ACE ASCP FINAL EXAM 2023-2024 ACTUAL EXAM
2 LATEST VERSIONS 280 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW!!
VERSION A
Which of the following disorders is associated with Dohle bodies and giant
platelets
A. Alder-Reilly anomaly
B. Chediak Higashi syndrome
C. May-Hegglin anomaly
D. Pelger-Huet anomaly – ANSWER- C. May-Hegglin anomaly
Rationale: May-Hegglin anomaly (MHA) is an autosomal dominant disorder
characterized by various degrees of thrombocytopenia that may be associated with
purpura and bleeding; giant platelets containing few granules; and large, welldefined, basophilic, cytoplasmic inclusion bodies in granulocytes that resemble
Dohle bodies
An antiepileptic (or anticonvulsant) used to control seizure disorders is
A. Acetaminophen
B. Lithium
C. Phenytoin
D. Digoxin – ANSWER- C. Phenytoin<\/p>\n\n\n\n
Rationale: Phenytoin is an antiepileptic drug, also called an anticonvulsant. It
works by slowing down impulses in the brain that cause seizures. Phenytoin is
used to control seizures
What test is used to monitor unfractionated heparin therapy
A. APTT
B. PT
C. drvvt
D. TT – ANSWER- A. APTT
Zollinger-Ellison (Z-E) syndrome is characterized by great (for example, 20 fold)
elevation of the level of
A. Pepsin
B. Gastrin
C. Glucagon
D. Cholecystokinin – ANSWER- B. Gastrin
Rationale: Zollinger-Ellison syndrome (ZES) is caused by a non-beta islet cell,
gastrin-secreting tumor of the pancreas that stimulates the acid-secreting of the
stomach to maximal activity, with consequent gastrointestinal mucosal ulceration
Which of the following is a quantitative assay for fecal fat
A. H2O2
B. NADH
C. Sudan Black
D. Weighing and extraction – ANSWER- D. Weighing and extraction
Rationale: The quantitative test involves drying and weighting a 72-hour stool
specimen, then using an extraction technique to separate the fats, which are
subsequently evaporated and weighed. This measurement of the total output of<\/p>\n\n\n\n
fecal fat per 24 hours in a three-day specimen is the most reliable test for
steatorrhea.
Bilirubin crystals – ANSWER- Bilirubin crystals along with Tyrosine and Leucine
crystals seen\/indicative of liver disease
Anti IgG (+); C3d (+); what should the MLS do?
A. Elution
B. IAT
C. DAT
D. Pre-warm – ANSWER- A. Elution
Rationale: In the 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
Sezary syndrome
A. Monocytes
B. B-cells lymphoproliferative
C. T-cells lymphoproliferative
D. Basophils – ANSWER- C. T-cells lymphoporliferative
Rationale: Sezary syndrome is an aggressive form of a type of blood cancer called
cutaneous T-cell lymphoma
17-Ketosteroids is produced in the
A. Adrenal glands
B. Hypothalamus<\/p>\n\n\n\n
C. Thyroid gland
D. Pituitary gland – ANSWER- A. Adrenal glands
Rationale: 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
Which of the following least react with Anti-H
A. O
B. A2
C. A1
D. A1B – ANSWER- D. A1B
Rationale: O>A2>B>A2B>A1>A1B
In calibrating a centrifuge, one should use a
A. Tachometer
B. Barometer
C. Revulometer
D. Nanometer – ANSWER- A. Tachometer
Rationale: Centrifuges are calibrated using a tachometer and a stopwatch
Which of the following test is used to screen Chronic Granulomatous Disease
(CGD)
A. Ham’s acidified serum test
B. NBT (Nitroblue Tetrazolium) Dye Test
C. G6Pd Florescent Screening Test
D. AOTA – ANSWER- B. NBT (Nitroblue Tetrazolium) Dye Test<\/p>\n\n\n\n
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<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following enzymes has the longest elevation after Myocardial Infarction (MI)?<\/p>\n\n\n\n
CK-MB<\/p>\n\n\n\n
Myoglobin<\/p>\n\n\n\n
Troponin<\/p>\n\n\n\n
AOTA
C. Troponin<\/p>\n\n\n\n
Troponin is elevated up to 10-14 days after Myocardial Infarction.<\/p>\n\n\n\n
Lactic acid specimen:<\/p>\n\n\n\n
Chilled and separated from cells<\/p>\n\n\n\n
Heated<\/p>\n\n\n\n
Room temperature<\/p>\n\n\n\n
Request EDTA sample only
A. Chilled and separated from cells<\/p>\n\n\n\n
Feedback Special Handling: No tourniquet. Place on ice immediately and deliver to lab or aliquot within 15 minutes. DO NOT FREEZE WHOLE BLOOD SPECIMEN.<\/p>\n\n\n\n
Specific gravity measured by refractometer: 1.035. Protein and glucose both trace in reagent strip:<\/p>\n\n\n\n
Presence X-ray medium<\/p>\n\n\n\n
Albuminuria<\/p>\n\n\n\n
Glucosuria<\/p>\n\n\n\n
Normal
A. Presence X-Ray medium<\/p>\n\n\n\n
Feedback Xray medium\/Radiographic dye can cause erroneous results in urine specific gravity measurement.<\/p>\n\n\n\n
A patient with walking pneumonia is being treated with penicillin. State one possible condition why the patient is not recovering:<\/p>\n\n\n\n
The organism produces beta lactamase<\/p>\n\n\n\n
The organism has no cell wall<\/p>\n\n\n\n
The organism has capsule<\/p>\n\n\n\n
The organism produces an enzyme that neutralizes the antibiotic
B. The organism has no cell wall.<\/p>\n\n\n\n
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).<\/p>\n\n\n\n
What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48?<\/p>\n\n\n\n
2.75<\/p>\n\n\n\n
6.09<\/p>\n\n\n\n
5.68<\/p>\n\n\n\n
30
B. 6.09<\/p>\n\n\n\n
Feedback:
CV= SD\/meanX100,
(5.48\/90)X100= 6.09.<\/p>\n\n\n\n
Blood smear below denotes Hairy Cell Leukemia (HCL), which of the following test is used to identify this type of leukemia?
Image. 1
Myeloperoxidase<\/p>\n\n\n\n
Tartrate-resistant acid phosphatase<\/p>\n\n\n\n
Tartrate-resistant alkaline phosphatase<\/p>\n\n\n\n
Sudan Black
B. Tartrate-resistant acid phosphatase<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Use to differentiate Salmonella from Citrobacter:<\/p>\n\n\n\n
Lysine decarboxylase<\/p>\n\n\n\n
ONPG<\/p>\n\n\n\n
Indole<\/p>\n\n\n\n
Vogues Proskauerterm-9
A. Lysine decarboxylase<\/p>\n\n\n\n
Feedback:
Salmonella (+); Citrobacter (-)<\/p>\n\n\n\n
Arrange the common Rh antigens according to immunogenicity (greatest to least):<\/p>\n\n\n\n
D>c>E>C>e<\/p>\n\n\n\n
D>C>E>c>e<\/p>\n\n\n\n
D>c>E>e>C<\/p>\n\n\n\n
C>D>c>E>e
A. D>c>E>C>e<\/p>\n\n\n\n
Feedback Most immunogenic D > c > E > C > e least immunogenic.<\/p>\n\n\n\n
Most common error in Polymerase Chain Reaction (PCR) is NUCLEIC ACID CONTAMINATION.
A True (Correct Answer)
B False
A. True<\/p>\n\n\n\n
What disease is associated with the possession of HLA-B27?<\/p>\n\n\n\n
Ankylosing spondylitis<\/p>\n\n\n\n
Hashimoto’s Disease<\/p>\n\n\n\n
Goodpasture’s syndrome<\/p>\n\n\n\n
SLE
A. Ankylosing spondylitis<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Burr cells are seen in the peripheral blood smear, this is indicative of? (Fig. 2)<\/p>\n\n\n\n
Uremia (Kidney Disease)<\/p>\n\n\n\n
Anemia<\/p>\n\n\n\n
Leukemia<\/p>\n\n\n\n
Liver Disease
A. Uremia (kidney Disease)<\/p>\n\n\n\n
Feedback:<\/p>\n\n\n\n
The above shown picture illustrates Burr cells, these cells are indicative of Uremia (kidney disease)<\/p>\n\n\n\n
Anti IgG (-); C3d (+): What should the MLS do?<\/p>\n\n\n\n
Elution<\/p>\n\n\n\n
IAT<\/p>\n\n\n\n
DAT<\/p>\n\n\n\n
Pre-warm
D. Pre-warm<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Maximum interval which a recipient sample maybe used for crossmatching if the patient has been recently transfused, has been pregnant?<\/p>\n\n\n\n
2 days<\/p>\n\n\n\n
6 days<\/p>\n\n\n\n
3 days<\/p>\n\n\n\n
NOTA
C. 3 days<\/p>\n\n\n\n
CIN (Cefsulodin, Irgasan, Novobiocin) Agar is a recommended culture medium for the recovery of:<\/p>\n\n\n\n
Rhodococcus equi<\/p>\n\n\n\n
Cardiobacterium hominis<\/p>\n\n\n\n
Brucella suis<\/p>\n\n\n\n
Yersinia enterocolitica
D. Yersinia enterocolitica<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
What is the formula for sensitivity?<\/p>\n\n\n\n
TP\/(TP+FN)x100<\/p>\n\n\n\n
TP\/(TP+FP)x100<\/p>\n\n\n\n
(TP+FN)\/TPx100<\/p>\n\n\n\n
(TP+FP)\/TNx100
A. TP\/(TP+FN)x100<\/p>\n\n\n\n
CThe anemias of the qualitative hemoglobinopathies, such as sickle cell anemia, are morphologically classified as:<\/p>\n\n\n\n
Microcytic, hypochromic<\/p>\n\n\n\n
Macrocytic, normochromic<\/p>\n\n\n\n
Normocytic, normochromic<\/p>\n\n\n\n
NOTA
C. Normocytic, normochromic<\/p>\n\n\n\n
According to AABB standards, Fresh Frozen Plasma (FFP) must be infused within what period of time following thawing?<\/p>\n\n\n\n
24 hrs<\/p>\n\n\n\n
36 hrs<\/p>\n\n\n\n
48 hrs<\/p>\n\n\n\n
72 hrs
A. 24 hours<\/p>\n\n\n\n
A woman having menstrual cycle would have the ff. result:<\/p>\n\n\n\n
Increased TIBC<\/p>\n\n\n\n
Increased Ferritin<\/p>\n\n\n\n
Increase % Saturation<\/p>\n\n\n\n
Normal Transferrin
A. Increased TIBC<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Causative agent of “Cat bite fever”<\/p>\n\n\n\n
Pasteurella multocida<\/p>\n\n\n\n
Actinomyces israelii<\/p>\n\n\n\n
Bartonella henselae<\/p>\n\n\n\n
Leptospira interrogans
A. Pasteurella multocida<\/p>\n\n\n\n
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 \u03b2-hemolytic Streptococcus pyogenes infections.<\/p>\n\n\n\n
What is the sugar fermented by Staphylococcus aureus?<\/p>\n\n\n\n
Mannitol<\/p>\n\n\n\n
Sucrose<\/p>\n\n\n\n
Glucose<\/p>\n\n\n\n
Maltose
A. Mannitol<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Identify the organism: Fig. 3<\/p>\n\n\n\n
Blastomyces dermatitidis<\/p>\n\n\n\n
Malasezia furfur<\/p>\n\n\n\n
Alternaria<\/p>\n\n\n\n
Candida albicans
A. Blastomyces dermatitidis<\/p>\n\n\n\n
Feedback The above image show broad base budding.<\/p>\n\n\n\n
What is the first step in agglutination?<\/p>\n\n\n\n
Sensitization<\/p>\n\n\n\n
Precipitation<\/p>\n\n\n\n
Diffusion<\/p>\n\n\n\n
Lattice formation
A. Sensitization<\/p>\n\n\n\n
Feedback Agglutination involves two process: First, sensitization or initial binding. Second, lattice formation or formation of large aggregates.<\/p>\n\n\n\n
Sterilization of autoclave:<\/p>\n\n\n\n
121\u00b0C at 20 lbs\/psi for 30 minutes<\/p>\n\n\n\n
121\u00b0C at 15 lbs\/psi for 15 minutes<\/p>\n\n\n\n
85\u00b0C for 15 lbs\/psi 30 minutes<\/p>\n\n\n\n
100\u00b0C for 20 lbs\/psi 50 minutes
B. 121\u00b0C at 15 lbs\/psi for 15 minutes<\/p>\n\n\n\n
Feedback Many autoclaves are used to sterilize equipment and supplies by subjecting them to high-pressure saturated steam at 121\u00b0C (249 \u00b0F) for around 15-20 minutes depending on the size of the load and the contents.<\/p>\n\n\n\n
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?<\/p>\n\n\n\n
15,000\/ul<\/p>\n\n\n\n
24,700\/ul<\/p>\n\n\n\n
27,300\/ul<\/p>\n\n\n\n
12,500\/ul
B. 24,700\/ul
Feedback Corrected WBC count= Uncorrected WBC count x100\/nRBCs+100: Thus, (37,000ulx100\/50+100= 24,700ul)<\/p>\n\n\n\n
Gram positive bacilli; non-motile; non-hemolytic; catalase positive; spore forming:<\/p>\n\n\n\n
B. anthracis<\/p>\n\n\n\n
B. cereus<\/p>\n\n\n\n
N. meningitidis<\/p>\n\n\n\n
N. lactamica
B. B. anthracis<\/p>\n\n\n\n
Feedback Important distinguishing characteristics between B. anthracis and B. cereus is motility, B. anthracis is non motile while B. cereus is motile.<\/p>\n\n\n\n
Hair perforation test\/Hair baiting test is for identification of which two fungi?<\/p>\n\n\n\n
Aspergillus niger and A. japonicus<\/p>\n\n\n\n
Tinea pedis and T. corporis<\/p>\n\n\n\n
Trichophyton mentagrophyte and T. rubrum<\/p>\n\n\n\n
C. albicans and C. tropicalis
C. Trichophyton mentagrophyte and T. rubrum<\/p>\n\n\n\n
Feedback Trichophyton mentagrophyte is positive and T. rubrum is negative<\/p>\n\n\n\n
What is the minimum platelet count before you perform apheresis?<\/p>\n\n\n\n
500<\/p>\n\n\n\n
200<\/p>\n\n\n\n
150<\/p>\n\n\n\n
250
C. 150.<\/p>\n\n\n\n
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<\/p>\n\n\n\n
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:<\/p>\n\n\n\n
Leptospira<\/p>\n\n\n\n
Actinobacillus<\/p>\n\n\n\n
Capnocytophaga<\/p>\n\n\n\n
Chlamydia
C. Capnocytophaga<\/p>\n\n\n\n
Feedback The term Capnocytophaga comes from “Capno” for its dependence on CO2 and “cytophaga” for its flexibility and mobility shift (” gliding motility “).<\/p>\n\n\n\n
Urine with an specific gravity consistently between 1.002 and 1.003 indicates:<\/p>\n\n\n\n
Acute glomerulonephritis<\/p>\n\n\n\n
Renal tubular failure<\/p>\n\n\n\n
Addison’s disease<\/p>\n\n\n\n
Diabetes insipidus
D. Diabetes insipidus<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Primidone monitoring: suspected to have primidone overdose, but the serum concentration is within the normal range, what should the MLS do next?<\/p>\n\n\n\n
Measure procainamide concentration<\/p>\n\n\n\n
Measure phenobarbital concentration<\/p>\n\n\n\n
Measure phenytoin concentration<\/p>\n\n\n\n
Eliminate primidone overdose as possible diagnosis
B. Measure phenobarbital concentration<\/p>\n\n\n\n
Feedback Primidone is a structural analog of phenobarbital.<\/p>\n\n\n\n
Postprandial turbidity of the serum is due to the presence of?<\/p>\n\n\n\n
Fatty acid<\/p>\n\n\n\n
Cholesterol<\/p>\n\n\n\n
Phospholipid<\/p>\n\n\n\n
Lipoproteins
D. Lipoproteins<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
An alkaline urine refrigerated becomes turbid because of?<\/p>\n\n\n\n
Amorphous phosphates<\/p>\n\n\n\n
Amorphous urates<\/p>\n\n\n\n
WBC<\/p>\n\n\n\n
Bacteria
A. Amorphous phosphates<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Test for Paroxysmal Cold Hemoglobinuria (PCH):<\/p>\n\n\n\n
Autohemolysis test<\/p>\n\n\n\n
Donath-Landsteiner Test<\/p>\n\n\n\n
Sucrose hemolysis test<\/p>\n\n\n\n
NOTA
B. Donath-Landsteiner Test<\/p>\n\n\n\n
Feedback Normal= (-) hemolysis on test and control, PCH= (-) hemolysis on control but (+) hemolysis on test sample.<\/p>\n\n\n\n
In emphysema, the absence of alpha-1 globulin peak is due the deficiency of:<\/p>\n\n\n\n
A1-Antitrypsin (AAT)<\/p>\n\n\n\n
Macroglobulin<\/p>\n\n\n\n
Hemopexin<\/p>\n\n\n\n
Transferrin
A1-Antitrypsin (AAT)<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Identify the organism: Fig. 4<\/p>\n\n\n\n
Clostridium difficile<\/p>\n\n\n\n
Mycobacterium tuberculosis<\/p>\n\n\n\n
Listeria monocytogenes<\/p>\n\n\n\n
Corynebacterium diphtheriae
A. Mycobacterium tuberculosis<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
A and B blood group antigens are derived when glycosyltransferases add specific sugars to precursor H. What is the terminal sugar for B antigen?<\/p>\n\n\n\n
Fucose<\/p>\n\n\n\n
D-galactose<\/p>\n\n\n\n
N-acetylglucosamine<\/p>\n\n\n\n
N-acetylgalactosamine
B. D-galactose<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
The reverse Camp Test, lecithinase production, double zone hemolysis and gram stain morphology are all useful identification of:<\/p>\n\n\n\n
Campylobacter jejuni<\/p>\n\n\n\n
Staphylococcus aureus<\/p>\n\n\n\n
Listeria monocytogenes<\/p>\n\n\n\n
Clostridium perfringens
D. Clostridium perfringens<\/p>\n\n\n\n
Feedback:<\/p>\n\n\n\n
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).<\/p>\n\n\n\n
According to AABB Standards, at least 90% of all Apheresis Platelets units tested shall contain a minimum of how many platelets?<\/p>\n\n\n\n
5.5 X 10^11<\/p>\n\n\n\n
5.0 X 10^11<\/p>\n\n\n\n
3.0 X 10^11<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
When performing semen analysis, sperm count is done:<\/p>\n\n\n\n
After collection<\/p>\n\n\n\n
After liquefaction<\/p>\n\n\n\n
No certain time<\/p>\n\n\n\n
NOTA
B. After liquefaction<\/p>\n\n\n\n
Feedback Sperm count is done after liquefaction which is approximately 20-30 minutes.<\/p>\n\n\n\n
Latex agglutination for Staphylococcus aureus:<\/p>\n\n\n\n
Protein A and nuclease<\/p>\n\n\n\n
Phosphotase and protein A<\/p>\n\n\n\n
Protein A and clumping factor<\/p>\n\n\n\n
All of the above
C. Protein A and clumping factor<\/p>\n\n\n\n
Which of the following blood test uses radioimmunoassay test to detect direct and specific IgE?<\/p>\n\n\n\n
Radioallergosorbent Test (RAST)<\/p>\n\n\n\n
Radioimmunosorbent Test (RIST)<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
None of the above
A. Radioallergosorbent Test (RAST)<\/p>\n\n\n\n
Feedback RAST test is used to detect direct and specific IgE. RIST test is used to detect total serum IgE.<\/p>\n\n\n\n
