Ace ASCP Exam Questions & Answers with Rationales Complete Solutions Graded A 2024

Which of the following condition is the most common cause of increase anion gap? A. Metabolic alkalosis B. Metabolic acidosis Respiratory acidosis Respiratory alkalosis - B. Metabolic acidosis High anion gap metabolic acidosis is caused generally by the body producing too much acid or not producing enough bicarbonate. This is often due to an increase in lactic acid or ketoacids, or it may be a sign of kidney failure. More rarely, high anion gap metabolic acidosis may be caused by ingesting methanol or overdosing on aspirin. Which of the following enzymes has the longest elevation after Myocardial Infarction (MI)? CK-MB Myoglobin Troponin AOTA - C. Troponin Troponin is elevated up to 10-14 days after Myocardial Infarction. Lactic acid specimen: Chilled and separated from cells Heated Room temperature Request EDTA sample only - A. Chilled and separated from cells Ace ASCP Exam Questions & Answers with Rationales Complete Solutions Graded A 2024 Feedback Special Handling: No tourniquet. Place on ice immediately and deliver to lab or aliquot within 15 minutes. DO NOT FREEZE WHOLE BLOOD SPECIMEN. Specific gravity measured by refractometer: 1.035. Protein and glucose both trace in reagent strip: Presence X-ray medium Albuminuria Glucosuria Normal - A. Presence X-Ray medium Feedback Xray medium/Radiographic dye can cause erroneous results in urine specific gravity measurement. A patient with walking pneumonia is being treated with penicillin. State one possible condition why the patient is not recovering: The organism produces beta lactamase The organism has no cell wall The organism has capsule The organism produces an enzyme that neutralizes the antibiotic - B. The organism has no cell wall. Feedback Pneumonia caused by Mycoplasma pneumoniae is routinely treated with antibiotics, although the disease is usually self-limiting. The disease is treated with macrolide, tetracycline, or fluoroquinolone classes of antibiotics. All mycoplasmas lack a cell wall and, therefore, all are inherently resistant to beta-lactam antibiotics (e.g., penicillin). What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48? 2.75 6.09 5.68 30 - B. 6.09 Feedback: CV= SD/meanX100, (5.48/90)X100= 6.09. Blood smear below denotes Hairy Cell Leukemia (HCL), which of the following test is used to identify this type of leukemia? Image. 1 Myeloperoxidase Tartrate-resistant acid phosphatase Tartrate-resistant alkaline phosphatase Sudan Black - B. Tartrate-resistant acid phosphatase Feedback: Hairy cells demonstrate strong positivity for tartrate-resistant acid phosphatase (TRAP) staining. The hairy cells are larger than normal and positive for CD19, CD20, CD22, CD11c, CD25, CD103, and FMC7. Use to differentiate Salmonella from Citrobacter: Lysine decarboxylase ONPG Indole Vogues Proskauerterm-9 - A. Lysine decarboxylase Feedback: Salmonella (+); Citrobacter (-) Arrange the common Rh antigens according to immunogenicity (greatest to least): D>c>E>C>e D>C>E>c>e D>c>E>e>C C>D>c>E>e - A. D>c>E>C>e Feedback Most immunogenic D > c > E > C > e least immunogenic. Most common error in Polymerase Chain Reaction (PCR) is NUCLEIC ACID CONTAMINATION. A True (Correct Answer) B False - A. True What disease is associated with the possession of HLA-B27? Ankylosing spondylitis Hashimoto's Disease Goodpasture's syndrome SLE - A. Ankylosing spondylitis Feedback: Ankylosing spondylitis belongs to a group of arthritis conditions that tend to cause chronic inflammation of the spine (spondyloarthropathies). The HLA-B27 gene can be detected in the blood of most patients with ankylosing spondylitis. Burr cells are seen in the peripheral blood smear, this is indicative of? (Fig. 2) Uremia (Kidney Disease) Anemia Leukemia Liver Disease - A. Uremia (kidney Disease) Feedback: The above shown picture illustrates Burr cells, these cells are indicative of Uremia (kidney disease) Anti IgG (-); C3d (+): What should the MLS do? Elution IAT DAT Pre-warm - D. Pre-warm Feedback Prewarm technique can be used to prevent cold-reactive alloantibodies or autoantibodies from reacting in the IAT phase. Specifically, prewarm technique prevents cold antibodies from binding complement at RT (as opposed to 37o C ) and subsequently being detected by anti-C3 in the IAT by polyspecific AHG serum. Maximum interval which a recipient sample maybe used for crossmatching if the patient has been recently transfused, has been pregnant? 2 days 6 days 3 days NOTA - C. 3 days CIN (Cefsulodin, Irgasan, Novobiocin) Agar is a recommended culture medium for the recovery of: Rhodococcus equi Cardiobacterium hominis Brucella suis Yersinia enterocolitica - D. Yersinia enterocolitica Feedback: CIN Agar is recommended for use in the selective and differential isolation of Yersinia and Aeromonas species from clinical specimens, environmental samples, and food sources. Yersinia enterocolitica will exhibit bull's eye appearance on the said agar. What is the formula for sensitivity? TP/(TP+FN)x100 TP/(TP+FP)x100 (TP+FN)/TPx100 (TP+FP)/TNx100 - A. TP/(TP+FN)x100 CThe anemias of the qualitative hemoglobinopathies, such as sickle cell anemia, are morphologically classified as: Microcytic, hypochromic Macrocytic, normochromic Normocytic, normochromic NOTA - C. Normocytic, normochromic According to AABB standards, Fresh Frozen Plasma (FFP) must be infused within what period of time following thawing? 24 hrs 36 hrs 48 hrs 72 hrs - A. 24 hours A woman having menstrual cycle would have the ff. result: Increased TIBC Increased Ferritin Increase % Saturation Normal Transferrin - A. Increased TIBC Feedback A total iron binding capacity value above 450 mcg/dL usually means that there's a low level of iron in your blood. This may be caused by a lack of iron in the diet, increased blood loss during menstruation, pregnancy, or a chronic infection. Causative agent of "Cat bite fever" Pasteurella multocida Actinomyces israelii Bartonella henselae Leptospira interrogans - A. Pasteurella multocida Feedback Pasteurella species are commonly isolated pathogens in most animal bites, especially in dog- and cat-related injuries. These injuries can be aggressive, with skin manifestations typically appearing within 24 hours following a bite. These wounds can exhibit a rapidly progressive soft-tissue inflammation that may resemble group A β-hemolytic Streptococcus pyogenes infections. What is the sugar fermented by Staphylococcus aureus? Mannitol Sucrose Glucose Maltose - A. Mannitol Mannitol salt agar is a commonly used growth medium in microbiology. It encourages the growth of a group of certain bacteria while inhibiting the growth of others. It contains a high concentration (7.5%-10%) of salt (NaCl), making it selective for gram positive bacteria Staphylococci (and Micrococcaceae) since this level of NaCl is inhibitory to most other bacteria. It is also a differential medium for mannitol fermentors, containing mannitol and the indicator phenol red. Staphylococcus aureus