Kahoot Flashcards
The stained smear of bone marrow specimens obtained from an immunodeficient patient revealed small intracellular cells. The organism grew as a mold on enriched media at 25°C and as a yeast at 37°C. Microscopic examination of the mold revealed thick, round, tuberculate macroconidia. What is most likely identification?
Histoplasma Capsulatum
Determine the calculated osmolality given the following data: sodium=135mEq/L; glucose=95 mg/dL; BUN= 10 mg/dL.
2(NA) + Glucose/18 +Bun/ 2.8 =
2(135) + 95/18 + 10/2.8 = 270+5.278+3.57= 278.848
In infectious mononucleosis IgG-EBNA antibodies first appear in:
IgM
A 42-year-old male presents with anorexia, nausea, fever, and icterus of the skin and mucous membranes. He noticed that his urine had appeared ark for the past several days. The physician orders a series of biochemical tests. Based on the following test results, what is the most likely diagnosis?
Serum alkaline phosphatase- markedly elevated
Serum alanine aminotransferase- slightly elevated
Serum aspartate aminotransferase- slightly elevated
Serum gamma-glutamyltransferase- markedly elevated
Serum total bilirubin-moderately elevated
Urine bilirubin- positive
Fecal urobilinogen- decreased
Obstructive jaundice
Antibodies against streptolysin O, hyaluronidase, and DNase B are measured in the diagnosis of which disease?
Rheumatic fever
eGFR calculated by the MDRD formula takes into account the age, race, gender and what else for its calculations?
Creatinine
A 6-month-old male infant presents with failure to thrive. His mother notes that he has loose, foul smelling stools, a representative field of his blood smear is shown here. What is the diagnosis?
Abetalipoproteinemia
A permanent stained smear of a fecal specimen revealed the trophozoite in the image below. The organism measure 55 in diameter should be reported as:
Entamoeba coli trophozoite
Antibodies to cyclic citrullinated proteins (anti-CCP) are specific diagnostic indicators for:
Rheumatoid Arthritis
A 68 year old patient has a white blood cell count of 19x10^9/L. The wright’s stain peripheral smear below. What is the expected chromosomal abnormality?
picture of smudge cell is it trisomy 12? CLL
The TUL reaction in the image below is suggesting which organism?
E. Coli
Which of the following is necessary to prevent an anaphylactic allergic transfusion reaction due to known IgA antibody in a patient?
Red Blood Cell units should be washed
Acid fast coccobacilli recovered from an immunodeficient patient suggest infection by which mycobacteria?
M. Avium complex
When a therapeutic drug is suspected of causing toxicity, which specimen is most appropriate for an initial investigation?
Peak Blood sample
A patient wants to donate his own blood for surgery scheduled in 1 weeks and has a Hgb of 11g/dl. What is his eligibility status?
Yes, autologous.
A 30-year-old woman is admitted to the hospital. She has truncal obesity, buffalo humpback, moon face, purple striae, hypertension, hyperglycemia, increased facial hair, acne, and amenorrhea. The physician orders endocrine testing. The results are as follows:
Urine free cortisol- increased
Serum cortisol( 8 AM)- increased
Plasma ACTH- decreased
Dexamethasone suppression test:
Overnight low dose- no suppression of serum cortisol
High dose- no suppression of serum cortisol
What is the most probable diagnosis?
-Adrenocortical carcinoma
Characteristics necessary for the definitive identification of mycobacterium tuberculosis are:
Rough, nonpigmented colony, slow growth at 37 C, niacin production positive, nitrate reduction positive
What might a positive antibody screen and a negative auto control indicate?
An alloantibody has been detected.
The abnormal hemoglobin can form as a result of chronic constipation or medication and represents irreversible change to the hemoglobin molecule which cannot carry oxygen and will persist until the RBCs caring this abnormal hemoglobin are removed from circulation:
Sulfhemoglobin
An increased TSH and decreased T4 Provide laboratory evidence of which disease?