Which of the following factors are affected by Coumadin Therapy?<\/p>\n\n\n\n
III, VII, VIII<\/p>\n\n\n\n
X, V, II, I<\/p>\n\n\n\n
II, VII, IX, X<\/p>\n\n\n\n
AOTA
c.<\/p>\n\n\n\n
Feedback The following factors are said to be Vitamin K Dependent factors. Coagulation factors affected by coumadin drugs are: II, VII, IX and X.<\/p>\n\n\n\n
What analyte is monitored in preeclampsia?<\/p>\n\n\n\n
Potassium<\/p>\n\n\n\n
Ammonia<\/p>\n\n\n\n
Magnesium<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Identify: FI.g 5<\/p>\n\n\n\n
Heinz bodies<\/p>\n\n\n\n
Basophilic stippling<\/p>\n\n\n\n
Howell-Jolly bodies<\/p>\n\n\n\n
Auer rods
A. Heinz Bodies<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
High-Level Aminoglycoside Resistance:<\/p>\n\n\n\n
Micrococcus<\/p>\n\n\n\n
Staphylococcus<\/p>\n\n\n\n
Enterococci<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
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?<\/p>\n\n\n\n
Give Jk(b) negative crossmatch compatible blood<\/p>\n\n\n\n
Crossmatch type specific units and release only compatible units for transfusion<\/p>\n\n\n\n
Phenotype the patient’s red cells for the Jk(b) antigen<\/p>\n\n\n\n
AOTA
A. Give Jk(b) negative crossmatch compatible blood<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
When introducing a new manual technique, which is the best approach?<\/p>\n\n\n\n
Case presentation<\/p>\n\n\n\n
Workshop<\/p>\n\n\n\n
Lecture<\/p>\n\n\n\n
All of the above
B. Workshop<\/p>\n\n\n\n
Duckert’s Test 5M Urea Solubility Test is used of:<\/p>\n\n\n\n
Factor II deficiency<\/p>\n\n\n\n
Factor XIII deficiency<\/p>\n\n\n\n
Factor VIII deficiency<\/p>\n\n\n\n
Factor XII deficiency
B. Factor XIII deficiency<\/p>\n\n\n\n
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)<\/p>\n\n\n\n
Which of the following should be tested in cases of Antacid overdose?<\/p>\n\n\n\n
pH<\/p>\n\n\n\n
Potassium<\/p>\n\n\n\n
Ammonia<\/p>\n\n\n\n
Chloride
A. pH<\/p>\n\n\n\n
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).<\/p>\n\n\n\n
17-Ketosteroids is produced in the:<\/p>\n\n\n\n
Adrenal glands<\/p>\n\n\n\n
Hypothalamus<\/p>\n\n\n\n
Thyroid glands<\/p>\n\n\n\n
Pituitary glands
A. Adrenal glands<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
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:<\/p>\n\n\n\n
Methylene blue<\/p>\n\n\n\n
Bromphenol blue<\/p>\n\n\n\n
Thymol blue<\/p>\n\n\n\n
Bromthymol blue
A. Methylene blue<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
2-month old baby with Normal WBC, Normal platelet, reticulocyte count: 0.1%:<\/p>\n\n\n\n
Pure red cell aplasia<\/p>\n\n\n\n
Chronic Myelogenous Leukemia<\/p>\n\n\n\n
Myelofibrosis with myeloid metaplasia<\/p>\n\n\n\n
Polycythemia vera
A. Pure red cell aplasia<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Autologous Donation:<\/p>\n\n\n\n
Age has no requirement<\/p>\n\n\n\n
Hgb atleast 11 g\/dl, Hct atleast 33%<\/p>\n\n\n\n
Single unit is removed at a time, with atleast 3 day intervals<\/p>\n\n\n\n
AOTA
D. AOTA<\/p>\n\n\n\n
Feedback Donating blood for your own surgery is called an autologous donation. These blood units are collected and stored until the patient’s surgery.<\/p>\n\n\n\n
Order of migration of hemoglobins during alkaline electrophoresis, starting from the origin towards the anode:<\/p>\n\n\n\n
C,S,F,A<\/p>\n\n\n\n
C,S,A,F<\/p>\n\n\n\n
S,C,A,F<\/p>\n\n\n\n
A,F,S,C
A. C, S, F, A<\/p>\n\n\n\n
Feedback The order of migration of different hemoglobins starting from the origin is C,S,F,A. Fastest towards the anode is Hemoglobin A.<\/p>\n\n\n\n
Effect of increased Aldosterone to sodium and potassium:<\/p>\n\n\n\n
Decreased Sodium; Decreased Potassium<\/p>\n\n\n\n
Increased Sodium; Increased Potassium<\/p>\n\n\n\n
Increased Sodium; Decreased Potassium<\/p>\n\n\n\n
NOTA
C. Increased sodium; decreased potassium<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Hallmarks of this type of anemia:<\/p>\n\n\n\n
Formation of a fusion protein, AML1-ETO or RUNX1-RUNX1T1, due to a translocation of chromosome 8 to chromosome 21 or t(8;21):<\/p>\n\n\n\n
Acute Myeloid Leukemia (AML)<\/p>\n\n\n\n
Chronic Lymphocytic Leukemia (CLL)<\/p>\n\n\n\n
Acute Promyelocytic Leukemia (APL)
A. Acute Myeloid Leukemia (AML)<\/p>\n\n\n\n
Feedback FAB M2 is a subtype of Acute Myeloid Leukemia. It is also known as “Acute Myeloblastic Leukemia with Maturation”.<\/p>\n\n\n\n
Standardization of Mueller-Hinton Agar?<\/p>\n\n\n\n
adjust pH to 7.2<\/p>\n\n\n\n
adjust pH to 6.5<\/p>\n\n\n\n
adjust pH to 8.5<\/p>\n\n\n\n
All of the above
A. Adjust pH to 7.2<\/p>\n\n\n\n
First marker to be positive in HIV infection:<\/p>\n\n\n\n
HIV antibody<\/p>\n\n\n\n
HIV RNA<\/p>\n\n\n\n
CD4\/CD8 ratio<\/p>\n\n\n\n
p24
D. p24<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following pigments will deposit on urate and uric acid crystals to form a a precipitate described as “brick dust”?<\/p>\n\n\n\n
Urobilin<\/p>\n\n\n\n
Bilirubin<\/p>\n\n\n\n
Uroerythrin<\/p>\n\n\n\n
Urochrome
C. Uroerythrin<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Vibrio culture media:<\/p>\n\n\n\n
Fletcher’s Agar<\/p>\n\n\n\n
Bismuth Sulfite Agar<\/p>\n\n\n\n
TCBS<\/p>\n\n\n\n
BAP
C. TCBS<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Moth balls (naphtalene) poisoning may show which of the following red cell characteristics?<\/p>\n\n\n\n
Howell-Jolly bodies<\/p>\n\n\n\n
Ovalocytes<\/p>\n\n\n\n
Sickle cells<\/p>\n\n\n\n
Heinz Bodies
D. Heinz bodies<\/p>\n\n\n\n
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<\/p>\n\n\n\n
pH 7.22, pC02: 35, H2CO3: 10<\/p>\n\n\n\n
Metabolic acidosis<\/p>\n\n\n\n
Metabolic alkalosis<\/p>\n\n\n\n
Respiratory acidosis<\/p>\n\n\n\n
Respiratory alkalosis
A. Metabolic acidosis<\/p>\n\n\n\n
Feedback Normal values: pH- 7.35-7.45 pCO2: 35-45 HCO3: 22-26<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
What is the effect of dextran, why it is difficult to interpret in blood banking?<\/p>\n\n\n\n
It inhibits Anti-A and Anti-B<\/p>\n\n\n\n
It causes rouleaux<\/p>\n\n\n\n
It destroys the D antigen on red cell surface<\/p>\n\n\n\n
It has soluble like antigen
B. It causes rouleaux.<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
An ASO test can only be valid if the controls have yielded acceptable results. Which of the following indicates valid ASO Test?<\/p>\n\n\n\n
Hemolysis in both SLO and red cell control<\/p>\n\n\n\n
Positive control, hemolysis in all tubes<\/p>\n\n\n\n
No hemolysis on SLO control<\/p>\n\n\n\n
No hemolysis on red cell contro
D. no hemolysis on red cell control<\/p>\n\n\n\n
Feedback For an ASO tube test to be valid, the SLO control should show hemolysis and the RBC control tube should show no hemolysis.<\/p>\n\n\n\n
With what leukemia is Disseminated Intravascular Coagulation (DIC) associated?<\/p>\n\n\n\n
M3<\/p>\n\n\n\n
M1<\/p>\n\n\n\n
M6<\/p>\n\n\n\n
CML
A. M3<\/p>\n\n\n\n
Feedback M3- Acute Promyelocytic Leukemia (T15;17).<\/p>\n\n\n\n
Precipitation of ribosomes and RNA: Figure 7<\/p>\n\n\n\n
Heinz bodies<\/p>\n\n\n\n
Howell- Jolly bodies<\/p>\n\n\n\n
Basophilic stippling<\/p>\n\n\n\n
Auer rods
C. Basophilic stippling<\/p>\n\n\n\n
Feedback 1. Fine stippling= polychromatophilia (production of RBCs). 2. Coarse stippling= lead poisoning.<\/p>\n\n\n\n
What does hemoglobin F consist of?<\/p>\n\n\n\n
Two alpha and two beta chains<\/p>\n\n\n\n
Two alpha and two gamma chains<\/p>\n\n\n\n
Two alpha and two delta chains<\/p>\n\n\n\n
Four beta chains
B. 2 alpha, 2 gamma chains<\/p>\n\n\n\n
Specimen for blood gas analysis?<\/p>\n\n\n\n
Powdered EDTA<\/p>\n\n\n\n
Syringe with cap<\/p>\n\n\n\n
Citrated syringe with needle pierced on rubber stopper<\/p>\n\n\n\n
Heparinized syringe with needle pierced on rubber stopper
D. Heparinized syringe with needle pierced on rubber stopper<\/p>\n\n\n\n
Weak D:<\/p>\n\n\n\n
A. All antigens are present but under expressed<\/p>\n\n\n\n
B. Develops antibody<\/p>\n\n\n\n
C. A and B<\/p>\n\n\n\n
D. All antigens are expressed
A. All antigens are present but under expressed<\/p>\n\n\n\n
Cytogenetic anomaly in Acute Promyelocytic Leukemia (M3):<\/p>\n\n\n\n
t(9:22)<\/p>\n\n\n\n
t(15:17)<\/p>\n\n\n\n
t(8:21)<\/p>\n\n\n\n
None of the above
B. t(15:17)<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
From which source are you most likely to see this parasite?
Fig.8
Stool<\/p>\n\n\n\n
Urine<\/p>\n\n\n\n
Sputum<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Tropical sprue has the peripheral blood picture of:<\/p>\n\n\n\n
Malaria<\/p>\n\n\n\n
Thalassemia<\/p>\n\n\n\n
Megaloblastic anemia<\/p>\n\n\n\n
IDA
C. Megaloblastic Anemia<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Identify the organism: Fig. 9<\/p>\n\n\n\n
Enterobius vermicularis<\/p>\n\n\n\n
Ascaris lumbricoides<\/p>\n\n\n\n
Trichinella spiralis<\/p>\n\n\n\n
Taenia solium
B. Ascaris lumbricoides<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Laboratory Results: Decreased T3, Decreased T4, Decreased TSH<\/p>\n\n\n\n
Secondary Hyperthyroidism<\/p>\n\n\n\n
Secondary Hypothyroidism<\/p>\n\n\n\n
Primary Hyperthyroidism<\/p>\n\n\n\n
Primary Hypothyroidism
B. Secondary Hypothyroidism<\/p>\n\n\n\n
Feedback The cause of secondary hypothyroidism is failure of the pituitary gland to secrete thyroid stimulating hormone (TSH).<\/p>\n\n\n\n
Encapsulated yeast seen in Diabetes Mellitus:<\/p>\n\n\n\n
C. albicans<\/p>\n\n\n\n
C. neoformans<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
NOTA
B. C. Neoformans<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
What test is use to detect Weak D?<\/p>\n\n\n\n
Elution<\/p>\n\n\n\n
Adsorption<\/p>\n\n\n\n
DAT<\/p>\n\n\n\n
IAT
D. IAT<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Alpha-1 globulin flat curve in a protein electrophoresis indicates?<\/p>\n\n\n\n
Multiple myeloma<\/p>\n\n\n\n
Inflammation<\/p>\n\n\n\n
Juvenile cirrhosis<\/p>\n\n\n\n
Nephrotic syndrome
C. Juvenile cirrhosis<\/p>\n\n\n\n
Feedback Juvenile cirrhosis (AAT Deficiency) exhibits alpha-1 globulin flat curve in a protein electrophoresis.<\/p>\n\n\n\n
Rheumatoid Factor:<\/p>\n\n\n\n
IgG that binds to the Fc portion of abnormal IgM<\/p>\n\n\n\n
IgM that binds to the Fc portion of abnormal IgG<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
None of the above
B. IgM that binds to the Fc portion of abnormal IgG<\/p>\n\n\n\n
If total cholesterol is 230 mg\/dl, HDL is 55 mg\/dl and triglycerides is 190 mg\/dl, what is the concentration of LDL?<\/p>\n\n\n\n
137 mg\/dl<\/p>\n\n\n\n
125 mg\/dl<\/p>\n\n\n\n
85 mg\/dl<\/p>\n\n\n\n
140 mg\/dl
A. 137 mg\/dl<\/p>\n\n\n\n
Feedback Friedewald formula (1972)= LDL= Total cholesterol-HDL-TAG\/5 (mg\/dl) 230-55-(190\/5)= 137 mg\/dl<\/p>\n\n\n\n
Which of the following methods used for HIV identification is considered a signal amplification technique?<\/p>\n\n\n\n
DNA PCR<\/p>\n\n\n\n
Reverse Transcriptase PCR<\/p>\n\n\n\n
Branched Chain DNA Analysis<\/p>\n\n\n\n
Nucleic acid sequence-based assay (NASBA)
C. Branched Chain DNA analysis.<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following stain is recommended for identification of Cryptococcus neoformans?<\/p>\n\n\n\n
Methyl red<\/p>\n\n\n\n
Congo red<\/p>\n\n\n\n
Wright stain<\/p>\n\n\n\n
India ink
D. India ink<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Role of a supervisor in a laboratory:<\/p>\n\n\n\n
Democratic<\/p>\n\n\n\n
Autocratic<\/p>\n\n\n\n
Laissez-faire<\/p>\n\n\n\n
All of the above
A. Democratic<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Stomatocytes are indicative of? Fig. 10<\/p>\n\n\n\n
Sideroblastic anemia<\/p>\n\n\n\n
Liver Disease<\/p>\n\n\n\n
IDA<\/p>\n\n\n\n
Folate deficiency
B. Liver Disease<\/p>\n\n\n\n
Feedback Stomatocytes can be seen with some acquired conditions such as chronic liver disease (most often due to alcoholism) or acute alcohol intoxication.<\/p>\n\n\n\n
Which of the following least react with Anti-H?<\/p>\n\n\n\n
O<\/p>\n\n\n\n
A2<\/p>\n\n\n\n
A1<\/p>\n\n\n\n
A1B
D. A1B<\/p>\n\n\n\n
Feedback O>A2>B>A2B>A1>A1B<\/p>\n\n\n\n
Lowest concentration of drug in patients blood stream:<\/p>\n\n\n\n
Peak<\/p>\n\n\n\n
Trough<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
None of the above
B. Trough<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Concentration of a substance is directly proportional to the amount of light absorbed or inversely proportional to the logarithm of the transmitted light:<\/p>\n\n\n\n
Nernst equation<\/p>\n\n\n\n
Beer’s law<\/p>\n\n\n\n
Boyle’s law<\/p>\n\n\n\n
NOTA
B. Beer’s law<\/p>\n\n\n\n
Which of the following is best used to visualize oval fat bodies and crystals?<\/p>\n\n\n\n
Interference contrast<\/p>\n\n\n\n
Phase contrast<\/p>\n\n\n\n
Polarizing<\/p>\n\n\n\n
Bright-field
C. Polarizing<\/p>\n\n\n\n
Feedback Oval fat bodies contain lipids and may polarized and form maltese cross formation. They are best seen using polarizing microscope.<\/p>\n\n\n\n
Urinalysis result shows the following:<\/p>\n\n\n\n
RBC= 20-25\/hpf
Hyaline cast- 6-8\/hpf
WBC= 5-10\/hpf
RTE Cells: 25-35\/hpf<\/p>\n\n\n\n
They are most likely indicative of:<\/p>\n\n\n\n
Glomerulonephritis<\/p>\n\n\n\n
Tubular necrosis<\/p>\n\n\n\n
Pyelonephritis<\/p>\n\n\n\n
Nephrotic syndrome
B. Tubular necrosis<\/p>\n\n\n\n
Causative agent of pseudomembranous colitis?<\/p>\n\n\n\n
C. perfringens<\/p>\n\n\n\n
C. difficile<\/p>\n\n\n\n
C. jejuni<\/p>\n\n\n\n
All of the above
B. C. Difficile<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
SC1-(37\/LISS): 0 (Anti-IgG): +\/-
SC2-(37\/LISS): 0 (Anti-IgG): +\/-<\/p>\n\n\n\n
Use polyspecific AHG<\/p>\n\n\n\n
Report as Negative<\/p>\n\n\n\n
Report as Positive<\/p>\n\n\n\n
NOTA
A. Use polyspecific AHG<\/p>\n\n\n\n
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<\/p>\n\n\n\n
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?<\/p>\n\n\n\n
Group D streptococcus<\/p>\n\n\n\n
Enterococcus<\/p>\n\n\n\n
Streptococcus pyogenes<\/p>\n\n\n\n
Micrococcus
B. Enterococcus<\/p>\n\n\n\n
Feedback Only Enterococcus can grow both 6.5% NaCl and Bile Esculin<\/p>\n\n\n\n
Causative agent of Eye conjunctivitis:<\/p>\n\n\n\n
C. trachomatis<\/p>\n\n\n\n
H. ducreyi<\/p>\n\n\n\n
L. monocytogenes<\/p>\n\n\n\n
T. pallidum
A. C. trachomatis<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Polycythemia vera mutation?<\/p>\n\n\n\n
ADAMS<\/p>\n\n\n\n
JAK2<\/p>\n\n\n\n
Rpp<\/p>\n\n\n\n
Bcl\/BCR
B. JAK2<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following antigen\/s is enhanced by enzymes?<\/p>\n\n\n\n
Kidd, Rh<\/p>\n\n\n\n
Lewis, P<\/p>\n\n\n\n
ABO<\/p>\n\n\n\n
All of the abov
A. All of the above<\/p>\n\n\n\n
Feedback:
(KLARP) Kidd, Lewis, ABO, Rh and P antigens are enhanced by enzymes, MNS and Duffy antigens are destroyed by enzymes.<\/p>\n\n\n\n
What is measured in the urease method determination of BUN?<\/p>\n\n\n\n
Uricase<\/p>\n\n\n\n
Urea<\/p>\n\n\n\n
NAD<\/p>\n\n\n\n
Nitrogen
C. NAD<\/p>\n\n\n\n
Feedback Nicotinamide Adenine Dinucleotide (NAD) is being measured in the final step of urease method determination of BUN, it is measured at 340nm.<\/p>\n\n\n\n
It is sometimes referred to as the “pork worm” due to it being typically encountered in undercooked pork products: Fig 11<\/p>\n\n\n\n
Trichinella spiralis<\/p>\n\n\n\n
Trichuris trichiura<\/p>\n\n\n\n
Enterobius vermicularis<\/p>\n\n\n\n
Taenia saginata
A. Trichinella spiralis<\/p>\n\n\n\n
In HIV:<\/p>\n\n\n\n
Increased Total Lymphocyte<\/p>\n\n\n\n
Increased CD8<\/p>\n\n\n\n
Decreased CD4<\/p>\n\n\n\n
Normal CD8\/CD4
C. Decreased CD4<\/p>\n\n\n\n
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).<\/p>\n\n\n\n
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?<\/p>\n\n\n\n
2 units of each of the ABO Blood groups<\/p>\n\n\n\n
1 unit of group O, Rh positive whole blood<\/p>\n\n\n\n
Any units that are expiring within the day<\/p>\n\n\n\n
Units of group O, Rh-negative Red Blood Cells.
