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ACE ASCP FINAL EXAM 2025 - 2026| LATEST UPDATE
WITH 280Qs&As WITH RATIONALES|GRADED A+
Which of the following condition is the most common cause of increase anion gap? A.Metabolic alkalosis B. Metabolic acidosis Respiratory acidosis Respiratory alkalosis B. Metabolic acidosis RATIONALE: High anion gap metabolic acidosis is caused generally by the body producing too much acid or not producing enough bicarbonate. This is often due to an increase in lactic acid or ketoacids, or it may be a sign of kidney failure. More rarely, high anion gap metabolic acidosis may be caused by ingesting methanol or overdosing on aspirin. Which of the following enzymes has the longest elevation after Myocardial Infarction (MI)? CK-MB Myoglob in Troponi n AOTA C. Troponin RATIONALE: Troponin is elevated up to 10 - 14 days after Myocardial Infarction. Lactic acid specimen: Chilled and separated from cells Heated Room temperature Request EDTA sample only A. Chilled and separated from cells
RATIONALE: Feedback Special Handling: No tourniquet. Place on ice immediately and deliver to lab or aliquot within 15 minutes. DO NOT FREEZE WHOLE BLOOD SPECIMEN. Specific gravity measured by refractometer: 1.035. Protein and glucose both trace in reagent strip: Presence X-ray medium Albuminuria Glucosuria Normal A. Presence X-Ray medium RATIONALE: Xray medium/Radiographic dye can cause erroneous results in urine specific gravity measurement. A patient with walking pneumonia is being treated with penicillin. State one possible condition why the patient is not recovering: The organism produces beta lactamase The organism has no cell wall The organism has capsule The organism produces an enzyme that neutralizes the antibiotic B. The organism has no cell wall. RATIONALE: 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, all are inherently resistant to beta-lactam antibiotics (e.g., penicillin). What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48? 2.
Arrange the common Rh antigens according to immunogenicity (greatest to least): D>c>E>C>e D>C>E> c>e D>c>E>e
C C>D>c>E>e A. D>c>E>C>e RATIONALE: Most immunogenic D > c > E > C > e least immunogenic. Most common error in Polymerase Chain Reaction (PCR) is NUCLEIC ACID CONTAMINATION. A True (Correct Answer) B False A. True What disease is associated with the possession of HLA-B27? Ankylosing spondylitis Hashimoto's Disease Goodpasture's syndrome SLE A. Ankylosing spondylitis RATIONALE: Ankylosing spondylitis belongs to a group of arthritis conditions that tend to cause chronic inflammation of the spine (spondyloarthropathies). The HLA-B gene can be detected in the blood of most patients with ankylosing spondylitis. Burr cells are seen in the peripheral blood smear, this is indicative of? (Fig. 2) Uremia (Kidney
Disease) Anemia Leukemia Liver Disease A. Uremia (kidney Disease) RATIONALE: The above shown picture illustrates Burr cells, these cells are indicative of Uremia (kidney disease) Anti IgG (-); C3d (+): What should the MLS do? Elution IA T DA T Pre-warm D. Pre-warm RATIONALE: Prewarm technique can be used to prevent cold-reactive alloantibodies or autoantibodies from reacting in the IAT phase. Specifically, prewarm technique prevents cold antibodies from binding complement at RT (as opposed to 37o C ) and subsequently being detected by anti-C3 in the IAT by polyspecific AHG serum. Maximum interval which a recipient sample maybe used for crossmatching if the patient has been recently transfused, has been pregnant? 2 days 6 days 3 days NOTAC. 3 days CIN (Cefsulodin, Irgasan, Novobiocin) Agar is a recommended culture medium for
normochromic NOTAC. Normocytic, normochromic According to AABB standards, Fresh Frozen Plasma (FFP) must be infused within what period of time following thawing? 24 hrs 36 hrs 48 hrs 72 hrs A. 24 hours A woman having menstrual cycle would have the ff. result: Increased TIBC Increased Ferritin Increase % Saturation Normal Transferrin A. Increased TIBC Feedback A total iron binding capacity value above 450 mcg/dL usually means that there's a low level of iron in your blood. This may be caused by a lack of iron in the diet, increased blood loss during menstruation, pregnancy, or a chronic infection. Causative agent of "Cat bite fever" Pasteurella multocida Actinomyces israelii Bartonella henselae Leptospira interrogans A. Pasteurella multocida Feedback Pasteurella species are commonly isolated pathogens in most animal bites, especially in dog- and cat-related injuries. These injuries can be aggressive, with skin manifestations typically appearing within 24 hours following a bite.
