Feedback Flashcards
The laboratory of perpetual help is:
Tertiary laboratory
Capability of primary lab except:
Routine Chemistry
Microbiology culture and sensitivity for aerobe and anaerobe:
Hospital-based Tertiary Laboratory
Which of the following is not a characteristic of a leader:
Does things right
Consists of the detailed day to day operations needed to meet the immediate needs of the laboratory:
Tactical Planning
Most error in lab occurs in:
A. Pre-analytic
B. Analytic
C. Post-analytic
A. Pre-analytic
This includes specimen processing:
Analytic
Competition from other local laboratories are example of:
Threats
Use of modern technology and equipment:
Strength
The laboratory of AFP medical center is an example of:
Government-owned tertiary lab
All scope of clinical lab except:
None of the above
Service capability of primary lab:
Qualitative platelet count
- Which of the following is true:
A. Micrbiology aerobic and anearobic C&S hospital based only
B. Micrbiology aerobic and anearobic C&S hospital based and nonhospital based
C. Both
D. Neither
A. Micrbiology aerobic and anearobic C&S hospital based only
B. Micrbiology aerobic and anearobic C&S hospital based and nonhospital based
C. Both
Which is not a purpose of the laboratory:
Dictate patient management
Secondary lab KOH is done in hospital base only:
False
After the results, electronic copy signature is acceptable in accordance in E commerce law:
True or False
True
Pre analytic error during post collection except:
Inadequate patient preparation
Refers to all complex steps that must take place before a specimen can be analyzed:
A. Pre-analytic
B. Analytic
C. Post-analytic
Pre-analytic
Must take into consideration multiple factors and variables that may affect the succeeding steps:
A. Pre-analytic
B. Analytic
C. Post-analytic
Pre-analytic
Screening process…:
A. Pre-analytic
B. Analytic
C. Post-analytic
Analytic
Manual or automated:
A. Pre-analytic
B. Analytic
C. Post-analytic
Analytical
Final phase of the laboratory process:
A. Pre-analytic
B. Analytic
C. Post-analytic
Post-analytical
Keeping of records:
A. Pre-analytic
B. Analytic
C. Post-analytic
Post-analytic
30 y/o patient with headache, fatigue, pallor, tachycardia… decreased haemoglobin, hematocrit, iron:
Microcytic, hypochromic
- Haptoglobin in hemolytic anemia:
Increase
Decrease
No Change
DECREASE
INDIRECT BILIRUBIN in hemolytic anemia:
Increase
Decrease
No Change
INCREASE
Reticulocyte count in hemolytic anemia:
Increase
Decrease
No Change
INCREASE
RDW in hemolytic anemia:
Increase
Decrease
No Change
INCREASE
Erythroid precursors from bone marrow in hemolytic anmeia:
Increase
Decrease
No Change
INCREASE
A patient present with DIC was recently diagnosed and tested positive for micro coagulation testing. What does the D-dimer measure?
Cleaved crosslink
A 45 y.o. man was diagnosed with primary hypoaldosteronism. Which of the lab result is most consistent with the diagnosis?
Increase or Decrease of Na K sereum HCO3 Urine Na Urine K
decrease Na
increase K
decrease serum HCO3 increase urine Na
decrease urine K
Man undergoes elective sigmoid resection.
ph ↓ pCO2 ↓ Bicarbonate ↓ Potassium ↑ BUN ↑ Creatinine ↑
Diagnosis?
A. Excessive sodium intake B. Fluid deficit C. Acute renal failure D. Surgical resection of both ureters E. Fistula between ureter and colon
C. Acute renal failure
70 y.o. man undergoes electrolyte sigmoid resection for diverticulitis. On the 2nd post-operative day his average urine output is only around 35-45mL/hr. IVF rate increase to 100mL/hr days after his urinary output is 50-55mL/hr. Lab study reveals the following: ph 7.25 pCO2 30 HCO3 50 K 5.0 BUN 85mg/dL Creatinine 4.1 Which of the following is most likely diagnosis?
A. Excessive sodium intake B. Fluid deficit C. Acute renal failure D. Surgical resection of both ureters E. Fistula between ureter and colon
C. Acute renal failure
34. A 60 yr old man is admitted to the hospital with a 2 week history of progressive lethargy and obtundation. Lab results are: Na 105 K 4.0 Plasma osmolality 22 Urine osmolality 604 Urine sodium 78
What is the most likely diagnosis?
SIADH
Low sodium in plasma and urine; high urine osmolality:
SIADH
Substance that is absorbed but not secreted is administered to the patient until steady state plasma level of 0.1 mg/dL. Second urine specimen is 60 ml and the administered substance is 10 ml.
What is the GFR?
100 ml
Chart is given, which is primary hyperthyroidism:
Low TSH
High T4
- Respiratory Failure secondary to poliomyelitis and the respirator was set on high:
Normal slightly increase (pO), Markedly decrease (pCO), Decrease (ph)
A 60-year-old diabetic man notes bone pain, especially in his hands, for the past 6 months. Laboratory shows the following results: Sodium: Normal Potassium: Normal CO2: Normal Glucose: Elevated Creatinine: Elevated Calcium: Elevated Phosphorus: Elevated Total Protein: Normal Albumin: Normal
Which of the following conditions is this patient most likely to have?
