ASCP Recalls Exam Questions and Complete Solutions Graded A+

  FFP used for - Answer: Multiple coagulation deficiencies Factor XI deficiency Cryoprecipitate used for - Answer: Replace fibrinogen loss due to DIC Massive bleeding Dysfibrinogenemia with active bleeding Plateletpheresis preparation steps - Answer: Light spin (remove RBC) Heavy spin (spin down PLT and WBC) Supernatant goes into bag for freezing (FFP) Remaining plasma, platelets, and WBC = platelets Irradiated blood prevents - Answer: GVHD Also used for cancer patients, or patients who are immunocompromised Leukocyte reduced blood prevents - Answer: Febrile nonhemolytic transfusion reactions (FNHTRs) Blood generally kept at what temperature? - Answer: 1-10C Platelets and granulocytes kept at what temperature? - Answer: 20-24C Platelets usually kept on agitator to ensure that the platelets are continuously oxygenated ACD, CPD, CPD2 expiration - Answer: 21 days CPDA-1 expiration - Answer: 35 days Rouleaux resolution - Answer: Saline wash and repeat Common IgM antibodies in blood bank (Cold) - Answer: anti-I, H, M, N, P1, Lea, Leb Common IgG antibodies in blood bank (Warm) - Answer: anti-D, C, c, E, e, M (some), K, k, Fya, Fyb, Jka, Jkb Antibodies enhanced by enzyme panel - Answer: RhIp Lewis the Kidd Rh, I, Lea, Leb, Jka, Jkb Overproduction of IgM associated with - Answer: Waldenstrom's Primary Macroglobulinemia Overproduction of IgG associated with - Answer: Multiple Myeloma Serum calcitonin elevated in - Answer: Medullary carcinoma of thryroid Normal myeloid:erythroid ratio - Answer: 2:1 to 4:1 Centromere ANA pattern - Answer: CREST syndrome Homogeneous or speckled ANA pattern - Answer: SLE Speckeled ANA pattern - Answer: RA or Sjorgen's Measurement of sodium/chloride in sweat is useful test for - Answer: Cystic Fibrosis Analytes increased due to delay in centrifugation - Answer: AST, ALT, Potassium, Creatinine Analytes decreased due to delay in centrifugation - Answer: Glucose, ionized calcium, bicarbonate, folate Reducing sugars include - Answer: Lactose, glucose, ribose Incorporation of sulfamethoxazole and trimethoprim in culture media enhance recovery of - Answer: Strep. pyogenes Longer staining times associated with which type of smear - Answer: Bone marrow smear Dosage associated with homozygous or heterozygous cells - Answer: Homozygous Confirmatory test for syphilis - Answer: FTA-ABS (fluorescent treponemal antibody absorption test) VRDL and RPR are utilize which type of methodology - Answer: Flocculation Mycobacterium species positive for nitrate reduction - Answer: Mycobacterium tuberculosis Measles (rubella), mumps, polio vaccine deferral time period - Answer: 2 weeks Burkitt's lymphoma - Answer: 8:14 translocation; associated with EBV; "starry sky" appearance on histology Hodgkin Lymphoma (HL) - Answer: is a malignant lymphoma Reed Sternberg cells are the hallmark of HL. Enlarged, painless lymph node in the neck (often the first sign of HL). A defective clot retraction might be caused by - Answer: Lack of defect of platelet receptor IIb/IIIa German measles vaccine deferral time period - Answer: 4 weeks This protozoa can be routinely cultured - Answer: Acanthamoeba spp. Aspirin prevent synthesis of - Answer: Thromboxane A2 Mycobacterium spp whose colonies are photochromogenic - Answer: Mycobacterium kansaii Burkholderia cepacia - Answer: GNB that is motile with polar tufts of flagella and produces yellow pigment Oxidase (+) Pyocyanin (-) Arginine dihydrolase (-) Known to cause fulminating lung infections in CF patients Burkholderia mallei - Answer: Glander's disease forms nodular lesions in the lung tissue and can cause ulcers leading to sepsis and death. Clenched fist cellulitis associated with what organism - Answer: Eikenella corrodens CEA tumor marker - Answer: colorectal cancer Intestinal amebiasis symptoms - Answer: Abdominal cramps Fever Diarrhea Bloody stool Type of anemia where inability to incorporate iron into protoporphyrin ring - Answer: Sideroblastic anemia Immunoassay for hCG uses which subunit of hCG - Answer: Beta Parasite typically comes from cat feces - Answer: Toxoplasma gondii This condition made up of small clots made of platelets and large forms of VWF - Answer: TTP (thrombotic thrombocytopenic purpura) Normal heme contains - Answer: Four heme and four globin chains Detection of MRSA - Answer: Zone of <10mm with an oxacillin disk on MH agar Molecular tests for mecA gene Drug of choice for Clostridium difficile and MRSA - Answer: Vancomycin (glycopeptide, inhibit cell wall synthesis) Drugs of choice for pseudomonas aeruginosa and other aerobes - Answer: Ciprofloxacin, Norfloxacin (quinolines, inhibit nucleic acid synthesis) Drug of choice for UTI, enteric infections - Answer: Sulfamethoxazole (Sulfonomides, analogue of PABA) Extended-spectrum beta-lactamases - Answer: Enzymes that give bacteria immunity to both penicillin and cephalosporin antibiotics Tiny GN coccobacilli associated with wild boar - Answer: Brucella