produce yellow colonies with yellow zones, whereas other Staphylococci produce small pink or red colonies with no colour change to the medium. If an organism can ferment mannitol, an acidic byproduct is formed that will cause the phenol red in the agar to turn yellow. Identify the organism: Fig. 3 Blastomyces dermatitidis Malasezia furfur Alternaria Candida albicans - A. Blastomyces dermatitidis Feedback The above image show broad base budding. What is the first step in agglutination? Sensitization Precipitation Diffusion Lattice formation - A. Sensitization Feedback Agglutination involves two process: First, sensitization or initial binding. Second, lattice formation or formation of large aggregates. Sterilization of autoclave: 121°C at 20 lbs/psi for 30 minutes 121°C at 15 lbs/psi for 15 minutes 85°C for 15 lbs/psi 30 minutes 100°C for 20 lbs/psi 50 minutes - B. 121°C at 15 lbs/psi for 15 minutes Feedback Many autoclaves are used to sterilize equipment and supplies by subjecting them to high-pressure saturated steam at 121°C (249 °F) for around 15- 20 minutes depending on the size of the load and the contents. A newborn infant has a WBC count of 37,000/ul with the differential count revealing the presence of 50 nRBCs per 100 WBCs. What is the corrected WBC count? 15,000/ul 24,700/ul 27,300/ul 12,500/ul - B. 24,700/ul Feedback Corrected WBC count= Uncorrected WBC count x100/nRBCs+100: Thus, (37,000ulx100/50+100= 24,700ul) Gram positive bacilli; non-motile; non-hemolytic; catalase positive; spore forming: B. anthracis B. cereus N. meningitidis N. lactamica - B. B. anthracis Feedback Important distinguishing characteristics between B. anthracis and B. cereus is motility, B. anthracis is non motile while B. cereus is motile. Hair perforation test/Hair baiting test is for identification of which two fungi? Aspergillus niger and A. japonicus Tinea pedis and T. corporis Trichophyton mentagrophyte and T. rubrum C. albicans and C. tropicalis - C. Trichophyton mentagrophyte and T. rubrum Feedback Trichophyton mentagrophyte is positive and T. rubrum is negative What is the minimum platelet count before you perform apheresis? 500 200 150 250 - C. 150. Feedback Apheresis donors with low normal pre-procedure platelet counts (150 - 200 x 10 9/L) and Hb concentration (12.5 - 13 g/dL) should be examined for post- donation drops in these haematological parameters Gram negative bacteria, normally found in the oropharyngeal tract of mammals, they are involved in the pathogenesis of some animal bite wounds as well as periodontal diseases. This bacteria exhibits GLIDING MOTILITY: Leptospira Actinobacillus Capnocytophaga Chlamydia - C. Capnocytophaga Feedback The term Capnocytophaga comes from "Capno" for its dependence on CO2 and "cytophaga" for its flexibility and mobility shift (" gliding motility "). Urine with an specific gravity consistently between 1.002 and 1.003 indicates: Acute glomerulonephritis Renal tubular failure Addison's disease Diabetes insipidus - D. Diabetes insipidus Feedback Low specific gravity (SG) (1.001-1.003) may indicate the presence of diabetes insipidus, a disease caused by impaired functioning of antidiuretic hormone (ADH). Low SG also may occur in patients with glomerulonephritis, pyelonephritis, and other renal abnormalities. 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 - B. Measure phenobarbital concentration Feedback Primidone is a structural analog of phenobarbital. Postprandial turbidity of the serum is due to the presence of? Fatty acid Cholesterol Phospholipid Lipoproteins - D. Lipoproteins Feedback For approximately two to eight hours following a meal there is an additional LIPOPROTEIN class, called chylomicrons, representing the transport of dietary fat absorbed in the intestine. A patient with an anti-K and an anti-JKa in her plasma needs 2 units of RBC for surgery. How many group specific units would need to be screened to find 2 units of RBC? The frequency of Jka+ is 80% and K+ frequency is 15%. - B. 12 Feedback Formula: Number of units to crossmatch is equivalent to: # of units need by patient/(frequency of negativity of antigen #1 x frequency of negativity of antigen #2). Negativity of Jka+ is .20%, Negativity of K+ is .85%. Using the formula, 2 units/(.20x.85)=11.76 rounded to 12. An alkaline urine refrigerated becomes turbid because of? Amorphous phosphates Amorphous urates WBC Bacteria - A. Amorphous phosphates Feedback Amorphous phosphates are usually formed in alkaline urine and they are without a color. The precipitate of amorphous phosphates is white while Amorphous urates are yellow, yellow-brown or pinkish in color. They tend to form in acidic urine and their precipitate is pink with a cloudy appearance of the mixed urine. Amorphous urates are a normal presence in the urine. Test for Paroxysmal Cold Hemoglobinuria (PCH): Autohemolysis test Donath-Landsteiner Test Sucrose hemolysis test NOTA - B. Donath-Landsteiner Test Feedback Normal= (-) hemolysis on test and control, PCH= (-) hemolysis on control but (+) hemolysis on test sample. In emphysema, the absence of alpha-1 globulin peak is due the deficiency of: A1-Antitrypsin (AAT) Macroglobulin Hemopexin Transferrin - A1-Antitrypsin (AAT) Feedback Alpha-1 antitrypsin deficiency is an inherited disorder that may cause lung disease and liver disease. Affected individuals often develop emphysema, which is a lung disease caused by damage to the small air sacs in the lungs (alveoli). Characteristic features of emphysema include difficulty breathing, a hacking cough, and a barrel-shaped chest. Identify the organism: Fig. 4 Clostridium difficile Mycobacterium tuberculosis Listeria monocytogenes Corynebacterium diphtheriae - A. Mycobacterium tuberculosis Feedback Mycobacterium tuberculosis is an obligate pathogenic bacterial species in the family Mycobacteriaceae and the causative agent of tuberculosis. M. tuberculosis has an unusual, waxy coating on its cell surface primarily due to the presence of mycolic acid. Cells are curved rod-shaped and are often seen wrapped together, due to the presence of fatty acids in the cell wall that stick together. This appearance is referred to as cording, like strands of cord that make up a rope. M. tuberculosis is characterized in tissue by caseating granulomas containing Langhans giant cells, which have a "horseshoe" pattern of nuclei. A and B blood group antigens are derived when glycosyltransferases add specific sugars to precursor H. What is the terminal sugar for B antigen? Fucose D-galactose N-acetylglucosamine N-acetylgalactosamine - B. D-galactose Feedback The A Blood Type is the H antigen with N-acetylgalactosamine attached. The B Blood Type is the H antigen with D-galactose attached. The O Blood Type is the H antigen with no additional sugar attached. The reverse Camp Test, lecithinase production, double zone hemolysis and gram stain morphology are all useful identification of: Campylobacter jejuni Staphylococcus aureus Listeria monocytogenes Clostridium perfringens - D. Clostridium perfringens Feedback: Clostridium perfringens (formerly known as C. welchii, or Bacillus welchii) is a Gram-positive, rod-shaped, anaerobic, spore-forming pathogenic bacterium of the genus Clostridium. Clostridium perfringens shows double-zone hemolysis on blood agar. Small area of beta hemolysis are noted (complete lysis of red blood cells) surrounded by a larger zone of alpha hemolysis (partial hemolysis). According to AABB Standards, at least 90% of all Apheresis Platelets units tested shall contain a minimum of how many platelets? 