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Rated 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
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
Myoglobin
Troponin
AOTA ✔✔C. Troponin
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
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
What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48?
30 ✔✔B. 6.
Feedback: CV= SD/meanX100, (5.48/90)X100= 6.09.
Blood smear below denotes Hairy Cell Leukemia (HCL), which of the following test is used to identify this type of leukemia? Image. 1 Myeloperoxidase
Tartrate-resistant acid phosphatase
Tartrate-resistant alkaline phosphatase
Sudan Black ✔✔B. Tartrate-resistant acid phosphatase
Feedback: Hairy cells demonstrate strong positivity for tartrate-resistant acid phosphatase (TRAP) staining. The hairy cells are larger than normal and positive for CD19, CD20, CD22, CD11c, CD25, CD103, and FMC7.
Use to differentiate Salmonella from Citrobacter:
Lysine decarboxylase
ONPG
Indole
Vogues Proskauerterm-9 ✔✔A. Lysine decarboxylase
Feedback: Salmonella (+); Citrobacter (-)
Arrange the common Rh antigens according to immunogenicity (greatest to least):
SLE ✔✔A. Ankylosing spondylitis
Feedback: Ankylosing spondylitis belongs to a group of arthritis conditions that tend to cause chronic inflammation of the spine (spondyloarthropathies). The HLA-B27 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)
Feedback:
The above shown picture illustrates Burr cells, these cells are indicative of Uremia (kidney disease)
Anti IgG (-); C3d (+): What should the MLS do?
Elution
IAT
DAT
Pre-warm ✔✔D. Pre-warm
Feedback 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
(TP+FN)/TPx
(TP+FP)/TNx100 ✔✔A. TP/(TP+FN)x
CThe anemias of the qualitative hemoglobinopathies, such as sickle cell anemia, are morphologically classified as:
Microcytic, hypochromic
Macrocytic, normochromic
Normocytic, normochromic
NOTA ✔✔C. 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
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?
Sensitization
Precipitation
Diffusion
Lattice formation ✔✔A. Sensitization
Feedback Agglutination involves two process: First, sensitization or initial binding. Second, lattice formation or formation of large aggregates.
Sterilization of autoclave:
121°C at 20 lbs/psi for 30 minutes
121°C at 15 lbs/psi for 15 minutes
85°C for 15 lbs/psi 30 minutes
100°C for 20 lbs/psi 50 minutes ✔✔B. 121°C at 15 lbs/psi for 15 minutes
Feedback Many autoclaves are used to sterilize equipment and supplies by subjecting them to high-pressure saturated steam at 121°C (249 °F) for around 15-20 minutes depending on the size of the load and the contents.
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
Capnocytophaga
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:
Feedback Primidone is a structural analog of phenobarbital.
Postprandial turbidity of the serum is due to the presence of?
Fatty acid
Cholesterol
Phospholipid
Lipoproteins ✔✔D. Lipoproteins
Feedback For approximately two to eight hours following a meal there is an additional LIPOPROTEIN class, called chylomicrons, representing the transport of dietary fat absorbed in the intestine.
A patient with an anti-K and an anti-JKa in her plasma needs 2 units of RBC for surgery. How many group specific units would need to be screened to find 2 units of RBC? The frequency of
Jka+ is 80% and K+ frequency is 15%. ✔✔B. 12
Feedback Formula: Number of units to crossmatch is equivalent to: # of units need by patient/(frequency of negativity of antigen #1 x frequency of negativity of antigen #2).
Negativity of Jka+ is .20%, Negativity of K+ is .85%. Using the formula, 2 units/(.20x.85)=11.76 rounded to 12.
An alkaline urine refrigerated becomes turbid because of?
Amorphous phosphates
Amorphous 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