spp. This condition is associated with oligoclonal band in CSF electrophoresis - Answer: Multiple sclerosis Cell indicative of kidney disease - Answer: Tubular epithelial cells Species-specific genes for MRSA - Answer: 16S and 23S ribosomal RNA genes DNA gyrase (gyrA) Superoxide dismutase (sodA) UA findings associated with nephrotic syndrome - Answer: Oval fat bodies Fatty and waxy casts Renal tubular epithelial cells Heavy proteinuria Foamy appearance Follow up tests for speckled ANA patterns - Answer: Smith antibodies SS-A/SS-b+ antibodies Microorganism associated with tinea cruris AKA jock itch - Answer: Epidermophyton floccosum Inactive X-chromosome in the somatic cells of mammalian females that appear as nuclear appendages - Answer: Barr body Deferral time for terminated pregnancy in the 3rd trimester - Answer: 6 weeks Overproduced IgM associated with - Answer: Waldenstrom's disease Common cause of atrophic rhinitis - Answer: Klebsiella ozaenae Clinical symptoms of nephrotic syndrome - Answer: Swelling Weight gain from fluid retention Poor appetite High BP Confirmatory test for circulating lupus anticoagulant - Answer: Platelet neutralization test This sexually transmitted parasite displays symptoms in women but men are frequently asymptomatic 4 anterior flagella and granules along its axostyle - Answer: Trichomonas vaginalis Hypersegmented neutrophils associated with - Answer: Megaloblastic anemia which is commonly caused by vitamin B12 deficiency Hemosiderin-laden macrophages in CSF sample associated with - Answer: Intracranial hemorrhage Washed RBC will decrease/prevent which type of RBC transfusion reaction - Answer: Allergic reaction Washing cells removes excess plasma proteins This organism has dark septate hyphae, large conidia and typically contain 4 cells - Answer: Curvularia spp. Alternaria sp. - Answer: CHAINED poroconidia HORIZONTAL and VERTICAL SEPTA CLUB shaped bases ADAMSTS13 - Answer: Cleaves multimers of vWF from multimers into monomers Lack of causes TTP Deficiency is either genetic or more commonly: Produce autoantibody Adult female with autoantibody Atypical RBCs associated with post-splenectomy - Answer: Acanthocytes Echinocytes Codocytes Spherocytes Schistocytes Howell-Jolly bodies Dubin-Johnson syndrome - Answer: autosomal recessive, conj hyperbilirubinemia, defect in bili transport, black color to liver p239 Organisms known to cause bacterial vaginosis - Answer: Mobiluncus spp Gardnerella vaginalis Rapidly progressive fungal infection of the sinuses in immunosuppressed or diabetic patients - Answer: Phycomycosis Neoplastic T lymphocytes that have irregular, convoluted (cerebriform) nuclear outlines - Answer: Sezary cells This Pseudomonas spp produces pyocyanin - Answer: Pseudomonas aeruginosa Electrolyte panel tests - Answer: Sodium Potassium Chloride CO2 Hallmark of May-Hegglin anomaly - Answer: Giant platelets, lagre dohle body like inclusions within neutrophils, eosinophils, basophils, and monocytes Hallmark of Pelger-Huet anomaly - Answer: Hyposegmented neutrophils (dumbell shape) Alder-Reilly Anomaly - Answer: Inability to degrade mucopolysaccharides results in accumulation of lipids On a slide, every leukocyte seen exhibits dense, basophilic coarse granulation This organism is endemic in Southern and Central California Growth of 2-21 days - Answer: Coccidioides immitis Cause of tularemia - Answer: Francisella spp. Poikilocytosis - Answer: Variation in shape Anisocytosis - Answer: Variation in size Activation unit in classical complement pathway - Answer: C4, C2, C3 Urea nitrogen RR - Answer: 6-20 mg/dL Creatinine RR - Answer: 0.6-1.2 mg/dL This malarial parasite presents reticulocytes with Schuffner's dots - Answer: Plasmodium vivax Platelet satellitism can be result of blood collection in which type of tube - Answer: EDTA (purple top) What chromosome is alpha chain globin coded on - Answer: Chromosome 16 What chromosome is beta chain globin coded on - Answer: Chromosome 11 Method for long-term diabetic monitoring in SS patients - Answer: Fructosamine This organism is normal flora of skin, cause of opportunistic mycoses in immunocompromised patients Pink pigment is hallmark characteristic - Answer: Rhodotorula spp. Common cause of septic arthritis in patients <30y - Answer: Neisseria gonorrhoeae This adsorption technique removes cold Ab such as anti-I - Answer: Rabbit erythrocyte stroma (RESt) I RESt This plasmodium spp. contains 6 to 12 merozoites - Answer: Plasmodium malariae This biomarker is regulator of myocyte contraction - Answer: cTnT Bordet-Gengou and Regan-Lowe - Answer: Bordetella pertussis Buffered Charcoal Yeast Extract (BCYE) - Answer: Legionella spp. Cystine Glucose Agar - Answer: Francisella tularensis Skirrow agar - Answer: Helicobacter pylori Thiosulfate Citrate Bile Salts Sucrose Agar (TCBS) - Answer: Vibrio Tinsdale agar, Loeffler's medium - Answer: Corynebacterium diptheriae Only helminth egg routinely recovered in sputum samples - Answer: Paragonimus westermani