D. Units of group O, Rh-negative RBCs<\/p>\n\n\n\n
Feedback For emergency transfusions, group O negative RBC units should be used.<\/p>\n\n\n\n
Accumulation of glucocerebroside, wrinkled\/crumples cytoplasm (chicken scratch):<\/p>\n\n\n\n
Tay Sach’ disease<\/p>\n\n\n\n
Gaucher’s disease<\/p>\n\n\n\n
Sandhoff’s disease<\/p>\n\n\n\n
Sea blue histiocytosis
B. Gaucher’s disease<\/p>\n\n\n\n
Feedback Gaucher’s disease is a genetic disorder in which glucocerebroside (a sphingolipid, also known as glucosylceramide) accumulates in cells and certain organs.<\/p>\n\n\n\n
Reference ranges is performed in a new methodology to:<\/p>\n\n\n\n
To test instrument precision<\/p>\n\n\n\n
To test instrument accuracy<\/p>\n\n\n\n
To assess control ranges<\/p>\n\n\n\n
All of the above
A. To test instrument precision<\/p>\n\n\n\n
Which of the following laboratory test is most likely to be affected if the streptokinase therapy on a patient has failed?<\/p>\n\n\n\n
Platelet aggregation studies<\/p>\n\n\n\n
D-dimer Test<\/p>\n\n\n\n
Concentration of Vitamin K dependent factors<\/p>\n\n\n\n
Substitution studies
B. D dimer Test<\/p>\n\n\n\n
Feedback Streptokinase is a fibrinolytic agent and will cause D-dimer to elevate<\/p>\n\n\n\n
Description of Zygomycetes:<\/p>\n\n\n\n
Septate hyphae with basidiospores<\/p>\n\n\n\n
Septate hyphae with sporangiospores<\/p>\n\n\n\n
Aseptate hyphae with sporangiospores<\/p>\n\n\n\n
Aseptate hyphae with basidiospores
C. Aseptate hyphae with sporangiospores<\/p>\n\n\n\n
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<\/p>\n\n\n\n
The anemias of the qualitative hemoglobinopathies, such as sickle cell anemia, are morphologically classified as:<\/p>\n\n\n\n
Microcytic, hypochromic<\/p>\n\n\n\n
Macrocytic, normochromic<\/p>\n\n\n\n
Normocytic, normochromic<\/p>\n\n\n\n
NOTA
C. Normocytic, normochromic<\/p>\n\n\n\n
Type 1 hypersensitivity reactions are due to:<\/p>\n\n\n\n
Release of mediator<\/p>\n\n\n\n
Cytolysis due to antibody<\/p>\n\n\n\n
Deposits of Ag-Ab complex<\/p>\n\n\n\n
AOTA
A. Release of mediator<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
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:<\/p>\n\n\n\n
Cholesterol<\/p>\n\n\n\n
Triiodothyronine (T3)<\/p>\n\n\n\n
Thyroid-Stimulating Hormone (TSH)<\/p>\n\n\n\n
Thyroxine-Binding Globulin (TBG)
C. Thyroid- Stimulating Hormone (TSH)<\/p>\n\n\n\n
Lifetime marker of HBV infection:<\/p>\n\n\n\n
Anti-HBc<\/p>\n\n\n\n
Anti-HBs<\/p>\n\n\n\n
HbsAg<\/p>\n\n\n\n
HbcAg
A. Anti-HBc<\/p>\n\n\n\n
Feedback Anti-HBc is considered a sensitive lifetime marker of HBV infection.<\/p>\n\n\n\n
Anthropophilic; exhibits antler “NAIL HEAD” hyphae also known as “FAVIC CHANDELIER”:<\/p>\n\n\n\n
Trichophyton mentagrophytes<\/p>\n\n\n\n
Trichophyton schoenleinii<\/p>\n\n\n\n
Trichophyton rubrum<\/p>\n\n\n\n
All of the above
B. Trichophyton schoenleinii<\/p>\n\n\n\n
Feedback Microscopic morphology of Trichophyton schoenleinii exhibits antler NAIL HEAD hyphae aka FAVIC CHANDELIER.<\/p>\n\n\n\n
Which of the following can cause false DECREASE in ESR?<\/p>\n\n\n\n
Macrocytes<\/p>\n\n\n\n
Tilting of tube<\/p>\n\n\n\n
Vibration<\/p>\n\n\n\n
Delay in set up
D. Delay in set up<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Azotemia is increase in?<\/p>\n\n\n\n
BUN<\/p>\n\n\n\n
Creatinine<\/p>\n\n\n\n
Ammonia<\/p>\n\n\n\n
Uric Acid
A. BUN<\/p>\n\n\n\n
Feedback Azotemia is a medical condition characterized by abnormally high levels of nitrogen containing compounds.<\/p>\n\n\n\n
Select the best\/acceptable donor for blood donation:<\/p>\n\n\n\n
Patient that received a transfusion 8 months ago<\/p>\n\n\n\n
Woman that gave birth 4 weeks ago<\/p>\n\n\n\n
Man that donated blood 10 weeks ago<\/p>\n\n\n\n
Patient with Hgb: 11 g\/dl
C. Man that donated blood 10 weeks ago<\/p>\n\n\n\n
Feedback Only choice C is qualified for blood donation, the interval between donations of whole blood is eight weeks (56 days).<\/p>\n\n\n\n
Case analysis:<\/p>\n\n\n\n
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?<\/p>\n\n\n\n
Add anticoagulant<\/p>\n\n\n\n
Reduce anticoagulant<\/p>\n\n\n\n
Ask for a new specimen<\/p>\n\n\n\n
Report the results
D. Report the results<\/p>\n\n\n\n
Feedback The patient could be a baby, thus high hematocrit.<\/p>\n\n\n\n
Drug toxicity screening of a 6 year old girl has increased presence of ACETAMINOPHEN. What test should be done next?<\/p>\n\n\n\n
ALT and AST<\/p>\n\n\n\n
BUN and Creatinine<\/p>\n\n\n\n
Salicylates<\/p>\n\n\n\n
CK and LDH
A. ALT and AST<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Causative agent of Infectious Mononucleosis:
Cytomegalovirus
Epstein-Barr virus
Poxvirus
HPV
B. Epstein Barr Virus<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Cushing Syndrome exhibits which of the following:<\/p>\n\n\n\n
Hypoglycemia<\/p>\n\n\n\n
Hyperglycemia<\/p>\n\n\n\n
Hypercalcemia<\/p>\n\n\n\n
Hyponatremia
B. Hyperglycemia<\/p>\n\n\n\n
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<\/p>\n\n\n\n
Calculate for the % Saturation:<\/p>\n\n\n\n
UIBC- 185
Fe- 125<\/p>\n\n\n\n
80%<\/p>\n\n\n\n
50%<\/p>\n\n\n\n
40%<\/p>\n\n\n\n
30%
C. 40%<\/p>\n\n\n\n
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%.<\/p>\n\n\n\n
The manual eosinophil count by hemocytometer is also called:<\/p>\n\n\n\n
Thorn test<\/p>\n\n\n\n
Direct absolute eosinophil count<\/p>\n\n\n\n
Relative eosinophil count<\/p>\n\n\n\n
Indirect absolute eosinophil count
B. Direct absolute eosinophil count<\/p>\n\n\n\n
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 \u00d7 or high power (45\u00d7).<\/p>\n\n\n\n
What test is used to monitor unfractionated heparin therapy?<\/p>\n\n\n\n
APTT<\/p>\n\n\n\n
PT<\/p>\n\n\n\n
drvvt<\/p>\n\n\n\n
TT
A. APTT<\/p>\n\n\n\n
Feedback APTT is used to monitor unfractionated heparin therapy.<\/p>\n\n\n\n
Reactive monocytosis is seen in:<\/p>\n\n\n\n
Tuberculosis<\/p>\n\n\n\n
Allergic reaction<\/p>\n\n\n\n
Hypersensitivity<\/p>\n\n\n\n
Infectious mononucleosis
A. Tuberculosis<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Aman medium contains which of the following?<\/p>\n\n\n\n
Nile blue<\/p>\n\n\n\n
Cotton blue<\/p>\n\n\n\n
Victoria blue<\/p>\n\n\n\n
Toluidine blue
B. Cotton blue<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
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?<\/p>\n\n\n\n
Correct for temperature<\/p>\n\n\n\n
Correct for glucose<\/p>\n\n\n\n
Ask for new specimen<\/p>\n\n\n\n
Do nothing, report the results
A. Correct for temperature<\/p>\n\n\n\n
Feedback High protein, glucose and bilirubin levels can elevate the specific gravity. Low temperature may decrease the sensitivity of the test<\/p>\n\n\n\n
What is the purpose of Protein S and Protein C?<\/p>\n\n\n\n
Act as a natural anticoagulant<\/p>\n\n\n\n
Activates protein coagulants<\/p>\n\n\n\n
Activates fibrinolytic system<\/p>\n\n\n\n
All of the above
A. Act as a natural anticoagulant<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Uncompetitive inhibition:<\/p>\n\n\n\n
The inhibitor binds the enzyme-substrate complex<\/p>\n\n\n\n
The inhibitor binds to the allosteric site<\/p>\n\n\n\n
The inhibitor competes with the substrate towards the active site in an enzyme<\/p>\n\n\n\n
NOTA
A. The inhibitor binds the enzyme-substrate complex<\/p>\n\n\n\n
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).<\/p>\n\n\n\n
Which of the following is known as the metabolite of cocaine?<\/p>\n\n\n\n
Metanephrines<\/p>\n\n\n\n
Benzoylecgonine<\/p>\n\n\n\n
Morphine<\/p>\n\n\n\n
Benzenamine
B. Benzoylecgonine<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following is associated with Alder-Reilly inclusions?<\/p>\n\n\n\n
Two-lobed neutrophils<\/p>\n\n\n\n
Mucopolysaccharidosis<\/p>\n\n\n\n
Membrane defect of lysosomes<\/p>\n\n\n\n
Dohle bodies and giant platelets
B. Mucopolysaccharidosis<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Leptospira culture media:<\/p>\n\n\n\n
Fletcher<\/p>\n\n\n\n
TCBS<\/p>\n\n\n\n
MAC<\/p>\n\n\n\n
EMBC
A. Fletcher<\/p>\n\n\n\n
Increased growth rate (cell division), Susceptible to antimicrobial agents:<\/p>\n\n\n\n
Stationary\/Plateau phase<\/p>\n\n\n\n
Lag Phase<\/p>\n\n\n\n
Log\/Exponential Phase<\/p>\n\n\n\n
Decline Phase
C. Log\/exponential phase<\/p>\n\n\n\n
Macrocytes typically seen in megaloblastic anemia are:<\/p>\n\n\n\n
Tear drop shaped<\/p>\n\n\n\n
Ovalocytes<\/p>\n\n\n\n
Target cells<\/p>\n\n\n\n
AOTA
B. Ovalocytes<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Anti IgG (+); C3d (+): What should the MLS do?<\/p>\n\n\n\n
Elution<\/p>\n\n\n\n
IAT<\/p>\n\n\n\n
DAT<\/p>\n\n\n\n
Pre-warm
A. Elution<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following will be the first to increase after Myocardial Infarction (MI)
LD
CK-MB
Myoglobin
Troponin I
C. Myoglobin<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following is the preferred culture media for Legionella pneumophilia?<\/p>\n\n\n\n
Regan Lowe Agar<\/p>\n\n\n\n
Buffered Charcoal Yeast Extract (BCYE) Agar<\/p>\n\n\n\n
Celsulodin Irgasan Novobiocin (CIN) Agar<\/p>\n\n\n\n
Chocolate Agar
B. Buffered Charcoal Yeast Extract (BCYE) agar<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
What plasma level is decrease in hyperglycemia?<\/p>\n\n\n\n
Sodium<\/p>\n\n\n\n
Calcium<\/p>\n\n\n\n
Potassium<\/p>\n\n\n\n
Magnesium
A. Sodium<\/p>\n\n\n\n
Feedback Hyperglycemia causes osmotic shifts of water from the intracellular to the extracellular space, causing a relative dilutional hyponatremia<\/p>\n\n\n\n
Thrombocytosis: 1,000 x 10^9\/L, functionally abnormal platelets:<\/p>\n\n\n\n
Essential thrombocythemia<\/p>\n\n\n\n
Polycythemia vera<\/p>\n\n\n\n
Absolute thrombocythemia<\/p>\n\n\n\n
NOTA
A. Essential thrombocytopenia<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following patients is most at risk for hyperosmolar non-ketotic coma?<\/p>\n\n\n\n
A 70 year old, Type 2 diabetic patient<\/p>\n\n\n\n
A 30 years old, Type 2 diabetic patient<\/p>\n\n\n\n
A 40 years old hypertensive patient<\/p>\n\n\n\n
AOTA
A. A 70 year old, Type 2 diabetic patient<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Which of the following Plasmodium would least likely show the presence of trophozoites and schizonts in the peripheral blood?<\/p>\n\n\n\n
P. malariae<\/p>\n\n\n\n
P. vivax<\/p>\n\n\n\n
P. falciparum<\/p>\n\n\n\n
P. ovale
P. Falciparum<\/p>\n\n\n\n
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<\/p>\n\n\n\n
Patient comes with lesion on the arm.<\/p>\n\n\n\n
Mold Form: flowerette\/daisy like conidia
Yeast Form: Cigar-shaped (asteroid) bodies<\/p>\n\n\n\n
Sporothrix schenckii<\/p>\n\n\n\n
Trichophyton mentagrophytes<\/p>\n\n\n\n
Tricophyton rubrum<\/p>\n\n\n\n
Piedraia hortae
A. Sporothrix sschenckii<\/p>\n\n\n\n
Feedback S. schenckii causative agent of Rose Gardener’s disease (cord-like multiple subcutaneous nodules).<\/p>\n\n\n\n
Production of abnormally small amounts of urine:<\/p>\n\n\n\n
Anuria<\/p>\n\n\n\n
Oliguria<\/p>\n\n\n\n
Polyuria<\/p>\n\n\n\n
Aminoaciduria
B. Oliguria<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Sodium Flouride as anticoagulant:<\/p>\n\n\n\n
Binds antithrombin<\/p>\n\n\n\n
Prevents glycolysis<\/p>\n\n\n\n
No effect at all<\/p>\n\n\n\n
NOTA
B. Prevents glycolysis<\/p>\n\n\n\n
Feedback Sodium Flouride acts as an glycolysis inhibitor.<\/p>\n\n\n\n
Which ionophore is used in potassium electrode?<\/p>\n\n\n\n
Copper<\/p>\n\n\n\n
Valinomycin<\/p>\n\n\n\n
Glass<\/p>\n\n\n\n
Flouride
B. Valinomycin<\/p>\n\n\n\n
Feedback Valinomycin is ionophore used in potassium electrode<\/p>\n\n\n\n
A patient has increased serum calcium but normal parathyroid hormone levels. This can be associated with:<\/p>\n\n\n\n
Parathyroid carcinoma<\/p>\n\n\n\n
Metastatic carcinoma<\/p>\n\n\n\n
Hypoproteinemia<\/p>\n\n\n\n
Parathyroid metaplasia
B. Metastatic carcinoma<\/p>\n\n\n\n
Feedback Local bone metastases induced osteoclastic activity causes bone resorption, raising calcium levels in the blood.<\/p>\n\n\n\n
Which of the following below shows “identity pattern” in an Ouchterlony Double Diffusion? Fig 13<\/p>\n\n\n\n
A<\/p>\n\n\n\n
B<\/p>\n\n\n\n
C<\/p>\n\n\n\n
NOTA
A<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Two consecutive values in which they are in the +2SD of the same mean or in the -2SD of the same mean:<\/p>\n\n\n\n
2:2s<\/p>\n\n\n\n
10:x<\/p>\n\n\n\n
1:2s<\/p>\n\n\n\n
R:4s
A. 2:2s<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Anti-A= 4+
Anti-B= 4+
Weak D= 2+<\/p>\n\n\n\n
Rh control= 0
A cells= 0
B cells= 0<\/p>\n\n\n\n
ABO grouping is wrong<\/p>\n\n\n\n
Rh grouping is wrong<\/p>\n\n\n\n
Rh control is wrong<\/p>\n\n\n\n
Do nothing, interpret the results
D. Do nothing, interpret the results<\/p>\n\n\n\n
Biochemical reaction:<\/p>\n\n\n\n
Bile esculin positive
6.5% NaCl negative<\/p>\n\n\n\n
Streptococcus bovis<\/p>\n\n\n\n
Streptococcus pneumoniae<\/p>\n\n\n\n
Enterococcus faecalis<\/p>\n\n\n\n
Enterococcus faecium
A. Streptococcus bovis<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Absorbs light and emit at longer wavelength:<\/p>\n\n\n\n
Fluorometer<\/p>\n\n\n\n
Nephelometer<\/p>\n\n\n\n
AAS<\/p>\n\n\n\n
TLC
A. Fluorometer<\/p>\n\n\n\n
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<\/p>\n\n\n\n
This catalase positive, gram positive bacilli with diptheroid morphology is highly resistant to many antibiotics and is associated with immunocompromised patients.<\/p>\n\n\n\n
C. jeikeium<\/p>\n\n\n\n
L. monocytogenes<\/p>\n\n\n\n
C. diptheriae<\/p>\n\n\n\n
E. rhusiopathiae
C. diptheriae<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Carbon Dioxide in ISE measures:<\/p>\n\n\n\n
CO2- pressure<\/p>\n\n\n\n
CO2- content<\/p>\n\n\n\n
pH<\/p>\n\n\n\n
HCO3
A. CO2 pressure<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Three (3) test tubes are negative to AHG (Antihuman Globulin), when check cell is added, the result is still negative, what is the error?<\/p>\n\n\n\n
Insufficient saline from automated cell washer<\/p>\n\n\n\n
Serum was omitted from the reaction<\/p>\n\n\n\n
Insufficient incubation period<\/p>\n\n\n\n
All of the above
B. Serum was omitted from the reaction<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
The best diagnostic test for excessive alcoholic consumption:<\/p>\n\n\n\n
AST<\/p>\n\n\n\n
ALP<\/p>\n\n\n\n
GGT<\/p>\n\n\n\n
ALT
C. GGT<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Eosinophils in LAP (Leukocyte Alkaline Phosphatase) score:<\/p>\n\n\n\n
Not counted<\/p>\n\n\n\n
Double the value<\/p>\n\n\n\n
Constant value<\/p>\n\n\n\n
None of the above
A. Not counted<\/p>\n\n\n\n
Feedback Eosinophils do not show alkaline phosphatase activity and must not be counted.<\/p>\n\n\n\n
Gall bladder surgery:<\/p>\n\n\n\n
PT: Normal
APTT: Increase
What to do next?<\/p>\n\n\n\n
Factor XII Test<\/p>\n\n\n\n
Factor VIII Test<\/p>\n\n\n\n
Dilute RVVT<\/p>\n\n\n\n
Factor IX Test
A. Factor XII test<\/p>\n\n\n\n
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)<\/p>\n\n\n\n
Causative agent of “Cat scratch disease”?
Pasteurella multocida
Bartonella henselae
Afipia felis
Pleisomonas
B. Bartonella henselae<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
Sputum sample has 25 PMN cells, 10 epithelial cells on HPO, in oil immersion bacteria and fungi were seen, what to do?<\/p>\n\n\n\n
Culture bacteria only<\/p>\n\n\n\n
Culture fungi only<\/p>\n\n\n\n
Culture both bacteria and fungi<\/p>\n\n\n\n
Reject specimen
C. Culture both bacteria and fungi<\/p>\n\n\n\n
Feedback The specimen meets the criteria for a good specimen, culturing both bacteria and fungi would be the best answer.<\/p>\n\n\n\n
The extrinsic system of coagulation is monitored by which test?<\/p>\n\n\n\n
Activated Partial Thromboplastic Time (APTT)<\/p>\n\n\n\n
Prothrombin time (PT)<\/p>\n\n\n\n
Fibrinogen assay<\/p>\n\n\n\n
Thrombin Time (TT)
B. PT<\/p>\n\n\n\n
Feedback PT is used to monitor Extrinsic system. Factor VII is under extrinsic system.<\/p>\n\n\n\n
Portwine urine color:<\/p>\n\n\n\n
Antibiotics intake<\/p>\n\n\n\n
Cola intake<\/p>\n\n\n\n
Bilirubinemia<\/p>\n\n\n\n
Porphyria
D. Porphyria<\/p>\n\n\n\n
Feedback In acute intermittent porphyria, the substrate porphobilinogen will accumulate in urine. It spontaneously polymerizes to coporphobilinogen in urine giving urine port-wine color.<\/p>\n\n\n\n
An antiepileptic (or anticonvulsant) used to control seizure disorders is:<\/p>\n\n\n\n
Acetaminophen<\/p>\n\n\n\n
Lithium<\/p>\n\n\n\n
Phenytoin<\/p>\n\n\n\n
Digoxin
C. Phenytoin<\/p>\n\n\n\n
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<\/p>\n\n\n\n
Sezary syndrome:<\/p>\n\n\n\n
Monocytes<\/p>\n\n\n\n
B-cells lymphoproliferative<\/p>\n\n\n\n
T-cells lymphoproliferative<\/p>\n\n\n\n
Basophils
C. T-cells lymphoproliferative<\/p>\n\n\n\n
Feedback Sezary syndrome is an aggressive form of a type of blood cancer called cutaneous T-cell lymphoma.<\/p>\n\n\n\n
Rouleaux is undetectable at what phase?<\/p>\n\n\n\n
AHG<\/p>\n\n\n\n
IS<\/p>\n\n\n\n
Room temp<\/p>\n\n\n\n
All of the above
A. AHG<\/p>\n\n\n\n
Feedback Rouleaux is not detectable at AHG phase due to serum being washed away.<\/p>\n\n\n\n
On an automated instrument:<\/p>\n\n\n\n
Hgb=45 g\/dl
Hct=33%<\/p>\n\n\n\n
The technologist does a manual Hct and the result is 33.5%. What should the MLS do next?<\/p>\n\n\n\n
Repeat all<\/p>\n\n\n\n
Ask for new specimen<\/p>\n\n\n\n
Report the manual results and original Hgb result<\/p>\n\n\n\n
Check for lipemia
D. Check for lipemia<\/p>\n\n\n\n
Routine rotavirus detection can be done with?
EIA
Electron microscopy
Shell Vial culture
None of the above
A. EIA<\/p>\n\n\n\n
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?<\/p>\n\n\n\n
Novobiocin susceptibility<\/p>\n\n\n\n
Furazolidone (100 ug\/disk) susceptibility<\/p>\n\n\n\n
Bile esculin<\/p>\n\n\n\n
Leucine aminopeptidase production
B. Furazolidone (100 ug\/disk) susceptibility<\/p>\n\n\n\n
Feedback Micrococcus and Staphylococcus can be differentiated by susceptibility to furazolidone (100 ug\/disk). Staphylococcus is susceptible and Micrococcus is resistant.<\/p>\n\n\n\n
Transudates are usually:<\/p>\n\n\n\n
Purulent<\/p>\n\n\n\n
Has bacteria<\/p>\n\n\n\n
Non inflammatory<\/p>\n\n\n\n
All of the above
C. Non inflammatory<\/p>\n\n\n\n
Feedback Transudates are clear and translusent thus, eliminating choices A and B.<\/p>\n\n\n\n
Which of the following laboratory tests can differentiate Pseudomonas aeruginosa from Pseudomonas putida?<\/p>\n\n\n\n
Flagella<\/p>\n\n\n\n
Oxidase production<\/p>\n\n\n\n
Growth at 42 degrees celsius<\/p>\n\n\n\n
Pyoverdin production
C. Growth at 42 degrees celsius<\/p>\n\n\n\n
Feedback P. aeruginosa had the widest range of growth temperature (25-42C)<\/p>\n\n\n\n
Cause of false negative ABO typing:<\/p>\n\n\n\n
Rouleaux<\/p>\n\n\n\n
Positive DAT<\/p>\n\n\n\n
37C<\/p>\n\n\n\n
LISS
B. Positive DAT<\/p>\n\n\n\n
Feedback A positive DAT means that there are antibodies attached to the RBCs, thus giving false negative results.<\/p>\n\n\n\n
Excessively blue stain causes:<\/p>\n\n\n\n
Prolonged staining time<\/p>\n\n\n\n
Inadequate washing<\/p>\n\n\n\n
Too high alkalinity of stain<\/p>\n\n\n\n
AOTA
D. AOTA<\/p>\n\n\n\n
Which of the following anemia exhibits pancytopenia?<\/p>\n\n\n\n
Aplastic anemia<\/p>\n\n\n\n
Pernicious anemia<\/p>\n\n\n\n
Megaloblastic anemia<\/p>\n\n\n\n
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).<\/p>\n\n\n\n
The drug procainamide is prescribed to treat cardiac arrhythmia. What biologically active liver metabolite of procainamide is often measured simultaneously?<\/p>\n\n\n\n
N-acetylprocainamide (NAPA)<\/p>\n\n\n\n
Primidone<\/p>\n\n\n\n
Phenobarbital<\/p>\n\n\n\n
Benzoylecgonine
A. N-acetylprocainamide (NAPA)<\/p>\n\n\n\n
Feedback NAPA is the active metabolite of procainamide.<\/p>\n\n\n\n
Blood agglutination was noted below, what would the MLS do to differentiate it from Rouleaux? Figure 14<\/p>\n\n\n\n
Prewarm<\/p>\n\n\n\n
Dilute with 22% Albumin<\/p>\n\n\n\n
Dilute with normal saline<\/p>\n\n\n\n
AOTA
C. Dilute with normal saline<\/p>\n\n\n\n