Primary Hypothyroidism
A 55 -year-old male was treated and admitted to the hospital. Her pre-admission results were:
WBC 3.2x10^9/L RBC 3.1X10^12/L Hct 34% Hgb: 10.7g/dL RDW: 17.6
MCV:110fL, MCH 34.5 pg MCHC: 32g/dL
The wright’s stained peripheral smear of this patient is shown. A definitive diagnosis can be made with additional procedure:
Megaloblastic Anemia Assay Folate and Vitamin B12
Gram staining was performed on a smear of staphylococcus aureus and escherichia coli for quality control measures. Microscopic examination of the smear appears in the image below. The technologist should perform the quality control should:
read it as regular
The specificity of the antibody in the cold autoimmune hemolytic anemia is most often directed toward:
Ii systems
A patient presenting with polyuria, nocturia, polydipsia, and high specific gravity is exhibiting symptoms of:
Diabetes Mellitus
Five days after a transfusion, a patient returned to his physician for postsurgical blood tests. It was noted that the hemoglobin value decreased from 11g/dL to 9ml/dL during that time. The patient had not experienced any symptoms. To rule out a delayed hemolytic transfusion reaction, what test should be performed?
A. DAT on current sample, elution if positive
B. antibody screen on the current sample
C. blood smear to check for spherocytes
D. all of the above
Which of the following statements about cortisol in cushing’s syndrome is true?
Twenty-four-hour urinary free cortisol is a more sensitive test than plasma total cortisol
All of the following are characteristics of ABO hemolytic of the fetus and newborn( HDFN) except:
The antibody is IgM
A sperm count is diluted 1:20 and 50 sperm are counted in 2 large squares of the Neubauer counting chamber. The sperm count in mLs
Number of sperm counted x dilution factor/volume x 1000 = sperm/ml.
50 x 20/ 0.02 x (1000) = 50,000,000 or 5.0 x 10 ^7 sperm/ml
A group O patient was crossmatched with group B red blood cells. What phase of the crossmatch will first detect this incompatibility?
Immediate spin
What is the most likely diagnosis given this microscopic finding?
picture of RBC CASTS
glomerulonephritis
Which of the following biochemical parameters is found only in the myocardium and therefore provides specific evidence of cardiac injury when increased 4-6 hours after chest pain onset?
Cardiac Troponin I
A 27- year-old woman arrives at the emergency department with acute bleeding and swollen gums. Lab results are:
WBC:25.7 X 10^9L Absolute neutrophil count 0.8x10^9/L RBC:2.3 X 10^12/L Hematocrit 27% Platelet count 35 x 10^9/L Peripheral Smear Result: 30% blasts 70% Abnormal Promyelocytes in her peripheral blood; Some of these cells contain Auer rods What cytogenetic finding would be expected in this condition?
AML
Detection of oxacillin/methicillin resistant staphylococcus aureus in antimicrobial susceptibility may be enhanced by:
Incubating for 24 hours with added salt
The serum electrophoretic pattern seen here is consistent with:
monoclonal gammopathy
Mrs. PL is a first trimester pregnancy woman suspected of having been infected with toxoplasmosis after taking care of a friend’s cat. Initial serological tests indicate a specific IgG titer of 1:64. A second sample taken three weeks later had a titer of 1:256. These results are indicative of:
current infection
A request is received in the laboratory for assistance in selecting the appropriate tests for diagnosing lyme disease. Which of the following is most reliable for diagnosis?
Microhemagglutination test on serum, examination of a gram staining smear
Immunization for measles vaccine would result in a temporary donor deferral for:
4 weeks
A clean- catch urine is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first and 3 hours later the specimen is sent to the microbiology department. The specimen should:
Be rejected due to time delay
A patient is admitted to the hospital with intense chest pains. The patient’s primary care physician requests that the emergency room doctor order several tests, including a lipid profile with cholesterol fractionation. The patients results are as follows:
Total Cholesterol= 400 mg/dL
Triglycerides= 300 mg/dL
HDL Cholesterol=100mg/dL
The LDL cholesterol for this patient would be __________ mg/dL
240
A soft fecal specimen collected at 1:30pm was submitted to the laboratory at 2:00 pm
with a request for O&P examination. At 2:05 pm, you received a blood smear for you to read on a patient with a possible diagnosis of malaria. What is the most appropriate course of action?
