SMART Flashcards
Double embedding:
Infiltrated with ________ then embedded with ______.
Celloidin; Paraffin
Flotation waterbath temp:
45 to 50 C
To remove formalin pigments:
Picric acid
To remove mercurial deposits:
Iodine
Explosive when dry:
Picric acid
Function of alum in hematoxylin:
Mordant
Primary importance of Frozen Sections:
RAPID DIAGNOSIS
Enzyme histochemistry:
Frozen section
Second best choice for routine cytologic examination after Papanicolau:
Phase contrast microscopy
NOT SUITABLE fixative for kidney structures:
Bouin’s
Cell death due to ischemia (loss of blood supply) is known as infarction, and is manifested by characteristic histologic appearance:
COAGULATION NECROSIS
bacteria responsible of Pseudomembranous colitis and diarrhea:
Clostridium difficile
Most frequently recovered Corynebacterium species from human clinical material. It is part of the normal skin microbiota:
Corynebacterium amycolatum
Primary fungal pathogen in HIV patients:
Candida albicans
parasite with double-walled, wrinkled cyst form:
Acanthamoeba castellanii
Intracellular form of blood and tissue flagellates:
Leishmanial form
Normal stool pH:
pH 7 to 8
Stool pH associated with CHO disorders:
pH 5.5 or less
Microhematocrit centrifugate for:
10,000 g for 5 minutes
Standing plasma test determine:
creamy layer (chylomicrons); turbid (VLDL)
Microanatomical fixatives should never contain ________ because it inhibits hematoxylin.
osmic acid/osmium tetroxide
Nuclear fixatives should contain ________ due to its affinity for nuclear chromatin.
glacial acetic acid
These fixatives should never contain Glacial Acetic Acid because it destroys the mitochondria and Golgi bodies:
Cytoplasmic fixatives (Flemming’s without HAc, Regaud’s, Orth’s, Helly’s and formalin with post-chroming)
Manual paraffin wax infiltration and embedding:
At least four (4) changes of wax are required at 15 minutes interval to ensure complete removal of the clearing agent from tissue. The specimen is then immersed in another fresh solution of melted paraffin for approximately 3 hours to ensure complete embedding or casting of tissue.
microtome invented by Paldwell Treffall:
Cambridge/Rocking microtome
Bond between Best carmine and glycogen:
Coulombic attraction/electrostatic bonds, hydrogen bonds
Routine H and E:
Regressive staining, it involves a differentiation step
Stains for the glomerular basement membrane:
PAS, Azocarmine stain
Postmortem clotting:
immediately after death, rubbery consistency
Antemortem thrombi:
friable, characterized by fibrin precipitation
Leadership:
DIRECTING
COMPONENTS OF FIBRIN GLUE:
cryoprecipitate (fibrinogen) and topical thrombin
Donor deferral, measles (rubeola) vaccination:
2 weeks
Donor deferral, German measles (Rubella) vaccination:
4 weeks
When stained with Sternheimer-Malbin stain:
GLITTER CELLS stain ________ as opposed to the VIOLET COLOR usually seen with NEUTROPHILS.
Glitter cell stain LIGHT BLUE
After episodes of hemoglobinuria, yellow-brown granules may be seen in renal tubular epithelial cells and casts or free-floating in the urine sediment.
To confirm that these granules are hemosiderin, the ________ is used and stains the hemosiderin granules a ________. (RTE cells with HEMOSIDERIN).
Prussian blue stain for iron; blue color
Second most prevalent protein in CSF:
Prealbumin (transthyretin)
is usually defined as a newborn’s first bowel movement.
which is formed in the intestine from fetal intestinal secretions and swallowed amniotic fluid.
It is a dark green, mucus-like material. It may be present in the amniotic fluid as a result of fetal distress.
MECONIUM
Blood should NEVER be drawn from a vein in an arm with a ____ (temporary dialysis access device) or ____ (a permanent surgical fusion of a vein and an artery).
cannula (temporary dialysis access device);
fistula (a permanent surgical fusion of a vein and an artery)
Adverse reaction of Aminoglycosides:
Nephrotoxicity and ototoxicity
neuromotor irritability accompanied by muscular twitching and eventual convulsions; generally due to low calcium levels (hypocalcemia):
TETANY
Reagent for the APT test:
1% NaOH
APT test: fetal blood
pink solution
APT test: maternal blood
yellow-brown supernatant
test for choline:
(Iodine, KI/ dark brown rhombic crystals)
Florence test
test for spermine:
(Picric acid, TCA/ yellow leafshaped crystals, needles)
Barbiero’s test
test to differentiate hemoglobin from myoglobin, ammonium sulfate will precipitate hemoglobin:
Blondheim’s test
Nanometer is also ____ micron
millimicron
Embedding medium for EM is
Plastic
Best vital stain is
neutral red
Vital stain for mitochondria is
Janus Green
Ferning:
Early pregnancy
Pap’s consists of 3 stains:
Harris hematoxylin,
OG 6
and EA
Total renal BLOOD flow is
1200 mL/min
Total renal PLASMA flow is
600 to 700 mL/min
Most potent estrogen is
Estradiol
Most important androgen in terms of potency and amount secreted is
(Marshall)
testosterone
Conn syndrome:
primary aldosteronism
male-pattern hair growth in women; most common cause is PCOS (polycystic ovary syndrome, Marshall)
Hirsutism
Primary male hypogonadism:
____ testosterone
____ LH and FSH
Decreased testosterone;
Increased LH and FSH
Secondary male hypogonadism:
____ testosterone
____ LH and FSH
Decreased testosterone;
Decreased LH and FSH
early morning before the patient has eaten or become physically active. This is a good time to draw blood specimens because the is at rest and food has not been ingested during the night.
BASAL STATE
substance than can yield a hydrogen ion or hydronium ion when dissolved in water
ACID
substance than can yield hydroxyl ions (OH-)
BASE
properties of osmotic pressure, freezing point, boiling point and vapor pressure
COLLIGATIVE PROPERTIES
t-test:
compare Accuracy, Mean
TAM
T - t test
A - Accuracy
M - Mean
f-test:
compare precision, SD
SPF
S -SD
P - Precision
F - f test
type of error:
1:2SD, 1:3SD, R:4S (ODD NUMBERS)
Random error
type of error:
2:2SD, 4:1SD, 10:x (EVEN NUMBERS)
Systematic error
Order kinetics:
reaction rate is dependent on enzyme concentration only
ZERO-ORDER KINETICS
Order kinetics:
reaction rate is directly proportional to substrate concentration
FIRST-ORDER KINETICS
thickening or hardening of the walls of arteries:
Arteriosclerosis
accumulation of lipid in the veins and arteries:
Atherosclerosis
elevated urea in blood (Turgeon: urea and creatinine):
Azotemia
deficiency of adrenocortical hormones:
Addison’s disease
aldosterone-secreting adrenal adenoma:
Conn’s syndrome
excessive production of glucocorticoids (cortisol):
Cushing’s syndrome
tumors of the adrenal medulla or sympathetic ganglia that produce and release large quantities of catecholamines:
Phaeochromocytoma
cessation of menstruation
Amenorrhea
Greek work YELLOW; irreversible scarring process by which normal liver architecture is transformed into abnormal nodular architecture:
Cirrhosis
hereditary disorder in which there is DECREASED BILIRUBIN TRANSPORT into the hepatocytes:
Gilbert’s syndrome
hereditary DEFICIENCY of the UDPG-TRANSFERASE ENZYME:
Crigler-Najjar syndrome
associated with increased plasma conjugated bilirubin, inborn error of metabolism:
Dubin-Johnson syndrome
possibly of viral origin, where there is also a block in the excretion of conjugated bilirubin but without liver pigmentation:
Rotor syndrome
is a defect of copper transport from the liver resulting in overload of copper in liver and brain:
Wilson’s disease
is an X-linked recessive disorder in which defective transport of copper from mucosal cells results in copper deficiency:
Menkes disease
chronic autoimmune thyroiditis; it is the most common cause of primary hypothyroidism:
Hashimoto’s thyroiditis
diffuse toxic goiter
Graves’ disease
chronic protein deficiency under conditions of adequate non–protein calorie intake, which leads to marked hypoalbuminemia; may result from the net loss of albumin from both the intravascular and extravascular pools
Kwashiorkor
a deficiency of calories with adequate protein status. In this condition; the serum albumin level remains normal despite considerable loss of body weight
Marasmus
cells of the testicles that produce testosterone
Leydig cells
Kidds =
Duffy =
Kidds = anti-Jka, -Jkb
Duffy = anti-Fya, -Fyb
“Kid(d)s and Duffy the Monkey (Rh) eat Lots of M&Ns”
Kidds = anti-Jka, -Jkb
Duffy = anti-Fya, -Fyb
Monkey = Rh antibodies
M&Ns = anti-M, -N, -S, -s
Lots = dosage
cell membrane marker of stem cells:
CD34
GRANULAR, DIRTY, BROWN CASTS representing hemoglobin degradation products such as methemoglobin:
ACUTE TUBULAR NECROSIS
Providing an antibody with its corresponding antigen under optimal conditions so that the antibody will attach to the antigen, thereby removing the antibody from the serum:
ADSORPTION
process whereby cells that are coated with antibody are treated in such a manner as to disrupt the bonds between the antigen and antibody:
ELUTION
simplest type of mutation
Only one nucleotide in the DNA sequence is changed
Includes substitutions, insertions, and deletions:
POINT MUTATION
gene that does not appear to produce a detectable antigen; a silent gene:
AMORPH
connection between two blood vessels, either direct or through connecting channels:
ANASTOMOSIS
ANTI-A1 LECTIN:
DOLICHOS BIFLORUS
ANTI-B LECTIN:
BANDEIRAEA SIMPLICIFOLIA
ANTI-H LECTIN:
ULEX EUROPAEUS
ANTI-M LECTIN:
IBERIS AMARA
ANTI-N LECTIN:
VICIA GRAMINEA
phenomenon whereby an antibody reacts more strongly with a red blood cell carrying a double dose (homozygous inheritance of the appropriate gene) than with a red blood cell carrying a single dose (heterozygous inheritance) of an antigen:
DOSAGE
portion of the antigen molecule that is directly involved in the interaction with the antibody; the ANTIGENIC DETERMINANT:
EPITOPE
antigenic characteristic of the red blood cell membrane that is unique to an individual or a related family of individuals and therefore is not commonly found on all cells (usually less than 1% of the population):
PRIVATE ANTIGEN
antigen characteristic of the red blood cell membrane found commonly among individuals, usually more than 98% of the population:
PUBLIC ANTIGEN
programmed cell death:
Apoptosis
small hemorrhagic spot, LARGER THAN PETECHIA, in the skin or mucous membrane, forming a rounded or irregular blue or purplish patch; also known as bruise:
Ecchymosis
fingernails are thin, flattened and concave; associated with iron deficiency anemia:
Koilonychia
thin, flat red cell with hemoglobin at periphery and increased central pallor; hypochromic cell:
Leptocyte
this presence is definitive histologic diagnosis of HODGKIN’S DISEASE
Reed-Sternberg cell
leukocytes of the myelocytic series, and sometimes all leukocytes contain coarse azurophilic mucopolysaccharide granules:
Alder-Reilly anomaly
needle-shaped or round inclusion in the cytoplasm of myeloblasts and promyelocytes; composed of condensed primary granules:
Auer rod
congenital, autosomal recessive disorder, characterized by partial albinism, photophobia and the presence of abnormally large blue granules in leukocytes:
Chediak-Higashi anomaly
autosomal dominant inherited blood cell disorder characterized by thrombocytopenia and granules containing cytoplasmic inclusions similar to Dohle bodies:
May-Hegglin anomaly