Feedback Saline test confirms the presence of agglutination by mixing a drop of uncoagulated blood with a (larger) drop of saline solution. The mixture is then placed on a slide with a coverslip and observed under the microscope. In the presence of agglutination, the red blood cells will remain clumped: this indicates a positive test . In the presence of rouleaux formation (a physiological phenomenon associated with plasma proteins), the red blood cells will spread out individually: this indicates a negative test .<\/p>\n\n\n\n
A positive culture of sputum was stained. Carbolfucshin was added, washed, decolorized and malachite blue was used as counter stain. Two entire field was scanned and no acid fast bacilli were found. The most probably cause is:<\/p>\n\n\n\n
Wrong primary stain was used<\/p>\n\n\n\n
Wrong counter stain was used<\/p>\n\n\n\n
Inadequate scanning of slide<\/p>\n\n\n\n
Inadequate decolorization
C. Inadequate scanning of slide<\/p>\n\n\n\n
Feedback Good practice in reading AFB slide should be 100 fields.<\/p>\n\n\n\n
Which of the following platelet responses is most likely associated with classic von Willebrand’s disease?<\/p>\n\n\n\n
Decreased amount of ADP in platelets<\/p>\n\n\n\n
Abnormal aggregation with Adenosine diphosphate (ADP)<\/p>\n\n\n\n
Decreased platelet aggregation to ristocetin<\/p>\n\n\n\n
All of the above
C. Decreased platelet aggregation to ristocetin<\/p>\n\n\n\n
Feedback Platelet aggregation studies in vWD show a decreased aggregation in the presence of ristocetin and normal aggregation with ADP, epinephrine and collagen.<\/p>\n\n\n\n
Stray light can be detected in a spectrophotometer by utilizing a:<\/p>\n\n\n\n
Sharp cut off filter<\/p>\n\n\n\n
Mercury vapor lamp<\/p>\n\n\n\n
Potassium dichromate solution<\/p>\n\n\n\n
Holmium oxide glass
A. Sharp cut off filter<\/p>\n\n\n\n
Feedback:Other distractors are methods to detect stray light.<\/p>\n\n\n\n
Swarming phenomenon bacteria, what should be the follow up test for identification?<\/p>\n\n\n\n
Indole<\/p>\n\n\n\n
Methyl red<\/p>\n\n\n\n
Sugar fermentation<\/p>\n\n\n\n
Vogues proskauer
A. Indole<\/p>\n\n\n\n
Feedback Swarming phenomenon is being exhibited by Proteus species, to identify Proteus vulgaris from Proteus mirabilis, indole test is done. Proteus vulgaris: Indole positive. Proteus mirabilis: Indole negative.<\/p>\n\n\n\n
Butcher’s cut: H2S positive, Gram positive rod, Alpha-Hemolytic and Non-motile:<\/p>\n\n\n\n
Erysiphelothrix rhusiopathiae<\/p>\n\n\n\n
Bacillus anthracis<\/p>\n\n\n\n
Listeria monocytogenes<\/p>\n\n\n\n
Campylobacter jejuni
A. Erysiphelothrix rhusiopathiae<\/p>\n\n\n\n
During the past month, Staphylococcus epidermidis has been isolated from blood cultures at 2-3 times the rate from the previous year. The most logical explanation for the increase in these isolates is that:<\/p>\n\n\n\n
The blood culture media are contaminated with this organism<\/p>\n\n\n\n
The hospital ventilation system is contaminated with S. epidermidis<\/p>\n\n\n\n
There has been a break in proper skin preparation before drawing blood for culture<\/p>\n\n\n\n
A relative virulent isolate is being spread from patient to patient
C. There has been a break in proper skin preparation before drawing blood for culture<\/p>\n\n\n\n
Widal and Weil-Felix test are classified under what type of serologic test?<\/p>\n\n\n\n
Passive agglutination<\/p>\n\n\n\n
Reverse passive agglutination<\/p>\n\n\n\n
Direct agglutination<\/p>\n\n\n\n
Coagglutination
C. Direct agglutination<\/p>\n\n\n\n
Feedback Febrile agglutination test such as Widal and Weil-Felix test are examples of direct agglutination.<\/p>\n\n\n\n
What blood type should be transfused to the baby?<\/p>\n\n\n\n
Mother: Type O, Rh negative, with anti-D, anti-C, anti-I and anti-Lea
Child: Type A, Rh positive, DAT (+)<\/p>\n\n\n\n
Type O, Rh negative, without C, I and Lea antigen<\/p>\n\n\n\n
Type O, Rh negative, with C, I, and Lea antigen<\/p>\n\n\n\n
Type A, Rh positive, with C, I and Lea antigen<\/p>\n\n\n\n
None of the above
A. Type O, Rh negative, without C, I and Lea antigen (Correct Answer)<\/p>\n\n\n\n
Schales and schales method is a mercurimetric titration used in the analysis of:<\/p>\n\n\n\n
Chloride<\/p>\n\n\n\n
Calcium<\/p>\n\n\n\n
Phosphorous<\/p>\n\n\n\n
Chromium
A. Chloride<\/p>\n\n\n\n
Feedback Schales and schales method is a mercurimetric titration method for chloride analysis. It involves titrating chloride with a solution of mercury forming soluble but non-ionized mercuric chloride.<\/p>\n\n\n\n
In Rhabdomyolysis, breakdown of what component causes kidney damage?<\/p>\n\n\n\n
Haptoglobin<\/p>\n\n\n\n
Myoglobin<\/p>\n\n\n\n
Creatinine<\/p>\n\n\n\n
CK
B. Myoglobin<\/p>\n\n\n\n
Feedback When muscle is damaged, a protein called myoglobin is released into the bloodstream. It is then filtered out of the body by the kidneys. Myoglobin breaks down into substances that can damage kidney cells<\/p>\n\n\n\n
Type of light observed at 750nm:<\/p>\n\n\n\n
Ultraviolet<\/p>\n\n\n\n
Infrared<\/p>\n\n\n\n
Blue<\/p>\n\n\n\n
Green
B. Infrared<\/p>\n\n\n\n
Feedback Visible range is approximately between 400-700nm. Less than 400nm would be ultraviolet light, while longer than 700nm would be infrared.<\/p>\n\n\n\n
Carrier of endogenous triglycerides:<\/p>\n\n\n\n
VLDL<\/p>\n\n\n\n
LDL<\/p>\n\n\n\n
HDL<\/p>\n\n\n\n
Chylomicrons
A. VLDL<\/p>\n\n\n\n
Feedback VLDL carries endogenous triglycerides, while Chylomicrons carries exogenous triglycerides.<\/p>\n\n\n\n
Synovial fluid arrived in the laboratory. It is viscous. What to do next?<\/p>\n\n\n\n
Add acetic acid<\/p>\n\n\n\n
Dilute with NSS<\/p>\n\n\n\n
Add hyaluronidase<\/p>\n\n\n\n
Perform test immediately
C. Add hyaluronidase<\/p>\n\n\n\n
Feedback Induced tryptic digestion of HYALURONIC ACID will destroy the synovial fluid lubricating abilities without lowering its viscosity. It has also been shown that hyaluronic acid can be depolymerized without altering its lubricating capacity.<\/p>\n\n\n\n
Rapid detection test for legionella in urine specimen:<\/p>\n\n\n\n
Electron Microscopy<\/p>\n\n\n\n
Cell culture<\/p>\n\n\n\n
Antigen detection test<\/p>\n\n\n\n
FTA
C. Antigen detection test<\/p>\n\n\n\n
Feedback Urine antigen testing for Legionella has 70% sensitivity and approaches 100% specificity.<\/p>\n\n\n\n
Which of the following is a quantitative assay for fecal fat?<\/p>\n\n\n\n
H202<\/p>\n\n\n\n
NADH<\/p>\n\n\n\n
Sudan Black<\/p>\n\n\n\n
Weighing and extraction
D. Weighing and Extraction<\/p>\n\n\n\n
Feedback The quantitative test involves drying and weighing a 72-hour stool specimen, then using an extraction technique to separate the fats, which are subsequently evaporated and weighed. This measurement of the total output of fecal fat per 24 hours in a three-day specimen is the most reliable test for steatorrhea.<\/p>\n\n\n\n
Fig. 15<\/p>\n\n\n\n
The protein electrophoresis shown below indicates?<\/p>\n\n\n\n
A1-Antitrypsin deficiency<\/p>\n\n\n\n
Multiple Myeloma<\/p>\n\n\n\n
Nephrotic syndrome<\/p>\n\n\n\n
All of the above
Feedback The above pattern shows an abnormal serum protein electrophoresis pattern in a patient with multiple myeloma. Note the large spike in the gamma region.<\/p>\n\n\n\n
Specimen for diagnosis of rotavirus<\/p>\n\n\n\n
Stool<\/p>\n\n\n\n
Throat swab<\/p>\n\n\n\n
Blood<\/p>\n\n\n\n
Urine
A. Stool<\/p>\n\n\n\n
Feedback The rotavirus test is a stool test used to diagnose a rotavirus infection. Rotavirus affects the intestines and causes vomiting and diarrhea. This infection is especially common in young children, but it can affect adults, too. A rotavirus infection causes a condition called viral gastroenteritis.<\/p>\n\n\n\n
An isolate on chocolate agar from a patient with epiglottitis was suggestive of Haemophilus species. Additional testing showed that the isolate required NAD for growth and was nonhemolytic. The organism is most likely Haemophilus:<\/p>\n\n\n\n
ducreyi<\/p>\n\n\n\n
parainfluenzae<\/p>\n\n\n\n
haemolyticus<\/p>\n\n\n\n
influenzae
B. Parainfluenzae<\/p>\n\n\n\n
Feedback Haemophilus parainfluenzae requires NAD (V factor) for growth but not hemin (X factor). This distinguishes it from H. influenzae. H. haemolyticus is hemolytic, and H. ducreyi does not cause epiglottitis.<\/p>\n\n\n\n
Amniotic fluid is evaluated using Liley graph and change in absorbance at 450nm. What is being evaluated and why?<\/p>\n\n\n\n
Lamellar bodies, increases in FLM<\/p>\n\n\n\n
HCG, which increases in Down syndrome<\/p>\n\n\n\n
AFP, which increases in spina bifida<\/p>\n\n\n\n
Bilirubin, which increases in HDN
D. Bilirubin, which increases in HDN<\/p>\n\n\n\n
Feedback A fetus with hemolytic disease will have increased bilirubin in the amniotic fluid. Bilirubin absorbs light at 450nm.<\/p>\n\n\n\n
(Urine creatinine x the volume of the 24 hour urine sample) divided by the value of the plasma creatinine:<\/p>\n\n\n\n
Formula for specific gravity<\/p>\n\n\n\n
Formula for anion gap<\/p>\n\n\n\n
Formula for creatinine clearance<\/p>\n\n\n\n
Formula for osmolality
C. Formula for creatinine clearance<\/p>\n\n\n\n
The principle of the reagent strip test for urine protein depends on:<\/p>\n\n\n\n
Copper reduction<\/p>\n\n\n\n
Protein error of indicators<\/p>\n\n\n\n
An enzyme reaction<\/p>\n\n\n\n
Toluidine reaction
B. Protein error of indicators<\/p>\n\n\n\n
When using winged blood collection device (butterfly) for coagulation study:<\/p>\n\n\n\n
Use non-additive top and transfer to blue top<\/p>\n\n\n\n
A waste tube should be drawn first<\/p>\n\n\n\n
Do nothing, just collect sample right away<\/p>\n\n\n\n
NOTA
B. A waste tube should be used first
Feedback If a winged blood collection device (butterfly) is used to collect a light-blue top tube for coagulation studies, a waste tube should be drawn first. The waste tube must also be a light-blue top tube or a tube that contains no additives. This waste tube is drawn first to remove the air in the tubing of the winged collection device. Once blood flows through the tubing, the waste tube can be removed and discarded. The waste tube does not need to be completely filled.<\/p>\n\n\n\n
Low incidence antigen usually not present on Antibody Screening or Panel Cells:<\/p>\n\n\n\n
Wra<\/p>\n\n\n\n
Lw<\/p>\n\n\n\n
I<\/p>\n\n\n\n
Jka
A. Wra<\/p>\n\n\n\n
Nephelometry involves the measurement of:<\/p>\n\n\n\n
Light scatter<\/p>\n\n\n\n
Atomic absorption<\/p>\n\n\n\n
Light absorption<\/p>\n\n\n\n
Light transmission
A. Light scatter<\/p>\n\n\n\n
Feedback When light strikes a particle in a solution, it can be absorbed, transmitted, reflected, or scattered. Nephelometry is used to measure the light scattered by particles in a solution. It is useful for measuring protein levels in fluids, and antigen-antibody complexes.<\/p>\n\n\n\n
RBCs must be washed in saline at least 3 times before the addition of AHG reagent to?<\/p>\n\n\n\n
Remove traces of free serum globulins<\/p>\n\n\n\n
Wash away any hemolyzed cells<\/p>\n\n\n\n
Neutralize any excess AHG reagent<\/p>\n\n\n\n
All of the above
Next
A. Remove traces of free serum globulins<\/p>\n\n\n\n
Which of the following causes antibody against TSH?
SLE
Grave’s Disease
Hashimoto’s Thyroiditis
Rheumatoid Arthritis
B. Grave’s disease<\/p>\n\n\n\n
Feedback The thyrotropin receptor (TSH receptor) is the antigen for TSH receptor antibodies (TRAbs). It is a seven transmembrane G protein coupled receptor that is involved in thyroid hormone signalling. TRAbs are present in 70-100% of Grave’s Disease. In Hashimoto’s Thyroiditis, T4 is decreased and TSH is increased. Anti-TPO (anti-thyroid peroxidase) antibodies are most commonly associated with Hashimoto’s thyroiditis.<\/p>\n\n\n\n
Identify the organism: Bile esculin positive; 6.5 NaCl: positive, PYR negative; LAP negative<\/p>\n\n\n\n
Group D strep<\/p>\n\n\n\n
Group B Strep<\/p>\n\n\n\n
Leuconostoc<\/p>\n\n\n\n
Enterococcus
C. Leuconostoc<\/p>\n\n\n\n
“Whooping cough bacillus”:<\/p>\n\n\n\n
Bordetella bronchiseptica<\/p>\n\n\n\n
Bordetella pertussis<\/p>\n\n\n\n
Haemophilus aegypticus<\/p>\n\n\n\n
NOTA
B. Bordetella pertussis<\/p>\n\n\n\n
Feedback Stages of Whooping cough: 1. Catarrhal, 2. Paroxysmal, 3. Convalescence, preferred sample of choice of isolation of B. pertussis is nasopharyngeal swab.<\/p>\n\n\n\n
What is the treatment for warfarin toxicity?<\/p>\n\n\n\n
Vitamin K<\/p>\n\n\n\n
Cryoprecipitate<\/p>\n\n\n\n
Factor IX concentrate<\/p>\n\n\n\n
Factor VIII concentrate
A. Vitamin K<\/p>\n\n\n\n
Feedback Therapeutic approach would be to withhold 1 dose of warfarin and orally administer vitamin K<\/p>\n\n\n\n
Blood was collected on November 1. Blood was then frozen in glycerol on November 5. What should the expiration date read?<\/p>\n\n\n\n
Nov 1; 1 year from now<\/p>\n\n\n\n
Nov 5; 1 year from now<\/p>\n\n\n\n
Nov 1; 10 years from now<\/p>\n\n\n\n
Nov 5; 10 years from now
C. Nov1; 10 years from now<\/p>\n\n\n\n
Feedback Blood is sometimes frozen in order to preserve rare types. Glycerol is used in the freezing process. Once frozen, the expiration date of the blood is extended to 10 years from the date of phlebotomy. If the blood is needed, it is defrosted and the new expiration time becomes only 24 hours from the time it is defrosted.<\/p>\n\n\n\n
Blood collected in blue top (sodium citrate tube) for coagulation studies, after centrifugation, packed red cells (Hct) comprise 60% of the whole blood. What should the MLS do next?<\/p>\n\n\n\n
Add citrate anticoagulant<\/p>\n\n\n\n
Reduce citrate anticoagulant<\/p>\n\n\n\n
Dilute with NSS<\/p>\n\n\n\n
Report result
B. Reduce citrate anticoagulant.<\/p>\n\n\n\n
Feedback In 1980, CLSI released H21-A4 guidelines for coagulation testing, which included the recommendation to adjust\/correct the amount of citrate in blue-top evacuated blood collection tubes for patients presenting hematocrits greater than 55%.<\/p>\n\n\n\n
Tap-water bacillus:<\/p>\n\n\n\n
M. gordonae<\/p>\n\n\n\n
M. tuberculosis<\/p>\n\n\n\n
M. avium<\/p>\n\n\n\n
M. smegmatis
A. M. gordonae<\/p>\n\n\n\n
Feedback M gordonae is ubiquitous and may be found in soil, water (eg, ground, tap, bottled), whirlpools, unpasteurized milk, mucous membranes of healthy persons, urine, and gastric fluid. It is the most commonly encountered nontuberculous mycobacterium in water, with concentrations as high as 1000 colony-forming units per milliliter.<\/p>\n\n\n\n
Which amino acid substitution is responsible for Hemoglobin S?<\/p>\n\n\n\n
Lysine for glutamic acid at sixth position of the beta chain<\/p>\n\n\n\n
Valine for glutamic acid at the sixth position of the beta chain<\/p>\n\n\n\n
Arginine for glutamic acid at sixth position of the beta chain<\/p>\n\n\n\n
Alanine for glutamic acid at sixth position of the beta chain
B. Valine for glutamic acid at the sixth position of the beta chain<\/p>\n\n\n\n
In what blood group type expression of antigens is weakened or in some cases negative during pregnancy?<\/p>\n\n\n\n
P<\/p>\n\n\n\n
Lewis<\/p>\n\n\n\n
i\/I<\/p>\n\n\n\n
Kell
B. Lewis<\/p>\n\n\n\n
Feedback Pregnant women transiently exhibit Le(a-b-) phenotype and Lewis antibodies are sometimes formed during pregnancy<\/p>\n\n\n\n
Interpret: Urine was tested for glucose:<\/p>\n\n\n\n
Glucose Reagent strip: Positive (+)
Clinitest: Negative (-)<\/p>\n\n\n\n
Presence of reducing sugar (Galactose)<\/p>\n\n\n\n
Glucose is present<\/p>\n\n\n\n
Galactosuria<\/p>\n\n\n\n
Ascorbate interference
B. Glucose is present<\/p>\n\n\n\n
Feedback A positive dipstick glucose assay and a negative clinitest suggest presence of glucose. While a negative dipstick glucose assay and a positive clinitest suggest that some substance other than glucose is present in the urine. These sugars include galactose, lactose, and fructose.<\/p>\n\n\n\n
Smudge cells are seen in what type of leukemia?<\/p>\n\n\n\n
Acute Myelogenous Leukemia (AML)<\/p>\n\n\n\n
Chronic Myelogenous Leukemia (CML)<\/p>\n\n\n\n
Acute Lymphocytic Leukemia (ALL)<\/p>\n\n\n\n
Chronic Lymphocytic Leukemia (CLL)
D. Chronic Lymphocytic Leukemia (CLL)<\/p>\n\n\n\n
Feedback Smudge cells are remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure. Smudge cells, also called basket cells, are most often associated with abnormally fragile lymphocytes in disorders such as chronic lymphocytic leukemia (CLL).<\/p>\n\n\n\n
What is the significance of eosinophils in urine?<\/p>\n\n\n\n
Kidney tumors<\/p>\n\n\n\n
Acute interstitial nephritis<\/p>\n\n\n\n
Parasitic infection<\/p>\n\n\n\n
UTI
B. Acute interstitial nephritis<\/p>\n\n\n\n
Feedback Greater than 5% eosinophils in urine indicates acute interstitial nephritis<\/p>\n\n\n\n
Why albumin is the first protein to be detected in tests for renal failure?<\/p>\n\n\n\n
Its molecular size is largest<\/p>\n\n\n\n
Its molecular size is smallest<\/p>\n\n\n\n
It is very negatively charged<\/p>\n\n\n\n
AOTA
B. Its molecular size is the smallest<\/p>\n\n\n\n
Feedback In healthy individual, the kidneys prevent albumin and other proteins from entering the urine as waste. If the kidneys are damaged however, it will allow proteins to pass into the urine. The first type of protein to appear in urine is albumin as its molecular size is smaller than most other proteins.<\/p>\n\n\n\n
In primary biliary cirrhosis, which of the following antibodies is seen in high titers?<\/p>\n\n\n\n
Anti-parietal cell<\/p>\n\n\n\n
Anti-DNA<\/p>\n\n\n\n
Anti-smooth muscle<\/p>\n\n\n\n
Antimitochondrial
Feedback Primary Biliary Cirrhosis (PBC) is characterized by the presence of antimitochondrial antibodies.<\/p>\n\n\n\n
Alkali denaturation test detects what type of hemoglobin?<\/p>\n\n\n\n
Hemoglobin C<\/p>\n\n\n\n
Hemoglobin F<\/p>\n\n\n\n
Hemoglobin S<\/p>\n\n\n\n
Hemoglobin H
B. Hemoglobin F<\/p>\n\n\n\n
Feedback The test is based on differences between maternal and fetal hemoglobin. Maternal blood contains adult hemoglobin composed of two alpha and two beta subunits (aka hemoglobin A or HbA; i.e., normal adult hemoglobin). Fetal blood contains fetal hemoglobin composed of two alpha and two gamma subunits (aka hemoglobin F or HbF; i.e., normal fetal hemoglobin).<\/p>\n\n\n\n
Viral specimen was received in the laboratory, what would the tech do when sending it to a reference laboratory within 96 hours?<\/p>\n\n\n\n
Store in ambient temperature<\/p>\n\n\n\n
Lyophilize the sample<\/p>\n\n\n\n
Loffler’s serum slant and refrigerate<\/p>\n\n\n\n
Pack in ice
D. Pack in ice<\/p>\n\n\n\n
Dry ice (4 degrees): 1. Stuart’s viral transport medium, 2. Leibovits-Emory, 3. Earles\/Hanks balance salt solution.<\/p>\n\n\n\n
Increased bilirubin in urine will make it color?<\/p>\n\n\n\n
Pink<\/p>\n\n\n\n
Red<\/p>\n\n\n\n
Dark yellow<\/p>\n\n\n\n
Brown
C. Dark Yellow<\/p>\n\n\n\n
Feedback Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver, it makes the urine appear dark yellow (yellow foam).<\/p>\n\n\n\n
A blue top specimen was drawn from a catheter and tested for PT and PTT. The result are significantly higher than yesterday’s results. What is the most likely explanation?<\/p>\n\n\n\n
Heparin contamination<\/p>\n\n\n\n
Specimen was too old<\/p>\n\n\n\n
Report the results<\/p>\n\n\n\n
Hematocrit was too high
A. Heparin contamination<\/p>\n\n\n\n
Feedback If correct procedures is not followed when drawing blood from central venous access devices, heparin contamination can cause inaccurate results.<\/p>\n\n\n\n
5HIAA in urine indicates:<\/p>\n\n\n\n
Carcinoid tumors<\/p>\n\n\n\n
Renal disease<\/p>\n\n\n\n
Nephrotic syndrome<\/p>\n\n\n\n
AOTA
A. Carcinoid tumors<\/p>\n\n\n\n
Feedback The 5-hydroxyindoleacetic acid (5-HIAA) urine test is used to help diagnose and monitor carcinoid tumors. It may be ordered by itself or along with a blood serotonin and\/or chromogranin A level. 5-HIAA is the primary metabolite of serotonin that is excreted in the urine. Concentrations of 5-HIAA may be significantly increased when a person has a carcinoid tumor that produces serotonin.<\/p>\n\n\n\n
Intraoperative autologous blood stored in 1-5C, how many hours it should be administered?<\/p>\n\n\n\n
4<\/p>\n\n\n\n
5<\/p>\n\n\n\n
12<\/p>\n\n\n\n
24
D. 24<\/p>\n\n\n\n
A characteristic morphologic feature in hemoglobin C disease is:<\/p>\n\n\n\n
Macrocytosis<\/p>\n\n\n\n
Spherocytosis<\/p>\n\n\n\n
Rouleaux formation<\/p>\n\n\n\n
Target cells
D. Target cells<\/p>\n\n\n\n
Feedback Codocytes also known as target cells are red blood cells that have the appearance of a shooting target with a bullseye.<\/p>\n\n\n\n
