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ADVANCE PATHOLOGY > LQ 1 > Flashcards

LQ 1 Flashcards

1
Q

The methods of extraction, storage, and handling of nucleic acid molecules, depends on the type of the tissue from where they were extracted .

TRUE
FALSE

A

FALSE

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2
Q

What do these Molecular Testing detect?

  • thrombophilia mutations (Factor II, Factor V, MTHFR 677, and MTHFR 1298 genotypes
  • HIV-1 RNA & HBV DNA & HCV RNA
    CMV
  • Mycoplasma pneumoniae & Bordetella pertussis.
  • influenza A and B viruses

CLEAVASE/INVADER TECHNOLOGY

A

thrombophilia mutations (Factor II, Factor V, MTHFR 677, and MTHFR 1298 genotypes

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3
Q

What do these Molecular Testing detect?

  • thrombophilia mutations (Factor II, Factor V, MTHFR 677, and MTHFR 1298 genotypes
  • HIV-1 RNA & HBV DNA & HCV RNA
    CMV
  • Mycoplasma pneumoniae & Bordetella pertussis.
  • influenza A and B viruses

LOOP-MEDIATED AMPLIFICATION (LAMP)

A

Mycoplasma pneumoniae & Bordetella pertussis

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4
Q

What do these Molecular Testing detect?

  • thrombophilia mutations (Factor II, Factor V, MTHFR 677, and MTHFR 1298 genotypes
  • HIV-1 RNA & HBV DNA & HCV RNA
    CMV
  • Mycoplasma pneumoniae & Bordetella pertussis.
  • influenza A and B viruses

NICKING ENZYME AMPLIFICATION REACTION (NEAR)

A

influenza A and B viruses

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5
Q

In Transcription, the antisense strand is the__.

template strand & non-coding strand???
non-template strand & non-coding strand
template strand & coding strand
non-template strand & coding strand

A

non-template strand & coding strand

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6
Q

Muddy brown urine casts with high urine protein are usually seen in

A. Post-renal azotemia
B. Prerenal azotemia
C. Intrarenal azotemia

A

C. Intrarenal azotemia

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7
Q

Confirmatory tests require ____ to be certain of the diagnosis.

A.low specificity
B. low sensitivity
C. high specificity
D. high sensitivity

A

C. high specificity

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8
Q

A test with a higher sensitivity ____ a greater proportion of persons ____ disease.

A. identifies – without
B.excludes - without
C.identifies – with
D.excludes - with

A

C.identifies – with

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9
Q

The fundamental characteristics of TARGET AMPLIFICATION METHODS EXCEPT:

A.The primers bind to complementary sequences on one strand of double-stranded targets.
B.The amplification products in all the techniques are defined by two oligonucleotide primers.
C.They are enzyme-mediated processes that synthesize copies of target nucleic acid.
D.All produce millions to billions of copies of the targeted sequence in a matter of hours

A

A.The primers bind to complementary sequences on one strand of double-stranded targets.

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10
Q

Amniocentesis can be typically done during this period of gestation:

A.between 18-20 weeks
B.between 16 and18 weeks
C. between 20 - 28 weeks
D.between 14 and16 weeks

A

B.between 16 and18 weeks

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11
Q

The postanalytic evaluation process, on the clinical significance of the Laboratory Test result, includes the following:

A.critical values
B.delta checks
C.reference ranges
D.linearity ranges
E.pretest and posttest probability
F.1st, 3rd, & 5th choices only
G. 2nd & 4th choices only
H.All of the above

A

F.1st, 3rd, & 5th choices only

A.critical values

C.reference ranges

E.pretest and posttest probability

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12
Q

Chorionic villus sampling (CVS), which provides tissue from the developing placenta is obtained by the transabdominal or transvaginal procedure, performed at _______ gestation.

A.18 – 22 weeks
B.14 to 18 weeks
C.10 to 14 weeks
D.22-26 weeks

A

C. 10 to 14 weeks The transabdominal or transvaginal procedure is performed at 10 to 14 weeks gestation.

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13
Q

The methods of extraction, storage, and handling of nucleic acid molecules, depends on the type of the tissue from where they were extracted.

A.TRUE
B.FALSE

A

B.FALSE

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14
Q

In virus, the main enzyme responsible for synthesizing a double helix complementary DNA strand (cDNA) from RNA is___:

A.ribonuclease H
B.RNA polymerase
C.reverse transcriptase
D.integrase

A

C.reverse transcriptase

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15
Q

The major cause of simultaneous elevation of prothrombin time & activated partial thromboplastin time is _______.

A.Coumadin therapy
B.Combined Heparin & Coumadin therapy
C.Heparin therapy
D.Disseminated intravascular coagulation
E.Coagulation Factor Deficiency

A

D.Disseminated intravascular coagulation

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16
Q

A frequent cause of inadequate samples is the presence of high concentrations of interfering substances in the specimen such as in the following conditions:

A.Lipemia
B.Hemolysis
C.Gammopathies
D.Icterus
E.1st, & 3rd choices only
F.2nd & 4th choices only
G.All of the above

A

G.All of the above

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17
Q

How are cytosines connected to guanines?

A.10 hydrogen bonds
B.2 hydrogen bonds
C.3 hydrogen bonds
D.25 hydrogen bonds

A

C.3 hydrogen bonds

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18
Q

It is the process of comparing a current laboratory result with results obtained on a previous specimen from the same patient.

A.critical values
B.delta checks
C.reference ranges
D.linearity ranges
E.pretest and posttest probability
F,1st, 3rd, & 5th choices only
G.2nd & 4th choices only
H.All of the above

A

B.delta checks

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19
Q

These are laboratory results that may represent a life-threatening situation that may not otherwise be readily detectable.

A.critical values
B.delta checks
C.reference ranges
D.linearity ranges
E.pretest and posttest probability
F.1st, 3rd, & 5th choices only
G.2nd & 4th choices only
H.All of the above

A

A.critical values

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20
Q

The usual blood gas picture in a patient with diabetes mellitus.

A.Metabolic alkalosis
B.Respiratory acidosis
C.Metabolic acidosis
D.Respiratory alkalosis

A

C.Metabolic acidosis

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21
Q

Osler’s rule.