cutaneous T CELL LYMPHOMA characterized by exfoliative erythroderma, peripheral lymphadenopathy and Sezary cells present in the skin, lymph nodes and peripheral blood:
Sezary syndrome
rare disorder of fat metabolism caused by deficiency of glucocerebrosidase:
Gaucher’s disease
mutations to platelet GP IB or GP IX, defect of platelet adhesion
Bernard-Soulier syndrome
mutations to platelet GP IIb or IIIa; defect of fibrinogen-dependent platelet aggregation
Glanzmann’s thrombasthenia
protein produced by the neutrophils and stored in the secondary granules that is able bind iron:
Lactoferrin
basic pipet:
GLASS PIPET
blood samples for glucose testing and for other assays are used frequently in many health care facilities for bedside testing, or point-of-care testing (POCT):
CAPILLARY BLOOD SAMPLES
hormone produced by the hypothalamus to regulate water reabsorption in the COLLECTING DUCT:
ANTIDIURETIC HORMONE
regulates flow of blood to and within the kidneys by responding to changes in blood pressure and plasma sodium content:
RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM
BLACK, TARRY STOOL associated with gastrointestinal hemorrhage:
MELENA
stool associated with pancreatic disorder, bile-duct obstruction:
BULKY/FROTHY STOOL
stool associated with intestinal constriction:
RIBBON-LIKE STOOL
stool associated with upper GI bleeding, iron therapy, charcoal, BISMUTH (antacids):
BLACK STOOL
absence of sperm in a semen sample:
AZOOSPERMIA
low sperm count:
OLIGOSPERMIA
immature spermatozoa:
SPERMATIDS
Part of the germinal epithelium of the seminiferous tubules, give rise to spermatozoa:
SERTOLI CELLS
cells of the testicles that produce testosterone:
LEYDIG CELLS
tip of a spermatozoa head, which contains enzymes for entry into an ovum:
ACROSOMAL CAP
color-change phenomenon occurring because PROTEINS ACT AS HYDROGEN ION ACCEPTORS AT A CONSTANT PH:
PROTEIN ERROR OF INDICATORS
abrupt change in the mean of a series of results:
SHIFT
gradual change in one direction of the mean of a control substance:
TREND
step-by-step documentation of the handling and testing of legal specimens:
CHAIN OF CUSTODY
continuous link in the transmission of harmful microorganisms between a source and a susceptible host:
CHAIN OF INFECTION
institutional policy to provide customer satisfaction:
TOTAL QUALITY MANAGEMENT (TQM)
institutional program that focuses on customer satisfaction and expectations:
CONTINUOUS QUALITY IMPROVEMENT (CQI)
light scattered at an angle of less than 90 degrees, which indicates the SIZE OF A CELL:
FORWARD angle light scatter
light scattered at 90 degrees in a flow cytometer that indicates the GRANULARITY OF A CELL:
SIDE ANGLE, right angle light scatter
test that measures TOTAL IgE:
RADIOIMMUNOSORBENT TEST (RIST)
test that measures ANTIGEN-SPECIFIC IgE:
RADIOALLERGOSORBENT TEST (RAST)
RNA viral cause of German or 3-day measles:
RUBELLA
single-stranded RNA virus that cause measles:
RUBEOLA
amoeboid movement of cells such as monocytes and polymorphonuclear neutrophils to a site of inflammation in phagocytosis:
DIAPEDESIS
congenital defect of the third and fourth pharyngeal pouches that affects thymic development, leading to a T-cell deficiency. Patients are subject to recurring viral and fungal infections:
DiGeorge anomaly
dysproteinemia synonymous with gamma heavy-chain disease. This abnormality is characterized by the presence of monoclonal protein composed of the heavy-chain portion of the immunoglobulin molecule:
Franklin’s disease
An alternate term for multiple myeloma:
Kahler’s disease
molecule when coupled to a hapten, makes the hapten capable of stimulating an immune response:
CARRIER
simple chemical group that can bind to antibody once it is formed but that CANNOT stimulate antibody formation unless tied to a larger carrier molecule:
HAPTEN
single antigenic determinant. It is functionally the portion of an antigen that combines with an antibody paratope:
EPITOPE
part of the antibody molecule that makes contact with the antigenic determinant:
PARATOPE
frequency of positive results obtained in testing a population of individuals who are positive for antibody:
SENSITIVITY
proportion of negative test results obtained in the population of individuals who actually lack the antibody in question:
SPECIFICITY
antigens that are expressed in the developing fetus and in rapidly dividing tissue, such as that associated with tumors, but that are absent in normal adult tissue:
ONCOFETAL ANTIGENS
malignant tumor of EPITHELIAL TISSUE origin:
CARCINOMA
malignant tumor of CONNECTIVE TISSUE origin:
SARCOMA
PRC was attached to the ____ pursuant to Executive Order No. 565.
Executive Order No. 565-A was issued, delegating the Presidential power of control over the PRC to the DOLE Secretary.
Department of Labor and Employment
DRIVING FORCE of the bicarbonate buffer system is
CARBON DIOXIDE
time from ordering a test through analysis in the laboratory to the charting of the report:
TURNAROUND TIME (TAT)
Hazardous chemicals should be labeled with a description of their particular hazard, such as:
POISONOUS, CORROSIVE OR CARCINOGENIC
Information contained in the Material Safety Data Sheets (MSDS) includes the following:
physical and chemical characteristics, fire and explosion potential, reactivity potential, health hazards and methods for safe handling
Urinometer is placed with a ____ MOTION. The scale reading is then taken at the ____ OF THE URINE MENISCUS.
SPINNING MOTION;
BOTTOM OF THE URINE MENISCUS
Studies have shown that although everyone who eats ____ produces a urine odor, ONLY certain genetically predisposed people can smell the odor.
ASPARAGUS
CABBAGE urine odor:
METHIONINE MALABSORPTION
The ____ portion of MYOGLOBIN IS TOXIC TO RENAL TUBULES and high concentrations can cause ____
heme portion; acute renal failure
CASTS have tendency to locate ____ OF THE COVERSLIP.
NEAR THE EDGES
ETHYLENE GLYCOL (anti-freeze) poisoning:
MONOHYDRATE CAOX
coffin-lid or FEATHERY APPEARANCE (as they disintegrate):
TRIPLE PHOSPHATE
provides a method for counting UNDILUTED seminal fluid. Sperms are immobilized by heating part of the specimen prior to charging the chamber:
MAKLER COUNTING CHAMBER
provides OBJECTIVE determination of both SPERM VELOCITY and TRAJECTORY (DIRECTION OF MOTION):
COMPUTER-ASSISTED SEMEN ANALYSIS (CASA)
A maximum of ____ AMNIOTIC FLUID is collected in sterile syringes. The first 2 to 3 mL collected can be contaminated by maternal blood, tissue fluid and cells and are discarded:
30 mL amniotic fluid
diarrhea with increased RETENTION of water and solutes in the large intestine associated with MALABSORPTION AND MALDIGESTION:
OSMOTIC DIARRHEA
diarrhea with increased SECRETION of water and electrolytes into the large intestine caused by BACTERIAL ENTEROTOXINS:
SECRETORY DIARRHEA
Plasmapheresis donor, total protein at least:
6 g/dL
Packed red blood cells LEAK ____ into the plasma or additive solution of the blood component during storage. Rapid infusion of a large volume of packed red blood cells may put patient populations such as neonates and patients with cardiac, hepatic, or renal dysfunction at risk of developing hyperkalemia. The transient hyperkalemia related to massive transfusion appear to be related to the patient’s acid base balance, ionized calcium levels, and rate of infusion of the packed red blood cells
POTASSIUM
Significant Antibody titer in HDN:
HARMENING
4th edition: significant is
5th edition: significant is
6th edition: critical titer is
4th edition: significant is 32
5th edition: significant is 16 to 32
6th edition: critical titer is 16
In pancreatic adenocarcinoma, 96% of tumors with CA 19-9 levels >1,000 U/mL are considered ____ (cannot be removed completely through surgery)
UNRESECTABLE (cannot be removed completely through surgery)
individual facility COMPARE ITS RESULTS WITH THOSE OF ITS PEERS:
BENCHMARKING
average value:
MEAN
most frequently occurring value:
MODE
middle value within range:
MEDIAN
_____ systematic error - y-intercept:
CONSTANT
______ systematic error - SLOPE:
PROPORTIONAL
Fungi (dermatophyte) produces macroconidia that are large, multicellular, and club-shaped with smooth walls:
EPIDERMOPHYTON FLOCCOSUM
Reporting Mixed Lymphocyte Reaction:
either Stimulation Index (SI) or percent relative response (%RR)
are nodules found in the hearts of individuals with RHEUMATIC FEVER:
ASCHOFF BODIES
a metallic element must NOT GO through drain disposal:
MERCURY
can be recycled by distillation or by drain disposal, can be detoxified by commercial product, or can be disposed of by licensed waste hauler:
FORMALDEHYDE WASTES
represent the second X chromosome in females and may be seen in 2 to 3% of neutrophils in FEMALES. The number of Barr bodies in a cell is one less than the number of X chromosomes present in a cell:
BARR (sex chromatin) BODY or DRUMSTICK
rough endoplasmic reticulum containing RNA and may represent localized failure of the cytoplasm to mature. They are found in infections, poisoning, burns and following chemotherapy:
DOHLE BODIES
granulocytes usually contain several very large, reddish-purple or greenish-gray staining granules in the cytoplasm; in the monocytes and lymphocytes they stain bluish purple and may be present singly, or there may be several in one cell. These granules represent ABNORMAL LYSOSOMES:
CHEDIAK-HIGASHI
Sickling of the RBCs is maximal at ___ and _____ as the temperature lowers.
37C; decreases
Platelets on top of the red cell should not be confused with RBC inclusion body. There is generally a ______ surrounding the platelet when it is positioned on top of the RBC.
non-staining halo
ESR: invalid results
bubbles and fibrin clots
measure HUMIDITY:
HYGROMETERS
ALCOHOL FIXATIVE CONCENTRATIONS; _____ because less concentrated solutions will produce lysis of cells.
70% to 100%
Ethanol and methanol, including Carnoy’s solution are commonly used fixatives for _____.
nucleic acids
physical agent similar in mechanism to vacuum oven (heat) and agitation to increase movement of molecules and accelerate fixation. It is also used to accelerate staining, decalcification, immunohistochemistry and electron microscopy
MICROWAVE
LAST ALCOHOL BATH FOR DEHYDRATION SHOULD BE _____. A blue discoloration of _____ crystals will indicate FULL SATURATION WITH WATER. Alcohol is then discarded and changed with fresh solution.
PURE ETHANOL; COPPER SULFATE
Skeletal muscle contains bundles of very long, multinucleated cells with cross-striations. Their contraction is quick, forceful, and usually under voluntary control:
STRIATED, VOLUNTARY
Cardiac muscle also has cross-striations and is composed of elongated, often branched cells bound to one another at structures called intercalated discs that are unique to cardiac muscle. Contraction is involuntary, vigorous, and rhythmic:
STRIATED, INVOLUNTARY
Smooth muscle consists of collections of fusiform cells that lack striations and have slow, involuntary contractions:
NONSTRIATED, INVOLUNTARY
cell death produced by the Tubercle Bacillus. In gross state, the necrotic tissue has the appearance of soft, friable CHEESE:
CASEOUS NECROSIS
Three (3) major changes that are observed in the NUCLEUS: _____, _______ (segmentation and fragmentation) and _____ (dissolution of the nucleus).