Which of the following would show dosage?<\/p>\n\n\n\n
Anti-e<\/p>\n\n\n\n
Anti-M<\/p>\n\n\n\n
Anti-K<\/p>\n\n\n\n
Anti-Le(a)
B. Anti-M
Feedback MNS antibodies display dosage (they react stronger against cells which are homozygous vs heterozygous for the antigen in question).<\/p>\n\n\n\n
Pinworm infection a.k.a enterobiasis:
Figure 16<\/p>\n\n\n\n
Enterobius vermicularis
Taenia saginata
Schistosoma haematobium
Taenia solium
A. Enterobius vermicularis<\/p>\n\n\n\n
Feedback Pinworm infection, also known as enterobiasis, is a human parasitic disease caused by the pinworm. The most common symptom is itching in the anal area. This can make sleeping difficult. Transparent adhesive tape (e.g. Scotch Tape) applied on the anal area will pick up deposited eggs, and diagnosis can be made by examining the tape with a microscope.<\/p>\n\n\n\n
Prolonged apnea, anesthesized by by succinylcholine, the enzyme responsible for the reaction is?<\/p>\n\n\n\n
Cholinesterase<\/p>\n\n\n\n
Aldolase<\/p>\n\n\n\n
Pseudocholinesterase<\/p>\n\n\n\n
AFP
C. Pseudocholinesterase
Feedback Pseudocholinesterase (butyrylcholinesterase) is a drug metabolizing enzyme responsible for hydrolysis of the muscle relaxant drugs succinylcholine and mivacurium. Deficiency from any cause can lead to prolonged apnea and paralysis following administration of succinylcholine and mivacurium.<\/p>\n\n\n\n
What enzyme is increase in Mumps?<\/p>\n\n\n\n
Amylase<\/p>\n\n\n\n
Lipase<\/p>\n\n\n\n
LDH<\/p>\n\n\n\n
CK
A. Amylase<\/p>\n\n\n\n
Feedback Salivary amylase levels are elevated in Mumps<\/p>\n\n\n\n
Agglutination reaction wherein a particle coated with a known antigen reacts with an antibody?<\/p>\n\n\n\n
Passive Agglutination<\/p>\n\n\n\n
Direct Agglutination<\/p>\n\n\n\n
Precipitation<\/p>\n\n\n\n
Flocculation
A. Passive agglutination<\/p>\n\n\n\n
RDW measures:<\/p>\n\n\n\n
Inclusions inside of RBCs<\/p>\n\n\n\n
Poikilocytosis<\/p>\n\n\n\n
Anisocytosis<\/p>\n\n\n\n
Hypochromia
C. Anisocytosis<\/p>\n\n\n\n
Feedback Anisocytosis is identified by RDW and is classified according to the size of RBC measured by MCV.<\/p>\n\n\n\n
Checking and reporting of patient value difference from previous analysis is term as:<\/p>\n\n\n\n
Delta check<\/p>\n\n\n\n
Quality check<\/p>\n\n\n\n
Sieving<\/p>\n\n\n\n
Trend
A. Delta check<\/p>\n\n\n\n
Feedback Delta check refers to checking and reporting of patient value difference from the previous analysis<\/p>\n\n\n\n
In respiratory acidosis, a compensatory mechanism is the increase in:<\/p>\n\n\n\n
Respiration rate<\/p>\n\n\n\n
Plasma bicarbonate concentration<\/p>\n\n\n\n
Ammonia formation<\/p>\n\n\n\n
Blood pCO2
B. Plasma bicarbonate concentration<\/p>\n\n\n\n
Which of the following is used to compare two sets of mean?<\/p>\n\n\n\n
Chi-square<\/p>\n\n\n\n
CV<\/p>\n\n\n\n
Standard Deviation<\/p>\n\n\n\n
Paired T-test
D. Paired t test<\/p>\n\n\n\n
Feedback Paired T-test-Calculate a range of values that is likely to include the population mean of the differences<\/p>\n\n\n\n
Glass membrane electrode is used to measure what?<\/p>\n\n\n\n
CaCl2<\/p>\n\n\n\n
Bicarbonate<\/p>\n\n\n\n
pH<\/p>\n\n\n\n
Na+
C. pH<\/p>\n\n\n\n
Feedback Glass membrane is most often used to measure pH in a solution<\/p>\n\n\n\n
Cessation of urine flow is defined as:<\/p>\n\n\n\n
Anuria<\/p>\n\n\n\n
Azotemia<\/p>\n\n\n\n
Dysuria<\/p>\n\n\n\n
Diuresis
A. anuria<\/p>\n\n\n\n
Feedback Anuria is defined as failure of the kidneys to produce urine.<\/p>\n\n\n\n
A urine specimen was submitted for isolation of cytomegalovirus (CMV). The urine was inoculated into human fibroblast tissue culture tubes. After 72 hours, no cytopathic effect was observed in the culture tubes. The most appropriate course of action is to:<\/p>\n\n\n\n
Repeat the test using monkey kidney cell culture tubes<\/p>\n\n\n\n
Request CMV serology as CMV cannot be isolated<\/p>\n\n\n\n
Incubate the culture tubes for 2-3 weeks longer<\/p>\n\n\n\n
Request a fecal specimen as urine is inappropriate
C. Incubate the culture tubes for 2-3 weeks longer<\/p>\n\n\n\n
Feedback CMV is a slow growing herpesvirus, and may require 3 weeks to grow in conventional viral culture.<\/p>\n\n\n\n
Identify the organism: Fig 17<\/p>\n\n\n\n
Histoplasma capsulatum<\/p>\n\n\n\n
Candida albicans<\/p>\n\n\n\n
Tinea pedis<\/p>\n\n\n\n
Sporothrix schenckii
A. Histoplasma capsulatum<\/p>\n\n\n\n
Feedback H. capsulatum produces two types of conidia, globose macroconidia, 8-15 \u00b5m, with distinctive tuberculate or finger-like cell wall ornamentation, and ovoid microconidia, 2-4 \u00b5m, which appear smooth or finely roughened.<\/p>\n\n\n\n
PBS shown would be seen in: Fig 18<\/p>\n\n\n\n
Presence of Cold-agglutinins<\/p>\n\n\n\n
Rheumatoid arthritis<\/p>\n\n\n\n
Paroxysmal Cold Hemoglobinuria<\/p>\n\n\n\n
NOTA
A. Presence of cold agglutinins<\/p>\n\n\n\n
Creatine Phosphokinase (CPK) in a patient with a myocardial infarction will:<\/p>\n\n\n\n
Rise 6 hours after heart attack, peak in 18 hours and return to baseline in 3 days<\/p>\n\n\n\n
Rise 6 to 10 hours after heart attack, peak at 12 to 48 hours and return to baseline in 4 days<\/p>\n\n\n\n
Rise 24 to 72 hours after heart attack, peak in 4 days, and return to baseline in 14 days<\/p>\n\n\n\n
Cause a corresponding rise in alpha-fetoprotein
A. Rise 6 hours after heart attack, peak in 18 hours and return to baseline in 3 days<\/p>\n\n\n\n
Feedback CPK is the first enzyme to rise following a heart attack, so doctors measure it before the other cardiac enzymes. If creatine kinase-MB (CK-MB) rises, it means the heart sustained severe damage.<\/p>\n\n\n\n
The purpose of POTASSIUM PERMANGANATE in Auramine-Rhodamine stain is: QUENCHING AGENT<\/p>\n\n\n\n
True<\/p>\n\n\n\n
False
A. True<\/p>\n\n\n\n
Presence of lupus anticoagulant leads to:<\/p>\n\n\n\n
Activation of fibrinolytic system<\/p>\n\n\n\n
Thrombosis (micro emboli clots)<\/p>\n\n\n\n
Bleeding<\/p>\n\n\n\n
Continuous activation of the clotting cascade
B. Thrombosis (micro emboli clots)<\/p>\n\n\n\n
Feedback Lupus anticoagulant is a misnomer, as it is actually a prothrombotic agent. Lupus anticoagulant antibodies in living systems cause an increase in inappropriate blood clotting.<\/p>\n\n\n\n
Identify the crystal shown below: Fig 19<\/p>\n\n\n\n
Triple phosphate<\/p>\n\n\n\n
Calcium oxalate<\/p>\n\n\n\n
Tyrosine<\/p>\n\n\n\n
Fiber
A. Triple phosphate<\/p>\n\n\n\n
Feedback Triple phosphate crystals may be normal but often are associated with alkaline urine and UTI (typically associated with Proteus species). These crystals are colorless and have a characteristic “coffin lid” appearance.<\/p>\n\n\n\n
What is correct Polymerase Chain Reaction (PCR) sequence?<\/p>\n\n\n\n
Annealing, Extension, Denaturation<\/p>\n\n\n\n
Extension, Denaturation, Annealing<\/p>\n\n\n\n
Denaturation, Extension, Annealing<\/p>\n\n\n\n
Denaturation, Annealing, Extension
C. Denaturation, Annealing, extension<\/p>\n\n\n\n
Feedback Denaturation- This step is the first regular cycling event and consists of heating the reaction chamber to 94-98\u00b0C (201-208 \u00b0F) for 20-30 seconds. This causes DNA melting, or denaturation, of the double-stranded DNA template by breaking the hydrogen bonds between complementary bases, yielding two single-stranded DNA molecules. Annealing- In the next step, the reaction temperature is lowered to 50-65\u00b0C (122-149 \u00b0F) for 20-40 seconds, allowing annealing of the primers to each of the single-stranded DNA templates. Two different primers are typically included in the reaction mixture: one for each of the two single-stranded complements containing the target region. The primers are single-stranded sequences themselves, but are much shorter than the length of the target region, complementing only very short sequences at the 3′ end of each strand. Extension- The temperature at this step depends on the DNA polymerase used; the optimum activity temperature for Taq polymerase is approximately 75-80 \u00b0C (167-176 \u00b0F), though a temperature of 72\u00b0C (162 \u00b0F) is commonly used with this enzyme. In this step, the DNA polymerase synthesizes a new DNA strand complementary to the DNA template strand by adding free dNTPs from the reaction mixture.<\/p>\n\n\n\n
Ionized calcium was left standing for a while. What change would happen to the sample?<\/p>\n\n\n\n
Change in pH<\/p>\n\n\n\n
Evaporation<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
NOTA
A. Change in pH<\/p>\n\n\n\n
Feedback Ionized calcium when stored in refrigerator or room temperature, values increased due to the drop in pH that comes with cell metabolism.<\/p>\n\n\n\n
Which of the following is the product of purine metabolism?<\/p>\n\n\n\n
Ammonia<\/p>\n\n\n\n
Creatinine<\/p>\n\n\n\n
Uric acid<\/p>\n\n\n\n
Bilirubin
C. Uric Acid<\/p>\n\n\n\n
Feedback Uric acid is the end product of an exogenous pool of purines and endogenous purine metabolism.<\/p>\n\n\n\n
Which assay, using 24-hour urine, is considered the BEST single screening test for PHEOCHROMOCYTOMA?<\/p>\n\n\n\n
Homovallic acid (HVA)<\/p>\n\n\n\n
Metanephrines<\/p>\n\n\n\n
Vanillylmandelic acid (VMA)<\/p>\n\n\n\n
Catecholamines
B. Metanephrines<\/p>\n\n\n\n
Feedback The most reliable screening tests for diagnosis of pheochromocytoma is measurement of plasma-free fractionated metanephrines and urinary fractionated metanephrines.<\/p>\n\n\n\n
Unconjugated bilirubinemia is seen in:<\/p>\n\n\n\n
Primary biliary cirrhosis<\/p>\n\n\n\n
Acute hepatitis<\/p>\n\n\n\n
Chronic hemolytic anemia<\/p>\n\n\n\n
All of the above
C. Chronic hemolytic anemia<\/p>\n\n\n\n
In hypothalamic-pituitary-adrenal axis, hypothalamus stimulate the release of cortisol from adrenal gland through:<\/p>\n\n\n\n
ACTH<\/p>\n\n\n\n
Corticotropin Releasing Hormone (CRH)<\/p>\n\n\n\n
Gonadotropin Releasing Hormone (GRH)<\/p>\n\n\n\n
Thyrotropin Releasing Horome (TRH
Corticotropin Releasing Hormone (CRH)<\/p>\n\n\n\n
Prolonged PT and APTT with depleted fibrinogen levels and platelet can be associated with:<\/p>\n\n\n\n
Acute DIC<\/p>\n\n\n\n
Von Willebrand Disease<\/p>\n\n\n\n
Hemophilia A<\/p>\n\n\n\n
Glanzmann’s Thrombasthenia
A. Acute DIC<\/p>\n\n\n\n
Most potent activator enzyme:<\/p>\n\n\n\n
Magnesium<\/p>\n\n\n\n
Sodium<\/p>\n\n\n\n
Potassium<\/p>\n\n\n\n
All of the above
A. Feedback Over 300 enzymes require the presence of magnesium ions for their catalytic action, including all enzymes utilizing or synthesizing ATP, or those that use other nucleotides to synthesize DNA and RNA.<\/p>\n\n\n\n
The formation of germ tubes presumptively identifies:<\/p>\n\n\n\n
Candida tropicalis<\/p>\n\n\n\n
Candida albicans<\/p>\n\n\n\n
Candida glabarata<\/p>\n\n\n\n
Candida parapsilosis
B. Candida albicans<\/p>\n\n\n\n
Feedback Candida albicans produces germ tubes.<\/p>\n\n\n\n
The binding strength of an antibody for an antigen is referred to as:<\/p>\n\n\n\n
Avidity<\/p>\n\n\n\n
Specificity<\/p>\n\n\n\n
Affinity<\/p>\n\n\n\n
Titer
A. Avidity<\/p>\n\n\n\n
The term that denotes a situation in which the effect of two antimicrobial agents together is greater than the sum of the effects of either drug alone is:<\/p>\n\n\n\n
Antagonism<\/p>\n\n\n\n
Additivism<\/p>\n\n\n\n
Sensitivity<\/p>\n\n\n\n
Synergism
D. Synergism<\/p>\n\n\n\n
A patient was diagnosed with streptococcal pharyngitis 6 months ago. Now he is showing signs of glumerulonephritis. What will be seen in the renal biopsy?<\/p>\n\n\n\n
S. agalactiae<\/p>\n\n\n\n
S. pyogenes<\/p>\n\n\n\n
H. influenzae<\/p>\n\n\n\n
S. aureus
Next
S. pyogenes<\/p>\n\n\n\n
Feedback S. pyogenes is the most common causative agent of pharyngitis.<\/p>\n\n\n\n
Which of the following below shows “partial identity pattern” in an Ouchterlony Double Diffusion? Fig 13<\/p>\n\n\n\n
A<\/p>\n\n\n\n
B<\/p>\n\n\n\n
C<\/p>\n\n\n\n
AOTA
B. Feedback In the “pattern of partial identity”, the antibodies in the antiserum react more with one of the antigens than the other. The “spur” is thought to result from the determinants present in one antigen but lacking in the other antigen<\/p>\n\n\n\n
Antibody to acetylcholine receptor:<\/p>\n\n\n\n
SLE<\/p>\n\n\n\n
Goodpasteur syndrome<\/p>\n\n\n\n
Multiple sclerosis<\/p>\n\n\n\n
Myasthenia gravis
D. Myasthenia gravis<\/p>\n\n\n\n
Feedback Myasthenia gravis (MG) is a relatively rare autoimmune disorder in which antibodies form against nicotinic acetylcholine (ACh) postsynaptic receptors at the neuromuscular junction (NMJ) of the skeletal muscles.<\/p>\n\n\n\n
Pink mucoid colonies on MAC
TSI=A\/A
Spot indole test: POSITIVE<\/p>\n\n\n\n
Klebsiella oxytoca<\/p>\n\n\n\n
Enterobacter gergoviae<\/p>\n\n\n\n
Klebsiella pneumoniae<\/p>\n\n\n\n
Salmonella
A. Klebsiella oxytoca<\/p>\n\n\n\n
Protein electrophoresis in pH 8.6, What proteins are closest to cathode?<\/p>\n\n\n\n
Albumin and Alpha 2<\/p>\n\n\n\n
Albumin and Alpha 1<\/p>\n\n\n\n
Beta and Gamma<\/p>\n\n\n\n
NOTA
c. beta and gamma<\/p>\n\n\n\n
Feedback Order of migration from Anode to Cathode: Albumin, Alpha-1, Alpha-2, Beta and Gamma<\/p>\n\n\n\n
Which of the following is a primary immunodeficiency characterized by cellular (T-cell lymphocytes) deficiency, defective thymus gland, congenital heart disease and hypocalcemia?<\/p>\n\n\n\n
Down Syndrome<\/p>\n\n\n\n
DiGeorge Syndrome<\/p>\n\n\n\n
Edward’s Syndrome<\/p>\n\n\n\n
Severe Combined Immunodeficiency
B. DiGeorge’s syndromes<\/p>\n\n\n\n
Feedback DiGeorge syndrome is a primary immunodeficiency disease caused by abnormal formation of certain tissues during fetal development. The defect may affect the thymus gland and impair production of T lymphocytes. Most people with DiGeorge syndrome have a genetic defect on chromosome 22.<\/p>\n\n\n\n
Decreased serum sodium but all other electrolytes and serum osmolality were normal. What to do next?<\/p>\n\n\n\n
Perform Indirect ISE<\/p>\n\n\n\n
Perform Direct ISE<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
Report results
Feedback The measuring technology that provides the physiologically correct values is called DIRECT ISE. This method is typically used in blood gas analyzers and POC electrolyte analyzers. In the direct ISE, the sample is not diluted and the results are correct even if the volume of plasma water is modified<\/p>\n\n\n\n
The protein electrophoresis shown below indicates?<\/p>\n\n\n\n
Acute inflammation<\/p>\n\n\n\n
Multiple myeloma<\/p>\n\n\n\n
Nephrotic syndrome<\/p>\n\n\n\n
AOTA
C. Nephrotic syndrome<\/p>\n\n\n\n
Feedback Alpha-2 macroglobulin (AMG or A2M) may be elevated in children and the elderly. This is seen as a sharp front to the alpha-2 band. AMG is markedly raised (10-fold increase or greater) in association with glomerular protein loss, as in nephrotic syndrome. Due to its large size, AMG cannot pass through glomeruli, while other lower-molecular weight proteins are lost. Enhanced synthesis of AMG accounts for its absolute increase in nephrotic syndrome.<\/p>\n\n\n\n
Which of the following test is used to screen Chronic Granulomatous Disease (CGD)?<\/p>\n\n\n\n
Ham’s acidified serum test<\/p>\n\n\n\n
NBT (Nitroblue Tetrazolium) Dye Test<\/p>\n\n\n\n
G6PD Flourescent Screening Test<\/p>\n\n\n\n
AOTA
B. NBT (Nitroblue Tetrazolium) Dye test<\/p>\n\n\n\n
Feedback The nitroblue tetrazolium test checks if certain immune system cells can change a colorless chemical called nitroblue tetrazolium (NBT) into a deep blue color. This test is done to screen for chronic granulomatous disease. People who have frequent infections in the bones, skin, joints, lungs, and other parts of the body may have this test done.<\/p>\n\n\n\n
Wright-stained smear from a patient with elevated reticulocyte count should show:<\/p>\n\n\n\n
Rouleaux<\/p>\n\n\n\n
Polychromasia<\/p>\n\n\n\n
Microcytosis<\/p>\n\n\n\n
Agglutination
B. Polychromasia<\/p>\n\n\n\n
Feedback Polychromasia (also known as Polychromatophilia) is a disorder where there is an abnormally high number of immature red blood cells found in the bloodstream as a result of being prematurely released from the bone marrow during blood formation.<\/p>\n\n\n\n
Which test differentiates E. coli 0157:H7?<\/p>\n\n\n\n
Mannitol<\/p>\n\n\n\n
Sorbitol<\/p>\n\n\n\n
Lactose<\/p>\n\n\n\n
Glucose
B. Sorbitol<\/p>\n\n\n\n
Feedback E. coli O157:H7 is an enteric pathogen that typically causes hemorrhagic colitis and bloody diarrheal illnesses. It may be followed by hemolytic uremic syndrome, especially in young children. MacConkey Agar with Sorbitol is recommended for isolation of this organism. E. coli O157:H7 is sorbitol nonfermenter thus forms colorless colonies while any bacteria capable of fermenting sorbitol (including other E. coli species) form pink colonies on MacConkey Agar with Sorbitol.<\/p>\n\n\n\n
The growth of which of the following fungi will be enhanced by olive oil?<\/p>\n\n\n\n
Malassezia furfur<\/p>\n\n\n\n
T. mentagrophytes<\/p>\n\n\n\n
T. rubrum<\/p>\n\n\n\n
None of the above
a. Malassezia furfur<\/p>\n\n\n\n
Feedback Saturated fatty acids likely encourage Malassezia overgrowth.<\/p>\n\n\n\n
What does the pH measurement needs?<\/p>\n\n\n\n
pH with known buffer at constant temperature<\/p>\n\n\n\n
pH with unknown buffer at constant temperature<\/p>\n\n\n\n
pH with known buffer and constant HCO3 concentration<\/p>\n\n\n\n
None of the above
A. pH with known buffer at constant temperature<\/p>\n\n\n\n
Which of the following describes the mathematical expression of anion gap?<\/p>\n\n\n\n
(Na + K) + (Cl – HCO3)<\/p>\n\n\n\n
(Na – K) + (Cl – HCO3)<\/p>\n\n\n\n
(Na + K) x (Cl + HCO3)<\/p>\n\n\n\n
(Na + K) – (Cl + HCO3)
D. (Na+K)-(Cl+HCO3)<\/p>\n\n\n\n
Non-treponemal assays for syphilis such as Rapid Plasma Reagin (RPR) and Veneral Disease Research Laboratory (VDRL) detects the presence of:<\/p>\n\n\n\n
Anti-cardiolipin antibodies<\/p>\n\n\n\n
Cardiolipin<\/p>\n\n\n\n
Anti-treponemal antibodies<\/p>\n\n\n\n
Treponema pallidum
A. Anti-cardiolipin antibodies<\/p>\n\n\n\n
Feedback RPR and VDRL detects the presence of reagin, which are anti-cardiolipin antibodies present in patient infected syphilis.<\/p>\n\n\n\n
Case Analysis:<\/p>\n\n\n\n
Bilirubin is tested for a new born baby. For 3 consecutive days, the bilirubin results are high, on the 4th day, bilirubin results became normal. Determine what is the cause:<\/p>\n\n\n\n
Baby undergone phototherapy<\/p>\n\n\n\n
Hemolysis on the 1st to 3rd day<\/p>\n\n\n\n
Hemolysis on the 4th day<\/p>\n\n\n\n
Normal results
A. Baby undergone phototherapy<\/p>\n\n\n\n
Feedback Phototherapy (light treatment) is the process of using light to eliminate bilirubin in the blood. Your baby’s skin and blood absorb these light waves. These light waves are absorbed by your baby’s skin and blood and change bilirubin into products, which can pass through their system.<\/p>\n\n\n\n
Final degenerative form of cast:<\/p>\n\n\n\n
Waxy Cast<\/p>\n\n\n\n
Hyaline Cast<\/p>\n\n\n\n
WBC Cast<\/p>\n\n\n\n
RBC Cast
A. Waxy cast<\/p>\n\n\n\n
Principle of reagent strip of pH:<\/p>\n\n\n\n
Double indicator system<\/p>\n\n\n\n
Change in dissociation constant (pKa)<\/p>\n\n\n\n
Sodium nitroprusside reaction<\/p>\n\n\n\n
NOTA
A. Double indicator system<\/p>\n\n\n\n
Feedback It is common to use a double indicator system comprising methyl red and bromothymol blue. Methyl red produces a color change from red to yellow in the range of pH 4 to 6 and the bromothymol blue changes from yellow to blue between pH 6 and 9. In the range 5 to 9 the strips show colors that change from orange at pH 5, passing through yellow and green to dark blue at pH 9.<\/p>\n\n\n\n
Elevated level of aminolevulinic acid in urine is due to the presence of?<\/p>\n\n\n\n
Magnesium<\/p>\n\n\n\n
Copper<\/p>\n\n\n\n
Lead<\/p>\n\n\n\n
Zinc
C. Lead<\/p>\n\n\n\n
Feedback Lead poisoning affects many organs in the body. Lead inhibits \u03b4-aminolevulinic acid dehydratase (ALAD), an enzyme with two co-dominantly expressed alleles, ALAD1 and ALAD2.<\/p>\n\n\n\n
Biosafety Level (BSL) for Mycobacterium tuberculosis:<\/p>\n\n\n\n
BSL I<\/p>\n\n\n\n
BSL II<\/p>\n\n\n\n
BSL III<\/p>\n\n\n\n
BSL IV
C. BSLIII<\/p>\n\n\n\n