5.5 X 10^11 5.0 X 10^11 3.0 X 10^11 6.5 X 10^11 - Feedback As per AABB Standards, at least 90% of platelet pheresis units sampled must contain at least 3.0 x 10^11 platelets. When performing semen analysis, sperm count is done: After collection After liquefaction No certain time NOTA - B. After liquefaction Feedback Sperm count is done after liquefaction which is approximately 20-30 minutes. Latex agglutination for Staphylococcus aureus: Protein A and nuclease Phosphotase and protein A Protein A and clumping factor All of the above - C. Protein A and clumping factor Which of the following blood test uses radioimmunoassay test to detect direct and specific IgE? Radioallergosorbent Test (RAST) Radioimmunosorbent Test (RIST) A and B None of the above - A. Radioallergosorbent Test (RAST) Feedback RAST test is used to detect direct and specific IgE. RIST test is used to detect total serum IgE. Which of the following factors are affected by Coumadin Therapy? III, VII, VIII X, V, II, I II, VII, IX, X AOTA - c. Feedback The following factors are said to be Vitamin K Dependent factors. Coagulation factors affected by coumadin drugs are: II, VII, IX and X. What analyte is monitored in preeclampsia? Potassium Ammonia Magnesium Ionized Calcium - c. Magnesium Feedback Preeclampsia is a pregnancy-specific disorder characterized by hypertension and excess protein excretion in the urine. It is an important cause of maternal and fetal morbidity and mortality worldwide. Magnesium sulfate (MgSO4) is the agent most commonly used for treatment of eclampsia and prophylaxis of eclampsia in patients with severe pre-eclampsia. Identify: FI.g 5 Heinz bodies Basophilic stippling Howell-Jolly bodies Auer rods - A. Heinz Bodies Feedback Heinz bodies (also referred to as "Heinz-Ehrlich bodies") are inclusions within red blood cells composed of denatured hemoglobin. It is also seen in cases of moth balls (naphthalene) ingestion. High-Level Aminoglycoside Resistance: Micrococcus Staphylococcus Enterococci AOTA - C. Enterococci Feedback Enterococci are intrinsically resistant to aminoglycosides; a combination therapy using aminoglycoside with vancomycin has been known to increase the effectiveness of the aminoglycoside. It is important to identify this high-level aminoglycoside resistance (HLAR) to provide appropriate therapy. A patient's record shows a previous anti-Jk(b), but the current antibody screen is negative. What further testing should be done before transfusion? Give Jk(b) negative crossmatch compatible blood Crossmatch type specific units and release only compatible units for transfusion Phenotype the patient's red cells for the Jk(b) antigen AOTA - A. Give Jk(b) negative crossmatch compatible blood Feedback Delayed hemolytic transfusion reactions may occur in recipients who are previously immunized but who do not have detectable antibody, if they receive blood with the corresponding antigen. When there is a history of clinically significant antibodies, donor red cells should be phenotyped and antigen-negative blood selected. A complete AHG crossmatch must be performed. When introducing a new manual technique, which is the best approach? Case presentation Workshop Lecture All of the above - B. Workshop Duckert's Test 5M Urea Solubility Test is used of: Factor II deficiency Factor XIII deficiency Factor VIII deficiency Factor XII deficiency - B. Factor XIII deficiency Feedback Duckert's Test is for factor XIII deficiency, Reagent: 5M Urea. Test Results: Normal: Clot is insoluble to urea (24 hrs), Abnormal: Factor XIII deficiency: Clot is soluble to urea (24 hrs) Which of the following should be tested in cases of Antacid overdose? pH Potassium Ammonia Chloride - A. pH Feedback Antacids do just what their name suggests: they neutralize the normal stomach acid (HCl), causing the pH to rise to a nearly neutral pH of around 6 to 7. As the pH rises above 4, pepsin activity decreases or stops. Some types of antacids, made of sodium bicarbonate (NaHCO3) or calcium carbonate (CaCO3), are easily absorbed into a person's body and can cause a pH imbalance, possibly leading to kidney damage or other problems (Berkow, 1987). 17-Ketosteroids is produced in the: Adrenal glands Hypothalamus Thyroid glands Pituitary glands - A. Adrenal glands Feedback 17-ketosteroids are substances that form when the body breaks down male steroid sex hormones called androgens and other hormones released by the adrenal glands in males and females, and by the testes in males. The oxygen sensitive indicator that is used to ensure that anaerobic jars or chambers have met the anaerobic conditions required for anaerobes to grow is: Methylene blue Bromphenol blue Thymol blue Bromthymol blue - A. Methylene blue Feedback Methylene blue is used as an indicator of anaerobiosis. It remains blue when there is oxygen present in the environment but turns colorless if anaerobic conditions are met. 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 - 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. Autologous Donation: Age has no requirement Hgb atleast 11 g/dl, Hct atleast 33% Single unit is removed at a time, with atleast 3 day intervals AOTA - D. AOTA Feedback Donating blood for your own surgery is called an autologous donation. These blood units are collected and stored until the patient's surgery. Order of migration of hemoglobins during alkaline electrophoresis, starting from the origin towards the anode: C,S,F,A C,S,A,F S,C,A,F A,F,S,C - A. C, S, F, A Feedback The order of migration of different hemoglobins starting from the origin is C,S,F,A. Fastest towards the anode is Hemoglobin A. Effect of increased Aldosterone to sodium and potassium: Decreased Sodium; Decreased Potassium Increased Sodium; Increased Potassium Increased Sodium; Decreased Potassium NOTA - C. Increased sodium; decreased potassium Feedback Hyperaldosteronism can cause high blood pressure, low potassium levels and an abnormal increase in blood volume because of the way the hormone affects the body. It's also possible to have low levels of aldosterone. Addison's Disease, a disease that causes a general loss of adrenal function, can be a cause. Sodium and potassium always have inverse relationship. Hallmarks of this type of anemia: Formation of a fusion protein, AML1-ETO or RUNX1-RUNX1T1, due to a translocation of chromosome 8 to chromosome 21 or t(8;21): Acute Myeloid Leukemia (AML) Chronic Lymphocytic Leukemia (CLL) Acute Promyelocytic Leukemia (APL) - A. Acute Myeloid