Parathyroid hyperplasia
- Select the letter that best depicts primary hypothyroidism:
High TSH, Low T4
riggers for histamine release are the following except:
A. IgE mediated mast cell
B. Physical injury
C. Anaphylotoxins
D. Cell adhesion molecules
D. Cell adhesion molecules
The following are important component in acute inflammation, except:
A. Vasodilation
B. Emigration of leukocytes
C. Release of chemical mediators
D. NOTA
D. NOTA
Activated by antigen-antibody complex:
Classical Pathway
Central convergence point for all pathways:
C3
C4
C5
C6
C3
To facilitate communication between cells, to assist in up-regulation or down-regulation of the immune response:
Cytokines
This complement activation pathway appears to be important in early defense against pathogenic microorganims:
A. Classical Pathway
B. Alternative Pathway
C. MBL Pathway
D. NOTA
B. Alternative Pathway
True of complement system, except:
A. Promote inflammation and host defense
B. Microorganism identification
C. Unregulated tissue damage is a possible complication
D. Not necessary to measures the serum complement level to track disease activity
D. Not necessary to measures the serum complement level to track disease activity
In Classical pathway, antigen-antibody complex sequentially binds and activate the following component except:
C3
C4
C5
C6
C3
Complement decreased in SLE and low levels in active disease:
C3
C4
Both
Both C3 and C4
Functions of complement system, except: A. To promote host defense B. To promote clearance of apoptotic debris C. To regulate immune response D. NOTA
D. NOTA
Complex glycoprotein that bind living tissues together, mediate cell migration during embryogenesis, wound healing and inflammatory response:
Adhesion molecules
Cell mediators that involves calcium:
Cadherins
Cancer serum tumor markers CA-19-9 and CA125 are epitopes that represent this type of CAM:
Mucin
The simplest functional assay in the classical pathway ch50 measures total hemolytic complement activity.
True or False
TRUE
The protein C5 is the central convergence point of the three activated complement pathways:
True or False
FALSE
- A patient with gram negative septicemia and pyogenic infection often have deficient C3 or components of alternative pathway.
TRUE
Complement plays a key role in the glomerular damage in many cases of glomerulonephritis.
TRUE
The kinin generating system is another inflammatory response pathway present in plasma that controls the generation of peptides important in the inflammatory response.
TRUE
Spontaneous bleeding in skin and mucosa such as petechia, echymosis is usually secondary to: A. Thrombocytopenia B. Platelet defect C. Liver disease D. Both A and B
D. Both A and B
The final common pathway of coagulation involves:
Formation of Thrombin
A defect in the aggregation of platelets is/are secondary to:
A. vWF deficiency
B. GP1b deficiency
C. GPIIb/IIIa deficiency
D. A and B are correct
C. GPIIb/IIIa deficiency-glanzman
A defect in platelet adhesion maybe secondary to:
A. vWF deficiency
B. GP1b deficiency
C. GPIIb/IIIa deficiency
D. A and B are correct
D. A and B are correct
The screening test for the diagnosis for coagulation problem are:
Bleeding time
PT
PTT
AOTA
All of the above (Bleeding time, PT, PTT)
Undetectable K:
A. Factor II
B. Factor V
C. Factor IX
D. AOTA
1972-vit k factors
B. Factor V
The most common inherited bleeding disorder in humans:
Von Willebrand
A deficiency or inhibition of one or more factors VII, X, V, II is suggested by:
A. prolonged ThrombinTime
B. prolonged PT
C. prolonged aPTT
D. decrease fibrinogen
B. prolonged PT -extrinsic
Deficiency or defect in factors II, V, VIII, IX, X, XI, XII and fibrinogen?
A. prolonged ThrombinTime
B. prolonged PT
C. prolonged aPTT
D. decrease fibrinogen
Prolongation of aPTT -intrinsic
The following clotting factors are produced by the liver except: A. Fibrinogen B. Prothombin C. vWF D. Christmas factor
C. vWF
Vacutainer for coagulation assay: color
Blue top tube
The vacutainer tube for CBC is:
color
Purple top tube
The following are Vitamin K dependent except:
Factor II Factor V Factor VII Factor IX Factor X
Factor V
Deficiency or mutation in coagulation proteins or factor that leads to thrombophilia, except:
Factor VII
Which of the following are true about DIC?
A. DIC is a severe form of consumptive coagulopathy
B. Systemic activation of hemostasis leads to widespread intravascular fibrin deposition with associated depletion of prohemostatic and anticoagulant factors
C. With parallel secondary fibrinolysis, potentially leading to a wide range of adverse outcomes, including thrombotic occlusion of small/ mid-sized vessels, organ dysfunction/failure, and/or bleeding.
D. AOTA
D. AOTA
Triggers disseminated intravascular coagulation (DIC):
A. Septicemia
B. Cancer
C. Systemic inflammatory response syndrome
D. All of the above
D. All of the above
True of severe Hemophilia A and B:
All of the above
The following statements about Aspirin is FALSE:
Aspirin acetylated inhibition bind to cyclooxygenase 2-tama to so hindi ito yun sagot
Which of the following does not contribute to clot formation? A. Calcium B. Phospholipid C. Heparin D. Thrombin
C. Heparin-anticougulant
Major antagonist of Vitamin K:
Warfarin
Defect in platelet-platelet interaction (disorders of aggregation):
A. Von willebrand disease (defect or defeciency in vwf)
B. Bernard-soulier syndrome (defect or defeciency in gp1b)
C. Congenital afibrinogenemia (defeciency in plasma fibrinogen)
D. Storage pool deficiency
glanzman -lahat ng choices adhesion problem maliban sa C
C. Congenital afibrinogenemia (defeciency in plasma fibrinogen)
The following is true of prothrombin time:
A. Prolonged PT is caused by deficiency of Factor VII, Factor X, Factor IX, II and I
B. INR is calculated as INR=(PT measured)/(PT mean)ISI
C. PT is more sensitive than aPTT
D. All are correct
D. All are correct
Most effective test for DIC:
D-Dimer test
Parasitologic easy-to-do test:
Direct Wet Mount
Most involves ingestion except:
Strongyloides
Not a characteristic of nematodes:
Incomplete digestive tract
Cellulose tape exam:
Enterobius
Causes rectal prolapse:
T. trichiura
Tissue biopsy reveals encysted larvae:
Trichina worm
What parasite causes human cysticercosis?
