Pinstripes Flashcards
An increase TSH and decreased t4 provide lab evidence of which disease
Hypothyroidism
In which scenario can an antibody be ruled out
patient serum does not react with a
cell known to carry the corresponding antigen
WBC count: 230 x 20/ (4 x 0.1)
=11.5
The specificity of the antibody in cold autoimmune hemolytic anemia is most often directed toward
Ii system
Detection of oxacillin/methicillin resistant staphylococcus aureus in antimicrobial susceptibility may be enhanced by
incubating for 24 hrs with added salt
All of the following are characteristic of abo hemolytic disease of fetus and newborn except
Mother is group A
A permanent stained smear of a fecal specimen revealed the trophozoite in the image below… Trophozite 55 microns in diameter
Entamoeba coli trophozoite
Serum protein electrophoresis pattern is consistent with:
monoclonal gammopathy
What term describes the process to identify what factors contribute to the occurrence of a nonconformance
root cause analysis
An OGTT was performed on a patient the 2 hour serum glucose level was 145 mg/do this should be interpreted as
pre-diabetes (impaired glucose tolerance)
- Less than 140: normal
- 140 - 199: pre-diabetes
- 200+ : diabetes
Which of the following biochemical parameters is found only in the myocardium and
therefore provides specific evidence of cardiac injury when increased 4-6 hours:
cardiac troponin I
Select the order of processes in southern blot transfer technique:
DNA extraction/ Gel electrophoresis, Blotting, Probe labeling, Hybridization & washing, detection
Which of the following set of results is consistent with uncompensated metabolic acidosis
ph 7.25; HCO3 15 mmol/L; pCO2 37 mm Hg
Perls prussian blue stain increase
Iron
shows up = dont have anemia
Smudge cells
CLL, trisomy 12 del 11q,13q, 17)
Thrombotic thrombocytopenic purpura deficiency
Adamts 13 Protease
This abnormal hemoglobin can form as a result of chronic constipation constipation or medication and represents an irreversible change to the hemoglobin molecule which cannot carry oxygen and will persist until RBCs carrying this abnormal Hgb are removed from the circulation
Sulfhemoglobin
Which of the following is a characteristic of indirect immunofluorescent assays is
correct
. The anti-immunoglobulin has fluorescent label
Which of the following illnesses is not caused by streptococcus pyogenes directly but rather by destructive host defense response
acute rheumatic fever
Patient serum is mixed with gel particles that have been sensitized with Treponema pallidum antigens as well as with unsensitized gel particles in a separate well. Agglutination was observed in the well with sensitized gel particles but not in the well with unsensitized gel particles. What is the interpretation of these results?
Positive for anti-T pallidum antibodies
A patient’s hepatitis b profile is positive for hepatitis b surface antibody only. This patient
Was vaccinated against Hep B
A newborn infant tests positive for anti-hbc IgG. This result is evidence that:
the mother was infected with hepatitis B
Which of the following statements about cortisol in Cushing syndrome is true:
24 hour urinary free cortisol is a more sensitive test than plasma total cortisol
When a therapeutic drug is suspected of causing toxicity which specimen is the most appropriate:
peak blood sample
Which of the following sets of tests would be the most useful in diagnosing an acute myocardial infection
CK-MB, troponin, myoglobin
A blood specimen is obtained from an individual who is known to have elevated
lipids (triglycerides) and the serum appears milky. This individual’s physician has ordered an estrogen immunoassay that your laboratory performs using a nephelometric technique. Which one of the following statements is correct concerning the possible outcome of this assay?
the lipemic specimen will produce interferring background light intensity and excess light scatter in this type of assay
How does the net charge of the proteins in a sample affect the electrophoretic mobility of protein:
it is directly proportional to electrophilic mobility
In which condition is the highest level of serum gastrin usually seen
Z-E syndrome
A 42 year old male presents with anorexia nausea fever and icterus of the skin andmucous membranes he noticed that his urine had appeared dark for the past several days. The physician orders a series of biochemical tests. Based on the following test results, what is the most likely diagnosis? Serum alkaline phosphatase—slightly elevated, Serum alanine aminotransferase—markedly elevated, Serum aspartate It is directly proportional to electrophoretic mobility.
