‘On an automated instrument Hgb=45 g/dl and Hct=33%. The technologists does a manual Het and the result is 33.5%. What should he do? AL Releace all the original results B. Ask or new specimen © Check original specimen forlipemia v- Your Answer) D. Report the manual reculte and original Hgb result Feedback Lipemia can falsely elevate Hgb results in automated instruments, The bacteria ication? A. Group streptococcus B. Non goupD streptococcus ©. Entrococcus w (our Answer) D. Streptococcus Pyogenes Feedback Only Enterococcus can grow on both 6.5% NaCl and bile esculin, h statement is true rega A. Prevents coagulation inside the blood vessels of SLE patients 1g lupus anticoagulant? 1B. Causes micro emboli (clots) formation in blood vessels of SLEpatients Yous Avnwn) .Convertsfibrinogen to fibrin D. Elevates complement Cactevels Feedback (One of the symptoms in Systemic Lupus Erythematosus is micro clot formation. What Hepatitis B marker shows previous infection? AL HBeAg. BL HBste CAnt-HBe v (oursnaner DL AntitBe Feedback ‘Anti-HB¢ is positive when person has pravious infection, Review https://www.cde.gov/hepatitis/hbv/pdf/serologicchartva.pdfA3 year old child has sever anemia with very low rbc of 4.7 x *0° °™” count but his WBC and Platelet counts are normal. What's the most likely diagnosis? A. Aplastic anemia B. Pureredeelloplasis v (ous s0e © AL D. Lead poisoning Feedback In pure red call aplasia only re cell production Is affected and WE and platelet counts are normal. it's not likely that RBC count falls that low in lead poisoning. In Biliary obstruction, how does the urine bilirubin and urobilinogen change? AL_Urine bilirubin is positive, urablinagen ic increased B. Urine bilirubin ienegative, urobilinogen does not change €. Urine bilirubin isnegative, urobilinogen ie increased D. Urine bilirubin is positive, urobilinogen is decreased or negative vou save) Foodback In bilary obstruction, biitubin does not reach duadenum where it would be reduced to urobilinagen and then recirculate into the blood, therefore urobilinogen in the urine willbe negative or decreased. When bile duct is obstructed, conjugated bilirubin will increase in blood an appearin urine. Which parasite is known for its autoinfection capability? A. Accatislumbrcoides BL Strongyloides stercoralis Vou: . Necatoramericanue D. Schistosoma haematobium Feedback ‘The Strongyloides life cycles more complex than that of most nematodes withits alteration between free-living and parasitic cycles, nd its potential for autoinfaction and multiplication within the host. When Primidone is administered, what other compound must be quanti druglevels? AL NAPA din serum to monitor B. Phenobarbital Your sooner €. Procainamide D.Phenytoin Feedback Primidone is the inactive from of phenobarbital. It quickly converts to phencbarbital. When primicone is administered, both compounds need to be quantified,Cvalocytesininfants p> Stomatocytesin iver cizense : Acanthocyte in abetaligoproteinemia DL Burrcellein uremia Feedback ‘Stomatocytes are seen in alcoholic ver disease, ‘A3 year old's urine specimen shows 25 renal tubular epithelial calls under high objective, granular casts, 3-5 WBC and nitrite is negative. A. Pyelonephitis B. Acute tubularnecresis . Renatcalcu >. None ofthe above Feedback High number of renal tubular epithelial cells and granular casts point to acute tubular necrosis On a automated coagulation analyzer, PT controls New controls produce same results, What do you do? A. Change Recembiplastin in range but PTT controls are out of BL Repeat tilitcomes in ange Change reagent iluent 1D. CaCi2 mighthave been acced to APTT reagent acidentally, change reagents and repeat Feedback ecambiplastin and reagent diluent are components of the kit for automated FT test, not APTT. It sa CLIA violation to keep repeating test tillit comes in range. CaCI2 and Phospholipid are two vials in automated APTT kits and come ready to use.Detection of antigen in urine specimen can be used for which of the following pneumonia infections? A. Fusobacterium B. YPestis G. Legionella vo soos D. Mycobacterium tuberculosis Feedback Urinary antigen testing has grown in popularity for several significant respiratory infections, particularly Legionella pneumophila, Streptococcus pneumoniae, and Histoplasma capsulatum. Apatient diagnosed with acute myocardial infarction is treated with streptokinase. What test is abnormal immediately