Part 1 Flashcards
What is the composition of the inclusion seen in this RBC?
A. DNA
B. RNA
C Iron
D. Denatured hemoglobin
Deficiencies of cell membrane proteins
This cell is a spherocyte and is most often associated with a deficiency or defect of membrane spectrin, though other proteins (band 3, ankyrin) may also be deificient or defective.
The smear represented below displays
A. Congenital ovalocytosis
B. Hemoglobin C disease
C.Poor RBC fixation
D. Delay in smear preparation
Hemoglobin C disease
Hemoglobin C crystals can be seen in patients with hemoglobin C disease. 768
With this blood picture, an additional test indicated is:
A. Alkali denaturation
B. Alkaline phosphatase stain
C. Peroxidase stain
D. Hemoglobin electrophoresis
Hemoglobin electrophoresis
Feedback
Hemoglobin C crystals can be seen in patients with hemoglobin C disease, but the condition must be confirmed with hemoglobin electrophoresis.
The cell seen in the image below is most consistent with:
A. Chronic myelogenous leukemia
B. Infectious mononucleosis
C. Hairy cell leukemia
D. Sezary syndrome
Hairy cell leukemia
Feedback
A variable number of malignant cells in hairy cell leukemia (HCL) will stain positive with tartrate resistant acid phosphatase (TRAP+). Although this cytochemical reaction is fairly specific for HCL, TRAP activity has occasionally been reported in B-cell and rarely T-cell leukemia.
When performing platelet aggregation studies, which set of platelet aggregation results would most likely be associated with Bernard–Soulier syndrome?
A. Normal platelet aggregation to collagen, ADP and ristocetin
B.
C. Normal platelet aggregation to epinephrine and ristocetin; dcreased aggregation to collagen and ADP
D. Normal platelet aggregation to epinephrine, ristocetin and collagen; decreased aggregation to ADP
The cell seen in the image below is most consistent with ?
A. Chronic myelogenous leukemia
B. Infectious mononucleosis
C. Hairy cell leukemia
D. Sezary syndrome
c. Hairy cells
Hairy cell leukemia
Which of the following can affect the PFA-100 closure time?
A. Aspirin
B. Thrombocytopenia
C. Anemia
D. All of the above
D. PLATELET FUNCTION ASSAY (PFA)
The PFA-100 assay measures platelet function to exposing a blood sample to high shear forces and causing the platelets to aggregate, thereby simulating platelet plug formation, The time for the aperture to close is directly proportional to platelet function. However, not only do platelet function interfere with the PFA-100 closure times but thrombocytopenic and anemic samples can also give artifactual lengthened closure times.
A confirmatory test for paroxysmal nocturnal hemoglobinuria is ?
A. Heat instability test
B. Sucrose hemolysis
C. Flow cytometric immunophenotyping
D. Dithionite solubility
C. Flow cytometric immunophenotyping
Flow cytometry Immunophenotyphing is used to confirm PNH.
CD 55 negative, CD 59 negative
Which of the following test results are consistent with a diagnosis of paroxysmal nocturnal hemoglobinuria (PNH)?
A. Decreased conversion of NADH to NAD
B. Increased production of globulin
C.Decreased hemolysis in acidified serum
D.Diminished CD55 in hematopoietic cells
D.Diminished CD55 in hematopoietic cells
CD55 is normal associated with all hematopoietic cells and PNH shows low intensity staining for these molecules.
The anticoagulant that directly inhibits thrombin is:
A. LMWH
B.Argatroban
C.Warfarin
D.Rivorxaban
B. Argatroban
ARGATROBAN is a direct thrombin inhibitor that reversibly binds and inactivated free and clot bound thrombin.
What staining method is used most frequently to stain and manually count reticulocytes?
A.Immunofluorescence
B. Supravital staining
C.Romanowsky staining
D.Cytochemical staining
B.Supravital staining
The reticulum within the reticulocytes consists of ribonucleic acid (RNA), which cannot be stained with Wright’s stain. Supravital staining with new methylene blue is used to identify the reticulocytes.
The WHO classification requires what percentage for the blast count in the blood or bone marrow for the diagnosis of AML?
A. At least 30%
B. At least 20%
C. At least 10%
D. Any percentage
B. At least 20%
The WHO classification of AML requires that ≥20% of nucleated bone marrow cells be blasts, while the FAB classification generally requires ≥30%. WHO classifies AML into five subgroups: These are acute myeloid leukemias with recurrent genetic disorders; acute myeloid leukemia with multilineage dysplasia; acute myeloid leukemia and myelodysplastic syndromes, therapy related; acute myeloid leukemia not otherwise categorized; and acute leukemia of ambiguous lineage.