Store in the fridge… work on malaria slide
Specimens for viral culture should be collected:
Within 2 to 3 days
Which best describes the reaction of the organism growing on MacConkey agar in the image below?
Lactose fermenter
What term describes the process to identify what factors contributed to the occurrence of a nonconformance?
Root Cause analysis
Negative results obtained in the nitrocephin (beta-lactamase) test can be reported after 10 minutes of incubation for all organisms tested except for ??__ which requires 60 minutes of incubation before reporting negative results.
Staph. Aureus
Viral genomes and virus names are grouped below. Which grouping of nucleic acid is incorrectly paired with one or both viruses and the core or genome of the viruses is either DNA or RNA. All of the following nucleic acid and viruses are appropriately grouped except:
RNA varicella zoster; RNA hepatitis A
A blood specimen is obtained from an individual who is known to have elevated serum triglycerides. This individual’s physician has ordered an estrogen immunoassay that your laboratory performs using a nephelometric technique. Which of the following statements is correct concerning the possible outcome of this assay?
The lipemic specimen will produce interfering background light intensity and excess light scatter in this type of assay
A blood specimen is obtained from an individual who is known to have elevated serum triglycerides. This individual’s physician has ordered an estrogen immunoassay that your laboratory performs using a nephelometric technique. Which of the following statements is correct concerning the possible outcomes of this assay?
The lipemic specimen will produce interfering background light intensity and excess light scatter in this type of assay
Tertiary syphilis is characterized by the following:
Gummas..
The results below are from a 35-year-old male patient: wbc- 5.3 x 10^9 rbc- 5.5 x 10^12 hemoglobin- 11.7 x 10^ g/dL hematocrit- 36.1 % mcv- 65.4 fL mch- 21.2 pg mchc- 32.4 g/dL rdw- 15.4 plt- 350 x 10^12 high performance liquid chromatography hbF 2.2% hbA 82.5 % hbA2 5.3% Which of the following disorders are suggested by these findings:
B thalassemia minor
- Tests for the detection of occult blood rely on which chemical reaction?
Pseudoperoxidase activity of hemoglobin
An OGTT was performed on a patient. The 2 hour serum glucose level was 145 mg/ dL. This should be interpreted as:
Impaired glucose tolerance
Identify the elements seen in the image below from a synovial fluid analyzed with a polarizing microscope:
Monosodium Urate Crystal
- Which of the following is a disorder with absent platelet glycoprotein lb/lX and the patient presents with moderate thrombocytopenia, large platelets, and normal aggregometry with all agents except ristocetin?
Bernard Soulier Syndrome
Which of the following cells can be found in a vaginal wet prep?
Clue cells
A man is suspected of having pneumococcal pneumonia. Which of the following is used to screen the etiologic agent for sensitivity to the penicillinase resistant penicillins and test for susceptibility to antibiotics?
Oxacillin disk diffusion
In an indirect ELISA method designed to detect antibody to rubella virus in the patient’s serum the conjugate used would be:
Antihumman IgG conjugated to an enzyme
Which of the following sets of tests would be the most useful in diagnosing an acute myocardial infection?
CK-MB,Troponin, myoglobin
Results of the tests obtained on a small child who had easy bruising, tiredness, difficulty breathing and decreased urinary output were:
Hb 6.5 g/dL
Platelets 41 x 10^ 9/L
PT and PTT within normal range
His mother indicated he had an episode of bloody diarrhea about 2 weeks earlier, but it has not recurred. Based on the clinical and limited laboratory findings, what is the most likely condition
HUS hemolytic uremic syndrome
What is the correct WBC count if the WBC is 14.46 x 10^9/L and there were 47 nucleated RBCs seen per 100 white blood cells noted on a differential count?
