Practice Exam Flashcards

Question

Sputum sample has 25 PMN cells, 10 epithelial cells on HPO, in oil immersion bacteria and fungi were seen, what to do? A. culture bacteria only B. culture fungi only C. culture both bacteria and fungi D. reject specimen

Answer 1

C. culture both bacteria and fungi The specimen meets the criteria for a good specimen, culturing both bacteria and fungi would be the best answer.

Answer 2

C. May-Hegglin anomaly May-Hegglin anomaly (MHA) is an autosomal dominant disorder characterized by various degrees of thrombocytopenia that may be associated with purpura and bleeding; giant platelets containing few granules; and large, well-defined, basophilic, cytoplasmic inclusion bodies in granulocytes that resemble Dohle bodies.

Answer 3

D. Paired T-test The Paired Samples T-Test is a statistical test used to determine if 2 paired groups are significantly different from each other on your variable of interest. Your variable of interest should be continuous, be normally distributed, and have a similar spread between your 2 groups. Your 2 groups should be paired (often two observations from the same group) and you should have enough data (more than 5 values in each group).

Answer 4

B. S. pyogenes S. pyogenes is the most common causative agent of pharyngitis.

Answer 5

C. Uric acid

Answer 6

C. Growth at 42 C P. aeruginosa has the widest range of growth temperature (25-42C)

Answer 7

A. Moraxella catarrhalis M. catarrhalis is biochemically inert and does not ferment carbohydrates (assacharolytic)

Answer 8

A. weekly spore test with B. stearothermophilus

Answer 9

A. crystals Birefringent crystals are found in the synovial fluid of \>90% of patients with acutely inflamed joints. Crystal identification aids in the diagnosis of joint disease. Monosodium urate crystals are seen in gouty fluids. Urate crystals are mainly needle-shaped and strongly doubly refractile, and may be found within leukocytes. Calcium pyrophosphate crystals are present in chondrocalcinosis. Calcium pyrophosphate dehydrate crystals usually appear as rhomboids and tend to be small, measuring between 1 and 20 um.

Answer 10

C. Juvenile cirrhosis AAT flat curve = AAT deficiency AAT is INCREASED in inflammation.

Answer 11

C. Impaired plasma glucose FBS: 0-50 mg/dl = hypoglycemia FBS: 50-100 mg/dl = Normal FBS: 100-125 = Impaired FBS: \>126 = provisional diabetes

Answer 12

C. Tangier disease Tangier disease is an inherited disorder characterized by significantly reduced levels of HDL in the blood. HDL transports cholesterol and certain fats (phospholipids) from the body's tissues to the liver, where they are removed from the blood. HDL is often referred to as the "good cholesterol" because high levels of this substance reduces the chance of developing heart and blood vessel diseases.

Answer 13

B. Hemoglobin F The test is based on differences between maternal and fetal hemoglobin. Maternal blood contains adult hemoglobin composed of two alpha and two beta subunits (aka hemoglobin A or HbA; i.e., normal adult hemoglobin). Fetal blood contains fetal hemoglobin composed of two alpha and two gamma subunits (aka hemoglobin F or HbF; i.e., normal fetal hemoglobin). **Fetal hemoglobin is resistant to alkali denaturation.**

Answer 14

C. Dark yellow Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. It makes urine appear dark yellow (yellow foam).

Answer 15

A. presence of protein other than albumin

Answer 16

A. light scatter

Answer 17

D. A1B O\>A2\>B\>A2B\>A1\>A1B

Answer 18

B. 95 The **_UIBC_** is calculated by subtracting the serum iron from the TIBC: 215-120 = 95

Answer 19

C. Troponin Troponin stays elevated up to 10-14 days after MI.

Answer 20

A. CO2 pressure The carbon dioxide ion selective electrode uses a gas-permeable membrane to separate the sample solution from the electrode internal solution. Dissolved carbon dioxide in the sample solution diffuses through the membrane until an equilibrium is reached between the partial pressure of CO2 in the sample solution and the CO2 in the internal filling solution. In any given sample the partial pressure of carbon dioxide will be proportional to the concentration of carbon dioxide.

Answer 21

B. NBT (Nitroblue Tetrazolium) Dye test Indirectly detects the production of superoxide by neutrophils represented by a blue-black precipitate Useful in the diagnosis of chronic granulomatous disease Increased enzyme activity that is present in neutrophils during a bacterial infection is capable of reducing this stain to formazan, which forms a black precipitate (positive), in fatal granulomatous disease the neutrophils do not have the normal ability to kill certain organisms and are unable to reduce the stain (negative)

Answer 22

A. Anti-smooth muscle Chronic Active Hepatitis (CAH) has at least 2 subsets: (1) Classic (Type 1) - associated with a positive ANA test and positive smooth muscle antibodies. The condition is associated with an attack on the hepatocytes. (2) Type 2 - most often seen in children; positive for antibodies to liver-kidney microsome type 1 (ALKM-1) and/or liver-cytosol antigen 1 (ALC-1).