A.For patients under the age of 60 years, try to attribute all abnormal laboratory findings to a single cause.
B.Never rely on a single out-of-reference range value to make a diagnosis.
C.Only if there is no possible way to correlate all abnormal findings should the possibility of multiple diagnoses be entertained.
D.1st & 3rd choices only
E.1st & 2nd choices only
F.All of the above

A

D.1st & 3rd choices only

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22
Q

Which findings would be diagnostic of a severe liver failure?

Choices: Decreased
Increased

serum bilirubin
total protein
De Ritis ratio
Lactate Dehydrogenase

A

serum bilirubin - increased
total protein - decreased
De Ritis ratio - increased
Lactate Dehydrogenase - increased

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23
Q

A patient complaining of dizziness has the following Lab results below. Microcytic Normocytic erythrocytes; Normal serum iron/total Iron binding capacity ratio; Decreased red cell count; Normal iron binding capacity; Decreased serum iron; Normal red cell distribution width; High ferritin. What is the most probable diagnosis?

A.Anemia of Chronic Disease
B.Renal Failure
C.Aplastic Anemia
D.Iron Deficiency Anemia
E.Hemolytic Anemia
F.Megaloblastic Anemia

A

A. Anemia of Chronic Disease

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24
Q

Which findings would be diagnostic of massive muscle tissue necrosis?

Myoglobin
Potassium
Creatine Kinase (CK)

A

Myoglobin - increase
Potassium - increase
Creatine Kinase (CK) - increase
????

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25
Q

A jaundiced patient with all high serum enzymes & bilirubin, but normal protein, is most likely to have _____.

A.Obstructed cystic duct
B.Inflamed liver
C.Hemolytic anemia
D.Hepatoma

A

B.Inflamed liver

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26
Q

MOLECULAR TESTS for Disease Detection

REVERSE LINE-BLOT HYBRIDIZATION

  • gene expression profiling & DNA sequencing
  • HIV-1 RNA & HBV DNA & HCV RNA
  • CMV
  • cytokines in inflammation
  • M tuberculosis
A

M tuberculosis

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27
Q

MOLECULAR TESTS for Disease Detection

ASSAYS CAPTURE HYBRID

  • gene expression profiling & DNA sequencing
  • HIV-1 RNA & HBV DNA & HCV RNA
  • CMV
  • cytokines in inflammation
  • M tuberculosis
A
  • CMV
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28
Q

MOLECULAR TESTS for Disease Detection

MICROARRAYS OLIGONUCLEOTIDE

  • gene expression profiling & DNA sequencing
  • HIV-1 RNA & HBV DNA & HCV RNA
  • CMV
  • cytokines in inflammation
  • M tuberculosis
A
  • gene expression profiling & DNA sequencing
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29
Q

MOLECULAR TESTS for Disease Detection

MACROARRAYS

  • gene expression profiling & DNA sequencing
  • HIV-1 RNA & HBV DNA & HCV RNA
  • CMV
  • cytokines in inflammation
  • M tuberculosis
A
  • cytokines in inflammation
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30
Q

These cells can be cultivated and made to undergo more than twice but a limited number of divisions before senescence by adding cytokines and lectins to the growth media.

A.Neutrophils
B.gastrointestinal mucosal cells
C.nasal epithelial cells
D.fibroblasts
E.Lymphocytes

A

A.Neutrophils

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31
Q

Which findings would be diagnostic of disseminated intravascular coagulopathy (DIC) in a patient with fulminant liver failure?

Choices: Decreased
Increased

activated partial thromboplastin time (aPTT)
partial thromboplastin time (PTT)
D-dimer
platelet counts

A

activated partial thromboplastin time (aPTT) - increased

partial thromboplastin time (PTT) - increased

D-dimer - increased

platelet counts - decreased

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32
Q

Factors That Influence Reference Ranges:

Choices:
* inter-individual variation
* pre-analytical factor with physician as specimen collector
* analyst & laboratory factor

A.time between receipt of specimen and analysis

A
  • pre-analytical factor with physician as specimen collector
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33
Q

Factors That Influence Reference Ranges:

Choices:
* inter-individual variation
* pre-analytical factor with physician as specimen collector
* analyst & laboratory factor

exposure to environmental factors

A
  • inter-individual variation
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34
Q

Factors That Influence Reference Ranges:

Choices:
* inter-individual variation
* pre-analytical factor with physician as specimen collector
* analyst & laboratory factor

.time between specimen collection and specimen endorsement

A
  • pre-analytical factor with physician as specimen collector
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35
Q

Factors That Influence Reference Ranges:

Choices:
* inter-individual variation
* pre-analytical factor with physician as specimen collector
* analyst & laboratory factor

sample transport

A
  • inter-individual variation
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36
Q

Factors That Influence Reference Ranges:

Choices:
* inter-individual variation
* pre-analytical factor with physician as specimen collector
* analyst & laboratory factor

type of laboratory methods

A
  • analyst & laboratory factor
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37
Q

In the documentation of panic values, the following information should be written & recorded except:

A.name of patient
B.title or position of the caregiver who is notified
C.the time and date of notification
D.the read-back by the health care worker
E.critical value
F.name of caregiver
G.All except 1st & 5th choices
H.All except 2nd & 6th choices
I.No exception

A

I.No exception

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38
Q

The most common site for cervical neoplastic changes.

A.Cervical-vaginal junction
B.Endometrial-endocervical junction
C.Endocervical-exocervical junction

A

C.Endocervical-exocervical junction

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39
Q

A “Normal of Negative FNAC” report means:

A.the absence of any disease
B.the Physician could have missed the tumor location
C.the tumor could be fibrotic & less cellular
D.the tumor could be predominantly fluid with scarce cells
E.last 3 choices only
F.All of the above

A

F.All of the above

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40
Q

This factor on the part of the Clinician affects greatly the accuracy of the cytologic examination:

A.sample collection
B.interpretation of smears
C.patient & sample preparation
D.staining of the material
E.1st & 3rd choices only
F.2nd & 4th choices only
G.All of the above

A

E.1st & 3rd choices only

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41
Q

Obtaining specimens from the vaginal posterior fornix is an example of ___.

A.aspiration cytology
B.exfoliative cytology
C.abrasive cytology

A

B.exfoliative cytology

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42
Q

Rhonda K. Roby, a major author on DNA analysis for identification, traced the 1st ever recorded parentage argument to the time of the King who was granted _____.