: Z-E syndrome
aminotransferase—markedly elevated, Serum gamma-glutamyltransferase— markedly elevated, Serum total bilirubin—moderately elevated, Urine bilirubin—positive, Fecal urobilinogen—decreased
alcoholic cirrhosis
Which of the following enzymes is responsible for the conjugation of bilirubin
UDP-glucuronyl transferase
Which of the following statements about thin layer chromatography (TLC) for drug screening is true
a drug is identified by comparing its Rf value and staining to standards
notes: Sample components are identified by comparison with standards on the
Anion gap reference range and calculation Ans: AG = (Na + K) - (Cl + HCO3) or Na - (Cl + HCO3) Normal Range: 16- 20 (12-16 if K not included)
increased and increased anion gap (gap is 38)?
Which of the following cells can be found in a vaginal wet prep:
clue cells
A patient presenting with polyuria nocturia polydipsia and high specific gravity is exhibiting symptoms of what disorder?
diabetes mellitus
A clean catch urine is submitted to the lab for routine urinalysis and culture The routine urinalysis is done first, and 3 hours later, the specimen is sent to the microbiology department for the culture. The specimen should
be rejected due to the time delay
eGFR calculated by the MDRD formula takes into account the age, BUN, race, albumin, and what else for its calculations
creatinine
does not include body weight
eGFR is estimated GFR calculated by the abbreviated MDRD equation : 186 x (Creatinine/88.4)-1.154 x (Age)-0.203 x (0.742 if female) x (1.210 if black).
Are triphosphate Crystals pathologic
nonpathologic, highly alkaline urine and common in urinary tract infections (coffin lid shaped)
The urinalysis result most closely associated with renal disease is a positive
protein
A sperm count is diluted 1:20 and 50 sperm are counted in 2 large squares
5,000 UL
(5 x 10^6)
(50x20x5)
What does RBC casts and WBC casts indicate:
????
notes:
RBC casts indicate: glomerulonephritis
b. WBC casts indicate: interstitial nephritis, pyelonephritis, pyelonephritis, infection, inflammation
C. Hyaline Case indicate: stress, exercise, fever, heat exposure, dehydration, glomerulonephritis, pyelonephritis, chronic renal disease, congestive heart failure
Test for the detection of occult blood rely on which chemical reaction:
guaiac reaction
Pseudoperoxidase activity of hemoglobin
Polarizing microscope image:
calcium pyrophosphate crystal: blue pseudo-gout
monosodium urate crystal: yellow gout
image?
A DAT result showed 3+ with anti-IgG, what is the first step to identify the antibody coating the red cells?
perform an elution
possible causes of extra antigens appearing in the forward grouping include all of the following except:
ABO subgroup?
A 60 year old man was transfused with 1 unit of packed red blood cells following
knee surgery. His hematocrit was determined to be 27% before transfusion, what is his expected hematocrit after transfusion :
30%
27+3
What phenotypes will be expressed when the Le, Se and H genes are inherited:
Le(a-b+)
What might a positive antibody screen and a negative auto control indicate: It may indicate that
an alloantibody has been detected
What is tested in an antibody screen:
patient serum is tested against group O reagent screening cells
why are screening cells group O,
To prevent interference with anti-A and anti-B in patient serum
During an antibody screen was 1+ reaction at AHG with donor cells with the antigen profile fya+fyb- when tested with patients serum. All other donor cells on the panel were negative, including those that were Fya(+), Fyb(+). Given these results, what might be the conclusion?
single antibody (showing dosage)
A patient wants to donate his own blood for surgery scheduled in 1 weeks and has a hgb of 11g/dl. What is his eligibility status:
(He can’t donate his blood)?
If the donation is autologous, his hemoglobin can be at least 11g/dL. He can donate if his surgery is a week before surgery
Which of the following statements is true regarding igG sensitized cells:
they must be used to confirm a negative antiglobulin tube test
A group B patient requires fresh frozen plasma (ffp). Group B ffp is not available the next component of choice is:
Group AB
A group O patient was crossmatched with group B red blood cells. What phase of the crossmatch will first detect this incompatibility:
immediate spin
The purpose of the AHG crossmatch is to
detect clinically significant IgG antibodies to antigens on the donor cells.
Immunization for measles vaccine would result in a temporary donor deferral for
4 weeks
4 weeks for varicella, measles[German Rubella], and standard MMR (measles)
Which of the following is true about platelets:
transfused within 5 days
Which of the following is necessary to prevent an anaphylactic allergic transfusion reaction due to a known IgA antibody:
RBC should be washed.
The specificity of the antibody in cold autoimmune hemolytic anemia is most often
directed toward:
I, i
A 30 year old woman is admitted to the hospital. She has truncal obesity, Buffalo humpback, moon face, purple striae, hypertension, hyperglycemia, increased facial hair, acne, amenorrhea. The physician orders endocrine testing. The results are as follows Urine free cortisol - increased, Serum cortisol (8AM) - increased, Plasma ACTH - decreased, Dexamethasone suppression test, Overnight low dose- no suppression of serum cortisol, High dose- no suppression of serum cortisol. What is the most probable diagnosis?