PYKNOSIS,
KARYORRHEXIS (segmentation and fragmentation),
KARYOLYSIS (dissolution of the nucleus)
Four (4) phases or stages of CELL DEGENERATION:
CLOUDY SWELLING,
FATTY DEGENERATION,
CELL DEATH OR NECROSIS
and CALCIFICATION.
BM aspiration is performed by a physician and may be obtained by:
____ biopsy: most frequently performed method
____ biopsy
____ (entering through the skin) ____ (small object used to remove circular section of tissue) biopsy (core of bone with accompanying marrow is obtained)
Needle biopsy;
Surgical biopsy;
Percutaneous TREPHINE biopsy
Antibody enhanced by ACIDIFYING THE PATIENT SERUM:
anti-M
Most common cause of transfusion reactions:
CLERICAL ERRORS
Donor unit SEAL HAS BEEN BROKEN:
DISCARD THE UNIT
Noticeable clots in RBC unit: DO NOT ISSUE THE UNIT, indication of
contamination or bacterial growth
FIRST STEP in laboratory investigation of transfusion reaction:
CHECK FOR CLERICAL ERRORS
SAGM, ADSOL shelf life:
42 days
________ or red blood cells may be performed up to 3 days after the red cell expire
REJUVENATION
Preparation of leukopoor RBCs:
filtering, centrifugation and washing
longest expiration date: RBCs
FROZEN RBCs
Component of choice for vWD:
CRYOPRECIPITATE
Transfusion of BUFFY COAT IS BEST INDICATED for:
NEWBORNS with severe infections
Test performed on blood that will be transfused to an acidotic or hypoxic infant:
HEMOGLOBIN S
CD marker responsible for E-rosette formation between T cells and sheep RBCs:
CD2
Joining (J) chain:
IgM and secretory IgA
Ig that helps initiate the classical complement pathway:
IgM and IgG
Primary immune response:
IgM
Highest titer in secondary response:
IgG
Immunoglobulin crosslinks mast cells to release histamine:
IgE
Substance detected by RPR and VDRL test:
REAGIN
Test for HIV infection in infants who are born to HIV-positive mothers:
PCR
Best indicator of early acute HBV infection:
HBsAg
First antibody detected in serum after infection with HBV:
anti-HBc
Blood products are tested for which virus before being transfused to newborns:
CMV
Anti-smooth muscle (ASMA) antibodies:
chronic active hepatitis
Nuclear matrix protein (NMP-22):
urinary bladder cancer
Last stage in the erythrocytic series capable of mitosis:
POLYCHROMATOPHILIC NORMOBLAST
Last nucleated stage in the erythrocytic series:
ORTHOCHROMATOPHILIC NORMOBLAST
Appearance of primary/nonspecific granules:
PROMYELOCYTE
Appearance of secondary/specific granules:
MYELOCYTE
Last stage in the granulocytic series capable of mitosis:
MYELOCYTE
Youngest cell in the granulocytic series to NORMALLY appear in peripheral blood:
BAND
Preferable site for BM aspiration and biopsy in adult:
ILIAC CREST
Miller disc is an ocular device to facilitate counting of:
RETICULOCYTES
Organ that removes erythrocyte inclusions without destroying the cell:
SPLEEN
Megaloblastic anemia:
MACROCYTIC, NORMOCHROMIC
Anemia in sickle cell disease:
NORMOCYTIC, NORMOCHROMIC
Iron deficiency anemia, thalassemia:
MICROCYTIC, HYPOCHROMIC
AUTOSPLENECTOMY occurs in
SICKLE CELL ANEMIA
Anti-P, DONATH-LANDSTEINER ANTIBODY:
PCH
Major leukocyte in aplastic anemia:
LYMPHOCYTES
cells in G6PD deficiency
BITE CELLS
Microangiopathic hemolytic anemia:
schistocytes and nucleated RBCs
ANTIBIOTIC implicated in aplastic anemia:
CHLORAMPHENICOL
Type of anemia in acute leukemia:
NORMOCYTIC, NORMOCHROMIC
Hodgkin’s disease:
REED-STERNBERG CELLS
Myelofibrosis:
TEARDROP RBCs
DIC is most often associated with M3:
acute promyelocytic leukemia
Peripheral smear of patient with MULTIPLE MYELOMA:
ROULEAUX
Franklin’s disease:
GAMMA HEAVY CHAIN DISEASE
TRAP(+):
Hairy cell leukemia
CD ____: Common ALL (CALLA)
CD 10
PRIMARY INHIBITOR OF FIBRINOLYTIC SYSTEM:
ALPHA2-ANTIPLASMIN
PT and APTT result in patient with polycythemia:
BOTH PROLONGED
ASPIRIN inhibits
CYCLOOXYGENASE
Primary importance of FROZEN SECTIONS:
RAPID DIAGNOSIS
Lupus anticoagulant is directed against:
PHOSPHOLIPID
3Fs:
FATS/FORMALIN/FROZEN SECTIONS
Carbohydrate fixation:
ALCOHOLIC FIXATIVES
Protein fixation:
NEUTRAL BUFFERED FORMALDEHYDE OR FORMALDEHYDE VAPOR
Glycogen fixation: ____ such as Rossman’s fluid or cold absolute alcohol
ALCOHOL-BASED
MERCURIC CHLORIDE: fixative of choice for
TISSUE PHOTOGRAPHY
Zenker’s fluid:
LIVER, SPLEEN, CONNECTIVE TISSUE FIBERS and NUCLEI
Zenker’s-formol (Helly’s):
PITUITARY GLAND, BM, BLOOD-CONTAINING ORGANS SUCH AS SPLEEN AND LIVER
Heidenhain’s susa solution:
TUMOR BIOPSIES ESPECIALLY SKIN
Regaud’s (Moller’s/Muller’s) fluid:
CHROMATIN, MITOTIC FIGURES, GOLGI BODIES, RBC and colloid-containing tissues
Orth’s fluid: study of early degenerative process and tissue necrosis, demonstrates ____ and other bacteria
rickettsia
LEAD FIXATIVES:
ACID MUCOPOLYSACCHARIDES
fixation of embryos and pituitary biopsies:
BOUIN’S
Bouin’s is NOT SUITABLE FOR FIXING ____
KIDNEY structures, lipid and mucus
Glacial acetic acid solidifies at
17C
Carnoy’s fluid:
CHROMOSOMES, LYMPH GLAND AND URGENT BIOPSIES
Newcomer’s fluid:
fixing of mucopolysaccharides and nuclear proteins
most common and fastest decalcifying agent
NITRIC ACID
decalcifies and softens tissues at the same time
PERENYI’S FLUID
most ideal, most sensitive method for determining the extent of decalcification
X-ray or radiological method
Embedding medium for electron microscopy:
EPON (PLASTIC MEDIUM)
Manual H and E staining:
REGRESSIVE STAINING
Flotation water bath: ____, approximately 6-10C lower than the mp of wax
45 to 50C
ORCEIN: vegetable dye extracted from
LICHENS
probably the oldest of all stains
IODINE
Stain demonstrating MITOCHONDRIA
JANUS GREEN
Stain for the basement membrane:
PAS, AZOCARMINE
Stain for Helicobacter pylori:
TOLUIDINE BLUE, CRESYL VIOLET ACETATE
Mountant refractive index should be as close as possible to that of the glass slide which is
1.518
POLYCLONAL ANTIBODIES: most frequently used animal is the ____ followed by goat, pig, sheep, horse, guinea pig and others
RABBIT
MONOCLONAL ANTIBODIES used animal:
MICE
In renal tubular acidosis, the pH of urine is:
CONSISTENTLY ALKALINE
Daily loss of protein in urine, normally does not exceed:
150 mg
Renal threshold for glucose is:
160 to 180 mg/dL
Hemoglobin differentiated from myoglobin:
ammonium sulfate (BLONDHEIM’S TEST)
Sternheimer-Malbin stain:
CRYSTAL VIOLET AND SAFRANIN
Pseudocasts: formed by
amorphous urates
Moderate hematuria and RBC casts:
ACUTE GLOMERULOPNEPHRITIS
Pyuria with bacterial and WBC casts:
PYELONEPHRITIS
Crystals appears in urine as long, thin hexagonal plate, and is linked to ingestion of large amounts of benzoic acid:
HIPPURIC ACID
Oval fat bodies:
lipid-containing RTE cells
GREATEST PROTEINURIA: (Heavy Proteinuria >4 g/day)
NEPHROTIC SYNDROME
Whewellite and weddellite kidney stones:
CALCIUM OXALATE
Struvite:
TRIPLE PHOSPHATE/magnesium ammonium phosphate
Apatite:
CALCIUM PHOSPHATE
Limulus lysate test:
Gram negative bacterial endotoxin
Amoeba in CSF: characteristic pseudopod mobility in
WET PREP ON PRE-WARMED SLIDE
GOUT:
uric acid or monosodium urate
PSEUDOGOUT:
calcium pyrophosphate
BEST TEST for determining the status of the fetoplacental unit:
SERUM FREE ESTRIOL
SPERM with SMALL OR ABSENT HEADPIECE:
acrosomal deficiency
Most common cause of male infertility:
VARICOCELE
Stain to determine SEPRM VIABILITY:
EOSIN
Stain of choice for SPERM MORPHOLOGY:
Pap’s stain
Serum GASTRIN levels would be greatest in:
ZOLLINGER-ELLISON SYNDROME
Blood should NEVER be drawn from a vein in an arm with a ____ (temporary dialysis access device) or _____ (a permanent surgical fusion of a vein and an artery).
CANNULA (temporary dialysis access device); FISTULA (a permanent surgical fusion of a vein and an artery)
Glassware CLEANING SOLUTION:
ACID DICHROMATE
______ is used in AAS
HOLLOW CATHODE LAMP
Gaussian (normal) distribution:
Mean = median = mode
Material with physical and chemical properties closely resembling the test specimen and containing preanalyzed concentrations of the substances being measured:
CONTROL
Material of known composition available in a highly purified form:
STANDARD
Measuring potassium, antibiotic incorporated into the membrane:
VALINOMYCIN
Flame color
Sodium:
Lithium:
Potassium:
Rubidium:
Magnesium:
Sodium: YELLOW FLAME
Lithium produces a red flame
Potassium a violet flame
Rubidium a red flame
Magnesium a blue flame
Reliable index of intestinal carbohydrate absorption:
D-XYLOSE
Condensation of glucose with aromatic amine in hot glacial acetic acid solution to produce a green-colored product:
O-TOLUIDINE
REFERENCE METHOD for glucose:
HEXOKINASE
Split in the albumin band:
BISALBUMINEMIA
Compound normally found in urine that may be used to assess the completeness of a 24-hour urine collection:
CREATININE
Myocardial infarction: ___ then ___ then ___
CK then AST then LD
Specimen of choice for analysis of acid-base disturbances:
ARTERIAL BLOOD
Anticoagulant of choice for blood gas analysis:
HEPARIN
Symptom of HYPOCALCEMIA:
TETANY
Calcium and phosphate metabolism is regulated by the:
PARATHYROID
In the blood, bicarbonate leaves the RBCs and enters the plasma through an exchange mechanism with:
CHLORIDE
Major mineralocorticoid:
ALDOSTERONE
Adrenal medulla secretes this hormone in the greatest quantity:
EPINEPHRINE
Hollander insulin test is used to confirm:
VAGOTOMY
Most potent estrogen:
ESTRADIOL
Assay to monitor the fetoplacental unit:
ESTRIOL
Hormone associated with galactorrhea, pituitary adenoma, and amenorrhea:
PROLACTIN
Zollinger-Ellison syndrome is characterized by elevation of:
GASTRIN
Conn’s disease: _____ caused by adrenal adenoma, carcinoma or hyperplasia
PRIMARY HYPERALDOSTERONISM
Increased 5-HIAA: ________, carcinoid tumor composed of argentaffin cells. Carcinoid tumors are usually found in the intestine or lung.