Answer 23

B. Factor XIII deficiency Duckert's Test is for factor XIII deficiency. Reagent: 5M urea Normal: Clot is insoluble to urea (24 hrs) Abnormal: Clot is soluble to urea (24 hrs) = Factor XIII deficiency

Answer 24

A. Amylase Salivary amylase levels are elevated in Mumps.

Answer 25

C. Lavender top (EDTA) Tacrolimus, cyclosporine, and sirolimus are immunosupressive drugs and are tested using whole blood.

Answer 26

C. Biosafety Level II; Safety Cabinet II BSL I - BSC I BSL II - BSC II BSL III - BSC III BSL IV - BSC III

Answer 27

A. Give Jk(b) negative crossmatch compatible blood Delayed hemolytic transfusion reactions may occur in recipients who are previously immunized but who do not have detectable antibody, if they receive blood with the corresponding antigen. When there is a history of clinically significant antibodies, donor red cells should be phenotyped and antigen-negative blood selected. A complete AHG crossmatch must be performed.

Answer 28

B. Anti-I Anti-I antibodies are the most common antibodies found if antibody screens are done at immediate spin at room temperature. They are IgM immunoglobulins. Auto-anti-I is a common "cold agglutinin." High-titer anti-I is also commonly associated with Mycoplasma pneumoniae infections. Treatment would be giving the patient appropriate antibiotics.

Answer 29

B. Beer's Law

Answer 30

B. Furazolidone (100 ug/disk) susceptibility Micrococcus and Staphylococcus can be differentiated by susceptibility to furazolidone (100 ug/disk). Staphylococcus = susceptible Micrococcus = resistant

Answer 31

D. Target cells Codocytes, also known as target cells, are RBCs that have the appearance of a bullseye.

Answer 32

B. Infrared Visible range: 400-700 nm \<400 nm: UV light \>700 nm: Infrared

Answer 33

A. Ankylosing spondylitis Ankylosing spondylitis belongs to a group of arthritis conditions that tend to cause chronic inflammation of the spind. The HLA-B27 gene can be detected in the blood of most patients with ankylosing spondylitis.

Answer 34

B. Skin snipping Dracunculiasis is typically asymptomatic for the first year. Symptoms typically develop when the worm erupts through the skin. Local symptoms include intense itching and a burning pain at the site of the skin lesion.

Answer 35

B. tourniquet left for more than 10 minutes Excessive tourniquet time or fist clenching during phlebotomy leads to efflux of potassium from the muscle cells into the bloodstream.

Answer 36

D. Heinz bodies Ingestion of naphthalene-containing mothballs is a common occurrence in children. Heinz body formation, hemoglobinuria and mild methemoglobinaemia can occur due to poisoning with this substance.

Answer 37

C. Branched Chain DNA Analysis Branched DNA (bDNA) is a signal amplification technology used in clinical and research labs to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays.

Answer 38

C. GGT GGT can be used to screen for chronic alcohol abuse (it will be elevated in about 75% of chronic drinkers) and to monitor for alcohol use.

Answer 39

C. VII, IX, X The following factors are said to be vitamin K dependent factors. Coagulation factors affected by coumadin drugs are: II, VII, IX, and X.

Answer 40

B. HDL, LDL, IDL, VLDL

Answer 41

B. Cotton blue Aman medium contains lactophenol blue. It contains lactic acid, phenol, and aniline blue (cotton blue). It is an excellent mounting medium for most fungi. It preserves and stains fungi with shades of blue.

Answer 42

D. Diabetes insipidus Low specific gravity (1.001-1.003) may indicate the presence of diabetes insipidus, a disease caused by impaired function of anitdiuretic hormone (ADH). Low SG may also occur in patients with glomerulonephritis and other renal abnormalities.

Answer 43

C. Lead Lead poisoning affects many organs in the body. Lead inhibits gamma-aminolevulinic acid dehydratase (ALAD), an enzyme with two co-dominantly expressed alleles, ALAD1 and ALAD2.

Answer 44

B. after liquefaction Liquefaction takes approximately 20-30 minutes.

Answer 45

C. Haemophilus influenzae H. influenzae requires X and V factors. Sheep blood agar supplies X factor and the staphylococci produce V factor, so colonies grow around staph colonies.

Answer 46

A. N-acetylprocainamide (NAPA)

Answer 47

D. Pack in ice Dry ice (4 degrees): 1. Stuart's viral transport medium, 2. Leibovitus-Emory, 3. Earles/Hanks balance salt solution.

Answer 48

C. P. falciparum

Answer 49

B. Secondary hypothyroidism The cause of secondary hypothyroidism is failure of the pituitary gland to secrete TSH.

Answer 50

A. C. trachomatis

Answer 51

B. release of ADP Under normal conditions, small disk-shaped platelets circulate in the blood freely and without interaction with one another. ADP is stored in dense bodies inside blood platelets and is released upon platelet activation. ADP interacts with a family of ADP receptors found on platelets (P2Y1, P2Y12, and P2X1), which leads to platelet activation.