This organism will show black colony with red ring on XLD agar - Answer: Edwardsiella tarda This genotype is highest in Caucasians - Answer: CDe/ce (R1r) Primary virulence factor of Streptococcus pneumoniae - Answer: Capsular polysaccharide Associated with Spelunker's Scourge production of macroconidia with a conspicuous prickly surface High percentage in Midwest, found in bat poop - Answer: Histoplasma capsulatum Common cause of nontuberculous mycobacteria (NTM) small, smooth, and dome-shaped early in incubation. - Answer: Mycobacterium avium complex (MAC) Cause of false positive for ketones - Answer: L-Dopa metabolites Manic-depression primary treatment - Answer: Lithium A markedly elevated 5-hydroxyindoleacetic acid (5-HIAA) associated with - Answer: Carnicoid tumor Normal flora in mouth but may produce thrush - Answer: Candida albicans Where is CSF produced - Answer: choroid plexus This enzyme conjugates bilirubin - Answer: Glucuronyl transferase Organism associated with tinea pedis - Answer: Epidermophyton floccosum (large shaped macroconidia each with 3-5 cells separated by septa) Trichophyton rubrum (teardrop shaped microcondia , "birds on a fence morphology") Epidermophyton floccosum - Answer: Dermatophyte; tinea pedis with red itchy scaly feet Trichophyton rubrum - Answer: (This is a mold that can cause topical infections.) A fungus that can cause topical infections of the skin and scalp including athlete's foot and ringworm Fatty cast - Answer: Contains refractile oval fat bodies Analyte to detect early nephropathy in diabetic patient - Answer: Albumin Confirmatory test for urobilinogen - Answer: Watson-Shwartz test Blood product with best source of fibrinogen - Answer: Cryoprecipitate Phagocytosis steps - Answer: 1. Chemotaxis 2. Adherence 3. Engulfment 4. Phagosome formation 5. Fusion. 6. Digestion and destruction Cardiac biomarker to detect recent reinfarction - Answer: CK-MB This is measured to test for ketoacidosis - Answer: Acetoacetic acid Freshwater broad fish tapeworm, largest human tapeworm Infection through consumption of freshwater fish - Answer: Diphyllobothrium latum Type IV hyperlipoproteinemia - Answer: High triglycerides and increased VLDL Type I hyperlipoproteinemia - Answer: Deficiencies of lipoprotein lipase Type II hyperlipoproteinemia - Answer: High triglyceride and LDL Most common Type III hyperlipoproteinemia - Answer: High chylomicrons and IDL Type V hyperlipoproteinemia - Answer: High chylomicrons and VLDL This inclusion is a result of immunoglobulin accumulations commonly found in multiple myeloma patients - Answer: Russell bodies Peroxidase stain differentiates which cell populations - Answer: Lymphocytic (-) and granulocytic (+) Cooley's anemia also known as - Answer: Beta thalassemia major This parasite is associated with acid-fast, small oocysts on surface of duodenal mucosa - Answer: Cryptosporidium Yeast cells in UA - Answer: Presence of budding Which viral family contains DNA as its nucleic acid - Answer: Poxviridae Process of monoclonal antibody production - Answer: Fusion of antibody specific lymphocyte and myeloma cell Vitamin K dependent clotting factors - Answer: 2, 7, 9, 10 Think 1972 Warfarin (Coumadin) inhibits which factors - Answer: All vitamin K dependent factors, 2,7, 9, 10 A low LAP score indicates - Answer: CML (<13) RR 13-130 A high LAP score indicates - Answer: Leukemoid reaction (>160) RR 13-130 This stain confirms hairy cell leukemia diagnosis - Answer: TRAP stain "Trap the Hairy beast" Optimal specimen to diagnose Naegleria fowleri infection - Answer: CSF sample Houseflies are a transport host for which categories of parasites - Answer: Flagellates & Amebae Number of patients correctly diagnosed for the disease or not having the disease - Answer: Efficiency When is a trough level measured - Answer: Before next dose is given Cylindroid in UA - Answer: Varied morphology of hyaline cast Lancefield carbohydrate antigen found on Strep. agalactiae - Answer: Group B Lancefield carbohydrate antigen found on Strep. anginosus - Answer: Group F, G, A Lancefield carbohydrate antigen found on Strep. pyogenes - Answer: Group A Autohemolysis test useful in diagnosis of - Answer: Hereditary spherocytosis Rapid growth of gray-white smooth non-pigmented colonies both on chocolate agar and Middlebrook 7H10 - Answer: Mycobacterium chelonae In what condition will you see Howell-Jolly bodies - Answer: Megaloblastic anemia Hypo-functioning spleen Splenectomy Which thalassemia will not contain Bart's hemoglobin at birth - Answer: Heterozygous alpha thalassemia-2 silent carrier Causes of hypernatremia - Answer: Excess water loss Decreased water intake Increased sodium intake or retention Most frequent cause of subcutaneous mycetoma of foot, musty odor Occurs from deep splinter - Answer: Nocardia brasiliensis Pseudomonas species will have yellow colony pigmentation on blood agar - Answer: Pseudomonas fulva Isolated from CSF of newborn, produced small, grayish, slightly translucent