Specimen Handling, Preparation and Processing Flashcards

1
Q

The Following are indicators for amniocentesis EXCEPT FOR:
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

A

D

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2
Q

When a bone marrow (bm) sample can not be delivered to the lab within 4 hours,
the sample should be:
A. Kept on dry ice
B. Put in media and kept at room temperature
C. Kept at 37oC
D. Put in formalin

A

B

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3
Q
A PB sample is clotted. What do you do? 
 A.  Break up clot
 B.  Add heparin
 C.  Spin and culture supernatant
 D.  Discard
A

A

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4
Q
All the following information is required during the specimen set-up procedure
EXCEPT: 
 A.  Patient information
 B.  Sample type
 C.  Sample quality
 D.  Infectious agent
A

D

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5
Q
When should samples be logged in? 
 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
A

B

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6
Q
How long do you wait before requesting an amniotic fluid if no cell attachment is
observed? 
 A.  3 days
 B.  10 days
 C.  21 days
 D.  28 days
A

B

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7
Q

All of the following will result in culture failure EXCEPT:
A. Transport at room temperature
B. Sample shipped on ice
C. Specimen exposed to 40oC
D. Improper sterile techniques used

A

A

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8
Q
Which cells would you want to use for long term serial cytogenetic studies?
 A.  epithelial
 B.  fibroblast
 C.  cocci
 D.  amniocytes
 E.  lymphocytes
A

B

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9
Q
Which statement(s) regarding the CVS procedure is (are) true? 
A.  It was introduced in 1968.
B.  It involves removal of a sample of placental tissue by transcervical aspiration with a thin plastic catheter.
C.  It involves removal of a sample of placental tissue by transabdominal aspiration with a 20 gauge needle.
D.  All of the above are true 
E.  B and C are true
A

D

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10
Q
Lab C noticed that patient samples from one of their doctors had poor or no growth as compared to their other doctors samples. No evidence of contamination was observed and all material needed for sample collection and transportation is provided to the doctors by the laboratory. What could cause this discrepancy in culture viability?
 A.  Collection technique
 B.  Incubator systems
 C.  Toxic plastic containers
 D.  Culture media
A

A

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11
Q
A woman knows that she is a carrier for Fragile X syndrome. What prenatal test can be done with the highest accuracy for Fragile X as early in the pregnancy as possible? 
 A.  Fetal blood sampling
 B.  Chorionic villus sampling
 C.  Amniocentesis
 D.  Maternal serum triple screening
A

B

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12
Q
The anticoagulant of choice for peripheral blood is:
 A.  Sodium citrate
 B.  Lithium heparin
 C.  Sodium heparin
 D.  EDTA
A

C

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13
Q
Sodium heparin 
 A.  Swells cells
 B.  Removes water from cells
 C.  Stimulates mitotic activity
 D.  Precipitates nucleic acid
 E.  Prevents clotting
A

E

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14
Q
Which of the following is least likely to be toxic to cells? 
 A.  Sodium heparin
 B.  Lithium heparin
 C.  Sodium hydroxide
 D.  Gentamycin
A

A

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15
Q
Penicillin/Streptomycin is used to control 
A.  mycoplasma
B.  bacteria
C.  fungi
D.  all of the above
A

B

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16
Q

A pathologist is sending solid tumor specimens to a cytogenetics laboratory for analysis. What instructions should be given to the pathologist concerning the preparation and transport of the specimen to ensure the highest chance of successful culture?

A. Ensure the sterility of the specimen by placing it in formalin until it reaches the laboratory.
B. Ensure that the specimen does not contain necrotic or fatty tissue.
C. Ensure that the specimen is transported on dry ice to prevent decomposition.
D. All of the above.

A

B

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17
Q

It is possible for the collecting syringe used in amniocentesis to be toxic to the amniotic cells.
A. True
B. False

A

True

18
Q

A solid tumor specimen can NOT be shipped from the hospital to a cytogenetics laboratory in another city due to a major holiday which will not allow the sample to be shipped via Federal Express Overnight delivery. How should the sample be stored so that the cells will remain alive until they can be delivered and placed in culture?

A. The specimen should be preserved by placing it in formalin until it reaches the laboratory.
B. The specimen should be placed in media and then in a 37oC incubator until it can be shipped.
C. The specimen should be stored at -20oC or on dry ice to prevent cellular decay.
D. The specimen should be placed in media and then refrigerated until it can be shipped.

A

D

19
Q

Blood is received for cytogenetic analysis in a busy clinical laboratory. It will be several hours before a cytogenetic technologist will be able to do the set-up procedure. How should this blood be stored during the interim period?

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 0oC	
 D.  All of the above
A

A

20
Q
What is the optimal temperature for transport of amniotic fluid specimens? 
	 A.  37oC	
	 B.  40oC	
	 C.  0oC	
 	 D.  20oC
A

D

21
Q

All of the following will result in culture failure EXCEPT:

A. Transport at room temperature

 B.  Sample shipped on ice	
 C.  Specimen exposed to 40oC	
 D.  Improper sterile techniques used
A

A

22
Q

Which statement about maternal cell contamination is true?