ARGENTAFFINOMA
Thyroid hormones are derived from the amino acid:
TYROSINE
Pharmacological parameters that determine serum drug concentration:
liberation, absorption, distribution, metabolism and excretion (LADME)
Route of drug administration associated with 100% bioavailability:
INTRAVENOUS
TRINDER REACTION:
SALICYLATE
Acetaminophen (paracetamol) is particularly toxic to the
LIVER
Increased trough levels of AMINOGLYCOSIDES in the serum are often associated with toxic effects to the _____
KIDNEY
Aminoglycoside: ______ (toxic to ______) and _____ (damage _____)
NEPHROTOXIC, KIDNEYS; OTOTOXIC, EARS
Specimen appropriate for determining exposure to lead:
WHOLE BLOOD
HEROIN is synthesized from
MORPHINE
is the principal active component of MARIJUANA
TETRAHYDROCANNABINOL (THC)
ODOR OF BITTER ALMONDS:
CYANIDE POISONING
Garlic on breath, metallic taste on mouth. ARSENIC HAS HIGH AFFINITY TO _____. Analysis of urine, hair, and nails, using ion emission spectroscopy, is important for the diagnosis of chronic ARSENIC poisoning (Henry).
KERATIN
Total renal BLOOD flow:
1,200 mL/min
Total renal PLASMA flow:
600 to 700 mL/min
Glomerulus serves as nonselective filter (SIEVE) of plasma substances with MW of less than
70,000 daltons
Serum osmolarity:
275 to 300 mOsm
Urine osmolarity range:
50 and 1,400 mOsm
Normal person excretes approximately _______ in the form of titratable acid (H+) or ammonium ions (NH4+)
70 mEq/day of acid
Urine volume range ______ in 24 hours
600 to 2,000 mL
Urine volume average _____ in 24 hours
1,200 to 1,500 mL
Normal random urine pH:
pH 4.5 to 8
First morning urine pH:
5 to 6
1 g/dL protein, raise urine specific gravity by refractometer or urinometer by
0.003
1 g/dL glucose, raise urine specific gravity by refractometer or urinometer by
0.004
Calibration of refractometer using distilled water:
1.000
Calibration of refractometer using 5% NaCl:
1.022 ± 0.001
Urine protein:
less than 10 mg/dL or 100 mg/24 hours (Henry less than 150mg/24 hours)
Significant AER:
20 to 200 ug/min or 30 to 300 mg albumin/24 hours
Renal threshold for glucose is
160 to 180 mg/dL
Ketones:__ BHA, ___ AAA and___ Acetone
78% BHA
20% AAA
2% Acetone
Concentration of myoglobin must be at least _____ before a red pigmentation can be visualized
25 mg/dL
Ehrlich’s units (EU) are ____ to mg/dL
EQUAL
Normal values for the Addis count: ______ RBCs, ______ WBCs and epithelial cells and _______ hyaline casts in a 12-hour urine
0 to 500,000 RBCs, 0 to 1,800,000 WBCs, 0 to 5,000 hyaline casts
Centrifugation for urine microscopic exam:
400 RCF for 5 minutes
Volume of sediment, glass slide method 20 uL or 0.02 mL covered by _____ coverslip
22 x 22 mm
_____ RTE cells/hpf indicates tubular injury and specimens should be referred for cytologic urine testing
More than 2
Approximately ____ of CSF is produced every hour in the choroid plexuses and reabsorbed by the arachnoid villi
20 mL
CSF
Total volume in adult:
newer edition Strasinger 90 to 150 mL
(old edition 140 to 170 mL)
CSF
Total volume in neonate:
10 to 60 mL
CSF
Normal adult CSF: WBCs/uL
0 to 5 WBCs/uL
CSF
Neonates: WBCs/uL
0 to 30 WBCs/uL
Reactive lymphocytes in CSF
viral infections
Moderately elevated WBC count (less than 50 WBCs/uL) with increased normal and reactive lymphocytes and plasma cells may be indicative of:
MS or other degenerating neurologic disorders
Increased eosinophils in CSF:
parasitic infections, fungal infections primarily COCCIDIOIDES IMMITIS
CSF glucose is approximately ____ that of plasma glucose
60 to 70 percent
Normal CSF protein:
15 to 45 mg/dL
Normal concentration of glutamine in CSF:
8 to 18 mg/dL
Liquefaction within
30 to 60 minutes
Seminal fluid Volume
2 to 5 mL
Seminal fluid pH
7.2 to 8
Sperm morphology: should be evaluated
at least 200 sperms
Sperm viability test:
Modified Bloom’s (eosin-nigrosin)
Sperm Motility is evaluate in approximately
20 high-power fields
Sperm concentration:
newer edition Strasinger >20 M to 250 M per mL (old edition: 20 M to 160 M per mL)
Sperm count
≥ 40 M per ejaculate*
Most common dilution is ___ prepared using a MECHANICAL (positive-displacement) rather than a Thoma pipette
1:20
Minimum motility of 50% with a rating of 2.0 after 1 hour is considered
normal
Fructose per ejaculate
≥ 13 umol
Specimens for fructose should be tested within _____ to prevent fructolysis
2 hours or FROZEN
RAPE, presence of sperm:
- Enhancing specimen with ____ and examining under PHASE MICROSCOPY
- ACP
- Seminal glycoprotein p30 (prostatic specific antigen [PSA]), which is present even in the absence of sperm
- ABO, DNA
XYLENE
Motile sperm can be detected for up to ___ after intercourse, whereas nonmotile sperm can persist for ___. As the sperm die off, only the heads remain and may be present for 7 days after intercourse.
24 hours;
3 days
Synovial Fluid Volume
less than 3.5 mL
Synovial Fluid Normal:
clear and pale yellow
Synovial Fluid able to form
4 to 6 cm string
Synovial Fluid RBC/uL
Less than 2,000 RBCs/uL
Synovial Fluid WBC/uL
Less than 200 WBCs/uL
Synovial Fluid Glucose less than ____ lower than the blood glucose
10 mg/dL
SEROUS FLUID: TRANSUDATES AND EXUDATES
Most reliable differentiation:
Fluid-to-blood ratios for protein and LD
SEROUS FLUID: TRANSUDATES AND EXUDATES
WBC counts greater than _____ and RBC counts greater than _____ are indicative of an exudate
1,000/uL; 100,000/uL
Pleural fluid cholesterol greater than 60 mg/dL or a pleural fluid to serum cholesterol ratio greater than 0.3 provides a reliable information that the fluid is an ____
exudate
Fluid to serum total bilirubin ratio of 0.6 or more indicates the presence of an ____
exudate
Pleural fluid pH lower than__ may indicate the need for chest-tube drainage, in addition to antibiotics in cases of pneumonia. The finding of pH as low as 6 indicates esophageal rupture that is allowing the influx of gastric fluid
7.3
RBC counts GREATER THAN 100,000/uL are indicative of
BLUNT TRAUMA INJURIES
Normal WBC counts are less than 500 cells/uL and the count increases with
bacterial peritonitis and cirrhosis
CA 125 antigen, source is from
OVARIES, FALLOPIAN TUBES or ENDOMETRIUM
Large intestine is capable of absorbing approximately ____ of water
3,000 mL
Most representative, for fecal fats; ___-day stool collection
3
Muscle fibers: slide is examined for 5 minutes. Only ______ fibers are counted, and the presence of more than 10 is reported as increased
undigested
Bleeding in excess of _______ of stool is considered pathologically significant
2.5 mL/150 gram
Normal stool pH is between
7 and 8
pH below 5.5 in cases of
CARBOHYDRATE DISORDERS
SCREENING PROCEDURE that is helpful in the diagnosis of many diseases, it is one indicator of the body’s ability to fight disease, it is used to MONITOR the effects of drug and radiation therapy, and it may be employed as an INDICATOR OF PATIENT’S PROGRESS in certain diseased states such as infection or anemia.
Complete Blood Count
Hematocrit:
amount of plasma that still remains in RBC portion after the microhematocrit has been spun. Increased in macrocytic anemias, spherocytosis, thalassemia, hypochromic anemia and sickle cell anemia:
TRAPPED PLASMA
Hematocrit:
When comparing spun hematocrit results obtained on an electronic cell counter, the spun hematocrit results vary from ___ HIGHER because of this trapped plasma (unless cell counter has been calibrated).
1 to 3% HIGHER
Hematocrit:
Anticoagulated blood should be centrifuged within____ of collection when the blood is stored at room temperature.
6 hours
Hematocrit:
Overanticoagulation: FALSELY ___ due to shrinkage of cells
FALSELY LOW
Hematocrit:
______ denote poor technique but do not affect the results
Air bubbles
Hematocrit:
Incomplete sealing of the microhematocrit tubes: FALSELY ___
FALSELY LOW
Hematocrit:
Inadequate centrifugation of the microhematocrit tubes or allowing the tubes to stand longer than several minutes after centrifugation: FALSELY ___
FALSELY ELEVATED
Hematocrit may be expressed in either of two ways (1) as percentage, e.g., 42% or (2) as a decimal point, e.g., 0.42.
WBC count:
Count above 11 x 10 9th/L is termed
LEUKOCYTOSIS
WBC count:
Mix the Thoma pipet for approximately 3 minutes (Brown) to ensure hemolysis and adequate mixing [Rodak 10 minutes] PLEASE FOLLOW RODAK, 10 MINUTES.
WBC count:
Manual counts, no more than 10-cell variation between the four squares
Platelet count:
Prolonged BT and poor clot retraction are found when there is
marked thrombocytopenia
Platelet count:
EDTA: decreased platelet clumping but increased MPV
Platelet count:
If concentration of EDTA exceeds 2mg/mL of whole blood, platelets may ______, causing invalidly higher count
SWELL AND THEN FRAGMENT
Platelet count:
Using Rees-Ecker diluting fluid, the platelet count must be completed within 30 minutes of diluting in order to ensure against platelet _________
DISINTEGRATION
Platelet count:
1% ammonium oxalate, the dilution is stable for ____
8 hours
ESR:
Macrocytes tend to settle ___ rapidly than microcytes
more rapidly
ESR:
Anisocytosis and poikilocytosis: falsely ____ ESR
falsely lower
ESR:
Agglutination: more rapid sedimentation rate
ESR:
In severe anemia: ESR IS MARKEDLY INCREASED
The ESR of patients with severe anemia is of little diagnostic value, because it will be falsely elevated.
Sugar water test:
Citrated whole blood
Sugar water test:
In anemia, the hemolysis may be slightly increased in PNH negative specimens
Sugar water test:
Use of defibrinated blood may cause positive results due to the hemolysis of traumatized RBCs
Sugar water test:
Test should be performed WITHIN 2 HOURS of obtaining the specimen
Sucrose hemolysis test:
Citrated whole blood
Sucrose hemolysis test:
Increased hemolysis (<10%) may be found in leukemia or myelosclerosis
Sucrose hemolysis test:
PNH: 10% to 80% hemolysis
Acid serum test:
Whole blood defibrinated
Acid serum test:
When patient has received blood transfusions, less lysis occurs because of the presence of normal transfused red blood cells
Thyroxine conversion factor (µg/dL to nmol/L) 12.9
X-axis: HORIZONTAL, ABSCISSA, INDEPENDENT VARIABLES
Y-axis: VERTICAL, ORDINATE, DEPENDENT VARIABLES
UREA: Colorimetric: diacetyl [ inexpensive, lacks specificity]
UREA: Enzymatic: NH3 formation [greater specificity, more expensive]
CREATININE: Colorimetric: end point [simple, nonspecific]
CREATININE: Colorimetric: kinetic [rapid, increased specificity]
CREATININE: Enzymatic [measure ammonia colorimetrically or with ion-selective electrode]
URIC ACID: Colorimetric [problems with turbidity, several common drugs interfere]
URIC ACID: Enzymatic: UV [need special instrumentation and optical cells]
URIC ACID: Enzymatic: H2O2 [interference by reducing substances]
Constituents of a number of common foods, including BANANAS, VANILLA, TEA AND COFFEE, may react in the test for HMMA. HMMA is also VMA. 4-Hydroxy-3-Methoxymandelic acid (HMMA)
Laboratory personnel should be aware of the MECHANICAL HAZARDS of equipment such as CENTRIFUGES, AUTOCLAVES, and HOMOGENIZERS.