Answer 52

A. Vitamin K

Answer 53

B. Its molecular size is the smallest. In a healthy individual, the kidneys prevent albumin and other proteins from entering the urine as waste. If the kidneys are damaged however, it will allow proteins to pass into the urine. The first type of protein to appear in urine is albumin as its molecular size is smaller than most other proteins.

Answer 54

B. Bartonella henselae

Answer 55

D. Yersinia enterocolitica CIN Agar is recommended for use in the selective and differential isolation of Yersinia and Aeromonas species from clinical specimens, environmental samples, and food sources. Yersinia enterocolitica will exhibit bull's eye appearance on the said agar.

Answer 56

D. India Ink Cryptococcus neoformans can be visualized by the India Ink due to its large polysaccharide capsule. Organisms that possess a polysaccharide capsule exhibit a halo around the cell against the black background created by the India Ink.

Answer 57

C. decreased microhematocrit

Answer 58

B. acute interstitial nephritis Greater than 5% eosinophils in urine indicates acute interstitial nephritis.

Answer 59

B. CA 19-9 CA 15-3 - breast cancer CA 125 - ovarian cancer CEA - cancer of the large intestine (colon and rectal cancer)

Answer 60

A. increased TIBC A TIBC value above 450 mcg/dL usually means that there is a low level of iron in your blood. This may be caused by lack of iron in the diet, increased blood loss during menstruation, pregnancy, or chronic infection.

Answer 61

C. E. cloacae

Answer 62

D. all of the above

Answer 63

B. Anti-M MNS antibodies display dosage = they react stronger against cells which are homozygous vs. heterozygous for the antigen in question.

Answer 64

D. lipoproteins For approximately 2-8 hours following a meal, there is an additional lipoprotein class, called chylomicrons, representing the transport of dietary fat absorbed in the intestine.

Answer 65

C. Nov 1: 10 years from now Blood is sometimes frozen in order to preserve rare types. Glycerol is used in the freezing process. Once frozen, the expiration date of the blood is extended to 10 years from the date of phlebotomy. If the blood is needed, it is defrosted and the new expiration date becomes only 24 hours from the time it is defrosted.

Answer 66

A. acute myeloid leukemia (AML) FAB M2 is a subtype of AML. It is also known as "acute myeloblastic leukemia with maturation."

Answer 67

A. amorphous phosphates Amorphous phosphates are formed in alkaline urine and are colorless. The precipitate of amorphouse phosphates is white, while amorphous urates are yellow, yellow-brown, or pinkish in color. They tend to form in acidic urine and their precipitate is pink with a cloudy appearance in mixed urine. Amorphous urates are a normal presence in the urine.

Answer 68

B. health hazard Blue quadrant = health hazard Red quadrant = flammability hazard Yellow quadrant = reactivity/stability hazard White = special information

Answer 69

B. reduce citrate anticoagulant In 1980, CLSI released H21-A4 guidelines for coagulation testing, which included the recommendation to adjust/correct the amount of citrate in blue-top evacuated blood collection tubes for patients presenting with hematocrits greater than 55%.

Answer 70

A. To remove traces of free serum globulins

Answer 71

D. synergism

Answer 72

A. presence of cold-agglutinins Cold agglutinin disease (CAD) is a rare disorder affecting 15% of patients with autoimmune hemolytic anemia (AIHA). The disease is defined by the presence of cold agglutinins (autoantibodies which are active at temperatures below 30°C). Cold agglutinins cause red blood cells to clump together (agglutinate) at low temperatures. Cold agglutinin disease can be primary (idiopathic) or secondary, caused by an underlying condition, such as infection (Mycoplasma pneumoniae, Infectious mononucleosis, CMV), lymphoproliferative disorder, autoimmune disease or neoplasm. The majority of cold agglutinin disease is secondary and is due to the presence of monoclonal IgM (kappa subtype in the majority of the cases), which has the properties of a cold agglutinin and is associated with an underlying low-grade B-cell lymphoma (Waldenström’s macroglobulinemia or lymphocytic lymphoma). Idiopathic and lymphoma-associated cold AIHA tend to be chronic while infections tend to cause an acute disease.

Answer 73

B. Prothrombin Time (PT)

Answer 74

A. B. anthracis The important distinguishing characteristics between B. anthracis and B. cereus is motility. B. anthracis = non-motile B. cereus = motile

Answer 75

B. metabolic acidosis High anion gap metabolic acidosis is generally caused by the body producing too much acid or not producing enough bicarbonate. This is often due to an increase in lactic acid or ketoacids, or it may be a sign of kidney failure. More rarely, high anion gap metabolic acidosis may be caused by ingesting methanol or overdosing on aspirin.

Answer 76

A. methylene blue Methylene blue is used as an indicator of anaerobiosis. It remains blue when there is oxygen present in the environment but turns colorless if anaerobic conditions are met.

