1 Flashcards by Rhoan Jane Altura Calunsag

An acid-fast bacillus is isolated and produces an orange pigment when grown in either the light or the dark. Which type of organism has most likely been isolated?

• Photochromogen
• Scotochromogen
• Nonphotochromogen
• Rapid grower

• Scotochromogen

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The Direct Antiglobulin Test (DAT) is used to detect:

• Antibodies sensitizing red cells
• Antibodies in the plasma.
• Antigens coating red cells
• Antigens in the plasma.

• Antibodies sensitizing red cells

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A laboratory manager wants to evaluate the timeliness of patient services in order to prevent medical errors caused by a delay in treatment.
Measuring the turnaround time for which of these analytes would provide the most timely and valuable information?

• Routine glucose tests performed on patients admitted to the medical floors.
• Lipid panels performed by the outpatient clinic.
• Troponin tests from the emergency department.
• Urine creatinine clearance testing conducted on patients seen in the diabetes clinic.

• Troponin tests from the emergency department.

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Cell counts on CSF specimens should be performed within what time frame following collection of the CSF sample?

• Within one hour
• Within four hours
• Within eight hours
• Within 24 hours

• Within four hours

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Most antibodies present in cord blood are of origin.

• Fetal
• Maternal
• Paternal
• Maternal and paternall

• Maternal

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Which one of the following methods is the best way to confirm your patient’s identity?

• Look at the sign on the patient’s door or above the patient’s bed.
• Ask the patient to state his/her name, and check the patient’s armband, comparing the full name and medical record number to that shown on your preprinted collection list.
• Ask the patient to confirm his/her name as in the following example: “Is your name
Ms. Smith?”
• First collect the blood specimen, then establish patient identity, then label with the correct preprinted computer generated label.

• Ask the patient to state his/her name, and check the patient’s armband, comparing the full name and medical record number to that shown on your preprinted collection list.

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Normal crystals that can be found in urine include:

•Leucine
• Tyrosine
• Cystine
•Triple phosphate

•Triple phosphate

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A physician obtains a peritoneal fluid sample by lavage on a patient who complained of fever and abdominal pain following an automobile accident.
The fluid is analyzed in the laboratory. How should the sample shown in the image to the right be reported?
The correct answer is highlighted below

• Lymphocytes
• Eosinophils and parasites
• Mesothelial cells
•Neutrophils and bacteria

•Neutrophils and bacteria

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What is the primary target of HBV?

• Heart
• Liver
• Lungs
• Brain

• Liver

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The lecithin to sphingomyelin ratio (L/S) is used to assess:

• Fetal neurological development.
• Fetal lung maturity
• Fetal viability
• Fetal liver development

• Fetal lung maturity

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Which of the following tests would be most affected by microclots in an EDTA tube drawn for a
СВС?

• RBC
• Hematocrit
• Hemoglobin
• Platelet count

• Platelet count

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If an Rh negative patient is administered a unit of R1R1 packed red cells, which one of the following antibodies would be most likely to develop:

• Anti-c
• Anti-E
• Anti-e
• Anti-D

• Anti-D

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What would you expect the serum iron (SI) and total iron-binding capacity (TIBC) to be in a person with hereditary hemochromatosis (HH)?

• Increased SI and decreased TIBC
• Decreased SI and decreased TIBC
• Decreased SI and increased TIBC
• Increased SI and increased TIBC

• Increased SI and decreased TIBC

Iron overload states are collectively referred to as hemochromatosis. Primary iron overload is most frequently associated with hereditary hemochromatosis which is a single-gene homozygous recessive disorder. The expected values would show the serum iron is increased and the total iron-binding capacity is decreased.

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What form of immunity is expected to provide long-term protection after hepatitis B vaccine (HBV) is administered to an immunocompetent person?

• Active
• Passive
• Adaptive
• Innate (Natural)

• Active

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Methicillin-resistant Staphylococcus aureus (MRSA) is a serious health concern in the hospital environment and also in the community for patients who have had no contact with the healthcare setting. In order to control the spread of MRSA and prevent infection with the organism, it is recommended to screen patients for MRSA prior to being admitted to a healthcare setting. Which of the following antimicrobials is best to use when testing for methicillin resistance?

