Lois

 Kyle  A.  Zabat,  RMT   PIONEER  REVIEW  CENTER   #RMT2019  Page  ⎥  1  
 
LOWESS NOTES
BY: LOIS KYLE A. ZABAT

6) Chart used to measure Tonk's Youden & Regional QC.

1) Error that occurs in Error that Systematic error influences observations Interlab QC Chart used to measure Intralab QC Levey-Jennings,
one direction? occurs in one consistently in one direction (higher or lower). The Westgard multirule chart.
direction? measures of slope and y-intercept provide the estimate 7) Sample Used for Blind sample. Proficiency samples are specimens that have known
of systematic error. EQAP concentrations of an analyte for the test of interest.
(Bishop 6th ed, p. 94) 8) Part of Quality Preparation of Sample for send-out, Machine calibration Rechecking
Error that does Random error varies from sample to sample. It is Management Program of results. QMPS encompasses all phases from Pre-analytical, Analytical
not recur in present in all measurements and can be either positive System (QMPS) and Post-analytical phase.
regular pattern? or negative. Can be a result of many factors such as 9) Part of Program Blood culture contamination, Quality control,
instrument, operator, reagent, and environmental System Quality (PQS) Test interpretation by physician. PQS encompasses all phases from
variations. Pre-analytical, Analytical and Post-analytical phase.
Error that is Proportional systematic error represents the slope. 10) Part of Analytical Improperly stored reagent.
dependent on problem
concentration Other parts of Analytical problem include:
Error that is Constant systematic error represents the y-intercept. Instrument not calibrated correctly, Specimen mixed up, incorrect
independent of volume of specimen, Interfering substance, Instrument precision problem
concentration 11) Proportion of Proportion of individuals TP Positive Predictive Value
𝟏𝟎𝟎  𝒙
2) Control values Reject. This signifies violation of R4s rule. This error allows detection of individuals with true with true positive result TP  +  FP
exceeding the +2s and random error. (Bishop) positive result.
Proportion of individuals TN Negative Predictive Value
another exceeds the −2s 𝟏𝟎𝟎  𝒙
with true negative result TN  +  FN
what to do next?
Proportion of individuals TP Diagnostic Sensitivity
3) 8 consecutive controls Reject. This signifies violation of 81s rule. This error allows detection of 𝟏𝟎𝟎  𝒙
with the disease whom test TP  +  FN
observations exceeding systematic error. is positive
+11s or -11s what to do Proportion of individuals TN Diagnostic Specificity
next? without the disease whom test 𝟏𝟎𝟎  𝒙
TN  +  FP
4) 2 consecutive controls Reject. This signifies violation of 22s rule. This error allows high is negative
exceeding the same +22s sensitivity to systematic error. 12) Assay for BUN which is Assay for Urea which is inexpensive and Colorimetric, endpoint
or -22s what to do next? Random error (Imprecision) 1:2s, 1:3s, Human or specific nonspecific (diacetyl)
Assay for Urea which is specific Enzymatic: NH3
R:4s operator errors
Formation
Mislabeling,
Assay for Creatinine which is simple, Colorimetric, endpoint
pipetting, mixing nonspecific
errors Assay for Creatinine which is rapid and specific Colorimetric, kinetic
Systematic error 2:2s, 4:1s, Analytical errors Assay for Creatinine which measures Ammonia Enzymatic
(Inaccuracy/Bias) 10:x Deterioration of colorimetrically or with ion-selective electrode
reagent, Assay for Uric acid with turbidity problems Colorimetric
Calibration errors Assay for Uric acid with special instrumentation Enzymatic, UV
5) Measures of Dispersion SD, CV, Range. Dispersion/imprecision is measured by SD & CV Assay for Uric acid with reducing substances Enzymatic, H2O2
Measures of Central Tendency Mean, Median, Mode. interference (Calbreath)
Lois
 Kyle
 A.
 Zabat,
 RMT
 
 REVIEW
 CENTER
 
 Page
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13) Jaffe colorimetric Colorimetric: Endpoint
reaction
14) UV light UV light (<400 nm)
Infrared light (>700nm)
15) Commonly used media Commonly used media
for electrophoresis for Electrophoresis
1) Paper (simplest)
2) Starch gel (needs in-
house prep)
3) Cellulose acetate
4) Agarose gel
5) PAGE (Polyacrylamide
Gel Electrophoresis)
16 SPE is used to LDL, CRP, Igs, C3
Quantitatively measure: Albumin
Alpha1 globulins
Alpha2 - globulins
Beta globulin
Gamma globulin
17-19 Factors affecting CAUSES INCREASE
fluorescence measurement Increase light exposure
pH
Absorbance of sample
20) Type of glass with high Borosilicate
degree of thermal resistance
21) Components of Positive Piston, piston seal and capillary
displacement pipette (3)
22) 1 ul 1 microliter
23) Not true about Discrete Reagents are pumped through continuous tubing (Continuous flow
Analyzer analyzer)
Discrete Analyzer
It can run multiple tests in a sample at one run and capable of STAT testing.