beta-hemolytic colonies on sheep blood agar - Answer: Listeria monocytogenes Anion gap formula - Answer: Na - (Cl + HCO3) MCH formula and units - Answer: (HGB x 10) / RBC [pg] RR: 26-32 pg MCV formula - Answer: (Hct x 10)/RBC [fL] RR: 80-100 fL <80 fL = microcytic >100 fL = macrocytic MCHC formula and units - Answer: (HGB X 100)/HCT [g/dL] RR: 32-36 g/dL <32 g/dL = hypochromic >36 g/dL = possible spherocytosis SeNsitivity formula - Answer: TP/(TP+FN) Shows who actually has positive for disease SPecificity formula - Answer: TN/(TN+FP) Shows whos actually negative for the disease Corrected reticulocyte count - Answer: Reticulocyte count * (HCT/45) Corrected reticulocyte count >3% indicates good marrow response and suggests peripheral destruction Corrected reticulocyte count <3% indicates poor marrow response and indicates underproduction Normality equation - Answer: N = (g/L)/eq wt. Substance responsible to bilirubin conjugation - Answer: Glucuronic acid This Nocardia spp. can hydrolyze casein, but cannot hydrolyze acetamide - Answer: Nocardia brasilienis May sometimes be seen as a naturally occurring antibody - Answer: Anti-Lua RBC cast UA - Answer: appear as brown to almost colorless Significant microbial target for NK cells - Answer: Viruses Site used for CSF collection - Answer: L3-L4 This HBV marker is associated with transmission - Answer: HBeAg Best specimen type for recovery of Diphyllobothrium latum - Answer: Stool Globin gene loci order for C16 - Answer: Zeta, alpha 2, alpha 1 Globin gene loci order for C11 - Answer: Beta, delta, epsilon High hsCRP indicate ( >10 mg/L ) - Answer: Acute inflammation such as infection This nematode egg is characteristically flattened on one side - Answer: Enterobius vermicularis Habitats in milk and milk products, and is responsible for both the color (yellow) and aroma of certain cheeses. - Answer: Brevibacterium spp. Infective stage for intestinal amebae - Answer: Cyst Defective platelet component in Bernard-Soulier - Answer: Glycoprotein Ib/IX T cell CD markers - Answer: CD2, CD3. CD4 (T helper only), CD8 (Cytotoxic t cell only) B cell CD markers - Answer: CD19, CD20, CD21 NK cell CD markers - Answer: CD16 and CD56 Type I hypersensitivity reaction - Answer: IgE mediated Release of histamine eg. food allergy, bee sting Type II hypersensitivity - Answer: IgG, IgM and complement mediated eg. transfusion rxn, Hashimoto's, autoimmune hemolytic anemia Type III hypersensitivity - Answer: immune complex mediated eg. SLE, RA Type IV hypersensitivity - Answer: T cell mediated; monocyte and lymphocyte infiltration eg. contact dermatitis, TB skin test, leprosy, GVHD Prozone - Answer: antibody excess false negative Postzone - Answer: antigen excess false negative Nephelometry measures - Answer: Light scattered Nonlattice v lattice sensitivity comparison - Answer: Nonlattice is more sensitive eg. RIA, EIA, FIA CRP (C-Reactive Protein) - Answer: Acute phase protein Released after inflammation or tissue damage Non-specific hs-CRP (high sensitivity C-reactive protein) - Answer: High sensitivity used to indicate risk of coronary artery disease Syphilis caused by - Answer: Treponema pallidum RA lab findings - Answer: High titers of RF Low titers of complement Positive anti-cyclic citrullinated peptide (anti-CCP) Confirmatory test for RA - Answer: CCP (cyclic citrullinated peptides) Confirmatory test for celiac disease - Answer: Tissue transglutaminase antibody (tTG-IgA, tTG-IgG) Causative agent of infectious mono - Answer: EBV Order of EBV antibodies - Answer: 1. Anti-EA 2. Anti-VCA IgM 3. Anti-VCA- IgG 4. Anti-EBNA HIV attacks which cell - Answer: Helper T cells (CD4) Proteins specific for HIV demonstrated in western blot - Answer: p24, gp41, gp120, gp160 Viral hepatitis associated with what lab findings - Answer: Increase in AST, ALT, GGT HBeAg associated with - Answer: Acute infection, virus is replicating in pt Graves autoantibody specificity - Answer: TSH Hashimotos autoantibody specificity - Answer: Thryoglobulin MS autobody specificity - Answer: Myelin sheath of nerves or myelin protein RA autobody specificity - Answer: IgG (Fc) - 19s anti-IgM Sjorgen's autobody specificity - Answer: Salivary duct, tear duct What condition is caused by Typnosoma cruzi - Answer: Chagas disease Humans acquire this infection from raw, smoked, undercooked, dried, or pickled fish - Answer: Clonorchiasis CMV infection associated with decrease in which cells - Answer: CD4 cells This anemia is associated with bone marrow failure & development of dystrophic nails/white patches in the mouth - Answer: Dyskeratosis congenita Vitamin associated with rickets - Answer: Vitamin D Vitamin associated with night blindness - Answer: Vitamin A Vitamin associated with scurvy - Answer: Vitamin C Another name for inadequate protein/caloric intake - Answer: Marasmus Half-life of cyclosporine and tacrolimus - Answer: 10-12 hours Bioavailability of drug refers to - Answer: fraction of administered drug that reaches the bloodstream