A.King Solomon, God gave him much with wisdom and riches
B.the gene for being genius
C.divine wisdom confirm
D.doctorate degree in counseling
E.scholarly wisdom

A

C.divine wisdom confirm

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43
Q

Sputum collection for Tuberculosis must be collected this number of times before proclaiming a patient as Negative:

A.One time only if chest X-ray is negative
B.Twice in any day for a week
C.Once daily x 3 consecutive days
D.Thrice in one day 4 hours apart

A

C.Once daily x 3 consecutive days

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44
Q

Uses of DNA analysis includes:

A.inclusion or exclusion of crime suspect
B.help answer specimen mix-ups in the Lab
C.inclusion or exclusion of paternity claims
D.reconstruction of families
E.1st & 3rd choices only
F.2nd & 4th choices only
G.All of the above

A

G.All of the above

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45
Q

DNA is useful as marker because____

A.it is present in all cells of the body
B.it has the same structure in each body cell
C.it could withstand most environmental insults
D.its testing is very sensitive when replication enzyme is used
E.1st & 2nd choices only
F.3rd & 4th choices only
G.All of the above

A

G.All of the above

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46
Q

This DNA can be retrieved from calcified postmortem bone even for centuries.

A.nuclear DNA
B.nucleoid DNA
C.mitochondrial DNA
D.any of the above
Source: Identity Analysis PPT

A

C.mitochondrial DNA

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47
Q

Paternity can be proven by the following tests:

A.laboratory chemical testing of blood & body fluids for child & alleged father
B.blood typing of child & alleged father
C.DNA analysis
D.2nd & 3rd choices only
E.All of the above

A

D.2nd & 3rd choices only

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48
Q

Routine blood group used for investigations in cases of disputed parentage EXCEPT:

Duffy
ABO
HLA
Rh
Lewis

A

Lewis

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49
Q

What is the maximum but adequate amount of amniotic fluid can a physician withdraw without endangering the fetus:

20 to 30 mL
5-10 mL
30-50 mL
20 to 40 mL

A

20 to 30 mL

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50
Q

How would you apply each Type of Cytological techniques?

  • Abrasive cytology
  • Aspiration cytology
  • Exfoliative cytology

Avoided urine

A

Exfoliative cytology

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51
Q

How would you apply each Type of Cytological techniques?

  • Abrasive cytology
  • Aspiration cytology
  • Exfoliative cytology

buccal mucosal smear

A
  • Abrasive cytology
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52
Q

How would you apply each Type of Cytological techniques?

  • Abrasive cytology
  • Aspiration cytology
  • Exfoliative cytology

breast tumor

A
  • Aspiration cytology
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53
Q

How would you apply each Type of Cytological techniques?

  • Abrasive cytology
  • Aspiration cytology
  • Exfoliative cytology

thyroid nodule

A
  • Aspiration cytology
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54
Q

This/These is/are TRUE of chromatographic tests, except :

  • Gas Chromatography-Mass Spectroscopy is the gold-standard for detection and quantitation of volatile compounds.
  • Capillary electrophoresis is one example
  • Applied mainly to the qualitative detection of drugs of abuse and toxins
  • In Enzyme-mediated immunologic technique (EMIT),the drug is covalently attached to an enzyme and separated in a high resistance flow column.
A
  • In Enzyme-mediated immunologic technique (EMIT),the drug is covalently attached to an enzyme and separated in a high resistance flow column.
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55
Q

Among the bodytissues, this is /these are the most stable source/s of postmortem tissue DNA:

Bone
liver
brain
teeth
1st & 4th choices only
2nd & 3rd choices only
all of the above

A

1st & 4th choices only

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55
Q

The major cause of simultaneous elevation of prothrombin time & activated partial thromboplastin time is a

Coumadin therapy
Coagulation Factor Deficiency
Disseminated intravascular coagulation
Combined Heparin & Coumadin therapy
Heparin therapy

A

Disseminated intravascular coagulation

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56
Q

A double swab techniqueis the preferred method for collection of DNA in the following condition:

from large pools of blood and bloodstains.
dry biologic fluid
from bitemarks on bodies
biologic fluid deposited on a surface

A

from bitemarks on bodies

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57
Q

TRUE of neuroleptics and antipsychotic major tranquilizers :

A. Difficult to monitor the levels in serum because of the large number of metabolites of each drug.
B. Reference ranges for serum levels have not been established.
C. used mainly in the treatment of acute schizophrenia used mainly in Tx of schizophrenia,
D. A Block the actions of dopamine and serotonin postsynaptically in the limbic system and motorcortex
E.. 1st, 2nd, & 4th choices only
F. . 2nd, 3rd, & 4th choices only
G. 1st, 3rd, & 4th choices only
H. All of the above

A

H. All of the above

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58
Q

The following are true of environmental toxins:

A. Acquired hemochromatosis is caused by overingestion of iron.
B. The most common drug of abuse is ethanol.
C. Organophosphates contained in pesticides interfere with neurotransmission by inhibiting the enzyme acetylcholinesterase (AChE).
D. Arsenic is used in rodenticides, herbicides, insecticides, ceramics, production of livestock feed and medicines.
E. 1st & 3rd choices only
F. 2nd & 4th choices only
G. All of the above

A

G. All of the above

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59
Q

Lead in blood:

A. ls measured in serum and plasma
B. Absorption may occur by inhalation or ingestion.
C. Both organic and inorganic compounds may be highly toxic.
D. Most serious effects occur in the CNS and peripheral nervous system.
E. 1st, 2nd, & 3rd choices only
F. 2nd, 3rd, & 4th choices only
G. 1st, 3rd, & 4th choices only
H. All of the above

A

F. 2nd, 3rd, & 4th choices only

B. Absorption may occur by inhalation or ingestion.
C. Both organic and inorganic compounds may be highly toxic.
D. Most serious effects occur in the CNS and peripheral nervous system

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60
Q

DNA in the pathology laboratory can be used to

resolve specimen mix-ups
confirm or refute mislabeling of biopsy specimens. true resolved alleged sample switching
evaluate engraftment of marrow after transplantation
1st & 2nd choices only
3rd & 4th choices only
All of the above

A

All of the above

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61
Q

The immunoglobulin that initiate aspects of the allergic reaction and binds to basophils via the Fe region.

IgG
IgA
IgE
IgM

A

IgE

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62
Q

Absence of an expected genetic marker in a child when the parent in question appears to be homozygous (one allele present) for the gene:

two-haplotype exclusion
indirect exclusion
reverse homozygosity
1st & 2nd choices only
2nd & 3rd choices only
All of the above

A

2nd & 3rd choices only

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63
Q

Acute poisoning may be caused by which of the following?