Each mixture of reagent and samples are handled separately in its own reaction
vessel
It requires small amount of samples
Most popular and versatile
24) Horizontal centrifuge Horizontal centrifuge
(Swinging-bucket)
Fixed angle (Angle-head)
PIONEER
#RMT2019
25) Trace Element with Increased in AM:
diurnal variation
Very short (Ciulla) Increased in PM:
Very long
Cellulose acetate, Agarose, PAGE 26) Floating creamy layer Chylomicrons
after 24 hours of standing Causes turbidity after 24 hours of standing plasma VLDL
based on charge (major) and size (minor) plasma
based on surface charge & molecular size 27) Needle for venipuncture 21 in x 1 in
28) Venipuncture needle 15° (15-30)
based on size angle
based on electrical charge 29) BP cuff for 40 mmHg
based on size (major) and charge (minor) venipuncture inflated at a (40-60 mmHg)
minimum of (mmHg)
30) Shelf life of Evacuated Stability of additives and vacuum retention (Turgeon)
Albumin tubes dependent on
Alpha1 antitrypsin, HDL lipoproteins 31) Normally, after eating 1-2 hours (1.5-2 hrs)
Ceruloplasmin, Haptoglobin, Alpha2 glucose returns after:
macroglobulin, lipoprotein 32) Glucose metabolism at Glucose metabolism at 0-4C : 2 mg/dl/hr
Transferrin, hemopexin, Complement, Fibrinogen, 0-4C : Glucose metabolism at Room temperature 7 mg/dl/hr
CRP, LDL 33) Effect of leukocytosis on Substantial decrease
Immunoglobulins glucose
CAUSES DECREASE 34) IDDM Young, Decrease insulin, autoantibodies (+)
Increase temperature
Increase adsorbing particles (Quenching) 35) Normal C-peptide DM II
Scratched or dirty glassware 36) POCT for glucose Capillary blood
37) Largest lipoprotein Chylomicrons
38) Major apolipoprotein in B-100
LDL
39) Major lipoprotein HDL, LDL, VLDL
40) Minor lipoprotein Lp(a), IDL
41) NCEP >40 years old Age Moderate Risk High Risk
moderate risk 2 - 19 >170 mg/dL >185 mg/dL
20 - 29 >200 mg/dL >220 mg/dL
30 - 39 _________ _________
≥ 40 _________ _________
42) HDL at risk for CVD <35 mg/dl
43) Protein which migrates gamma globulin
to most negative electrode Prealbumin Indicator of malnutrition. Binds thyroid hormone and
Vertical when not in used (transthyretin) retinol-binding protein. Usually not visible on routine
Lower RPM (3000 RPM) SPE.
Longer centrifugation time Albumin Contributes to oncotic pressure, binds Bilirubin,
Capable of higher RPM (7000 RPM) steroids and fatty acids
Most common & Rapid
Lois
 Kyle
 A.
 Zabat,
 RMT
  PIONEER
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α1 - Globulins 49) Most specific dye Most specific dye binding for protein
α1-antitrypsin Decreased in pulmonary emphysema binding for protein Most sensitive:
α1- fetoprotein Tumor marker for hepatic and gonadal tumors, Most commonly used:
Decreased in Down syndrome Interfering substances HABA
α1-acid glycoprotein (orosomucoid) has very high carbohydrate content, Heparin Increased
Binds progesterone Hemolysis Increased
α1-antichymotripsin Hereditary deficiency associated with asthma Bilirubin Decreased
Gc-globulin (Vit. D binding protein) Binds Vit. D and actin Salicylate Decreased
α2 - Globulins 50) Enzymatic reaction Increased altered coenzyme and product
α2 - Macroglobulin 10x increased in Nephrotic syndrome Decreased enzyme and substrate
Ceruloplasmin Copper-binding protein 51) E + S = ES = E + P Catalytic mechanism
Haptoglobin Binds alpha chain of free hemoglobin 52) Enzyme data -Can be checked with other results
β - Globulins interpretation -Negative results are useful
-No truly organ specific
Transferrin (Siderophilin) Transports iron. Negative (APR) Acute
Phase Reactant 53) Pronounced Pronounced elevation of ALP Bone tumor, Paget's, Bile Duct obstruction
elevation of ALP (5x or more) Biliary cirrhosis
Hemopexin Removes circulating heme and porphyrins. Decreased
in hemolytic disorders Moderate elevation of ALP (3-5x) IM, Metastatic Bone tumors
β2-Microglobulin Component of HLA class I. Found on most nucleated Slight elevation of ALP (up to 3x) Viral hepatitis, cirrhosis
cells. Pronounced elevation of LD Megaloblastic Anemia, Renal infarction,
Complement Participates in immune reaction. Decreased in SLE, (5x or more) Hepatitis