T. solium
Maltese cross formation:
Babeiosis
Soon after returning from a trip to Costa Rica, a 41-year-old woman develops recurrent chills and high fever that recur every 48h. Examination of her peripheral blood reveals red granules (Schüffner’s dots) in enlarged, young erythrocytes. Which of the following organisms is most likely to have produced her signs and symptoms?
P. ovale
Responsible for bladder cancer and has apical spine:
Schistosoma hematobium
This amoeba causes intestinal ulcers, liver and lung abscesses:
E. histolytica
A visitor from overseas was hospitalized due to suspected tuberculosis. The laboratory received a bloody sputum sample with orange brown flecks. What is the suspected organism?
Paragonimus westermani
Causes fatal meningoencephalitis:
Naegleria fowleri
Visceral larva migrans:
Toxoplasma canis
Bronchial AIDS silver methenamine:
A. Stercoralis B. Gondii C. Carinii D. Bancrofti E. Parvum
C. Carinii
Thru tick bites and blood transfusions except:
A. Babesia
B. Trypanosoma
C. Leishmanosis
D. AOTA
C. Leishmanosis -sand flies
Demonstrates the characteristic “falling leaf” motility of trophozoites:
- 21.
Giardia lamblia
Quartan Fever:
P. falciparum
P. ovale
P. malariae
P. vivax
P. malariae
James dot pigmentation:
P. falciparum
P. ovale
P. malariae
P. vivax
P. Ovale
Malignant (Tertian) Malaria:
P. falciparum
P. ovale
P. malariae
P. vivax
P. falciparum
Infect duffy blood group:
P. falciparum
P. ovale
P. malariae
P. vivax
P. vivax
New reported case. 1st seen in primates:
P. knowlesi
Scavenging of free radicals:
Vitamin B12
Vitamin C
Vitamin E
Vitamin K
Vitamin E
Hydroxylation of collagen:
Vitamin B12
Vitamin C
Vitamin E
Vitamin K
Vitamin C
Myelinization of spinal tracts:
Vitamin B12
Vitamin C
Vitamin E
Vitamin K
Vitamin B12
DNA metabolism / Uric acid production:
Molybdenum
Metallothionein:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
Zinc
Hyperglycemia/Hyperlipidemia:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
Chromium
Keshan Syndrome/cardiomyopathy:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
KS-Sel
Selenium
Pancreas:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
Pa Manga
Manganese
Neural tube defects:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
Neural-Fo
Folate
Prostate:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
ProZinc
Zinc
Spleen:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
SpC
Chromium
Fat:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
at-ALt
Cobalt
Adrenals:
Chromium Cobalt Folate Manganese Molybdenum Selenium Zinc
AdMoly
Molybdenum
Not true regarding folate?
All folate content of food is lost during cooking
True about thiamine except:
Thiamine is absorbed in small intestine and bound to prothrombin
Vitamins are organic molecule needed in trace amounts for health, reproduction and growth. They are as follows except:
A. Except for vitamin D essential vitamin are derived from food
B. Synthesis in the small intestines, not nutritionally significant because they are poorly absorbed
C. Deficiency causes clinical significance
D. Humans do not synthesize ascorbic acid, they need supplementation to prevent scurvy
B. Synthesis in the small intestines, not nutritionally significant because they are poorly absorbed
True about trace elements except:
Quantitation is done using quantitative procedure
Vitamin D promotes absorption of calcium and phosphate in the small intestine. Deficiency results to or from, EXCEPT:
A. Deficiency is due to inadequate intake
B. Insufficient sunlight reaching the skin
C. Inadequate absorption, as in fat malabsorption diseases
D. Failure of conversion to active metabolite in adult respiratory distress syndrome
E. Rickets in children, osteomalacia in adults
D. Failure of conversion to active metabolite in adult respiratory distress syndrome
Zinc deficiency is common in patients with the following except: A. Diabetes insipidus B. Alcohol abuse C. Liver disease D. Kidney disease
A. Diabetes insipidus
Manifestation of severe zinc deficiencies, except:
A. Hypogonadism, dwarfism, deformed bones
B. Poor wound healing, abnormal hair and nails
C. Loss of taste, GI disturbances, poor chylomicron function
D. Teratogenic in pregnancy with congenital malformations, prematurity
E. NOTA
E. NOTA
Dietary iodine is normally ingested as iodine and is the basic element in the synthesis of thyroid hormone. The following statements are true regarding the processes involving thyroid hormone except:
It is transported from the thyroid follicle
True of Panthotenic acid except:
A. Part of CoA (for TCA) and ACP (for lipid)
B. Panthothenic acid transported in erythrocytes
C. Highest concentration in liver, adrenals, kidneys, brain, heart, and testes
D. Panthothenic acid rarely present in food
D. Panthothenic acid rarely present in food
Capability of primary lab except:
Routine Chemistry
Microbiology culture and sensitivity for aerobe and anaerobe:
Hospital-based Tertiary Laboratory
65 year old man. Fatigued for 10 mos, PE unremarkable, decreased hemoglobin, decreased hematocrit, increased MCV, what do you request?
