MLS ASCP Recall Exam Questions with Complete Solutions Graded A+

  Primidone monitoring: suspected to have primidone overdose, but the serum concentration is within the normal range, what should the MLS do next? Measure procainamide concentration Measure phenobarbital concentration Measure phenytoin concentration Eliminate primidone overdose as possible diagnosis - Answer: B. Measure phenobarbital concentration Feedback Primidone is a structural analog of phenobarbital. 2-month old baby with Normal WBC, Normal platelet, reticulocyte count: 0.1%: Pure red cell aplasia Chronic Myelogenous Leukemia Myelofibrosis with myeloid metaplasia Polycythemia vera - Answer: A. Pure red cell aplasia Feedback In pure red cell aplasia only red cell production is affected and WBC and platelet counts are normal. It is not likely that RBC count falls that low in lead poisoning. Which of the following stain is recommended for identification of Cryptococcus neoformans? Methyl red Congo red Wright stain India ink - Answer: D. India ink Feedback Cryptococcus neoformans, because of its large polysaccharide capsule, can be visualized by the India Ink stain. Organisms that possess a polysaccharide capsule exhibit a halo around the cell against the black background created by the India Ink. Drug toxicity screening of a 6 year old girl has increased presence of ACETAMINOPHEN. What test should be done next? ALT and AST BUN and Creatinine Salicylates CK and LDH - Answer: A. ALT and AST Feedback Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations begin to rise within 24 hours after an acute ingestion and peak at about 72 hours. In severe overdose, transaminase elevation can be detected as early as 12-16 hours post-ingestion. Toxicity is defined as serum AST or ALT concentrations greater than 1000 IU/L. A rapid progression of transaminase values to 3000 IU/L or greater reflects severe hepatotoxicity. Causative agent of Infectious Mononucleosis: Cytomegalovirus Epstein-Barr virus Poxvirus HPV - Answer: B. Epstein Barr Virus Feedback Epstein-Barr virus (EBV), also known as human herpesvirus 4, is a member of the herpes virus family. It is one of the most common human viruses. EBV is found all over the world. Most people get infected with EBV at some point in their lives. EBV spreads most commonly through bodily fluids, primarily saliva. EBV can cause infectious mononucleosis, also called mono, and other illnesses. Reactive monocytosis is seen in: Tuberculosis Allergic reaction Hypersensitivity Infectious mononucleosis - Answer: A. Tuberculosis Feedback All patients with tuberculosis demonstrates a marked increase in proliferation activity of monocytopoiesis and premature monocyte marrow release. These changes indicate a high monocyte consumption which probably is caused by a high macrophage death rate due to the high macrophage-toxicity of tubercle bacilli. Patient comes with lesion on the arm. Mold Form: flowerette/daisy like conidiaYeast Form: Cigar-shaped (asteroid) bodies Sporothrix schenckii Trichophyton mentagrophytes Tricophyton rubrum Piedraia hortae - Answer: A. Sporothrix sschenckii Feedback S. schenckii causative agent of Rose Gardener's disease (cord-like multiple subcutaneous nodules). Carbon Dioxide in ISE measures: CO2- pressure CO2- content pH HCO3 - Answer: A. CO2 pressure Feedback The carbon dioxide ion selective electrode uses a gas-permeable membrane to separate the sample solution from the electrode internal solution. Dissolved carbon dioxide in the sample solution diffuses through the membrane until an equilibrium is reached between the partial pressure of CO2 in the sample solution and the CO2 in the internal filling solution. I any given sample the partial pressure of carbon dioxide will be proportional to the concentration of carbon dioxide. Three (3) test tubes are negative to AHG (Antihuman Globulin), when check cell is added, the result is still negative, what is the error? Insufficient saline from automated cell washer Serum was omitted from the reaction Insufficient incubation period All of the above - Answer: B. Serum was omitted from the reaction Feedback Check cells are used as a quality control measure for negative indirect or direct antiglobulin tests performed in test tubes and should always be positive when added. A positive culture of sputum was stained. Carbolfucshin was added, washed, decolorized and malachite blue was used as counter stain. Two entire field was scanned and no acid fast bacilli were found. The most probably cause is: Wrong primary stain was used Wrong counter stain was used Inadequate scanning of slide Inadequate decolorization - Answer: C. Inadequate scanning of slide Feedback Good practice in reading AFB slide should be 100 fields. 5HIAA in urine indicates: Carcinoid tumors Renal disease Nephrotic syndrome AOTA - Answer: A. Carcinoid tumors Feedback The 5-hydroxyindoleacetic acid (5-HIAA) urine test is used to help diagnose and monitor carcinoid tumors. It may be ordered by itself or along with a blood serotonin and/or chromogranin A level. 5-HIAA is the primary metabolite of serotonin that is excreted in the urine. Concentrations of 5-HIAA may be significantly increased when a person has a carcinoid tumor that produces serotonin. Which of the following is used to compare two sets of mean? Chi-square CV Standard Deviation Paired T-test - Answer: D. Paired t test Feedback Paired T-test-Calculate a range of values that is likely to include the population mean of the differences The purpose of POTASSIUM PERMANGANATE in Auramine-Rhodamine stain is: QUENCHING AGENT True False - Answer: A. True A patient was diagnosed with streptococcal pharyngitis 6 months ago. Now he is showing signs of glumerulonephritis. What will be seen in the renal biopsy? S. agalactiae S. pyogenes H. influenzae S. aureus - Answer: S. pyogenes Feedback S. pyogenes is the most common causative agent of pharyngitis. A CSF specimen was sent to the laboratory at 2am, gram stain was done and subsequent culture is to be done by the next shift. What temperature should be the specimen kept? Incubated at 35 degrees celsius Stored at room temperature Stored at 70 degrees celsius Freeze the specimen - Answer: A. Incubated at 35 degrees celsius Feedback Fastidous organisms such as Neisseria and Haemophilus frequently isolated from the CSF of patients with bacterial meningitis are preserved by placing the fluid in 3%-7% CO2 at 35C-37C (or at room temperature for no longer than 30 min), if the specimen cannot be cultured immediately. Defect in PNH (Paroxysmal Nocturnal Hemoglobinuria)? Spectrin CD55 and CD59 CD3 Cobalamin - Answer: B. CD59 Feedback A low level of complement activation is a constant physiological phenomenon greatly amplified during inflammatory or infectious diseases; thus, PNH erythrocytes chronically undergo intravascular hemolysis in PNH patients due to CD55 and CD59 deficiency. Which of the following is used to neutralized Anti-P1 antibody? Ulex europaeus Lectin seeds Hydatid cyst fluid AOTA - Answer: C. Hyatid cyst fluid Feedback Similar antigens found in nature (bird droppings, pigeon eggs, hydatid cyst fluid) can be used to neutralize anti-P in a patient's serum. What is urobilinogen? Colorless product of bilirubin metabolism Results in increase bile Breakdown of amino acids All of the above - Answer: A. Colorless product of bilirubin metabolism what health hazard is represent by the image? - Answer: oxidizing agent Disseminated intravascular coagulation (DIC) is associated with what acute leukemia? - Answer: Acute promyelocytic leukemia