Specimen handling and processing Flashcards by Rojeen Niazi

The Following are indicators for amniocentesis EXCEPT FOR: (1 B1)
a) Maternal age
b) Parental chromosome abnormality
c) A family history of an X-linked disorder
d) A family history of an autosomal recessive disorder

d) A family history of an autosomal recessive disorder

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When a bone marrow (bm) sample can not be delivered to the lab within 4 hours, the sample should be: (1A3)
a) Kept on dry ice
b) Put in media and kept at room temperature
c) Kept at 37°C
d) Put in formalin

b) Put in media and kept at room temperature

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A PB sample is clotted. What do you do? (1B3)
a) Break up clot.
b) Add heparin.
c) Spin and culture supernatant.
d) Discard

a) Break up clot.

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All the following information is required during the specimen set-up
procedure EXCEPT: (1 C)
a) Patient information
b) Sample type
c) Sample quality
d) Infectious agent

d) Infectious agent

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When should samples be logged in? (1 C)
a) At the end of the day.
b) As soon as they arrive in the laboratory.
c) After they are set up.
d) By the same person each day.

b) As soon as they arrive in the laboratory.

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How long do you wait before requesting an amniotic fluid if no cell
attachment is observed? (1 B3)
a) · 3 days
b) 10 days
c) 21 days
d) 28 days

b) 10 days

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All of the following will result in culture failure EXCEPT: {1A3)
a) Transport at room temperature.
b) Sample shipped on ice.
c) Specimen exposed to 40°C.
d) Improper sterile techniques used.

a) Transport at room temperature.

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Which cells would you want to use for long term serial cytogenetic
studies?(1 81)
a) epithelial
b) fibroblast
c) cocci
d) amniocytes
e) lymphocytes

b) fibroblast

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Which statement(s) regarding the CVS procedure is (are) true? (1Al)
a) It was introduced in 1968.
b) Placentaltissue can be obtainedby transcervical aspiration.
c) Placentaltissue can be obtainedby transabdominal aspiration with a needle.
d) All ofthe above are true

d) All ofthe above are true

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Lab C noticedthat patientsamples fromone of theirdoctors had poor or no growth as compared to their otherdoctors’samples. No evidence of contamination wasobserved and allmaterial needed forsample
collection and transportation is providedto the doctors by the laboratory. What couldcause this discrepancy in culture viability? (1A1)
a) Collection technique
b) Incubator systems
c) Toxic plastic containers
d) Culture media

a) Collection technique

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What prenatal test can be done with the highest accuracy and as early in thepregnancy aspossible? (1A1)
a) Percutaneous umbilical cord blood
b) Chorionic villus sampling
c) Amniocentesis
d) Maternal serum triple screening

b) Chorionic villus sampling

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In a cytogenetics laboratorythe anticoagulant of choicefor peripheralblood is: (lA2a)
a) Sodium citrate
b) Lithium heparin
c) Sodium heparin
d) EDTA

c) Sodium heparin

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The primary effect of Sodium heparin is to: (1A2a)
a) Swell cells
b) Remove water from cells
c) Stimulate mitotic activity
d) Precipitate nucleic acid
e) Prevent clotting

e) Prevent clotting

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Which of the following has the lowest toxicity to exposed cells? (1A2)
a) Sodium heparin
b) Lithium heparin
c) Sodium hydroxide
d) Gentamycin

a) Sodium heparin

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Which of the following microbes does Penicillin/Streptomycincontrol? (lA2b)
a) mycoplasma
b) bacteria
c) fungi
d) all ofthe above

b) bacteria

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A pathologist is sending solid tumor specimens to a cytogeneticslaboratory for analysis. What instructions
should be given to the pathologist concerning the preparationand transport of the specimen to insure the
highest chance ofsuccessful culture? (1A3)
a) Ensure the sterility of the specimen by placingit in formalin until it reaches the laboratory.
b) Ensure that the specimen does not containnecrotic or fatty tissue.
c) Ensure that the specimen is transportedon dry ice to prevent decomposition.
d) All ofthe above.

b) Ensure that the specimen does not containnecrotic or fatty tissue.