Assay for folate and B12
Blood test levels typically seen in hemolytic anemia.
Increase or Decrease
Haptoglobin
DECREASE
Blood test levels typically seen in hemolytic anemia.
Increase or Decrease
Indirect bilirubin
INCREASE
Blood test levels typically seen in hemolytic anemia.
Increase or Decrease
Reticulocyte
INCREASE
Blood test levels typically seen in hemolytic anemia.
Increase or Decrease
RDW
INCREASE
Blood test levels typically seen in hemolytic anemia.
Increase or Decrease
Erythrocyte precursor rate
INCREASE
- A 22-y/o female went to your clinic complaining of “feeling down”. Physical exam showed waxy pale skin and mucous membres. Extremities also showed purplish spots that do not blanch when pressed. Blood test revealed low RBC, WBC, and platelets. Bone marrow showed predominantly fat with decreased amount of cells.
What is the diagnosis?
Aplastic anemia
True of Hereditary Angioedema:
Cause is heterozygous decrease in C1-inh
Bullous pemphigoid and epidermolysis bullosa acquisita:
C3
C4
C5a
C3 and C4
C5a
Complement for SLE:
C3 & C4
Cell mediator of inflammation:
Neutrophils
True of complement system EXCEPT:
A. Host defense
B. Apoptosis
C. Immune Response
D. NOTA
- Vitamin K dependent: factors X, IX, VII, II except:
Factor V
D. NOTA
Complex glycoproteins that bind living cells together:
Adhesion molecules
Act as chemoattractants to neutrophils:
C3
C4
C5a
C3 and C4
C5a
Vitamin K dependent except
Factor II Factor V Factor VII Factor IX Factor X
Except Factor V
Deficiency or mutation in coagulation proteins or factor that leads to thrombophilia except:
Factor VII
Which of the following ere true about DIC:
A. DIC is a severe form of consumptive coagulopathy
B. Systemic activation of hemostasis leads to widespread intravascular fibrin deposition with associated depletion of prohemostatic and anticoagulant factors
C. With parallel secondary fibrinolysis, potentially leading to a wide range of adverse outcomes, including thrombotic occlusion of small/midium sized vessels organ dysfunction or failure and or bleeding
D. AOTA
D. AOTA
Single-stranded DNA
A. 1base+1triphospahate+1sugar
B. 1base+2triphospahate+1sugar
C. 1base+3triphospahate+1sugar
D. 1base+4triphospahate+1sugar
A. 1base+1triphospahate+1sugar
Process where mRNA goes splicing and capping:
A. Post translation
B. Post transcription
C. Methylation
D. PolyA tail
B. Post transcription
Recognizes specific short DNA sequence base pair and cleaves DNA molecule at recognition site:
Endonuclease
Correct complement sequence for DNA
G/C
G/T
G/A
G/C
GAAGGAG-CTTCCTC
Sections of DNA that specify amino acid sequence of proteins?
Codon
Faster and more specific test which will determine a specific gene and mutation or presence of chromosomal derangement?
FISH
Amplifying DNA:
PCR
Isothermal template amplification technique that can be used to detect trace amounts of DNA or RNA of a particular sequence:
Strand displacement amplification
Clinical situation/s involving immune complex reactions
A. Rheumatoid Arthritis
B. PSGN (Post-Streptococcal Glomerulonephritis)
C. Chaga’s disease
D. A and B
D. A and B
Clinical situation/s involving cytotoxic reactions:
A. Autoimmune Hemolytic Disease
B. Autoimmune Thrombocytopenia
C. Myasthenia gravis
D. All of the above
D. All of the above
Test for humoral B-cell immunity
Quantitative Igs
Test for Inflammation
ESR and CPR
- Positive / Negative cutoffs:
A. If the mean plus 2 standard deviation is chosen as the cutoff, approx. 2.5% of the healthy population will test +
B. If the mean plus 3 standard deviation is chosen as the cutoff, approx. 0.15% of the health population should test +
C. Both
C. Both
In Grave’s disease, following pharmacologic therapy, what is the relationship of the titer of TSI with likelihood of remission?
The titer of TSI are inversely correlated with the likelihood of remission
Gladiatorum is produce by:
HSV
Antigenic shift:
Influenza A
Influenza B
SA
Influenza A
Antigenic drift:
Influenza A
Influenza B
DB
Influenza B
80% of the CROUP is caused by this virus
A. Para-Influenza
B. Herpes Simplex Virus
C. Adenovirus
D. Meta-pneumoniae
A. Para-Influenza
PIV is considered the 2nd most common cause of lower respiratory tract infection. What is the most common type of PIV causing this?
PIV2
PIV3
PIV4
PIV3
Method of virus detection in general:
RT PCR
Non Replicative form of Chlamydial infection:
Elementary Bodies
Intracytoplasmic inclusions
Reticulate Bodies
Elementary Bodies
Non Infectious form of Chlamydia:
Elementary Bodies
Intracytoplasmic inclusions
Reticulate Bodies
Reticulate Bodies
Histologically, diagnosis of chlamydial infections is best demonstrated by:
Elementary Bodies
Intracytoplasmic inclusions
Reticulate Bodies
Intracytoplasmic inclusions
Condition that affects the lymphatic and circulation:
LGV
Slightly more sensitive than CA15-3:
CA27-29
Breast CA:
CA15-3
Monitoring of clinical course of patients with breast cancer:
CA 15-3
Non-seminous, molar pregnancy:
B-HCG
Important prognostic and predictive tumor marker for breast cancer?