These wounds can exhibit a rapidly progressive soft-tissue inflammation that may resemble group A β-hemolytic Streptococcus pyogenes infections. What is the sugar fermented by Staphylococcus aureus? Mannitol Sucros e Glucos e Maltose A. Mannitol Mannitol salt agar is a commonly used growth medium in microbiology. It encourages the growth of a group of certain bacteria while inhibiting the growth of others. It contains a high concentration (7.5%-10%) of salt (NaCl), making it selective for gram positive bacteria Staphylococci (and Micrococcaceae) since this level of NaCl is inhibitory to most other bacteria. It is also a differential medium for mannitol fermentors, containing mannitol and the indicator phenol red. Staphylococcus aureus produce yellow colonies with yellow zones, whereas other Staphylococci produce small pink or red colonies with no colour change to the medium. If an organism can ferment mannitol, an acidic byproduct is formed that will cause the phenol red in the agar to turn yellow. Identify the organism: Fig. 3 Blastomyces dermatitidis Malasezia furfur Alternaria Candida albicans A. Blastomyces dermatitidis Feedback The above image show broad base budding. What is the first step in agglutination?
27,300/ul 12,500/ul B. 24,700/ul Feedback Corrected WBC count= Uncorrected WBC count x100/nRBCs+100: Thus, (37,000ulx100/50+100= 24,700ul) Gram positive bacilli; non-motile; non-hemolytic; catalase positive; spore forming: B. anthracis B. cereus N. meningitidis N. lactamica B. B. anthracis Feedback Important distinguishing characteristics between B. anthracis and B. cereus is motility, B. anthracis is non motile while B. cereus is motile. Hair perforation test/Hair baiting test is for identification of which two fungi? Aspergillus niger and A. japonicus Tinea pedis and T. corporis Trichophyton mentagrophyte and T. rubrum C. albicans and C. tropicalis C. Trichophyton mentagrophyte and T. rubrum Feedback Trichophyton mentagrophyte is positive and T. rubrum is negative What is the minimum platelet count before you perform apheresis? 500 200 150 250 C. 150.
Feedback Apheresis donors with low normal pre-procedure platelet counts (150 - 200 x 10 9/L) and Hb concentration (12.5 - 13 g/dL) should be examined for post-donation drops in these haematological parameters Gram negative bacteria, normally found in the oropharyngeal tract of mammals, they are involved in the pathogenesis of some animal bite wounds as well as periodontal diseases. This bacteria exhibits GLIDING MOTILITY: Leptospira Actinobacillus Capnocytopha ga Chlamydia C. Capnocytophaga Feedback The term Capnocytophaga comes from "Capno" for its dependence on CO2 and "cytophaga" for its flexibility and mobility shift (" gliding motility "). Urine with an specific gravity consistently between 1.002 and 1.003 indicates: Acute glomerulonephritis Renal tubular failure Addison's disease Diabetes insipidus D. Diabetes insipidus Feedback Low specific gravity (SG) (1.001-1.003) may indicate the presence of diabetes insipidus, a disease caused by impaired functioning of antidiuretic hormone (ADH). Low SG also may occur in patients with glomerulonephritis, pyelonephritis, and other renal abnormalities. Primidone monitoring: suspected to have primidone overdose, but the serum concentration is within the normal range, what should the MLS do next? Measure procainamide concentration Measure
urates WBC Bacteria A. Amorphous phosphates Feedback Amorphous phosphates are usually formed in alkaline urine and they are without a color. The precipitate of amorphous phosphates is white while Amorphous urates are yellow, yellow-brown or pinkish in color. They tend to form in acidic urine and their precipitate is pink with a cloudy appearance of the mixed urine. Amorphous urates are a normal presence in the urine. Test for Paroxysmal Cold Hemoglobinuria (PCH): Autohemolysis test Donath-Landsteiner Test Sucrose hemolysis test NOTAB. Donath-Landsteiner Test Feedback Normal= (-) hemolysis on test and control, PCH= (-) hemolysis on control but (+) hemolysis on test sample. In emphysema, the absence of alpha-1 globulin peak is due the deficiency of: A1-Antitrypsin (AAT) Macroglobu lin Hemopexin Transferrin A1-Antitrypsin (AAT) Feedback Alpha-1 antitrypsin deficiency is an inherited disorder that may cause lung disease and liver disease. Affected individuals often develop emphysema, which is a lung disease caused by damage to the small air sacs in the lungs (alveoli). Characteristic features of emphysema include difficulty breathing, a hacking cough, and a barrel-shaped chest.