Lead
Iron
Arsenic
carbon monoxide
Cyanide

A

carbon monoxide

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64
Q

Aspiration biopsy procedure is not indicated for:

the spleen
patients with bleeding disorders
patient at risk for bleeding from chemo-radiation or from cancer itself patient taking blood thinning drugs.
Last 3 choice only
All of the above

A

All of the above

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65
Q

Differentiate between the following Cytopathology procedures:

  • involves examination of spontaneously sledded cells from lining of an organ into a cavity
  • examination of cells collected or removed by brushing or artificial mechanical desquamation
  • a procedure in which a thin needle is inserted into a swelling to collect a sample of cells or some amount of fluid
  • a percutaneous procedure that involves removing a piece of tissue from a lesion or mass, using a hollow needle
  • cutting a sample of the suspicious tissue from a mass for purposes of Diagnosis

CORE NEEDLE BIOPSY

A
  • a percutaneous procedure that involves removing a piece of tissue from a lesion or mass, using a hollow needle
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66
Q

Differentiate between the following Cytopathology procedures:

  • involves examination of spontaneously sledded cells from lining of an organ into a cavity
  • examination of cells collected or removed by brushing or artificial mechanical desquamation
  • a procedure in which a thin needle is inserted into a swelling to collect a sample of cells or some amount of fluid
  • a percutaneous procedure that involves removing a piece of tissue from a lesion or mass, using a hollow needle
  • cutting a sample of the suspicious tissue from a mass for purposes of Diagnosis

EXFOLIATIVE CYTOLOGY

A
  • involves examination of spontaneously sledded cells from lining of an organ into a cavity
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67
Q

Differentiate between the following Cytopathology procedures:

  • involves examination of spontaneously sledded cells from lining of an organ into a cavity
  • examination of cells collected or removed by brushing or artificial mechanical desquamation
  • a procedure in which a thin needle is inserted into a swelling to collect a sample of cells or some amount of fluid
  • a percutaneous procedure that involves removing a piece of tissue from a lesion or mass, using a hollow needle
  • cutting a sample of the suspicious tissue from a mass for purposes of Diagnosis

ABRASIVE CYTOLOGY

A
  • examination of cells collected or removed by brushing or artificial mechanical desquamation
68
Q

Differentiate between the following Cytopathology procedures:

  • involves examination of spontaneously sledded cells from lining of an organ into a cavity
  • examination of cells collected or removed by brushing or artificial mechanical desquamation
  • a procedure in which a thin needle is inserted into a swelling to collect a sample of cells or some amount of fluid
  • a percutaneous procedure that involves removing a piece of tissue from a lesion or mass, using a hollow needle
  • cutting a sample of the suspicious tissue from a mass for purposes of Diagnosis

ASPIRATION CYTOLOGY

A
  • a procedure in which a thin needle is inserted into a swelling to collect a sample of cells or some amount of fluid
69
Q

Differentiate between the following Cytopathology procedures:

  • involves examination of spontaneously sledded cells from lining of an organ into a cavity
  • examination of cells collected or removed by brushing or artificial mechanical desquamation
  • a procedure in which a thin needle is inserted into a swelling to collect a sample of cells or some amount of fluid
  • a percutaneous procedure that involves removing a piece of tissue from a lesion or mass, using a hollow needle
  • cutting a sample of the suspicious tissue from a mass for purposes of Diagnosis

SURGICAL BIOPSY

A
  • cutting a sample of the suspicious tissue from a mass for purposes of Diagnosis
70
Q

The presence of these cells confirm the specimen as “sputum” rather than “mere saliva’.

A. flat squamous cells saliva
B. foamy macrophages
C. columnar ciliated cells
D. Neutrophils puede nis sputum kay bacterial
E. 2nd & 3rd choices only?
All of the above

A

E. 2nd & 3rd choices only?

71
Q

If helper T-cells (subset type 1) are induced by IL-12, what cytokine induces the helper T-cells (subset type 2) ?

IL-4
IL-17
IL-5
IFN-y

A

IL-4

72
Q

Molecular Techniques are used in the medical field for the following purpose EXCEPT:

detecting abnormal genes in patient specimens
establishing patterns of gene expression that are characteristic of specific diseases.
germline genetic modification”
diagnosis of different types of cancers

A

germline genetic modification”

73
Q

True of basic techniques/methods for detecting drugs in serum and urine, except:

a. In Thin-layer chromatography, compounds are separated based on their relative affinities for a polar solid stationary phase.
b. Nonvolatile compounds can be detected using Liquid chromatography-Mass spectroscopy.
c. In EMIT and FPIA, the drug serum concentration and the color resulting from the enzymatic reaction and decrease in fluorescence polarization is nonlinear.
d. In both chromatographic techniques and homogeneous methods, the drug must bind to antibody before it is detected.
e. In HPLC, The internal standard is similar in structure to the drug/s of interest and added in a known concentration, and the percentage of recovery from the column is extrapolated for al drugs of interest.

A

d. In both chromatographic techniques and homogeneous methods, the drug must bind to antibody before it is detected.

74
Q

The micronutrient essential for thymic development and is severely deficient in malnourished patients.

iron
selenium
zinc
vitamin C

A

zinc

75
Q

In the documentation of panic values, the following information should be written & recorded except:

name of patient
title or position of the caregiver who is notified the time and date of notification
the read-back by the health care worker critical value
name of caregiver
All except 1st & 5th choices
All except 2nd & 6th choices
No exception

A

No exception

76
Q

Diagnose: high 24hr urine sodium, low urine osmolality, low serum sodium

SIADH
Bartter’s syndrome
Diabetes insipidus
Dehydration

A

SIADH

77
Q

It is the predominant antibody in secretions

IgM
IgD
IgG
IgA”

A

IgA”

78
Q

Reasons for difficulty of obtaining reference ranges for antidepressants are:

Most are metabolized using the cytochrome P450 system and different antidepressants require different isoforms of cytochrome P450
large numbers of metabolites that vary significantly in concentration in individuals. Most are lipophilic and therefore stored in tissue and slowly released
High volumes of distribution of these drugs.
all are correct

A

all are correct

79
Q

A frequent cause of inadequate samples is the presence of high concentrations of interfering substances in the specimen such as in the following conditions:

Lipemia
Hemolysis
Gammopathies
Icterus
1st, & 3rd choices only
2nd & 4th choices only
All of the above

A

All of the above

80
Q

The following statements are CORRECT regarding Mitochondrial DNA EXCEPT:

useful for identifying remains.
hundreds to thousands of copies per cell inherited from both parents
small-sized

A

inherited from both parents

81
Q

To ensure documentation of the identification of the tested individuals & the collection of evidences, the following are the CORRECT steps EXCEPT:

documents showing the chain of custody of samples
appropriate informed consent- true ni
record of hematopoietic stem cell transplant.
history of any recent transfusion in the preceding month
samples individually packaged, sealed, and stored

A

history of any recent transfusion in the preceding month

82
Q

The first and most critical step for evidence:

requesting informed consent
noting recent transfusion in the preceding month
documenting the chain of custody of samples recording hematopoietic stem cell transplant.protein
extraction of DNA from biologic sources

A

extraction of DNA from biologic sources

83
Q

he usual blood gas picture in a patient with diabetes mellitus.

Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
Respiratory acidosis

A

Metabolic acidosis

84
Q

he use of fixatives, such as alcohol, formalin, or a mixture of both is indicated in al types of cells / tissue sampling techniques.

True in biopsy techniques only
False
True in all techniques
Fresh specimens may not be soaked in fixatives
True in cytology techniques only

A

True in all techniques

85
Q

When do you put the smears &/or tissue in the fixative solution?

right after slide smearing or as soon as tissue is collected
immediately after air drying the cytology smears
instantly after the surgical biopsy wound is sutured
as soon as the physician gets the opportunity
2nd & 3rd choices only
All of the above

A

right after slide smearing or as soon as tissue is collected

86
Q

The simplest of the cells / tissue sampling techniques:

Surgical biopsy
Core needle biopsy
Abrasive cytology
Aspiration cytology
Exfoliative cytology

A

Exfoliative cytology

87
Q

The fundamental characteristics of TARGET AMPLIFICATION METHODS EXCEPT:

a. TRUE All produce millions to billions of copies of the targeted sequence in a matter of hours b. The amplification products in al the techniques are defined by two oligonucleotide primers.
c. They are enzyme-mediated processes that synthesize copies of target nucleic acid.
d. The primers bind to complementary sequences on one strand of double-stranded targets.

A

d. The primers bind to complementary sequences on one strand of double-stranded targets.

88
Q

A phase of clinically evaluating a suspected patient with immunodeficiency which utilizes thymic MRI imaging and skin testing

analytic immune stage
confirmatory stage
screening stage
none of these 3 choices

A

confirmatory stage

89
Q

An antigenic substances can be composed of:

large polysaccharides
proteins
glycoproteins
all of these 3 choices

A

all of these 3 choices

90
Q

Which findings would be diagnostic of massive muscle tissue necrosis?

decreased
increased

Potassium

A

increase

91
Q

Which findings would be diagnostic of massive muscle tissue necrosis?

decreased
increased

Myoglobin

A

increase

92
Q

Which findings would be diagnostic of massive muscle tissue necrosis?

decreased
increased

creatine kinase (CK)

A

increased

93
Q

High- grade squamous intraepithelial lesions (HSIL) comprise of the following findings:

Koilocytosis & Cervical Intraepithelial Neoplasia (CIN 1)
(Cervical Intraepithelial Neoplasia) CIN 2 & CIN 3
1st & 2nd choices only
All of the above

A

(Cervical Intraepithelial Neoplasia) CIN 2 & CIN 3

94
Q

Pap smear is recommended every 1-2 years for the following:

women between ages 18 -70 years
who have ever had sexual activity
women of any age who are sexually active
1st & 2nd choices only
All of the above dili kani??

A

1st & 2nd choices only ????

95
Q

Which statement is correct regarding Sputum collection for acid fast bacilli testing?

sputum specimen must be collected on three consecutive days
each sputum smear on from each collection day must become positive
collect only once if first smear is positive for AFB.
1st & 3rd choices only
All of the above

A

sputum specimen must be collected on three consecutive days

96
Q

Chorionic villus sampling (CVS), which provides tissue from the developing placenta is obtained by the transabdominal or transvaginal procedure, performed at gestation.

22-26 weekshigh
10 to 14 weeks
14 to 18 weeks
18 - 22 weeks

A

10 to 14 weeks

97
Q

To preserve the DNA, this specimen should be transported in ice:

bone marrow
amniotic fluid
blood
chorionic vili
solid tissue

A

solid tissue

98
Q

Interpret: Normal T4&TSH, no mass lesion

Normal
Euthyroid
Either A or B
none of the above

A

Either A or B

99
Q

These cells can be cultivated and made to undergo more than twice but a limited number of divisions before senescence by adding cytokines and lectins to the growth media.

fibroblasts
Neutrophils
Lymphocytes
nasal epithelial cells gastrointestinal mucosal cells

A

Neutrophils

100
Q

These are laboratory results that may represent a life-threatening situation that may not otherwise be readily detectable.

critical values
delta checks
reference ranges
linearity ranges
pretest and posttest probability
1st, 3rd, & 5th choices only
2nd & 4th choices only

A

critical values

101
Q

In progenitor stem cell transplantation what comes out in the result.

the DNA of recipient’s parents
the donor’s DNA
the recipient’s DNA

A

the donor’s DNA

102
Q

Interpret: Elevated TSH, Normal RDW

Primary hyperthyroidism
Primary adrenalism
Euthyroid
Hypothyroidism

A

Hypothyroidism

103
Q

Infection with this organism can result to squamous koilocytotic atypia, dysplasias, & eventually to carcinoma when untreated.

Human Papillomaviru
Gardnerella vaginalis
Trichomonas vaginalis
Monilia
Herpes Simplex

A

Human Papillomaviru

104
Q

Given the correct culture conditions, these cells can divide and grow in vitro for 50-100 generations.