Third Taenia: Taenia asiatica or the Taiwan Taenia
Fungal elements fluoresce green with acridine orange
Reporting of normal urine crystals: reported as rare, few, moderate, or many per hpf
Abnormal crystals may be averaged and reported per lpf
Reagent for APT test: 1% NaOH
Infective stage of Leishmania to man: PROMASTIGOTE
Infective stage of Trypanosoma to man: TRYPOMASTIGOTE
Infective stage of Plasmodia to man: SPOROZOITES
Eosinophilic meningoencephalitis: ANGIOSTRONGYLUS CANTONENSIS
When an accident involving electrical shock occurs, the ELECTRICAL SOURCE MUST BE REMOVED IMMEDIATELY.
URINARY MEATUS: external urinary opening
POLYURIA: greater than 2.5 L/day in adults
OLIGURIA: less than 400 mL/day in adults
Yellow-orange specimen caused by the administration of phenazopyridine (brand name Pyridium) or azo-gantrisin compounds to people who have urinary tract infections [drug for UTI: orange and viscous urine]
CLINITEST tablets contain copper sulfate, sodium carbonate, sodium citrate, and sodium hydroxide
ACETEST provides sodium nitroprusside, glycine, disodium phosphate, and lactose in tablet form. The addition of lactose gives better color differentiation. Acetest tablets are hygroscopic; if the specimen is not completely absorbed within 30 seconds, a new tablet should be used.
Bence Jones protein coagulates at temperatures between 40°C and 60°C and dissolves when the temperature reaches 100°C.
Automated reagent strip readers: REFLECTANCE PHOTOMETRY
Casts have a tendency to locate NEAR THE EDGES OF THE COVER SLIP
Squamous epithelial cells: Rare, few, moderate, or many per LPF
Transitional epithelial cells: Rare, few, moderate, or many per HPF
RTE CELLS REPORTING: AVERAGE NUMBER PER 10 HPFS
MUCOPOLYSACCHARIDES: Acid-albumin and the CTAB tests (+) thick, white turbidity
MUCOPOLYSACCHARIDES: Metachromatic staining spot test: BLUE SPOT
Very slight amount of OXYHEMOGLOBIN: PINK CSF
Conversion of oxyhemoglobin to unconjugated bilirubin: YELLOW CSF
Heavy hemolysis: ORANGE CSF
Red or brown seminal fluid: BLOOD
Normal appearance of gastric fluid: PALE GRAY with mucus
Amniotic fluid OD 450: When BILIRUBIN is present, a rise in OD is seen at 450 nm because this is the wavelength of maximum bilirubin absorption.
Rare: 0–10 bacteria/hpf
Few: 10–50 bacteria/hpf
Moderate: 50–200 bacteria/hpf
Many: >200 bacteria/hpf
First layer of spun hematocrit: FATTY LAYER
Second layer of spun hematocrit: PLASMA
Third layer of spun hematocrit: BUFFY COAT
Bottom layer of spun hematocrit: PACKED CELLS
Patients with CML negative for the Philadelphia chromosome: POOR PROGNOSIS
LEUKOCYTOSIS >11 x 10 9th/L
Forward light scatter: CELL SIZE
Side light scatter: CELL GRANULARITY
KERATOCYTES: helmet cells/with horn-like projections
ANTI-dsDNA: most specific antibody for SLE
Anti-smooth muscle antibody (ASMA): CHRONIC ACTIVE HEPATITIS
Polymerase chain reaction: MOLECULAR
Restriction fragment length polymorphism: MOLECULAR
Enhanced by acidifying patient serum: anti-M
Wiener and coworkers gave a name to one such agglutinin, calling its antigen I for “individuality.” The ANTIBODY REACTED WITH MOST BLOOD SPECIMENS tested.
For patients with history of FEBRILE NONHEMOLYTIC TRANSF REACTION: LEUKOPOOR RBCs
Irradiation of blood components: CESIUM
CORDOCENTESIS, or PERCUTANEOUS UMBILICAL BLOOD SAMPLING (PUBS), results in a fetal blood specimen that can be used for rapid karyotyping or molecular studies.
Nuclear matrix protein (NMP-22): URINARY BLADDER CANCER
CARD PREGNANCY/POSITIVE: Two separate black or gray bands, one at T and the other at C, are visible in the results window, indicating that the specimen contains detectable levels of hCG. Although the intensity of the test band may vary with different specimens, the appearance of two distinct bands should be interpreted as a positive result.
CARD PREGNANCY/NEGATIVE: If no band appears at T and a black or gray band is visible at the C position, the test can be considered negative, indicating that a detectable level of hCG is not present.
CARD PREGNANCY/INVALID: If no band appears at C or incomplete or beaded bands appear at the T or C position, the test is invalid. The test should be repeated using another Card Pregnancy Test device.
CARD PREGNANCY: If the test band appears VERY FAINT, it is recommended that a new sample be collected 48 hours later and tested again using another Card Pregnancy Test device.
The standard screening method for HIV antibody has been the ELISA, and the standard confirmatory test is the Western blot.
Aside from Western blot, other confirmatory tests, including indirect immunofluorescence assay (IFA), radioimmunoprecipitation assay (RIPA), line immunoassays, and rapid confirmatory tests, have also been developed.
HBs ag: active infection
HBe ag: active hepatitis B with HIGH DEGREE OF INFECTIVITY
IgM anti-HBc: current or recent acute hepatitis B
Total anti-HBc: current or past hepatitis B
Anti-HBe: recovery from hepatitis B
Anti-HBs: immunity to hepatitis B
HBV DNA: acute, atypical, or occult hepatitis B; viral load may be used to monitor effectiveness of therapy
ITIS: inflammation
Length: METER
Mass: KILOGRAM
Time: SECONDS
Quantity of mass: MOLE
Electric current: AMPERE
Thermodynamic temperature: KELVIN
Luminous intensity: CANDELA
Main cause of TREND is DETERIORATION OF REAGENTS
Main cause of SHIFT is IMPROPER CALIBRATION OF THE INSTRUMENT
POCT: near-patient testing, decentralized testing, bedside testing and alternate-site testing
POCT: usually by nonlaboratorian personnel (nurses, respiratory therapists, etc)
Absorbance (A) = abc = 2-log%T
The bacteriological examination of water consists of (1) total plate counts (2) detecting the presence or absence of coliforms and the estimation of MPN (MOST PROBABLE NUMBER)
Water analysis, presumptive test: FORMATION OF GAS IN THE LACTOSE BROTH
Water analysis, confirmed test: FORMATION OF GAS IN BGBL BROTH or TYPICAL COLIFORM COLONIES ON EMB/ENDO AGAR
Water analysis, completed test: FORMATION OF ACID AND GAS IN THE LACTOSE BROTH and the DEMONSTRATION OF GRAM NEGATIVE NONSPOREFORMING BACILLI
Herpesviruses: cardinal feature of the group is LATENCY
Reoviruses: derivation of the word: R(respiratory), E(enteric), O(orphan)
ASCHOFF BODIES: rheumatic fever
CREOLA BODIES: cluster of columnar cells, bronchial asthma
ELEMENTARY BODIES: infectious particles of Chlamydia
SCLEROTIC BODIES: dark brown-black organisms, chromoblastomycosis
ASTEROID BODIES: concentric radiating eosinophilic material (ag-ab reaction), sporotrichosis
NEGRI BODIES: rabies
GUARNIERI BODIES: poxvirus
OWL’S EYE INCLUSION BODIES: cytomegalovirus
PSAMMOMA BODIES: elements with concentric striations of collagen-like materials, benign conditions, ovarian or thyroid carcinoma
KOPLIK’S SPOTS: MEASLES
Hand, foot and mouth disease: COXSACKIEVIRUS
In CYSTIC FIBROSIS of the pancreas, the increase in NEUTRAL FATS confer the greasy “BUTTER-STOOL” appearance.
PROGRESSIVE CHANGES:
Hypertrophy - increase in size of an organ due to an increase in size of individual cells
PROGRESSIVE CHANGES:
Hyperplasia - increase in size of an organ due to increase in number of cells
RETROGRESSIVE CHANGES:
Hypoplasia - failure of an organ to reach mature size
RETROGRESSIVE CHANGES:
Aplasia - organ is represented only by mass of fatty or fibrous nodule
RETROGRESSIVE CHANGES:
Agenesia - complete non-appearance of an organ
RETROGRESSIVE CHANGES:
Atresia - failure of an organ to form an opening
RETROGRESSIVE CHANGES:
Atrophy - ACQUIRED decrease in size of a normally sized organ
DEGENERATIVE CHANGES:
Dysplasia - change in size, shape and orientation of cell
DEGENERATIVE CHANGES:
Metaplasia - change from one adult cell type to another
DEGENERATIVE CHANGES:
Anaplasia or Dedifferentiation - change to a more primitive or embryonic cell type
DEGENERATIVE CHANGES:
Neoplasia or Tumor - continuous abnormal proliferation of cells
MALIGNANT TUMOR:
Carcinoma - malignant tumor of EPITHELIAL TISSUE origin
MALIGNANT TUMOR:
Sarcoma - malignant tumor of CONNECTIVE TISSUE origin
PRIMARY SIGNS OF DEATH (3)
Respiratory, circulatory and nervous failure
SECONDARY SIGNS OF DEATH (7)
Algor mortis - cooling
Rigor mortis - stiffening
Liver mortis - purplish discoloration
Desiccation
Putrefaction
Postmortem clotting
Autolysis
CLASS SYSTEM
Class I - absence of atypical cytologic picture
Class II - atypical cytologic picture but no evidence of malignancy
Class III - cytologic picture SUGGESTIVE BUT NOT CONCLUSIVE of malignancy
Class IV - cytologic picture STRONGLY SUGGESTIVE of malignancy
Class V - cytologic picture CONCLUSIVE of malignancy.
Visceral larva migrans (VLM): Toxocara cati, Toxocari canis
Cutaneous larva migrans (CLM): Ancylostoma braziliense, A. caninum
Infective stage is the sheathed filariform larva: HOOKWORM
Infective stage is the unsheathed filariform larva: THREADWORM
Semilunar cutting plates, BIPARTITE bursa: NECATOR AMERICANUS
Two pairs of teeth, TRIPARTITE bursa: ANCYLOSTOMA DUODENALE
Alkaline phosphatase immunoassay (APIA) for Schistosoma antibodies
NON-OPERCULATED AND MATURE (embryonated) when laid: SCHISTOSOMA eggs
OPERCULATED AND MATURE (embryonated) when laid: HETEROPHYES, OPISTORCHISand CLONORCHIS eggs
Clonorchis, Opistorchis and Heterophyid egg CANNOT be differentiated under an ordinary light microscope.