after the treatment? A Pr BT ©. Dedimer v tyourdnewer D. DRWT Feedback Streptokinasefs a fibrinolytic agent and will cause D-dimer to elevate. \Hair perforation test is for identification of which two fungi? A. Tiichophyton mentagrophyte and rubrum v pour acouer 8. Aspergilus niger end japonicus Candida albicans Ctrapicals , Tinea pedis and corporis Feadhack Hair perforation tests used for identtication of Tmentagraphyte(#) and Trubrum(-) If RBC life span is shortened, what will happen to HAic level? A. Lowersthelevel v (ous) B. Elevates the level CG Noerect D. Variable effect Feedback It will lowerthe HAIC results. What does latex test for Staphylococcus aureus detect? AL Surface entigen 8 B._ProteinA and clumpingfactor ¥ (/ou-Arsver Capsular Polysaccharide D. Exctonins Band C Feedback The latex test for S.aureus detects protein A and clumping factor[What does a delta check mean when doing automated clinical measurements? [A.. Patientresltie more than 26D of control's mean value Means the controlenced te be re-run 1G. Signficant change in pation’ ab result compared to previous recut V Vous ioone D. Patient result ismore than 25D of contrel's mean value Feedback Delta check is a warning programmed in laboratory software. ittriggers when 2 patient's result is significantly diferent from previous result. Itcan be because of mies-labeling { wrong patient), wrong tube for that test, a problem with integrity ofthe specimen, or random error. In any case, ithas to be investigated. Agram stain is done on a CSF specimen in the evening shift and shows gram negative rods. How should the technologist store it for a culture on the next day? A. Freeze at-20¢ B. Keepat around 35C ¥ inursnene) CC. Refigerate D. Freezeat-70C Feedback Mast CSF specimen forculture can be kept at raom temperature or at 25¢ and 5% CO? if applicable ‘At what stage the second phase and the irreversible platelet aggregation occurs? A. UWE activation and attachment B. Release of ADP from dense granules v7 iour Assur) © Thrombin activates fbinogen D._ When intincic pathway is activated Feedback Please study: http://www practical-haemostasis.com/Platelets/platelat_function_testing_lta.html ‘Aman showed up in clinic with a "cat scratch" infection. The culture revealed gram negative pleomorphic rods. Colonies were very slow to grow. It is most likely? A. Bacteroides B. Pasteurella €. Bortonetl vous snewe) D. Acenitobacer Feedback "cat scratch’ is the name of the disease caused by Bartonella henselae ‘Why walking pneumonia is not treated with peni Mycoplasma, the agent af walking pneumonia, doesnot haves cell all V(luro=n) 2 Mycoplasma pneumoniae produces beta actemaze Peniciln causes allergy in hace patients pape ialling preumonia ie vical infection and penicillin ie not ffactive Feedback All mycoplasmas lack a cell wall and, therefore, all are inherently resistant to beta-lactam antibiotics such as penicilin.nJesence of lupus anticoagulant leads to: A. B. c D. Activation of fibrinolytic system Thrombosis (micro emboli clots) ¥ (your Answer) Bleeding Continuous activation of the clotting cascade Dostprandial turbidity of the serum is due to the presence of? AL popre Fatty acid B. Cholesterol c D. . Lipoproteins ¥ (your answer) Phospholipid A=OAnti-B= +mf,A cells= 44;B cells~ 0 Polyagglutination BX ¥ (Your Answer) Bath NOTABlood collected in citrated tube, decreased ratio of plasma to cells 68% was the hematocrit, what to do next? A. Add citrate anticoagulant B. Reduce citrate anticoagulant * (your answer) C. Dilute with NSS D. Report result ¥ (conest Answer) Feedback The patient can be a baby, thus high hematocrit. 2-month old baby with Normal WBC, Normal platelet, reticulocyte count: 0.1%: ‘A. Pure red cell aplasia ¥ (your ancwer) B. Chronic Myelogenous Leukemia C. Myelofibrosis with myeloid metaplasia D. Polycythemia vera Feedback In pure red cell aplasia only red cell production is affected and WBC and platelet counts are normal. It is not likely that RBC count falls that low in lead poisoning. 