DIC and malnutrition Moderate elevation of LD (3-5x) Myocardial and Pulmonary infarctions
Fibrinogen Activated by thrombin, Seen only in plasma and not in Hemolytic conditions
serum
Slight elevation of LD (up to 3x) Most liver diseases
C-reactive protein CRP is one of the first APR to rise during
inflammation. Pronounced elevation of CK MI, Duchenne' Muscular Dsytrophy,
γ - Globulins (5x or more) Polymyositis, Dermatomyositis
Immunoglobulin G Antibodies (mostly in secondary immune response) Mild/Moderate elevation of CK Severe exercise, trauma
Immunoglobulin A Antibodies (in secretions) Pronounced elevation of AST MI, Acute hepatocellular damage
Immunoglobulin M Antibodies (first antibody produced in immune (5x or more)
response) Moderate elevation of AST (3-5x) Biliary tract obstruction
Immunoglobulin D Antibodies (surface of B cell) Slight elevation of AST (up to 3x) Viral hepatitis, cirrhosis
Immunoglobulin E Antibodies (allergic and anaphylactic reactions) 54) Heart Heart enzymes LD, AST
44) Iron transporter transferrin enzymes Liver enzymes LD, AST, ALT, ALP, GGT, 5'N
45) Used to assess filtration Crea, Cystatin Muscle enzymes LD, AST, CK1, Aldolase
rate 55) Enzyme significant when decreased cholinesterase
46) Indicative of Increased BUN, Urea, Uric acid, 56) Isoenzymes LD ALP
Glomerulonephritis Massive proteinuria LD - 1 HHHH (MI, Hemolytic) Liver - most rapid
Hyperlipiduria LD - 2 HHHM (Megaloblastic) Intestine - slowest
LD - 3 HHMM (Carcinoma) Placenta - most heat stable
47) True for creatinine Not affected by diet LD - 4 HMMM (Liver) Bone - most heat labile
Reflects muscle mass LD - 5 MMMM (Skeletal muscle) (LBPI) (PILB)
Completely filtered by the kidneys LD - X Sperm (Abnormal) Kidney
Can be reabsorbed LD - 6 Cardiovascular failure
48) Uremia Increased BUN
Lois
 Kyle
 A.
 Zabat,
 RMT
  PIONEER
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CK Tumor 66) pH, pCO2 are used to measure pH
CK - BB Brain (Cancers) Regan 67) Alkalemia pH >7.45
CK - MB Heart (MI) Nagao 68) Primary Respiratory alkalosis
CK - MM Muscle (Major Kasahara compensatory for CAUSE COMPENSATION
CK - Mt/Mi Metabolic
57) ALP Intra and extrahepatic cholestasis acidosis Metabolic Bicarbonate deficiency, Hyperventilation
increased in Intrahepatic cholestasis include: Hepatocellular disorders such as cirrhosis, hepatitis acidosis DKA
Extrahepatic cholestasis include: Obstruction of bile duct Renal failure
Diarrhea
58) Chief Cl Metabolic Bicarbonate excess Hypoventilation
counterion of Counterbalance of sodium: Chloride alkalosis Vomiting (Least efficient)
sodium Countercurrent of sodium: Potassium Hypochloremia
59) Increased Severe burns Hypokalemia
sodium due to Hyperaldosteronism
water imbalance Cushings syndrome Respiratory CO2 excess Bicarbonate retention
Diabetes insipidus acidosis Hypoventilation
60) Decreased Nephrotic syndrome COPD
sodium due to Congestive heart failure Drug overdose
water imbalance Cirrhosis Respiratory CO2 loss Bicarbonate excretion
Renal failure alkalosis Hyperventilation (most efficient)
61) Calcium Calcium regulator PTH, Calcitonin, Vit. D Anxiety, Asthma,
regulator Magnesium regulator PTH, Calcitonin, Vit. D Salicylate, Emphysema
Phosphate regulator ___________ 69) Blood gas result in DPO MAc LOLOCO
62) Increased HIMUDPILES • Paraldehyde Myocardial infarction Decrease pO2
Anion gap • Hypernatremia • Isoniazid/Iron/Ibuprofen/Inhalant Metabolic Acidosis
• Instrument error • Lactic acidosis Normal/Low pCO2
• Methanol • Ethylene glycol poisoning 70) Blood gases Bicarbonate
• Uremia • Salicylate, starvation Oxygen
• Diabetic Ketoacidosis Carbon Dioxide
63) Decreased Hypercalcemia
Anion gap Hypoalbuminemia 71) ADH is Hypothalamus
Multiple Myeloma produced by
Instrument Error
64) Great effect Na, Cl, HCO3
on osmolality
Other functions:
Enzyme cofactors: Mg, Ca, Zn
Acid-base balance: K, Cl, HCO3
Neuromuscular excitability: K, Ca, Mg
Myocardial rhythms and contractions K, Ca, Mg
Blood coagulation Ca, Mg
ATPase pump regulator Mg
Integral for nerve impulses K 72) CNS Benzodiazepines
65) Enzyme Zn, Ca, Mg depressant Barbituarates
cofactors Cocaine
Lois
 Kyle
 A.
