PASS ASCP 2019 LATEST – MUST STUDY
Two consecutive values (in which); they are within the
+2SD or -2SD of the same mean - 2,2s - Westgard QC
rulev
Which condition causes the ESR to decrease? - B -
Vibration of the desk
In obstructive liver disease, red cells tend to have the
following morphology - Macrocytes; in OLD, lipids
deposit on the surface of RBC's, and cause them to
become macrocytic
Pink mucoid colonies on MAC
TSI = A/A
Spot indole = positive - Klebsiella oxytoca; the
difference between K. pneumoniae and K. oxytoca is
the indole test.
Weakened (or sometimes no) expression of antigens
during pregnancy is seen in what blood group type? -
Lewis; pregnant women transiently exhibit Le(a-b-)
phenotype and Lewis antibodies are sometimes formed
during pregnancy
TIBC = 240 ug/dL
Serum iron = 144 ug/dL
Ferritin = 250 ug/dL
What is the UIBC%? - 40%
240 (TIBC)-144 (serum iron) = 96
96 = unsaturated fraction of TIBC
96/240 (TIBC) = 0.4 or 40%
Ferritin isn't used for this calculation
ABO Typing is done
Forward = Anti-A (4), Anti-B (4+)
Reverse = A cell (2+), B-cells (2+)
What to do next? - Incubate reagents and specimen at
room temp for 15-30 min and repeat; suggests cold
agglutinins
Reactive Monocytosis is seen in - Tuberculosis; all
patients with TB demonstrate monocytosis, likely due to
high macrophage death rate due to toxicity from the
macros consuming tubercule bacilli.
A urine specimen was kept in the fridge overnight at
10C. Glucose level is 1000 mg/dL, and the SG is 1.010.
What should the tech do? - Correct for temperature;
high protein, glucose, and bilirubin levels can elevate
the SG. Results can be reported with pos for glucose.
How does oral contraceptive change levels of iron
stores? - Iron stores are higher (higher ferritin seen)
Describe blastoconidia - One large mother cell that
produces multiple daughter cells (budding)
What does a delta check mean when doing automated
clinical measurements? - Significant change in the PT's
lab result compared to the previous result.
Define Azotemia - Increased BUN in the blood
If volume of fetal bleed is 62 mL, how many vials of
RhIG should be given to the mother? - 3 vials; one 300
mL vial of RhIG will protect against 30mL of D-pos fetal
blood. when the number to the right of the decimal is
less than 5, round down and add one dose. When the
number to the right of the decimal is greater than 5,
round up and add one dose.
Which bacteria are of concern when it comes to water
contamination? - Legionella Pneumophilia (more
mentioned)
Cryptosporidium
Campylobacter Jejuni
Eschericha Coli (more mentioned)
Salmonella
Vibrio cholerae
ID this catalase pos, gram pos bacilli (diptheroid morph)
is highly resistant to many antibiotics, and is associated
with immunocompromised patients - Corynebacterium
Diptheriae; non-spore forming, non-motile
How to differentiate between Yersinia pestis and
Yersinia enterocolitica? - Motility; Y. pestis is non-motile
/ urease neg
Enterolytica is motile / urease pos
Which compound has the same physiological effect as
procainamide? - NAPA
In Auramine-Rhodamine stain for acid fast bacteria,
what is the function of potassium permanganate? -
Quenching factor/counter stain
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PASS ASCP 2019 LATEST – MUST STUDY
What is the name for echinocytes and when are they
seen? - Burr cells; seen during a slow drying smear as an
artifact
What does caffeine benzoate do in the Jendrassik-Grof
method for measuring bilirubin? - Acts as an accelerator
What does the PCO2 electrode measure? - pH
Hemolysis pattern of Strep pneumoniae - Alpha
Hemolytic (dark and greenish)
In megaloblastic anemias, RBC's are: - Macrocytic,
Normochromic (normochromic because there is NO
defect in Hgb synthesis)
binding strength of an antibody to its antigen is called: -
Avidity
What can make CSF appear cloudy? - Crystals (WBC up
to 5 per mm3 and proteins up to 45 mg/dL are normal)
Which test is used to confirm presence of Bence-Jones
proteins? - Immunofixation electrophoresis ; BJ protein
is a globlulin (secreted by plasma cells) and is meaured
in the urine to help diagnose multiple myseloma
(mostly) / Waldenstrom's macroglobulinemia
Reagent used in sickle cell solubility test? - Sodium