Lymphocytes
gastrointestinal mucosal cells
nasal epithelial cells
Neutrophils
Fibroblasts
MRC5 cells are secondary human lung fibroblasts

A

Fibroblasts

105
Q

MOLECULAR TESTING FOR DISEASES

  • HPV; thrombophilia mutations (Factor I,Factor V)
  • Clostridium difficile; group A and Group B beta hemolytic streptococci; Mycoplasma pneumoniae;
  • Neisseria gonorrhoeae, Chlamydia trachomatis, Human papillomavirus (HPV);Trichomonas vaginalis,
  • influenza A and B viruses
  • HIV-1 RNA; HBV DNA,; HCV RNA

LOOP-MEDIATED AMPLIFICATION (LAMP)

A
  • Clostridium difficile; group A and Group B beta hemolytic streptococci; Mycoplasma pneumoniae;
106
Q

MOLECULAR TESTING FOR DISEASES

  • HPV; thrombophilia mutations (Factor I,Factor V)
  • Clostridium difficile; group A and Group B beta hemolytic streptococci; Mycoplasma pneumoniae;
  • Neisseria gonorrhoeae, Chlamydia trachomatis, Human papillomavirus (HPV);Trichomonas vaginalis,
  • influenza A and B viruses
  • HIV-1 RNA; HBV DNA,; HCV RNA

CLEAVASE/INVADER TECHNOLOGY

A
  • thrombophilia mutations (Factor I,Factor V) (Factor II, Factor V,
    MTHFR 677, and MTHFR 1298 genotypes
107
Q

MOLECULAR TESTING FOR DISEASES

  • HPV; thrombophilia mutations (Factor I,Factor V)
  • Clostridium difficile; group A and Group B beta hemolytic streptococci; Mycoplasma pneumoniae;
  • Neisseria gonorrhoeae, Chlamydia trachomatis, Human papillomavirus (HPV);Trichomonas vaginalis,
  • influenza A and B viruses
  • HIV-1 RNA; HBV DNA,; HCV RNA

NICKING ENZYME AMPLIFICATION REACTION (NEAR)

A
  • influenza A and B viruses
108
Q

MOLECULAR TESTING FOR DISEASES

  • HPV; thrombophilia mutations (Factor I,Factor V)
  • Clostridium difficile; group A and Group B beta hemolytic streptococci; Mycoplasma pneumoniae;
  • Neisseria gonorrhoeae, Chlamydia trachomatis, Human papillomavirus (HPV);Trichomonas vaginalis,
  • influenza A and B viruses
  • HIV-1 RNA; HBV DNA,; HCV RNA

TRANSCRIPTION-BASED AMPLIFICATION

A
  • Neisseria gonorrhoeae, Chlamydia trachomatis, Human papillomavirus (HPV);Trichomonas vaginalis,
109
Q

The principle behind this instrument is to categorize cells based on their size and nuclear complexity. It is primarily used to classify different types of leukemia.

Microlymphocytotoxicity by dye exclusion
Enzyme-Inked immunosorbent spot assay
Protein electrophoresis
Flow Cytometry

A

Flow Cytometry

110
Q

These can destroy the stability of DNA:

detergents
gasoline
metal ions
Ultraviolet radiation
3rd & 4th choices only
1st & 2nd choices only
All of the above

A

3rd & 4th choices only
???

111
Q

TRUE of Control swabs Except:

packaged separately, and clearly labelled collected adjacent to the fluid stain
collected to either convict or free the accused
collected one item at a time
collected from an unstained area

A

collected to either convict or free the accused

112
Q

The laboratory test that determines the presence of markers of immunoglobulins synthesized in the central nervous system due to an autoimmune disease or an immunologic response to an infection.

Immunofixation electrophoresis
Cryoglobulin testing
Oligoclonal immunoglobulim band testing
Immunoglobulin free light chain analysis

A

Oligoclonal immunoglobulim band testing

113
Q

Which findings would be diagnostic of a severe liver failure?

increased
decreased

total protein
De Ritis ratio
Lactate Dehydrogenase
serum bilirubin

A

total protein-decreased
De Ritis ratio-increased
Lactate Dehydrogenase-increased
serum bilirubin-increased

114
Q

Interpret: Normal AST, Normal ALT, Low total protein, low albumin, high ammonia

Primary adrenalism
Cirrhosis
Fulminant failure
Metabolic acidosis

A

Cirrhosis

115
Q

A jaundiced patient with al high serum enzymes & bilirubin, but normal protein, is most likely to have a

Obstructed cystic duct
Hemolytic anemia
Inflamed liver
Hepatoma

A

Inflamed liver

116
Q

Advantages of DNA Testing EXCEPT:

a. DNA is resistant to strong acids, alkalis, detergents, and environmental factors. yes
b. allows for individualization of the source of the semen
c. DNA results can be obtained from minute samples and even invisible trace DNA deposits.
d. DNA testing can only be performed on fresh specimens yesyes

A

d. DNA testing can only be performed on fresh specimens yesyes

117
Q

A patient complaining of dizziness has the following Lab results below. Microcytic Normocytic erythrocytes; Normal serum iron /total Iron binding capacity ratio; Decreased red cell count; Normal iron binding capacity; Decreased serum iron; Normal red cell distribution width; High ferritin. What is the most probable diagnosis?

Anemia of Chronic Disease
Renal Failure
Hemolytic Anemia
Iron Deficiency Anemia
Megaloblastic Anemia
Aplastic Anemia

A

Anemia of Chronic Disease

118
Q

Diagnose:

Low 24 hrs urine sodium, normal urine osmolality, high serum sodium, **low urine sodium **

a. Damage to the left parietal lobe can result in what is called “Gerstmann’s Syndrome.” It includes right-left confusion, difficulty with writing (agraphia) and difficulty with mathematics (acalculia). Itcan also produce disorders of language (aphasia) and the inability to perceive objects normally (agnosia).
b. Diuretics effect
c. Adrenal failure
d. Cushing’s disease

A

d. Cushing’s disease

119
Q

In the criminalistics context, DNA can be used:

to link or exculpate a suspect to a crime, to recognize serial crimes
to aid in accident reconstruction
identification of human remains
1st & 2nd choices only
3rd & 4th choices only
All of the above

A

All of the above

120
Q

Muddy brown urine casts with high urine protein is usually seen in a

Intrarenal azotemia
Prerenal azotemia
Post-renal azotemia

A

Intrarenal azotemia

121
Q

the antigenic stimuli for activating the cellular response comes from the following areas of the cell ,except:

mitochondrial
cytosolic
extracellular
endosomal

A

mitochondrial

122
Q

Osler’s rule.

a. For patient under the age of 60 years, try to attribute al abnormal laboratory findings to a single cause.
b. Never rely on a single out-of-reference range value to make a diagnosis.
c. Only if there is no possible way to correlate al abnormal findings should the possibility of multiple diagnoses be entertained.
d. 1st & 3rd choices only
e, 1st & 2nd choices only
f. All of the above

A

d. 1st & 3rd choices only

123
Q

In virus, the main enzyme responsible for synthesizing a double helix complementary DNA strand (cDNA) from RNA is__:

RNA polymerase
ribonuclease H
reverse transcriptase
integrase

A

reverse transcriptase

124
Q

An allele present in the child but not in the mother is referred to as the ___.

obligatory paternal gene (OG)
direct exclusion gene
obligatory paternal allele
1st & 3rd choices only
All of the above

A

1st & 3rd choices only

125
Q

collected for therapeutic drug monitoring

Choices:
Urine
saliva
serum
stool

A

serum

126
Q

used for screening in the Emergency Room
setting -

Choices:
Urine
saliva
serum
stool

A

urine

127
Q

What is the ‘gold standard’ for detection and quantitation of volatile drugs and poisons?