• Methicillin
• Cefoxitin
• Penicillin
• Oxacillin

• Cefoxitin

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Which of the following statement is INCORRECT regarding the bone marrow biopsy specimen?

• Bone marrow cellularity can be accurately determined
• Cellular morphologic detail can be determined.
• Bone marrow architecture can be examined
Prussian blue staining could be used to evaluate iron stores, and diagnosis of anemia.

• Cellular morphologic detail can be determined.

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Given the following information,calculate the results in mg/24 hrs for a 24-hour urine protein.
Total volume for 24 hours = 2,400 mL
Urine protein = 2.7 mg/dL

• 64.8 mg/24 hrs
• 10.87 mg/24 hrs
• 57.5 mg/24 hrs
• 5.89 mg/24 hrs

• 64.8 mg/24 hrs

Feedback
2.7 mg/dL X 2400 mL/24 hr X 1 dL/100 mL
= (2.7 mg X 2400)/100
= 64.8 mg/24 hr

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Which group of conditions increases the risk of Hbs polymerization?

• Acid pH, dehydration, decreased level of 2,3-DPG
Alkaline pH, dehydration, increased level of 2,3-DPG
• Acid pH, dehydration, increased level of 2,3-DPG
• Alkaline pH, dehydration, decreased level of 2,3-DPG

• Acid pH, dehydration, increased level of 2,3-DPG

Feedback
The risk of Hbs polymerization is enhanced by a low (acid) pH, a state of dehydration, and increased levels of 2,3-DPG. Increased temperature (above
37°C) also adds to the risk.

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When a Specked Nuclear Antibody (ANA) pattern is observed, what follow-up test for antibodies related to Systemic Lupus Erythematosus (SLE) is not beneficial?

• Testing for antibodies to Smith (Sm)
• Testing for all antibodies to the extractable nuclear antigens (ENA)
• Testing for antibodies to SS-A/SS-B+
• Testing for antibodies to URNP+ and dcSScl

• Testing for antibodies to URNP+ and dcSScl

U1RNP+ and Scl-70 antibodies are extractable nuclear antigens that yield a speckled ANA pattern, but they are not associated with Systemic Lupus Erythematosus (SLE). U1RNP+ is associated with mixed connective tissue disease undifferentiated connective tissue disease; Scl-70+ is associated with Diffuse cutaneous scleroderma.

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The direct antiglobulin test (DAT) is most unreliable when diagnosing hemolytic disease of the fetus and newborn due to which blood group system?

• АВО
• Duffy
•Rh
• Kidd

• АВО

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All of the following statements about fluorometry are true, EXCEPT:

• Fluorometry is more sensitive than spectrophotometry.
• Both excitation and emission spectra are characteristics of the analyte.
• Fluorescence is indirectly proportional to the analyte being measured.
• Fluorometers typically utilize monochromators or optical filters.

• Fluorescence is indirectly proportional to the analyte being measured.

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The causative agent of infectious mononucleosis attaches to a receptor on which of the following cells?

• T helper cell
• B lymphocyte
• T suppressor cell
• NK cell

• B lymphocyte

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When evaluating a patient for a suspected Wilson’s Disease diagnosis, decreased concentrations of ceruloplasmin would be expected along with:

• Decreased urine copper
• Increased urine copper
• Normal urine copper
•Increased serum copper

• Increased urine copper

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The small, transparent, gray-yellow 48 hour colonies incubated at 37°C. as illustrated in the upper photograph, are surrounded by wide zones of beta hemolysis. This culture was obtained from a throat swab of a patient with pharyngitis. The lower photograph demonstrates the 213susceptibility of this isolate to the bacitracin “A” disc. What is the presumptive identification of this isolate?

