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ASCP MLS QUESTIONS AND ANSWERS
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What feature is most often found with patients with a splenectomy on a Wright's stained blood smear? ✔✔Howell-Jolly bodies
Patients with antibody to the following antigen are immune to Hepatitis B: ✔✔Surface antigen (HbSAg)
Which two of the following tests are helpful for documenting previous Streptococcal throat and skin infections: ✔✔ASO titer and Anti-DNase B
In mass spectrometry, the "appearance potential" is defined as the: ✔✔Minimum energy required for the appearance of a particular fragment ion in mass spectrum
What is generally accepted as the lower threshold value for semen pH from fertile males? ✔✔7.
Coulometry: ✔✔An automated method for measuring chloride which generates silver ions in the reaction
Erythroleukemia: ✔✔Also known as Acute Myelogenous Leukemia type M6. This type is associated with either the presence of both erythroid and myeloid precursors OR strictly erythroid precursors.
Myelomonocytic leukemia ✔✔Is associated with an increase in myeloid and monocytic cell precursors, but not red blood cell precursors
Species that are Lysine (+), arginine (=) and ornithine (+): ✔✔Enterobacter aerogenes, Edwardsiella species and most Serratia species
Lysine reaction for all Citrobacter: ✔✔Negative
Key identifying characteristic for Pantoa (Enterobacter) agglomerans: ✔✔negative reactions for the three decarboxylases commonly tested ( Lysine, arginine and ornithine)
Which organism is MOST likely responsible for septic reactions associated with Red Blood Cell transfusions? ✔✔Yersina entercolitica is most likely responsible for septic reactions in transfusions of Red Blood Cells. This organism is usually acquired by ingestion of contaminated food and causes mild symptoms of abdominal pain and diarrhea. Growth of Y. entercolitica is enhanced in iron-rich environments such as red cell components.
ANA ✔✔See 2 quiz #
Prozone effect: ✔✔Results in a false positive reaction; is the result of antibody excess and dilution of antibody can help prevent its occurrence
Purpose of a bi-chromatic analyzer with dual wavelengths is: ✔✔Minimize the effect of interference
Key characteristics of Micrococcus: ✔✔Susceptible to bacitracin ("A") and resistant to furazolidone; gram positive cocci in tetras, bacteria cells of micrococcus luteus are larger than those of the staphylococci and can arrange in tetras
What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hrs? ✔✔95 mL/min One method of calculating a glomerular filtration rate is using creatinine and urine volume to determine creatinine clearance. The equation is as follows:
Creatinine Clearance = (urine creatinine X urine flow rate) / plasma creatinine; where urine flow rate = volume in mL /24 hours x h/60 min)
In this case = creatinine clearance = 124 X (2200/24 x hour/60) / 2 = 94.7 or 95 ml/min
Estrogen and progesterone markers are most commonly used to provide prognostic information about: ✔✔Breast cancer
The prozone effect ( when performing a screening titer) is most likely to result in: ✔✔Prozone effect (due to antibody excess) will result in an initial false negative in spite of the large amount of antibody in the serum, followed by a positive result as the specimen is diluted.
Which of the following Rh antigens is found the highest frequency in the Caucasian population: A. C B. E C. c D. e ✔✔D. e
The accuracy of an immunoassay is its ability to discriminate between results that are true positives and results that are true negatives. Two parameters of test accuracy are specificity and sensitivity. Which of these statements apply to an immunoassay with high specificity, but low sensitivity? ✔✔Accurately identifies the absence of disease and has few false-positives
A test with high specificity accurately detects the absence of disease. The more specific a test is, the fewer false-positive results will occur. A test with high sensitivity accurately identifies the presence of disease. The more sensitive a test, the fewer false-negative results it produces. In the case stated in this question, the immunoassay has high specificity, so it has few false-positives and will accurately detect those individuals who do not have the disease or condition that is
Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity? ✔✔Adiponectin is a protective cytokine. This cytokine is anti-inflammatory and increases insulin sensitivity. Adiponectin is usually decreased in obesity.
Distinguishing characteristics of Mycobacterium fortuitum: ✔✔Mycobacterium fortuitum is positive for iron uptake, nitrate, arysulfatase, and growth on MacConkey agar without crystal violet in five days.
CD5 antigen is normally found on which of the following lymphocyte populations? ✔✔Mature T cells
Define: Congestive heart failure ✔✔A left ventricular dysfunction resulting from aging, hypertension, atherosclerosis or muscle damage from an AMI or repeated AMIs.
Define infarction: ✔✔An area of tissue death that occurs due to lack of oxygen.
Define: Ischemia ✔✔An inadequate blood supply that decreases availability of oxygen.