dithionite; If HbS is present, it will form liquid crystals
and give the solution a cloudy/turbid appearance.
Large, circular, gray/smooth colonies are seen on a BAP
with swarming motility. What test should be done next?
- Indole; Swarming is characteristic of Proteus, and the
Indole is done to differentiate between P. vulgaris (pos)
and P. mirabilus (neg)
A and B blood group antigens are derived when
glycosyltransferases add specific sugars to precursor H.
Heat is the terminal sugar for B antigen? - D-galactose
Which solution is used for HDL measurement? -
Heparin-Maganese (precipitation factor used)
Which enzyme can help with DX of muscular dystrophy?
- CPK (elevated CPK levels are indicative of muscle
disease)
5 HIAA test is used for what disease? - Carcinoid tumors
(usually done on a 24 hr urine sample)
Rapid detection test for legionella in a urine sample? -
Antigen-detection test
What is the carrier of endogenous triglycerides? - VLDL
(chylomicrons carry exogenous)
Which conditions can be observed in Cushing's
Syndrome? - Hyperglycemia / Hypercalcemia
Why would the color change from blue to orange, and
then back to blue in a Clinitest? - "Pass through
phenomenon;" When amount of sugar is over 2000
mg/dL, this phenomenon occurs.
Describe / ID Alternaria fungus morphology - Alternaria
(drumstick) - associated with hay fever /
hypersensitivity / asthma
Describe / ID Fusarium fungus morphology - Fusarium -
soil fungi associated with burn victim / BM infections
(green beans)
Describe / ID Aspergillus fungus morphology -
Aspergillus (flower/bloom) - farmer's lung
Describe / ID Candida fungus morphology - Candida -
dimorphic yeast (albicans grows a germ tube)
A 3 year old child has severe anemia with a very low
RBC count of 1.7x10^6, but WBC and PLT counts are
normal. What's the most likely DX? - Pure RBC aplasia;
only RBC production is affected. RBC count's usually
won't fall that low in lead poisoning.
If RPR test is pos, and ABS-FTA is neg, what is the
interpretation of the results? - False pos RPR; repeat in
2 weeks. ABS-FTA test is the fluorescent treponemal
antibody absorption test. Confirms RPR
A smear is made that covers 60% of the slide, and the
WBC's are clustered at the end. What should you do? -
Reject the slide; prolonged storage of blood in EDTA can
cause WBC's to cluster. Reject the entire specimen.
A gram stain performed on a sputum sample revealed
gram neg diplococci within PMN's. Oxidase pos, and
carbohydrate degredation is inert. What is the
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PASS ASCP 2019 LATEST – MUST STUDY
organism? - Moraxella catarrhalis; this bacteria is
inert/asacchrolytic
ID stomatocytes; what condition are they commonly
associated with? - Mouth cells; liver disease (alcoholic)
D-Dimer test is normal, but FDP is abnormal. What does
this mean? - Primary fibrinogenolysis; D-dimer is
abnormal/pos when actual clot has been formed and
then broken down; FDP (fibrinogen degredation
products) can present when there is no clot, but a
primary fibrinogenolysis is going on.
the anemias of the qualitative hemoglobinopathies,
such as sickle cell anemia, are morphologically classified
as: - Normocytic, normochromic
Which enzyme is the best indicator of excessive alcohol
consumption? - GGT
A sputum sample has 25 PMN cells, 10 Epis, and
bacteria/fungi were seen in oil immersion. What do you
do? - Culture both the bacteria and fungi; good
specimen criteria is met. You reject with 25+ epis
What's the formula for specificity? - TN/(TN+FP)x100
True neg = TN
False pos = FP
PT, aPTT, and TT are all abnormal. What's the most
likely cause? - Afibrinogenemia; can be caused by
aribrinogenmia, dysfibrogenemia, DIC, heparin
contamination, and thrombin inhibitors
Which test is used to ID Hairy Cell Leukemia? - TRAP
(tartarate-resistant acid phosphatase) activity is present
in the leukemic cells of most HCL patients.
What's the best blood type of choice for blood
transfusion for newborns? - O negative which has been
crossmatched with the mother's blood
What is the drug of choice for MRSA isolates? -
Vancomycin
17-Ketosteroids are produced in the: - Adrenal glands;
they form when the body breaks down androgens and
