ACSP Recalls 1 Exam Questions with Complete Solutions Graded A+

  1. Bacteria isolated from a wound TSI A/A, oxidase (+), The most likely organism is: - Answer: Aeromonas 2. Plate cocci in chains. Patient with endocarditis, alpha hemolysis, bile esculin (+), NaCl (no growth). The most likely organism is: - Answer: Strep. Galloliticus (bovis) Patient with pharyngitis complicates to glomerulonephritis. The most likely organism is: - Answer: Strep. Pyogenes Preferred rapid test for Legionella pneumophilia Ag: - Answer: Ag in urine Bacteria LAP(-), Bile esculin (+), NaCl (growth), PYR(-): - Answer: Leuconostoc Organism isolated in Hecktoen: TSI K/A, H2S (+), PAD (-), Lysine decarboxylase (-), Urea (+), citrate (+). What should the technologist do? - Answer: Report as normal flora Child with walking pneumonia due to Mycoplasma and is prescribed penicillin. 2 weeks later, still sick. What happened? - Answer: The microorganism doesn't have cellular wall Latex agglutination for S. aureus: detects which virulence factors - Answer: Protein A and coagulase Child with cat scratch, BGN, catalase (-), oxidase (-), motile. The most likely organism is: - Answer: Bartonella henselae Difference between P. aeruginosa and P. putida? - Answer: Growth on 42C Bacteria grows pink on McConkey, Indol(-), citrate (+), Lysine decarboxylase (-), ONPG (+): - Answer: Enterobacter cloacae Rotavirus specimen: - Answer: stool Parasite that doesn't present schizont and trophozoite: - Answer: P. falciparum Test of hair penetration allows to differentiate: - Answer: T.mentagrophytes (+) / T. rubrum (-) 15. Patient comes in with lesion on arm, the organism presents delicate hyphae with microconidias: - Answer: Sporothrix schenkii What are blastoconidias? - Answer: budding (simple budding = mother -> daughter cell) Urine with pH 4.5 due to diet high in ___ - Answer: proteins 18. Urine at 10C measured in a refractometer SG 1.024, 1000 mg of glucose. What should the technologist do? - Answer: Correction of the refractometer due to glucose 19. Strip RBC (+), microscope (-), this is due to what? - Answer: Diluted alkaline urine 20. Patient that physically appears to be pregnant but the HCG is negative. U/A: decreased SG proteins: trace, why the test result is negative? A. low SG B. False negative because of the protein trace C. There's no HCG detectable because it's produce 6-8 days after conception. - Answer: A. low SG (urine is too dilute = urine is mostly water) 21. CSF for culture, MLS only manages to perform Gram stain in his shift, what should the technologist do? - Answer: Incubate at 35C w 5% CO2 22. Urinalysis result for a child had tubular renal cells 25-30, granular casts: - Answer: tubular necrosis Fecal fat methods: - Answer: extraction and process Pancreas cancer marker: - Answer: CA 19-9 26. Long term marker of hepatitis that is also in acute infection: - Answer: Anti-HBc 27. Screening test for HTLV-I (+), HTLV-II (-): - Answer: Report HTLV-I by Western Blot 28. Patient titles EBV>IgG 1:128, IgM1:10, CMV IgG>1:128, IgM1:38, IgG<1:10: - Answer: Acute infection with Toxoplasma 29. HbeAg Abs cutoff 0.700, patient 0.300: - Answer: indeterminate 30. IgE RIST: - Answer: measures Total IgE 31. CBC with RBC: 2.46 Hgb: 14 Hct: 36%= - Answer: Lipemic sample 32. On peripheral slide, RBC's and WBC's looked pinkish-error due to: - Answer: pH too acidic 33. False decreased in ESR: - Answer: sample sat for more than 8 hours before testing 34. plate of RBC all agglutinated (not rouleaux), what's causing this? - Answer: Mycoplasma pneumoniae (assoc with anti-I) 35. The same plate of agglutinated RBC, with witch condition is associated? - Answer: Cold autoantibody 36. Plate with Burr cells: - Answer: Uremia (HUS) 37. Plate with stomatocytes: - Answer: Liver disease 38. 2-year old girl with anemia Normo-Normo, Retics 0.1%, WBC and Platelets normal: - Answer: Pure Red Cell Aplasia 39. Table of CBC results. Two methods to measure Hgb (method 1: 14g/dL, method 2: 13g/dL), the second method utilized Lyse. What happened? - Answer: HgbC crystals are Lyse resistant 40. Plate with RBC (hyperchromic, anisocytosis), inclusions (1-2/ RBC) in Wright. Patient has 18.5% of retics. What should the technologist do? - Answer: Use Prussian Blue (to confirm presence of pappenheimer) 41. Reactive Monocytosis: - Answer: Tuberculosis 42. MI patient who was treated with streptokinase. Which of the results suggests that treatment wasn't successful? - Answer: PT 25 43. What affects HgbA1C: - Answer: Life span of RBC 44. Calculate % of Saturation- UIBC 185 Fe 125 - Answer: TIBC= 185+125=310 %sat (125/310)*100= 40% 45. A patient is tested for primidone, what other test can you perform? - Answer: Phenobarbital 46. PT normal (11s), PTT (56), Mix 1:1plasma (47) a. factor XII deficiency b. factor VIII deficiency c. fibrinolysis d. something about stypven - Answer: b. factor VIII deficiency 47. In what condition do you find abnormally low erythropoietin? - Answer: Polycythemia Vera 48. Patient with autoimmune condition presents infection with S. pyogenes, S. aureus and (__) what is the possible deficiency? - Answer: Neutrophils 49. Sample taken from indwelling catheter. Patient isn't on any anticoagulants yet PTT and TT are way elevated: - Answer: Heparin contamination (from catheter) 50. In the second phase of platelet aggregation what is irreversible? - Answer: Fibrin formation 51. Lupus anticoagulant causes: - Answer: thrombocytosis 52. Controls and patient PTT elevated, control and patient PT elevated: - Answer: thromboplastin was added by error 53. Rouleaux are undetectable at what phase? - Answer: AHG 54. Patient with DAT (+) Rh patient Rh control IS 0 IS 0 AHG + AHG + - Answer: (maybe DAT not due to anti-D; need to do antibody screen) 55. EDTA tube: report DAT+ Polyspecific IgG Complement IS 0 0 0 AHG 1+ 0 1+ - Answer: Antibody is complement (not IgG) (could titer after) 56. Anti-A Anti-B A B 4+ 4+ 2+ 2+ What would the technologist do? - Answer: Test with cell panel (could be cold Ab) 57. Anti-A Anti-B A B 0 2mf+ 4+ 0 Discrepancy due to ... - Answer: Bx-subgroup 58. Whole blood donation stops at 390ml: - Answer: PRBC (low volume unit) 59. Le(a) Le(b) IS 37 AHG 0 + 1+ 0 0 0 + 1+ 0 0 + 0 0 +/-2w +/-2w + 0 0 +/-2w +/-2w - Answer: Glycolipid absorbed from plasma 60. Patient A+, Le (a+b-): - Answer: has Le(a) 61. Antibody that deteriorates in storage: - Answer: P1 62. Pregnant woman O-, anti-D, anti-C, anti-I, previously she had anti-Le(a), baby is A+ with DAT (+), anti-D and anti-C are identified, which blood would you give? - Answer: O- without C 63. Table. Choose positive controls to test for anti-c and negative control to test anti-Fy(a): - Answer: C+c+ for the positive control (heterozygous) and Fy(a) for the negative control (homozygous) 64. Detection of Ab where 11 tubes resulted negative in AHG, but when CC added, 4 of them didn't agglutinate. Due to... - Answer: Machine didn't correctly dispense saline in the wash (AHG got neutralized, false negatives) 65. Table. IS 37 AHG CC SCI 0 0 0 2+ SCII +/- +/- 0 2+ What should tech do? - Answer: Add 4 drops of serum (use more serum to get stronger reaction) 66. Baby A+, DAT-, Mother O- before birth: Do ____ test - Answer: rosette 67. Patient DAT (4+), IAT(+), did eluate and the results are DAT(2+) they auto absorb serum and keeps reacting to SC-I and SC-II in AHG, what should you do? Panel cells enzyme panel cells report DAT make another auto absorption - Answer: panel cells (if specific agg patterns = allo-Ab; if nonspecific agg patterns = didn't wash enough, need to re-do elution) 68. Anti-A Anti-B Rh Du Ctrl D 0 0 3+ + - IS 37 AHG CC SC I 0 0 0 2+ SC II 0 0 0 2+ AC 0 0 2+ not tested What is the likely cause? - Answer: can be either allo OR auto antibody (need to elute to find out which one) donor received Hep B immunoglobulin 8 weeks ago: ok to donate? - Answer: no, differ 72. Patient with Hct 62%, the sodium citrate tube was centrifuged and noticed that the blood plasma ratio was low. What should the MLS do? a. take sample with more anticoagulant b. take sample with less anticoagulant c. take sample in heparin d. report - Answer: report results (the high Hct can be from a new born sample or it can be a dehydrated patient) 73. Coagulation machine, controls and patient where run in duplicate. Controls where normal, patient 1 PT normal PTT abnormal, patient 2 PT abnormal PTT normal a. CaCl2 b. Thromboplastin c. something about a light d. controls - Answer: c (instrument malfunction; a light source is used to detect clot) 74. Instrument linearity something about comparing means: - Answer: Paired T-test 75. Calibration of blood gases analyzer: - Answer: 2 buffers with known pH and constant temperature 76. Formula TP/(TP +FN): - Answer: Sensitivity 77. Absorbance formula: - Answer: 2-log%T 78. Patient is tested for Procainamide and results negative, what other test can you do? - Answer: NAPA 79. Patient with fasting blood 155mg/dl and random 225mg/dl: - Answer: Do OGTT 80. Enzyme controls resulted in 3SD below the mean and the controls with no enzyme resulted in 2SD below mean. What is causing this? a. controls where left at room temperature d. something about they being in deterioration - Answer: (left at RT for a long time? then A, if no time specification, maybe d?) 81. What causes postprandial lipemia? - Answer: Fatty acids 82. Cause for decreased serum Na? - Answer: Hyperglycemia 83. Patient with elevated Ca and normal PTH: - Answer: Metastasized cancer 84. What increases in Cushing? - Answer: ACTH and Cortisol 85. Positive strip for glucose, negative clinitest: - Answer: presence of Glucose 86. Patient with hyponatremia, all the other electrolytes were normal: - Answer: hyperglycemia 87. pCO2 electrode measures: - Answer: pH 88. Patient had dyspnea caused by anesthesia, what should be measured? - Answer: Pseudocholinesterase 89. Patient fasting 120mg/dl, non-fasting 160mg/dl: - Answer: impaired