OPERCULATED AND IMMATURE (unembryonated) when laid: FASCIOLA, FASCIOLOPSIS, PARAGONIMUS and ECHINOSTOMA eggs
Amoebic LIVER abscess (ALA) is the most common extra-intestinal form of amoebiasis
Entamoeba polecki cyst: consistently UNINUCLEATED (1 NUCLEUS)
ACHROMATIC karyosomal granules: IODAMOEBA BUTSCHLII
Amoeboflagellate: NAEGLERIA
Granulomatous amoebic meningoencephalitis: ACANTHAMOEBA
Gay bowel syndrome: G. LAMBLIA
Entero-string/String test: G. LAMBLIA
K39 and FAST (Fast Agglutination Screening Test) for Leishmania
Rupture of RBCs every 72 hours: P. MALARIAE
Band trophozoite: P. MALARIAE
Amoeboid trophozoite: P. VIVAX
Crescent-shaped gametocytes: P. FALCIPARUM
Cyclospora cayetanensis: cyanobacterium-like body (CLB)
Circumoval Precipitin Test (COPT) SCHISTOSOMES
Sabin Feldman Dye test: TOXOPLASMA
Sheather sugar flotation technique: CRYPTOSPORIDIUM
Stool preservatives: formalin, Schaudinn’s solution, PVA (polyvinyl alcohol), MIF (merthiolate-iodine-formalin) and SAF (sodium acetate-acetic acid formalin)
Fecal concentration procedure (formalin-ether/ethyl acetate) FOUR LAYERS a) top layer of ether or ethyl acetate, b) a plug of fatty debris adherent to the wall of the tube, c) layer of formalin, and d) sediment.
DELAFIELD HEMATOXYLIN stain is mainly useful in demonstrating the detailed structures of MICROFILARIAE.
Iron conversion factor from conventional to SI (µmol/L): 0.179
Bilirubin conversion factor from conventional to SI (µmol/L): 17.1
Thyroxine conversion factor to SI (µg/dl to nmol/L): 12.9
Specimen collection & processing: Pre-analytical QA
Long-term accuracy of analytical methods: External QC
Abrupt change: Shift
Gradual change: Trend
One control value exceeds +2s and another exceeds -2s: R4s
2 consecutive ctrl values exceed the same mean +2s or -2s: 2:2s
Fixed-angle centrifuge advantages over the horizontal centrifuge: Lesser air friction, smaller increase in sample temperature, quicker sedimentation of small particles, and operated over higher speed
Used to determine whether there is statistically significant difference between the SD of 2 groups of data: f-test
Used to determine whether there is statistically significant difference between the means of 2 groups of data: t-test
Sample of known quantity with several analytes.: Control
Anticoagulant for cardiopulmonary bypass: Heparin
Basal state collection: Early morning blood collection
Uses 2 monochromators, affected by quenching: Fluorometry
Uses 2 photodetectors, for the sample beam and reference beam: Double – beam in space
Obsolete blood glucose methodologies: Folin- Wu, Nelson Somogyi
Chemical method for glucose, still widely used: Ortho-toluidine, condensation method
Test for chylomicrons, creamy layer on top: Standing plasma test
Apolipoprotein component of VLDL: Apo-B100
Transports exogenous triglycerides: Chylomicrons
Transports endogenous triglycerides: VLDL
Highest cholesterol content: LDL
One step method for cholesterol determination: Liebermann - Burchardt
Cholesterol esterase: Used in enzymatic method of cholesterol determination
CV of HDLc (NCEP Guidelines for Acceptable Measurement Error): ≤ 4%
Assay for Uric acid that uses mercury arc vapor lamp: Enzymatic: UV
Greater specificity and more expensive BUN assay: Enzymatic: ammonia formation
Simple, Nonspecific test for Creatinine determination : Colorimetric: end point
Categories of Azotemia: Pre-renal, Renal, Post-renal
Test used to assess the ability to conjugate bilirubin and secrete bile: SERUM BILIRUBIN LEVELS
Gamma spike/ Monoclonal gammopathy: Multiple myeloma
Beta-gamma bridging: Hepatic cirrhosis
Reaction rate is directly proportional to substrate concentration: First-order kinetics
Enzyme specific for both pancreas and salivary glands: Amylase
Clinically significant if decreased: Cholinesterase
Substrate used in Bowers-McComb method for ALP activity measurement: p-nitrophenylphosphate
Chief counterion of sodium: Chloride
Driving force of bicarbonate buffer system: CARBON DIOXIDE
Chloride and Bicarbonate relationship: Reciprocal
Confirmatory test for Acromegaly: Glucose suppression test
Increased in Hypothyroidism (primary): TSH
T3 uptake levels in Hypothyroidism : Decreased
Begins with patient identification and continues until testing is completed and the results are reported : Chain of custody
Requires whole blood EDTA sample: Cyclosporine and Tacrolimus tests
Method of choice for measuring antidepressants: HPLC
Gold standard for drug testing: GC-MS
Inhibits acetylcholinesterase: Organophosphates & Carbamates
Dissociable substance that yields hydrogen ions: Acid
Dissociable substance that yields hydroxyl ions: Base
Dissociable substance that accepts hydrogen ions: Base
Dissociable substance that accepts hydroxyl ions: Acid
Comparing patient’s results with previous results: Delta check
POCT is most often performed by nurses, perfusionists (who operate heart-lung machine during open heart surgery), respiratory therapists and physician themselves.
Expressed in Ehrlich units (mg/dl): Urobilinogen
Used to differentiate myoglobin and hemoglobin: Blondheim’s test
Degree of Hazard 1: Slight hazard
Degree of Hazard 2: Moderate hazard
Degree of Hazard 3: Serious hazard
Degree of Hazard 4: Extreme hazard
Handwashing: Clean between fingers 15 sec (or 20 sec , 6th ed), downward
When skin or eye contact occurs, the best first aid is to immediately: Flush the area with water for at least 15 minutes and then seek medical attention
Preservative of choice for urine cytology studies: Saccomano’s fixative
Urine specimen for Urobilinogen: Afternoon sample (2-4pm)
Storage conditions for reagent strip: Cool, dry place
Reagent incorporated in Ketone pad: Sodium nitroprusside
Hoesch Test: Ehrlich’s reagent in 6M HCl
Speckled pattern on blood parameter: Hematuria
Principle of Automated Reagent Strip Reader: Reflectance photometry
Soluble in dilute acetic acid: Red blood cells, amorphous phosphates, carbonates
Soluble in ether: Lipids, chyle, lymphatic fluid
Appear microscopically as yellow brown-granules and produce a characteristic pink sediment (brick dust), uroerythrin: AMORPHOUS URATES
Cause a white precipitate following specimen refrigeration: Amorphous phosphates
Tubular injury: 2 or more RTE cells per HPF
Telescoped sediment: Elements of glomerulonephritis and nephrotic syndrome
Glitter cells: Neutrophils seen in hypotonic urine
Formation of casts: Hyaline→cellular→granular→waxy
Hyaline cast consists entirely of: Uromodulin
Crystals seen in liver disease: Bilirubin, tyrosine, leucine
Forms of Struvite: Coffin-lid, Feather-like, Fern-leaf, Prism, Colorless sheets, Flakes
Ethylene glycol poisoning: Monohydrate Calcium Oxalate (oval, dumbbell)
Most frequent parasite encountered in urine: Trichomonas vaginalis
Fecal contaminant in urine: Pinworm ova
Diluent for CSF WBC Count: 3% Glacial HAc with methylene blue
Precipitation test for CSF total protein: TCA and SSA
Positive for pellicle clot formation: Tubercular meningitis
Oligoclonal bonding in CSF bonding but not in serum → Multiple sclerosis, encephalitis, Guillain-Barre syndrome and neurosyphilis
Semen fructose test is not tested within 2 hours: Specimen must be FROZEN
Reagent used in Florence test which detects choline: Potassium iodide, Iodine
Used to assess sperm cell velocity and trajectory: Computer-assisted semen analysis (CASA)
Normal volume of synovial fluid: less than 3.5 ml
Normal synovial fluid glucose: <10mg/dl lower than blood glucose
Cells seen in synovial fluid which resembles polished rice macroscopically: Rice bodies
Type of effusion caused by congestive heart failure: Transudate
Sputum: Not a normal body fluid, tracheobronchial secretions
Important diagnostic test for Pneumocystic carinii in immunocompromised patients: Bronchoalveolar lavage
Tests for Neural Tube defects: AFP, acetylcholinesterase
Microviscosity test for fetal lung maturity: measured by FLUORESCENCE POLARIZATION
Green amniotic fluid: MECONIUM
Dark red-brown color of amniotic fluid: FETAL DEATH
Normal Gastric fluid appearance: PALE GRAY WITH MUCUS
Noninvasive test to determine gastric acidity: DIAGNEX TUBELESS TEST
Collagen-like material with concentric striations seen in ovarian and thyroid carcinomas: PSAMMOMA BODIES
Melena: BLACK AND TARRY STOOL
Laminar flow: Biosafety Cabinet class II
HEPA filter: Removes org > 0.3 um (bacteria, fungi)
Blood culture collection: 2-3 samples (Max. 3 BAILEY’S) at least 1 hour apart in 24 hours
Grade A milk: <75,000 bacteria per mL when raw, and <15,000 bacteria once pasteurized
Enteric agar: XLD, EMB, HEA
Rickettsial stains: Gimenez, Macchiavello
Concentration of Hydrogen Peroxide as disinfectant: 3% H2O2
MIO medium: Motility Indole Ornithine
Quaternary ammonium compounds are inactivated by: Organic substances
Fite-Faraco stain: Hematoxylin as counterstain instead of methylene, AFB
Sodium polyanethol sulfonate: Anti-phagocytic, anti-complement
Bromthymol blue as indicator: HEA, TCBS, Simmon’s citrate agar
Nasopharyngeal swabs: H. influenzae, N. meningitidis, B. pertussis
Inhibits gram-positive bacteria: Crystal violet and sodium desoxycholate (bile salt)
Inhibits gram-negative bacteria: Sodium azide, phenylethyl alcohol
Detects gram-negative endotoxin: Limulus lysate test
Protein A: Staphylococcus aureus, coagglutination
Slime layer production: Staphylococcus epidermidis
Protein M: Streptococcus pyogenes
Colonies with ground glass appearance: Legionella (Mahon)
Increased resistance of Pseudomonas aeruginosa to aminoglycosides: Increased calcium and magnesium
Smallest free-living organism: Mycoplasma
Benchmarking: Comparison with peers
Histoplasma cross-reacts with: Blastomyces, Aspergillus and Coccidioides
Aman medium stain: Lactophenol cotton blue
Czapek’s medium: Isolation of Aspergillus
African histoplasmosis: Histoplasma duboisii
Test for Candida albicans that uses serum: Germ tube test
Chlamydospore production of Candida albicans: Cornmeal agar
Candidiasis infection affecting the oral cavity: Thrush
General isolation media for fungi: Saboraud’s dextrose agar
Major biologic hazard to laboratory personnel: Coccidioides immitis
Sensitive fungal (fluorescent) dye that binds to cell wall: Calcofluor white
Chromoblastomycosis: Sclerotic bodies
Rose gardener’s disease: Sporotrichosis
Eosinophilic material due to antigen-antibody reaction in cases of sporotrichosis: Asteroid body
Largest DNA virus: Poxvirus
Smallest DNA virus: Parvovirus
Largest RNA virus: Paramyxovirus
Smallest RNA virus: Enterovirus (Picornaviridae)
Cross reactive antigen in all human adenoviruses: Hexon
Gastroenteritis in children during winter months: Rotavirus
Nonbacterial gastroenteritis in adults: Norovirus
Toxic to HSV: Calcium alginate
Isolation medium for Cytomegalovirus: Human fibroblast cells
True amoeba: GENUS Entamoeba
Trophozoite with ingested red blood cell: Entamoeba histolytica
Trophozoite with ingested WBC: Entamoeba gingivalis
Gay bowel syndrome: Giardiasis
Cercaria minus a tail: Schistosomule
Infective stage of Diphyllobothrium latum: Plerocercoid larva
Resembles Diphyllobothrium latum adult: Spirometra