Answer 77

B. measure phenobarbital concentration Primidone is a structural analog of phenobarbital.

Answer 78

C. rapid progession of the disease

Answer 79

A. Acute myelocytic leukemia * *_RBC:_** Normocytic normochromic type of anemia * *_WBC:_** Multiple myeloblasts ( more than 20%) will be seen. Myeloblasts may contain several fine rods-like structures called **Auer rods**. These are seen only in **acute** leukemias of **myeloid** differentiation. * *_PLATELETS:_** Moderate to severe thrombocytopenia can be seen.

Answer 80

A. Chloride The schales and schales method is a mercurimetric titration method for chloride analysis. It involves titrating chloride with a solution of mercury forming soluble but non-ionized mercuric chloride.

Answer 81

A. Tuberculosis All patients with tuberculosis demonstrate a marked increase in proliferation activity of monocytes and premature monocyte marrow release. These changes indicate a high monocyte consumption, which is probably caused by a high macrophage death rate due to the high macrophage-toxicity of tubercle bacilli.

Answer 82

C. A donor who was given hepatitis B immune globulin 6 months ago.

Answer 83

C. Chronic hemolytic anemia

Answer 84

C. add hyaluronidase Induced tryptic digestion of hyaluronic acid will destroy the synovial fluid lubricating abilities without lowering its viscosity. It has also been shown that hyaluronic acid can be depolymerized without altering its lubricating capacity.

Answer 85

B. sorbitol E. coli 0157:H7 is an enteric pathogen that typically causes hemorrhagic colitis and blood diarrheal illnesses. It may be followed by hemolytic uremic syndrome, especially in young children. MacConkey Agar with Sorbitol is recommended for isolation of this organism. E. coli 0157:H7 is a sorbitol nonfermenter, thus forms colorless colonies while any bacteria capable of fermenting sorbitol (including other E. coli species) form pink colonies on MacConkey agar with sorbitol.

Answer 86

A. Fletcher

Answer 87

B. plasma bicarbonate concentration

Answer 88

A. double indicator system It is common to use a double indicator system comprising methyl red and bromothymol blue. Methyl red produces a color change from red to yellow in the range of pH 4-6 and the bromothymol blue changes from yellow to blue between pH 6-9. In the range 5-9 the strips show colors that change from orange at pH 5, passing through yellow and green to dark blue at pH 9.

Answer 89

B. H. parainfluenzae H. parainfluenzae requires NAD (V factor) for growth but not hemi (X factor). This distinguishes it from H. influenzae. H. haemolyticus is hemolytic. H. ducreyi does not cause epiglottitis.

Answer 90

A. Pasteurella multicoda

Answer 91

A. sodium Hyperglycemia causes osmotic shifts of water from the intracellular to the extracellular space, causing a relative dilutional hyponatremia.

Answer 92

B. JAK2 Approximately 95% of all PV patients have a mutation of the JAK2 gene in their blood-forming cells. This mutation leads to hyperactive JAK (Janus Kinase) signaling, causing the body to make the wrong number of blood cells.

Answer 93

A. pure red cell aplasia

Answer 94

A. tachometer

Answer 95

B. Chronic Myelogenous Leukemia The Philadelphia chromosome is a specific abnormality in chromosome 22 of leukemia cancer cells (particularly CML cells). This chromosome is defective and unusually short because of reciprocal translocation of genetic material between chromosome 9 and chromosome 22, and contains a fusion gene called BCR-ABL1. A very good way to differentiate Leukomoid reaction from CML is by doing a Leukocyte Alkaline Phosphatase (LAP) staining. LAP score for Leukomoid reaction is high, while low for CML.

Answer 96

A. incubated at 35 degree celsius Fastidious organisms such as Neisseria and Haemophilus frequently isolated from the CSF of patients with bacterial meningitis are preserved by placing the fluid in 3-7% CO2 at 35-37C (or at room temperature for no longer than 30 minutes), if the specimen cannot be cultured immediately.

Answer 97

B. swab material inhibitied the sample

Answer 98

B. workshop

Answer 99

C. 80-100 fl

Answer 100

B. D-galactose L-fucose = terminal sugar for O antigen N-acetylglucosamine = terminal sugar for A antigen D-galactose = terminal sugar for B antigen

Answer 101

A. the inhibitor binds the enzyme-substrate complex

Answer 102

B. microcytic, hypochromic

Answer 103

A. BUN Azotemia is a medical condition characterized by abnormally high levels of nitrogen containing compounds.

Answer 104

C. NAD NAD is being measured in the final step of urease method determination of BUN. It is measured at 340 nm.

Answer 105

A. presence of X-ray medium X-ray medium/radiographic dye can cause erroneous results in urine specific gravity measurement. High concentrations of protein and glucose (high MW substances) can intefere with specific gravity results and must be corrected for.

Answer 106

B. Zygomycetes Zygomycetes commonly recovered from clinical specimens are Rhizopus spp. and Mucor spp. Both display aseptae hyphae, while the other groups above display septate hyphae.