The erythrocytosis seen in relative polycythemia occurs because of:
In which of the following conditions does LAP show the least activity?
A.Leukomoid reactions
B.Idiopathic myelofibrosis
C.Polycythemia vera
D.Chronic myelogenous leukemia
D. Chronic myelogenous leukemia
Cells that exhibit a positive stain with acid phosphatase and are not inhibited with tartaric acid are characteristically seen in:
A.Infectious mononucleosis
B.Infectious lymphocytosis
C.Hairy cell leukemia
D.T-cell acute lymphoblastic leukemia
C. Hairy cell leukemia
When performing platelet aggregation studies, which set of platelet aggregation results would most likely be associated with Bernard–Soulier syndrome?
A.Normal platelet aggregation to collagen, ADP and ristocetin
B.Normal platelet aggregation to collagen, ADP and epinephrine; decreased aggregation to ristocetin
C.Normal platelet aggregation to epinephrine and ristocetin; dcreased aggregation to collagen and ADP
D.Normal platelet aggregation to epinephrine, ristocetin and collagen; decreased aggregation to ADP
B. Normal platelet aggregation to collagen, ADP and epinephrine; decreased aggregation to ristocetin
Which of the following is an appropriate screening test for the diagnosis of lupus anticoagulant?
A.Thrombin time test
B.Diluted Russell’s viper venom test (DRVVT)
C. D-dimer test
D. FDP test
B. Diluted Russell’s viper venom test (DRVVT)
Which of the following abnormalities is consistent with the presence of lupus anticoagulant?
A. Decreased APTT/bleeding complications
B. Prolonged APTT/thrombosis
C. Prolonged APTT/thrombocytosis
D. Thrombocytosis/thrombosis
B. Prolonged APTT/thrombosis
What is the interpretation when an Ouchterlony plate shows crossed lines between wells 1 and 2 (antigen is placed in the center well and antisera in wells 1 and 2)?
X
A.No reaction between wells 1 and 2
B.Partial identity between wells 1 and 2
C. Nonidentity between wells 1 and 2
D. Identity between wells 1 and 2
C. Nonidentity between wells 1 and 2
Which statement best describes passive agglutination reactions used for serodiagnosis?
A. Such agglutination reactions are more rapid because they are a single-step process
B. Reactions require the addition of a second antibody
C. Passive agglutination reactions require biphasic incubation
D. Carrier particles for antigen such as latex particles are used
D. Carrier particles for antigen such as latex particles are used
Interpret the following results for HIV infection. ELISA: positive; repeat ELISA: negative; Western blot: no bands
A. Positive for HIV
B. Negative for HIV
C. Indeterminate
D. Further testing needed
B. Negative for HIV
These results are not indicative of an HIV infection and may be due to a testing error in the first ELISA assay. Known false-positive ELISA reactions occur in autoimmune diseases, syphilis, alcoholism, and lymphoproliferative diseases. A sample is considered positive for HIV if it is repeatedly positive by ELISA or other screening method and positive by a confirmatory method.
Antibodies to thyroid peroxidase can be detected by using agglutination assays. Which of the following diseases may show positive results with this type of assay?
A. Graves’ disease and Hashimoto’s thyroiditis
B. Myasthenia gravis
C. Granulomatous thyroid disease
D.Addison’s disease
A. Graves’ disease and Hashimoto’s thyroiditis
Blood is crossmatched on an A positive person with a negative antibody screen. The patient received a transfusion of A positive RBCs 3 years ago. The donors chosen for crossmatch were A positive. The crossmatch was run on the Ortho Provue and yielded 3+ incompatibility. How can these results be explained?
A. The patient has an antibody to a low-frequency antigen
B. The patient has an antibody to a high-frequency antigen
C. The patient is an A2 with anti-A1
D.The patient is an A1 with anti-A2
C. The patient is an A2 with anti-A1
What type RBCs can be transfused to an A2 person with anti-A1
A. A2 only
B. A2 or O
C. B
D. AB
B. A2 or O
What should be done if all forward and reverse ABO results as well as the autocontrol are positive?
A. Wash the cells with warm saline, autoadsorb the serum at 4°C
B. Retype the sample using a different lot number of reagents
C. Use polyclonal typing reagents
D. Report the sample as group AB
A. Wash the cells with warm saline, autoadsorb the serum at 4°C
If a patient has a positive direct antiglobulin test, should you perform a weak D test on the cells?