 Zabat,
 RMT
  PIONEER
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73) Not part of Salicylate, Acetaminophen, Ibuprofen
TDM
74-76 DILUTION: 2uL of serum mixed to 8uL NSS
DILUTION
What is the dilution? 1:5
Diluent to sample ratio: 8:2
Total volume to serum ratio: 10 : 2
77) Treating all Standard precautions
specimens The term universal precautions refers to the concept that all blood and bloody body
infectious is fluids should be treated as infectious because patients with bloodborne infections can be 85 - 86 Degree of 0 No hazard
stated in asymptomatic or unaware they are infected. In 1996, the CDC expanded the concept hazard: 1+ Slight hazard
and changed the term to standard precautions, which integrated and expanded the 2+ Moderate hazard
elements of universal precautions to include contact with all body fluids (except 3+ Serious hazard
sweat), regardless of whether blood is present. 4+ Extreme hazard
78) Hazard associated with extremely low temperature Cryogenic hazards 87) Conversion 0.0555
79) 1st action done on electrical shock Unplug the equipment factor for glucose
80) NFPA Red Flammability 88) Bicarbonate <10 and >40
symbol Other hazards: panic value
Reactivity - Yellow 89) Tests used to PT, Albumin, Bilirubin
Health - Blue assessed liver except Factor Assay
Special hazard - White function of liver
81) Fire Water & dry chem only transplant
extinguisher for Class A Water & Dry Chem patient
Class A Class B Water, dry chem & CO2 (halon) 90) Overzealous Results to Hypoglycemia
treatment of DM
Class C Water, dry chem & CO2 (halon)
91-92 Biosafety Biosafety cabinet with no recirculation I, B2
Class D Dry chem, CO2 cabinet Front is open Class I
Class E Allowed to burn 70% of air is recirculated through HEPA Class II, A
82 - 84 Class A Wood, paper & plastic 30% of air is recirculated through HEPA Class II, B1
Classification of Class B Flammable organic chemicals No Recirculation Class II, B2
fires Class C Electrical equipments With Negative pressure Class II, B3
Wood, paper & Class D Combustible metal Uses 2 HEPA filters Class III
plastic Class E Arsenal fire 93) Mancini Allowed to diffuse to completion before measurement
Class K Cooking oil, Grease, fats method Reaction takes about 18 hours
Square of diameter is equal to antigen concentration

   
   
   
 
 
 
Lois  Kyle  A.  Zabat,  RMT   PIONEER  REVIEW  CENTER   #RMT2019  Page  ⎥  6  
 
  21 Hektoen Enteric agar turned yellow from a child E. coli
MICROBIOLOGY suffering diarrhea from eating cheeseburger
1 FREQUENCY OF EQUIPMENT TESTING (Mahon p.92) 22 H2S (+), LDC (-), Urease (-) Citrobacter
Equipment Test type Frequency 23 Mannitol (neg) S. dysenteriae
GasPak Jar Temperature, CO2 Daily 24 It is found to be intracellular and evades immune Yersinia enterocolitica
Anaerobe chamber Temperature, Anaerobiosis, humidity Daily system through its phagocytic capsule
25 Curved, motile gram negative bacilli Campylobacter, Helicobacter, Arcobacter
Biohazard hood Air flow Annually except Enterobacteriaceae
Centrifuge Checking of RPM Every 6 months 26 NLF, yellow and associated with Cystic B. cepacia
Microscope Cleaned and adjusted Quarterly fibrosis
27 Granulomatous lesion in animals Actinocella
Autoclave Temperature, Spore testing Weekly
28 Causative agent of soft chancre H. ducreyi
Balance Accuracy of weights Annually 29 Ammonia odor, dark purple C. violaceum
2 Quality Control duration Once a week (Mahon p. 294) 30 No disease associated, causes acne Priopionobacteria
if disk diffusion disk QC testing is recommended each day that patient tests are performed, with 31 Niacin and Nitrate positive MTB
initial daily QC for 1 the QC strains (20-30 days), the frequency of testing can be reduced to 32 Scothochromoges light and dark
month is found effective weekly if a laboratory can demonstrate acceptable QC performance. 33 Used for PCR testing of Bordetella, DNA
3 Positive control for Gram stain S. aureus Neisseria, Chlamydia
4 Nutritive media BAP 34 Silver stain is for identifying Spirochetes
5 Media for Neisseria TM, MTM, ML 35 Gold standard for Rickettsia IFA
6 Selective for Salmonella XLD 36 Spoilage in food produces Acid
7 In Thioglycollate broth, anaerobes would be seen in bottom of the broth 37 ssRNA, helical Flavivirus
8 Growth on agar slant can be seen as pellicle 38 Specimen used for viral testing Nasopharyngeal swab