other adrenal gland hormones
What is the specimen of choice for FK506 (Tacrolimus),
Cyclosporine, and Sirolimus? - EDTA; those are all
immuno-suppresant drugs
HPV test is more often done for what condition? -
Genital Warts (HPV is the most common STI in the USA)
A PT with a pancreatic mass will be tested for? - CA-19-9
(marker for pancreatic cancer)
If an individual is a non-secretor (se se) with Lewis
phenotype LE(a+b-), what antigen will be detected in his
or her fluids? - Le A (only antigen that can be secreted
by a non-secretor)
Describe and ID Histoplasma capsulatum fungus -
globular macroconidia with finger-like protrusions, and
ovoid microconidia with smooth/finer edges.
Total cholesterol = 220 mg/dL
HDL = 45 mg/dL
Triglycerides = 250 mg/dL
What is the LDL concentration? - LDL = TC - HDL -
TG/5.0(mg/dL)
= 220 - 45 - (250/5.0)
= 125 LDL
What is used to compare two sets of mean? - Paired T
test; calculates a range of values that is likely to include
the population mean of the differences
Rh neg phenotype is most likely a result of - RHD
deletion
if the DAT is positive on the cord blood, what is done
next? - Antibody screen on maternal blood; is is
assuming the ABO and Rh type of the baby/mom are
known. If the baby's type isn't known, the next step is to
do the ABO/Rh typing
Gram neg bacteria, normally found in the
oropharyngeal tract of mammals, are involved in the
pathogenesis of some animal bite wounds, as well as
periodontal diseases.
This bacteria exhibits "gliding"motility: -
Capnocytophaga
(capno = CO2 dependence)
(cytophaga = flexibility / mobility)
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PASS ASCP 2019 LATEST – MUST STUDY
Calculate the anion gap:
Na+ = 138 mEq/L
Cl- = 102 mEq/L
HCO3 = 27 mEq/L - 9
Formula = Na+ - (Cl- + HCO3-)
What test is used to monitor unfractionated heparin
therapy (not UFH test)? - APTT; used for UFH.... but not
LMWH (Anti Xa assay is used)
Enzymes enhance which blood group systems? - ABO,
Rh, Kidd, Lewis
What is ANA (anti-nuclear antibody) test used for? - To
detect and help DX certain autoimmune disorders;
ANA's are a group of autoantibodies produced by a
person's immune system when it fails to distinguish
between self and non-self.
ANA patterns seen and what do they indicate?
Homogenous (diffuse)
Speckled
Nucleolar
Centromere (peripheral) - Homogenous (diffuse) - assoc
with SLE / drug Lupus
Speckled - Assc with SLE, sjogren, rheumatoid arthritis,
scleroderma, polymyositis
Nucleolar - scleroderma / polymyositis
Centromere (peripheral) - scleroderma and CREST
What types of cells in Sezary syndrome become
cancerous?? - T-cells; aggressive form of blood cancer
called cutaneous T-cell lymphoma
Target cells (codocytes) in blood can cause what when
automated methods are used? - high WBC count;
codocytes are more resistant to being lysed due to
increased surface volume, and can falsely increase WBC
count.
Target cells (codocytes) are associated with? - liver
disease, thalassemia, Hgb C, and splenectomy among
others
A gram stain from a BAP shows gram pos cocci in
chains, which are non-hemolytic. The bacteria will grow
on 6.5 NaCl, and is bile esculin pos. What's the most
likely ID? - Enterococcus (only entero can grow on both
6.5 and bile esculin)
What is flocculation? - The bridging and binding of
destabilized solids into larger particles; differs from
precipitation in that colloids are only SUSPENDED in a
solution, not actually dissolved. Used in VDRL and RPR
testing.
Describe the lab manager's role? - Democratic
What are pappenheimer bodies? When are they seen? -
Iron particles; can be seen in groups and variable sizes.
Can be seen in sideroblastic anemia and
hemoglobinopathies.
What urine test can help diagnose pheochromocytoma?
Define pheochromocytoma - methanephrines;
pheochromocytoma is a rare adrenal gland tissue
tumor. Too much epinephrine and nor epinephrine are
excreted
Acidic urine specimens are frequently seen in? - High
protein diet
Alkaline urine specimens are frequently seen in? -
Bacterial infection / diuretic drugs such as azo
What's the predominant cell type in CLL? - B-Cells
ID the bacteria grown anaerobically on chocolate agar,
with a gram stain showing long, Gram neg rods with
