Western Lab All Quizes Flashcards
1
Q
- High Density lipoproteins (HDL)…
Select one:
A. are found mainly in animal and vegetable fats that are solid at room temperature.
B. deliver cholesterol to cells throughout the body.
C. return cholesterol to the liver, where it is converted into bile salts for elimination.
D. regulates the body’s production of cholesterol based on the amount of saturated fat that is consumed.
A
- c
2
Q
2. What lab value should be monitored in a patient with thrombophlebitis who is undergoing treatment with oral anticoagulant therapy with warfarin (Coumadin)? Select one: A. PTT/aPTT B. Hemoglobin (Hgb) C. platelet count D. Hematocrit (Hct) E. PT/INR
A
- E
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood does not clot properly. Aka: aPTT Activated partial thromboplastin time
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. Formal name: Prothrombin Time and International Normalized Ratio
3
Q
- The physician orders blood coagulation tests to evaluate a patient’s blood-clotting ability. Which test is used to determine a patient’s response to heparin therapy?
Select one:
A. Partial thromboplastin time (PTT/aPTT)
B. Platelet count
C. Bleeding time (BT)
D. Prothrombin time (PT)
A
- a
Heparin is used to prevent blood clots from forming in people who have certain medical conditions or who are undergoing certain medical procedures that increase the chance that clots will form.
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood does not clot properly. Aka: aPTT Activated partial thromboplastin time
4
Q
- A 23-year-old female aeronautical engineer complains of a rash on her ankles and shins, and easy bruising for 10 days. The rash is not itchy or painful. She denies recent contact with new soaps or detergents. The bruises occur on her arms and sides, unrelated to trauma.
On further questioning, she reports nosebleeds, gum bleeding with flossing, and an unusually heavy menses two weeks ago. On physical exam, she has no lymphadenopathy or hepatosplenomegaly. Her stool is Guaiac positive. This is a close up of her rash:
The physician ordered CBC, Peripheral blood smear and PT, aPTT. The results are as following:
CBC:
Patient; Normal
WBC (x 103/ml): 6.0; 4.3-10
Hemoglobin (gm/dl): 13.1; 12-16
Hematocrit (%): 39; 38-50
RBC (x 106/ml): 4.7; 4.2-5.4
MCV (fL): 86; 78-96 (Mean Cell Volume) average RBC
Platelet Count (x 103/ml): 3; 150-450
MPV (fl): 14; 7.2-11.1 (Mean Platelet Volume)
Peripheral Blood Smear: Remarkable for low count of platelets, slightly increased in size indicating quick turnover in bone marrow. MPV is the average volume of platelets and is measured in fL (femtoliters).
PT = 11.6 seconds (normal 10.4 - 12.8 seconds)
aPTT = 32 seconds (normal 24 - 34 seconds)
What is the likely diagnosis?
Select one:
A. Systemic lupus erythematosus (SLE-autoimmune disorder of connective tissue)
B. Hepatitis (inflammation of liver)
C. Aplastic anemia (anemia due to bone marrow failure)
D. Acute leukemia (malignant increase of white blood cells)
E. Autoimmune thrombocytopenia
A
- e
Thrombocytopenia is any disorder in which there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is sometimes associated with abnormal bleeding.
5
Q
5. This cell fights against infection and is a/an: Select one: A. Neutrophil B. Monocyte C. Lymphocyte D. Eosinophil E. Basophil
A
- a
6
Q
6. A person with a hematocrit of 66 and hemoglobin of 22 is most likely to have the condition named: Select one: A. Polycythemia B. Anemia C. Infectious mononucleosis D. Leukemia
A
- a
Polycythemia: Abnormal increase in RBC count
Anemia: 10% or more decrease in RBC count
Infectious mononucleosis, or “mono”, is an infection usually caused by the Epstein-Barr virus. The virus spreads through saliva, which is why it’s sometimes called “kissing disease.” Mono occurs most often in teens and young adults.