A.Gas chromatography-mas spectroscopy (GC-MS)
B.High-Performance Liquid chromatograpy (HPLC)
C.Thin-layer chromatography (TLC)

A

A.Gas chromatography-mas spectroscopy (GC-MS)

128
Q

What are the areas of study / application in Toxicology?

A.detection of drugs of abuse

A. detection of drugs of abuse
B.determination of levels of therapeutic drug
C.detection of markers
D.detection of toxins
E.1st & 3rd choices only
F.2nd & 4th choices only
G.All of the above
Source:Toxicology and Therapeutic PPT

A

G.All of the above

129
Q

What is the psychoactive agent of ‘marijuana’?

A.Delta-9 tetrahydrocannabinol
B.3,4-methylenedioxymethamphetamine
C.Methamphetamine HCL

A

A.Delta-9 tetrahydrocannabinol

130
Q

Predominant immunoglobulin in secretions *

IgE
IgA
IgG
IgM

A

IgA

131
Q

Identify the Immunoglobulin in the picture below

IgG
IgA
IgE
IgM

A

IgM

132
Q

The immunoglobulin that exists as a dimer

IgG
IgA
IgE
IgM

A

IgA

133
Q

Immunoglobulin that can cross the placenta

IgG
IgA
IgE
IgM

A

IgG

134
Q

Immunoglobulin present during the early stages of an immune response to an infection

IgG
IgA
IgE
IgM

A

IgM

135
Q

This test for COVID-19 virus needs a respiratory specimen:

PCR testing
Antigen Testing
Antibody testing kini blood
1st & 2nd choices only
2nd & 3rd choices only
All of the above

A

1st & 2nd choices only

136
Q

Reasons for difficulty of obtaining reference ranges for antidepressants are:

Most are metabolized using the cytochrome P450 system and different antidepressants require different isoforms of cytochrome P450
large numbers of metabolites that vary significantly in concentration in individuals.
Most are lipophilic and therefore stored in tissue and slowly released
High volumes of distribution of these drugs.
all are correct

A

all are correct

137
Q

The four areas of study in Toxicology include the following, except:

detection of toxins the individual is exposed to - yes
determination of levels of therapeutic drugs administered to patients
detection of mutated proteins and abnormal DNA sequences
detection of drugs
no exception

A

no exception

138
Q

All of the following statements about Drugs of abuse are correct, except :

The tricyclic antidepressants are used to treat psychotic states such as schizophrenia.
Many of these drugs act directly on dopaminergic and norepinephrinergic neurotransmitter systems.
Rapid emergency room screening methods are Thin-layer chromatography and EMIT.
Employment screening and forensic testing would require an independent confirmatory technique from the screen method.
Most compounds contain a basic amino-group.

A

The tricyclic antidepressants are used to treat psychotic states such as schizophrenia.

NEUROLEPTIC DAW DAPAT

139
Q

This/These are true as to the following anti-inflammatory drugs:

Aspirin is a steroidal compound that is an analgesic and antipyretic.
Acetaminophen is preferred over Aspirin as toxicity never occur.
Nonsteroidal anti-inflammatory agents block cyclooxygenase.
Acetylsalicylic acid (Aspirin) exhibits anticoagulant activity though inhibition of COX in platelets.
All of the above are true.

A

Acetylsalicylic acid (Aspirin) exhibits anticoagulant activity though inhibition of COX in platelets.

140
Q

Monitoring of therapeutic drugs is essential because of the following reasons:

Possible toxic side effects of medications
Lack of patient compliance resulting in subtherapeutic levels that may require intervention.
To achieve a constant serum level that will be therapeutic
Therapeutic efficacy of metabolites of some therapeutic drugs are unknown.
1st & 3rd choices only
2nd & 4th choices only
All of the above

A

All of the above

141
Q

Effects of carbon monoxide intoxication on the body :

inhibits a variety of phosphodiesterases, thereby causing bronchoconstriction and apnea.
binds avidly to iron causing inactivation of iron containing enzymes in redox reactions.
blocks the synthesis of tetrahydrofolic acid resulting in blockage of DNA synthesis.
produces tissue hypoxia as a result of decreased oxygen transport
accumulates in soft tissues and bone in chronic toxicity.

A

produces tissue hypoxia as a result of decreased oxygen transport

141
Q

It is the most primitive of all the immunoglobulins and primarily confined to the intravascular space.

IgG
IgE
IgA
IgM

A

IgM

141
Q

Corticosteroids are :

highly effective anti-inflammatory agents
effective in blocking inflammation by similar mechanisms as Nonsteroidal anti-inflammatory drugs.
used to treat congenital hyperbilirubinemia as it enhances the metabolism of bilirubin by inductionof cytochrome P450- dependent enzymes.
Side effects are fluid retention, osteoporosis, GI bleeding, mental changes

1st, 2nd, & 3rd choices only
2nd, 3rd, & 4th choices only
1st, 2nd, & 4th choices only
All of the above

A

1st, 2nd, & 4th choices only
?

142
Q

It is the best studied immunoglobulin isotype and possess a high diffusion coefficient.

IgE
IgM
IgG
IgA

A

IgG

143
Q

The mechanisms of drugs of abuse include:

stimulate pathways that utilize norepinephrine as the neurotransmitter
binds to sodium-potassium activated ATPase thereby blocking sodium efflux
Undergo metabolism in the extramitochondrial microsomal system in hepatocytes - extramitochondrial , microsomal system of hepatocytes (oxidative)
block sodium influx and secondary calcium influxes
1st, 2nd, & 3rd choices only
2nd, 3rd, & 4th choices only
1st, 3rd, & 4th choices only
All of the above

A

2nd, 3rd, & 4th choices only

144
Q

At what part of the antibody do antigens react/bind to?