39BS shown would be seen in: A. Presence of Cold-agglutinins ¥ your answer) B. Rheumatoid arthritis €, Paroxysmal Cold Hemoglobinuria D. NOTA Three (3) test tubes are negative to AHG (Antihuman Globulin), when check cell Is added, the result is still negative, what is the error? ‘A. Insufficient saline from automated cell washer B, Serum was omitted from the reaction v (Your Answer) . Insufficient incubation period D. AOTA Feedback Check cells are used as a quality control measure for negative indirect or direct antiglobulin tests performed in test tubes and should always be positive when added.What blood type should be transfused to the baby?Mother: Type O, Rh negative, with anti-D, anti-C, anti-I and anti-LeaChild: Type 4, Rh positive, DAT (+) A. Type O, Rh negative, without C, T and Lea antigen ¥ (your answer) B. Type 0, Rh negative, with C, I, and Lea antigen C. Type A, Rh positive, with C, I and Lea antigen D. NOTA 'Adrenal Cushing Syndrome mechanism: A. ACTH decreased, cortisol decreased B. ACTH increased, cortisol increased C. ACTH decreased, cortisol increased ¥ (your Ansner) D. ACTH increased, cortisol decreased Feedback When the adrenal glands develop a tumor, like any other endocrine gland, they usually produce excess amounts of the hormone normally produced by these cells. If the adrenal tumor is composed of cortisol- producing cells, excess cortisol will be produced, Under these conditions, the normal pituitary will sense the excess cortisol and will stop making ACTH in an attempt to slow the adrenal down. In this manner, physicians can readily distinguish whether excess cortisol is the result of @ pituitary tumor or an adrenal tumor. Zushing Syndrome exhibits which of the following: A. Hypoglycemia B. Hyperglycemia v (vour answer) ©. Hypercalcemia D. Hyponatremia Feedback In Cushing Syndrome, there is an increase in cortisol which promotes glycogenolysis which is the breakdown of glycogen to glucose. Clinical signs of Cushing syndrome: Moon Face and Buffalo lump on the shoulder Wause of false negative ABO typina: A. Rouleaux B. Positive DAT ¥ (our Answer) ©. 37C D. Liss Feedback A positive DAT means that there are antibodies attached to the RBCs, thus giving false negative results. ‘What to do?Mother: Type "O", Rh negative, no antibody to D AgChild: Type “O", Rh positive A. Transplacental transfusion B. Rhig Administration v ¢vour Answer) C. Do nothing, report the results D. DATBiochemical reaction: Bile esculin positive6.5% NaCl negative A. Streptococcus bovis ¥ (your answer) B. Streptococcus pneumoniae C. Enterococcus faecalis D. Enterococcus faecium $tomatocytes are indicative of? A. Sideroblastic anemia B, Liver Disease ¥ (your Answer) C. IDA D. Folate deficiency Feedback Stomatocytes can be seen with some acquired conditions such as chronic liver disease (most often due to alcoholism) or acute alcohol intoxication. Yarbon Dioxide in ISE measures: A. CO2- pressure ¥ (Your Answer) B. CO2- content . pH D. HCO3 Feedback The carbon dioxide ion selective electrode uses @ gas-permeable membrane to separate the sample solution from the electrode internal solution. Dissolved carbon dioxide in the sample solution diffuses through the membrane until an equilibrium is reached between the partial pressure of C02 in the sample solution and the CO2 in the internal filling solution. T any given sample the partial pressure of carbon dioxide will be proportional to the concentration of carbon dioxide.14) initial screening for anti-HIV1/2 using ELISA tested REACTIVE. What should be done next? A. Perform immunofixation test B. Perform confirmatory test using PCR C. Perform Western Blot ¥ (your & D. Repeat test using ELISA Feedback Westem Blot is being used as a confirmatory test for HIV. }BIhich of the following is used to compare two sets of mean? A. Chi-square B. cv C. Standard Deviation D, Paired T-test ¥ (your Ansner) Feedback Paired T-test-Calculate a range of values that is likely to include the population mean of the differences 5h an automated instrument: Hgb=45 g/diHct=33%The technologist does a manual Het and the result is 33.5%. What should the MLS do next? A. Repeat all B. Ask for new specimen C. Report the manual results and original Hgb result D. Check for lipemia v (your Arsen) ‘Z)patient with walking pneumonia is being treated with penicillin. State one possible condition why the patient is not recoverin ‘A. The organism produces beta lactamase B, The organism has no cell wall ¥ (your Ansnes) €. The organism has capsule D. The organism produces an enzyme that neutralizes the antibiotic Feedback Pneumonia caused by Mycoplasma pneumoniae is routinely treated with antibiotics, although the disease is usually self-limiting. The disease is treated with macrolide, tetracycline, or fluoroquinolone classes of antibiotics. All mycoplasmas lack a cell wall and, therefore, alll are inherently resistant to beta-lactam antibiotics (€.9., penicillin)ubinemia: positive; urine bilirubin= positive; urine urobilinogen= positive 38) conjugated A. Unconjugated bilirubi B. Unconjugated bilirubin= negative; urine bilirubin= positive; urine urobilinogen= negative C. Unconjugated bilirubin= positive; urine bilirubin= negative; urine urobilinogen= positive ¥ (Your Answer) D. Unconjugated bilirubin= negative; urine bilirubin= negative; urine urobilinogen= negative Feedback Except for the presence of high serum unconjugated bilirubin levels, the results of liver tests in Crigler- Najjar syndrome type 1 are normal. Serum bilirubin levels range from 20-50 mo/dL. Conjugated bilirubin is absent from serum, and bilirubin is not present in urine. Definitive diagnosis of Crigler-Najjar syndrome requires high-performance liquid chromatography of bile or a tissue enzyme assay of a liver biopsy sample. 3)rr cells are seen in the peripheral blood smear, this is indicative of? 2 aa, A. Uremia (Kidney Disease) ¥ (your Answer) B, Anemia C. Leukemia D. Liver Disease Feedback The above shown picture illustrates Burr cells, these cells are indicative of Uremia (kidney disease)pid detection test for legionella in urine specimen: A. Electron Microscopy B. Cell culture C. Antigen detection test v (Your Answer) D. FTA Feedback Urine antigen testing for Legionella has 70% sensitivity and approaches 100% specificity. B3midone monitoring: suspected to have primidone overdose, but the serum concentration is within the normal range, what should the MLS do next? A. Measure procainamide concentration B, Measure phenobarbital concentration ¥ (Your arswer) C. Measure phenytoin concentration D. Eliminate primidone overdose as possible diagnosis Feedback Primidone is a structural analog of phenobarbital hich of the ff would cause a PBS like this? A. PCH B. Mycoplasma pneumoniae ~ (vour Arsver Cc. PNH D. AOTAhich of the following laboratory test Is most likely to be affected if the streptokinase therapy on a patient has failed? A, Platelet aggregation studies B. D-dimer Test ¥ (your Answer) C. Concentration of Vitamin K dependent factors D. Substitution studies Feedback Streptokinase is @ fibrinolytic agent and will cause D-dimer to elevate 4Qalutination reaction wherein a particle coated with a known antigen reacts with an antibody? A. Passive Agglutination B. Direct Agglutination C. Precipitation v (your Anewer) D. Flocculation BYtogenetic anomaly in Acute Promyelocytic Leukemia (M3): A. 1(9:22) B. (15:17) ¥ cvour arsw c. t(8:21) D. None of the above Feedback Acute promyelocytic leukemia is characterized by a chromosomal translocation involving the retinoic acid receptor-alpha gene on chromosome 17 (RARA). In 95% of cases of APL, retinoic acid receptor-alpha (RARA) gene on chromosome 17 is involved in a reciprocal translocation with the promyelocytic leukemia gene (PML) on chromosome 45, a translocation denoted as t(15;17)(q22;q12). The RAR receptor is dependent on retinoic acid for regulation of transcription Byolonged apnea, anesthesized by by succinylcholine, the enzyme responsible for the reaction is? A. Cholinesterase B. Aldolase €. Pseudocholinesterase ¥ (your answer) D. AFP Feedback Pseudocholinesterase (butyrylcholinesterase) is 2 drug metabolizing enzyme responsible for hydrolysis of the muscle relaxant drugs succinylcholine and mivacurium. Deficiency from any cause can lead to prolonged apnea and paralysis following administration of succinylcholine and mivacurium.Batex agglutination for Staphylococcus aureus: A. Protein A and nuclease B. Phosphotase and protein A C. Protein A and clumping factor v (vour answer) D. AOTA Byerpret: Urine was tested for glucose: Negative (-) A. Presence of reducing sugar (Galactose) lucose Reagent strip: Positive (+)Clinitest: B. Glucose is present v (Your Answer C. Galactosuria D. Ascorbate interference BYtient comes with lesion on the arm.Mold Form: flowerette/daisy like conidiaYeast Form: Cigar-shaped (asteroid) bodies A. Sporothrix schenckii v ¢vour answer) B. Trichophyton mentagrophytes Cc icophyton rubrum: D. Piedraia hortae Feedback S. schenckii causative agent of Rose Gardener's disease (cord-like multiple subcutaneous nodules) Bientify the organisi negative A. Group D strep B. Group B Strep Bile esculin positive; 6.5 NaCl: positive, PYR negative; LAP C. Leuconostoc ¥ (your ansver) D. Enterococcus