Growth on agar broth can be seen as turbidity 39 True for optimal viral collection except collected at night
Growth on agar plate can be seen as colony 40 True for virion _________
9 Blood draw must be done during Febrile episode 41 Positive fungi report with Quantity
10 >25 epithelial cells indicates Sputum is mixed with saliva 42 C. albicans can be cultured and produces Blastoconidia and chlamydoconidia
11 Blood is drawn and used in Microbio for Blood culture 43 Host that harbors organism Reservoir
12 Oxygen acceptor Aerobic 44 Scabies, type of infection Ectoparasite
13 Pleural, Pericardial and Peritoneal fluid 30 minutes 45 Contaminant in parasite culture Mineral oil
must be transported within 46 Stool with delayed testing must be stored in 4C up to 24 hours
14 Method used to isolate desirable bacteria Streak method 47 FECT is not for Trophozoite
15 If disk diffusion disk is too large or too Make sure that bacteria must be plated within 15 48 Destroyed when specimen is refrigerated Trophozoite
small what should be done? minutes 49 Emulsifying stain for cyst & trophozoite Lugol's iodine
16 Relationship between MIC and Disk Inverse relationship 50 Needs warm and moist to molt E. vermicularis
diffusion testing 51 Migrating larva in skin Hookworm
17 Pinpoint colonies S. pyogenes 52 Acquired through skin penetration Strongyloides
18 Beta hemolytic gram+ cocci on BAP, S. agalactiae 53 Blackfly vector Onchocerca volvulus
Oxidase negative, Hippurate hydrolysis + 54 Barber's pole A. cantonensis
19 Beta hemolytic gram+ cocci on BAP, S. agalactiae 55 Resembles pollen grain cyst Dipylidium
Oxidase negative, CAMP positive 56 With abopercular knob D. latum
20 True for E. coli Oxidase negative 57 Infective reservoir for Intermediate host Rodents
Facultative anaerobe of E. muliculoris
Motile 58 Can be diagnosed using urine S. haematobium
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59 Resembles S. haematobium but is Acid S. intercalatum 25 Magnifies HPO ocular
fast positive 26 Significant cell Clue cells
60 Infective stage of P. westermanii Metacercaria 27 Eosinophil count is indicated in CSF if 500/ 10 fields
61 Liver fluke Chlonorchis 28 Pyuria Presence of WBC in urine
62 Which of the following must be reported D. fragilis 29 Most common fecal contaminant E. vermicularis
to the clinician 30 Squamous cell counted in RFFM/LPO
63 Gold standard for malaria Thick and thin blood film 31 CaOx envelope Dihydrate
64 Leishmania types __________ 32 Double envelope Wheddelite
65 Found in cat food Toxoplasma 33 RBC in dilute urine Swell with halo
66 Critical value except Negative malarial smear 34 Apatite Calcium phosphate
67 Dessicant is for Removing moisture 35 Differentiates uric acid and Cystine Refringent
68 Donning of PPE 36 Liver Disease Bilirubin crystals
69 Not PPE hand sanitizer 37 Stair Case pattern Lipiduria
70 N95 can be found effective if snug fit into nose 38 Metabolic disorder Cystine
71 Effective way to disseminate new PA, Newspaper, Present lecture 39 In treating kidney stones, monitor pH, blood
information Ward book 40 (+) melanuria caused by increased Tyrosine
72 CM Can't remember 41 Nephrotic syndrome proteinuria
73 IS HBsAg Panel 42 Preferred for sputum/BAL NaCl induced
  43 Leukocytes in BAL/hpf 0-10 WBC/HPF
CLINICAL MICROSCOPY 44 Dark-red brown Amniotic fluid Fetal death
1 BUN, ethnicity, albumin MDRD 45 Amniotic fluid testing Spectrophotometer
2 First morning is recommended for testing except for urine culture 46 Foam shake test 95% ethanol
3 Polyuria >2L/24 hours 47 HCG Indirect test for fetus
4 No urine formation Anuria 48 Analytical sensitivity 25 mIU/ml
5 Few particulates print easily seen Hazy 49 In Normal pregnancy, detected within 7 days
6 Ammoniacoccal odor UTI 50 HCG Test Immunoassay
7 Causes increased turbidity in an alkaline urine Phosphates 51 CSF Tube 1 storage Frozen
8 Principle of protein reagent pad The error of indicators 52 CSF Tube 2 is for Microbiology
9 2,4 dichloroaniline diazonium salt bilirubin 53 CSF WBC diluent 3% Acetic acid
10 Volume for testing SG by Urinometer 50 ml 54 Added to increase CSF yield 30% albumin
11 1.005 Hyposthenuria 55 Crytococcus neoformans Urease positive
12 1.010 indicative of Acute tubular necrosis 56 Multiple Sclerosis Myelin Basic Protein
13 1:5 dilution for a urine with SG of (1.009) 1.045 57 Oligoclonal band in CSF but not in serum Neurosyphilis