• Streptococcus pyogenes (Group A)
• Streptococcus agalactiae (Group B)
• Streptococcus pneumoniae
Streptococcus anginosus (Group F

• Streptococcus pyogenes (Group A)

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Streptococcus pyogenes (Group A) will have the initial observation of relatively small transparent colonies surrounded by broad zones of beta hemolysis provides for presumptive identification of Streptococcus Group A. This identification can be confirmed by demonstrating susceptibility to bacitracin, as observed by the wide clear zone surrounding the A disc. Streptococcus agalactiae (Group B) colonies are also relatively small, transparent, and surrounded by a zone of beta hemolysis, commonly less in diameter than that observed with S. pyogenes. A presumptive identification can be made by demonstrating a positive CAMP test in which an arrow-head zone of hemolysis is observed at the interface of a beta-hemolytic streptococcus with the streak line of Staphylococcus aureus. The A disk bacitracin test shows resistance.

Streptococcus pneumoniae colonies are small, gray, and glistening with alpha hemolysis. The identification may require an optochin disc susceptibility instead of the bacitracin test. Streptococcus anginosus (Group F) colonies are pinpoint in size and surrounded by narrow zones of beta hemolysis. Identification can be made by demonstrating a positive Group F latex agglutination reaction. This species is commonly recovered from purulent, deep-tissue abscesses. It is resistant to the bacitracin test.

Serum proteins can be separated by cellulose acetate electrophoresis into how many basic fractions: • 4 fractions • 5 fractions •6 tractions •7 fractions

• 5 fractions

Which of the following tests included on a urine reagent strip would never be reported out as negative? • Urobilinogen • Bilirubin • Leukocyte esterase • Nitrite

• Urobilinogen

What is the purpose of the Total Complement Activity (CH50) assay? • Measures classic or terminal complement pathways • Detects a deficiency in factor B, factor D, or properdin • Detects a Lectin pathway component deficiency Measures the alternative complement pathway

• Measures classic or terminal complement pathways

After birth, which of the following is the biggest concern for a newborn infant suffering from hemolytic disease of the fetus and newborn? • Accumulation of bilirubin • Anemia due to red blood cell destruction • Decrease in bilirubin level • Low hematocrit values

• Accumulation of bilirubin

A 42-year-old chain smoker experienced an increase in cough, sputum production, and intermittent shortness of breath for over one week. A diagnosis of chronic bronchitis with acute exacerbation was made. The image shows a Gram stain of an early morning, spontaneously expectorated sputum. Based on the pleomorphic coccobacilli shown in the Gram stain, what is the most likely cause of the exacerbation? • Bordetella bronchiseptica • Haemophilus influenzae •Moraxella catarrhalis •Klebsiella pneumoniae

• Haemophilus influenzae

The movement of a cell toward or away from a source of some diffusable chemical is called: • Chemotaxis • Traction • Crawling •Attachment

• Chemotaxis

An Rh negative mother has just given birth to an Rh positive baby after 18 hours of strenuous labor. Her rosette test was positive. Upon performing the Kleihauer-Betke stain procedure, the percentage of fetal cells is found to be 1.9%. The mother's total blood volume is 5,000 mL. What dose of Rh Ig (RhoGam) should be administered to the mother? • 1 vial • 2 vials • 3 vials •4 vials

•4 vials KB% x blood volume = volume of baby blood 1.9% x 5,000mL = 95 mL baby blood in maternal circulation 95mL / 30 mL per Rh Ig vial = 3.17 vials

Which of the following crystals would most likely be found in normal ALKALINE urine? • Amorphous urates • Triple phosphate • Uric acid • Calcium oxalate

• Triple phosphate

What condition would be suspected in an asymptomatic patient with greater than 20% atypical (reactive) lymphocytes on their peripheral blood smear? • Herpes simplex virus infection • Epstein-Barr virus infection • Bacterial meningitis • Acute leukemia

• Epstein-Barr virus infection

A specimen from a 23-year-old female patient who is a Bombay phenotype arrives in the blood bank. • Type AB red blood cells can be transfused to this patient • Type O red blood cells can be transfused to this patient in an emergency • Type O NEG blood can be transfused to this patient • Patient can receive only Bombay phenotype blood