tapered ends. - Fusobacterium; "spindle shaped"
In photometric method of bilirubin measurement,
analyzers measure the color change at what
wavelength? - 454 nm
Which test is done when pesticide exposure is
suspected? - Cholinesterase
What chemistry value will be the first to increase after
Myocardial Infarction? - Myoglobin; when heart of
skeletal muscle is injured, myoglobin is released into the
blood and can be measured within a few hours post-
injury
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PASS ASCP 2019 LATEST – MUST STUDY
What solution is contained inside a reference
electrode? - KCl (potassium chloride)
What serves as the specimen of choice for the
demonstration of tertiary syphilis? - CSF; tertiary
syphilis most often involves the CNS; CSF-VRDL is done
to confirm. Brain and spinal cord involvement is often a
sign of late-stage syphilis
In hydrops fetalis, what kind of Hgb is found? - Bart's
(y4; 4 gamma chains)
The fetus doesn't survive
Describe Hgb H - HgbH (b4; 4 beta genes)
Alpha thal minor deletion? - 2 alpha genes deleted
silent carrier (thal) gene deletion? - Single alpha
deletion
TIBC = 200 ug/dL
Iron = 125 ug/dL
Calculate UIBC? - UIBC = 75 (TIBC - Iron = UIBC)
What are Howell-Jolly bodies? - DNA fragments; usually
pitted by spleen to form helmet cells.
Assc with alcoholism, post-splenectomy, Beta thal
major, severe hemolytic anemia, megaloblastic anemia
What can cause a false pos urobilinogen on urine strips?
- porphobilinogen or sulfonamides
exposure to light can cause false neg
Macrocytes typically seen in megaloblastic anemia are
what shape? - ovalocytes
round macrocytes are assc with alcoholism and
obstructive liver disease
How to calc coefficient of variation (%)? - SD / MEAN x
100
A blue top was drawn from a catheter, and tested for
PT/PTT. Results are significantly higher than yesterday's.
What's the most likely explanation? - Heparin
contamination
In which blood type system are the antigens NOT a part
of the RBC membrane, and are made by tissue cells,
carried in the plasma, and absorb onto RBC surface? -
Lewis; newborns don't have Lewis antigens
In blood bank DAT testing, 3 tubes are negative to AHG
(antihuman globulin), and when cell check is added, the
result is still negative. What's the error? - Serum wasn't
added to the tube for the reaction to take place. Cell
check = quality control, and should always be positive.
In respiratory acidosis, the compensatory mechanism is
the increase in: - Plasma bicarbonate concentration
In Rhabdomyolysis, breakdown of what component
causes kidney damage? - myoglobin
What is true regarding the weak D phenotype? - All
epitopes are present but are under-expressed
Test results with a low TSH and elevated Free T4
indicate what? - Hyperthroidism
Hashimoto's thyroiditis - an autoimmune disease in
which the body's own antibodies attack and destroy the
cells of the thyroid gland; associated with
hypothyroidism
A patient on warfarin (coumadin) is tested for protein C.
How does this affect their test results? - Decreased
levels of Protein C; anticoag drugs interfere with protein
C and/or Protein S assays.
Best diagnostic test for excessive alcoholic
consumption? - GGT
What is true of the lupus anticoagulant? - Causes micro
emboli (clots) formation in the blood vessels of patients
with SLE (systemic lupus erythematosus)
Glass membrane electrode is used for what
measurement? - pH (in solution)
In primary biliary cirrhosis, which of the following
antibodies is seen in high titers? - Anti-mitochondiral
When Primidone is administered, what other
compound must be quantified in serum to monitor drug
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PASS ASCP 2019 LATEST – MUST STUDY
levels? - Phenobarbital (primodone = inactive form of
phenobarbital)

A critically ill patient becomes comatose. The doctor

believes the coma is due to hepatic failure. The assay
most helpful in DX is? - Ammonia; high level of fatality

The extrinsic system of coagulation is monitored by

which test? - PT (prothrombin time)

Unconjugaed bilirubinemia - Unconjugated bilirubin =

pos
Urine bilirubin = neg
Urine urobilinogen = neg

Assoc. With Crigler-Najjar Syndrome

What nutrient -

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