 A.  There is a 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 of maternal C-band polymorphisms is not helpful in identifying cases of maternal cell contamination.	
 D.  Discarding the first 2-3 cc of amniotic fluid can increase the risk of maternal cell contamination.
A

B

23
Q

Not all cells received by a cytogenetics laboratory will grow well in culture for any number of reasons. When amniotic fluid specimens are collected for culture, which of the following are safeguards against culture failure?

 A.  Samples are collected in one syringe.	
 B.  The first 5 cc of fluid are discarded.	
 	 C.  Two culture are set up with two different types of media	
 D.  T12 1/2 flasks are used.
A

C

24
Q

Of the tissue types selected from abortus specimens, the one that exhibits the best growth rate is:

 A.  Fetal skin	
 B.  Spleen	
 	 C.  Chorionic villi	
 D.  Umbilical cord
A

C

25
Q

The type of cell analyzed with the CVS direct preparation is:

 A.  yolk sac endoderm	
 	 B.  cytotrophoblast	
 C.  mesenchymal stroma	
 D.  syncytiotrophoblast
A

B

26
Q

Why is the villi obtained in CVS procedures cleaned by the technologists?

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.

A

C

27
Q

Lymph node is the tissue of choice for cytogenetic analyses of lymphomas.
A. True
B. False

A

TRUE

28
Q

Which of the following is (are) specimen factors that could adversely effect culture outcome?

 A.  High or low wbc	
 B.  Clotting	
 C.  Sample quantity	
 	 D.  All of the above
A

D

29
Q

Why is enumeration of cells in marrow and blood important?

 A.  Those patients who have a large number of cells have a better prognosis.	
 B.  It is important to ensure that all cultures have the same number of dividing cells.	
 	 C.  It is important to maintain uniform culture conditions, and cell concentration varies greatly from sample to sample.	
 D.  Bone marrow cells will not grow in culture unless the cell density is at least one million cells per ml.
A

C

30
Q

Mark is preparing a peripheral blood specimen for culture. When he assesses the specimen for adequate cell volume, the Coulter counter acts erratically. The count exceeds 100,000. How should he proceed?

 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.  Run the controls through the Coulter 
          Counter and check the accuracy.
A

B

31
Q

What is the recommended final cell concentration of cells for bone marrow cultures for chromosome studies?

A. 1 million cells per ml of media

 B.  2 - 3 million cells per ml of media	
 C.  3 - 4 million cells per ml of media	
 D.  5 million cells per ml of media
A

A

32
Q

The high culture failure rate in solid tumors is likely due to:

 A.  specimen contamination	
 B.  specimen necrosis	
 C.  delay in transit	
 	 D.  all of the above
A

D

33
Q

When a clotted BM specimen comes into the lab, the technologist should:

 A.  Request a new specimen	
 B.  Discard the specimen	
 	 C.  Place the specimen in a warm waterbath and attempt to break up clot.	
 D.  Set up the clotted BM as usual
A

C

34
Q

Clinical indications for karyotyping include all the following EXCEPT:

A. Multiple malformations in a newborn
B. Single malformation in a newborn
C. Mental retardation of unknown etiology
D. Offspring with a chromosomal
rearrangement
E. Recurrent pregnancy loss

A

B

35
Q

Which of the following is not an indication for routine peripheral blood chromosome analysis?

A. Advanced maternal age.
B. To determine whether a chromosomal 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

A

36
Q

All of the following information is required during the specimen set-up procedure EXCEPT:

 A.  patient information	
 B.  sample type	
 C.  sample quality	
 	 D.  infectious agent
A

D

37
Q

To verify the appropriateness of a specimen for chromosome analysis, which of the following is the most important data to accompany the specimen?

 A.  The patients sex	
 	 B.  Reason for referral	
 C.  Date of birth	
 D.  Time of collection
A

B

38
Q

Failure rates for cytogenetic analysis of bone marrow specimens can be influenced by:

	 A.  Recent treatment of the patient	
	 B.  The specific disease	
	 C.  Amount of specimen	
	 D.  Time between collection of specimen and set-up of culture	
 	 E.  All of the above
A

E

39
Q

Your laboratory receives specimens from the following cases. Which case would you assign the highest priority?

A. A 24 year old woman who has had three miscarriages and one normal child.
B. The 28 year old husband of the woman above.
C. Amniotic fluid from a 36 year old womans current pregnancy of 18 weeks gestation.
D. A baby who is in the INCU with a myelomeningocele, a heart defect, intrauterine growth deficiency, a tightly clenched fist and an unusually positioned great toe.
E. A 10 year old boy who is small for his age and has small hands, moderate mental retardation, protruding ears, droopy eyelids and a small mouth.

A

D

40
Q

Which of the following situations would be the most likely to benefit from high resolution banding?

A. Detecting a complete deletion of the short arm of chromosome 10.
B. Detecting an i(8q)
C. Detecting the extra Y in a 47,XXY case.
D. Detecting a microdeletion on chromosome 15q.

A

D