• Patient can receive only Bombay phenotype blood

Which of the following methods would be used to confirm the presence of Bence-Jones protein in the urine: • Urine protein electrophoresis or immunoelectrophoresis • Benedict qualitative test • Ictotest • Watson-Schwartz test

• Urine protein electrophoresis or immunoelectrophoresis Either protein electrophoresis or immunoelectrophoresis can be used to confirm Bence-Jones proteinuria. Benedict test is used for detecting glycosuria. The Ictotest is used for detecting urine bilirubin. Watson-Schwarz test is used in the detection of porphobilinogen and urobilinogen.

The top image shows a MacConkey agar plate on which mucoid, lactose fermenting colonies are present. The bottom image is the bacterial isolate streaked on the surface of a Mueller-Hinton agar plate. The disk to the left is ceftazidime, and the disk to the right is a combination of ceftazidime + clavulanic acid. Note the larger zone of inhibition around the combination disk on the right, an indicator for extended-spectrum beta-lactamase (ESBL) activity. Which of the following organisms fits this situation? • Proteus mirabilis • Klebsiella pneumoniae • Enterobacter aerogenes • Serratia marcescens

• Klebsiella pneumoniae

Which immunoglobulin is associated with anaphylactic shock? • lgA • gD • IgE

• IgE

Thromboelastography (TEG) is a methodology used to assess blood coagulation. The prothrombin time (PT) and activated partial thromboplastin time (APTT) are more commonly used. All of the following are things that TEG can assess that the PT and APTT cannot assess EXCEPT? • Platelet function • Clot strength • Fibrinolysis • Factor deficiencies

• Factor deficiencies

Patients with which of the following conditions would benefit most from washed red cells: • Warm autoimmune hemolytic anemia • Cold autoimmune hemolytic anemia • IgA deficiency with anti-IgA • Multiple red cell alloantibodies

• IgA deficiency with anti-IgA

Illustrated in this photomicrograph is a Giemsa-stained impression smear prepared from an aspirate of an enlarged cervical lymph node. Human infections are acquired through the ingestion of poorly cooked meat. Pregnant women in particular are advised to avoid handling cats and the ingestion of undercooked meat. Based on the morphology of the 8 um long organisms observed in the photomicrograph, select the name of the protozoan parasite as listed for making a presumptive identification. • Leishmania species •Trypanosoma cruzi •Toxoplasma gondii •Onchocerca volvulus

•Toxoplasma gondii

Which of the following electrolytes is most likely to be spuriously elevated in a hemolyzed specimen? • Sodium • Potassium •Chloride • BUN

• Potassium

All of the following can cause erroneously decreased automated platelet counts EXCEPT? • Platelet clumping • Platelet satellitosis • Clotting • WBC fragmentation.

• WBC fragmentation.

Which of the following viruses or diseases is screened for in blood donors only using questions asked during the donor screening and selection process? • Hepatitis B • West Nile Virus •Malaria •HIV

•Malaria

In the microbiology laboratory, the following specimens are received at the same time. Which specimen is classified as a level 1 specimen, requiring immediate processing? • Catheter tip for quantitation • Swab in transport medium • Amniotic fluid •Unpreserved teces

• Amniotic fluid

Of the specimens listed, amniotic fluid is classified as a level 1 critical specimen. Level 1 specimens should be processed immediately due to the invasiveness of collection and the potential of life-threatening illness. Unpreserved specimens, such as feces or sputum, are classified as level 2 specimens and should follow level 1 specimens in order of processing. If not processed quickly, level 2 specimens may degrade or demonstrate overgrowth of contaminating flora. Level 3 specimens that require quantitation, such as urine, tissue, or catheter tip, should also be processed quickly for accurate results. Appropriate storage or preservation should be initiated for level 2 or 3 specimens if a delay in processing occurs. Lastly, level 4 specimens, such as urine or feces in preservative, or swabs in transport medium, are processed after levels 1-3, but within laboratory guidelines.

A normal hemoglobin molecule is comprised of the following: • Ferrous iron and four globin chains • Four heme and four globin chains • Four heme and one globin chains • One heme and four globin chains

• Four heme and four globin chains

All of the following are true about all members of the Enterobacteriacee, EXCEPT: • They are all gram-negative • They are all oxidase-positive • They are all bacilli • They all ferment glucose

• They are all oxidase-positive

Which of the following is a cause of metabolic alkalosis? • Late-stage Salicylate poisoning • Uncontrolled diabetes mellitus •Chronic Obstructive Pulmonary Disease (COPD) •Excessive vomiting

•Excessive vomiting

Which of the following antibodies is detected primarily in the antiglobulin phase of the crossmatch? The correct answer is highlighted below •Anti-Fya •Anti-M •Anti-B •Anti-Py

•Anti-Fya Feedback The Duffy system consists of Fya and Fyo Antibodies to these antigens are IgG and are detected in the antiglobulin phase. Anti-M, Anti-B, and Anti-P, are typically IgM antibodies and may agglutinate saline suspended cells at room temperature.

Which of the following cardiovascular risk markers is a more sensitive version of a test that is used to assess inflammation? •Oxidized-LDL • hs-CRP • ApoB/ApoA1 • LpPLA2

• hs-CRP Feedback hs-CRP is a more sensitive version of the C-reactive protein (CRP) test, a test that has been used for many years to assess inflammation in settings such as lupus, transplantation, infection, etc. This new test measures low levels of CRP, (hs-CRP) and can therefore be used to monitor the risk of cardiovascular disease. Levels of <1 mg/L, 1to 3 mg/L, and > 3mg/L correspond to low, moderate, and high risk for future cardiovascular events.

Which one of the following statements about directed donations is TRUE? • They are safer than random donor units. • They will never cause graft-versus-host disease. • They do not cause logistical problems for blood banks. • They are often perceived by the recipient as safer than random donor units.

• They are often perceived by the recipient as safer than random donor units.

HIV is known as a retrovirus because: • It infects the liver • RNA is used as the template for DNA synthesis • DNA is used as the template for RNA synthesis •It contains matrix protein (M) and nucleoprotein (NP)

• RNA is used as the template for DNA synthesis

Which of the following are seen in Pelger-Huet anomaly? • Dark, abundant neutrophil granules • Neutrophils with at least 3 nuclear lobes • Hyposegmented neutrophils • Decreased platelets

• Hyposegmented neutrophils

A blood specimen is received in the laboratory for testing five hours after collection. Which of the following test results may be falsely decreased? • Serum/plasma potassium • Serum/plasma creatinine • Serum/plasma lactate dehydrogenase (LD) • Serum/plasma glucose

• Serum/plasma glucose

Which infection control measure above and beyond standard precautions (special precaution) should be used by a healthcare worker who will be collecting a blood specimen from a TB patient? • Gloves • Rubberized sleeves • Respiratory protection controls • No special precautions needed

• Respiratory protection controls

All of the following are ways hemoglobin functions EXCEPT: • Transport Oxygen • Transport Carbon Dioxide • Transport Nitric Oxide • Transport Haptoglobin

• Transport Haptoglobin Feedback Hemoglobin serves to transport oxygen, carbon dioxide, and nitric oxide. Haptoglobin is a plasma protein that binds to free hemoglobin which forms a complex that can then be removed by macrophages.

What is the acceptable way to thaw Fresh Frozen Plasma? • Leaving it at room temperature away from agitation • Refrigerating the FFP on a bottom rack • Placing the FFP in a 37° C water bath • Placing the FFP in a 121° C or higher in a steam sterilizer

• Placing the FFP in a 37° C water bath

Which one of the following sets of laboratory results is consistent with hemolytic anemia? • Increased concentration of haptoglobin; negative hemoglobinuria • Decreased erythrocyte survival; increased catabolism of heme; decreased haptoglobin levels • Decreased serum LDH activity; normal catabolism of heme •Normal concentration of haptoglobin; marked hemoglobinuria

• Decreased erythrocyte survival; increased catabolism of heme; decreased haptoglobin levels

A 46-year-old woman was admitted to the hospital through the emergency room after having a bout of severe diarrhea for 3 days along with headaches, muscle aches, shortness of breath, and an increased heart rate. Blood gas measurements were ordered by her concerned physician. The results showed the following: pH = 7.30 pCO2 = 32 mm Hg HCO3 = 15 mmol/L 002 = 93 mmol/L What acid-base disorder is most consistent with this patient's results and symptoms? •Respiratory acidosis • Respiratory alkalosis • Metabolic acidosis • Metabolic alkalosis

• Metabolic acidosis Since the primary change involves HCO3, this is a metabolic process, hence the diagnosis of metabolic acidosis. pH •7.35 - 7.45 pCO2 •35 - 45 mm Hg HCO3 •22 - 29 mmol/L PO2 •85 - 105 mmol/L

Which of the following is LEAST useful in differentiating hemophilia A from hemophilia B? • Factor VIII and IX assays • Clinical history • Activated Partial thromboplastin time (aPTT) • Mixing studies (correction studies)

• Activated Partial thromboplastin time (aPTT) Feedback The aPTT test will be abnormal in both hemophilia A and B, so this test does not provide clinical differentiation between the two. Factor assays, clinical history, and mixing studies can help to differentiate between hemophilia A and B. Hemophilia A results from a Factor VIll deficiency and Hemophilia B is caused by a deficiency in Factor IX, thus assays for both factors would be the most helpful.

In the month following a brief visit to the Philippines, a 42-year-old male missionary experienced a gradual onset of abdominal pain, belching, and intermittent diarrhea. Physical examination and blood chemistries revealed dehydration and electrolyte imbalances with low plasma levels of potassium, sodium, and calcium. The 60 um ovum, as illustrated in the image, was observed in a stool concentrate. Select the correct presumptive identification of this organism. • Trichostrongylus • Necator americanus • Capillaria philippinensis • Trichuris trichiura

• Capillaria philippinensis

Which one of the following is a TRUE statement concerning alkaline phosphatase? • It is optimally active at pH 5 • It is decreased in bone disorders involving the osteoblasts • It is increased in obstructive jaundice • It is increased in myocardial infarctions

• It is increased in obstructive jaundice Feedback increased levels of alkaline phosphatase are found in patients suffering from obstructive jaundice. This enzyme is optimally active around a pH of 9.0-10.0 and is increased in bone disorders involving osteoblasts such as Paget's disease.

Which of the following is the MOST likely discrepancy seen when a person demonstrates an "acquired B-antigen" phenomenon? • Forward typing appears to be B, but reverse group type is O. • Forward typing appears to be AB, but reverse group type is A. • Forward typing appears to be AB, but reverse group type is B. • Forward typing appears to be B, but reverse group type is AB.

• Forward typing appears to be AB, but reverse group type is A.

Which of the following organisms appear Gram-positive when using the Gram Stain? • Haemophilus influenzae • Escherichia coli • Peptostreptococcus anaerobius • Bacteroides fragilis

• Peptostreptococcus anaerobius

Approximately 80 - 90% of the neutrophils on the peripheral blood smear of a young man are similar to those in the image. This peripheral smear most likely represents which condition? • Infection, with a shift to the left • Folic acid deficiency • Pelger-Huet anomaly • Leukemoid reaction

• Pelger-Huet anomaly -hypo-segmented neutrophils

Select the equation which is used to determine the pH of a solution containing a weak acid and its salt. • Van Deemter equation • Van Slyke equation • Nernst equation • Henderson-Hasselbalch equation

• Henderson-Hasselbalch equation

Which symptom of hemolytic disease of the fetus and newborn (HDFN) is associated with low levels of glucuronyl transferase? • Anemia • Increased reticulocyte count • Jaundice • Cardiac failure