Answer 107

C. Myoglobin Myoglobin is a small, oxygen-binding protein found in the heart and skeletal muscle. When heart or skeletal muscle is injured, myoglobin is released into the blood. Blood levels of myoglobin can rise very quickly with severe muscle damage and can be measured within a few hours following an injury.

Answer 108

C. Coxsackie A Hand, foot, and mouth disease (HFMD) is usually caused by Enterovirus 71 or Coxsackie virus A16.

Answer 109

A. correct for temperature High protein, glucose, and bilirubin levels can elevate specific gravity. Low temperature may decrease the sensitivity of the test.

Answer 110

A. 35 days Citrate phosphate dextrose-adenine 1: A medium which supplies ATP and extends the shelf life of packed red cells destined for transfusion to 35 days with a higher ATP level than earlier-generation red cell preservation media.

Answer 111

D. Anti-mitochondrial

Answer 112

A. Anti-cardiolipin antibodies

Answer 113

B. 121C at 15 lbs/psi for 15 minutes Many autoclaves are used to sterilize equipment and supplies by subjecting them to high-pressure saturated steam at 121C (249F) for around 15-20 minutes depending on the size of the load and the contents.

Answer 114

A. test instrument precision

Answer 115

B. 24,700/ul

Answer 116

B. dilute with alkaline urine

Answer 117

A. Klebsiella oxytoca

Answer 118

A. Radioallergosorbent Test (RAST) RAST = detects direct and specific IgE RIST = detects serum IgE

Answer 119

C. log/exponential phase

Answer 120

C. Protein A and clumping factor The single most important test used to distinguish S.aureus from other staphylococci demonstrates production of coagulase. S.aureus produces two forms of coagulase. Bound coagulase, otherwise known as "clumping factor", can be detected by carrying out a slide coagulase test, and free coagulase can be detected using a tube coagulase test. The slide coagulase test is traditionally carried out with a drop of plasma (rabbit plasma anticoagulated with EDTA is recommended) but often are used commercial latex slide agglutination tests (in the picture drySPOT™, Oxoid). Blue latex particles are coated with porcine fibrinogen, rabbit IgG and polyclonal antibodies raised against capsular polysaccharide of S.aureus. The test is able to detect the presence of bound coagulase, Protein A (a protein found on the cell surface of about 95% of human strains of S.aureus; it has the ability to bind the Fc portion of immunoglobulin G (IgG) and capsular polysaccharide (present in certain methicillin-resistant strains of S.aureus). The capsule can mask both Protein A and the clumping factor thereby preventing agglutination. Approximately 97% of human strains of S.aureus possess both bound coagulase and extracellular staphylocoagulase. S.hyicus, S.intermedius, S.lugdunensis, S.xylosus, S.schleiferi and S.haemolyticus may give positive results in coagulase tests (or rapid latex procedures). S.aureus and S.hyicus are PYRase negative. All the other strains named above will be positive. S.hyicus and S.intermedius are rarely encountered in the clinical laboratory.

Answer 121

A. cardiac troponins Troponins are contractile proteins that regulate muscle contraction along with tropomyosin and calcium.

Answer 122

D. units of group O, Rh negative red blood cells

Answer 123

D. denaturation, annealing, extension **_Denaturation_** - this step is the first regular cycling event and consists of heating the reaction chamber to 94-98\*C for 20-30 seconds. This causes DNA melting, or denaturation, of the double-stranded DNA template by breaking the hydrogen bonds between complementary bases, yeilding 2 single-stranded DNA molecules. **_Annealing_** - the reaction temperature is lowered to 50-60\*C for 20-40 seconds, allowing annealing of the primers to each of the single-stranded DNA templates. Two different primers are typically included in the reaction mixture: one for each of the 2 single-stranded complements containing the target region. The primers are single-stranded sequences themselves, but are much shorter than the length of the target region, complementing only very short sequences at the 3' end of each strand. **_Extension_** - the temperature depends on the DNA polymerase used; the optimum activity temperature for Taq polymerase is approximately 75-80\*C, though a temperature of 72\*C is commonly used with this enzyme. In this step, the DNA polymerase synthesizes a new DNA strand complementary to the DNA template strand by adding free dNTPs from the reaction mixture.

Answer 124

C. incubate the culture tubes for 2-3 weeks longer CMV is a slow growing herpesvirus, and may require 3 weeks to grow in conventional viral culture. The urine sample is the best sample for the recovery of CMV. There are inclusion bodies in leukocytes of urine sediments. CMV produces an increase in the absolute number of suppressor cell (CD8+) lymphocytes and a decrease in helper cell (CD4+) lymphocytes.

Answer 125

A. avidity

Answer 126

B. Gaucher's disease

Answer 127

A. carcinoid tumors The 5-hydroxyindoleacetic acid (5-HIAA) urine test is used to help diagnose and monitor carcinoid tumors. It may be ordered by itself or along with a blood serotonin and/or chromogranin A level. 5-HIAA is the primary metabolite of serotonin that is excreted in urine. Concentrations of 5-HIAA may be significantly increased when a person has a carcinoid tumor that produces serotonin.