This abnormal RBC is associated with idiopathic myelofibrosis - Answer: Teardrop cells (dacryocytes) Increased serum osmolality associated with what condition - Answer: Diabetes insipidus Decrease water volume = increase serum osmolality This mycobacterium spp is associated with the enlargement of posterior cervical lymph nodes - Answer: Mycobacerium scrofulaceum Causes West African Sleeping Sickness - Answer: Trypanosoma brucei gambiense Assay performed for diagnosis of congestive heart failure - Answer: BNP (B-type natriuretic peptide) Ovarian cancer tumor marker - Answer: CA125 Function of Haptoglobin - Answer: binds free hemoglobin Raynaud's phenomenon associated with a deficiency of the complement fraction - Answer: C7 Permanent skin colonizer - Answer: Cutibacterium (Propionibacterium) acnes Reactive lymphocytes are associated with what condition - Answer: Infectious mononucleosis Schistosoma haematobium is known to cause - Answer: Bilharziasis Fusobacterium - Answer: This anaerobic bacteria will fluoresce green under UV light Fusobacterium nucleatum - Answer: Small, gray/white, convex colonies on SBA is commensal in the upper respiratory tract and has been associated with hospital-acquired aspiration pneumonia, lung abscesses, and empyema in hospitalized patients Cushing's syndrome associated with high levels of - Answer: Cortisol Major virulence factor of group A beta-hemolytic streptococci (eg. strep. pyogenes) - Answer: M antigen or M protein prevents phagocytosis Zollinger-Ellison syndrome associated with elevation of - Answer: Gastrin CFU-GEMM - Answer: colony forming unit- granulocyte, erythrocyte, monocyte, megakaryocyte CFU-Mk - Answer: colony forming unit - megakaryocytes CFU-E - Answer: colony forming unit - erythrocyte Transferrin function - Answer: Fe transport protein Ferritin function - Answer: major Fe storage Heme precursor mnemonic - Answer: While in DELTA POUR YOUR COP, PRONTO, a cup of HEME Neisseria can be differentiated from each other by - Answer: carbohydrate utilization Creatinine clearance formula - Answer: Crcl = (urine creatinine/serum creatinine) * (urine volume/time) This parasite is known to contain ingested red blood cells in its trophozoite form - Answer: Entamoeba histolytica Gene translocation of AML - Answer: t(15;17) This antibody will demonstrate MF reactivity - Answer: Lutheran JAK 2 mutation indicates what conditions - Answer: myeloproliferative neoplasms eg. polycythemia vera, essential thrombocythemia, Primary Myelofibrosis (PMF) This GN diplococcus does not ferment any sugar - Answer: Moraxella catarrhalis Dohle bodies are associated with what conditions - Answer: sepsis, bacterial infections, and severe burns Cyst, Large, homogeneous, intra-cytoplasmic green-staining central body w trichrome stain - Answer: Blastocystis hominis Test that can be used to detect a recent infection with Strep pyogenes - Answer: Antistreptolysin O (ASO) Which strictly human pathogen causes chancroid (sores on genitals) - Answer: Haemophilus ducreyi major action of angiotensin 2 - Answer: increased vasoconstriction medication used for narcolepsy - Answer: Amphetamine When testing for ethanol via enzymatic method, what is measured? - Answer: NADH proportional to amount of ethanol in sample Formalin-Ethyl Acetate Sedimentation - Answer: Ethyl, debris, formalin, sediment oxidase-positive organism that is associated with gastrointestinal infections in children - Answer: Plesiomonas shigelloides HbH are made up of what globin chain - Answer: beta chain tetramers NK cells express which CD markers - Answer: CD2, CD11b, CD16 Clostridium spp. produces a toxin that is a potential bioweapon - Answer: Clostridium botulinum Afghanistan and Iraq U.S. soldiers outbreak - Answer: Acinetobacter baumannii Barrel-shaped arthroconidia - Answer: Coccidioides immitis Fanconi anemia is what type of anemia - Answer: Aplastic anemia Beta lactam antibiotics mode of action - Answer: inhibit cell wall synthesis Precursor of indole - Answer: tryptophan Chediak-Higashi syndrome associated with what abnormal gene - Answer: CHS1 LYST Sandfly is the insect vector for - Answer: Leishmania spp. Leishmaniasis - Answer: amastigote form may be seen within reticuloendothelial cells of bone marrow, spleen, or liver. Urn or vase shaped phialides - Answer: Phialophora verrucosum mold form produces short conidiophores with a single, round conidium lollipop appearance - Answer: Blastomyces dermatitidis What class of drug does theophylline belong to - Answer: bronchodilators antibiotic that inhibits RNA synthesis - Answer: Rifampin causes wound infections in persons having contact with contaminated water and has a distinct propensity to invade the bloodstream and cause septicemia - Answer: Vibrio vulnificus HgbF made up of what two globin chains - Answer: alpha and gamma HgbA2 made up of what two globin chains - Answer: alpha and delta Left shift of oxygen dissociation curve - Answer: Left shift is the "Love shift"..."Oxygen Loves