Her2/neu
CA-125:
Ovarian Cancer
CEA:
Colon Cancer
A visitor is hospitalized due to suspected tuberculosis. The laboratory received a blood-tinged sputum with orange brown flecks. Preliminary tuberculin test is negative.
What organism is the cause?
P. westermani
Which of the ff. causes fatal meningoencephalitis?
N. Fowleri
Which of the ff organisms cause visceral larva migrans:
A. Brazilensis B. A. lumbricoides C. S. stercoralis D. T. carinii E. T. gondii
C. S. stercoralis
Transmitted to humans through tick bites and blood transfusion:
Babesia
Falling leaf like motility:
G. Lamblia
Differential diagnosis if cyrptosporidium pravum to cyclospora cayetenensis
oocyte size: cryptosporidium bigger
Hydroxylation of collagen
Vitamin C
DNA metabolism/ uric acid production:
Molybdenum
Methallothionine
Zinc
Keshan/Cardiomyopathy:
SELENIUM
Menke’s:
COPPER
Wernicke-Korsakoff:
VITAMIN B1
Neural tube defect:
FOLATE
Haptoglobin binds with myoglobin in cases of rhabdomyolysis.
TRUE or FALSE
FALSE
Serum protein electrophoresis can be used to screen patients suspected of having AAT deficiency: TRUE or FALSE
TRUE
Which one of the following options are appropriate indications for requesting protein electrophoresis?
a) Lytic bone lesions
b) Recurrent infections
c) Incidental finding of increased serum
total protein
d) Unexplained bone pain or fracture
e) AOTA
e) AOTA
A 10-year old boy presents with lethargy, hip pain, and high grade fever. Past medical history reveals several hospital confinements due to pneumonia. His neonatal history is unremarkable. His CBC results are within reference ranges. The child is negative for HIV antibody. Blood cultures yield S. aureus. Serum electrophoresis will most likely show which one of the following patterns?
Puro picture yun choices but A yun sagot. Yun may mataas na A1b and nonexistent na gamma, as in walang gamma.
A 36-year-old woman on oral contraceptives undergoes heparin treatment for pulmonary embolis. Her blood is drawn in a red tap tube for serum protein electrophoresis. A distinct band is noted just anodal to the gamma fraction. What is the most likely cause of this unexpected band?
a) Haptoglobulin
b) IgG
c) Fibrinogen
d) Transferrin
e) Alpha-2-macroglobulin
c) Fibrinogen
Refer to the previous question. Your answer in #5 migrates to which one of the following fractions?
a) Alpha-1
b) Alpha-2
c) Beta-1
d) Beta-2
e) Beta gamma
e) Beta gamma
20/M brought to the ED following a vehicular crash. Examination finds small _____ draining from his right nasal passage. The physician is not sure if this draining fluid is CSF. He sends the fluid specimen to the lab for identification. Electrophoresis demonstrates double band. This extra band is due to a variant of:
a) Ferritin
b) Transferrin
c) Albumin
d) Haptoglobulin
e) Alpha-2-macroglobulin
b) Transferrin
Refer to previous question. Your answer in #7 migrates to which one of the following fractions?
a) Alpha-1
b) Alpha-2
c) Beta-1
d) Beta-2
e) Beta gamma
d) Beta-2
A previously healthy 20 year-old man developed bilateral leg swelling two years ago that was managed with diuretics and steroids. He denies any history of kidney disease, malaria, TB, and syphilis. This patient has been hospitalized several times over the past two years for the same complaint. His BP is 110/70 mmHg. PE is remarkable for peripheral edema and rales in both lower lung fields. Pedal edema (+2) is noted. Lab tests show the ff results:
Hb = 13.9 g/dL (N: 13.5-17.5)
Hct = 40% (N: 40-54)
Cholesterol = 441 mg/dL (N<200)
Triglycerides = 225 mg/dL (N:<150)
Serum creatinine = 2.1 mg/dL (N: 0.6-1.2) 24-hour urine protein = 12g (N<100mg) Urinalysis SG = 1.042, 4+ proteins, large numbers of granular and hyaline casts, 2-5 WBC/HPF, 10-20 RBC/HPF. Serum protein electrophoresis is done. Which one of the following conditions most likely account for the patient’s findings?
a) Multiple myeloma
b) Liver cirrhosis
c) Nephrotic syndrome
d) Waldenstrom’s macroglobulinemia
e) Lymphoma
c) Nephrotic syndrome
A 10 year old Nigerian boy presents with generalized edema, ascites and proteinuria. Over the next 3 weeks, he develops conjugated hyperbilirubinemia, severe coagulopathy, and prominent extrapyramidal features comprising of tremors at rest and in action, shuffling gate, and slurred speech. Slit-lamp examination of the eyes reveals a brownish-yellow ring on the corneo-scleral junction. The following are true of the case, except:
a) Urinary copper excretion is most likely increased in the patient.
b) The most likely diagnosis for this case can be excluded by a normal
ceruloplasmin result.
c) The case cannot be diagnosed with protein electrophoresis.
d) The most likely diagnosis of this case cannot be proved or excluded solely on liver copper content.
b) The most likely diagnosis for this case can be excluded by a normal
The minimum acceptable hemoglobin level for a homologous blood donor:
a) 11.0 g/L
b) 11.5 g/L
c) 12.0 g/L
d) 12.5 g/L
e) 13.0 g/L
d) 12.5 g/L
The following are reasons for permanent deferral for blood donations, EXCEPT:
a) Neonatal history of hepatitis infection
b) Confirmed case of HIV but with high CD4
c) History of sexual contact with anyone in exchange for monetary gain
d) History of Tegison (etretinate) use
e) All of the reasons above entail permanent deferral.
c) History of sexual contact with anyone in exchange for monetary gain
A potential blood donor with a history of Accutan
(isotretinoin) use comes to you for screening. What is your call?
a) Permanent deferral for the donor.
b) Defer the donor for at least one month from receipt of the last dose.
c) Defer the donor for at least two months from receipt of the last dose.
d) Defer the donor for at least one year from receipt of the last dose.
e) Defer the donor for at least two years from receipt of the last dose.
b) Defer the donor for at least one month from receipt of the last dose.