Answer 128

C. ACTH decreased, cortisol increased When the adrenal glands develop a tumor, like any other endocrine gland, they usually produce excess amounts of the hormone normally produced by these cells. if the adrenal tumor is composed of cortisol-producing cells, excess cortisol will be produced. Under these conditions, the normal pituitary will sense the excess cortisol and will stop making ACTH in an attempt to slow the adrenal down. In this manner, physicians can really distinguish whether excess cortisol is the result of a pituitary tumor or an adrenal tumor.

Answer 129

D. Multiple sclerosis Oligoclonal bands are an important indicator in the diagnosis of MS. More than 95% of all patients with MS have permanently observable oligoclonal bands.

Answer 130

A. Trichinella spiralis

Answer 131

B. Uremia (kidney disease)

Answer 132

A. benign prostatic hyperplasia

Answer 133

B. oxidase Aeromonas: TSI reaction: A/A, oxidase positive Enterobacteriaceae: oxidase negative

Answer 134

C. TCBS Thiosulfate-citrate-bile salts-sucrose agar, or TCBS agar, is a type of selective agar culture plate that is used in microbiology laboratories to isolate Vibrio spp.

Answer 135

A. C, S, F, A

Answer 136

C. Democratic Democratic - supervisor acts according to the mutual consent and discussion, or in other words he consults subordinates in the process of decision making. This is also known as participative or consultative supervision. Autocratic - the supervisor wields absolute power and wants complete obedience from his subordinates. He wants everything done strictly according to his instructions and never likes any intervention from his subordinates. Laissez-faire - also known as independent supervision; under this type of supervision, maximum freedom is allowed to the subordinates; this supervisor never interferes in the work of the subordinates.

Answer 137

B. 12 Formula: Number of units to crossmatch is equivalent to: # of units needed by the patient/(frequency of negativity of antigen #1 x frequency of negativity of antigen #2). Negativity of Jka+ is .20%, Negativity of K+ is .85%. Using the formula: 2 units/(.20 x .85) = 11.76 rounded to 12.

Answer 138

C. magnesium Preeclampsia is a pregnancy-specific disorder characterized by hypertension and excess protein excretion in the urine. It is an important cause of maternal and fetal morbidity and mortality worldwide. Magnesium sulfate (MgSO4) is the agent most commonly used for the treatment of eclampsia and prophylaxis of eclampsia in patients with severe pre-eclampsia.

Answer 139

B. DiGeorge Syndrome DiGeorge Syndrome is a primary immunodeficiency disease characterized by abnormal formation of certain tissues during fetal development. The defect may affect the thymus gland and impair production of T lymphocytes. Most people with DiGeorge syndrome have a genetic defect on chromosome 22.

Answer 140

B. SLE The kinetoplast located near the flagellum is stained, indicating the presence of anti-dsDNA antibodies in a person with SLE.

Answer 141

A. Type O, Rh negative, without C, I, and Lea antigen

Answer 142

B. Lewis Pregnant women transiently exhibit Le(a-b-) phenotype and Lewis antibodies are sometimes formed during pregnancy.

Answer 143

A. high protein intake In a regression analysis protein intake proved to be an independent factor modulating the ratio between urin-pH and renal ammonium excretion. The concomitant increase of renal net acid excretion and maximum renal acid excretion capacity in periods of high protein intake appears to be a highly effective response of the kidney to a specific food intake, leaving a large renal surplus capacity for an additional renal acid load.

Answer 144

B. Buffered Charcoal Yeast Extract (BCYE) agar BCYE agar is a selective growth medium used to culture or grown certain bacteria, particularly the gram-negative species Legionella pneumophila. It has also been used for the recovery of Acanthamoeba keratitis. The Legionellaceae are aerobic and nutritionally fastidious organisms. They require L-cysteine and iron salts for growth. Growth on BCYE agar after 3 or more days of incubation with no growth on blood agar and/or chocolate agar is one of the most useful presumptive clues that an isolate could be a species of Legionella. After 3-4 days of incubation, small white colonies of Legionella appear in BCYE agar which becomes grey in a few days. The colonies are round and convex with entire edges. The isolate may show typical ground glass (or iridescent) colony appearance.

Answer 145

B. Corticotropin Releasing Hormone (CRH)

Answer 146

C. inadequate scanning of the slide Good practice in reading AFB slides should be 100 fields.

Answer 147

D. All of the above (KLARP) Kidd, Lewis, ABO, Rh, and P antigens are enhanced by enzymes. MNS and Duffy antigens are destroyed by enzymes.

Answer 148

C. BSL III Biosafety level 3 is commonly used for research and diagnostic work involving various microbes that can be transmitted by aerosols and/or cause severe disease. These include Francisella tularensis, Mycobacterium tuberculosis, Chlamydia psittaci, Venezuelan equine encephalitis virus, Eastern equine encephalitis virus, SARS coronavirus, Coxiella burnetti, Rift Valley fever virus, Rickettsia rickettsii, several species of Brucella, chikungunya, yellow fever virus, and West Nile virus.