Identify the organism: Fig. 4 Clostridium difficile Mycobacterium tuberculosis Listeria monocytogenes Corynebacterium diphtheriaeA. Mycobacterium tuberculosis Feedback Mycobacterium tuberculosis is an obligate pathogenic bacterial species in the family Mycobacteriaceae and the causative agent of tuberculosis. M. tuberculosis has an unusual, waxy coating on its cell surface primarily due to the presence of mycolic acid. Cells are curved rod- shaped and are often seen wrapped together, due to the presence of fatty acids in the cell wall that stick together. This appearance is referred to as cording, like strands of cord that make up a rope. M. tuberculosis is characterized in tissue by caseating granulomas containing Langhans giant cells, which have a "horseshoe" pattern of nuclei. A and B blood group antigens are derived when glycosyltransferases add specific sugars to precursor H. What is the terminal sugar for B antigen? Fucose D-galactose N-acetylglucosamine N-acetylgalactosamine B. D-galactose Feedback The A Blood Type is the H antigen with N-acetylgalactosamine attached. The B Blood Type is the H antigen with D-galactose attached. The O Blood Type is the H antigen with no additional sugar attached. The reverse Camp Test, lecithinase production, double zone hemolysis and gram stain morphology are all useful identification of: Campylobacter jejuni
Feedback Sperm count is done after liquefaction which is approximately 20 - 30 minutes. Latex agglutination for Staphylococcus aureus: Protein A and nuclease Phosphotase and protein A Protein A and clumping factor All of the above C. Protein A and clumping factor Which of the following blood test uses radioimmunoassay test to detect direct and specific IgE? Radioallergosorbent Test (RAST) Radioimmunosorbent Test (RIST) A and B None of the above A. Radioallergosorbent Test (RAST) Feedback RAST test is used to detect direct and specific IgE. RIST test is used to detect total serum IgE. Which of the following factors are affected by Coumadin Therapy? III, VII, VIII X, V, II, I II, VII, IX, X AOTA c. Feedback The following factors are said to be Vitamin K Dependent factors. Coagulation factors affected by coumadin drugs are: II, VII, IX and X. What analyte is monitored in preeclampsia? Potassium Ammonia
Magnesiu m Ionized Calcium c. Magnesium Feedback Preeclampsia is a pregnancy-specific disorder characterized by hypertension and excess protein excretion in the urine. It is an important cause of maternal and fetal morbidity and mortality worldwide. Magnesium sulfate (MgSO4) is the agent most commonly used for treatment of eclampsia and prophylaxis of eclampsia in patients with severe pre-eclampsia. Identify: FI.g 5 Heinz bodies Basophilic stippling Howell-Jolly bodies Auer rods A. Heinz Bodies Feedback Heinz bodies (also referred to as "Heinz-Ehrlich bodies") are inclusions within red blood cells composed of denatured hemoglobin. It is also seen in cases of moth balls (naphthalene) ingestion. High-Level Aminoglycoside Resistance: Micrococcus Staphylococc us Enterococci AOTA C. Enterococci Feedback Enterococci are intrinsically resistant to aminoglycosides; a combination therapy using aminoglycoside with vancomycin has been known to increase the effectiveness of the aminoglycoside. It is important to identify this high-level aminoglycoside resistance (HLAR) to provide appropriate therapy.
deficiency: Clot is soluble to urea (24 hrs) Which of the following should be tested in cases of Antacid overdose? pH Potassiu m Ammoni a Chloride A. pH Feedback Antacids do just what their name suggests: they neutralize the normal stomach acid (HCl), causing the pH to rise to a nearly neutral pH of around 6 to 7. As the pH rises above 4, pepsin activity decreases or stops. Some types of antacids, made of sodium bicarbonate (NaHCO3) or calcium carbonate (CaCO3), are easily absorbed into a person's body and can cause a pH imbalance, possibly leading to kidney damage or other problems (Berkow, 1987). 17 - Ketosteroids is produced in the: Adrenal glands Hypothalam us Thyroid glands Pituitary glands A. Adrenal glands Feedback 17-ketosteroids are substances that form when the body breaks down male steroid sex hormones called androgens and other hormones released by the adrenal glands in males and females, and by the testes in males. The oxygen sensitive indicator that is used to ensure that anaerobic jars or chambers have met the anaerobic conditions required for anaerobes to grow is: Methylene
blue Bromphenol blue Thymol blue Bromthymol blue A. Methylene blue Feedback Methylene blue is used as an indicator of anaerobiosis. It remains blue when there is oxygen present in the environment but turns colorless if anaerobic conditions are met. 2 - month old baby with Normal WBC, Normal platelet, reticulocyte count: 0.1%: Pure red cell aplasia Chronic Myelogenous Leukemia Myelofibrosis with myeloid metaplasia Polycythemia vera A. Pure red cell aplasia 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. Autologous Donation: Age has no requirement Hgb atleast 11 g/dl, Hct atleast 33% Single unit is removed at a time, with atleast 3 day intervals AOTA D. AOTA Feedback Donating blood for your own surgery is called an autologous donation. These blood units are collected and stored until the patient's surgery. Order of migration of hemoglobins during alkaline electrophoresis, starting from the origin towards the anode:
