quiz
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quiz
Which of the following best describes the direct antiglobulin test principle:
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AHG detects antibody already coated to red cells
AHG prevents antibody from coating red cells
AHG is directed against cell antigens
AHG is directed against plasma antibodies
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In the DAT, or direct antiglobulin test, AHG is added to patient cells without the addition of antisera. This means that if a positive reaction occurs, it is due to the presence of already sensitized red blood cells which had a coating of antibody in vivo.
Label this serum protein electrophoresis (SPE) scan:
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Alpha - 1Alpha - 2BetaGamma
How long may blood be stored using CPDA-1 preservative prior to transfusion?
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5 days15 days25 days35 days
Peak#4
Peak#3
Peak#2
Peak#1
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Blood collected in CPDA-1 may be stored at 1 - 6 oC for up to 35 days.
Match each blood type with the corresponding antibody you would find in its serum:
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Anti-AAnti-BAnti-A, Anti-Bnone
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In type O patients, both anti-A and anti-B will be present since the patient does not have A or B antigens on their red cells. Individuals who are type A, will have anti-B and will not have anti-A. The reverse is true for type B individuals. Finally, type AB individuals will have neither anti-A or anti-B in their plasma.
Which of the following is not true about members of the Enterobacteriaceae:
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Gram-negativeOxidase positiveReduce nitrate to nitriteFerment glucose
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Any oxidase-positive organism can be excluded from the Enterobacteriaceae. The other characteristics are as a rule present in these organisms.
What is the primary functional unit of the kidney:
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UreterGlomerulusNephron
B
A
O
AB
Distal convoluted tubule
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The nephron, the basic functional unit of the kidney, consists of a glomerulus, the proximal convoluted tubule, the loop of Henle, the distal convoluted tubule, and the excretory duct.
To prepare 500 ml of a 5 % NaOH Solution how many grams of NaOH is required:
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5 grams10 grams25 grams50 grams
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A percent solution is prepared by combining grams of material (i.e NaOH) per 100ml of solvent.
In what section of the MSDS manual would you find information on which chemical might affect your health:
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Physical hazards sectionHealth hazards sectionReactivity hazards sectionGeneral contents section
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The acute and chronic health hazards of the chemical, together with signs and symptoms of exposure, must be listed. In addition, any medical conditions that are aggravated by exposure to the compound, must be included. The specific types of chemical health hazards defined in the standard include carcinogens, corrosives, toxins, irritants, sensitizers, mutagens, teratogens, and effects on target organs (i.e., liver, kidney, nervous system, blood, lungs, mucous membranes, reproductive
system, skin, eyes, etc.). The route of entry section describes the primary pathway by which the chemical enters the body. There are three principal routes of entry: inhalation, skin, and ingestion. This section of the MSDS supplies the OSHA PEL, the ACGIH TLV, and other exposure levels used or recommended by the chemical manufacturer. If the compound is listed as a carcinogen (cancer-causing agent) by OSHA, the National Toxicology Program (NTP), or the International Agency for Research on Cancer (IARC), this information must be indicated on the MSDS .
A solution of gamma globulins containing anti-Rh (D) is given to an Rh (D) negative mother to:
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Prevent fetal cells from initially sensitizing the motherNeutralize any of the child's antibody that may have passed the placental barrierNeutralize any natural maternal antibodies presentPrevent greater antibody response in a previously sensitized mother
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Gamma globulin (anti-D) is given to Rh-negative mothers to prevent any D antibody production, which could cause harmful effects in future pregnancies with an Rh-positive fetus. The administered anti-D will bind fetal Rh-positive cells that may come from the fetus in vivo; therefore the mother will not produce anti-D herself, preventing sensitization.
Which of the following media would you use to isolate Francisella tularensis:
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Sheep-blood agarLowenstein-Jensen mediaBordet-Gengou mediaCysteine-blood agar
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Although cysteine-blood agar was traditionally used, F. tularensis will also grow on commercially available Thayer-Martin and chocolate agar which have been enriched with supplemental nutrients.
Which of the following statements about synovial fluid is true?
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Markedly elevated neutrophils always correspond to bacterial joint infectionPatients with gout involving joints will have markedly elevated neutrophils in their synovial fluidFungal joint infections have synovial fluid with numerous lymphocytesTuberculous joint infections have synovial fluid with numerous plasma cells
Which of the following statements about Rickettsia is false:
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They are obligate intracellular parasitesThey are gram negative bacilliAssociated diseases are usually diagnosed by serologyThey are cultured in many hospital laboratories
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Various Rickettsial species cause typhus, Rocky Mountain spotted fever, Rickettsialpox, and Q fever. Rickettsial organisms are cultured only by research and reference laboratories, and the diagnosis is usually achieved by a combination of clinical findings, and acute and convalescent serology. Early diagnosis of Rocky Mountain spotted fever can also be made by immunoflourescence testing of a skin biopsy, where Rickettsia can often be found within endothelial cells of capillary vessels.
Which of the following is used primarily for the treatment of manic-depression:
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PhenobarbitalLithiumDigoxinAscorbic acid
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Lithium is commonly used in the treatment of manic depressive patients. Lithium exerts a dual effect on receptors for the neurotransmitter glutamate; acting to keep the amount of glutamate active between cells at a stable, healthy level, neither too much nor too little. This allows for a mood stabilization for these patients.
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Protein-bound calcium
Non-ionized calcium
Calcium carbonate
Free ionized calcium
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Ionized calcium is important in physiologic functions such as coagulation and neuromuscular conductivity.
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Contains all labile coagulation factors except cryoprecipitateHas a higher risk of transmitting hepatitis than does whole bloodShould be transfused within 24 hours of thawingNeed not be ABO-compatible
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Fresh Frozen Plasma (FFP) should be thawed at 37 degrees Celsius and transfused within 24 hours when stored at 1 to 6 degrees Celsius. Indications include bleeding related to coagulation factor deficiency if specific concentrates are not appropriate, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome. FFP should not be used as a volume expander, since there is a risk of transfusing bloodborne pathogens.
Increased excretion of creatinine would be expected in which of the following groups:
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Elderly males/femalesAdult malesAdult females
Children/infants
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Diets high in meats, and extreme exercise will cause a significant increase in creatinine excretion.
Which one of the following are not associated with a polyclonal (broadbased) increase in gamma globulins?
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Liver disease
Chronic inflammation
Immune reaction
Immunodeficiency
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Immunodeficiency would, of course, generally be associated with a decrease in serum immunoglobulin levels, and an associated decreased gamma band.
Match substance(s) secreted with their respective blood groups:
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A, B, & HB & HA & HH
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Type A patients will have both A and H substances secreted. B patients will have both B and H substances secreted. AB patients will have A, B, and H substances secreted. Type O patients will only secrete H substance.
All of the following parameters are measured by a blood gas analyzer except:
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AB
B
A
O
pCO2pHHCO3pO2
This question refers to results of the classical complement fixation test; match the result on the left with the presence or absence of hemolysis on the right.
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HemolysisNo hemolysis
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The indicator system hemolyzes when there is no antibody present in the patient's serum. When antibody is present in the patient's serum, antigen-antibody complexes are formed, depleting complement, and reducing or eliminating hemolysis. Absence of hemolysis therefore indicates the presence of antibodies in the patient's serum.
Which of the following are useful serological tests to document antecedent Streptococcal infections:
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ASOanti-DNAseM-antigenHemolysin
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ASO (antistreptolysin O titer) and DNAse (antideoxyribonuclease-B titer) are tests that can be used to detect antecedent streptococcal infections. The ASO is usually utilized to determine whether a previous group A Streptococcus infection has caused a poststreptococcal disease, such as rheumatic fever, scarlet fever, or glomerulonephritis. The anti-DNase test is utilized to determine whether a previous infection of group A beta-hemolytic Streptococcus has occured.
What is the purpose of using alcohol in the gram stain procedure:
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Absence of antibody in patient's serum
Antibody present in patient's serum
Fix all gram positive organismsDecolorize all gram positive organismsDecolorize all gram negative organismsFix all gram negative organisms
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The alcohol in the gram stain solution acts as a decolorizer which washes the stain away from everything in the smear except the gram-positive organisms.
The most common source of Anti-A1 is:
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Group A1
Dolichos biflorousGroup OArachis hypogea
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Absorbed group B antisera may be used as a source of anti-A1. More commonly, anti-A1 reagents are manufactured from the lectinDolichos biflorous.
Total magnification of a microscope can be determined by:
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Multiplying power of objective times the power of the ocularDividing the power of objective by the power of the ocularDividing the power of the ocular by the power of the objectiveAdding the power of the ocular and objective together X 10
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The total magnification of the microscope must be calculated by considering BOTH the optical and objective lenses. By multiplying these magnifications together, the result is the actual total magnification of a particular microscope.
Which of the following is not associated with RBC macrocytosis?
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AlcoholismHypothyroidismB12 deficiencyThalassemia
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Thalassemia is usually associated with microcytosis. The other conditions can cause macrocytosis of RBCs.
This suspicious form was recovered in blood.
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Plasmodium vivax ring formPlasmodium malariae band formPlasmodium falciparum ring formPseudoparasite
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Plasmodium falciparum ring forms often resemble a walkman headset by containing two chromatin dots instead of one, as commonly seen in the other Plasmodium species. These dots serve as connecting points for the ring of cytoplasm.
What is the maximum concentration of a chemical allowable for repeated exposure without producing adverse health effects called?