Leukemia: Bone marrow is replaced by neoplastic tissue. Leukemia is cancer of the white blood cells. White blood cells help your body fight infection. Your blood cells form in your bone marrow. In leukemia, the bone marrow produces abnormal white blood cells. These cells crowd out the healthy blood cells, making it hard for blood to do its work (too many leucocytes accumulated in the body)
Hematocrit Hct: % of RBC in total volume of blood. Example: Normal 45%, Anemia 30%, Polycythemia 70%
Dehydration: plasma & Erythrocytes total is not full and; hematocrit is at 70% of 3/4 full test sample
7
Q
- A 50-year-old white female seeks medical attention for easy fatigability that developed during the last 2 months. She also feels mildly short of breath with exertion such as walking up a flight of stairs, but she has no chest pain with exertion or at rest. She gives no history of bright red blood per rectum or black, tarry stools (melena), but she has had heavy menstrual periods for about a year. Her past medical history is relevant for anemia following her second pregnancy 8 years ago. She is on no prescribed medications. Family history is noncontributory.
Relevant physical examination was remarkable for pale conjunctiva. Rectal examination revealed no masses and heme negative brown stool was present.
Interpret her labs and select the right answer:
CBC; Patient Result; Normal Range
WBC: 8.2 X 103/μL; (4.8-10.8 X 103/μL)
Hgb: 8.0 g/dL; (12-15.6 g/dL)
Hct: 24%; (35-46%)
RBC: 4.0 X 106/μL; (3.8-5 X 106/μL)
MCV: 60 fL; (80-96.1 fL) Mean corpuscular volume
MCH: 20 pg; (27.5-33.2 pg) Mean corpuscular hemoglobin
MCHC: 33 g/L; (33.4-35.5 g/L) Mean corpuscular hemoglobin concentration
RDW: 16.5; (11.5-14.5) Red cell distribution width
Platelets: 500,000/μL; (150-400,000/μL)
Reticulocyte count: 3%; (0.5-1.7%). Reticulocytes are slightly immature red blood cells.
A. Hemolytic anemia (short life span of RBCs)
B. Megaloblastic anemia (RBCs are large)
C. The platelet count is suggestive of a myeloproliferative disorder (overactive bone marrow).
D. Hypochromic, microcytic anemia with anisocytosis.
A
- d
Decrease in MCHC is known as hypochromic (think “less color” because of less hemoglobin) anemia. This is seen in iron-deficiency anemia and thalassemia.
Thalassemia: inherited blood disorders. If you have one, your body makes fewer healthy red blood cells and less hemoglobin. Hemoglobin is a protein that carries oxygen to the body. That leads to anemia. Thalassemias occur most often among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent.
8
Q
A hematocrit value is normally about \_\_\_\_\_\_\_\_\_\_\_ the value of the hemoglobin. Select one: A. Three times B. One-third C. 700 times D. The same
A
- a
Hematocrit is the % of RBC in total volume of blood. Male 42-52%, Female 37-47%
Test tube is composed of (Plasma, leukocytes, platelets, erythrocytes). 45% (plasma), 55% (erythrocytes 44%, leukocytes, platelets 1%)
9
Q
9. Analysis of the arterial blood gave the following analysis: Pco216 mm of Hg (N=35-45 mm of Hg), HCO3 5mEq/L (N= 21-28 mEq/L) and pH of 7.1. What is the basic underlying acid-base disorder?Select one: A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Metabolic acidosis
A
- D
10
Q
<p>2. Estrogen/progesterone assays were done in a female patient with precious pregnancy. A declining level of above hormones was observed. This indicates:Select one: A. Failing pregnancy B. Menopause C. Normal pregnancy D. Ovarian tumor </p>
A
- A
11
Q
- A 54-year-old executive reported with vague complaints of fatigue, loss of appetite and some pain towards the right side of the abdomen. Physical examination revealed borderline enlargement of liver and important lab findings were:Serum AST 320 units/L (N=0-35 units/L)Serum ALT 120 units/L (N=0-40 units/L)Serum ALP 78 units/L (N= 30-140 units/L)Total bilirubin 23µmol/L (N=0-24 µmol/L)CBC and urinalysis were normal.Interpret the above findings:Select one:
A. Hepatocellular damage
B. Prehepatic jaundice Bilirubin levels are near the upper border of normal range so hemolytic or prehepatic jaundice is ruled out.