Define: Angina ✔✔Chest pain caused by inadequate supply of oxygen to heart myocardium.
Which of the following antigen groups is closely related to the ABO antigens on the red cell membrane? ✔✔I and i antigens are related biochemically and spatially to the ABH and Lewis
antigens on the red cell membrane. Anti-I is usually an autoantibody. It is common as a benign cold autoagglutinin. Strong anti-I is associated with Mycoplasma pneumonia infection, where it may be associated with cold autoimmune hemolytic anemia. Anti-I is characterized by its failure to react with cord red cells. Anti-i generally occurs as a cold reactive IgM antibody in the setting of infectious mononucleosis.
Distinguishing between T lymphs and B lymphs: ✔✔T lymphocytes are larger and have more vacuoles than B lymphocytes.
Define Galactosemia: ✔✔Galactosemia is an inherited metabolic disorder that affects an individual's ability to metabolize the sugar galactose effectively. Infants affected by galactosemia typically present with symptoms of lethargy, vomiting, diarrhea, failure to thrive, and jaundice. The presence of galactose in the urine sample is not picked up by the glucose pad on the urine test strip, however, the clinitest result is positive since it can detect different sugars in the urine, including galactose. True lactose intolerance will usually not become symptomatic in children until they are at least 3 years old (usually after age 7). Also, lactose intolerance is associated with diarrhea, but not closely associated with vomiting.
Distinguishing characteristics of Shigella species: ✔✔Shigella species generally do not usually exhibit motility. Shigella spp. are gram-negative rods which is known to cause Shigellosis. This is an infectious disease caused by Shigella which is associated with diarrhea, fever and stomach cramps.
on mast cells and cause the release of histamines. Allergen substances may be drugs or food consumed by the blood donor.
Contact dermatitis is mediated by: ✔✔T lymphocytes
Diagnosis of Diabetes: ✔✔A random glucose concentration greater than 200 mg/dL, with classical signs and symptoms of diabetes
A fasting glucose concentration greater than 126 mg/dL on more than one occasion.
An abnormal oral glucose tolerance test (OGTT), in which the glucose concentration is greater than 200 mg/dL 2 hours after a standard carbohydrate load.
Patients with Waldenstrom's macroglobulinemia demonstrate excessively increased concentrations of which of the following? ✔✔IgM
LIpemia in a serum smaple is most likely caused by an increase in serum levels of: ✔✔Triglycerides
The incidence fo hemolytic disease of the fetus and newborn due to anti-D would be expected to be rarest in which population? ✔✔Asians
What characteristics are often associated with alpha thalassemia intermedia? ✔✔Anemia, splenomagaly
Define Oliguria: ✔✔the production of abnormally small amounts of urine Correlated with acute glomerulonephritis
Le(a+b-) Le(a-b+) Le(a-b-) ✔✔Le sese Le Se lele sese or Se
B lymphocytes and T lymphocytes are derived from: ✔✔Hematopoietic stem cells
Which of the following will give the best overall picture of a patient's iron stores: ✔✔Ferritin (storage form of iron)
If a bacteria produces the enzyme tryptophanase to break down the amino acid tryptophan, which of the following tests will be positive with Kovacs reagent? ✔✔Indole test
Ringed sideroblast: ✔✔
Adiponectin: ✔✔Is aprotective cytokine. This cytokine is anti-inflammatory and increases insulin sensitivity. Adiponectin is usually decreased in obesity
Metabolic syndrome: ✔✔Includes high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels
In patients with suspected primary hypothyroidism associated with Hashimoto's thyroiditis, one would eexpect the following laboratory test results: T4___? TSH___? and TRH stimulation______? ✔✔decreased, increased, increased
In an adult where does hematopoiesis occurs? ✔✔Vertebrae, skull, proximal ends of long bones, ribs and pelvis in adults
Granulocyte concentrates MUST be administered within _____ of collection: ✔✔24 hours
Patients at risk for developing TA-GVHD: ✔✔Neonates less than 4 months old, fetuses, recipients with a congenital of acquired immunodeficiency, such as bone marrow or stem cell recipients and patients receiving chemotherapy and recipients of donor units from a blood relative
Iron deficiency anemia: ✔✔
Dubin-Johnson Syndrome: ✔✔An autosomal recessive disorder that causes an increase of conjugated bilirubin without elevation of liver enzymes (ALT, AST)
Crigler-Najjar syndrome: ✔✔Associated with increased levelss of bilirubin in the blood as teh disorder affect the etabolism of bilirubin
Gilbert's syndrome: ✔✔Causes an otherwise harmless jaundice, which does not require treatment, caused by hyperbilirubinemia
Distingush between Pappenheimer bodies an Howell-Jolly bodies: ✔✔Prussian blue stain would help differentiate between the two. Prussian blue stains iron. Pappenheimer bodies, which contain iron, will stain blue. Howell-Jolly bodies will not stain with Prussian blue because they do no contain iron. Both Howell-Jolly bodies and Pappenheimer bodies will stain with Wright- Giemsa stain.