Feedback Biosafety level 3 is commonly used for research and diagnostic work involving various microbes which can be transmitted by aerosols and\/or cause severe disease. These include Francisella tularensis, Mycobacterium tuberculosis, Chlamydia psittaci, Venezuelan equine encephalitis virus, Eastern equine encephalitis virus, SARS coronavirus, Coxiella burnetii, Rift Valley fever virus, Rickettsia rickettsii, several species of Brucella, chikungunya, yellow fever virus, and West Nile virus.<\/p>\n\n\n\n
The absence of the Philadelphia chromosome in granulocytic leukemia suggests:<\/p>\n\n\n\n
A polyclonal origin to the disease<\/p>\n\n\n\n
Excellent response to therapy<\/p>\n\n\n\n
Rapid progression of the disease<\/p>\n\n\n\n
Conversion from another myeloproliferative disorder
C. Rapid progression of the disease<\/p>\n\n\n\n
Feedback Prognostic implications of Philadelphia chromosome.<\/p>\n\n\n\n
Excessively pink stain causes:<\/p>\n\n\n\n
Prolonged washing time<\/p>\n\n\n\n
Mounting coverslips before they are dry<\/p>\n\n\n\n
Too high acidity of the stain<\/p>\n\n\n\n
AOTA
AOTA<\/p>\n\n\n\n
Cystic fibrosis associated bacteria\/s:<\/p>\n\n\n\n
Burkholderia cepacia<\/p>\n\n\n\n
Staphylococcus aureus<\/p>\n\n\n\n
Pseudomonas aeruginosa<\/p>\n\n\n\n
All of the above choices
All of the above choices<\/p>\n\n\n\n
Falsely increased potassium:<\/p>\n\n\n\n
Sample is not covered with carbon paper<\/p>\n\n\n\n
Tourniquet left for more than 10 minutes<\/p>\n\n\n\n
Sample is not chilled<\/p>\n\n\n\n
All of the above
B. Tourniquet left for more than 10 minutes<\/p>\n\n\n\n
Feedback Excessive tourniquet time or fist clenching during phlebotomy presumably leads to efflux of potassium from the muscle cells into the bloodstream.<\/p>\n\n\n\n
How would you differentiate V. parahaemolyticus from V. cholerae?<\/p>\n\n\n\n
Sucrose<\/p>\n\n\n\n
Glucose<\/p>\n\n\n\n
Lactose<\/p>\n\n\n\n
No possible differentiation
A. Sucrose<\/p>\n\n\n\n
Feedback V. cholerae is sucrose (+), it produces yellow colonies in TCBS while V. parahaemolyticus is sucrose(-), it produces green colonies in TCBS.<\/p>\n\n\n\n
Anti-A 4+
Anti-B 0<\/p>\n\n\n\n
A cells 0
B cells 0<\/p>\n\n\n\n
Polyagglutination<\/p>\n\n\n\n
Immunodeficient<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
None of the above
B. Immunodeficient<\/p>\n\n\n\n
Which blood group system is associated with resistance to P. vivax malaria?<\/p>\n\n\n\n
P<\/p>\n\n\n\n
Duffy<\/p>\n\n\n\n
Kell<\/p>\n\n\n\n
Kidd
B. Duffy<\/p>\n\n\n\n
Feedback Individuals with the Duffy-negative phenotype are resistant to P. vivax invasion, and the molecular mechanism that gives rise to the phenotype Fy(a-b-).<\/p>\n\n\n\n
Zollinger-Ellison (Z-E) syndrome is characterized by great (for example, 20 fold) elevation of the level of:<\/p>\n\n\n\n
Pepsin<\/p>\n\n\n\n
Gastrin<\/p>\n\n\n\n
Glucagon<\/p>\n\n\n\n
Cholecystokinin
B. Gastrin<\/p>\n\n\n\n
Feedback Zollinger-Ellison syndrome (ZES) is caused by a non-beta islet cell, gastrin-secreting tumor of the pancreas that stimulates the acid-secreting cells of the stomach to maximal activity, with consequent gastrointestinal mucosal ulceration.<\/p>\n\n\n\n
Which of the following disorders is associated with Dohle bodies and giant platelets?<\/p>\n\n\n\n
Alder-Reilly anomaly<\/p>\n\n\n\n
Chediak Higashi syndrome<\/p>\n\n\n\n
May-Hegglin anomaly<\/p>\n\n\n\n
Pelger-Huet anomaly
Feedback May-Hegglin anomaly (MHA) is an autosomal dominant disorder characterized by various degrees of thrombocytopenia that may be associated with purpura and bleeding; giant platelets containing few granules; and large, well-defined, basophilic, cytoplasmic inclusion bodies in granulocytes that resemble D\u00f6hle bodies.f<\/p>\n\n\n\n
A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is:<\/p>\n\n\n\n
ALT<\/p>\n\n\n\n
GGT<\/p>\n\n\n\n
AST<\/p>\n\n\n\n
Ammonia
A. Ammonia<\/p>\n\n\n\n
Feedback Hepatic encephalopathy (HE) is the occurrence of confusion, altered level of consciousness, and coma as a result of liver failure. In the advanced stages it is called hepatic coma or coma hepaticum. It may ultimately lead to death. Blood tests (ammonia levels) may assist in the diagnosis.<\/p>\n\n\n\n
Superior indicator of monitoring short-term effects of nutritional therapy:<\/p>\n\n\n\n
Sodium<\/p>\n\n\n\n
Prealbumin<\/p>\n\n\n\n
A-2 Globulin<\/p>\n\n\n\n
Chloride
B. Prealbumin<\/p>\n\n\n\n
Feedback The concentration of transthyretin and Retinol Binding Protein (RBP) complex, greatly decreased in protein-energy malnutrition<\/p>\n\n\n\n
In chronic active hepatitis, high titers of which of the following antibodies are seen?<\/p>\n\n\n\n
Anti-smooth muscle<\/p>\n\n\n\n
Antimitochondrial<\/p>\n\n\n\n
Anti-DNA<\/p>\n\n\n\n
Anti-parietal cell
A. Anti-smooth muscle<\/p>\n\n\n\n
Feedback Chronic Active Hepatitis (CAH) has at least 2 subsets, the classic or type I, which is associated with a positive ANA test and positive smooth muscle antibodies. The condition is associated with an attack on the hepatocytes.<\/p>\n\n\n\n
Which genotype(s) will give rise to the Bombay phenotype?<\/p>\n\n\n\n
HH only<\/p>\n\n\n\n
HH and Hh<\/p>\n\n\n\n
Hh and hh<\/p>\n\n\n\n
hh only
D. hh only<\/p>\n\n\n\n
Feedback H antigen deficiency is known as the “Bombay phenotype” (h\/h, also known as Oh) and is found in 1 of 10,000 individuals in India and 1 in a million people in Europe. There is no ill effect with being H deficient, but if a blood transfusion is ever needed, people with this blood type can receive blood only from other donors who are also H deficient.<\/p>\n\n\n\n
Identify the organism: Culture at 37 degrees in 10-20 days, Niacin test: negative, Nitrate reduction: positive, non-pigmented colonies when grown in the dark and turns pigmented yellow colonies only after exposure to light and reincubation:<\/p>\n\n\n\n
Fig. 21<\/p>\n\n\n\n
M. kansasii<\/p>\n\n\n\n
M. mycobacterium<\/p>\n\n\n\n
M. gordonae<\/p>\n\n\n\n
M. fortuitum
Feedback M. kansasii is a photocromogen type of mycobateria. Other photochromogens are M. marinum and M. simiae.<\/p>\n\n\n\n
Synovial fluid is analyzed with a polarizing microscope. Strongly birefringent needles are seen. This most likely indicates:<\/p>\n\n\n\n
Calcium pyrophosphate crystals<\/p>\n\n\n\n
Monosodium urate crystals<\/p>\n\n\n\n
Talc crystals<\/p>\n\n\n\n
Corticosteroid crystals
B. Monosodium urate crystals<\/p>\n\n\n\n
Feedback A, C, D are possibilities, but the most likely cause is monosodium urate (MSU). MSU (uric acid) are needles, whereas calcium pyrophosphate crystals are rhomboid and square. Corticosteroid crystals are birefringent and needle shaped but will only be present if the patient has been treated with corticosteroid injections. Talc crystals are found as contaminants, and are not needle shaped.<\/p>\n\n\n\n
The descending arrangement of lipoproteins according to protein\/lipid ratio:<\/p>\n\n\n\n
Chylomicron,IDL,VLDL,LDL,HDL<\/p>\n\n\n\n
HDL, LDL, IDL, VLDL<\/p>\n\n\n\n
Chylomicron, VLDL, IDL,LDL<\/p>\n\n\n\n
None of the above
B. HDL, LDL, IDL, VLDL<\/p>\n\n\n\n
Reason for synovial fluid turbidity:<\/p>\n\n\n\n
Crystals<\/p>\n\n\n\n
Protein<\/p>\n\n\n\n
Immunoglobulin<\/p>\n\n\n\n
All of the above
A. Crystals<\/p>\n\n\n\n
Feedback Birefringent crystals are found in the synovial fluid of >90% of patients with acutely inflamed joints. Crystal identification aids in the diagnosis of joint disease. Monosodium urate crystals are seen in gouty fluids. Urate crystals are mainly needle-shaped and strongly doubly refractile, and may be found within leukocytes. Calcium pyrophosphate crystals are present in chondrocalcinosis. Calcium pyrophosphate dehydrate crystals usually appear as rhomboids and tend to be small, measuring between 1 and 20 um<\/p>\n\n\n\n
In addition to carcinoma of the prostate, elevated prostate-specific antigen (PSA) can occur due to:<\/p>\n\n\n\n
Benign prostatic hyperplasia<\/p>\n\n\n\n
Statin therapy (cholesterol lowering drug)<\/p>\n\n\n\n
Exogenous steroid use<\/p>\n\n\n\n
Aspirin therapy
A. Benign prostatic hyperplasia<\/p>\n\n\n\n
Feedback PSA can be elevated due to benign prostatic hyperplasia (BPH).<\/p>\n\n\n\n
Exotic pets are often associated with the transmission of?<\/p>\n\n\n\n
Helicobacter spp.<\/p>\n\n\n\n
Campylobacter spp.<\/p>\n\n\n\n
Vibrio spp.<\/p>\n\n\n\n
Salmonella spp.
D. Salmonella spp.<\/p>\n\n\n\n
Feedback During the period from 1994 to 1996, an increase in the number of laboratory-confirmed cases of human salmonellosis associated with exposure to exotic pets including iguanas, pet turtles, sugar gliders, and hedgehogs.<\/p>\n\n\n\n
Which of the following prevents viral replication?<\/p>\n\n\n\n
Cytokines<\/p>\n\n\n\n
Interferon<\/p>\n\n\n\n
Lymphokines<\/p>\n\n\n\n
All of the above
B. Interferon<\/p>\n\n\n\n
Feedback Interferons (IFNs) are a group of signaling proteins[ made and released by host cells in response to the presence of several pathogens, such as viruses, bacteria, parasites, and also tumor cells. In a typical scenario, a virus-infected cell will release interferons causing nearby cells to heighten their anti-viral defenses.<\/p>\n\n\n\n
In calibrating a centrifuge, one should use a:<\/p>\n\n\n\n
Tachometer<\/p>\n\n\n\n
Barometer<\/p>\n\n\n\n
Revulometer<\/p>\n\n\n\n
Nanometer
A. Tachometer<\/p>\n\n\n\n
Feedback Centrifuges are calibrated using a tachometer and a stopwatch.<\/p>\n\n\n\n
A urine pH of 4.5 or less can be seen in:<\/p>\n\n\n\n
High protein intake<\/p>\n\n\n\n
Vomiting<\/p>\n\n\n\n
Hyperventilation<\/p>\n\n\n\n
Hyponatremia
A. High protein intake<\/p>\n\n\n\n
Feedback In a regression analysis protein intake proved to be an independent factor modulating the ratio between urine-pH and renal ammonium excretion. The concomitant increase of renal net acid excretion and maximum renal acid excretion capacity in periods of high protein intake appears to be a highly effective response of the kidney to a specific food intake leaving a large renal surplus capacity for an additional renal acid load.<\/p>\n\n\n\n
CD8:<\/p>\n\n\n\n
Helper T-Cells<\/p>\n\n\n\n
Cytotoxic T-cells<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
NOTA
B. Cytotoxic T cells<\/p>\n\n\n\n
Feedback A cytotoxic T cell (also known as TC, cytotoxic T lymphocyte, CTL, T-killer cell, cytolytic T cell, CD8+ T-cell or killer T cell) is a T lymphocyte (a type of white blood cell) that kills cancer cells, cells that are infected (particularly with viruses), or cells that are damaged in other ways.<\/p>\n\n\n\n
Who discovered the ABO Blood Group System?<\/p>\n\n\n\n
Karl Landsteiner<\/p>\n\n\n\n
Susumu Tonegawa<\/p>\n\n\n\n
Kyle Metchnikoff<\/p>\n\n\n\n
NOTA
A. Karl Landsteiner<\/p>\n\n\n\n
Feedback The ABO blood group system is widely credited to have been discovered by the Austrian scientist Karl Landsteiner, who identified the O, A, and B blood types in 1900.<\/p>\n\n\n\n
Which of the following serves as the specimen of choice for the demonstration of tertiary syphilis?<\/p>\n\n\n\n
Joint fluid<\/p>\n\n\n\n
Chancre fluid<\/p>\n\n\n\n
CSF<\/p>\n\n\n\n
Serum sample
C. CSF<\/p>\n\n\n\n
Feedback Tertiary syphilis most often involves the central nervous system. CSF would be the suitable sample of choice. CSF-VDRL test is done to diagnose syphilis in the brain or spinal cord. Brain and spinal cord involvement is often a sign of late-stage syphilis.<\/p>\n\n\n\n
A CSF specimen was sent to the laboratory at 2am, gram stain was done and subsequent culture is to be done by the next shift. What temperature should be the specimen kept?<\/p>\n\n\n\n
Incubated at 35 degrees celsius<\/p>\n\n\n\n
Stored at room temperature<\/p>\n\n\n\n
Stored at 70 degrees celsius<\/p>\n\n\n\n
Freeze the specimen
A. Incubated at 35 degrees celsius<\/p>\n\n\n\n
Feedback Fastidous organisms such as Neisseria and Haemophilus frequently isolated from the CSF of patients with bacterial meningitis are preserved by placing the fluid in 3%-7% CO2 at 35C-37C (or at room temperature for no longer than 30 min), if the specimen cannot be cultured immediately.<\/p>\n\n\n\n
Which of the following below shows “non-identity pattern” in an Ouchterlony Double Diffusion? Fig 13<\/p>\n\n\n\n
A<\/p>\n\n\n\n
B<\/p>\n\n\n\n
C<\/p>\n\n\n\n
NOTA
C<\/p>\n\n\n\n
Feedback In the “pattern of non-identity”, none of the antibodies in the antiserum react with antigenic determinants that may be present in both the antigens, i.e., the two antigens are immunologically unrelated as far as that antiserum is concerned.<\/p>\n\n\n\n
Type III Hyperlipoproteinemia:<\/p>\n\n\n\n
Elevated LDL<\/p>\n\n\n\n
Elevated cholesterol, Triglycerides; presence of B-VLDL<\/p>\n\n\n\n
Elevated VLDL<\/p>\n\n\n\n
Elevated VLDL and presence of chylomicrons
B. Elevated cholesterol, trig; presence of B-VLDL<\/p>\n\n\n\n
Mitotic cells (orange arrow) show uniform, discrete speckles. Resting cells (white arrow) shows 40-60 discrete speckles per cell nucleus: Fig 22<\/p>\n\n\n\n
SLE<\/p>\n\n\n\n
Sjogrens syndrome<\/p>\n\n\n\n
Scleroderma with CREST<\/p>\n\n\n\n
Rheumatoid arthritis
C. Scleroderma with CREST<\/p>\n\n\n\n
Feedback The above ANA pattern shows centromere pattern which is seen in Scleroderma with CREST.<\/p>\n\n\n\n
pH used for Malarial parasite staining:<\/p>\n\n\n\n
pH 6.8<\/p>\n\n\n\n
pH 5.3<\/p>\n\n\n\n
pH 7.2<\/p>\n\n\n\n
AOTA
C. pH 7.2<\/p>\n\n\n\n
Feedback pH 7.2 is used for malarial parasite staining, pH 6.8 is used for blood and bone marrow staining.<\/p>\n\n\n\n
Presence of teardrop cells in PBS, is indicative of what deficiency? Fig 23<\/p>\n\n\n\n
DNA<\/p>\n\n\n\n
RNA<\/p>\n\n\n\n
G6PD<\/p>\n\n\n\n
Myeloperoxidase
A. DNA<\/p>\n\n\n\n
Feedback They are usually characteristic of myelofibrosis, and seen with marrow disorders or marrow infiltrations, really because of improper production of blood cells from the bone marrow.<\/p>\n\n\n\n
Presence of teardrop cells in PBS, is indicative of what deficiency? Fig 23<\/p>\n\n\n\n
DNA<\/p>\n\n\n\n
RNA<\/p>\n\n\n\n
G6PD<\/p>\n\n\n\n
Myeloperoxidase
A. DNA<\/p>\n\n\n\n
Feedback They are usually characteristic of myelofibrosis, and seen with marrow disorders or marrow infiltrations, really because of improper production of blood cells from the bone marrow.<\/p>\n\n\n\n
An organism that exhibits the satellite phenomenon around colonies of staphylococci is:<\/p>\n\n\n\n
Klebsiella pneumoniae<\/p>\n\n\n\n
Neisseria gonorrhae<\/p>\n\n\n\n
Haemophilus influenzae<\/p>\n\n\n\n
Neisseria meningitidis
C. Haemophilus influenze<\/p>\n\n\n\n
Feedback Haemophilus influenzae requires X and V factors. Sheep blood agar supplies X factor and the staphylococci produce V factor, so colonies grow around staph colonies.<\/p>\n\n\n\n
In the NFPA safety diamond, the blue quadrant gives information about:<\/p>\n\n\n\n
Reactivity hazard<\/p>\n\n\n\n
Health hazard<\/p>\n\n\n\n
Additional notices<\/p>\n\n\n\n
Flammability hazard
B. Health hazard<\/p>\n\n\n\n
Feedback In the NFPA (National Fire Protection Association) safety diamond, the blue quadrant represents health hazard; red quadrant gives information about the flammability hazard; yellow quadrant represents reactivity or stability hazard; and white quadrant gives special information.<\/p>\n\n\n\n
Blood group that deteriorates upon storage:<\/p>\n\n\n\n
P<\/p>\n\n\n\n
I<\/p>\n\n\n\n
Lea<\/p>\n\n\n\n
K
A. P<\/p>\n\n\n\n
Feedback P1 antigen deteriorates rapidly upon storage.<\/p>\n\n\n\n
Reference standard for drug testing:<\/p>\n\n\n\n
GC-MS<\/p>\n\n\n\n
HPLC<\/p>\n\n\n\n
TLC<\/p>\n\n\n\n
Immunoassays
A. GC-MS<\/p>\n\n\n\n
Feedback The reference method for the qualitative identification of most organic compound is gas chromatography, mass spectrometer as the detector (Bishop, 4th ed.).<\/p>\n\n\n\n
Defect in PNH (Paroxysmal Nocturnal Hemoglobinuria)<\/p>\n\n\n\n
Spectrin<\/p>\n\n\n\n
CD59<\/p>\n\n\n\n
CD3<\/p>\n\n\n\n
Cobalamin
B. CD59<\/p>\n\n\n\n
Feedback A low level of complement activation is a constant physiological phenomenon greatly amplified during inflammatory or infectious diseases; thus, PNH erythrocytes chronically undergo intravascular hemolysis in PNH patients due to CD55 and CD59 deficiency.<\/p>\n\n\n\n
Normal value for Mean Corpuscular Volume (MCV):<\/p>\n\n\n\n
50-80 fl<\/p>\n\n\n\n
100-200 fl<\/p>\n\n\n\n
80-100 fl<\/p>\n\n\n\n
60-90 fl
C. 80-100 fl<\/p>\n\n\n\n
Feedback Normal value for MCV is 80-100 fl, formula for computation is MCV= Hctx10\/RBC.<\/p>\n\n\n\n
In photometric method of measuring bilirubin, analyzers measure the color change of what wavelength?<\/p>\n\n\n\n
454nm<\/p>\n\n\n\n
320nm<\/p>\n\n\n\n
350nm<\/p>\n\n\n\n
640nm
A. 454 nm<\/p>\n\n\n\n
Fiber strands in urine resemble what under the microscope?<\/p>\n\n\n\n
Waxy cast<\/p>\n\n\n\n
Hyaline cast<\/p>\n\n\n\n
WBC cast<\/p>\n\n\n\n
Fine granular cast
B. Hyaline cast<\/p>\n\n\n\n
Feedback Fiber strands (commonly fibers from diapers) resemble hyaline casts and may be mistaken for such.<\/p>\n\n\n\n
Which of the ff would cause a PBS like this? Fig. 24<\/p>\n\n\n\n
PCH<\/p>\n\n\n\n
Mycoplasma pneumoniae<\/p>\n\n\n\n
PNH<\/p>\n\n\n\n
All of the above
B. Mycoplasma pneumonia<\/p>\n\n\n\n
Fig. 25<\/p>\n\n\n\n
The image below shows immunoflourescence staining pattern of anti-DsDNA antibodies on Crithidia luciliae substrate. What autoimmune disease is indicative with this pattern?<\/p>\n\n\n\n
Rheumatoid Arthritis<\/p>\n\n\n\n
SLE<\/p>\n\n\n\n
Gout<\/p>\n\n\n\n
Myasthenia gravis
B. SLE<\/p>\n\n\n\n
Feedback The kinetoplast located near the flagellum is stained, indicating the presence of anti-dsDNA antibodies in a person with systemic lupus erythamatosus (SLE).<\/p>\n\n\n\n
Which group of molds can be ruled out when septate hyphae are observed in a culture?<\/p>\n\n\n\n
Dematiaceous<\/p>\n\n\n\n
Zygomycetes<\/p>\n\n\n\n
Dermatophytes<\/p>\n\n\n\n
Dimorphic molds
B. Zygomycetes<\/p>\n\n\n\n
Feedback Zygomycetes commonly recovered from clinical specimens are Rhizopus spp and Mucor spp. Both display aseptate hyphae, while the other groups above display septate hyphae.<\/p>\n\n\n\n
Adrenal Cushing Syndrome mechanism:<\/p>\n\n\n\n
ACTH decreased, cortisol decreased<\/p>\n\n\n\n
ACTH increased, cortisol increased<\/p>\n\n\n\n
ACTH decreased, cortisol increased<\/p>\n\n\n\n
ACTH increased, cortisol decreased
C. ACTH decreased, cortisol increased<\/p>\n\n\n\n
Feedback When the adrenal glands develop a tumor, like any other endocrine gland, they usually produce excess amounts of the hormone normally produced by these cells. If the adrenal tumor is composed of cortisol-producing cells, excess cortisol will be produced. Under these conditions, the normal pituitary will sense the excess cortisol and will stop making ACTH in an attempt to slow the adrenal down. In this manner, physicians can readily distinguish whether excess cortisol is the result of a pituitary tumor or an adrenal tumor.<\/p>\n\n\n\n
Ethylhydrocupreine hydrochloride susceptibility is a presumptive test for the identification of?<\/p>\n\n\n\n
S. agalactiae<\/p>\n\n\n\n
S. pyogenes<\/p>\n\n\n\n
S. pneumoniae<\/p>\n\n\n\n
Viridans streptococci
C. S. pneumoniae<\/p>\n\n\n\n
Feedback Optochin (or ethylhydrocupreine hydrochloride) is a derivative of hydroquinine introduced in 1911 by Morgenroth and Levy with the intention to treat pneumococci infection. It is now used in cell culture techniques for the presumptive identification of Streptococcus pneumoniae, which is optochin-sensitive, from other alpha-hemolytic streptococci such as viridans streptococci, which are resistant.<\/p>\n\n\n\n
Phenomenon in which large quantities of toxins are released as the bacteria dies during treatment:<\/p>\n\n\n\n
Swarming phenomenon<\/p>\n\n\n\n
Tonegawa phenomenon<\/p>\n\n\n\n
Jarisch-Herxheimer phenomenon<\/p>\n\n\n\n
Ellie-Metchnikoff phenomenon
C. Jarisch=Herxheimer phenomenon<\/p>\n\n\n\n
Feedback A Jarisch-Herxheimer reaction is a reaction to endotoxin-like products released by the death of harmful microorganisms within the body during antibiotic treatment.<\/p>\n\n\n\n
An initial screening for anti-HIV1\/2 using ELISA tested REACTIVE. What should be done next?<\/p>\n\n\n\n
Perform immunofixation test<\/p>\n\n\n\n
Perform confirmatory test using PCR<\/p>\n\n\n\n
Perform Western Blot<\/p>\n\n\n\n
Repeat test using ELISA
C. Perform Western Blot<\/p>\n\n\n\n
Feedback Western Blot is being used as a confirmatory test for HIV.<\/p>\n\n\n\n