Passing of proglottids of Taenia: Irritated by ALCOHOL
Taenia spp. eggs: Hexacanth embryo with thick radial striations
Cercarial dermatitis: Schistosomes
Length of needle in routine phlebotomy: 1.0 – 1.5 inches
Angle of draw in venipuncture: 15 to 30 ° angle (15 degree angle)
The distance of drop of blood from the edge of the slide: 1 cm
Blood production outside the bone marrow: EXTRAmedullary hematopoiesis
Hematopoietic stem cell marker: CD 34
Common acute lymphocytic leukemia antigen: CD 10
Test for Hemoglobin S which uses black line: Dithionate solubility test
Starry sky pattern under low power imparted by numerous macrophages with apoptotic debris: Burkitt’s lymphoma
Granules (tertiary granules) present in Neutrophil: Alkaline phosphatase
Euglobulin clot lysis time: Screening test for fibrinolysis
Screening test for PNH: Sugar water screening test
Derived from RBC Histogram: MCV, RDW
Derived from Platelet Histogram: MPV, PDW
In cyanmethemoglobin method, all hemoglobin are measured, except: Sulfhemoglobin
Color of blood in sulfhemoglobinemia: Mauve lavender
Patient with PNH received blood transfusion: Less lysis due to the presence of normal RBCs transfused
Positive instrumental errors: Bubbles in the sample, extraneous electrical pulsesand aperture plugs (most common)
Negative instrumental error: Excessive lysing of RBCs
Instrumental error that is either a positive or negative error: Improper setting of aperture current or threshold
Purplish red pinpoint hemorrhagic spots: Petechiae
Blood escapes into SMALL areas of skin and mucous membrane: Purpura
Blood escapes into LARGE areas of skin, mucous membrane, and other tissues: Ecchymosis
Primary hemostasis: Vasoconstriction
Outer surface of platelet: Glycocalyx
Contains microtubules that maintains platelet shape: Sol-gel zone
Platelet estimate of 100,000 to 149,000/µL: Slight decrease
Platelet estimate of 150,000 to 199,000/µL: Low normal
Labile factors: Factors V and VIII
Prematurely activates at cold temperature: Factors VII FXI
Vitamin K-dependent factors: Factors II, VII, IX, X
Normal value for TEMPLATE bleeding time: 6 – 10 minutes
Christmas factor: Factor IX
Rosenthal syndrome: Factor XI deficiency
Platelet estimate of 401,000 to 599,000/µl: Slight increase
Platelet estimate of 600,000 to 800,000/µL: Moderate increase
A surgical connection between to structures, it usually means a connection that is created between tubular structures, such as blood vessels or loops of intestines: ANASTOMOSIS
Polyclonal antibodies used in immunohistochemical techniques are frequently derived from: RABBIT
Most rapid of the common freezing agents: LIQUID NITROGEN
General purpose fixative: 10% neutral buffered formalin
Protein fixation: Neutral buffered formol saline or formaldehyde vapor
Fixatives for nucleic acids: Ethanol, methanol and Carnoy’s solution
Amount of fixative used has been 10 to 25 times the volume of tissue to be fixed. Recently, the maximum effectiveness of fixation is noted to be 20 times the tissue volume.
Recommended ratio of fluid to tissue volume for DECALCIFICATION is 20 to 1
Amount of dehydrating agent should not be less than 10 times the volume of tissue
Dehydration: Low grade to high grade alcohol
Absence of water: WHITE anhydrous copper sulfate
Presence of water: BLUE anhydrous copper sulfate
Clearing: Dealcoholization
Most rapid embedding technique: Vacuum embedding
Automated tissue processor: Fix, dehydrate, clear, and infiltrate
Histochemical demonstration of ENZYMES: FROZEN SECTION
ACRIDINE ORANGE is the most commonly used fluorochrome to demonstrate DNA and RNA in fresh or fixed tissues.
Von Kossa’s silver nitrate method: Calcium salts = black
Red chromogen for peroxidases: Aminoethylcarbazole (AEC)
Brown chromogen for peroxidases: Diaminobenzidine (DAB)
Administrative investigation:2 members of board + 1 legal officer
Policies and guidelines for Med Tech Education: CMO no. 14 s. 2006
Accreditation of clinical lab for training MT interns: CMO no. 6 s. 2008
STAT, STATIM: Immediately
Biodegradable wastes: Green bag
CC Bishop
REFERENCE METHOD FOR CHOLESTEROL AND TRIGLYCERIDES: GC-MS
CHOLESTEROL: Abell-Kendall ➡️GC-MS
TRIGLYCERIDE: Modification of van Handel and Zilversmit ➡️ GC-MS
CC Bishop
CHOLESTEROL MEASUREMENT
In the past, the reference method for cholesterol involved hexane extraction after hydrolysis with alcoholic KOH followed by reaction with Liebermann-Burchard color reagent, which comprises sulfuric and acetic acids and acetic anhydride.
Recently, the reference method has changed to a gas chromatography–mass spectrometry (GC–MS) method that now specifically measures cholesterol and does not detect related sterols.
CC Bishop
TRIGLYCERIDE MEASUREMENT
Like the reference method for cholesterol, the CDC has recently switched to a GC–MS method that involves the hydrolysis of fatty acids on triglycerides and the measurement of glycerol.
Urine for routine urinalysis: 10 to 15 ml urine (50 ml-container capacity)
Urine for drug testing: 30 to 45 ml (60 ml-container capacity)
Urine for cytology: at least 50 ml urine (Gregorios)
Venipucture: 15 to 30 degree angle
Arterial puncture: 45 to 60 degree angle (90 degrees for femoral artery)
Before blood is collected from the radial artery in the wrist, one should do a MODIFIED ALLEN TEST to determine whether the ulnar artery can provide collateral circulation to the hand after the radial artery puncture.
Central Venous Assess (CVA) collection: eliminates multiple phlebotomies and surgical situations. Five (5) ml of blood must be drawn and discarded to eliminate contaminants. CVA is not recommended for bacteriology (organisms can contaminate specimen)
Order of draw from CATHETER LINES: First 3 to 5 ml blood is discarded THEN, blood culture, anticoagulated tubes and clot tubes.
Donor bleeding: 45 degree angle to the skin, make a quick clean puncture; once in the skin, reduce the angle of the needle to about 10 to 20 degrees
Anaerobic and require ICE slurry (immediate cooling): Lactic acid, ammonia, blood gas (if not analyzed within 30 min = ↓ pH, and po2), iCa+2 (heparinized whole blood if not analyzed within 30 min)
C-Peptide test: evaluates hypoglycemia and continuous assessment of beta cell function
Increased C-peptide: Insulinoma, type 2 DM, ingestion of hypoglycemic drugs
Decreased C-peptide: Type 1 DM
Colorimetric method for Triglycerides: van Handel and Zilversmith
CDC reference method for TAG: Modified van Handel and Zilversmith ➡️GC-MS
Fluorometric method for Triglycerides: Hantzch condensation
Largest and least dense: CHYLOMICRONS
Smallest but the most dense: HDL
Found in obstructive jaundice and LCAT deficiency: Lipoprotein X
Floating beta lipoprotein: β-VLDL
Sinking pre-beta lipoprotein: Lp (a)
Triglycerides, LDLc: FASTING 12 to 14 hours
Formula for LDLc: Total cholesterol – HDL – VLDL
Friedewald VLDLc (mmol/L): Triglycerides/2.175
De Long VLDLc (mmol/L): Triglycerides/2.825
Friedewald VLDLc (mg/dL): Triglycerides/5
De Long VLDLc (mg/dL): Triglycerides/6.5
ONE-STEP direct method for cholesterol: LIEBERMANN-BURCHARDT (L-B)
One-step method for cholesterol: Colorimetry (Pearson, Stern and MacGavack)
Two-step method for cholesterol: C + Extraction (Bloors)
Three-step method for cholesterol: C+ E + Saponification (Abell-Kendall)
Four-step method for cholesterol: C + E + S + Precipitation (Schoenheimer, Sperry, Parekh and Jung)
REFERENCE METHOD FOR CHOLESTEROL: Abell-Kendall ➡️GC-MS (Bishop)
REFERENCE METHOD FOR TRIGLYCERIDE: Modification of van Handel and Zilversmit ➡️GC-MS (Bishop)
TANGIER’S DISEASE: HDL is abnormal and significantly reduced
Activated at cold temperature: Factors VII and XI (seven, eleven)
Labile factors, decrease on storage: Factors V and VIII (five, eight)
Wintrobe tube: 11.5 cm long, 3 mm bore
Westergren tube: 30 cm long, 2.5 mm bore
Capillary tube: 7 to 7.5 cm (70-75 mm) long, 1 mm bore (1.2 mm)
Macrohematocrit: Centrifuge at 2,000 to 2,300 g for 30 minutes
Microhematocrit: Centrifuge at 10,000 to 15,000 g for 5 minutes (five minutes)
Normocytic, normochromic: Acute blood loss, hemolytic anemia, aplastic anemia
Microcytic, hypochromic: Anemia of chronic disease, thalassemia, IDA and sideroblastic anemia
Macrocytic, normochromic: MEGALOBLASTIC ANEMIA
Poikilocytosis: DECREASED ESR
Correction for WBC count, Adult: 5 or more nucleated RBCs/100 WBC differential
Correction for WBC count, Neonate: 10 or more nucleated RBCs/100 WBC differential
Increased EDTA: Decreased hematocrit, decreased ESR
Hemoglobinopathies: QUALITATIVE defect in hemoglobin
Thalassemia: QUANTITATIVE defect in hemoglobin
Responsible for clot retraction: THROMBOSTHENIN
Electromechanical detection of fibrin clot: FIBROMETER
Photo-optical detection: Electra, COAG-A-MATE, Ortho-Koagulab
Stains for the BASEMENT MEMBRANE: PAS and azocarmine
Complement-dependent cytotoxicity: INVERTED PHASE CONTRAST microscope
Fixatives for H & E: All fixatives can be used except those that contain osmic acid. Osmic acid (like Flemming’s) inhibits hematoxylin
Manual H & E staining: REGRESSIVE STAINING, it includes a differentiation step
Harris hematoxylin: Primary/Basic/Nuclear stain
Eosin: Secondary/Counterstain/Acid/Cytoplasmic stain
Stain of choice for cytology: ORIGINAL Pap’s stain
Pap’s stain consists of 3 stains: Harris hematoxylin, Orange green (OG6) and Eosin Azure (EA)
Harris hematoxylin: stains the nucleus
OG 6: stains the cytoplasm of mature cells (superficial cells)
EA 36/50/65: stains the cytoplasm of immature cells (parabasal, intermediate cells)
LEGACY OF PAMET PRESIDENTS:
FIRST PRESIDENT: Charlemagne T. Tamondong “Emergence of the Profession” (1963-1967)
LEGACY OF PAMET PRESIDENTS:
Nardito D. Moraleta “Professional Recognition” (1967-1970)
LEGACY OF PAMET PRESIDENTS:
Felix E. Asprer “Legislative Agenda” (1970-1971, 1973-1976)
LEGACY OF PAMET PRESIDENTS:
Bernardo T. Tabaosares “Celebration of the Practice” (1971-1973)
LEGACY OF PAMET PRESIDENTS:
Angelina R. Jose “Career Advocacy” (1973)
LEGACY OF PAMET PRESIDENTS:
Venerable C.V. Chua (Venerable OCA) “Educational Enhancement” (1977-1981)
LEGACY OF PAMET PRESIDENTS:
Carmencita P. Acedera “Image Building” (1982-1991)
LEGACY OF PAMET PRESIDENTS:
Marilyn R. Atienza “Proactivism” (1992-1996)
LEGACY OF PAMET PRESIDENTS:
Norma N. Chang “International Leadership” (1997-2000)
LEGACY OF PAMET PRESIDENTS:
Agnes B. Medenilla “Organizational Dynamism” (2001-2002, 2005-2006)
LEGACY OF PAMET PRESIDENTS:
Shirley F. Cruzada “Interdisciplinary Networking” (2003-2004)
LEGACY OF PAMET PRESIDENTS:
Leila M. Florento “Beyond Expectations” (2007-2012)
LEGACY OF PAMET PRESIDENTS:
Romeo Joseph J. Ignacio “Soar Higher through V.O.I.C.E.” Visibility, Oneness, Integrity, Commitment and Excellence (2013 - 2015)
LEGACY OF PAMET PRESIDENTS:
Ronaldo E. Puno (2015-2020)
LEGACY OF PAMET PRESIDENTS:
Rommel Saceda (2020-2022)
LEGACY OF PAMET PRESIDENTS:
CURRENT PAMET PRESIDENT IS MA’AM LUELLA VERTUCIO (2020 to present)
FATHER OF PAMET: CRISANTO ALMARIO
PAMET was originally organized on SEPTEMBER 15, 1963
PAMET HYMN Music: Francis Jerota Pefanco
PAMET HYMN Lyrics: Hector Gentapanan Gayares, Jr.