Answer 149

B. Multiple myeloma

Answer 150

B. Mycoplasma pneumoniae

Answer 151

C. Basophilic stippling Fine stippling = polychromatophilia Coarse stippling = lead poisoning

Answer 152

B. Oliguria Oliguria is clinically classified as an output more than 80 ml/day but less than 400 ml/day. Anuria is clinically defined as less than 50 ml of urine output per day. Polyuria is a condition usually defined as excessive or abnormally large production or passage of urine.

Answer 153

C. dilute with normal saline The saline test confirms the presence of agglutination by mixing a drop of uncoagulated blood with a (larger) drop of saline solution. The mixture is then placed on a slide with a coverslip and observed under the microscope. In the presence of agglutination, the RBCs will remain clumped: this indicates a positive test. In the presence of rouleaux formation (a physiological phenomenon associated with plasma proteins), the RBCs will spread out individually: this indicates a negative test.

Answer 154

B. valinomycin

Answer 155

A. 70 year old, Type 2 diabetic patient Hyperosmolar hyperglycemia state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. The main risk factor is a history of diabetes mellitus type 2. Older people are most commonly affected.

Answer 156

A. elution The term elution refers to removing an antibody that is attached to the surface of an RBC. This procedure is most commonly used in the identification of complicated antibodies, sometimes in the workup of transfusion reactions or hemolytic disease of the newborn, as well as in the workup of warm autoantibodies.

Answer 157

A. mannitol Mannitol salt agar is a commonly used growth medium in microbiology. It encourages the growth of a group of certain bacteria while inhibiting the growth of others. It contains high concentration (7.5-10%) of salt (NaCl), making it selective for gram positive bacteria Staphylococci (and Micrococcaceae) since this level of NaCl is inhibitory to most other bacteria. It is also a differential medium for mannitol fermenters, containing mannitol and the indicator phenol red. S. aureus produce yellow colonies with yellow zones, whereas other Staphylococci produce small pink or red colonies with no color change to the medium. If an organism can ferment mannitol, an acidic byproduct is formed that will cause the phenol red in the agar to turn yellow.

Answer 158

D. stool The rotavirus test is a stool test used to diagnose a rotavirus infection. Rotavirus affects the intestines and causes vomiting and diarrhea. This infection is especially common in young children, but it can affect adults too. A rotavirus infection causes a condition call viral gastroenteritis.

Answer 159

C. 40% First, we need to find the TIBC. TIBC = UIBC + Fe TIBC = 185 + 125 = 310 Now compute for % saturation: serum iron/TIBC x 100 % saturation = (125/310) x 100 = 40%

Answer 160

B. Karl Landsteiner

Answer 161

B. urine Schistosoma haematobium is an important digenetic trematode, and is found in Africa and the Middle East. It is a major agent of schistosomiasis; more specifically, it is associated with urinary schistosomiasis.

Answer 162

C. megaloblastic anemia Tropical sprue is a malabsorption disease commonly found in tropical regions, marked with abnormal flattening of the villi and inflammation of the lining of the small intestine. Megaloblastic anemia is a macrocytic, normochromic anemia.

Answer 163

C. Trichuris trichiura The human whipworm is a round worm that causes trichuriasis when it infects a human large intestine. It is commonly known as the whipworm, which refers to the shape of the worm; it looks like a whip with sider "handles" at the posterior end. "Football shaped egg with hyaline plugs at each end."

Answer 164

B. Mucopolysaccharidosis The Alder-Reilly anomaly is seen in the mucopolysaccharidoses. The most characteristic finding is the metachromatic granules surrounded by a clear zone seen in lymphocytes. Dense granules, resembling toxic granulation in neutrophils, are seen in all leukocytes.

Answer 165

C. Trichophyton mentagrophyte and T. rubrum T. mentagrophyte = positive T. rubrum = negative

Answer 166

B. protein error of indicators

Answer 167

D. Pre-warm Prewarm technique can be used to prevent cold-reactive alloantibodies or autoantibodies from reacting in the IAT phase. Specifically, prewarm technique prevents cold antibodies from binding complement at RT (as opposed to 37C) and subsequently being detected by anti-C3 in the IAT by polyspecific AHG serum.

Answer 168

A. Heinz bodies

Answer 169

A. sharp cut off filter

Answer 170

C. thyroid-stimulating hormone (TSH)

Answer 171

D. 4 One vial of Rh immune globulin protects against a fetomaternal hemorrhage of 15 ml of red cells or 30 ml of whole blood. Divide the volume of fetomaternal hemorrhage (45 ml) by 15 = 3, then always add 1 extra vial = 4 vials.

Answer 172

A. Lysine decarboxylase Salmonella = positive Citrobacter = negative

Answer 173

B. Mycobacterium tuberculosis Mycobacterium tuberculosis is an obligate pathogenic bacterial species in the family Mycobacteriaceae and the causative agent of tuberculosis. M. tuberculosis has an unusual waxy coating on its cell surface primarily due to the presence of mycolic acid. Cells are curved, rod-shaped and are often seen wrapped together, due to the presence of fatty acids in the cell wall that stick together. This appearance is referred to as cording, like strands of cord that make up a rope. M. tuberculosis is characterized in tissue by caseating granulomas containing Langhans giant cells, which have a "horseshoe" pattern of nuclei.