(Uncorrected WBC count x 100)/(NRBCs per 100 WBC’s + 100)
(14.46 x 100) / (47 + 100) = 9.8
Results of the tests obtained on a small child who had easy bruising, tiredness, difficulty breathing and decreased urinary output were:
Hb 6.5 g/dL
Platelets 41 x 10^ 9/L
PT and PTT within normal range
His mother indicated he had an episode of bloody diarrhea about 2 weeks earlier, but it has not recurred. Based on the clinical and limited laboratory findings, what is the most likely condition
HUS hemolytic uremic syndrome
A blood sample from a 4 month infant which tested positive on the solubility test was run on cellulose acetate at pH 8.6. The plate with the results is seen in Hb Elect Strip presented the patient sample is in slot 6. What is the patient’s diagnosis?
IMAGE OF BLUE HYDRAGEL
Hemoglobin SC
A patient has a reactive RPR at a titer of 1:32 and a reactive TP-PA. What do these results indicate?
positive for syphilis
A DAT result showed 3+ with anti-IgG. What is the first step to identify the antibody coating the red cells?
Perform an elution
A 1:20 dilution is made in an unopoette with glacial acetic acid as the diluent. Two hundred and thirty (230) WBCs were counted in 4 large squares. What is the total WBC count?
WBC count = (dilution ratio x #of cells counted x 10)/ (# mm2 area counted)
WBC count = (20 x 230 x 10)/ 4 = WBC/uL (or 1.15 x 10^4 WBC/uL)
A patient has a reactive RPR at a titer of 1:32 and a reactive TP-PA. What do these results indicate?
Positive for syphilis
A college student seeks medical care for extreme fatigue and a swollen lymph node in the neck. The WBC count is 11 x 10^9/L. The differential and image is below: neutrophil 30% lymphocyte 58% monocyte 8% eosinophil 3% basophil 1%
What is the most likely diagnosis?
infectious mononucleosis
How does the net charge of the protein in a sample affect the electrophilic mobility of protein fractions?
It is directly proportional to electrophilic mobility
A 76 year old man is brought to the ER in a semiconscious state. He is confused and disoriented and lapses into semi-consciousness during transport to the ER. Laboratory results include the following:
Increased acidity and increased anion gap
A gram positive coccus was isolated from blood cultures of a patient with endocarditis and presumptively identified as Enterococcus faecalis. What should the technologist do next?
screen for high aminoglycoside resistance
The purpose of the AHG crossmatch is to:
Detect clinically significant IgG antibodies to antigens on the donor cells
During an antibody ID, there was 1+ reaction at AHG with donor cells with the antigen profile Fya+ Fyb- when tested with patient’s serum. All other donor cells on the panel were negative, including those cells that were Fya+Fyb+. Given these results, what might be the conclusion?
Showing dosage
A 4 year old boy presents with bruising, fever and coughing. The CBC results are as follows:
WBC count 15 x 10^9/L
HCT 23%
PLT 53 x 10^9/L
A bone marrow aspirate is presented: ADD IMAGE
The myeloperoxidase and non-specific esterase stains were negative and the TdT was positive. The surface marker studies were HLA-DR +, CD9 +, CD10 +, CD20 +, CD 22+. No cytoplasmic or surface immunoglobulins were detected. The most likely diagnosis is:
ALL-L3
Which of the following statements is true regarding IgG- sensitized cells (Check Cells):
They must be used to confirm a negative antiglobulin tube test
In which condition is the highest level of serum gastrin usually seen?
Zollinger -Ellison Syndrome
A patient has the following serologic profile: HBsAg: negative HBeAg: negative anti HBc IgM: negative anti HBc IgM: positive anti- HBs: positive anti- HBe: positive These results indicate:
past infection with HBV
Which of the following requires isolation on media enriched with blood incubated at 42 degrees celsius in an environment containing 5% oxygen, 10% carbon dioxide, and 85% nitrogen?