Leukemia (AML) Feedback FAB M2 is a subtype of Acute Myeloid Leukemia. It is also known as "Acute Myeloblastic Leukemia with Maturation". Standardization of Mueller-Hinton Agar? adjust pH to 7.2 adjust pH to 6.5 adjust pH to 8.5 All of the above - A. Adjust pH to 7.2 First marker to be positive in HIV infection: HIV antibody HIV RNA CD4/CD8 ratio p24 - D. p24 Feedback The p24 antigen test can detect the p24 protein on average 10 to 14 days after infection with HIV. p24 antigen is a viral protein that makes up most of the viral core. Serum concentrations of p24 antigen are high in the first few weeks after infection; tests sensitive to p24 antigen are therefore useful for diagnosing very early infection when antibody levels are still low. Which of the following pigments will deposit on urate and uric acid crystals to form a a precipitate described as "brick dust"? Urobilin Bilirubin Uroerythrin Urochrome - C. Uroerythrin Feedback Uroerythrin is a red pigment present in the urine, where it is part of a group of yellow, brown and red pigments generally designated as urochrome. Vibrio culture media: Fletcher's Agar Bismuth Sulfite Agar TCBS BAP - C. TCBS Feedback Thiosulfate-citrate-bile salts-sucrose agar, or TCBS agar, is a type of selective agar culture plate that is used in microbiology laboratories to isolate Vibrio spp. Moth balls (naphtalene) poisoning may show which of the following red cell characteristics? Howell-Jolly bodies Ovalocytes Sickle cells Heinz Bodies - D. Heinz bodies Feedback Ingestion of naphthalene-containing mothballs is a common occurrence in children. Heinz body formation, hemoglobinuria and mild methemoglobinaemia can occur due to poisoning with this substance pH 7.22, pC02: 35, H2CO3: 10 Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis - A. Metabolic acidosis Feedback Normal values: pH- 7.35-7.45 pCO2: 35-45 HCO3: 22-26 Grading of agglutination: Figure 6 1+ 2+ 3+ 4+ - D. 4+ Feedback (1+)= Fine granular appearance visually, but definite small clumps (10- 15 cells) per lower field, (2+)= Many fair large clumps with many free cells, (3+)= Three or four individual individual clumps with few free cells, (4+)= Single clump of agglutination with no free cells. What is the effect of dextran, why it is difficult to interpret in blood banking? It inhibits Anti-A and Anti-B It causes rouleaux It destroys the D antigen on red cell surface It has soluble like antigen - B. It causes rouleaux. Feedback Rouleaux- pseudoagglutination or the false clumping of erythrocytes when the cells are suspended in their own serum. This phenomenon resembles agglutination and is due to the presence of an abnormal protein, plasma expanders such as DEXTRAN or wharton's jelly from cord blood samples. An ASO test can only be valid if the controls have yielded acceptable results. Which of the following indicates valid ASO Test? Hemolysis in both SLO and red cell control Positive control, hemolysis in all tubes No hemolysis on SLO control No hemolysis on red cell contro - D. no hemolysis on red cell control Feedback For an ASO tube test to be valid, the SLO control should show hemolysis and the RBC control tube should show no hemolysis. With what leukemia is Disseminated Intravascular Coagulation (DIC) associated? M3 M1 M6 CML - A. M3 Feedback M3- Acute Promyelocytic Leukemia (T15;17). Precipitation of ribosomes and RNA: Figure 7 Heinz bodies Howell- Jolly bodies Basophilic stippling Auer rods - C. Basophilic stippling Feedback 1. Fine stippling= polychromatophilia (production of RBCs). 2. Coarse stippling= lead poisoning. What does hemoglobin F consist of? Two alpha and two beta chains Two alpha and two gamma chains Two alpha and two delta chains Four beta chains - B. 2 alpha, 2 gamma chains Specimen for blood gas analysis? Powdered EDTA Syringe with cap Citrated syringe with needle pierced on rubber stopper Heparinized syringe with needle pierced on rubber stopper - D. Heparinized syringe with needle pierced on rubber stopper Weak D: A. All antigens are present but under expressed B. Develops antibody C. A and B D. All antigens are expressed - A. All antigens are present but under expressed Cytogenetic anomaly in Acute Promyelocytic Leukemia (M3): t(9:22) t(15:17) t(8:21) None of the above - B. t(15:17) Feedback Acute promyelocytic leukemia is characterized by a chromosomal translocation involving the retinoic acid receptor-alpha gene on chromosome 17 (RARA). In 95% of cases of APL, retinoic acid receptor-alpha (RARA) gene on chromosome 17 is involved in a reciprocal translocation with the promyelocytic leukemia gene (PML) on chromosome 15, a translocation denoted as t(15;17)(q22;q12). The RAR receptor is dependent on retinoic acid for regulation of transcription. From which source are you most likely to see this parasite? Fig.8 Stool Urine Sputum Blood - B. Urine Feedback Schistosoma haematobium is an important digenetic trematode, and is found in Africa and the Middle East. It is a major agent of schistosomiasis; more specifically, it is associated with urinary schistosomiasis. Tropical sprue has the peripheral blood picture of: Malaria Thalassemia Megaloblastic anemia IDA - C. Megaloblastic Anemia Feedback Tropical sprue is a malabsorption disease commonly found in tropical regions, marked with abnormal flattening of the villi and inflammation of the lining of the small intestine. Megaloblastic anemia is a Macrocytic, Normochromic anemia. Identify the organism: Fig. 9S. Enterobius vermicularis Ascaris lumbricoides Trichinella spiralis Taenia solium - B. Ascaris lumbricoides Feedback The above shown image is a fertile egg of Ascaris lumbricoides. Ascaris lumbricoides is a roundworm, infects humans when an ingested fertilized egg becomes a larval worm (called rhabditiform larva) that penetrates the wall of the duodenum and enters the blood stream. Laboratory Results: Decreased T3, Decreased T4, Decreased TSH Secondary Hyperthyroidism Secondary Hypothyroidism Primary Hyperthyroidism Primary Hypothyroidism - B. Secondary Hypothyroidism Feedback The cause of secondary hypothyroidism is failure of the pituitary gland to secrete thyroid stimulating hormone (TSH). Encapsulated yeast seen in Diabetes Mellitus: C. albicans C. neoformans A and B NOTA - B. C. Neoformans Uncontrolled diabetics are prone to infections due to numerous factors as the glucose-rich blood serves as an excellent media for growth. Cryptococcus neoformans is an opportunistic fungus that is an important cause of CNS infections among immunocompromised patients, but it has only sporadically been reported in non-HIV-positive persons. The presence of elevated pro-inflammatory cytokines and abnormalities in numerous systemic indicators of inflammation in diabetics makes it conceivable that diabetics mount an exaggerated immune response to C. neoformans (paradoxical to their defective immune state) leading to grave outcomes. What test is use to detect Weak D? Elution Adsorption DAT IAT - D. IAT Feedback Some red cells possess the D antigen but it is expressed