Platelet components are stored up to ____ days at 20-24OC with continuous agitation.
a) 2
b) 5
c) 6
d) 7
b) 5
- Platelets prepared from a whole blood donation require which one of the following:
a) A light spin, then a heavy spin
b) Two light spins
c) A light spin and two heavy spins
d) A hard spin, then a light spin
e) Two heavy spins
a) A light spin, then a heavy spin
A 40 y/o man sustains major trauma following a
car accident. He is blood type O negative. Which of the following blood products would be unacceptable to transfuse?
a) B positive FFP
b) AB positive FFP
c) A negative platelets d) O positive red cells
e) AB positive red cells
e) AB positive red cells
The labels have come off some testing reagents in your blood bank. Your medtech is trying to find her anti-B, and she asks you what anti-B should be. Your answer:
a) Green
b) Orange
c) Blue
d) Yellow
e) Grey
d) Yellow
Tests were done to determine a patient’s blood type. Results are as follows:
Patient erythrocyte + anti-A serum: no agglutination
Patient erythrocyte + anti-B serum: agglutination Patient erythrocyte + anti-Rh(D) serum: no agglutination
Patient serum + Type A erythrocytes: agglutination
Patient serum + Type B erythrocytes: no agglutination
Patient serum + Type O erythrocytes: no agglutination
What is the patients’ blood type?
a) A positive
b) A negative
c) B positive
d) B negative
d) B negative
A 25 year old pregnant woman is preparing for her C-section tomorrow. Her forward typing is consistent with blood group O while her reverse typing is group A. What is the most common reason for error in typing?
a) Bombay phenotype
b) She is a non-secretor (??)
c) Clerical errors or a sample mix-up
d) Use of an uncalibrated centrifuge
e) She has undiagnosed acute myelogenous leukemia.
c) Clerical errors or a sample mix-up
Which of the following statements
characterizes a major crossmatch for RBC transfusion?
a) Prevents transmission of infectious diseases
b) Prevents formation of antibodies against donor blood group antigens
c) Prevents febrile transfusion reactions
d) Negative patient antibody screen
e) Guarantees survival of infused donor RBCs
d) Negative patient antibody screen
Bond formation coupled with ATP:
D. ligases
Oxidation-reduction:
A. Oxidoreductase
Elimination of double bond:
C. Lyase
Hydrolysis reaction:
B. Hyrdolase
Activity of erythrocyte ACP can be distinguished from prostatic acid phosphatase by:
a) Prostatic ACP is susceptible to formaldehyde, resistant to tartrate
b) Erythrocyte ACP is susceptible to formaldehyde
c) They cannot be distinguished from each other
b) Erythrocyte ACP is susceptible to formaldehyde
Exists predominantly in biliary tract as a marker for biliary dysfunction. It is also found in bone, bile ducts, intestine, and placenta.
a) ACP
b) ALP
c) ALT
d) AST
b) ALP
How do you distinguish bone and liver enzyme of ALP?
Heating
What is increased in intracellular liver damage
(hepatitis, cirrhosis) and after MI?
a) AST
b) ALT
c) ALP
d) ACP
a) AST
Which is more specific for liver damage?
a) AST
b) ALT
c) ALP
d) ACP
b) ALT
Which is used for monitoring hepatotoxic drugs?
a) AST
b) ALT
c) ALP
d) ACP
a) AST
Carcinoid syndrome:
Urine 5-HIAA
Pseudomembranous colitis:
E. Stool Clostridium dofficile toxin assay
Celiac disease:
D. Anti-tissue transglutaminase antibody
Protein losing enteropathy:
A. Stool a1 antitrypsin
Pancreatic insufficiency disease:
B. Fecal elastase
Ulcerative colitis:
E. p-ANCA
Crohn’s disease:
D. ASCA, anti-saccaromyces cerevisiae antibody
Colon carcinoma:
A. show deletion in one p53 allele
95% of pancreatic cancers:
B. mutated Kras
Mirizzi syndome:
C. CA19-9
Hep A:
C. RT PCR of feces
Hep B:
E. anamnestic response to the vaccine
Hep C:
B. Viral load, predictor of severity
Hep D:
A. Coinfection/Superinfection
Hep G:
D. Post-transfusion hepa
True of direct immunofluorescence:
b) A primary antibody with a fluorophore group bound to it and directly behind the epitope of the antigen it is specific for
True of indirect immunofluoescence:
a) A secondary antibody with a flurophore group bound to it and bound to fc portion of the primary antibody
Diagnosis of systemic rheumatic disease should
depend on:
a) Clinical characteristics
b) Lab testing and biopsy
c) Exclusion of other disease
d) AOTA
d) AOTA
Positive ANA test with a dilution of <1:160. The next step that the physician should do:
a) Order a panel of ANA specificities
b) Examine if there are symptoms, signs,
and lab findings of a rheumatic disease
c) Consider other autoimmune disease
d) Consider infections or _____ disorders
as the cause.