Current PAMET President: Ma’am Luella Vertucio
Current PASMETH President: Dean Jose Jurel Nuevo
Board of MT Head: Dr. Marilyn Barza
Board of MT Member: Ma’am Leila Lani Florento
PRC CHAIRPERSON: Atty. Charito Zamora
DOH SECRETARY Dr. Teodoro Herbosa
BIPHASIC MEDIUM/CASTANEDA BOTTLES: BRUCELLA
CIN medium: Y. enterocolitica
CCFA: C. difficile
BCYE medium: Legionella
HBT medium: Gardnerella
ssDNA: Parvovirus
dsRNA: Reovirus
Smallest RNA virus: Enterovirus (Picornaviridae)
Acid-resistant: Enterovirus
Acid-sensitive: Rhinovirus
KOPLIK’S SPOTS: MEASLES
Measles: RUBEOLA
German measles: RUBELLA
Chickenpox: VARICELLA
Odor of bitter almonds: CYANIDE
Garlic on breath, metallic taste on mouth: ARSERNIC
A blood alcohol level in the range of 80 mg/dL has been established as the statutory limit for operation of a motor vehicle in the United States.
This is associated with a diminution of judgment and motor performance.
The determination of blood ethanol concentration by the laboratory in cases of drunk driving requires an appropriate chain of custody, documentation of quality control, and proficiency testing records.
Potentiometry: measurement of pH and pCO2
Amperometry: measurement of pO2
High affinity to keratin: ARSENIC
Visible region: 400 to 700 nm
UV region <400 nm
Infrared region > 700 nm
Cholesterol, acceptable CV ≤ 3%
Triglyceride, acceptable CV ≤ 5%
HDLc, LDLc acceptable CV ≤ 4%
OBESE BMI ≥ 30 kg/sq.m. [ASIA-PACIFIC 25]
Overweight BMI 25 to 29.9 kg/sq.m.
Underweight BMI < 18.5 kg/sq.m.
BASAL STATE: early morning before the patient has eaten or become physically active
STAT for the Latin word statim meaning immediately. Tests that fall into this category include:
Glucose in diabetic ketoacidosis
Some drug levels such as theophylline
Amylase in suspected pancreatitis
CK in suspected MI
Hematocrit
Blood gases
Potassium
CRITICAL VALUES or PANIC VALUES: list of analytes that truly do have the potential to be lethal if unchecked for a short period.
SCHILLING TEST: Laboratory determination of vitamin B12 absorption
Hemostatic mechanisms comprise four (4) main systems: the vascular system, platelets, coagulation system and fibrinolytic system.
OSMOLALITY
Osmolality = 2Na + ( Glucose/20 ) + ( BUN/3 )
Osmolality = 1.86Na + ( Glucose/18 ) +
( BUN/2.8 ) + 9
ANION GAP (AG)
AG = Na - (Cl + HCO3)
AG = (Na + K) – (Cl + HCO3)
NORMAL URINARY CRYSTALS:
Uric acid is alkali soluble
NORMAL URINARY CRYSTALS:
Amorphous urates - soluble in alkali and heat
NORMAL URINARY CRYSTALS:
CaOx - soluble in dilute HCl
NORMAL URINARY CRYSTALS:
Amorphous phosphates - soluble in dilute acetic acid
NORMAL URINARY CRYSTALS:
Calcium phosphate - soluble in dilute acetic acid
NORMAL URINARY CRYSTALS:
Triple phosphate - soluble in dilute acetic acid
NORMAL URINARY CRYSTALS:
Ammonium biurate - soluble in acetic acid with heat
NORMAL URINARY CRYSTALS:
Calcium carbonate - forms gas from acetic acid
ABNORMAL URINARY CRYSTALS:
Cystine is soluble in ammonia, dilute HCl
ABNORMAL URINARY CRYSTALS:
Cholesterol is soluble in chloroform
ABNORMAL URINARY CRYSTALS:
Leucine is soluble in hot alkali or alcohol
ABNORMAL URINARY CRYSTALS:
Tyrosine is soluble in alkali or heat
ABNORMAL URINARY CRYSTALS:
Bilirubin is soluble in acetic acid, HCl, NaOH, ether and chloroform
ABNORMAL URINARY CRYSTALS:
Sulfonamides soluble in acetone
ABNORMAL URINARY CRYSTALS:
Radiographic dye soluble in 10% NaOH
ABNORMAL URINARY CRYSTALS:
Ampicillin crystals form bundles when refrigerated
F. tularensis is a very small, strictly aerobic, coccoid to pleomorphic rod-shaped, gram-negative bacillus that requires CYSTINE or CYSTEINE for growth
Legionella spp. may be isolated on BCYE agar supplemented with growth factors, including L-CYSTINE, FERRIC SALT, AND Α-KETOGLUTARATE.
Bordetella spp. are strictly aerobic, nonfermentative, catalase-positive, minute coccobacilli requiring NICOTINIC ACID, CYSTEINE, and usually METHIONINE for growth.
MEDICAL MALPRACTICE is misconduct or lack of skill by a health-care professional that results in injury to the patient.
NEGLIGENCE, which is defined as failure to give reasonable care by the health-care provider, must be proven in a malpractice suit.
SERUM or PLASMA is the specimen of choice for the determination of circulating concentrations of most drugs.
Analysis for the presence of ABUSED SUBSTANCES has focused primarily on the use of URINE as the test sample of choice. The urine specimen represents the net load of the drug over a long period, whereas the blood sample provides only a quick picture of the drug level at a specific time. DRUGS OF ABUSE, CALBREATH
CHAIN OF CUSTODY
Processing steps for such specimens—initial collection, transportation, storage, and analytical testing— must be documented by careful record keeping. Documentation ensures that there has been no tampering with the specimen by any interested parties, that the specimen has been collected from the appropriate person, and that the results reported are accurate.
Each step of the COLLECTION, HANDLING, PROCESSING, TESTING, AND REPORTING PROCESSES must be documented; this is called the chain of custody.
RICE BODIES are fragments of degenerating proliferative synovial cells or microinfarcted synovium.
OCHRONOTIC SHARDS, ground pepper appearance from pigmented cartilage fragments may be the result of a metabolic disorder (i.e., ochronosis).
PROBLEMS: RBCs appear gray, WBCs are too dark, eosinophil granules are gray, not orange.
CAUSES: Stain or buffer too alkaline (most common), inadequate rinsing, prolonged staining, heparinized blood sample.
PROBLEMS: RBCs are too pale or are RED, WBCs are barely visible.
CAUSES: Stain or buffer too acidic (most common), underbuffering (too short), over-rinsing.
HBeAg indicates HIGH INFECTIVITY.
CORDOCENTESIS, or percutaneous umbilical blood sampling (PUBS).
SPECIAL URINE PRESERVATIVES:
Formaldehyde – for Addis count
SPECIAL URINE PRESERVATIVES:
HCl – for epinephrine, norepinephrine, catecholamines, vanillylmandelic acid
SPECIAL URINE PRESERVATIVES:
Glacial acetic acid pH 4.5 – for aldosterone
SPECIAL URINE PRESERVATIVES:
Sodium carbonate – for porphyrins and urobilinogen (to ensure alkalinity)
SPECIAL URINE PRESERVATIVES:
Glacial acetic acid pH 2.0 – for serotonin
SPECIAL URINE PRESERVATIVES:
Conc. HCl – for steroids, ammonia, urea, total nitrogen
SPECIAL URINE PRESERVATIVES:
Chloroform – for aldosterone
SPECIAL URINE PRESERVATIVES:
Sulfuric acid – preserves calcium and other inorganic constituents
SPECIAL URINE PRESERVATIVES:
Sodium fluoride or benzoic acid – ideal for glucose analysis, prevents glycolysis
TYPES OF HUMAN STEM CELLS
Functionally, three types of human stem cells exist:
1. Totipotential stem cells
These cells are present in the first few hours after an ovum is fertilized.
Totipotential stem cells, the most versatile type of stem cell, can develop into any human cell type, including development from embryo into fetus.
2. Pluripotential stem cells
These cells are present several days after fertilization.
Pluripotent stem cells can develop into any cell type, except they cannot develop into a fetus.
3. Multipotential stem cells
These cells are derived from pluripotent stem cells.
They can be found in adults, but they are limited to specific types of cells to form tissues.
For example, bone marrow stem cells can produce all types of blood cells, bone cartilage, and adipose (fat) cells.
Rheumatic fever, which is manifested by fever, endocarditis (inflammation of heart muscle), subcutaneous nodules, and polyarthritis, usually follows respiratory tract infections and is thought to be mediated by antibodies produced against S. pyogenes M protein that cross-react with human heart tissue.
Acute glomerulonephritis, characterized by edema, hypertension, hematuria, and proteinuria, can follow respiratory or cutaneous infections and is mediated by antigen-antibody complexes that deposit in glomeruli, where they initiate damage.
WORLD HEALTH ORGANIZATION PUBLISHED STANDARDS FOR: 1. GOOD MANUFACTURING PRACTICE (GMP) 1999 2. GOOD CLINICAL PRACTICE (GCP) 1995 3. GOOD LABORATORY PRACTICE (GLP) 2001
Additional information: FUNCTIONS OF THE DANGEROUS DRUGS BOARD - The Dangerous Drugs Board. – The Board shall be the policy-making and strategy-formulating body in the planning and formulation of policies and programs on drug prevention and control.
Highest CK
Duchenne’s Muscular Dystrophy (DMD)
Highest LD
Pernicious anemia
Killer immunoglobulin-like receptor (KIR) system. KIRs are one of several types of cell surface molecules that regulate the activity of NK lymphocytes. Alloreactive NK cells have been shown to mediate a graft-versus-leukemia (GVL) reaction and prevent relapse after transplantation for certain types of hematologic malignancies.
Noted, these alloreactive NK cells have been shown to mediate a graft-versus-leukemia (GVL) reaction and prevent relapse after transplantation for certain types of hematologic malignancies.