Fab region
secretory component
Fc region
Disulfide bonds

A

Fc region
???

145
Q

This is NOT TRUE regarding using DNA as an identity marker:

different in all individuals including identical twins
the same in all cells of the body except the gametocytes
present throughout all the nucleated cells of the body
the same throughout life from the time of conception

A

different in all individuals including identical twins

146
Q

The mechanisms of action of the cardiotropics in slowing down electrical conduction include:

block sodium influx in phase I of the action potential
increase length of the action potential by blocking repolarizing potassium currents
inhibit the chronotropic effects of epinephrine and norepinephrinecoumadi
increase the length or refractory period by slowing the influx of calcium ions
1st & 3rd choices only
2nd & 4th choices only
All of the above

A

All of the above

147
Q

IS

What determines the nomenclature of an immunoglobulin?

the isotype of the light chain
the Fc region
the secretory component
the isotype of the heavy chain

A

the isotype of the heavy chain

148
Q

The zone wherein antigen and antibodies are approximately of equal molar concentration and where the largest antibody-antigen complexes occur/formeqed.

zone of equivalence
zone of disequivalence
zone of proportionality
zone of antibody equity

A

zone of equivalence

149
Q

*

Drugs used in the treatment of clinical depression include:

Tricyclic antidepressants
Monoamine oxidase inhibitors
trazodone and doxepin
lithium
Selective serotonin Reuptake inhibitors

A

Selective serotonin Reuptake inhibitors

150
Q

Interpret: Elevated TSH, Normal RDW

Primary hyperthyroidism
Primary adrenalism
Euthyroid
Hypothyroidism

A

Hypothyroidism

151
Q

True statements of sedative-hypnotics, except: .

Cannabis (marijuana), smoked or ingested orally is readily stored in the body fat and maybe detected in the urine 1-4 wks from ingestion.
Methaqualone is a local anesthetic that possess anticonvulsant and antitussive properties.
The sedative-hypnotic effects of barbiturates is due to the selective inhibition of the reticular activating system.
Cocaine is the oldest and most widely used of the mind-altering drugs.
All of the barbiturates are fat-soluble and pass easily across the blood-brain barrier.

A

Cocaine is the oldest and most widely used of the mind-altering drugs.

152
Q

This/ These is/ are TRUE of Immunosuppressives:

used to suppress both the humoral and cell-mediated immune systems.
Corticosteroids are the drugs of choice for use in maintenance of kidney and liver allografts because of their accessibility (false dapat cyclosporine
Many are antibiotics like rapamycin and mycophenolate mofetil.
Tacrolimus is the drug of choice in organ transplantation because of the absence of potential toxicities
1s & 3rd choices only
2nd & 4th choices only
All of the above

A

1s & 3rd choices only

153
Q

For CD4+ T-lymphocytes to be activated, the antigen presenting cells displays the antigen via this complex receptor.

Major histocompatibility complex receptor class II
Major histocompatibility comlex receptor class I
Fc region/receptor
Fab region

A

Major histocompatibility complex receptor class II

154
Q

A phase of clinically evaluating a suspected patient with immunodeficiency which correlates medical history and family history with complete blood counts and isohemagglutinin titers.

analytic immune stage
screening stage
none of these 3 choices
confirmatory stage

A

screening stage

155
Q

The primary medicinal use of Opiates is:

sedative-hypnotics
local anesthesia
analgesic/ to diminish or eliminate pain in a patient.
antitussive
tranquilizers

A

analgesic/ to diminish or eliminate pain in a patient.

156
Q

The following are techniques for detecting drugs in serum, except:

Fluorescence polarization immunoassay
Hemagglutination inhibition immunoassay
Thin-layer chromatography
High performance liquid chromatography
Microparticle enzyme immunoassay (Tacrolimus)

A

Hemagglutination inhibition immunoassay

157
Q

==
The laboratory test that determines the presence of markers of immunoglobulins synthesized in the central nervous system due to an autoimmune disease or an immunologic response to an infection.

Immunofixation electrophoresis
Cryoglobulin testing
Oligoclonal immunoglobulim band testing
Immunoglobulin free light chain analysis

A

Oligoclonal immunoglobulim band testing

158
Q

The following are examples of toxins, except :

Ethanol
Mercury
Cyanide
Iron
Lithium

A

Iron

159
Q

The following statements are true of Anti-asthmatics, except :

Theophylline is used for prevention of attacks and treatment of symptomatic exacerbations.
The basic mechanisms of these drugs result in relaxation of smooth muscle relaxation in the small airways
Oral anti-inflammatory agents interrupt the leukotriene/ arachidonic acid pathways involved in inflammation and bronchial reactivitiy true
Subcutaneous injection of epinephrine relieves bronchoconstriction in acute asthma attacks.
No exception.

A

Subcutaneous injection of epinephrine relieves bronchoconstriction in acute asthma attacks.

160
Q

Phenobarbital as an anticonvulsant, possess this/these following characteristics, except

neuronal membrane stabilizer through intercalation
given for withdrawal symptoms in infants born to opiate or barbiturate-addicted mothers.
Induce a number of the cytochrome P450 systems
Diminishes frequency of firing action potentials by potentiating the gamma-aminobutyric acid (GABA) effect
no exception

A

no exception

161
Q

Regarding Amphetamines :

Effectively detected by Thin layer chromatography and Enzyme-mediated immunologic technique .
Best specimen for detection by chromatography is urine.
They bear close resemblance to epinephrine and norepinephrine and maybe expected to exert sympathomimetic effects
May be confused with some antihistamines in routine testing.
All are correct

A

All are correct

162
Q

The following drugs slow down the electrical conduction in the heart by their effects on the action potentials in myocytes and conduction system.

Lidocaine block rapid sodium influx in phase 1
Betablockers like propranolol increases the intrasarcolemmal concentration of calcium
Amiodarone inhibits the chronotropic effects of adrenergic neurotransmitters.
Class IV drugs like Verapamil increasethe length of the refractory period by blocking the repolarizing potassium currents

A

Lidocaine block rapid sodium influx in phase 1

163
Q

the immunoglobulin whose Fc region binds to receptors of phagocytic cells (i.e. macrophages)

IgE
IgA
IgM
IgG

A

IgG

164
Q
A
165
Q
A

ADVANCE PATHOLOGY (2 decks)

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