a) Order a panel of ANA specificities
Positive ANA with a dilution of >1:160. The next
step of the physician should be:
a) Order a panel of ANA specificities
b) Examine if there are symptoms, signs,
and lab findings of a rheumatic disease
c) Consider other autoimmune disease
d) Consider infections or _____ disorders
as the cause.
a) Order a panel of ANA specificities
True of diabetic ketoacidosis, EXCEPT:
a) It is a serious and potentially fatal hypergylcemi condition requiring urgent treatment.
b) The ration of B-hydryoxybutyric acid
to acetoacetic acid is greatly
decreased.
c) It is frequently associated with nausea, vomiting, abdominal pain, electrolyte disturbances, and severe dehydration.
d) Type 2 diabetes patients who are poorly controlled, particularly in the presence of extreme stress or severe acute illness, can also develop DKA
b) The ration of B-hydryoxybutyric acid
to acetoacetic acid is greatly
decreased.
Hypoglycemia from endogenous secretion can be due to the ff, EXCEPT:
a) Insulin-secreting beta cell tumors
b) Congenital hyperinsulinism
c) Autoantibodies to insulin in patient who have never been treated with insulin
d) NOTA
d) NOTA
True of lactic acidosis, EXCEPT:
a) It is a product of pyruvic acid metabolism
b) Nucleoside reverse transcriptase inhibitors used in the treatment of human immunodeficiency virus infection can also induce lactic acidosis
c) Approximately 1400 mmol of lactic acid is produced daily in healthy individuals
d) High levels of lactic acid produced during strenous exercise are rapidly
cleared by renal mechanisms only
d) High levels of lactic acid produced during strenous exercise are rapidly
cleared by renal mechanisms only
Lactic acidosis is diagnosed by the presence of the following, except:
a) High blood lactose levels
b) High anion gap
c) Low blood ph
d) NOTA
d) NOTA
This autosomal recessive deffect results in failure of heptic glucose generation from gluconeogenic precursors:
a) Essential fructosuria
b) Hereditary fructose insufficiency
c) Fructose 1,6 biphosphatse deficiency
d) NOTA
d) NOTA
McArdle disease is secondary to defect in:
a) Muscle phosphorylase
b) Phosphoglycerate kinase
c) Pyruvate muscle isoenzyme
d) Phosphofructo kinase
d) Phosphofructo kinase
The following are associated with von Gierke disease, EXCEPT:
a) Glucose-6-phosphate
b) Lab findings are hypoglycemia, lactic
acidosis, hyperuricemia, and
dyslipidemia
c) Autosomal recessive
d) Phosphorylase kinase
d) Phosphorylase kinase
It is a non-reducing sugar composed of glucose and fructose connected by a glycosidic band.
a) Maltose = reducing (glucose+glucose)
b) Sucrose
c) Lactose = reducing (glucose+galactose)
d) NOTA
b) Sucrose
The following are functions of insulin except:
a) Promotes glycolysis
b) Promotes lipolysis
c) Stimulates synthesis of AA from pyruvate
d) Increases glucose entry into the cell
b) Promotes lipolysis
The following are true of galactokinase deficiency except:
a) Galactose cannot be converted into galactose-1-phosphate and this leads to cataract formation
b) Pseudotumor cerebri is another rare complication observed in this disorder
c) The diagnosis is made by demonstrating an elevated blood galactose level with normal urydyl transferase.
d) A galactose-free diet cannot reverse cataract even if it is started early in infancy.
d) A galactose-free diet cannot reverse cataract even if it is started early in infancy.
This enzyme converts testosterone to estradiol in peripheral tissues such as adipocytes:
a) 21-____
b) AOTA
c) Aromatase
d) DHEA-5
c) Aromatase
Activeform of testosterone:
a) DHT
b) DHEA
c) Both
d) None
a) DHT
Primary regulating hormone of reproductive function secreted and synthesized in the hypothalamus.
a) GNRH
b) FSH
c) LH
d) Prolactin
a) GNRH
Blighted ovum is indicated by which one of the following:
a) Increased estradiol and progesterone
b) Decreased estradiol and progesterone
c) Increased estradiol
d) Increased progesterone
a) Increased estradiol and progesterone
L/S ration that indicates fetal lung maturity:
a) 2.0
b) 2.5
c) 1.5
d) 1.0
b) 2.5
True or False: The primary risk to the fetus in hemolytic disease of the newborn is the accumulation of unconjugated bilirubin in the CNS.