14 Calibration of refractometer Distilled water 58 Semen hold at what temperature 37C
15 Reagent strip Room temp before use 59 Fructose testing storage Frozen
16 Causes alkaline urine Vegetable 60 Resorcinol Test storage Frozen
17 Microalbuminuria 20-200 ug/min 61 Eosin-nigrosin stains live sperm bluish-white
18 False (+) Urobilinogen Aminosalicylate 62 Normal count, Dec motility, Dec Seminal fluid support
19 Grading of 1+ Distinct turbidity concentration. Problem in?
20 Blondheim test Diff Hb and myoglobin 63 Tail deformitiy Poor motility
21 Test to differentiate porphobilinogen and urobilinogen Watson Schwartz 64 Clotted Male anti-sperm Ab
22 Bilirubin detected in urine Conjugated 65 Increase pleural fluid Effusion
23 Microscope best used for identifying cast Phase contrast 66 Transudate Cirrhosis
24 To turn Light Microscope to dark field, what should be changed Condenser 67 Synovial fluid for Glucose testing Na Fluoride
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68 Synovial fluid for Micro test Chilled heparin syringe 16 Antihemophilia Factor VIII
69 800 leukocytes will fall Inflammatory 17 Intrinsic factor
70 Parietal produce HCl in response to Gastrin 18 Increase APTT, what to do? Repeat APTT
71 Normal color of Gastrointestinal lavage pale, gray, with mucus 19 Decrease fibrinolysis except bleeding
72 FOBT Mass occult blood 20 FBN level in DIC Decrease
73 Vitamin contraindicated for FOBT test Vit. C 21 Drug that affects Prothrombin factors Warfarin
74 DNA, stain WBC in Sysmex Phenanthridine 22 DVT INR 2-3
75 Stain WBC in Automated analyzers Carbocyanin 23 End stage liver Disease FBN level <50
76 DOTS testing uses DSSM 24 Stem Cell mobility IL-3
77 Chain of infection 25 Hemoglobin found in embryogenesis Gower I, Gower II, Portland
78 Eyes spilled with Clinitest reagent, what to Boric acid for 15 mins 26 Largest cell in Bone Marrow megakaryocyte
do? 27 Cells found in stroma Fats, Megakaryocte, HSC
79 Improperly labeled what to do? Call nurse to relabel except Endothelial cell
80 Biodegradable waste Green 28 Cells found when there is a left shift myelocyte, metamyelocyte, band cell
81 Example of warning labels Poisonous, Carcinogen, except segmented
82 Handwashing downward 15 minutes 29 End of mitosis Stage 3
83 Bilirubin detected in urine Conjugated 30 Diff stage, mitosis ends Myelocyte
CASE STUDY 31 Area for platelet count 1 mm
84 LE +++ Recheck Reagent strip for Micro 32 N:C ratio during RBC development Decreasing
Glucose +++ 33 Eosinophil half-life 3.5 days
Protein ++ 34 Eosinophil lipid enzymes esterase and cyclooxygenase
Nitrite (-) 35 Neutrophil lineage with Tertiary granules metamyelocyte, band cell, neutrophil
5-10 RBC except myelocyte
Bacte (Many) 36 1st maturing stage in BM metamyelocyte
WBC (cocci are seen) 37 Last cell division myelocyte
86 How to determine if the cause is Renal or Nonrenal Abundant LE 38 MK II Moderately condensed
87 Why is Nitrite test negative? Bacteria present are cocci and not bacilli 39 Increase cell nucleus Mature megakaryocyte