A.No, the cells are already coated with antibody
B. No, the cells are Rh null
C. Yes, the immunoglobulin will not interfere with the test
D.Yes, Rh reagents are enhanced in protein media
A. No, the cells are already coated with antibody
If a patient has a positive direct antiglobulin test, should you perform a weak D test on the cells?
A.No, the cells are already coated with antibody
B. No, the cells are Rh null
C. Yes, the immunoglobulin will not interfere with the test
D.Yes, Rh reagents are enhanced in protein media
A. No, the cells are already coated with antibody
A unit of whole blood is collected at 10:00 a.m. and stored at 20°C–24°C. What is the last hour platelet concentrates may be made from this unit?
A. 4:00 pm
B. 6:00 pm
C. 7:00 pm
D. 8:00 pm
B. 6:00 pm
Platelets preparation from whole blood must be done within 8 hours of collection.
Which immunization has the longest deferral period?
A. Hepatitis B Ig (HBIG)
B. Rubella vaccine
C. Influenza vaccine
D. Yellow fever vaccine
A. Hepatitis B Ig (HBIG)
Which instrument requires a primary and secondary monochromators?
A. Spectrophotometer
B. Atomic absorption spectrophotometer
C. Fluorometer
D. Nephelometer
C. Fluorometer
A fluorometer uses a primary monochromator to isolate the wavelength for excitation, and a secondary monochromator to isolate the wavelength emitted by the fluorochrome.
Which serum protein should be measured in a patient suspected of having Wilson’s disease? Picture: Kayser–Fleischer rings (brown deposits at the edge of the cornea)
A. Hemopexin
B. Alpha-1 antitrypsin
C. Haptoglobin
D. Ceruloplasmin
D. Ceruloplasmin
A D zone test is performed on an isolate of Staphylococcus aureus to determine inducible clindamycin resistance (refer to the picture). Based on the result seen in the image, how should the erythromycin and clindamycin be reported?
A. Erythromycin: resistant; clindamycin: resistant
B. Erythromycin: resistant; clindamycin: susceptible
C. Erythromycin: susceptible; clindamycin: resistant
D. Erythromycin: susceptible; clindamycin: resistant
Erythromycin: resistant; clindamycin: susceptible
Smooth gray colonies showing no hemolysis are recovered from an infected cat scratch on blood and chocolate agar but fail to grow on MacConkey agar. The organisms are gram-negative pleomorphic rods that are both catalase and oxidase positive and strongly indole positive. The most likely organism is:
A. Capnocytophaga spp.
B. Pasteurella spp.
C. Proteus spp.
D. Pseudomonas spp.
B. Pasteurella spp.
SITUATION: Abdominal pain, fever, vomiting, and nausea prompted an elderly male to seek medical attention. A watery stool specimen producing no fecal leukocytes or erythrocytes was cultured and grew a predominance of gram-negative fermentative bacilli. The colonies were beta-hemolytic on blood agar and cream colored on MacConkey agar. The colonies were both oxidase and catalase positive. What is the most likely identification?
A. Aeromonas hydrophilia
B. Escherichia coli
C. Salmonella spp.
D. Shigella spp.
A. Aeromonas hydrophilia
Which single test best separates Klebsiella oxytoca from K. pneumoniae?
A. Urease
B. Sucrose
C. Citrate
D. Indole
Indole
K. oxytoca and K. pneumoniae are almost identical biochemically except for the ability to produce indole. Both organisms are usually positive for urease, sucrose, and citrate. However, K. oxytoca is indole positive and K. pneumoniae is indole negative.
Why might it be necessary for both pink (lactose-positive) and colorless (lactose-negative) colonies from an initial stool culture on MacConkey agar to be subcultured and tested further for possible pathogens?
A. Most Shigella strains are lactose positive
B. Most Salmonella strains are maltose negative
C. Most Proteus spp. are lactose negative
D. Pathogenic E. coli can be lactose positive or lactose negative
D. Pathogenic E. coli can be lactose positive or lactose negative
The drugs of choice for treatment of infections with Enterobacteriaceae are:
A. Aminoglycosides, trimethoprim–sulfamethoxazole, third-generation cephalosporins
B. Ampicillin and nalidixic acid
C. Streptomycin and isoniazid
D. Chloramphenicol, ampicillin, and colistin
A. Aminoglycosides, trimethoprim–sulfamethoxazole, third-generation cephalosporins
A leg culture from a nursing home patient grew gram-negative rods on MacConkey agar as pink to dark pink oxidase-negative colonies. Given the following results, which is the most likely organism? TSI = A/AG, indole negative, MR negative, VP +, citrate +, motility negative, H2S negative, urease +. Antibiotic susceptibility: RESISTANT to carbenicillin and ampicillin.
A.Serratia marcescens
B.Proteus vulgaris
C. Enterobacter cloacae
D. Klebsiella pneumoniae
Klebsiella pneumoniae
Which tests are most appropriate to differentiate between Pseudomonas aeruginosa and Pseudomonas putida?
A. Oxidase, motility, pyoverdin
B. Oxidase, motility, lactose
C. Mannitol, nitrate reduction, growth at 42°C
D. Oxidase, ONPG, DNase
C. Mannitol, nitrate reduction, growth at 42°C
The most noted differences between P. aeruginosa and Stenotrophomonas maltophilia are:
A. Oxidase, catalase, and TSI
B. Oxidase, catalase, and ONPG
C. Catalase, TSI, and pigment
D. Oxidase, 42°C growth, and polar tuft of flagella
D. Oxidase, 42°C growth, and polar tuft of flagella
A yellow pigment–producing organism that is oxidase positive, nonmotile, and does not grow on MacConkey agar is:
A. Acinetobacter baumannii
B Acinetobacter lwoffii
C. Chryseobacterium meningosepticum
D Burkholderia cepacia
B. Chryseobacterium meningosepticum
An elderly woman who cared for several domestic cats was hospitalized with suspected cat-scratch disease (CSD). Blood cultures appeared negative, but a small, slightly curved pleomorphic gram-negative bacillus grew on BHI agar (brain, heart infusion agar with 5% horse or rabbit blood). What is the most likely identification?
A. Bartonella spp
B. Haemophilus spp.
C. Brucella spp.
D. Kingella spp.
C. Bartonella spp
An antimicrobial combination that is useful in confirming the extended spectrum beta-lactamases in E. coli is:
A. Ampicillin + cefepime
B.Cefoxitin + penicillin
C.Ceftazidime + clavulanic acid
D.Cefpodoxime + cefotaxime
C.Ceftazidime + clavulanic acid
The antimicrobial susceptibility test for an Escherichia coli isolated from a peritoneal fluid had the following results: amikacin (resistant), ampicillin (susceptible), cefazolin - 1st generation (susceptible), cefoxitin - 2nd generation (susceptible), gentamicin (susceptible), and tobramycin (susceptible).
A. Report out the antimicrobial susceptibility results without further investigation
B.Verify the results as it is unusual for E. coli to be resistant to amikacin and susceptible to gentamicin and tobramycin
C.Verify the results as it is unusual for E. coli to be susceptible to ampicillin
D.Verify the results as it is unusual for E. coli to be susceptible to cefazolin
B.Verify the results as it is unusual for E. coli to be resistant to amikacin and susceptible to gentamicin and tobramycin
The antimicrobial susceptibility test for an Escherichia coli isolated from a peritoneal fluid had the following results: amikacin (susceptible), ampicillin (susceptible), cefazolin - 1st generation (susceptible), cefoxitin - 2nd generation (resistant), cefotaxime - 3rd generation (susceptible), and gentamicin (susceptible).
*
A. Report out the antimicrobial susceptibility results without further investigation
B. Verify the results as it is unusual for E.coli to be resistant to cefoxitin and susceptible to cefazolin
C. Verify the results as it is unusual for E. coli to be susceptible to ampicillin
D. Verify the results as it it unusual for E. coli to be susceptible to cefazolin
B. Verify the results as it is unusual for E.coli to be resistant to cefoxitin and susceptible to cefazolin
The antimicrobial susceptibility test for K. pneumonia isolated from a pleural fluid had the following results: amikacin (susceptible), ampicillin (susceptible), cefazolin - 1st generation (susceptible), cefoxitin - 2nd generation (susceptible), gentamicin (susceptible), and tobramycin (susceptible).
A. Report out the antimicrobial susceptibility results without further investigation
Verify the results as it is unusual for
B. K. pneumoniae to be susceptible to ampicillin
Verify the results as it is unusual for
C. K. pneumoniae to be susceptible to cefazolin
D. Verify the results as it is unusual for K. pneumoniae to be susceptible to both ampicillin and cefazolin
B. Verify the results as it is unusual for K. pneumoniae to be susceptible to ampicillin
The term internal auto infection is generally sed in referring to infections with:
A. Ascaris lumbricoides
B. Necator americanus
C.Trichuris trichiura
D. Strongyloides stercoralis
D. Strongyloides stercoralis
The polymerase chain reaction (PCR) involves three processes. Select the order in which these occur.
A.Extension→Annealing→Denaturation
B.Denaturation→Extension→Annealing
C.Annealing→Denaturation→Extension
D.Denaturation→Annealing→Extension
D.Denaturation→Annealing→Extension
In the PCR cycle, how is denaturation accomplished?
A. Heat
B. Alkali treatment
C. Addition of sulfonylurea
D. Formamide
A. Heat
What is the unique characteristic of the DNA polymerase, Taq DNA polymerase, used in PCR?
A. It can be enzyme labeled
B.It is more efficient than eukaryotic polymerases
C.It works with DNA of any species
D.It is heat stable
D.It is heat stable
Which of the following is an example of a signal amplification technique?
A. Branched-chain DNA detection
B. Polymerase chain reaction
C. Ligase chain reaction
D. Reverse-transcriptase PCR
Feedback
A. Branched-chain DNA detection
The detection of the DNA from cytomegalovirus(CMV) and human papillomavirus (HPV) is typically performed using the Hybrid Capture assay. What type of assay is Hybrid Capture?
A. Target amplification assay
B. Reverse transcriptase assay
C. Signal amplification assay
D. Viral load assay
Signal amplification assay
The field of proteomics studies which of the following?
A. Proteins on a cellular level
B. Serum proteins
C. Proteins in genes
D. The human genome
A. Proteins on a cellular level
A cell population is positive for surface markers CD45, CD3, CD4, and Tdt. Which type of leukocytes are these?
A. Lymphocytes
B.Granulocytes
C. Early myeloid precursors
D.Monocytes
A. Lymphocytes
An assay based on the principle of proteomics may be used for which of the following?
A. Screening for colorectal cancer
B. Screening for lung cancer
C.Identifying malignant breast tumors
D.Identifying malignant ovarian masses
D. Identifying malignant ovarian masses
Specimen for assay of tacrolimus and cyclosporine:
A.Plasma
B. Serum
C. Whole blood
D. Urine
C. Whole blood
Comparison of two means:
A. f test
B. t test
C. Standard deviation
D.Coefficient of variation
B. t test
Patient with Cushing’s syndrome exhibits:
A. Hypoglycemia
B. Hyperglycemia
C. Normal glucose
D. Variable glucose
A. Hyperglycemia
Tap water bacillus:
A.Mycobacterium avium
B. Mycobacterium gordonae
C. Mycobacterium marinum
D. Mycobacterium ulcerans
D. Mycobacterium gordonae
Stenotrophomonas maltophilia:
A. Ferments maltose
B. Oxidizes maltose
C. Oxidase positive
D. Gram positive bacilli
B. Oxidizes maltose
Specimen for detection of rotavirus:
A. Urine
B. Stool
C. Sputum
D. Blood
B. Stool
Olive oil loving fungi:
A.Microsporum canis
B.Trichophyton mentagrophytes
C.Trichosporon beigelii
D. Malassezia furfur
D. Malassezia furfur
Gram positive cocci, resistant to furazolidone:
A. Staphylococcus
B. Micrococcus
C. Both of these
D. None of these
B. Micrococcus
Gram positive cocci, sensitive to furazolidone
A. Staphylococcus
B. Micrococcus
C. Both of these
D. None of these
A. Staphylococcus
Acidic urine:
A. Renal tubular acidosis
B. High protein diet
C . Old specimen
D. Vomiting
B. High protein diet
Increased RTE cells and epithelial cell casts:
A. Acute glomerulonephritis
B. Acute pyelonephritis
C. Acute tubular necrosis
D. Nephrotic syndrome
C. Acute tubular necrosis
Urobilinogen:
A. Colorless
B. Green
C. Yellow
D. Orange
A. Colorless
False decrease in ESR:
A. Delay in testing
B. High room temperature
C. Mechanical vibration
D. Tilting of the tube
A. Delay in testing
Which of the following conditions is associated with reactive monocytosis?
A. Appendicitis
B. Infectious mononucleosis
C. Lymphocytic leukemia
D. Tuberculosis
D. Tuberculosis
Increased RBCs, decreased erythropoietin
A. Polycythemia vera
B. Relative polycythemia
C. Secondary absolute polycythemia with appropriate production of erythropoietin
D. Secondary absolute polycythemia with inappropriate production of erythropoietin
A. polycythemia vera