a) True
b) False
Hypoglycemia from endogenous insulin secretion can be due to the ff, EXCEPT:
a) Insulin-secreting beta cell tumors
b) Congenital hyperinsulinism
c) Autoantibodies to insulin in patients who
have never been treated with insulin
d) NOTA
b) False
The primary risk to the fetus in hemolytic disease of the newborn is one of the ff: a) Unconjugated bilirubin b) Anemia c) Both d) None
c) Both
True of Type I diabetes, EXCEPT:
a) Frequency of 5%-10%
b) C-peptide levels are very low or
undetectable
c) Autoantibodies may be present
d) Autoantibodies are absent
Hypoglycemia from endogenous insulin secretion can be due to the ff, EXCEPT:
a) Insulin-secreting beta cell tumors
b) Congenital hyperinsulinism
c) Autoantibodies to insulin in patients who
have never been treated with insulin
d) NOTA
d) NOTA
The ff are included in the diagnostic criteria for an insulinoma, EXCEPT:
a) Presence of signs and symptoms of hypoglycemia with plasma glucose level ≤55 mg/dL
b) Insulin level ≥3 uU/mL (18 pmol/L) by immunochemiluminometric assay
c) C-peptide concentration ≥0.6 ng/mL (0.2
nmol/L)
d) NOTA
d) NOTA
True of lactic acidosis, EXCEPT:
a) It is a product of pyruvic acid metabolism
b) Nucleoside reverse transcriptase inhibitors used in the treatment of human immunodeficiency virus infection can also induce lactic acidosis
c) Approximately 1400 mmol of lactic acid is produced daily in healthy individuals
d) High levels of lactic acid produced during strenous exercise are rapidly cleared by renal mechanisms only
d) High levels of lactic acid produced during strenous exercise are rapidly cleared by renal mechanisms only
Lactic acidosis is diagnosed by the presence of the following, except:
a) High blood lactose levels
b) High anion gap
c) Low blood ph
d) NOTA
d) NOTA
This autosomal recessive defect results in failure of hepatic glucose generation by gluconeogenic precursors such as lactate, glycerol, and alanine.
a) Essential fructosuria
b) Hereditary fructose intolerance
c) Fructose-1,6-bisphosphatase deficiency
d) NOTA
d) NOTA
It is produced in the delta cells which make up 5%-10% of the islet cells.
a) Glucagon
b) Somatostatin
c) Incretins
d) NOTA
b) Somatostatin
The following are used currently as predictive markers for diabetes, EXCEPT:
a) ICA
b) Anti-TPO
c) Anti-GAD
d) IAA
e) IAA-2 autoantibodies
b) Anti-TPO
Antibodies deposits are seen in BMZ (basement membrane zone) using immunofluoroscence.
a) Bullous phemphigoid
b) Pemphigus vulgaris
c) Pemphigus foliaceous
d) AOTA
a) Bullous phemphigoid
p-ANCA is best associated with
a) Ulcerative colitis
b) Crohn’s disease
c) Both UC and CD
d) Hepatic and hepatobiliary autoimmunity
a) Ulcerative colitis
ASCA is a marker for:
a) Hepatic and hepatibiliary disease
b) Inflammatory bowel disease
c) Pernicious anemia
d) Lymphocytic gastritis
b) Inflammatory bowel disease
VGCC (voltage-gated calcium channel) autoantibody screening is for the ff autoimmune diseases
a) Myasthenia gravis
b) Multiple sclerosis
c) Eaton Lambert myasthenic syndrome
d) AOTA
c) Eaton Lambert myasthenic syndrome
This type of cutaneous autoimmune disease involves specifically type III collagen:
a) IgA pemphigus
b) Dermatitis herpetiformis
c) Bullous pemphigoid
d) Epidermolysis bullous
c) Bullous pemphigoid
Linear/granular pattern of C3 deposits in IF is a consistent finding of:
a) Pemphigus vulgaris
b) Pemphigus follaceous
c) IgA pemphigus
d) Pemphigoid ____
a) Pemphigus vulgaris
The ff are examples of organ-specific disease, EXCEPT:
a) Celiac disease
b) Pemphigoid lesions
c) Goodpasteur syndrome
d) Autoimmune hepatitis
c) Goodpasteur syndrome
HLA-DQ2/HLA-DQ8:
a) Celiac disease
b) UC
c) CD
d) Pernicious anemia
a) Celiac disease
Intradermal acantholysis is the hallmark of:
a) Epidermolysis bullous
b) Dermatitis herpetiformis
c) Pemphigus follaceus
d) Pemphigus vulgaris
d) Pemphigus vulgaris
In the normal immune system, CD4 will differentiate into TH1 and TH2. The ff substances will be relased from TH2, EXCEPT:
a) IL2
b) TNF-alpha
c) Interferon gamma
d) IL4
d) IL4
Single best screening test for thyroid dysfunction:
a) TSH
b) T3
c) Total T4
d) Free T4
a) TSH
Characterized by thyroid stimulating
immunoglobulin and is the most common cause of ______
a) Toxic multinodular goiter
b) Plummer syndrome
c) Hashimoto thyroiditis
d) Grave’s Disease
d) Grave’s Disease
Lab test results that point to euthyroid sick syndrome:
a) TSH – low
b) T3 – high
c) T4 – high
d) rT3 – high
d) rT3 – high
The best screening test for this condition is ratio of plasma aldosterone concentration to plasma renin ____
a) Conn syndrome
b) Addison disease
c) Cushing syndrome
d) Primary adrenal insufficiency
a) Conn syndrome
In dexamethason suppression test, a dose of dexamethasone that suppresses both ACTH and cortisol ____ seen in:
a) Cushing syndrome
b) Addison disease
c) Conn disease
d) Normal individuals
d) Normal individuals
The anterior pituitary gland secretes the ff, EXCEPT:
a) Growth hormone
b) Prolactin
c) Oxytocin
d) TSH
c) Oxytocin
Prolactin levels of or greater than is almost always indicative of pituitary tumor:
a) 1 ug/L
b) 25 ng/mL
c) 100 ng/mL
d) 200 ng/mL
d) 200 ng/mL
Initial screening test for clinically suspected acromegaly
OGTT
TRH
IGF-1
TnRH
IGF-1
The adrenal cortex secretes the ff, except
a) Epinephrine and NE
b) Glucocorticoids
c) Estrogen and androgen
d) Aldosterone
a) Epinephrine and NE