so weakly that the cells are not agglutinated directly by anti-D sera. An indirect antiglobulin test is necessary to identify patients with the Weak D (formerly known as Du )phenotype. Weak D testing is done on all prenatal patients and candidates for Rh immune globulin. Weak D testing is also done on Rh negative donors to ensure they are truly D negative. Alpha-1 globulin flat curve in a protein electrophoresis indicates? Multiple myeloma Inflammation Juvenile cirrhosis Nephrotic syndrome - C. Juvenile cirrhosis Feedback Juvenile cirrhosis (AAT Deficiency) exhibits alpha-1 globulin flat curve in a protein electrophoresis. Rheumatoid Factor: IgG that binds to the Fc portion of abnormal IgM IgM that binds to the Fc portion of abnormal IgG A and B None of the above - B. IgM that binds to the Fc portion of abnormal IgG If total cholesterol is 230 mg/dl, HDL is 55 mg/dl and triglycerides is 190 mg/dl, what is the concentration of LDL? 137 mg/dl 125 mg/dl 85 mg/dl 140 mg/dl - A. 137 mg/dl Feedback Friedewald formula (1972)= LDL= Total cholesterol-HDL-TAG/5 (mg/dl) 230-55-(190/5)= 137 mg/dl Which of the following methods used for HIV identification is considered a signal amplification technique? DNA PCR Reverse Transcriptase PCR Branched Chain DNA Analysis Nucleic acid sequence-based assay (NASBA) - C. Branched Chain DNA analysis. Feedback Branched DNA (bDNA) is a signal amplification technology used in clinical and research laboratories to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays. Which of the following stain is recommended for identification of Cryptococcus neoformans? Methyl red Congo red Wright stain India ink - 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. Role of a supervisor in a laboratory: Democratic Autocratic Laissez-faire All of the above - A. Democratic Feedback (Democratic)- supervisor acts according to the mutual consent and discussion or in other words he consults subordinates in the process of decision making. This is also known as participative or consultative supervision. (Autocratic)- the supervisor wields absolute power and wants complete obedience from his subordinates. He wants everything to be done strictly according to his instructions and never likes any intervention from his subordinates. (Laissez-faire)- This is also known as independent supervision. Under this type of supervision, maximum freedom is allowed to the subordinates. The supervisor never interferes in the work of the subordinates. Stomatocytes are indicative of? Fig. 10 Sideroblastic anemia Liver Disease IDA Folate deficiency - B. Liver Disease Feedback Stomatocytes can be seen with some acquired conditions such as chronic liver disease (most often due to alcoholism) or acute alcohol intoxication. Which of the following least react with Anti-H? O A2 A1 A1B - D. A1B Feedback O>A2>B>A2B>A1>A1B Lowest concentration of drug in patients blood stream: Peak Trough A and B None of the above - B. Trough Feedback The trough level is the lowest concentration in the patient's bloodstream, therefore, the specimen should be collected just prior to administration of the drug. The peak level is the highest concentration of a drug in the patient's bloodstream. Concentration of a substance is directly proportional to the amount of light absorbed or inversely proportional to the logarithm of the transmitted light: Nernst equation Beer's law Boyle's law NOTA - B. Beer's law Which of the following is best used to visualize oval fat bodies and crystals? Interference contrast Phase contrast Polarizing Bright-field - C. Polarizing Feedback Oval fat bodies contain lipids and may polarized and form maltese cross formation. They are best seen using polarizing microscope. Urinalysis result shows the following: RBC= 20-25/hpf Hyaline cast- 6-8/hpf WBC= 5-10/hpf RTE Cells: 25-35/hpf They are most likely indicative of: Glomerulonephritis Tubular necrosis Pyelonephritis Nephrotic syndrome - B. Tubular necrosis Causative agent of pseudomembranous colitis? C. perfringens C. difficile C. jejuni All of the above - B. C. Difficile Feedback Pseudomembranous colitis refers to swelling or inflammation of the large intestine (colon) due to an overgrowth of Clostridium difficile (C. difficile) bacteria. This infection is a common cause of diarrhea after antibiotic use. SC1-(37/LISS): 0 (Anti-IgG): +/- SC2-(37/LISS): 0 (Anti-IgG): +/- Use polyspecific AHG Report as Negative Report as Positive NOTA - A. Use polyspecific AHG Feedback Since most incomplete antibodies are IgG, polyspecific AHG serum contains anti-IgG. Because some IgG and IgM antibodies also cause C3 to attach to red cells, polyspecific AHG serum also contains anti-C3, which can cause C3- coated red cells to agglutinate A gram stain from a blood agar shows gram positive cocci in chains, non- hemolytic. The bacteria grow on 6.5% NaCl and is Bile Esculin positive. What's the most likely identification? Group D streptococcus Enterococcus Streptococcus pyogenes Micrococcus - B. Enterococcus Feedback Only Enterococcus can grow both 6.5% NaCl and Bile Esculin Causative agent of Eye conjunctivitis: C. trachomatis H. ducreyi L. monocytogenes T. pallidum - A. C. trachomatis Feedback Chlamydial conjunctivitis is treated with both antibiotic pills and eyedrops or ointment to kill the chlamydia in your body. Your sexual partner must also be treated. Usually you will get better after taking the antibiotics for 3 to 4 weeks. Treatment for a newborn is antibiotic ointment and IV antibiotics. Polycythemia vera mutation? ADAMS JAK2 Rpp Bcl/BCR - B. JAK2 Feedback Approximately 95% of all PV patients have a mutation of the JAK2 gene in their blood-forming cells. This mutation leads to hyperactive JAK (Janus kinase) signaling, causing the body to make the wrong number of blood cells. Which of the following antigen/s is enhanced by enzymes? Kidd, Rh Lewis, P ABO All of the abov - A. All of the above Feedback: (KLARP) Kidd, Lewis, ABO, Rh and P antigens are enhanced by enzymes, MNS and Duffy antigens are destroyed by enzymes. What is measured in the urease method determination of BUN? Uricase Urea NAD Nitrogen - C. NAD Feedback Nicotinamide Adenine Dinucleotide (NAD) is being measured in the final step of urease method determination of BUN, it is measured at 340nm. It is sometimes referred to as the "pork worm" due to it being typically encountered in undercooked pork products: Fig 11 Trichinella spiralis Trichuris trichiura Enterobius vermicularis Taenia saginata - A. Trichinella spiralis In HIV: Increased Total Lymphocyte Increased CD8 Decreased CD4 Normal CD8/CD4 - C. Decreased CD4 Feedback A very low CD4 count (less than 200 cells/mm3) is one of the ways to determine whether a person living with HIV has progressed to stage 3 infection (AIDS). After checking the inventory, it was noted that there were no units on the shelf marked "May Issue as uncrossmatched: For Emergency only". Which of the following should be placed on this shelf? 