  40 Not meausred in Hb testing Sulfhemoglobin
HEMATOLOGY 41 Molecular defect Hb-S, Hb-C, Hb-CS
1 Concentration used for EDTA 2 mg/dl except Hb- SA
2 Venipuncture cardiovascular effect syncope 42 Not used for classifying anemia MCH
3 Fragments of megakaryocyte thrombocyte 43 Genetic disorder characterized by primitive quantitative Thalassemia
4 Not a test to check for coagulation platelet count reduction in globin chain synthesis for Hb
5 Test to confirm thrombocytopenia platelet count 44 Hemolytic anemia with fragmentation, seen with neurologic TTP
6 Test for vascular except coagulation factors signs, renal disease and thrombocytopenia.
7 Platelet adhesion disorders Bernard Soulier Syndrome & Afibrinogenemia 45 Small reddish blue DNA fragments due to karyorrhexis or Howell-Jolly bodies
8 Platelet aggregation disorders Glanzmann, Essential athrombia nuclear disintegration is an inclusion seen in:
9 Site for ATP and aggregation Organelles 46 Fine or coarse, deep blue to purple Lead poisoning
10 Macro platelets, thrombocytopenia May Hegglin Anomaly staining inclusion which are aggregates of Thalassemia
11 Included test for platelet Adhesion, Aggregation and Procoagulant activity ribosomes due to alteration of Hb Megaloblastic anemia
12 Initial vWD workup CBC, PT, APTT synthesis is seen in the following, except:
13 Not a serine protease HMWK except Hyposplenism
14 Carry Factor VIII vWF 47 PAS (+) Chronic Myelogenous Leukemia M6
15 Fletcher factor prekallikrein 48 Trapped plasma 1-3% higher
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49 Indicative for nRBC counting 5 nRBC In counting for WBC, check Interferences
50 WBC before counting must stand for 10 minutes 79- Enteric isolation gloves and glown
51 Platelets must be charged before counting 15 minutes 81 Most probable bacteria to be found Salmonella
52 Blood drop size for blood smear 2 - 3 mm Isolation is for patient and other patients
53 Well done smear: Finger shaped 82- Many promyelocyte with maturation were M2
54 Smear method to minimize distribution Battlement method 84 seen in a bone marrow smear, this might
error indicate:
55 Index of reticulocyte production RPI FAB classification Acute Myeloblastic Leukemia with maturation
56 Duplicate Retics count must be within 20% Type of ALL with large cell size, L3
57 Platelet count <50 dilute to 1:50 prominent nucleoli, and prominent
58 ESR Directly proportional to red cell mass vacuolation
59 Levy with Neubauer gradings, the area of 9 mm2 85 SOP of Laboratory manual includes Normal value,
each square would be? Limit of Detection,
60 Not computed in Hematology analyzers RBC Analytical techniques
61 What is the effect of cold agglutinins in Decreased RBC count except Supervisor
automated analyzers  
62 Specimen for APTT must be centrifuged 1 hour  
within ISBB
63 Characteristics of intravascular bleeding Methemoglobenemia, 1 Primary lymphoid organ Thymus
Decreased haptoglobin 2 Process of coating antigens to be more recognized by opsonization
Hemoglobinuria T cells
Hematuria 3 Not innate Antibody
except Increase haptoglobin 4 Antigenic part where antibody binds to epitope
64 Heme 1 iron, 4 pyrrole 5 Light chains kappa and lambda
65 Iron intracellular transport transferrin 6 Dimer in secretion IgA
66 Decrease LAP score CML 7 Connects monomer unit of IgM Sulfide bonds
67 MPO (-) basophil 8 Cytokines produced by Lymphocytes and NK cells
68 Abnormal TCT would be found in factor Factor I deficiency 9 CRP produced by hepatic cells
deficiency
10 AFP is produced by liver
69 Which can be used as buffer for staining distilled water
11 Acute phase reactant associated with reducing serum amyloid A
blood smear
cholesterol levels in the body
70 Differential scatter Forward and Orthogonal
12 Best marker to differentiate B cell and T cell CD4
CASE STUDY
13 Produced by activated T cells and NK cells IFN- G
71- Hydrogen sulfite + saponin test Dithionite test
14 MHC antigens are presented to T cells
73 This test detects Hb S
15 HLA type I test for T cell
(+) reaction for this test turbid, black line cannot be seen
16 True for immunization All
74- Peripheral Blood stain H&E
17 Anti-E attracts Basophil and Eosinophils
76 Moth-eaten cell, echinocyte are seeen due air from fan
18 Basophil and Mast cell IgE
to
19 C3 components have affnity to IgM
Holes are found in a short blood smear, Increase blood, Use clean slide, Increase angle
20 Not an Anaphylatoxin C6
what can help to fix the problem?
Not activated by MBL C1q
77- >100 WBC are seen what will be the effect Increased
21 Hives Type 1
79 in Hemoglobin level?
22 Alzheimers Neural Thread Protein
Effect in RBC count? Increased
23 Biliary cirrhosis Anti-mitochondrial
Lois  Kyle  A.  Zabat,  RMT   PIONEER  REVIEW  CENTER   #RMT2019  Page  ⎥  10  
 