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Threshold limit valueThreshold time limitTime limit valueShort term limit
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A threshold limit value is the maximum concentration of a chemical allowable for repeated exposure without producing adverse health effects.
Identify the urine sediment elements indicated by the arrow in the illustration:
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Cholesterol crystalsTriple phosphate crystalsAmorphous urate crystalsAmmonium biurate crystals
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Triple phosphate crystals appear as colorless prisms with 3 to 6 sides and oblique ends, or as "feathery sleeves". The have been described as "coffin lid shaped", and can occur normally in alkaline urine. They may indicate the presence of an infection.
An increase in the predominant white cell type in this illustration is indicative of:
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ThrombocytopeniaMonocytosisLeukopeniaLymphocytosis
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Lymphocytosis is a condition in which there is an increase in the lymphocyte population. In most laboratories, lymphocytosis is defined as lymphocyte counts greater than 40%, depending on the patient age.
What best describes the cells seen in this illustration:
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OvalocytesBurr cellsSickle cellsElliptocytes
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Burr cells (echinocytes) may occur as an artifact or in cases of heart disease, uremia, bleeding ulcers, and stomach cancer.
What abnormaility is present in the white blood cell indicated by the arrow?
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Döhle bodiesPelger-Huet anomalyToxic granulationAuer rods
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The cell is exhibiting toxic granulation. Toxic granulation can be seen in infections and inflammations.
Which two of the following are associated with macrocytic anemia?
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Iron deficiencyFish tapewormSickle cell diseaseFolic acid deficiency
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Both fish tapeworm and folic acid deficiency may appear as a macrocytic anemias.
What percentage solution of sodium hypochlorite (bleach) is recommended as a routine laboratory disinfectant:
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5 %10 %15 %20 %
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Diluted bleach is widely recommended as a general laboratory and hospital surface disinfectant. Preparing10% solutions of bleach on a regular basis is suggested.
In a normal CSF the protein concentration as compared to that in the serum is generally:
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Less than 50%Less than 30%Less than 10%Less than 1%
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Normal ratio of serum to CSF Protein is about 200 to 1, or less than 1%. Elevation of CSF total protein is a nonspecific finding, but usually indicates some type of disease involving the brain or meninges.
Which one of the following would not result in a rejection of an analytical run under the Westgard rules:
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One control observation exceeding the mean by 2.5 SDOne control observation exceeding the mean by 3.5 SDTwo consecutive control observations, one exceeding the mean by +2.5 SD, and the other by -2.5 SDTen consecutive control observations all less than the mean
Which one of the following statement about Campylobactor jejunisp. jejuni is false:
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It can occur in domestic animals, raw milk, and undercooked poultryIt does not require special media to grow outIt is associated with neutrophils (PMNs) in the stoolIt is a gram negative, curved or spiral shaped rod
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It requires selective media, such as Campy-BAP and Campy-thio to grow. It also requires incubation at 42° C, and 10% Carbon Dioxide. It is an important cause of acute diarrheal illness.
Which section of the MSDS would provide information on chemical hazards that might affect your health:
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Physical and chemical dataHealth hazard dataReactivity dataHazardous ingredients
data
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The health hazards section of a MSDS sheet contains this information. According to OSHA, "health hazard is defined as a chemical for which there is statistically significant evidence that acute or chronic health effects may occur in exposed employees. The term "health hazard" includes chemicals which are carcinogens, toxic or highly toxic agents, reproductive toxins, irritants, corrosives, sensitizers, hepatotoxins, nephrotoxins, neurotoxins, agents which act on the hematopoietic system, and agents which damage the lungs, skin, eyes, or mucous membranes."
Identify the urine sediment elements shown by the arrow:
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WBC castsRBC castsWaxy castsGranular casts
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WBC casts (leukocyte casts) usually indicate pyelonephritis.
This parasite resides in human intestine.
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Taenia solium scolexHymenolepis nana scolexDipylidium caninum scolexDiphyllobothrium latum scolex
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The Taenia solium scolex is identified by the presence of four suction-cuplike suckers and the presence of a fleshy rostellum with hooklets.
Which of the following tests must be repeated by the lab on homologous blood received from the Red Cross or other community blood sources:
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ABO, Rh, HBsAgABO, Rh, HBsAg, HIVABO, Rh, HIVABO, Rh
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The Red Cross and the community blood centers have already performed serological testing for infectious agents.
An India Ink preparation in used to identify:
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Crystals in synovial fluidCryptococcus neoformans in CSFBacteria in CSFWBCs in synovial fluid
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India ink preparation performed on spinal fluid is used to demonstrate the polysaccharide capsule of Cryptococcus neoformans by negative staining. Direct detection of capsular antigen by agglutination or immunoassay techniques is much more sensitive, and has largely replaced the India Ink stain for clinical specimens.