2 units of each of the ABO Blood groups 1 unit of group O, Rh positive whole blood Any units that are expiring within the day Units of group O, Rh-negative Red Blood Cells. - D. Units of group O, Rh- negative RBCs Feedback For emergency transfusions, group O negative RBC units should be used. Accumulation of glucocerebroside, wrinkled/crumples cytoplasm (chicken scratch): Tay Sach' disease Gaucher's disease Sandhoff's disease Sea blue histiocytosis - B. Gaucher's disease Feedback Gaucher's disease is a genetic disorder in which glucocerebroside (a sphingolipid, also known as glucosylceramide) accumulates in cells and certain organs. Reference ranges is performed in a new methodology to: To test instrument precision To test instrument accuracy To assess control ranges All of the above - A. To test instrument precision Which of the following laboratory test is most likely to be affected if the streptokinase therapy on a patient has failed? Platelet aggregation studies D-dimer Test Concentration of Vitamin K dependent factors Substitution studies - B. D dimer Test Feedback Streptokinase is a fibrinolytic agent and will cause D-dimer to elevate Description of Zygomycetes: Septate hyphae with basidiospores Septate hyphae with sporangiospores Aseptate hyphae with sporangiospores Aseptate hyphae with basidiospores - C. Aseptate hyphae with sporangiospores SSA (+); Protein reagent strip: (-): Presence of protein other than albumin False positive result False negative result Specimen too old - A. Presence of protein other than albumin The anemias of the qualitative hemoglobinopathies, such as sickle cell anemia, are morphologically classified as: Microcytic, hypochromic Macrocytic, normochromic Normocytic, normochromic NOTA - C. Normocytic, normochromic Type 1 hypersensitivity reactions are due to: Release of mediator Cytolysis due to antibody Deposits of Ag-Ab complex AOTA - A. Release of mediator Feedback Type I hypersensitivity is also known as Immediate Anaphylactic. Some examples are: anaphylaxis, hay fever, food allergies, asthma and bee sting. Type I hypersensitivity immune mediator is IgE. A 2 year old child with decreased serum T4 is described as being somewhat dwarfed, stocky, overweight and having coarse features. Of the following, the most informative additional laboratory test would be the serum: Cholesterol Triiodothyronine (T3) Thyroid-Stimulating Hormone (TSH) Thyroxine-Binding Globulin (TBG) - C. Thyroid- Stimulating Hormone (TSH) Lifetime marker of HBV infection: Anti-HBc Anti-HBs HbsAg HbcAg - A. Anti-HBc Feedback Anti-HBc is considered a sensitive lifetime marker of HBV infection. Anthropophilic; exhibits antler "NAIL HEAD" hyphae also known as "FAVIC CHANDELIER": Trichophyton mentagrophytes Trichophyton schoenleinii Trichophyton rubrum All of the above - B. Trichophyton schoenleinii Feedback Microscopic morphology of Trichophyton schoenleinii exhibits antler NAIL HEAD hyphae aka FAVIC CHANDELIER. Which of the following can cause false DECREASE in ESR? Macrocytes Tilting of tube Vibration Delay in set up - D. Delay in set up Feedback FALSE INCREASED RATE: Tube tilted (not vertical), Vibration of tube during test, Test > 1hr, Improper blood dilution, Improper mixing of blood and room temperature >25C. FALSE DECREASED RATE: Low temperature of blood, air bubbles in tube, Test <1 hr, Improper blood dilution, improper mixing of blood, room temperature <20C. Azotemia is increase in? BUN Creatinine Ammonia Uric Acid - A. BUN Feedback Azotemia is a medical condition characterized by abnormally high levels of nitrogen containing compounds. Select the best/acceptable donor for blood donation: Patient that received a transfusion 8 months ago Woman that gave birth 4 weeks ago Man that donated blood 10 weeks ago Patient with Hgb: 11 g/dl - C. Man that donated blood 10 weeks ago Feedback Only choice C is qualified for blood donation, the interval between donations of whole blood is eight weeks (56 days). Case analysis: A sample for Complete Blood Count (CBC) was received at the laboratory and was collected in EDTA tube (violet top), the reading for hematocrit was 68%, what should the MLS do next? Add anticoagulant Reduce anticoagulant Ask for a new specimen Report the results - D. Report the results Feedback The patient could be a baby, thus high hematocrit. 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 - 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 - 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. Cushing Syndrome exhibits which of the following: Hypoglycemia Hyperglycemia Hypercalcemia Hyponatremia - B. Hyperglycemia Feedback In Cushing Syndrome, there is an increase in cortisol which promotes glycogenolysis which is the breakdown of glycogen to glucose. Clinical signs of Cushing syndrome: Moon Face and Buffalo hump on the shoulder Calculate for the % Saturation: UIBC- 185 Fe- 125 80% 50% 40% 30% - C. 40% Feedback First we need to find TIBC, the formula for TIBC is, TIBC= UIBC+Fe, so TIBC= 185+125= 310, next compute for the % Saturation= serum iron/TIBCx100, thus, %Saturation= (125/310)x 100= 40%. The manual eosinophil count by hemocytometer is also called: Thorn test Direct absolute eosinophil count Relative eosinophil count Indirect absolute eosinophil count - B. Direct absolute eosinophil count Feedback It is possible to get direct eosinophil count. The direct method is quick and gives exact value of eosinophil. In this method the blood is diluted to 1:10 with a special diluting fluid. The diluted blood specimen is then charged in the counting chamber and the number of eosinophil are counted usually under 10 × or high power (45×). What test is used to monitor unfractionated heparin therapy? APTT PT drvvt TT - A. APTT Feedback APTT is used to monitor unfractionated heparin therapy. Reactive monocytosis is seen in: Tuberculosis Allergic reaction Hypersensitivity Infectious mononucleosis - 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. Aman medium contains which of the following? Nile blue Cotton blue Victoria blue Toluidine blue - B. Cotton blue Feedback Aman medium contains lactophenol blue. It contains lactic acid, phenol, and aniline blue (cotton blue). It is an excellent mounting medium for most fungi. It preserves and stains fungi with shades of blue. A urine specimen was kept in refrigerator over night (10 degrees). Glucose level is 1000 mg/dl. Specific gravity is 1.020. What should the MLS do? Correct for temperature Correct for glucose Ask for new specimen Do nothing, report the results - A. Correct for temperature Feedback High protein, glucose and bilirubin levels can elevate the specific gravity. Low temperature may decrease the sensitivity of the test What is the purpose of Protein S and Protein C? Act as a natural anticoagulant Activates protein coagulants Activates fibrinolytic system All of the above - A. Act as a natural anticoagulant Feedback Proteins C and S are two vitamin K-dependent plasma proteins that work in concert as a natural anticoagulant system. Activated protein C is the proteolytic component of the complex and protein S serves