Hb"....increased affinity A....factors 1. Increased O2 2. Decreased CO2 3. Increased pH 4. Decreased temp 5. Decreased 2, 3 DPG (de-gluer) 6. Fetal Hb 7. Carbon monoxide hemoglobin Right shift of the oxygen dissociation curve means - Answer: Decrease Hgb affinity for 02 (releases it readily) Acidosis (decrease pH) Increased temperature increased 2,3-DPG anemia, high altitude, cirrhosis, fever, high Co2 Methemoglobin - Answer: Fe3+, cannot bind O2 Carboxyhemoglobin - Answer: Carbon monoxide bound with hemoglobin Sulfhemoglobin - Answer: When sulfur binds to hemoglobin instead of oxygen, it is termed Only one not measured by cyanmethemoglobin method acanthocyte - Answer: Liver disease, abetalipoproteinemia Burr cells (echinocytes) - Answer: Uremia, pyruvate kinase (PK) deficiency Elliptocyte - Answer: hereditary elliptocytosis, thalassemia Schistocytes - Answer: DIC, hemolytic processes Drepanocyte (sickle cell) - Answer: HbSS Spherocytes - Answer: hereditary spherocytosis autoimmune hemolytic anemia Stomatocyte - Answer: hereditary stomatocytosis, liver disease target cell (codocyte) - Answer: -Liver disease -Hb C -Thalassemias -Other hemoglobinopathies Dacryocyte (Tear Drop) - Answer: Pernicious anemia Thalassemia Howell-jolly bodies composed of - Answer: DNA Basophilic stippling composed of - Answer: Aggregates of ribosomes Pappenheimer bodies (siderotic granules) composed of - Answer: Iron Heinz bodies composed of - Answer: Denatured hemoglobin Cabot ring (figure 8) composed of - Answer: Remnants of mitotic spindle ammonium biurate crystal - Answer: thorny- apple, yellow-brown spherical body with irregular spicules decreased haptoglobin indicates - Answer: intravascular hemolysis This candida spp has sagebrush appearing morphology when grown on cornmeal agar - Answer: Candida parapsilosis This parasites egg has similar morphology to trichuris trichiuria and prevalent in the northern Philippines - Answer: Capillaria philippinensis XLD Agar (Xylose Lysine Desoxycholate) - Answer: yellow colonies = E. coli yellow w black centers = Proteus colorless or red = Shigella red w black centers = Salmonella Modified Thayer Martin Agar - Answer: Selective agents, vancomycin and colistin, inhibit gram-positive cocci and gram-negative bacilli, respectively Enhance the growth of pathogenic Neisseria Loeffler Medium isolation for - Answer: Corynebacterium diphtheriae Bordet-Gengou agar isolation for - Answer: Bordetella pertussis Optimal temperature for Campylobacter - Answer: 42C Optimal temperature for Yersinia - Answer: 25-30C Tests for identification of beta-hemolytic streptococci - Answer: Bacitracin disk = Group A (susceptible) and Group B (resistant) SXT disk = Group A & B (resistant) v Group C & G (susceptible) PYR test = Group A (positive reaction) CAMP test = Group B (positive reaction) Organisms associated with shunt infections - Answer: Coag neg staph Kleb pneumoniae E. coli Osteoblast v Osteoclast morphology - Answer: Osteoblasts are smaller and have singular round nucleus which is eccentrically located. Resembles comet shape Osteoclasts are large and are multinucleated Inhibitor of platelet aggregation released by endothelial cells - Answer: prostacyclin Endolimax nana trophozoite - Answer: - Blot like karyosome - very small agent of acute conjunctivitis - Answer: Moraxella lacunata what cells are increased in CSF in pt with MS - Answer: lymphocytes Organisms known to cause Waterhouse Friderichsen syndrome - Answer: Neisseria gonorrhoeae Staphylococcus aureus Pneumococcus pneumoniae Haemophilus influenzae microaerophilic, curved, gram-negative rod which was isolated from a diarrhea stool - Answer: Campylobacter spp Zygomyces species causing tissue infections in humans. - Answer: Rhizopus Dipylidium caninum - Answer: Dog tapeworm - eggs Echonococcus granulosis - Answer: Diphyllobothrium latum - Answer: Hymenolepis nana - Answer: dwarf tapeworm, most common US tapeworm, direct infection Taenia spp. - Answer: The eggs measure 30-35 micrometers in diameter and are radially-striated. The internal oncosphere contains six refractile hooks. The total deferral time following a blood transfusion - Answer: 3 months rare genetic defect of macrophages where waste material remains in lysosome - Answer: Gaucher's disease tapeworm found in rodents - Answer: Hymenolepis diminuta "fried egg-like" growth colonies associated with - Answer: mycoplasma decreased M:E ratio indicates - Answer: erythroid hyperplasia, hemolytic anemia increased M:E ratio indicates - Answer: myeloid hyperplasia myeloid leukemia Hemoglobin S structure - Answer: Valine for glutamic acid "Sexy valine" to remember Hemoglobin C structure - Answer: Lysine for glutamic acid cellulose acetate (8.4 pH) hgb electrophoresis migration order - Answer: C(includes A2), S, F, A Crawl, slow, fast, accelerate citrate agar (6.2 pH) hgb electrophoresis migration order - Answer: What migrates with A2 hgb @ pH=8.6 - Answer: A2, C, E, O(arab), C(harlem) A2 CE Of Clubs what migrates