Anaerobic gram negative cocci after jaw surgery:<\/p>\n\n\n\n
Veilonella<\/p>\n\n\n\n
Peptostreptococcus<\/p>\n\n\n\n
Neisseria<\/p>\n\n\n\n
Legionella
A. Veilonella<\/p>\n\n\n\n
Hemolysis pattern of Streptococcus pneumoniae:<\/p>\n\n\n\n
Alpha Hemolytic<\/p>\n\n\n\n
Beta Hemolytic<\/p>\n\n\n\n
Gamma Hemolytic<\/p>\n\n\n\n
AOTA
A. Alpha hemolytic<\/p>\n\n\n\n
Feedback Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, alpha-hemolytic (under aerobic conditions). When alpha hemolysis (\u03b1-hemolysis) is present, the agar under the colony is dark and greenish.<\/p>\n\n\n\n
HBA1c results can be influenced by:<\/p>\n\n\n\n
RBC life span<\/p>\n\n\n\n
WBC life span<\/p>\n\n\n\n
Amount of albumin<\/p>\n\n\n\n
Concentration of glucose
A. RBC life span<\/p>\n\n\n\n
Feedback Lower-than-expected levels of HbA1c can be seen in people with shortened red blood cell lifespan, such as with glucose-6-phosphate dehydrogenase deficiency, sickle-cell disease, or any other condition causing premature red blood cell death.<\/p>\n\n\n\n
Which of the following differentiates S. maltophilia from other non-fermenter gram negative rod?<\/p>\n\n\n\n
Oxidase negative; DNase positive<\/p>\n\n\n\n
Oxidase positive; DNase negative<\/p>\n\n\n\n
Resistant to Optochin<\/p>\n\n\n\n
Sensitive to Optochin
A. Oxidase negative; DNase positive<\/p>\n\n\n\n
Feedback S. maltophilia is slightly smaller (0.7-1.8 \u00d7 0.4-0.7 \u03bcm) than other members of the genus. They are motile due to polar flagella, and grow well on MacConkey agar producing pigmented colonies. S. maltophilia is catalase-positive, oxidase-negative (which distinguishes it from most other members of the genus) and has a positive reaction for extracellular DNase.<\/p>\n\n\n\n
A gram stain performed on a sputum specimen revealed gram-negative diplococci within PMNs. Oxidase testing is positive and carbohydrate degradation test is inert. The organism is:<\/p>\n\n\n\n
Moraxella catarrhalis<\/p>\n\n\n\n
Neisseria meningitidis<\/p>\n\n\n\n
Neisseria lactamica<\/p>\n\n\n\n
NOTA
A. Moraxella catarrhalis<\/p>\n\n\n\n
Feedback Moraxella catarrhalis is biochemically inert and does not ferment carbohydrates (assacharolytic).<\/p>\n\n\n\n
Which of the following diseases results from a familial absence of high density lipoprotein (HDL)?<\/p>\n\n\n\n
Krabbe Disease<\/p>\n\n\n\n
Gaucher Disease<\/p>\n\n\n\n
Tangier Disease<\/p>\n\n\n\n
Tay-Sachs Disease
C. Tangier disease<\/p>\n\n\n\n
Feedback Tangier disease is an inherited disorder characterized by significantly reduced levels of high-density lipoprotein (HDL) in the blood. HDL transports cholesterol and certain fats called phospholipids from the body’s tissues to the liver, where they are removed from the blood. HDL is often referred to as “good cholesterol” because high levels of this substance reduce the chances of developing heart and blood vessel (cardiovascular) disease.<\/p>\n\n\n\n
The above shown crystals is indicative of? Fig 26<\/p>\n\n\n\n
Liver Disease<\/p>\n\n\n\n
Nephrotic syndrome<\/p>\n\n\n\n
Albuminuria<\/p>\n\n\n\n
Normal
A. Liver disease<\/p>\n\n\n\n
Feedback Tyrosine crystals appear as fine silky needles arranged in sheaves or bundles in acid urine. They are rarely present and may appear together with leucine and bilirubin crystals in liver disease.<\/p>\n\n\n\n
What is the specimen of choice for FK506 (Tacrolimus), Cyclosporine and Sirolimus?<\/p>\n\n\n\n
Gray top<\/p>\n\n\n\n
Heparin sodium<\/p>\n\n\n\n
Lavender Top (EDTA)<\/p>\n\n\n\n
Red top
C. Lavender Top (EDTA)<\/p>\n\n\n\n
Feedback Tacrolimus, cyclosporine and sirolimus are immunosuppresive drugs and are tested using whole blood.<\/p>\n\n\n\n
10% KOH was place to a vaginal discharge for microscopic examination. After addition, fishy odor comes out:<\/p>\n\n\n\n
Trichomonas<\/p>\n\n\n\n
Gardnerella vaginalis<\/p>\n\n\n\n
Staphylococcus saprophyticus<\/p>\n\n\n\n
AOTA
B. Gardnerella vaginalis<\/p>\n\n\n\n
Feedback The whiff test may be positive in up to 70% of Bacterial vaginosis patients. This test is performed by placing a drop of 10% KOH on the speculum after the vaginal examination or mixing vaginal fluid with a drop of KOH on a microscope slide. The KOH, by virtue of its alkaline properties, causes the release of volatile amines from the vaginal fluid. The amines are products of anaerobic bacterial metabolism.<\/p>\n\n\n\n
Analysis of CSF for oligoclonal bands is used to screen for which of the following disease states?<\/p>\n\n\n\n
Goodpasture’s Syndrome<\/p>\n\n\n\n
SLE<\/p>\n\n\n\n
Myasthenia gravis<\/p>\n\n\n\n
Multiple sclerosis
D. Multiple sclerosis<\/p>\n\n\n\n
Feedback Oligoclonal bands are an important indicator in the diagnosis of multiple sclerosis. More than 95% of all patients with multiple sclerosis have permanently observable oligoclonal bands.<\/p>\n\n\n\n
“Cold Antibody”, the blood in patient toes, fingertips, earlobes is cooler than 37C and the antibody coats cooled cells, binds complement, and causes hemolysis:<\/p>\n\n\n\n
Anti-P<\/p>\n\n\n\n
Anti-I<\/p>\n\n\n\n
Anti-i<\/p>\n\n\n\n
Anti-M
B. Anti-I<\/p>\n\n\n\n
Feedback Anti-I antibodies are the most common antibodies found if antibody screenings are done at immediate spin, room temperature. They are IgM immunoglobulins. Auto-anti-I is a common “cold agglutinin”. High-titer anti-I also commonly associated with Mycoplasma. pneumoniae infections. Treatment would be giving the patient appropriate antibiotics.<\/p>\n\n\n\n
Inside of a reference electrode is filled with what solution?<\/p>\n\n\n\n
KCL<\/p>\n\n\n\n
CuSO4<\/p>\n\n\n\n
AgNO3<\/p>\n\n\n\n
Distilled water
A. KCL<\/p>\n\n\n\n
What is\/are the antigens present in the secretions of a group A individual with phenotype Le(a+b-)?<\/p>\n\n\n\n
A, B, H<\/p>\n\n\n\n
A, H, Le(a)<\/p>\n\n\n\n
A, Le(a)<\/p>\n\n\n\n
Le(a)
D. Le(a)<\/p>\n\n\n\n
Feedback lele will not have Lewis antigens, but if Se present will have A, B and H in secretions. Genotype se\/se and have one Lewis antigen will have Le(a) in their secretions but no A, B or H.<\/p>\n\n\n\n
In Purified Protein Derivative (PPD) skin test for tuberculosis, T cell mediates what type of hypersensitivity?<\/p>\n\n\n\n
Type I<\/p>\n\n\n\n
Type IV<\/p>\n\n\n\n
Type II<\/p>\n\n\n\n
Type III
B. Type IV<\/p>\n\n\n\n
Feedback Type IV Hypersensitivity also known as (Delayed cell-mediated)- mechanism of this type is the release of lymphokines.<\/p>\n\n\n\n
Marker for pancreatic mass:<\/p>\n\n\n\n
CA 15-3<\/p>\n\n\n\n
CA 19-9<\/p>\n\n\n\n
CA 125<\/p>\n\n\n\n
CEA
B. CA 19-9<\/p>\n\n\n\n
Feedback CA 15-3- is used to monitor response to breast cancer treatment and disease recurrence. CA 125 – test may be used to look for early signs of ovarian cancer in women with a very high risk of the disease. CEA- measures the amount of this protein that may appear in the blood of some people who have certain kinds of cancers, especially cancer of the large intestine (colon and rectal cancer).<\/p>\n\n\n\n
Pernicious anemia is specifically associated with a deficiency of which of the following?<\/p>\n\n\n\n
Folic acid<\/p>\n\n\n\n
Iron<\/p>\n\n\n\n
Intrinsic factor<\/p>\n\n\n\n
Cyanocobalamin
C. Intrinsic Factor<\/p>\n\n\n\n
Feedback The most common cause of pernicious anemia is the loss of stomach cells that make intrinsic factor. Intrinsic factor helps the body absorb vitamin B12 in the intestine. The loss of parietal cells may be due to destruction by the body’s own immune system.<\/p>\n\n\n\n
Which parasite is known for its autoinfection capability<\/p>\n\n\n\n
Necator americanus<\/p>\n\n\n\n
Schistosoma haematobium<\/p>\n\n\n\n
Strongyloides stercoralis<\/p>\n\n\n\n
Ascaris lumbricoides
C. Strongyloides stercoralis<\/p>\n\n\n\n
Feedback Strongyloides life cycle is more complex than that of most nematodes with its alternation between free living and parasitic cycles, and its potential for autoinfection and multiplication within the host<\/p>\n\n\n\n
Increased levels of TdT (Terminal deoxynucleotidyl transferase) activity are indicative of:<\/p>\n\n\n\n
Acute lymphocytic leukemia<\/p>\n\n\n\n
Acute myelocytic leukemia<\/p>\n\n\n\n
Burkitt lymphoma<\/p>\n\n\n\n
Eosinophilia
A. Acute lymphocytic leukemia<\/p>\n\n\n\n
Feedback Terminal deoxynucleotidyl transferase (TdT), also known as DNA nucleotidylexotransferase (DNTT) or terminal transferase, is a specialized DNA polymerase expressed in immature, pre-B, pre-T lymphoid cells, and acute lymphoblastic leukemia\/lymphoma cells.<\/p>\n\n\n\n
Which of the following cells releases histamine\/heparin?<\/p>\n\n\n\n
Neutrophil, Eosinophil<\/p>\n\n\n\n
Eosinophil, Basophil<\/p>\n\n\n\n
Mastcell, Basophil<\/p>\n\n\n\n
Mastcell, Eosinophil
C. Mast cell, basophil<\/p>\n\n\n\n
Feedback A mast cell (also known as a mastocyte or a labrocyte) is a type of white blood cell. Specifically, it is a type of granulocyte derived from the myeloid stem cell that is a part of the immune and neuroimmune systems and contains many granules rich in histamine and heparin.Basophils appear in many specific kinds of inflammatory reactions, particularly those that cause allergic symptoms. Basophils contain anticoagulant heparin, which prevents blood from clotting too quickly. They also contain the vasodilator histamine, which promotes blood flow to tissues.<\/p>\n\n\n\n
Cast with a higher refractive index:<\/p>\n\n\n\n
Waxy Cast<\/p>\n\n\n\n
WBC Cast<\/p>\n\n\n\n
RBC Cast<\/p>\n\n\n\n
All of the above
A. Waxy Cast<\/p>\n\n\n\n
Which of the following is the agent of hand, foot and mouth disease?<\/p>\n\n\n\n
Herpes<\/p>\n\n\n\n
Coronavirus<\/p>\n\n\n\n
Coxsackie A<\/p>\n\n\n\n
Retrovirus
C. Coxsackie A<\/p>\n\n\n\n
Feedback Hand, foot and mouth disease (HFMD) is usually caused by Enterovirus 71 or Coxsackie virus A16.<\/p>\n\n\n\n
Which is an appropriate specimen to diagnose Dracunculus medinensis?<\/p>\n\n\n\n
Stool<\/p>\n\n\n\n
Skin snipping<\/p>\n\n\n\n
Feces<\/p>\n\n\n\n
All of the above
B. Skin lesion<\/p>\n\n\n\n
Feedback Dracunculiasis is typically asymptomatic for the first year. Symptoms typically develop when the worm erupts through the skin. Local symptoms include intense itching and a burning pain at the site of the skin lesion<\/p>\n\n\n\n
Which of the following regulates myocyte contraction?<\/p>\n\n\n\n
Cardiac troponins<\/p>\n\n\n\n
CK-MB<\/p>\n\n\n\n
Myoglobin<\/p>\n\n\n\n
AOTA
A. Cardiac troponins<\/p>\n\n\n\n
Feedback Troponins are contractile proteins that regulate muscle contraction along with tropomyosin and calcium. Recall that troponin levels in blood may be used to determine if someone has suffered a cardiac injury.<\/p>\n\n\n\n
Compute for UIBC (Unsaturated Iron Binding Capacity):<\/p>\n\n\n\n
Serum iron=120, TIBC= 215:<\/p>\n\n\n\n
130<\/p>\n\n\n\n
95<\/p>\n\n\n\n
128<\/p>\n\n\n\n
85
B. 95<\/p>\n\n\n\n
Feedback The UIBC is calculated by subtracting the serum iron from the TIBC. 215-120=95<\/p>\n\n\n\n
Indole: negative
MR: negative
LDC: negative
ODC: positive
ADH: positive<\/p>\n\n\n\n
K. pneumoniae<\/p>\n\n\n\n
K. oxytoca<\/p>\n\n\n\n
E. cloacae<\/p>\n\n\n\n
E. aerogenes
C. E cloacae<\/p>\n\n\n\n
Which of the following tests should be done first in order to differentiates Aeromonas spp from the Enterobacteriaceae?<\/p>\n\n\n\n
Oxidase<\/p>\n\n\n\n
Urease<\/p>\n\n\n\n
OF glucose<\/p>\n\n\n\n
Catalase
A. oxidase<\/p>\n\n\n\n
Feedback Aeromonas: TSI reaction: A\/A, and is Oxidase positive. Enterobacteriaceae is oxidase negative.<\/p>\n\n\n\n
Which of the following is used to neutralized Anti-P1 antibody?<\/p>\n\n\n\n
Ulex europaeus<\/p>\n\n\n\n
Lectin seeds<\/p>\n\n\n\n
Hydatid cyst fluid<\/p>\n\n\n\n
AOTA
C. Hyatid cyst fluid<\/p>\n\n\n\n
Feedback Similar antigens found in nature (bird droppings, pigeon eggs, hydatid cyst fluid) can be used to neutralize anti-P in a patient’s serum.<\/p>\n\n\n\n
Irreversible step in platelet aggregation?<\/p>\n\n\n\n
Release of PDF3<\/p>\n\n\n\n
Release of ADP<\/p>\n\n\n\n
Platelet shape<\/p>\n\n\n\n
All of the above
B. Release of ADP<\/p>\n\n\n\n
Feedback Under normal conditions, small disk-shape platelets circulate in the blood freely and without interaction with one another. ADP is stored in dense bodies inside blood platelets and is released upon platelet activation. ADP interacts with a family of ADP receptors found on platelets (P2Y1, P2Y12, and P2X1), which leads to platelet activation.<\/p>\n\n\n\n
57% Hematocrit is normal in:<\/p>\n\n\n\n
Male<\/p>\n\n\n\n
1 year old<\/p>\n\n\n\n
Newborn<\/p>\n\n\n\n
Female
C. Newborn<\/p>\n\n\n\n
Feedback Normal hematocrit value for newborn is 45% to 61%. Normal value ranges vary slightly among different laboratories.<\/p>\n\n\n\n
What is the result of unfilled EDTA?<\/p>\n\n\n\n
Decreased platelets<\/p>\n\n\n\n
Decreased RBC count<\/p>\n\n\n\n
Decreased microhematocrit<\/p>\n\n\n\n
Decreased hemoglobin
C. Decreased microhematocrit<\/p>\n\n\n\n
What to do?<\/p>\n\n\n\n
Mother: Type “O”, Rh negative, no antibody to D Ag
Child: Type “O”, Rh positive<\/p>\n\n\n\n
Transplacental transfusion<\/p>\n\n\n\n
RhIg Administration<\/p>\n\n\n\n
Do nothing, report the results<\/p>\n\n\n\n
DAT
B. RhIg Administration<\/p>\n\n\n\n
Feedback Rh immunoglobulin, is a blood product that can stop your immune system from attacking Rh-positive cells. When an Rh incompatibility is identified, Rhogam will be given, as a shot, during week 28 of pregnancy (it will also be given after chorionic villus sampling, amniocentesis, miscarriage, ectopic pregnancy, abortion, uterine bleeding, or any trauma during pregnancy that could leak some of the fetal cells over to you).<\/p>\n\n\n\n
Auer rods are most likely present in which of the following? Fig 27<\/p>\n\n\n\n
Acute myelocytic leukemia<\/p>\n\n\n\n
Erythroleukemia<\/p>\n\n\n\n
Chronic myelocytic leukemia<\/p>\n\n\n\n
Burn patient
A. Acute myelocytic leukemia<\/p>\n\n\n\n
Feedback Auer rods are clumps of azurophilic granular material that form elongated needles seen in the cytoplasm of myeloid leukemic blasts. They can be seen in the leukemic blasts of acute myeloid leukemia with maturation and acute promyelocytic leukemia (respectively known as acute myeloid leukemia M2 and M3 in the FAB classification).<\/p>\n\n\n\n
The optimum storage temperature for platelets is:<\/p>\n\n\n\n
-20 degrees celsius<\/p>\n\n\n\n
-12 degrees celsius<\/p>\n\n\n\n
22 degrees celsius<\/p>\n\n\n\n
4 degrees celsius
C. 22 degrees celsius<\/p>\n\n\n\n
Feedback Platelets are typically pooled before transfusion and have a shelf life of 5 to 7 days, or 3 days once the facility that collected them has completed their tests. Platelets are stored at room temperature (72 \u00b0F or 22 \u00b0C) and must be rocked\/agitated.<\/p>\n\n\n\n
Swab sample was taken from a wound and incubated on three different medias (including anaerobic media), no growth after. What happened?<\/p>\n\n\n\n
Wrong medias used<\/p>\n\n\n\n
Swab material inhibited the sample<\/p>\n\n\n\n
Incubation problem<\/p>\n\n\n\n
AOTA
B. Swab material inhibited the sample<\/p>\n\n\n\n
What is the biosafety level and biologic safety cabinet used for Poxvirus?<\/p>\n\n\n\n
Biosafety level III; Safety Cabinet II<\/p>\n\n\n\n
Biosafety level I; Safety Cabinet III<\/p>\n\n\n\n
Biosafety level II; Safety Cabinet II<\/p>\n\n\n\n
None of the above
C. Biosafety level II; Safety cabinet II<\/p>\n\n\n\n
Feedback Biosafety level II and Biological Safety Cabinet II practices and facilities must be used for activities involving poxviruses\/viral vectors that pose an infection hazard. (Center for Disease Control and Prevention).<\/p>\n\n\n\n
Characteristic: Red Bull’s Eye colony in CIN Medium:<\/p>\n\n\n\n
Klebsiella pneumoniae<\/p>\n\n\n\n
Serratia marcescens<\/p>\n\n\n\n
Clostridium difficile<\/p>\n\n\n\n
Yersinia enterocolitica
Feedback The characteristic deep red center with a transparent margin, or “bull’s-eye” appearance of Yersinia and Aeromonas colonies is important for identification, and is due to the presence of mannitol. Y. enterocolitica ferments the mannitol in the medium, producing an acid pH which gives the colonies their red color and the “bull’s eye” appearance.<\/p>\n\n\n\n
SIADH (Syndrome of Inappropriate Antidiuretic Hormone) which condition is seen and why?<\/p>\n\n\n\n
Increase plasma osmolality<\/p>\n\n\n\n
Hyponatremia due to high excretion in urine<\/p>\n\n\n\n
Hyponatremia due to dilution<\/p>\n\n\n\n
NOTA
C. Hyponatremia due to dilution<\/p>\n\n\n\n
Feedback In general, increased ADH causes water retention without interstitial fluid volume expansion and without edema or hypertension. The water retention causes hyponatremia, which is a key feature in SIADH. This is purely a problem of water metabolism with no abnormalities in total body sodium metabolism.<\/p>\n\n\n\n
FBS: 120 mg\/dl, OGTT: 140 mg\/dl<\/p>\n\n\n\n
Non-diabetic<\/p>\n\n\n\n
Diabetes Mellitus<\/p>\n\n\n\n
Impaired plasma glucose<\/p>\n\n\n\n
Normal
C. Impaired plasma glucose<\/p>\n\n\n\n
Feedback FBS: 0-50 mg\/dl: Hypoglycemia, 50-100 mg\/dl: Normal, 100-125 mg\/dl: Impaired, greater than 126 is provisional diabetes<\/p>\n\n\n\n
The crystals shown above is indicative of? Fig 28<\/p>\n\n\n\n
Nephrotic Syndrome<\/p>\n\n\n\n
Liver disease<\/p>\n\n\n\n
Glumerulonephritis<\/p>\n\n\n\n
Albuminuria
C. Liver disease<\/p>\n\n\n\n
Feedback The above shown crystals are bilirubin crystals. Bilirubin along with Tyrosine and Leucine are crystals seen\/indicative of Liver Disease<\/p>\n\n\n\n
Favors growth of anaerobic gram negative bacilli:<\/p>\n\n\n\n
Vitamin A and bile<\/p>\n\n\n\n
Pheynlethyl<\/p>\n\n\n\n
Vitamin B and bile<\/p>\n\n\n\n
Vitamin K and hemin
D. Vitamin K and hemin<\/p>\n\n\n\n
A fetomaternal hemorrhage of 45 ml of fetal Rh-positive packed RBCs has been detected in an Rh-negative woman. How many vials of Rh immune globulin (Rhogam) should be given?<\/p>\n\n\n\n
1<\/p>\n\n\n\n
2<\/p>\n\n\n\n
3<\/p>\n\n\n\n
4
D. 4<\/p>\n\n\n\n
Feedback One vial of Rh immune globulin protects against a fetomaternal hemorrhage of 15 ml of red cells or 30 ml of whole blood. Divide the volume of fetomaternal hemorrhage (45 ml) by 15= 3, then always add 1 extra vial= 4 vials total.<\/p>\n\n\n\n
Presence of Philadelphia Chromosome (t9;22); LAP = 0:<\/p>\n\n\n\n
Acute Lymphocytic Leukemia (ALL)<\/p>\n\n\n\n
Chronic Myelogenous Leukemia (CML)<\/p>\n\n\n\n
Acute Myelogenous Leukemia (AML)<\/p>\n\n\n\n
AOTA
B. Chronic myelogenous leukemia (CML)<\/p>\n\n\n\n
Feedback The Philadelphia chromosome or Philadelphia translocation is a specific genetic abnormality in chromosome 22 of leukemia cancer cells (particularly Chronic Myelogenous Leukemia (CML) cells). This chromosome is defective and unusually short because of reciprocal translocation of genetic material between chromosome 9 and chromosome 22, and contains a fusion gene called BCR-ABL1. Very good way to differentiate Leukomoid reaction from CML is by doing Leukocyte Alkaline Phosphatase (LAP) staining, LAP score for Leukomoid reaction is high, while for CML is low.<\/p>\n\n\n\n
Which of the following Plasmodium species will you see Schuffner dots?<\/p>\n\n\n\n
P. vivax<\/p>\n\n\n\n
P. ovale<\/p>\n\n\n\n
P. malariae<\/p>\n\n\n\n
A and B
D. A and b<\/p>\n\n\n\n
Feedback Sch\u00fcffner’s dots refers to a hematological finding that is associated with malaria, exclusively found in Plasmodium ovale and Plasmodium vivax. Plasmodium vivax induces morphologic alterations in infected host erythrocytes that are visible by light microscopy in Romanowsky-stained blood smears as multiple brick-red dots. These morphologic changes, referred to as Sch\u00fcffner’s dots, are important in the identification of this species of malarial parasite and have been associated by electron microscopy with caveolavesicle complexes along the erythrocyte plasmalemma. .<\/p>\n\n\n\n
Which of the following is deferred for blood donation?<\/p>\n\n\n\n
An employee who got hepatitis vaccine 1 week ago<\/p>\n\n\n\n
Autologous donor with hemoglobin of 11 g\/dl<\/p>\n\n\n\n
Donor who was given hepatits B immune globulin 6 months ago<\/p>\n\n\n\n
All of the above
C. Donor who was given hepatitis B immunoglobulin 6 months ago<\/p>\n\n\n\n
What is urobilinogen?<\/p>\n\n\n\n
Colorless product of bilirubin metabolism<\/p>\n\n\n\n
Results in increase bile<\/p>\n\n\n\n