C. Bilirary obstruction
A
- A
12
Q
- Male aged 28 years. His semen analysis report:Volume 2-5 mLLiquefaction time: 30 minutes after collection. pH: 8.00Sperm count or density: 26 million/LSperm motility: 12% excellent at 1 hour, 60% immotile, 15% sluggishSperm morphology: 5% normally shaped.Select one:
A. All other features of his semen analysis are within normal limits.
B. A satisfactory number of sperms have normal shape. C. It is unlikely for this man to make his partner pregnant.
D. Sperm count is normal. Sperm motility is acceptable.
A
- C
13
Q
13. All professionals entering healthcare profession in Alberta are subjected to Mantoux/tuberculin skin test. A negative test is indicated by a wheal size:Select one: A. None of the above applies. B. less than 5 mm wheal C. greater than 10 mm wheal D. less than 15 mm wheal
A
- B
14
Q
- Patient A is 19 years of age who presents to her physician’s office with mild jaundice. The patient reports being in good health until a week before, at which time she began having “flu” symptoms of headache, low-grade fever, nausea, loss of appetite, and malaise. She self-treated the fever with Tylenol. The symptoms persisted. Upon awakening this morning, she noticed that her sclera were icteric. She therefore contacted her physician’s office. In response to her physician’s questions, she indicated that her urine has been darker than usual.Other significant history includes that she was immunized against hepatitis B at 12 years of age and she recently visited Central America. Patient A returned to Canada 5 weeks ago. Results of laboratory tests are indicated in the following table:Test; Patient’s Results; Normal Value or RangeHematocrit (Hct); 40%; 37% to 47%Hemoglobin (Hgb); 13.3 mg/dL; 12.0–16.0 mg/dLWhite blood cell count; 6200 cell/microliter; 4300–10,800 cells/microliterAspartate aminotransferase (AST); 323 Units/L; 0-35 Units/LAlanine aminotransferase (ALT); 358 Units/L; 1-40 Units/LTotal bilirubin; 72 µmol/L; 0-24 µmol/LHBsAg; Negative; NegativeHBsAb; Positive; Positive indicates previous disease or immunization; negative indicates no exposureAnti-HAV IgM; Positive; NegativeAnti-HCV antibody; Negative; NegativeAlkaline phosphatase (ALP); 85 Units/mL; 30-140 Units/mLProthrombin time (PT); 11.6 seconds; Control 10.4 seconds (normal is ±2.0 seconds from control)Albumin; 3.8 mg/dL; 3.5–5.5 mg/dLGlucose; 84 mg/dL; 70–110 mg/dLSodium; 142 mEq/L; 135–150 mEq/LChloride; 102 mEq/L; 100–108 mEq/LPotassium; 3.8 mEq/L; 3.6–4.8 mEq/LSelect one:
A. Acute hepatitis C infection.
B. Previous exposure or immunity to hepatitis A virus. A previous exposure or immunity is indicated by presence ofHAV-Ab/IgG.
C. Acute hepatitis B infection
D. Acute viral hepatitis A infection
A
- D
15
Q
- A quantitative hCG test(beta hCG) measures the exact amount of hCG in your blood. Along with ultrasound it is invaluable in the diagnosis of ectopic pregnancy.Select one:
True
False
A
- True
16
Q
- In prehepatic jaundice urobilinogen is detected in urine.Select one:
True
False
A
- True
17
Q
- Prostate-specific antigen (PSA) is measured in blood of men to rule out prostate cancer and monitor the disease after treatment.Select one:True False
A
- True
