? - ANS-2 - 4 hrs When would you expect to see macrophages with hemosiderin granules after a cerebral hemorrhage? - ANS-12 - 48 hrs When would you expect to see hematoidin crystals after a cerebral hemorrhage? - ANS-48 hr - 2 wks What are transudates? - ANS-Diseases that occur outside the cavity What are exudates? - ANS-Diseases inside the cavity What is the appearance of transudates? - ANS-Clear, pale yellow; no clots What is the appearance of exudates? - ANS-Cloudy, purulent, or bloody; may clot (use EDTA) What is the expected white count of transudates? - ANS-1000/uL What is the expected white count of exudates? - ANS-1000/uL What is the expected specific gravity of transudates? - ANS-1.015 What is the expected specific gravity of exudates? - ANS-1.015