with S @ pH = 8.6 - Answer: S, D, G, L Sad Dog Gets Loved M0 classification predominant cell - Answer: Myeloblasts without differentiation M1 classification predominant cell - Answer: Myeloblasts with minimal maturation M2 classification predominant cell - Answer: Myeloblasts with maturation M3 classification predominant cell - Answer: Promyelocyte M4 classification predominant cell - Answer: Myeloblast and monoblast M5 classification predominant cell - Answer: Monoblast M6 classification predominant cell - Answer: Erythrocytic series M7 classification predominant cell - Answer: Megakaryocyte Russell's viper venom test - Answer: activates factor X in presence of reduced phospholipids Prolonged in lupus anticoagulant Hemophilia A deficiency of - Answer: Factor VIII Treat with commercial factor VIII "A ate 8" Hemophilia B deficiency of - Answer: Factor IX Treat w factor IX concentrates Hemophilia C deficiency of - Answer: Factor XI vWD treatment - Answer: DDAVP (desmopressin) releases subendothelial stores of VWF Aldosterone source and action - Answer: adrenal cortex; sodium retention Glucose reagent strip principle - Answer: utilizes copper reduction test Ketone reagent strip principle - Answer: sodium nitroprusside + ketone = purple color blood reagent strip principle - Answer: pseudoperoxidase activity of hemoglobin Bilirubin reagent strip principle nitrite reagent strip principle leukocyte reagent strip principle - Answer: Diazo salt reaction urobilinogen reagent strip principle - Answer: Ehrlich reaction involving para-dimethylaminobenzaldehyde squamous epithelial cell urine - Answer: largest, least significant transitional epithelial cells urine - Answer: may be increased in UTI renal tubular epithelial cells urine - Answer: tubular necrosis Oval fat bodies urine - Answer: Nephrotic syndrome confirm with sudan III or oil red O stain Normal crystals in urine - Answer: Acid urine: Uric Acid Amorphous Urates Calcium Oxalate Alkaline urine: Amorphous Phosphate Triple Phosphate Ammonium Biurate Calcium Carbonate Abnormal crystals in urine - Answer: Cystine Cholesterol Leucine Tyrosine Bilirubin filamentous fungus that inhabits the soil and plant material. It is commonly considered as a contaminant - Answer: Sepedonium Treatment of choice for Nocardia spp - Answer: Sulfoamides valinomycin membrane electrode is most selective for - Answer: Potassium potent immunosuppressive drug that has been shown to cause thrombi formation at levels above the therapeutic range - Answer: Tacrolimus Cardiac muscle CK isoenzymes - Answer: CK-MM and CK-MB Skeletal muscle CK isoenzyme - Answer: CK-MM Brain, GI, Colon, prostate, uterus CK isoenzyme - Answer: CK-BB AST - Answer: increased in MI, liver disease, muscle trauma ALT - Answer: increased in liver disease more specific than AST ALP - Answer: Increased in obstructive jaundice Increased in osteoblastic activity such as Paget's, osteoblastic tumors, rickets Lipase and amylase specific for - Answer: acute pancreatitis ACP - Answer: highest elevations in prostate carcinomas Troponin complexes - Answer: Troponin T (TnT) Troponin I (TnI) Troponin C (TnC) Troponin complexes specific to cardiac muscle - Answer: cTnT and cTnI BNP sensitive for - Answer: congestive heart failure hsCRP specific for - Answer: chronic inflammation Biliary obstruction includes which elevated enzymes - Answer: ALP 5NT GGT BILI Differentiate between Helicobacter and Campylobacter - Answer: Urease activity Helicobacter: Urease pos Campylobacter: Urease neg Hepatitis includes which elevated enzymes - Answer: AST ALT Hypernatremia is associated with what conditions - Answer: Cushing's syndrome Dehydration Hyperaldosteronism Hyponatremia is associated with what conditions - Answer: Diabetic acidosis Diarrhea Addison's Renal tubular disease encapsulated yeast that can be seen in immunocompromised patients due to its opportunistic capability. - Answer: Cryptococcus neoformans trichrome stain used for - Answer: identify protozoans and cysts Osmolality formula - Answer: 2(Na) + BUN/2.8 + Blood Glucose/18 This Candida spp colonies are arranged in relatively tight, compact clusters - Answer: Candida glabrata Known to cause chronic gastritis - Answer: Helicobacter pylori Formula for calculating number of donors to type - Answer: X = number of donors required/frequency of donors negative for the antigen(expressed as a decimal) Ascaris lumbricoides - Answer: Ascariasis (roundworm) Paragonimus westermani - Answer: Lung fluke producing ovoid operculated ova with terminal thickening Schistosoma masoni - Answer: (specific) snails, injection, fluke, Katayama fever; longterm hepatic and intestinal abnormalities, eggs with lateral spine; helminth The most common way to be infected by this bacteria is by eating or drinking unpasteurized/raw dairy products. - Answer: Brucella spp Auer rods associated with what type of leukemia - Answer: AML Cause of white piedra - Answer: Trichosporon beigelii associated with bite wounds from canines