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It is possible for the collecting syringe used in amniocentesis to be toxic to the amniotic cells. (lA3a)
a) True
b) False

a) True

A solidtumor specimen can NOT be shipped from thehospital to a cytogenetics laboratory in another city dueto a majorholiday which willnot allowthesample to be shipped viaFederalExpress Overnight delivery. Howshouldthe sample be storedso thatthe cells willremainaliveuntil they canbe delivered and placed in culture? (1A3b)
a) The specimen shouldbe preservedby placing it in formalin until it reaches the laboratory.
b) The specimen shouldbe placedin mediaandthenin a 37°C incubator until it can be shipped.
c) The specimen shouldbe storedat -20°C or on dry ice to preventcellulardecay.
d) The specimen should be placed in media andthenrefrigerated untilit can be shipped.

d) The specimen should be placed in media andthenrefrigerated untilit can be shipped.

Blood is receivedfor cytogenetic analysis in a busyclinicallaboratory. It will be severalhours before a
cytogenetic technologist willbe able to do the set-up procedure. How shouldthis bloodbe stored during
the interim period? (1A3b)
a) The blood should be stored at room temperature.
b) The blood should be stored on ice.
c) The blood should be stored in the freezer at 0°C
d) All ofthe above

a) The blood should be stored at room temperature.

When transportingprenatal specimensthe optimaltemperature is? (1A3b)
a) 37°C
b) 40°C
c) 0°C
d) 20°C

d) 20°C

All of the following will result in culture failure EXCEPT:(lA3b)
a) Transport at room temperature
b) Sample shipped on ice
c) Specimen exposed to 40°C
d) Improper sterile techniques used

a) Transport at room temperature

When whole blood is separated one will observe a layering of cells and liquid. The component of whole
blood which can be found in layer B is called: (IBla)
a) plasma
b) the buffy coat
c) red blood cells
d) saline

b) the buffy coat

When whole blood is separated one will observe a layering of cells and liquid. The component of whole
blood which can be found in layer A is called: (IBla)
a) plasma
b) the buffy coat
c) red blood cells
d) saline

a) plasma

Which statement about maternal cell contamination is true? (lBlc)
a) There is an decreased risk of maternal cell contamination when the sample is bloody.
b) Maternal cell contamination is not expected when the fetal karyotype is 46,XY.
c) The use ofmaternal C-band polymorphisms is not helpfulin identifying casesof maternal cell
contamination.
d) Discarding the first2-3 cc of amniotic fluid canincrease theriskofmaternal cellcontamination

b) Maternal cell contamination is not expected when the fetal karyotype is 46,XY.

Not all cells receivedby a cytogenetics laboratory will growwell in culture for any numberof reasons. When amniotic fluid specimens are collected for culture, whichof the following are safeguards against culture failure? (lBlc) a) Samples are collected in one syringe. b) The first 5 cc offluid are discarded. c) Two flasks are set up with two different types of media d) T12 1/2 flasks are used

c) Two flasks are set up with two different types of media

Of the tissue types selected fromabortus specimens, the onethat exhibits the best growthrate is:(IBId) a) Fetal skin b) Spleen c) Chorionic villi d) Umbilical cord

c) Chorionic villi

The type of cell analyzed with the CVS direct preparation is: (lBle) a) epiblast b) cytotrophoblast c) amniotic ectoderm d) hypoblast

b) cytotrophoblast

Why is the villi obtained in CVS procedures cleaned by the technologists? (lBle) a) To remove the blood from the sample. b) To remove dead tissue from the sample. c) To remove maternal tissue from the sample. d) To expose the rapidly growing cells in the villi.

c) To remove maternal tissue from the sample.