• Jaundice

Bacteria which require oxygen for proper growth are termed: • Obligate anaerobes • Obligate aerobes • Facultative anaerobes • Microaerophiles (microaerobes)

• Obligate aerobes

Which of the prospective donors below would be an acceptable blood donor? •Donor number 1: Blood pressure: 90/55 Pulse: 105 Temperature: 36.4°C (97.6 °F) •Donor number 2: Blood pressure: 200/90 Pulse: 72 Temperature: 37°C (98.6 °) •Donor number 3: Blood pressure: 110/72 Pulse:66 Temperature: 37.2°C (99.0 °F) •Donor number 4: Blood pressure: 100/70 Pulse: 98 Temperature: 38.3 (101.0 °F)

•Donor number 3: Blood pressure: 110/72 Pulse:66 Temperature: 37.2°C (99.0 °F) Systolic blood pressure must be less than or equal to 180; diastolic blood pressure must be less than or equal to 100; pulse must be within 50-100 beats per minute; temperature must be less than or equal to 37.5°C (99.5°F). Donor number 1 has a pulse above 100. Donor number 2 has a systolic blood pressure above 180. Donor number 4 has a temperature above 37.5°C (99.5°F).

In an standard electrophoretic separation, what zone appears first (anodal end) on the densitometric pattern? • Albumin • a-globulins • a2-globulins • B-globulins

• Albumin

Which of the following is an obligate intracellular parasite? • Proteus • Escherichia • Klebsiella • Rickettsia

• Rickettsia

The fibrinolytic system may be activated by which one of the following? • Streptokinase • Streptolysin • Fibrin • EDTA

• Fibrin

Which of the following analytes would be increased due to delay in centrifugation? • Bicarbonate • AST • Glucose •lonized Calcium

• AST Feedback The specimen should not be delayed for more than two hours prior to centrifugation because some of the analyte levels (such as glucose, ionized calcium, bicarbonate, folate, etc.) may be falsely decreased due to cellular consumption or falsely increased (such as potassium, ALT, AST, creatinine, etc.) because they are released over time from cells into serum or plasma.

All of the following tests are part of the Electrolyte Panel, ЕХСЕРТ? • Sodium • Cholesterol • Potassium • Chloride

• Cholesterol

What is the optimal time to begin initial microscopic examination of a semen specimen, assuming liquefaction is complete? •30 minutes •2 hours •4 hours •8 hours

•30 minutes

What is the optimal time to begin initial microscopic examination of a semen specimen, assuming liquefaction is complete? •30 minutes •2 hours •4 hours •8 hours

•30 minutes

Leading causes for laboratory rejection of a specimen include the following reasons EXCEPT: • Specimen collection tube with liquid anticoagulant not filled properly • A printed label is placed on the tube or container after specimen collection • Inappropriate specimen collection tube or container • Hemolyzed specimens

• A printed label is placed on the tube or container after specimen collection

Which of the following statements regarding the L/S ratio is TRUE? • A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent respiratory distress syndrome (RDS) • A ratio of 1.5:1 indicates fetal lung maturity in pregnancies associated with diabetes mellitus. • Sphingomyelin levels increase during the 3rd trimester causing the L/S ratio to fall slightly during the last two weeks of gestation. •A phosphatidylglycerol (PG) spot indicates the presence of meconium in the amniotic fluid

• A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent respiratory distress syndrome (RDS)

All of the following analytes would be significantly. increased in a plasma sample due to hemolysis, ЕХСЕРТ? • Potassium • LDH • Sodium •AST

• Sodium

The slide coagulase test is based on the detection of bound coagulase, also known as clumping factor, that is produced on the bacterial cell wall. This factor reacts directly with the fibrinogen in the plasma, resulting in the production of fibrin strands that in turn cause the cells to rapidly agglutinate. Coagulase reacting factor is a plasma substance with which the free coagulase produced by the bacterial cells reacts to form the clot seen in the tube coagulase test.