or felines - Answer: Pasteurella multocida Cladosporium sporulation - Answer: long chains of elliptical conidia each separated by a distinct scar, called a "dysjunctor" metabolic alkalosis causes - Answer: NaHCO3 infusion Citrate Antacids Vomiting K depletion Diuretic therapy Cushing syndrome Staphylococcus aureus - Answer: GPC, Coag pos Toxic shock syndrome, scalded skin syndrome, food poisoning resistant to penicillin, if MRSA use vanomycin Staphylococcus aureus diagnosis - Answer: BAP Growth in 7.5% NaCl and ferment mannitol Catalase pos, coagulase pos Streptococcus pyogenes (Group A) - Answer: GPC, Beta hemolytic Streptolysin O and S Sensitive to penicillin Causes: strep throat, impetigo, rheumatic fever Streptococcus agalactiae (Group B) - Answer: GPC, Narrow zone of beta hemolysis Neonatal sepsis and meningitis, UTI Neisseria gonnorhoeae - Answer: GNC, grows on CHOC and Thayer Martin Only ferments glucose Oxidase pos Neisseria meningitidis - Answer: GNC, grows on CHOC and Thayer Martin Only glucose AND maltose Oxidase pos Moraxella catarrhalis - Answer: Recommended treatment for MTB - Answer: Isoniazid, Rifampin, Ethambutol, and Pyrazinamide Blastocytis hominis - Answer: Mistaken for cysts of amebae These chemical substances induce platelet adhesion when there is a break in the inert epithelial lining of the vasculature - Answer: ADP and serotonin This isolate is most often part of the normal flora, serving in several body sites as a protection against harmful bacteria through the production of lactic acid - Answer: Lactobacillus Hyaline casts - Answer: Nonspecific, can be a normal finding, often seen in concentrated urine samples total cholesterol formula - Answer: HDL + LDL + 1/5 triglycerides is the recommended antimicrobial to use for the detection of methicillin resistance in Staphylococcus aureus isolates - Answer: Cefoxitin may appear as Gram-positive cocci in direct smears or smears prepared from blood cultures. Additionally, a lavender pigment may be produced on MacConkey, resembling lactose-fermentation - Answer: Acinetobacter spp. Wuchereria bancrofti transmittted via and causes what? - Answer: Mosquito, elephantiasis Bacillus anthracis - Answer: Catalase positive nonmotile nonhemolytic This parasite gives birth to microfilariae - Answer: Onchocerca volvulus Largest protozoan trophozoite - Answer: Balantidium coli (up to 100 microns) Stemphylium spp. - Answer: varied colony morphology Protocol for detection of MRSA via Kirby Bauer method - Answer: Mueller-Hinton agar utilizing 0.5 MacFarland standard 16-20 hour incubation at 35 C 30 microgram cefoxitin disk is recommended to detect mecA mediated resistance Oliguria associated with - Answer: Acute glomerulonephritis acute glomerulonephritis - Answer: Inflammation of glomerulus leading to leaking of RBC and protein (mild) into urine Cause: Post streptococcal infection. Immune system creates immune complexes in response to bacteria which inflames glomerulus Symptoms: ASO titer decreased GFR mild edema elevated BUN and creatinine Oliguria Nephrotic Syndrome - Answer: Changes to the glomerulus of nephron leading to leakage of HIGH amounts of protein into urine Cause: Changes to glomeruli, can be secondary to lupus, diabetes, heart failure Symptoms: Massive proteinuria (>3g per day) Hypoalbuminemia Hyperlipidema Edema Standard blood donation (450-500 mL) requires how many mL of anticoagulant - Answer: 63 mL Yellow-pigmented colonies when observed prior to exposure to light indicate the presumptive identification of one of the scotochromogens (Myco spp.) - Answer: Mycobacterium gordonae Yersinia enterocolitica - Answer: mesenteric lymphadenitis; sepsis in iron overload states Causes disease by direct invasion of tissues Proglottids (Tapeworm) - Answer: a segment of a tapeworm containing both male and female reproductive organs scolex (tapeworm) - Answer: Head of tapeworms Strobila (tapeworm) - Answer: body of tapeworm rostellum (tapeworm) - Answer: organ of attachment of tapeworms Best technique for monitoring severity of HDFN - Answer: Doppler ultrasound most responsible for increasing the ESR - Answer: Fibrinogen MOST likely responsible for septic reactions associated with red blood cell transfusions - Answer: Yersinia enterocolitica Aggregatibacter aphrophilus - Answer: the second most common cause of Aggregatibacter endocarditis Light yellow colonies on CHOC Small, white, non-hemolytic colonies on SBA Bismuth sulfite agar - Answer: Selective media for Salmonella (stool) Pseudomonas stutzeri - Answer: Produces dry, wrinkled colonies that are tough and adhere to media. The colonies are buff to light brown. Oxidase positive. Motile. Grows at 42 degrees Celsius. TIBC is a direct measurement of - Answer: transferrin Mycosis Fungoides - Answer: CD4 T cell neoplasm; skin lesions with Pautrier's microabscesses Microsporidium spp. - Answer: have characteristic intra-cytoplasmic tiny spores observed in the duodenal biopsy Positive methylene blue and PAS stains