What percentage of glycerol is generally used when freezing red cells of rare phenotypes:
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70 %40 %10 %5 %
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Cryopreservation of red cells is expensive, and of limited value for routine use since their shelf life after thawing is only 24 hours. It is invaluable for maintaining an inventory of rare blood phenotypes.
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MyelocyteMonocyteMetamyelocyteLymphocyte
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The cell shown in this image is a myelocyte. Myelocytes typically have an eccentric nucleus with cytoplasm similar to a mature neutrophils with a slightly bluer tint due to the cell's immaturity. Myelocytes have both primary and secondary granules present in the cytoplasm. The nucleus is less mature and therefore has a loose chromatin clumping pattern.
Lipemia in a serum sample is most likely caused by an increase in serum levels of:
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CholesterolTriglyceridesProteinPhospholipids
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Lipemia is generally caused by an increase in VLDL (very low density lipoproteins), which are primarily composed of triglycerides.
Identify the cell in this illustration indicated by the arrow:
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EosinophilMonocyteBasophilNeutrophil
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Eosiniphils have characteristic large prominent orange granules.
Which blood cell is found in the largest numbers in the peripheral blood of a normal adult:
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LymphocyteMonocyteBasophilSegmented neutrophil
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Segmented neutophils followed by lymphocytes are the most abundant cells found in the peripheral blood of normal adults.
Hypersegmentation of granulocytes is most commonly associated with:
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Inherited trait or lipid storage diseaseIron deficiencyViral infectionVitamin B12 or Folate deficiency
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Hypersegmentation can be the result of B12 or folate deficiency.
The gradual deterioration of an instrument's light source would most likely be reflected in the quality control results as:
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DriftShiftRandom errorsBias 1-2 SD on either side of the mean
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Drift is the slow progressive change in control values over time.
Which one of the following organisms is sensitive to bacitracin:
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Group A StreptococcusGroup B StreptococcusGroup D StreptococcusStaphylococci
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Group A Streptococcus is suseptible to bacitracin. Group B Streptococcus, Group D Streptococcus, and Staphylococci are resistant to bacitracin.
What is the best description of the phenomenon seen in this illustration?
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Rouleau formationCold agglutinationRosette formationMonocyte activation
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The image shown in this question is depicting a rosette formation. Here the red blood cells are surrounding and adhering to the outside of the white blood cell.
The WBC anomaly indicated by the arrow in this illustration is:
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Alder-Reilly anomalyPelger-Huet anomalyMay-Hegglin anomalyToxic granulation
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May-Hegglin anomaly is a rare autosomal dominant condition in which patients are at risk for bleeding and infections. It is characterized by the presence of large Dohle body like inclusions within neutrophils, eosinophils, basophils, and monocytes.
Match the viruses below with their associated conditions.
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HerpesWartsCommon ColdGastroenteritis in infants
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Herpesvirus: Herpes
Rhinovirus: Common Cold
Papovavirus: Warts
Rotavirus: Gastroenteritis in infants
Which of the following tests would be employed in order to detect neural tube defects:
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BilirubinL/S ratioAlpha fetoproteinCreatinine
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Maternal serum alpha fetoprotein is elevated neural tube defects, and decreased in fetal Down's syndrome.
Which of the following antigen groups is closely related to the ABO system:
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RhKellI, iDuffy
Herpesvirus
Papovavirus
Rhinovirus
Rotavirus
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I and i antigens are related biochemically and spatially to the ABH and Lewis antigens on the red cell membrane. Anti-I is usually an autoantibody. It is common as a benign cold autoagglutinin. Strong anti-I is associated with Mycoplasma pneumonia infection, where it may be associated with cold autoimmune hemolytic anemia. Anti-I is characterized by its failure to react with cord red cells. Anti-i generally occurs as a cold reactive IgM antibody in the setting of infectious mononucleosis.
The Western Blot Assay is used as a confirmatory test for which of the following:
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HBsAgCMV AntibodyAnti-HCVAnti-HIV-1
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Western blot testing is the gold standard for anti-HIV-1 confirmation.
Which of the following would best be determined by running the same control specimen multiple times:
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RegressionReliabilityAccuracyPrecision
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Precision is a measurement of a method's ability to repeatedly produce the same value on a given specimen after multiple measurements. It is usually estimated by running the same specimen at least 20 times and calculating the standard deviation.
This serum protein electrophoresis scan most likely represents which condition?
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Chronic inflammationMyocardial infarctionLiver diseaseMonoclonal gammopathy
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There is a broad based increase in the gamma band, corresponding to polyclonal hypergammaglobulinemia, as seen in chronic inflammation.
If a pipette is labeled (TC) " to contain " you would do the following:
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Drain pipette, but not blow outDrain contents then blow out or rinseDrain to last mark on pipetteDo not consider the meniscus when filling
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"TC" means the total volume contained in the pipette - you must blow out to remove total contents.