Adrenocortical carcinoma
A request is received in the laboratory for assistance in selecting the appropriate
test(s) for diagnosing Lyme disease. Which of the following is most reliable for diagnosis
Microhemagglutination test on serum, examination of
a gram staining smear
it is difficult to isolate B. burgdorferi from skin, blood, or other clinical samples. Therefore, laboratory detection of Lyme disease is based on serological assays such as EIA, I FA, and Western blot.
. A gram positive coccus was isolated from blood cultures of a patient with endocarditis and presumptively identified as enterococcus faecalis. What should the technologist do
screen for high glycoside resistance?
Characteristics necessary for the definitive identification of mycobacterium tuberculosis are
rough, nonpigmented colony, slow growth at 37C, niacin
production-positive, nitrate reduction-positive
Acid fast coccobacilli received from an immunodeficient patient suggest infection by which mycobacterium
M.Avium complex
Which of the following requires isolation on media enriched with blood incubated at 42°C, in an environment containing 5% oxygen…?
Campylobacter
LDL calculation question
240
Corrected wbc question
(14.87 x 100)/(100+47)
A 27 year old arrives at the emergency department with acute bleeding and swollen gums
AML
Five days after transfusion a patient returned to his physician for postsurgical blood tests. It was noted that the hemoglobin value decreased from 11 mg/dL to 9 mg/dL during that time. The patient had not experienced any symptoms. To rule out a delayed hemolytic transfusion reaction, what test should be performed?
all of the above
dat on current sample, elution if +
antibody screen on current sample
blood smear to check for spherocytes
All of the following are characteristics of abo hemolytic disease except
IgM
An antibody to the E antigen was identified in a patient who received multiple
transfusions. What is the most likely phenotype of the patient’s red cells?
R1R1
R1r
While performing the quality control on a gram stain procedure using a control slide of Staphylococcus and E. coli, the laboratory professional noticed that all of the bacteria, rods, and cocci are staining pink. This may be due to:
using too much decolorizer
solution: use less ethyl alcohol/acetone
Negative results obtained in the nitrocefin beta lactamase test can be reported after 10 minutes: which organism needs to be incubated for 60 minutes?
Staphylococcus aureus?
A 0.001 ml loop was used to inoculate a urine specimen to culture media after incubation the following colonies were observed: -MAC agar= 200 very pink colonies, -BAP agar= 210 large grey colonies. The tech should report:
> 100,000 CFUs/mL GNR
10^5
lactose fermenting GNR
Colonies growing on kvlb agar fluoresce during red when viewed under a wood lamp. The organism suggested is
prevotella and porphyrommonas species
Specimens for viral culture should be collected:
Notes: within 4 days of symptoms
Quizlet: within 2-3 days
Viral genomes and virus names are grouped below: Which group is wrong together (meaning one is DNA and the other is RNA)
RNA varicella zoster; RNA hepatitis A
A 4-year-old boy present with bruising, fever, and coughing. His white blood cell count is 15x109 /L, his hematocrit is 23% and his platelet count is 53 x 109/L. A bone marrow aspirate is obtained that reveals sheets of immature cells. Cytochemical studies for peroxidase and NSE are negative; the TdT is positive. Surface marker studies are done on the following phenotype: HLA - ; DR + ; CD19 + ; CD10 + ; Cμ - ; sIg - ; CD7 -. A portion of the aspirate is sent for cytogenetics and molecular studies. What is the most likely diagnosis?
Precursor B cell ALL with t(12;21) TEL-AML1
Factor XI deficiency:
hemophilia C; rosentiak syndrome- epistaxis, hematuria. PT
and BT normal Rx- FFP.
Factor IX deficiency:
Assay decreased here. Christmas/ Hemophilia B
The principle demonstrable antibodies in systemic lupus erythematosus are
Antinuclear antibodies
Tertiary syphilis is characterized by the following: It affects various organs
a. Skin lesions
Antibodies against streptolysin O, hyaluronidase and dnase B are measured in the diagnosis of
rheumatic fever
A patient has a reactive RPR at a titer of 1:32 and a reactive tp-pa:
Positive for syphilis
Mold thick round tuberculate
Histoplasma capsulatum
The mycelial form of which dimorphic mold produces thick walled, rectangular, or barrel
shaped alternate arthroconidia?
coccidioides immitis