Answer 174

A. water ADH binds to receptors on cells in the collecting ducts of the kidney and promotes reabsorption of water back into the circulation. In the absence of ADH, the collecting ducts are virtually impermeable to water, and it flows out as urine.

Answer 175

D. M3 M3 - Acute Promyelocytic Leukemia (T15;17)

Answer 176

A. act as a natural anticoagulant Protein S and C are two vitamin K denpendent plasma proteins that work in concert as a natural anticoagulant system. Activated protein C is the proteolytic component of the complex and protein S serves as an activated protein C binding protein that is essential for assembly of the anticoagulant complex on cell surfaces.

Answer 177

B. Candida albicans

Answer 178

C. Triple phosphate Triple phosphate crystals form in alkaline urine and are composed of magnesium, ammonium, and phosphate. These are rectangular in shape or similar to a "coffin lid." They are sometimes associated with a bacterial urinary tract infection caused by urea splitting bacteria.

Answer 179

A. Anti-HBc HBcAb

Answer 180

C. Capnocytophaga

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B. thrombosis (micro emboli clots) Lupus anticoagulant is a misnomer, as it is actually a prothrombotic agent. Lupus anticoagulant antibodies in living systems cause an increase in inappropriate blood clotting.

Answer 182

A. 24 hours

Answer 183

A. waxy cast

Answer 184

D. 24 hours

Answer 185

A. Blastomyces dermatitidis

Answer 186

B. Valine for glutamic acid at sixth position of the beta chain

Answer 187

B. Metanephrines

Answer 188

A. Essential thrombocythemia Essential thrombocythemia is an uncommon disorder in which your body produces too many blood platelets but functionally abnormal. This condition may cause you to feel fatigued, lightheaded and to experience headaches and vision changes. It also increases your risk of blood clots.

Answer 189

D. All of the above

Answer 190

D. Porphyria In acute intermittent porphyria, the substrate porphobilinogen will accumulate in the urine. It spontaneously polymerizes to coporphobilinogen in urine giving urine a port-wine color.

Answer 191

D. A and B Schuffner's dots refers to a hematological finding that is associated with malaria, exclusively found in P. ovale and P. vivax. Plasmodium vivax induces morphologic alterations in the infected host RBCs that are visible by light microscopy in Romanowsky-stained blood smears as multiple brick-red dots. These morphologic changes, referred to as Schuffner's dots, are important in the ID of this species of malarial parasite and have been associated by electron microscopy with caveolavesicle complexes along the RBC plasmalemma.

Answer 192

A. Acute DIC

Answer 193

A. TP/(TP+FN)x100

Answer 194

A. Baby underwent phototherapy Phototherapy (light treatment) is the process of using light to eliminate bilirubin in the blood. The baby's skin and blood absorb these light waves and the bilirubin is changed into products. These products then pass through their system.

Answer 195

C. Perform Western Blot Western blot is being used as a confirmatory test for HIV.

Answer 196

C. Perform Western Blot Western blot is being used as a confirmatory test for HIV.

Answer 197

B. Benzoylecgonine

Answer 198

A. Veillonella Veillonella spp. are nonmotile, gram-negative diplococci that are the anaerobic counterpart of Neisseria. Veillonella is part of the normal flora of the mouth and gastrointestinal tract and may be found in the vagina as well. Although of limited pathogenicity, Veillonella is often mistaken for the more serious gonococcal infection. Veillonella spp. are often regarded as contaminants; they are often associated with oral infections; bite wounds; head, neck, and various soft tissue infections; and they have also been implicated as pathogens in infections of the sinuses, lungs, heart, bone, and CNS. Recent reports have also indicated their isolation in pure culture in septic arthritis and meningitis.

Answer 199

B. Tartrate-resistant acid phosphatase

Answer 200

D. Check for lipemia -Lipemia (and it's turbidity) will cause a falsely elevated hemoglobin result on many analyzers.

Answer 201

B. ovalocytes Megaloblastic anemia is an anemia (of macrocytic classification) that results from inhibition of DNA synthesis during RBC production. When DNA synthesis is impaired, the cell cycle cannot progress from the G2 growth stage to the mitosis (M) stage.

Answer 202

D. all of the above

Answer 203

A. RBC life span Lower than expected values of HBA1c can be seen in people in with shortened RBC lifespan, such as with G-6-PD deficiency, sickle-cell disease, or any other condition causing premature RBC death.

Answer 204

A. waxy cast

Answer 205

C. Jarisch-Herxheimer phenomenon A Jarisch-Herxheimer reaction is a reaction to endotoxin-like products by the death of harmful microorganisms within the body during antiboitic treatment.

Answer 206

B. Ascaris lumbricoides