24 ____________ B27 63 Household ref 24 hours
25 Uses microtiter plate Radio 64 Coleman with ice 8 hours
26 RPR Negative 1:10 65 WB aliquoted 1 is used, 1 is 24 hours ref
27 False positive RPR pregnancy, IM 66 SDP due to plateletpheresis
28 HBsAg (+), Anti-Hbc IgM (-) Anti-Hbs (-) Chronic 67 Plasma components in 1-6 hours 24 hours
29 HIV/AIDS Reactive screen, Western blot 68 Blood bank ref 2-5 C
30 HTLV seen in saliva, amniotic and blood 69 Not significant for platelet sunlight
31 in sexual patient HTLV 1 70 platelet closed method 5 days
32 NOT AIDS 250 U/L CD4 cells 72 Quality Program in BB
33 Acute CMV Anti- EA IgM,  
VCA IgM, HISTOPATH, MTLB and Code of Ethics
EA IgG 1 System responsible for delivering urine and body Excretory System
34 Reagent attached to cardiolipin waste out of the body?
35 Congenital Toxoplasma IgM 2 Part of endocrin system except skin
36 RBC storage lesion 3 Caspases enzyme activated by Fas ligand and CD59 Apoptosis
37 Monospecific antibody is of IgG results to:
38 Polyclonal IgG and C3d 4 It is seen as decrease in the size of tissue or organs Atrophy
39 Rh Genotype dce/dce outside the range of normal variability, usually a
40 Most common antigenicity ABO consequence of a disease.
41 Most common Anti-A 5 Refers to increase in size of an organ or tissue due to Hyperplasia
42 Rh/ABO HDN diff DAT an increase in the number resulting from growth of
43 Discovery of this antibodies when rabbits were P, Pk new cells.
immunized. 6 It is best exmplified by the enlargement of glandular Hyperplasia
44 Poor Kell Leach epithelium of the female breast.
45 Immunogenic Fya(-) 7 Physiologic change during pregnancy resulting to Hyperplasia
46 Kidd needs (Enhancement media) enlargement of pregnancy uterus.
47 PEG, LISS Enhancement media 8 Cardinal sign of inflammation, except Hemorrhage
48 Enhanced by enzymes Rh, Kidd, P, I , Lewis, ABO 9 Fixative pH must be near neutral
49 Who can collect WB Nurse, medtech, physician 10 Fixative osmolality must be near slightly hypertonic
50 In double RBC pheresis Female lb 150 lb 11 Crucial step in tissue procesing fixative
51 250 ml of blood only was collectd, the Dilution of 1:14 12 Commercial formaldehyde 10%
anticoagulant must be 13 Correct order of tissue processing Dehydration, Clearing, Embedding
52 Gonorrhea deferred for 1 yr 14 Not flammable except chloroform
53 Cryoprecipitate contains except Factor I 15 Microwave advantage 60-80% faster than conventional processing
54 Allergic give leukoduced time
56 Non cardiogenic TRALI 16 Microwave Ag retrieval
57 Massive transfusion Increase iron 17 Significant in tissue processing temp or manner of processing?
58 Exchange transfusion remove bilirubin 18 Dealcoholization Clearing
59 All of the following are common causes platelet Pseudomonas 19 Most commonly used clearing agent xylene
contamination, except. 21 No automation yet in Histopath slide coverslipping
60 All of the following are common causes RBC Yersinia 22 Advantage of automated except Shortened processing method
contamination, except. 23 Frozen section advantage except Do not have good morphological
61 Reduced Hepa due to screening appearance
62 AHG pale green 24 Liquid cytology advantage clear background
Lois  Kyle  A.  Zabat,  RMT   PIONEER  REVIEW  CENTER   #RMT2019  Page  ⎥  11  
 
25 Mushy or greasy sample for cytology, what to do increase temperature 67 A donor who donates for a specific person who need Directed donor
next? blood is called
26 Black enamel for water bath is recommended To view creast and grease in ribbon 68 Clinical Chemistry is a minimum requirement in Secondary category
27 Special branch of Histopath Immunohistochem what laboratory category:
28 Staining deparaffinization 69 Expiration of water Ana Lab 1 year
29 Alcohol Hypertonic to hypotonic 70 Special department in the laboratory specializes for Toxicology
30 Alcohol Hydration and deparaffinization testing drugs and dangerous liquid levels in the body.
31 Fixative commonly used in cytology 95% ethanol 71 RA 10912 for to improve skills of professionals
32 delivering tissues to lab requirement except adding ethanol as fixative 72 RA 10912 for except product seminar
33 Surgical specimen specimen deterioration 73 PRC registration 21 years old
34 General rule in histopath PPE 74 10% in boards Histopath
35 Recieved in Histopath except sputum smear 75 Confidentiality privacy except actor
36 Done for nonshedding cells FNAC 76 Included in confidentiality inform the result to the family concerned
37 Organ for biopsy owner patient, 77 Random drug blood test Senior High school
38 Autopsy is performed to know cause of sudden death 79 Professional ethics about right action in lab
39 Stiffening Rigor mortis 80 This ISO contains the general requirements for ISO 15189
40 stain for cervico-vaginal smear H&E testing and calibrating laboratories.
41 Not for Chromatin Weissel 81 In vitro molecular PCR
42 Natural Hematoxylin 82 Chromosome pairs 23
43 Acid eosin
44 Stains DNA Fuelgen
45 Stain for fats Oil Red O
47 Affinity for dye Chromatic
48 For fungi Grocott 'But blessed is the one who trusts in the LORD, whose confidence is in him.
49 Acid rinse for decolorization They will be like a tree planted by the water that sends out its roots by the
51 Diff of Immunohistochem Few reagents on tissue
52 Added to buffer Distilled water
stream. It does not fear when heat comes; its leaves are always green. It has
53 Avoid cytology drying to avoid unbalance stain no worries in a year of drought and never fails to bear fruit.'
54 mounting mounting fluid Jeremiah 17:7-8
55 PPE is for biosafety
56 Time from receiving test order to release of result. turnaround time
57 Set of organizational structure, procedures, Quality standard
Heyy future RMT, when you present your worries, burdens and fears to God in prayer, he gives you the
processes, and resources needed to implement quality peace to not worry about situations. Being a Christian doesn't mean that you wont fail, it means Jesus
management. will catch you when you do. The closer you walk with God, the less room for anything to come in-
58 Activity of the management function that determines Quality assessment between, especially worries.
the quality policy.
59 Part of Post-analytical Quality Assurance: TAT Kaya Yan! God bless future RMT! :)
60 Post analytical question how many hours of result
#RMTbyMarch2020
61 Direct cost reagent
62 Professionalism turning off phone
63 Records except SOP
64 Needs in QA except Minute meetings
65 Inputs except positive feedback
66 Last step in handwashing dry hands with paper towel