Campylobacter
The following results were obtained on a 32 year male with a history of moderate to severe bleeding problems:
BT: 4 mins
PT: 12 sec
aPTT: 61 sec
Mixing Study (fresh plasma): correction
Mixing Study (aged serum): corrected
Mixing Study (adsorbed plasma): correction
These clinical manifestations and laboratory results are consistent with:
FvII ORliver disease or
bleeding disorders include: von willbrand, hemophilia A and B
.FvII ORliver disease or
bleeding disorders include: von willbrand, hemophilia A and B
A 60-year old man was transfused with 1 unit of packed red blood cells following knee surgery. His hematocrit was determined to be 27% before transfusion. What would you expect his hematocrit to be in 48 hours?
30%
Which of the following statements about TLC for drug screening is true?
A drug is identified by comparing its Rf value and staining to standards
The CBC result for a female patient were as follows:
Rbc: 3.7 x 10^ 12/L
Hb: 9.7 g/dL
Hct: 29%
MCV: 78 fL
MCH: 26 pg
MCHC: 33 g/dL
A Perl’s Prussian blue stain performed on the patient’s bone marrow showed the following:
Another expected finding in this condition is:
Increased TIBC…
What is the RPI for a patient with a reticulocyte count of 5%,RBC: 3.0x10^9/L and hematocrit of 25%( normal hematocrit:45%).
Hematocrit(%) Retic survival(days)= maturation corr 36-45 1.0 26-35 1.5 16-25 2.0 15 and below 2.5
RPI:
(5) (0.25/0.45) / 2.0 = 1.39
Which of the following set of results is consistent with uncompensated metabolic acidosis?
pH 7.25; HCO3 15 mmol/L; pCO2 37 mm Hg*
A 0.001 ml loop was used to inoculate a urine specimen to culture media. After incubation, the following colonies were observed:
MAC agar- 200 pink colonies
SBA-210 large gray colonies
The technologists should report:
> 100,000 CFUs/mL GNR
The mycelial form of which dimorphic mold produces thick walled rectangular barrel- shaped alternate arthroconidia?
Coccidioides immitis
The urinalysis result most closely associated with renal disease is a positive:
Protein
Which of the following enzymes is responsible for the conjugation of bilirubin?
UDP-glucuronyl transferase
What is tested in an antibody screen?
Patient serum is tested against group O reagent screening cells
Colonies growing on kanamycin-vancomycin laked blood KVLB agar fluoresce red when viewed under a Wood Lamp. The organism suggested is:
Prevetolla or Porphyromonas species
Possible causes of extra antigens appearing in the forward grouping include all of the following except?
ABO subgroup
the following crystal is found in: coffin shaped
nonpathologic, highly alkaline urine and common in urinary tract infections
Laboratory results were as follows: wbc- 10.0 x 10 ^9/L rbc- 3.1 x 10^12/L hb- 8.4 g/dL hct- 24% mcv- 78 fl
other tests:
serum iron-29 range (50-160)
serum ferritin- 400 range (15-300)
tibc- 160 range (250-400)
zinc protoporphyrin- 35 range (1-27)
the data is consistent with:
Anemia of Chronic Inflammation
Laboratory results were as follows: wbc- 10.0 x 10 ^9/L rbc- 3.1 x 10^12/L hb- 8.4 g/dL hct- 24% mcv- 78 fl
other tests:
serum iron-29 range (50-160)
serum ferritin- 400 range (15-300)
tibc- 160 range (250-400)
zinc protoporphyrin- 35 range (1-27)
the data is consistent with:
anemia of chronic imflammation
Which of the following is true about platelets
must be transfused within 5 days
newborn infant tests positive for anti-hbc IgG. This result is evidence that:
the mother was infected with hepatitis B
A patient’s hepatitis b profile is positive for hepatitis b surface antibody only. This patient
Was vaccinated against Hep B
Patient serum is mixed with gel particles that have been sensitized with Treponema pallidum antigens as well as with unsensitized gel particles in a separate well. Agglutination was observed in the well with sensitized gel particles but not in the well with unsensitized gel particles. What is the interpretation of these results?
Positive for anti-T pallidum antibodies
The principle demonstrable antibodies in systemic lupus erythematosus are
Antinuclear antibodies