as an activated protein C binding protein that is essential for assembly of the anticoagulant complex on cell surfaces. Uncompetitive inhibition: The inhibitor binds the enzyme-substrate complex The inhibitor binds to the allosteric site The inhibitor competes with the substrate towards the active site in an enzyme NOTA - A. The inhibitor binds the enzyme-substrate complex Feedback Uncompetitive inhibition, also known as anti-competitive inhibition, takes place when an enzyme inhibitor binds only to the complex formed between the enzyme and the substrate (the E-S complex). Which of the following is known as the metabolite of cocaine? Metanephrines Benzoylecgonine Morphine Benzenamine - B. Benzoylecgonine Feedback Benzoylecgonine is the compound tested for in most substantive cocaine urinalyses. It is the corresponding carboxylic acid of cocaine, its methyl ester. It is formed in the liver by the metabolism of cocaine. Which of the following is associated with Alder-Reilly inclusions? Two-lobed neutrophils Mucopolysaccharidosis Membrane defect of lysosomes Dohle bodies and giant platelets - B. Mucopolysaccharidosis Feedback The Alder-Reilly anomaly is seen in the mucopolysaccharidoses. The most characteristic finding is the metachromatic granules surrounded by a clear zone seen in lymphocytes. Dense granules, resembling toxic granulation in neutrophils, are seen in all leukocytes. Leptospira culture media: Fletcher TCBS MAC EMBC - A. Fletcher Increased growth rate (cell division), Susceptible to antimicrobial agents: Stationary/Plateau phase Lag Phase Log/Exponential Phase Decline Phase - C. Log/exponential phase Macrocytes typically seen in megaloblastic anemia are: Tear drop shaped Ovalocytes Target cells AOTA - B. Ovalocytes Feedback Megaloblastic anemia is an anemia (of macrocytic classification) that results from inhibition of DNA synthesis during red blood cell production. When DNA synthesis is impaired, the cell cycle cannot progress from the G2 growth stage to the mitosis (M) stage. Anti IgG (+); C3d (+): What should the MLS do? Elution IAT DAT Pre-warm - A. Elution Feedback In blood bank world, the term "Elution" refers to removing (or "dissociating") an antibody that is attached to the surface of a red blood cell. This procedure is most commonly used in identification of complicated antibodies, sometimes in the workup of transfusion reactions or hemolytic disease of the newborn, as well as in the workup of warm autoantibodies. Which of the following will be the first to increase after Myocardial Infarction (MI) LD CK-MB Myoglobin Troponin I - C. Myoglobin Feedback Myoglobin is a small, oxygen-binding protein found in heart and skeletal muscle. When heart or skeletal muscle is injured, myoglobin is released into the blood. Blood levels of myoglobin can rise very quickly with severe muscle damage and can be measured within a few hours following an injury. Which of the following is the preferred culture media for Legionella pneumophilia? Regan Lowe Agar Buffered Charcoal Yeast Extract (BCYE) Agar Celsulodin Irgasan Novobiocin (CIN) Agar Chocolate Agar - B. Buffered Charcoal Yeast Extract (BCYE) agar Feedback Buffered charcoal yeast extract agar is a selective growth medium used to culture or grow certain bacteria, particularly the Gram-negative species Legionella pneumophila. It has also been used for the recovery of Acanthamoeba keratitis. What plasma level is decrease in hyperglycemia? Sodium Calcium Potassium Magnesium - A. Sodium Feedback Hyperglycemia causes osmotic shifts of water from the intracellular to the extracellular space, causing a relative dilutional hyponatremia Thrombocytosis: 1,000 x 10^9/L, functionally abnormal platelets: Essential thrombocythemia Polycythemia vera Absolute thrombocythemia NOTA - A. Essential thrombocytopenia Feedback Essential thrombocythemia is an uncommon disorder in which your body produces too many blood platelets but functionally abnormal. This condition may cause you to feel fatigued, lightheaded and to experience headaches and vision changes. It also increases your risk of blood clots. Which of the following patients is most at risk for hyperosmolar non-ketotic coma? A 70 year old, Type 2 diabetic patient A 30 years old, Type 2 diabetic patient A 40 years old hypertensive patient AOTA - A. A 70 year old, Type 2 diabetic patient Feedback Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. The main risk factor is a history of diabetes mellitus type 2. Older people are most commonly affected. Which of the following Plasmodium would least likely show the presence of trophozoites and schizonts in the peripheral blood? P. malariae P. vivax P. falciparum P. ovale - P. Falciparum Feedback It is unusual to see mature trophozoites or schizonts of P. falciparum in the peripheral blood smears, as these are usually sequestered in the tissues Patient comes with lesion on the arm. Mold Form: flowerette/daisy like conidia Yeast Form: Cigar-shaped (asteroid) bodies Sporothrix schenckii Trichophyton mentagrophytes Tricophyton rubrum Piedraia hortae - A. Sporothrix sschenckii Feedback S. schenckii causative agent of Rose Gardener's disease (cord-like multiple subcutaneous nodules). Production of abnormally small amounts of urine: Anuria Oliguria Polyuria Aminoaciduria - B. Oliguria Feedback Oliguria is clinically classified as an output more than 80 ml/day but less than 400ml/day. Anuria is clinically defined as less than 50mL urine output per day. Polyuria is a condition usually defined as excessive or abnormally large production or passage of urine. Sodium Flouride as anticoagulant: Binds antithrombin Prevents glycolysis No effect at all NOTA - B. Prevents glycolysis Feedback Sodium Flouride acts as an glycolysis inhibitor. Which ionophore is used in potassium electrode? Copper Valinomycin Glass Flouride - B. Valinomycin Feedback Valinomycin is ionophore used in potassium electrode A patient has increased serum calcium but normal parathyroid hormone levels. This can be associated with: Parathyroid carcinoma Metastatic carcinoma Hypoproteinemia Parathyroid metaplasia - B. Metastatic carcinoma Feedback Local bone metastases induced osteoclastic activity causes bone resorption, raising calcium levels in the blood. Which of the following below shows "identity pattern" in an Ouchterlony Double Diffusion? Fig 13 A B C NOTA - A Feedback The antibodies in the antiserum react with both the antigens resulting in a smooth line of precipitate. The antibodies cannot distinguish between the two antigens. i.e., the two antigens are immunologically identical. Two consecutive values in which they are in the +2SD of the same mean or in the - 2SD of the same mean: 2:2s 10:x 1:2s R:4s - A. 2:2s Feedback 2(2s) is a Westgard multirule that indicates a reject of a run when 2 consecutive control observations are on the same side of the mean and exceed either the mean plus 2s or mean minus 2s. Anti-A= 4+ Anti-B= 4+ Weak D= 2+ Rh control= 0 A cells= 0 B cells= 0 ABO grouping is wrong Rh grouping is