All of the following media types should be inoculated for cerebrospinal fluid (CSF), EXCEPT: • Brucella agar plate (BRU) • Sheep blood agar plate (SAP) • Chocolate agar plate (CHOC) • Trypticase soy broth (TSB)

• Brucella agar plate (BRU)

Which of the following major cellular elements does not develop solely in the bone marrow? •Monocyte •Neutrophil •Lymphocyte •Macrophage

•Lymphocyte

What is the maximum number of white blood cells allowed in a leukocyte-reduced unit of red blood cells? •5 × 10^6 •1 × 10^10 •5.5 × 10^10 •3 × 10^11

•5 × 10^6 Feedback A unit of leukocyte-reduced red blood cells cannot contain more than 5.0 x 10^6white blood cells. A unit of apheresis granulocytes must contain at least 1.0 x 10^10white blood cells. A unit of platelets must contain at least 5.5 × 10^10 platelets. Leukocyte-reduced apheresis platelets must contain at least 3.0 x 10^11 platelets in at least 90% of the units tested.

The appearance of yellow colonies on HE agar indicates fermentation of lactose with the conversion of the thymol blue indicator. Of the species listed, only Shigella sonnei is a non-lactose fermenter that would produce translucent green non pigmented colonies when grown on HE agar. Shigella spp. are responsible for the diarrheal disease that characteristically exhibits blood and pus. It takes less than 100 organisms to cause infection, making it one of the most easily communicable bacterial diarrheal pathogens. Serratia marscens is generally a colonizer of the respiratory or urinary tract, not commonly the gastrointestinal tract. It is most often acquired in a hospital setting. Klebsiella oxytoca is also typically a colonizer of the respiratory or urinary tract and is often acquired in a hospital setting. Enterobacter sakasakil is a cause of lower respiratory tract infections, wound infections, and urinary tract infections

When performing a bone marrow analysis, all of the following cells types are included in the differential, ЕХСЕРТ? • Nucleated Red Blood Cells • Mature White Blood Cells • Non-nucleated Red Blood Cells • Immature White Blood Cells

• Non-nucleated Red Blood Cells

Patients who develop severe sepsis or septic shock commonly have____ plasma lactate values. • Decreased • Normal • Increased • Markedly decreased

• Increased

Which of these organisms is associated with the condition known as toxic shock syndrome? • Clostridioides difficile • Staphylococcus aureus • Enterococcus faecalis • Micrococcus luteus

• Staphylococcus aureus

What would be considered a common characteristic of anti-Jka and anti-Jkb? • The immunoglobulin class is IgM. • Agglutination reactions are best observed by DAT. • The antibodies show dosage with Kidd antigens on red cells. •The antibodies are naturally occurring.

• The antibodies show dosage with Kidd antigens on red cells.

Which of the following statements about hepatitis C virus (HCV) is true? • There is vaccination against infection with HCV. • The primary route of infection with HCV is airborne transmission. • Patients infected with HCV will always have observable symptoms. • The majority of individuals who are infected with HCV and develop antibodies in their serum (seroconvert) will develop a chronic infection and active liver disease.

• The majority of individuals who are infected with HCV and develop antibodies in their serum (seroconvert) will develop a chronic infection and active liver disease.

In cases where separate fungal cultures are incubated at both 30° C and 35°-37° C, a dimorphic yeast form may develop within 3-4 days as illustrated in the top photograph. The isolate is commonly recovered from puncture wounds of the fingers, wrists or arms among rose gardeners. The yeast colony has a smooth outer white border surrounding an inner pigmented center of growth that appear to be hyphal strands. What is the yeast identified by observing the microscopic features as illustrated in the bottom lactophenol stained mount? • Sporothrix schenckii • Histoplasma capsulatum • Blastomyces dermatitidis • Coccicioides immitis

• Sporothrix schenckii

Estrogen (ERs) and progesterone (PRs) receptors used as tumor markers are most commonly employed to provide prognostic information about: • Breast cancer • Uterine cancer. • Menopause • Cervical cancer

• Breast cancer

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