Symptomes of Acute leukemia: ✔✔Acute leukemia is associated with bone pain, hepatosplenomegaly, and swollen lymph nodes. In addition, infections (causing fevers) and bleeding are common. A high white blood cell count with man blasts in the peripheral blood and bone marrow, along with a low platelet and rbc count are also highly associated with this condition.
Differentiate between group D streptococcus, Group D enterococcus, Group B strep and Group A: ✔✔Group D streptococcus (bile esculin +, 6.5% NaCl -, PYR -)
The anemia of chronic infection is characterized by: ✔✔decreased serum iron levels; serum Fe levels low due to sequestration in macrophages and hepatocytes
IgG Index: ✔✔The IgG index is used to determine if increased IgG in CSF is due to increased production in the CNS or contamination from a breach to the blood-brain barrier.
Which of the following is a characteristic of Factor XII deficiency? ✔✔Negative bleeding history
Patients with a deficiency of factor XII tend to have thrombotic complications. The do not have bleeding problems most likely due to the lack of activation of fibrin lysis, also due to pathway activation of IX by VIIa/TF complex as well as the activation of Factor XI by thrombin
Heinz bodies are: ✔✔Denatured hemoglobin inclusions that are readily removed by the spleen.
Urobilinogen is formed in the: ✔✔Intestine
Causes of Vitamin B12 deficiency: ✔✔Pericious anemia in relapse, Patients on chronic hemodialysis and hodgkin disease
T lymphocytes that possess the CD8 surface marker mediate which of the following T-cell functions? ✔✔Cytotoxic T cells, which are capable of destroying targets such as tumor cells and virus-infected cells, bear the CD8 surface marker, while the other cell types listed ( delayed type hypersensitivity, regulatory and helper) are positive for the CD4 surface marker
Intrinsic Pathway: ✔✔Prekallikrein, heavy molecular weight kinogen, XII, XI, X, IX, VIII, V, II and I
Measured by APTT
Leukmoid Reaction: ✔✔
Vitamin K Factors: ✔✔factors II (prothrombin), VII, IX and X. Anticoagulation proteins: proteins C, S
Christmas Disease: ✔✔Deficiency in Factor IX
Amorphous urates is found in: ✔✔Acidic pH urine
Amorphous phosphate crystals are found in: ✔✔Amorphous phosphate, triple phosphate (ammonium magnesium phosphate), calcium phosphate, and ammonium urate crystals are frequently found in alkaline urine specimens
Tay-Sachs Disease: ✔✔A rare inherited disorder characterized by the near-total deficiency of the enzyme N-acetylbetahexosaminidase A.
Term that means varying degree of leukocytosis with a shift to the left and occasional nucleated red cell in the peripheral blood: ✔✔Leukoerythroblastosis
Alder-Reilly inclusions: ✔✔Mucopolysaccarids
Sodium nitroprusside on a urine reagent strip reacts with: ✔✔Acetoacetic (diacetic) acid- ketones
Glucose levels whole blood, serum and CSF: ✔✔serum>whole blood>CSF
Increased numbers of basophils are often seen in: ✔✔Chronic myelocytic leukemia
HLA antibodies are: ✔✔HLA antibodies are formed in response to pregnancy, transfusion or transplantation and are therefore not naturally occurring. They are associated with febrile nonhemolytic transfusion reactions and TRALI. They are directed against antigens found on granulocytes and other cells such as platelets.
Which of the following combinations is useful for confirming the presence of extended spectrum beta-lactamases in E coli? ✔✔Extended spectrum beta lactamases (ESBL) are inhibited by clavulanic acid. Confirmatory tests of the presence of ESBL are based on the enhanced activity of a beta-lactam antibiotic, usually cefotaxime or ceftazidime, when it is tested with clavulanic acid compared to the activity of the betalactam tested alone.
Low PCO2: ✔✔Represents alkalosis
Low HCO3: ✔✔Represents acidosis
Seriological marker for: Rheumatic fever Wegener's granulomatosis CREST syndrome Primary biliary cirrhosis ✔✔Antimyocardial antibodies Antineutrophili antibodies Anticentromere antibodies Antimitochondrial antibodies
Which T cell expresses the CD8 marker and acts specifially to kill tumor or virally infected cells? ✔✔T cytotoxic
The most frequent genotype among Rho (D)- negative persons is: ✔✔rr