Whenanalyzing lymphomas for cytogenetics, lymph nodebiopsies are the tissue of choice. (IB If) a) True b) False

a) True

Specimen factors that could adverselyeffect cultureoutcome include. (1B2) a) Cell type b) Clotting c) Sample quantity d) All ofthe above

d) All ofthe above

Determining the whitebloodcell countin bonemarrow andbloodisimportant because: (lB2c) a) Patients who have a low wbc have a worseprognosis. b) It is important in determining the number ofb last cells. c) It isimportant tomaintain uniform culture conditions, andcellconcentration varies greatly from sample to sample. d) Bone marrow cells will notgrow inculture unless the cell density is at least four million cells per ml.

c) It isimportant tomaintain uniform culture conditions, andcellconcentration varies greatly from sample to sample.

Mark is preparing a peripheral blood specimen forculture. When he assesses the specimen for adequate cellvolume, theCoulter counter acts erratically. The count exceeds 100,000. Howshould he proceed? (lB2c) a) Obtain a new specimen for repeat studies. b) Clean the Coulter Counter and remeasure the cell volume. c) Add Colchicine to the cell suspension and remeasure. d) Runthe controls through theCoulter Counter andcheck the accuracy.

b) Clean the Coulter Counter and remeasure the cell volume.

What is the recommended final cell concentration of cells for bone marrow cultures for chromosome studies? (lB2c) a) 1 million cells per ml ofmedia b) 1-2 million cells per ml ofmedia c) 2-4 million cells per ml ofmedia d) 5 million cells per ml ofmedia

c) 2-4 million cells per ml ofmedia

Solidtumorculturefailure can be caused by which of the following? (1B3) a) contamination b) necrosis c) growth ofnormal stromal cells d) all ofthe above

d) all ofthe above

Whena clotted BMspecimen comes intothe lab,the technologist should: (lB3a) a) Request a new specimen b) Discard the specimen c) Place the specimen in a warm waterbath andattempt tobreakup clot. d) Set up the clotted BM as usual

c) Place the specimen in a warm waterbath andattempt tobreakup clot.

Peripheral bloodG-band karyotype analysis isrequested for all the following EXCEPT: (1C1) a) Multiple malformations seen in a newborn b) Single malformation seen in a newborn c) Mental retardationof unknownetiology d) Multiple miscarriages

b) Single malformation seen in a newborn

Which ofthe following isnot an indication for routine peripheral blood chromosome analysis? (1C1) a) Advancedmaternalage. b) To determine whether achromosomal abnormality is constitutional or acquired in cancer patients. c) To study chromosome damage due to environmental exposure to chemicals, drugs, radiation etc. d) Multiple congenital anomalies with mental retardation.

a) Advancedmaternalage.

All ofthe following information is required during the specimen set-up procedure EXCEPT: (1C1) a) patient information b) sample type c) sample quality d) infectious agent

d) infectious agent

Which ofthe following patient information is the most important in verifying the appropirateness ofa specimen for chromosome analysis? (1C1) a) Time of collection b) Reason for referral c) Date ofbirth d) The patient's sex

b) Reason for referral

Failure rates for cytogenetic analysis ofbone marrow specimens can beinfluenced by: (1C2) a) Recenttreatment of the patient b) The specific disease c) Amount of specimen d) Time between collection ofspecimen and set-up of culture e) All ofthe above

e) All ofthe above

Which of thefollowing samples would you assign thehighest priority? (1C3) a) Aperipheral blood sample from a24 year old woman who has had three miscarriages and one normal child. b) Amniotic fluid from a 36 yearoldwoman who is 18weeks pregnant. c) A babywho is in the INCU withmultiple malformations d) A 13 year old child with ambiguous genitalia, moderate mental retardation and developmental delay.

c) A babywho is in the INCU withmultiple malformations

Which ofthe following situations would bethe most likely tobenefit from high resolution banding? (1C4) a) Detecting a complete deletion ofthe short arm of chromosome 10. b) Detecting an i(8q) c) Detecting the extra Y in a 47,XXY case. d) Detectinga microdeletion on chromosome 15q

d) Detectinga microdeletion on chromosome 15q