wrong Rh control is wrong Do nothing, interpret the results - D. Do nothing, interpret the results Biochemical reaction: Bile esculin positive 6.5% NaCl negative Streptococcus bovis Streptococcus pneumoniae Enterococcus faecalis Enterococcus faecium - A. Streptococcus bovis Feedback 6.5% NaCl test along with Bile-Esculin test, is used in many laboratories to distinguish Enterococcus species from the group D streptococci, Streptococcus bovis and Streptococcus lactis. Absorbs light and emit at longer wavelength: Fluorometer Nephelometer AAS TLC - A. Fluorometer Feedback A fluorometer or fluorimeter is a device used to measure parameters of fluorescence: its intensity and wavelength distribution of emission spectrum after excitation by a certain spectrum of light. These parameters are used to identify the presence and the amount of specific molecules in a medium. Modern fluorometers are capable of detecting fluorescent molecule concentrations as low as 1 part per trillion This catalase positive, gram positive bacilli with diptheroid morphology is highly resistant to many antibiotics and is associated with immunocompromised patients. C. jeikeium L. monocytogenes C. diptheriae E. rhusiopathiae - C. diptheriae Feedback The principal features of the Corynebacterium genus were described by Collins and Cummins in 1986. They are gram-positive, catalase-positive, nonspore-forming, nonmotile, rod-shaped bacteria that are straight or slightly curved Metachromatic granules are usually present representing stored phosphate regions. Carbon Dioxide in ISE measures: CO2- pressure CO2- content pH HCO3 - 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 - 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. The best diagnostic test for excessive alcoholic consumption: AST ALP GGT ALT - C. GGT Feedback GGT can be used to screen for chronic alcohol abuse (it will be elevated in about 75% of chronic drinkers) and to monitor for alcohol use. Eosinophils in LAP (Leukocyte Alkaline Phosphatase) score: Not counted Double the value Constant value None of the above - A. Not counted Feedback Eosinophils do not show alkaline phosphatase activity and must not be counted. Gall bladder surgery: PT: Normal APTT: Increase What to do next? Factor XII Test Factor VIII Test Dilute RVVT Factor IX Test - A. Factor XII test Feedback The plasma mixing test is the cornerstone test for the initial differential diagnosis of persistent and isolated aPTT prolongation; corrected cases suggest factor deficiency, while uncorrected cases suggest the presence of an inhibitor, such as lupus anticoagulant . We examined the cause of isolated aPTT prolongation in cancer patients before cancer surgery. Most patients with isolated aPTT prolongation who were scheduled for cancer surgery had factor deficiency (88.8%), primarily factor XII (75.0%). (NCBI) Causative agent of "Cat scratch disease"? Pasteurella multocida Bartonella henselae Afipia felis Pleisomonas - B. Bartonella henselae Feedback Bartonella henselae, formerly Rochalimaea, is a proteobacterium that can cause bacteremia, endocarditis, bacillary angiomatosis, and peliosis hepatis. It is also the causative agent of cat-scratch disease (bartonellosis) which, as the name suggests, occurs after a cat bite or scratch. The disease is characterized by lymphadenopathy (swelling of the lymph nodes) and fever. Sputum sample has 25 PMN cells, 10 epithelial cells on HPO, in oil immersion bacteria and fungi were seen, what to do? Culture bacteria only Culture fungi only Culture both bacteria and fungi Reject specimen - C. Culture both bacteria and fungi Feedback The specimen meets the criteria for a good specimen, culturing both bacteria and fungi would be the best answer. The extrinsic system of coagulation is monitored by which test? Activated Partial Thromboplastic Time (APTT) Prothrombin time (PT) Fibrinogen assay Thrombin Time (TT) - B. PT Feedback PT is used to monitor Extrinsic system. Factor VII is under extrinsic system. Portwine urine color: Antibiotics intake Cola intake Bilirubinemia Porphyria - D. Porphyria Feedback In acute intermittent porphyria, the substrate porphobilinogen will accumulate in urine. It spontaneously polymerizes to coporphobilinogen in urine giving urine port-wine color. An antiepileptic (or anticonvulsant) used to control seizure disorders is: Acetaminophen Lithium Phenytoin Digoxin - C. Phenytoin Feedback Phenytoin is an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. Phenytoin is used to control seizures Sezary syndrome: Monocytes B-cells lymphoproliferative T-cells lymphoproliferative Basophils - C. T-cells lymphoproliferative Feedback Sezary syndrome is an aggressive form of a type of blood cancer called cutaneous T-cell lymphoma. Rouleaux is undetectable at what phase? AHG IS Room temp All of the above - A. AHG Feedback Rouleaux is not detectable at AHG phase due to serum being washed away. On an automated instrument: Hgb=45 g/dl Hct=33% The technologist does a manual Hct and the result is 33.5%. What should the MLS do next? Repeat all Ask for new specimen Report the manual results and original Hgb result Check for lipemia - D. Check for lipemia Routine rotavirus detection can be done with? EIA Electron microscopy Shell Vial culture None of the above - A. EIA A yellow colony from a wound culture tested catalase-positive and coagulase negative. The organism stained as gram-positive cocci in clusters. Which of the following tests would differentiate between a coagulase-negative Staphylococcus and Micrococcus? Novobiocin susceptibility Furazolidone (100 ug/disk) susceptibility Bile esculin Leucine aminopeptidase production - B. Furazolidone (100 ug/disk) susceptibility Feedback Micrococcus and Staphylococcus can be differentiated by susceptibility to furazolidone (100 ug/disk). Staphylococcus is susceptible and Micrococcus is resistant. Transudates are usually: Purulent Has bacteria Non inflammatory All of the above - C. Non inflammatory Feedback Transudates are clear and translusent thus, eliminating choices A and B. Which of the following laboratory tests can differentiate Pseudomonas aeruginosa from Pseudomonas putida? Flagella Oxidase production Growth at 42 degrees celsius Pyoverdin production - C. Growth at 42 degrees celsius Feedback P. aeruginosa had the widest range of growth temperature (25-42C) Cause of false negative ABO typing: Rouleaux Positive DAT 37C LISS - B. Positive DAT Feedback A positive DAT means that there are antibodies attached to the RBCs, thus giving false negative results. Excessively blue stain causes: Prolonged staining time Inadequate washing Too high alkalinity of stain AOTA - D. AOTA Which of the following anemia exhibits pancytopenia? Aplastic anemia Pernicious anemia Megaloblastic anemia Iron Deficiency anemia - A. Aplastic anemia Feedback Aplastic anemia is a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged. This causes a deficiency of all three blood cell types (pancytopenia): red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia).