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Part 1 Ascpi > Part 1 > Flashcards

Part 1 Flashcards

1
Q

When using the turbidity (solubility) method for detecting the presence of hemoglobin S, an incorrect interpretation may be made when there is a/an:

A. Increased reticulocyte count
B. Glucose concentration >150 mg/dL
C. Blood specimen > 2 hours old
D. Decreased hematocrit

A

D. Decreased hematocrit

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2
Q

Which of the following best describes a monochromator?

A. A device used to isolate a specified range of wavelengths

B. A device used to amplify signals from photoemissive device

C. A device used to decrease interference from light scatter

D. A device used to UV from visible wavelengths of light

A

A. A device used to isolate a specified range of wavelengths

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3
Q

When measuring K+ with an ion-selective electrode by means of a liquid ion exchange membrane, what antibiotic will be incorporated into the membrane?

When measuring K+ with an ion-selective electrode by means of a liquid ion exchange membrane, what antibiotic will be incorporated into the membrane?
*
0/10
A. Monactin
B. Nonactin
C. Streptomycin
D. Valinomycin

A

D. Valinomycin

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4
Q

To calibrate the pH electrode in a pH/blood gas analyzer, it is necessary that:

A. The barometric pressure must be known and used for adjustments

B. Calibrating gases of known high and low concentrations be used

C. The calibration be performed at room temperature

D. Two buffer solutions of known pH be used

A

D. Two buffer solutions of known pH be used

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5
Q

Which glycoprotein binds with hemoglobin to facilitate the removal of hemoglobin by the reticuloendothelial system?

A. Haptoglobin
B. Ceruloplasmin
C. Alpha1-antitrypsin
D. Fibrinogen

A

A. Haptoglobin

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6
Q

Which of the following is the cutpoint for use of a fasting plasma glucose in diagnosis of diabetes mellitus?

A. 99 mg/dL
B. 126 mg/dL
C. 140 mg/dL
D. 200 mg/dL

A

B. 126 mg/dL

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7
Q

A person who has a 2-hour oral glucose tolerance of 173 mg/dL would be classified in which of the following categories?

A. Impaired fasting glucose
B. Impaired glucose tolerance
C. Normal glucose tolerance
D. Gestational diabetes

A

B. Impaired glucose tolerance

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8
Q

The turbid, or milky, appearance of serum after fat ingestion is termed postprandial lipemia, which is caused by the presence of what substance?

A. Bilirubin
B. Cholesterol
C. Chylomicron
D. Phospholipid

A

C. Chylomicron

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9
Q

A commonly used precipitating reagent to separate HDL cholesterol from other lipoprotein cholesterol fractions:

A. Zinc sulfate
B. Trichloroacetic acid
C. Heparin-manganese
D. Isopropanol

A

C. Heparin-manganese

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10
Q

To what metal does ceruloplasmin firmly bind?

A. Chromium
B. Copper
C. Zinc
D. Iron

A

B. Copper

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11
Q

For what colorimetric determination is the Trinder reaction widely used?

A.Acetaminophen
B. Propoxyphene
C. Salicylate
D. Barbiturate

A

C. Salicylate

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12
Q

Acetaminophen is particularly toxic to what organ?

A. Heart
B. Kidney
C. Spleen
D. Liver

A

D. Liver

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13
Q

Which of the following drugs is used as an immunosuppressant in organ transplantation, especially in liver transplants?

A.Methotrexate
B.Amiodarone
C. Tacrolimus
D. Paroxetine

A

C. Tacrolimus

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14
Q

What is the major active metabolite of the anticonvulsant drug primidone?

A. Phenytoin
B. Acetazolamide
C.NAPA
D. Phenobarbital

A

D. Phenobarbital

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15
Q

What is the active metabolite of the antiarrhythmic drug procainamide?

A.Pronestyl
B. Disopyramide
C. PEMA
D. NAPA

A

D. NAPA

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16
Q

Of the following therapeutic agents, those considered to be antiplatelet medications are:

A. Aspririn and Plavix
B. Coumadina and heparin
C. Heparin and protamine sulfate
D. Tissue plasminogen activator and streptokinase

A

A. Aspririn and Plavix

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16
Q

Which of the following will cause the thrombin time to be prolonged?

A.Hemophilia A
B.Presence of heparin
C. von Willebrand’s disease
D Factor V deficiency

A

B.Presence of heparin

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16
Q

A sodium citrate tube is received in the laboratory for PT and APTT testing. Results are as follows: PT 100 seconds (control 12 seconds); APTT 200 seconds (control 32 seconds). A mixing study was performed and there was no correction of either the prolonged PT or APTT. What would be the likely coagulation abnormality to consider?

A. Lupus inhibitor
B. Factor XIII deficiency
C. Hemophilia A
D. Factor V Leiden

A

A. Lupus inhibitor

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16
Q

Elevated anti-thyroglobulin and anti-thyroid peroxidase are suggestive of:

A. Graves disease
B. Hashimoto’s disease
C. Myasthenia gravis
D .Multiple sclerosis

A

B. Hashimoto’s disease

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16
Q

A clinical specimen is received in viral transport medium for viral isolation. The specimen cannot be processed for 72hours. At what temperature should it be stored?

A. -80C
B. -20C
C. 4C
D. 22C

A

A. -80C

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16
Q

There are many bacterial–antimicrobial resistance combinations. Which one of the following is of major international concern?

A. Sulfonamide resistance in Neisseria meningitidis

B. Penicillin G resistance in Neisseria gonorrhea

C. Ampicillin resistance in Haemophilus influenza

D. Erythromycin resistance in Streptococcus pyogenes

E. Vancomycin resistance in Staphylococcus aureus

A

E. Vancomycin resistance in Staphylococcus aureus

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16
Q

A first morning specimen would be requested to confirm which of the following?

A.Diabetes insipidus
B.Fanconi’s syndrome
C. Urinary tract infection
D. Orthostatic proteinuria

A

D. Orthostatic proteinuria

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17
Q

Glucosuria not accompanied by hyperglycemia can be seen with which of the following?

A. Hormonal disorders
B. Gestational diabetes
C. Diabetes mellitus
D. Renal disease

A

D. Renal disease

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18
Q

Which of the following results would be seen in urine from a patient with autoimmune hemolytic anemia?

A. Bilirubin = negative, urobilinogen = negative
B. Bilirubin = positive, urobilinogen = positive
C. Bilirubin = positive, urobilinogen = negative
D. Bilirubin = negative, urobilinogen = positive

A

D. Bilirubin = negative, urobilinogen = positive

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19
Q

The mucin clot test determines the presence of synovial fluid ______________.

A. Protein
B. Glucose
C. Fibrinogen
D. Hyaluronic acid

A

D. Hyaluronic acid

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20
Q

What is added to synovial fluid to determine the viscosity?

A. Sodium hydroxide
B. Acetic acid
C. Hydrochloric acid
D. Hyaluronic acid

A

B. Acetic acid

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21
Q

Crystals that appear needle-shaped under polarized light and are yellow when aligned with the slow vibration of compensated polarized light are______________.

A. Monosodium urate
B. Calcium pyrophosphate
C. Hydroxyapatite
D. Corticosteroid

A

A. Monosodium urate

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22
Q

Cells involved in cell-mediated immunity:

A. T cells

B. B cells

A

A. T cells

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23
Q

Cells involved in humoral immunity:

T cells
B cells

A

B cells

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24
Q

Postzone causes false-negative reactions in antibody titers as a result of which of the following?

A. Too much diluent added to test
B. Excess antibody in test
C. Excess antigen in test
D. Incorrect diluent added to test

A

C. Excess antigen in test

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25
Q

Anti-dsDNA antibodies are associated with which of the following?

A. Syphilis
B. CMV infection
C. Systemic lupus erythematosus
D. Hemolytic anemia

A

C. Systemic lupus erythematosus

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26
Q

Serum tested positive for HBsAg and anti-HBc IgM. The patient most likely has which of the following?

A. Acute hepatitis C
B. Chronic hepatitis B
C. Acute hepatitis B
D. Acute hepatitis A

A

C. Acute hepatitis B

27
Q

Testing for the D antigen was conducted at the IAT phase. A control was included in the testing. Both the patient’s red cells and the control tube reacted at 4+. How would you interpret this test?

A. The test is invalid because the control tube was positive

B. The patient is D-positive

C. the patient is D negative

D. The test should be repeated and the control tube omitted

A

A. The test is invalid because the control tube was positive

28
Q

Which antibody is typically considered to be an autoantibody if found in the serum of an adult?

A. Anti-K
B. Anti-I
C. Anti-D
D. Anti-Fy

A

B. Anti-I

29
Q

ou have performed an antibody screen using the tube method. All three screening cells tested negative. The Coombs check cells in all three tubes are also nonreactive. What should you do?

A. Respin the tubes and reread them

B. Report the antibody screen as negative
C. Repeat the antibody screen
D. Perform an antibody identification panel

A

C. Repeat the antibody screen

30
Q

A recently transfused patient has a 3+ reactive DAT with anti-IgG. Which procedure should be used to identify the specificity of the IgG antibody attached to the red cells?

A. Adsorption
B. Neutralization
C. Titration
D. Elution

A

D. Elution

31
Q

If you knew the DAT is positive, what would you expect the Rh control to be when doing a weak D test through AHG?

A. Negative
B. Positive
C. Mixed field
D. Hemolysis at 37 C would be seen

A

B. Positive

32
Q

Check (Coombs control) cells are:

A. Added to every negative antiglobulin test

B. Added to negative direct antiglobulin tests only
C. Used to confirm a positive Coombs’ reaction

Coated with both IgM and C3d

A

B. Added to negative direct

33
Q

If a person has the genetic makeup Hh, BO, LeLe, sese, what substance will be found in the secretions?

A. B substance
B. H Substance
C. Le a substance

D. Le b substance

A

C. Le a substance

34
Q

How many doses of RhIG are indicated for a Kleihauer-Betke reading of 0.6%?

A. 1
B. 2
C. 3
D. 4

A

B. 2

35
Q

What should be done FIRST if a mother types as O and the baby types as AB?

A. Report the results with no further testing

B. Try to get a sample from the father

C.Recheck all labels, get new samples, if necessary, and retest

D. Retype using all new reagents

A

C.Recheck all labels, get new samples, if necessary, and retest

36
Q

A patient presents to his physician for a lipid profile. The following results are received: HDL = 50 mg/dL; Total cholesterol = 300 mg/dL; Triglycerides = 200 mg/dL. The calculated LDL cholesterol is:

A. 200
B. 210
C. 290
D. 350

A

B. 210

37
Q

Laboratory tests are performed for a postmenopausal, 57-year-old woman as part of an annual physical examination. The patient’s random serum glucose is 220 mg/dL, and the glycated hemoglobin(HbA1c) is 11%. Based on this information, this patient would mostly likely be classified as:

A. Normal
B. Impaired
C. Having type 1 diabetes
D. Having type 2 diabetes

A

D. Having type 2 diabetes

38
Q

In which of the following disease states would you see an elevation in total bilirubin and conjugated bilirubin only?

A. Biliary obstruction
B. Hemolysis
C. Neonatal jaundice
D. Hepatitis

A

A. Biliary obstruction

39
Q

As a reduction product of bilirubin catabolism, this compound is partially reabsorbed from the intestines through the portal circulation for re-excretion by the liver. What is this compound?

A. Urobilinogen
B. Azobilirubin
C. Biliverdin
D. Urobilin

A

A. Urobilinogen

40
Q

Which selective medium is used for the isolation of gram-positive microorganisms?

A. Columbia CNA with 5% sheep blood

B. Trypticase soy agar with 5% sheep blood

C. Eosin-methylene blue agar

D. Modified Thayer-Martin medium

A

A. Columbia CNA with 5% sheep blood

41
Q

An expectorated sputum is sent to the laboratory for culture from a patient with respiratory distress. The Gram stain of the specimen shows many squamous epithelial cells (greater than 25/LPF) and rare neutrophils. The microscopic appearance of the organisms present include: Moderate gram-positive cocci in chains and diplococci, moderate gram-negative diplococci, moderate palisading gram-positive bacilli all in moderate amounts. This Gram stain is most indicative of:

A. Pneumococcal pneumonia

B. Anaerobic infection

C.Haemophilus pneumonia

D. Oropharyngeal flora

A

D. Oropharyngeal flora

42
Q

A gamma-hemolytic Streptococcus that blackens bile esculin agar but does not grow in 6.5% NaCl broth is most likely:

A. Streptococcus agalactiae

B. Streptococcus gallolyticus

C. Streptococcus pneumoniae

D. Enterococcus faecalis

A

B. Streptococcus gallolyticus

43
Q

Which of the following sets of tests best differentiates Salmonella and Citrobacter species?

A. KCN, malonate, beta-galactosidase and lysine decarboxylase

B. Dulcitol, citrate, indole and H2S production

C. Lactose, adonitol, KCN and motility

D. Lysine decarboxylase,
lactose, sucrose, malonate and indole

A

A. KCN, malonate, beta-galactosidase and lysine decarboxylase

44
Q

Providencia

A

These are typical biochemical reactions for Providencia. Key reactions that separate it from most other enteric organisms are lack of hydrogen sulfide production and phenylalanine deaminase positivity.

Citrate and ornithine reactions differentiate Providencia and Morganella.

45
Q

A child was bitten on the arm by her sibling and the resulting would grew a slender gram-negative bacilli that has the following characteristics: growth on sheep blood agar : colonies that “pit” the agar; colonies odor: like bleach; negative catalase; positive oxidase and no growth in TSI.

A

Eikenella corrodens
“Pitting of agar” and the bleach smell of the colonies are hallmark characteristics of Eikenella corrodens.

46
Q

The reverse CAMP test, lecithinase production, double zone hemolysis, and Gram stain morphology are all useful criteria in the identification of:

A

Clostridium perfringens

The reverse CAMP test, production of lecithinase and demonstration of double zone of hemolysis are tests and characteristics used for the identification of Clostridium perfringens.

47
Q

A neonatal blood culture collected through a catheter grows a small yeast. Microscopically, the yeast appear round at one end, with a budlike structure on a broad base at the other end. Growth is enhanced around olive oil-saturated discs. The organism isolated is:

A

Malassezia furfur
Malassezia furfur causes catheter-related sepsis, requires lipids for growth and is a small yeast with a white bud.

48
Q

Which of the following is the most useful morphological feature in identifying the mycelial phase of Histoplasma capsulatum?

A

8 to 14 um tuberculate macroconidia

The presence of tuberculate macroconidia indicates a presumptive identification of H. capsulatum. The identification of must be confirmed using nucleic acid probes or exoantigen testing.

Image:
Under a magnification of 800X, this photomicrograph revealed some of the ultrastructural details exhibited by Histoplasma capsulatum fungal organisms, which had been extracted from a Jamaican isolate that included a number of tuberculate, spheroidal macroconidia, and diaphanous filamentous hyphae.

49
Q

A mold grown at 25C exhibited delicate septate hyaline hyphae and many conidiophores extending at right angles from the hyphae. Oval, 2-5 um conidia were formed at the end of the conidiophores giving a flowerlike appearance. In some areas “sleeves” of spores could be found along the hyphae as well. A 37C culture of this organism produced small, cigar-shaped yeast cells. This organism is most likely:

A

Blastomyces dermatitidis

The characteristics listed define Sporothrix and differentiate it from other dimorphic fungi.

Picture:
Clinical manifestations of sporotrichosis in patients with chronic cutaneous and subcutaneous lesions, Madagascar, March 2013–June 2017. A–C) Lymphocutaneous lesions. D) Lymphocutaneous ulcerative budding and crusty lesion. E) Ulceroerosive and erythematosus lesion.

50
Q

AFB smear positive respiratory specimens may be reliably identified as Mycobacterium tuberculosis the same day the smear was read by:

A

Nucleic acid amplification

51
Q

An acid-fast bacillus recovered from an induced sputum had the following characteristics: Pigmentation: yellow in the dark, turning a deeper yellow-orange after 2 weeks of light exposure; negative nitrate reduction; positive Tween 80 hydrolysis and negative urease reaction.

A. Mycobacterium scrofulaceum

B. Mycobacterium gordonae

C. Mycobacterium szulgai

D. Mycobacterium flavescens

A

B. Mycobacterium gordonae

52
Q

When staining acid-fast bacilli with Truant auramine-rhodamine stain, potassium permanganate is used as

A. Decolorizing agent
B. Quenching agent
C. Mordant
D. Dye

A

A. Decolorizing agent

53
Q

A jaundiced 7-year-old boy, with a history of playing in a pond in a rat-infested area, has a urine specimen submitted for a direct darkfield examination. Several spiral organisms are seen. Which of the following organisms would most likely be responsible for the patient’s condition?

A. Spirillum minus
B. Streptobacillus moniliformis
C. Listeria monocytogenes
D. Leptospira interrogans

A

D. Leptospira interrogans

54
Q
A
55
Q

The white blood cells in this field are negative for peroxidase, chloroacetate esterase, and Sudan B. The cells are positive for terminal deoxynucleotidyl transferase (Tdt) and PAS. On the basis of these findings, what is the most appropriate classification of these cells?

A. Lymphoblasts with L1 morphology

B. Lymphoblasts with L2 morphology

C. Lymphoblasts with L3 morphology

D. Chronic lymphocytic leukemia

A

Lymphoblasts with L1 morphology

56
Q

A photomicrograph of an antinuclear antibody test using human fibroblasts, fluorescein isothiocyanate (FITC)–conjugated antihuman serum, and transmitted fluorescence microscopy. Which pattern of immunofluorescence is demonstrated in this field?

A. Homogenous
B. Peripheral
C. Nucleolar
D. Speckled

A

A. Homogenous

Using FITC-conjugated antihuman serum, diffuse apple-green fluorescence seen over the entire nucleus characterizes the homogenous pattern. At a significant titer, this pattern occurs in a variety of systemic autoimmune diseases including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, and Sjögren’s syndrome. The antibodies are directed against nucleoprotein; although they are mainly nonpathological, they are useful markers for active disease.

57
Q

A photomicrograph of a fungal slide culture stained with lactophenol cotton blue. The morphology is most consistent with which fungus?

A. Aspergillus
B.Penicillium
C. Scedosporium
D. Fusarium

A

A. Aspergillus

58
Q

A photomicrograph of a fungal slide culture stained with lactophenol cotton blue. The morphology is most consistent with which fungus?

A. Aspergillus
B. Penicillium
C. Scedosporium
D. Fusarium

A

Penicillium

Penicillium spp. produce conidia from a single row of phialides that resembles a brush or the skeleton of a hand.

59
Q

Fecal specimen seen using brightfield microscopy. The plate shows the ovum of which parasite?

A. Necator americanus
B. Trichuris trichiura
C. Acaris lumbricoides
D. Enterobius vermicularis

A

B. Trichuris trichiura

60
Q

Fecal specimen seen using brightfield microscopy. The plate shows the ovum of which parasite?

A. Necator americanus
B. Trichuris trichiura
C. Ascaris lumbricoides
D. Enterobius vermicularis

A

C. Ascaris lumbricoides

Ascaris ova are large and oval, usually measuring 50–75 μ long by 35–50 μ wide. They are often bile stained and may have a thick shell with a coarse covering (corticated). This egg demonstrates a contracted embryo, leaving space between the shell and the embryo at the opposing poles. This indicates that the egg is fertilized.

61
Q

This image demonstrates lymphocytes with characteristic cytoplasmic projections. B cell malignancy (CD19, CD20 positive).

A. Acute lymphoblastic leukemia
B. Acute myelogenous leukemia
C. Hairy cell leukemia
D. Myelodysplastic syndrome

A

C. Hairy cell leukemia

Hairy cell leukemia (HCL)
* Found in adults over 50 years old; more common in males (7:1)
* B cell malignancy (CD19, CD20 positive)
* Massive splenomegaly; extensive bone marrow involvement results in
dry tap on bone marrow aspiration
* Laboratory: Pancytopenia; cytoplasm of lymphocytes shows hair-like
projections; hairy cells are tartrate-resistant acid phosphatase (TRAP)
stain positive

62
Q

A patient on warfarin therapy will be deficient in a functional amount of

A. Fibrinogen and prothrombin
B. Stable and labile factors
C. Protein C and S
D. Fletcher and Fitzgerald factors

A

C. Protein C and S

63
Q

If a person has the genetic makeup Hh, AO, LeLe, sese, what substance will be found in the secretions?

A. A substance
B. H substance
C. Le a (Lewis a) substance
D. Le b (Lewis b) substance

A

C. Le a (Lewis a) substance

64
Q

Indicator of nutritional status and is one of the proteins that transports thyroid hormones:

A. Orosomucoid
B. Transthyretin
C. Ceruloplasmin
D. Transferrin

A

B. Transthyretin

65
Q

In serum protein electrophoresis, when a buffer solution of pH 8.6 is used, which of the following characterizes the proteins?

A. Exhibit net negative charge
B. Exhibit net positive charge
C. Exhibit charge neutrality
D .Migrate toward the cathode

A

A. Exhibit net negative charge

66
Q

In intravascular hemolysis, hemoglobin appear in the urine when:

A. Haptoglobin is increased
B. Haptoglobin is depleted

A

B. Haptoglobin is depleted

67
Q

Whole blood was collected at 10 am and stored at temperature of 4C. How do you prepare platelets from this unit?

A. Light spin followed by heavy spin
B.Heavy spin followed by light spin
C. Whole blood must be centrifuged at 1 to 6C
D. Platelets cannot be prepared

A

D. Platelets cannot be prepared

68
Q

Pink colonies were isolated MACCONKEY AGAR. Indole negative, citrate positive, LDC negative, ODC positive, ADH positive. What could be the possible identity of this organism?

A. Klebsiella pneumoniae
B. Klebsiella oxytoca
C. Enterobacter aerogenes
D. Enterobacter cloacae

A

D. Enterobacter cloacae

69
Q

Pink colonies were isolated MACCONKEY AGAR. Indole negative, citrate positive, LDC positive, ODC positive, ADH negative. What could be the possible identity of this organism?

A. Klebsiella pneumoniae
B. Klebsiella oxytoca
C. Enterobacter aerogenes
D. Enterobacter cloacae

A

C. Enterobacter aerogenes

70
Q

Aseptate hyphae with sporangiospores but without rhizoids

A. Rhizopus
B. Absidia
C. Mucor

A

C. Mucor

71
Q

Mother is Group A Rh positive, father is Group O Rh negative, their newborn suffered from HDN. Which of the following antibodies caused HDN?

A. Anti-A
B. Anti-D
C. Anti-d
D. Anti-c

A

D. Anti-c

72
Q

Before an AFB smear is reported as negative, it should be examined carefully by scanning at least _____ oil immersion fields.

A. 2 OIF
B. 10 OIF
C. 100 OIF
D. 300 OIF

A

D. 300 OIF

73
Q
A

Part 1 Ascpi (2 decks)

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