Breakdown of amino acids<\/p>\n\n\n\n
All of the above
A. Colorless product of bilirubin metabolism<\/p>\n\n\n\n
The following results were obtained from a pure culture of gram negative rods recovered from the pulmonary secretions of a 10 year old cystic fibrosis patient with pneumonia:<\/p>\n\n\n\n
Oxidase (+), Motility (+), Growth at 42C (+), Pigment= Red (Nonflouresecent)<\/p>\n\n\n\n
Pseudomonas aeruginosa<\/p>\n\n\n\n
Burkholderia cepacia<\/p>\n\n\n\n
Burkholderia pseudomallei<\/p>\n\n\n\n
Pseudomonas stutzeri
A. Pseudomonas aeruginosa<\/p>\n\n\n\n
Feedback P. aeruginosa is growing as biofilm within the lungs of cystic fibrosis patients. In certain conditions, P. aeruginosa can secrete a variety of pigments, including pyocyanin (blue-green), pyoverdine (yellow-green and fluorescent), and pyorubin (red-brown). These can be used to identify the organism.<\/p>\n\n\n\n
PEA and Columbia CNA Agar are used to culture:<\/p>\n\n\n\n
Gram positive bacteria<\/p>\n\n\n\n
Gram negative bacteria<\/p>\n\n\n\n
A and B<\/p>\n\n\n\n
NOTA
A. Gram positive bacteria<\/p>\n\n\n\n
Identify the organism: Fig 29<\/p>\n\n\n\n
Penicillium<\/p>\n\n\n\n
Blastoconidia<\/p>\n\n\n\n
Sporothrix<\/p>\n\n\n\n
Candida
a<\/p>\n\n\n\n
Resembles “HANDS OF SKELETON”- Penicillium<\/p>\n\n\n\n
Anti-A=0
Anti-B= +mf,<\/p>\n\n\n\n
A cells= 4+;
B cells= 0<\/p>\n\n\n\n
Polyagglutination<\/p>\n\n\n\n
Bx<\/p>\n\n\n\n
Both<\/p>\n\n\n\n
None of the above
B. Bx<\/p>\n\n\n\n
Type of anemia of Hookworm Infection:<\/p>\n\n\n\n
Normocytic, Normochromic<\/p>\n\n\n\n
Microcytic, Hypochromic<\/p>\n\n\n\n
Macrocytic, Normochromic<\/p>\n\n\n\n
Normocytic, Hypochromic
B. Microcytic, hypochromic<\/p>\n\n\n\n
Feedback The most important of these interactions is the hookworm’s interruption of nutrient acquisition by the host through its ingestion and digestion of host blood. This results in iron deficiency and eventually the microcytic hypochromic anemia or iron deficiency anemia that is the clinical hallmark of hookworm infection.<\/p>\n\n\n\n
Interpret and determine what is the cause:<\/p>\n\n\n\n
RBC reagent strip= positive
Microscopy= no RBC seen<\/p>\n\n\n\n
Dilute with acid solution<\/p>\n\n\n\n
Dilute alkaline urine<\/p>\n\n\n\n
Dilute with NSS<\/p>\n\n\n\n
All of the above
B. Dilute alkaline urine<\/p>\n\n\n\n
Which of the following drugs is used to treat bipolar disorders (manic depression)?<\/p>\n\n\n\n
Vancomycin<\/p>\n\n\n\n
Digoxin<\/p>\n\n\n\n
Lithium<\/p>\n\n\n\n
Procainamide
C. Lithium<\/p>\n\n\n\n
Feedback Lithium compounds, also known as lithium salts, are primarily used as a psychiatric medication. This includes in the treatment of major depressive disorder that does not improve following the use of other antidepressants, and bipolar disorder. In these disorders, it reduces the risk of suicide.<\/p>\n\n\n\n
Unconjugated bilirubinemia:<\/p>\n\n\n\n
Unconjugated bilirubin= positive; urine bilirubin= positive; urine urobilinogen= positive<\/p>\n\n\n\n
Unconjugated bilirubin= negative; urine bilirubin= positive; urine urobilinogen= negative<\/p>\n\n\n\n
Unconjugated bilirubin= positive; urine bilirubin= negative; urine urobilinogen= positive<\/p>\n\n\n\n
Unconjugated bilirubin= negative; urine bilirubin= negative; urine urobilinogen= negative
C. Unconjugated bilirubin= positive; urine bilirubin= negative; urine urobilinogen= positive<\/p>\n\n\n\n
Feedback Except for the presence of high serum unconjugated bilirubin levels, the results of liver tests in Crigler-Najjar syndrome type 1 are normal. Serum bilirubin levels range from 20-50 mg\/dL. Conjugated bilirubin is absent from serum, and bilirubin is not present in urine. Definitive diagnosis of Crigler-Najjar syndrome requires high-performance liquid chromatography of bile or a tissue enzyme assay of a liver biopsy sample.<\/p>\n\n\n\n
Nephelometry involves the measurement of
A. Light scatter
B. Atomic absorption
C. Light absorption
D. Light transmission
C. Light absorption
When light strikes a particle in a solution, it can be absorbed, transmitted, reflected, or scattered. Nephelometry is used to measure the light scattered by particles in a solution. It is useful for measuring protein levels in fluids, and antigen-antibody complexes<\/p>\n\n\n\n
Most potent activator enzyme is
A. Magnesium
B. Sodium
C. Potassium
D. AOTA
A. Magnesium
Over 300 enzymes require the presence of magnesium ions for their catalytic action, including all enzymes utilizing or synthesizing ATP, or those that use other nucleotides to synthesize DNA and RNA<\/p>\n\n\n\n
A characteristic morphologic feature in hemoglobin C disease is
A. Macrocytosis
B. Spherocytosis
C. Rouleaux formation
D. Target cells
D. Target cells
Codocytes also known as target cells are RBCs that have the appearance of a shooting target with a bullseye<\/p>\n\n\n\n
Two consecutive values in which they are in the +2SD of the same mean or in the -2SD of the same mean
A. 2:2s
B. 10:x
C. 1:2s
C. R:4s
2(2s) is a Westgard multirole 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<\/p>\n\n\n\n
Precipitation of ribosomes and RNA
A. Heinz bodies
B. Howell-Jolly bodies
C. Basophilic stippling
D. Auer rods
C. Basophilic stippling<\/p>\n\n\n\n
Mycobacterium tuberculosis
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 I tissue by cadeating granulomas containing Langhans giant cells, which have a “horseshoe” pattern of nuclei.<\/p>\n\n\n\n
Description of Zygomycetes
A. Septate hyphae with basidiospores
B. Septate hyphae with sporangiospores
C. Aseptate hypae with sporangiospores
D. Aseptate hyphae with basidiospores
C. Aseptate hypae with sporangiospores<\/p>\n\n\n\n
According to AABB standards, Fresh Frozen Plasma (FFP) must be infused within what period of time following thawing?
A. 24 hours
B. 36 hours
C. 48 hours
D. 72 hours
A. 24 hours<\/p>\n\n\n\n
Tropical sprue has the peripheral blood picture of
A. Malaria
B. Thalassemia
C. Megalobalstic anemia
D. IDA
C. Megaloblastic anemia.
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 intesting. Megaloblasitc anemia is Macrocytic\/Normochromis anemiwq<\/p>\n\n\n\n
What is used for cleaning surfaces in a laboratory
A. 5% Sodium Hypochlorite
B. 10% Sodium Hypochlorite
C. 15% Sodium Hypochlorite
D. NOTA
B. 10% Sodium Hypochlorite
Sodium hypochlorite (NaqOCL) is a comound that can be effeciey used for water purification. It is used on a large scale for surface purification, bleaching, odor removal, and water disinfection<\/p>\n\n\n\n
Which of the following disease results from a familial absence of high density lipoprotein (HDL)
A. Krabbe Disease
B. Gaucher Disease
C. Tangier Disease
D. Tay-Sachs Disease
C. Tangier Disease
Tangier disease is an inherited disorder characterized by significantly reduced levels of high-density lipoprotein (HDL) in the blood. HDL transports cholesterol and certain fats called phospholipids from the body’s tissues to the liver, where they are removed from the blood. HDL is often referred to as “good cholesterol” because high levels of this substance reduce the chances of developing heart and blood vessel disease<\/p>\n\n\n\n
Which of the following disorders is associated with Dohle bodies and giant platelets
A. Alder-Reilly anomaly
B. Chediak Higashi syndrome
C. May-Hegglin anomaly
D. Pelger-Huet anomaly
C. May-Hegglin anomaly
May-Hegglin anomaly (MHA) is an autosomal dominant disorder characterized by various degrees of thrombocytopenia that may be associated with purpura and bleeding; giant platelets containing few granules; and large, well-defined, basophilic, cytoplasmic inclusion bodies in granulocytes that resemble Dohle bodies<\/p>\n\n\n\n
An antiepileptic (or anticonvulsant) used to control seizure disorders is
A. Acetaminophen
B. Lithium
C. Phenytoin
D. Digoxin
C. Phenytoin
Phenytoin is an antiepileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. Phenytoin is used to control seizures<\/p>\n\n\n\n
What test is used to monitor unfractionated heparin therapy
A. APTT
B. PT
C. drvvt
D. TT
A. APTT<\/p>\n\n\n\n
Zollinger-Ellison (Z-E) syndrome is characterized by great (for example, 20 fold) elevation of the level of
A. Pepsin
B. Gastrin
C. Glucagon
D. Cholecystokinin
B. Gastrin
Zollinger-Ellison syndrome (ZES) is caused by a non-beta islet cell, gastrin-secreting tumor of the pancreas that stimulates the acid-secreting of the stomach to maximal activity, with consequent gastrointestinal mucosal ulceration<\/p>\n\n\n\n
Which of the following is a quantitative assay for fecal fat
A. H2O2
B. NADH
C. Sudan Black
D. Weighing and extraction
D. Weighing and extraction
The quantitative test involves drying and weighting a 72-hour stool specimen, then using an extraction technique to separate the fats, which are subsequently evaporated and weighed. This measurement of the total output of fecal fat per 24 hours in a three-day specimen is the most reliable test for steatorrhea.<\/p>\n\n\n\n
Bilirubin crystals
Bilirubin crystals along with Tyrosine and Leucine crystals seen\/indicative of liver disease<\/p>\n\n\n\n
Anti IgG (+); C3d (+); what should the MLS do?
A. Elution
B. IAT
C. DAT
D. Pre-warm
A. Elution
In the 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<\/p>\n\n\n\n
Sezary syndrome
A. Monocytes
B. B-cells lymphoproliferative
C. T-cells lymphoproliferative
D. Basophils
C. T-cells lymphoporliferative
Sezary syndrome is an aggressive form of a type of blood cancer called cutaneous T-cell lymphoma<\/p>\n\n\n\n
17-Ketosteroids is produced in the
A. Adrenal glands
B. Hypothalamus
C. Thyroid gland
D. Pituitary gland
A. Adrenal glands
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<\/p>\n\n\n\n
Which of the following least react with Anti-H
A. O
B. A2
C. A1
D. A1B
D. A1B
O>A2>B>A2B>A1>A1B<\/p>\n\n\n\n
In calibrating a centrifuge, one should use a
A. Tachometer
B. Barometer
C. Revulometer
D. Nanometer
A. Tachometer
Centrifuges are calibrated using a tachometer and a stopwatch<\/p>\n\n\n\n
Which of the following test is used to screen Chronic Granulomatous Disease (CGD)
A. Ham’s acidified serum test
B. NBT (Nitroblue Tetrazolium) Dye Test
C. G6Pd Florescent Screening Test
D. AOTA
B. NBT (Nitroblue Tetrazolium) Dye Test
The nitroblue tetrazolium test checks if certain immune system cells can change a colorless chemical called nitroblue tetrazolium (NBT) into a deep blue color. This test is done to screen for chronic granulomatous disease. People who have frequent infection sin the bones, skin, joints, lungs, and other parts of the body may have this test done.<\/p>\n\n\n\n
Ethylhydrocupreine hydrochloride susceptibility is a presumptive test for the identification of
A. S. agalactiae
B. S. pyogenes
C. S. pneumonia
D. Viridans streptococci
Optichin (or ethylhydrocupreine hydrochloride) is a derivative of hydroquinine introduced in 1911 by Morgenroth and Levy with the intention to treat pneumococci infection. It is now used in cell culture techniques for the presumptive identification of Streptococcus pneumonia, which is optichin-sensitive, from other alpha-hemolytic streptococci such as viridans streptococci, which are resistant<\/p>\n\n\n\n
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?
A. 15,000\/ul
B. 24,700\/ul
C. 27,300\/ul
D. 12,500\/ul
B. 24,700\/ul
Corrected WBC count = (Uncorrected WBC count x 100) \/ nRBCs + 100<\/p>\n\n\n\n
This catalase positive, gram positive bacilli with diptheroid morphology is highly resistant to many antibiotics and is associated with immunocompromised patients.
A. C. jeikeium
B. L. monocytogenes
C. C. diptheriae
D. E. rhusiopathiae
C. C. diptheriae
The principal features of the Corynebacterium genus were described by Collins and Cummins in 1986. They are gram positive, catalase positive, non spore forming, non motile, rod shaped bacteria that are straight or slightly curved Metachromatic granules are usually present representing stored phosphate regions.<\/p>\n\n\n\n
What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48?
A. 2.75
B. 6.09
C. 5.68
D. 30
B. 6.09
CV = (SD\/mean) x 100<\/p>\n\n\n\n
SSA (+); Protein reagent strip (-)
A. Presence of protein other than albumin
B. False positive result
C. False negative result
D. Specimen too old
A. Presence of protein other than albumin<\/p>\n\n\n\n
Pernicious anemia is specifically associated with a deficiency of which of the following
A. Folic Acid
B. Iron
C. Intrinsic factor
D. Cyanocobalamin
C. Intrinsic factor
The most common cause of pernicious anemia is the loss of stomach cells that make intrinsic factor. Intrinsic factor helps the body absorb vitamin B12 in the intestine. The loss of parietal cells may be due to destruction by the body’s own immune system<\/p>\n\n\n\n
Which blood group system is associated with resistance to P. vivax malaria
A. P
B. Duffy
C. Kell
D. Kidd
B. Duffy
Individuals with the Duffy-negative phenotype are resistant to P. vivax invasion, and the molecular mechanism that gives rise to the phenotype Fy(a-b-)<\/p>\n\n\n\n
Role of a supervisor in a laboratory
A. Democratic
B. Autocratic
C. Laissez-faire
D. AOTA
A. Democratic
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 know 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<\/p>\n\n\n\n
Glucose reagent strip (+)
Clinites (-)
A. Presence of reducing sugar (galactose)
B. Glucose is present
C. Galactosuria
D. Ascorbate interference
B. Glucose is present
A positive dipstick glucose assay and a negative clinitest suggest presence of glucose. While a negative dipstick glucose assay and a positive clinitest suggest that some substance other than glucose is present in the urine. These sugars include galactose, lactose, fructose<\/p>\n\n\n\n
A urine pH of 4.5 or less an be seen in
A. High protein intake
B. Vomiting
C. Hyperventilation
D. Hyponatremia
A. High protein intake
In a regression analysis protein intake proved to be an independent factor modulating the ratio between urine pH and renal ammonium excretion. The concomitant increase of renal net acid excretion and maximum renal acid excretion capacity in periods of high protein intake appears to be highly effective response of the kidney to a specific food intake leaving a large renal surplus of capacity for additional acid load.<\/p>\n\n\n\n
What disease is associated with the possession of HLA-B27
A. Ankylosing spondylitis
B. Hashimoto’s Disease
C. Goodpasture’s syndrome
D. SLE
A. Ankylosing spondylitis
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<\/p>\n\n\n\n
Which of the following condition is the most common cause of increase anion gap
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. 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<\/p>\n\n\n\n
Order of migration of hemoglobins during alkaline electrophoresis, starting from the origin towards the anode
A. C, S, F, A
B. C, S, A, F
C. S, C, A, F
D. A, F, S, C
A. C, S, F, A
The order of migration of different hemoglobins starting from the origin is CSFA. Fastest towards the anode is hemoglobin A<\/p>\n\n\n\n
Which of the following is associated with Alder-Reilly inclusions
A. Two-lobed neutrophils
B. Mucopolysaccaridosis
C. Membrane defect of lysosomes
D. Dohle bodies and giant platelets
B. Mucopolysaccaridosis
The Alder-Reilly anomaly is seen in the mucopolysaccaridoses. 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<\/p>\n\n\n\n
What is the minimum platelet count before you perform apheresis
A. 500
B. 200
C. 150
D. 250
C. 150
Apherisis donors with low normal pre-procedure platelet counts (150-200 x 10 9\/L) and Hgb concentration (12.5 – 13 g\/dL) should be examined for post-donation drops in these haematological parameters<\/p>\n\n\n\n
Carbon dioxide in ISE measures
A. CO2 – pressure
B. CO2 – content
C. pH
D. HCO3
A. CO2 – pressure
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. In any given sample the partial pressure of carbon dioxide will be proportional to the concentration of carbon dioxide<\/p>\n\n\n\n
Identify the organism: Culture at 37 degrees in 10-20 days, Niacin test negative, nitrate reduction test positive, non-pigmented colonies when grown in the dark and turns pigmented yellow colonies only after exposure to light
A. M. kansasii
B. M. mycobacterium
C. M. gordonae
D. M fortuitum
A. M. kansasii
M. kansasii is a photocromogen type of mycobacteria. Other photochromogens are M. marinum and M. simiae<\/p>\n\n\n\n
A fetomaternal hemorrhage of 45 ml of fetal Rh-positive packed RBCs has been detected in an Rh-negative woman. How many vials of Rh immune globulin (Rhogam) should be given
A. 1
B. 2
C. 3
D. 4
D. 4
One vial of Rh immune globulin protects against a fetomaternal hemorrhage of 15 ml of RBCs or 30 ml of whole blood. Divide the volume of fetomatermal hemorrhage (45 ml) by 15 = 3, then always add 1 extra vial = 4 vials total<\/p>\n\n\n\n
Routine rotavirus detection can be done with
A. EIA
B. Electron microscopy
C. Shell vial culture
D. NOTA
A. EIA<\/p>\n\n\n\n
Absorbs light and emit at longer wavelength
A. Fluorometer
B. Nephelometer
C. AAS
D. TLC
A. Fluorometer
A fluorometer or fluorimeter is a device used to measure parameters of fluorescence: its integrity 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<\/p>\n\n\n\n
Effect of increased Adosterone to sodium and potassium
A. Decreased sodium; decreased potassium
B. Increased sodium; increased potassium
C. increased sodium; decreased potassium
D. NOTA
C Increased sodium; decreased potassium
Hyperaldosteronism can cause high blood pressure, low potassium levels and an abnormal increase I 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.<\/p>\n\n\n\n
Cystic fibrosis associated bacteria\/s
A. Burkholderia cepacia
B. Staphyococcus aureus
C. Pseudomonas aeruginosa
D. All of the above choices
D. All of the above choices<\/p>\n\n\n\n
What is the effect of dextran, why is it difficult to interpret in blood banking
A. it inhibits Anti-A and Anti-B
B. It causes rouleaux
C. It destroys the D antigen on the red cell surface
D. It has soluble like antigen
B. It causes rouleaux
Roueaux – pseudoagglutination or the false clumping of erythrocytes when the cells are suspended in their own serum. The 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<\/p>\n\n\n\n
Cast with a higher refractive index
A. Waxy cast
B. WBC cast
C. RBC cast
D. AOTA
A. Waxy cast<\/p>\n\n\n\n
Final degenerative form of cast
A. Waxy cast
B. Hyaline cast
C. WBC cast
D. RBC cast
A. Waxy cast<\/p>\n\n\n\n
Tap-water bacillus
A. M. gordonae
B. M. tuberculosis
C. M. avium
D. M smegmatis
A. M gordonae
M. gordonae is ubiquitous and may be found in soil, water, whirlpools, unpasteurized milk, mucous membranes of healthy persons, urine, and gastric fluid. It is the most commonly encountered nontuberculous mycobacterium in water, with concentrations as high as 1000 colony-forming units per milliliter<\/p>\n\n\n\n
A urine specimen was kept in refrigerator overnight at 10 degrees. Glucose level is 1000 mg\/dl. Specific gravity is 1.010. What should the MLS do
A. Correct temperature
B. Correct glucose
C. Ask or new specimen
D. Do nothing, report the results
A. Correct for temperature
High protein, glucose, and bilirubin levels can elevate the specific gravity. Low temperature may decrease the sensitivity of the test.<\/p>\n","protected":false},"excerpt":{"rendered":"
ACE ASCP FINAL EXAM 2023-2024 ACTUAL EXAM2 LATEST VERSIONS 280 QUESTIONS ANDCORRECT DETAILED ANSWERS WITHRATIONALES (VERIFIED ANSWERS) |ALREADYGRADED A+||BRAND NEW!!VERSION AWhich of the following disorders is associated with Dohle bodies and giantplateletsA. Alder-Reilly anomalyB. Chediak Higashi syndromeC. May-Hegglin anomalyD. Pelger-Huet anomaly – ANSWER- C. May-Hegglin anomalyRationale: May-Hegglin anomaly (MHA) is an autosomal dominant disordercharacterized by […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-117189","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117189","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=117189"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117189\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=117189"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=117189"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=117189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}