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ASCP Recalls Exam | 521 Questions And Answers 3 pairs of hooklets in an ovum - Ans - Presence of lupus anticoagulant leads to .... Which is the agent of hand, foot and mouth disease of humans? - Ans - Coxsackie A virus Detection of antigen in urine specimen can be used for which of the following type of pneumonia infection a. Fusobacterium B. Y. Pestis C. Legionella D. Mycobacterium TB. - Ans - Legionella Antler hyphae found in ... - Ans - Microsporum Audouinii What grows on chocolate agar - Ans - Haemophilus spp. *requires X and V factor It could grow around colonies of with Staph. Aureus forming Satellitism as Staph. Aureus (in addition Neisseria and Pneumococcus) releases NAD AKA factor Factor 5. Hemin is factor 10. Double zone of hemolysis and beta lactamase - Ans - Clostridium Perfringens Which increases first after an Ml - Ans - Myoglobin myoglobin>cT>CK>AST>LD (Myglobin rises within 30 min and last for 18-24 hours. Tropinin | rises 4-10 hrs post MI, peaks at 14-20 hrs and remains elevated for 4-10 days, most specific and last the longest in blood. CKMB rises 6-10 hours, peaks and 24 hrs and last for 2-3 days, least specific. LD1>LD2 slowest to rise after MI.) Which of the following parasite cause autoinfection in immunocompromised patients? - Ans - Strongyloides Stercoralis Which of the following causes antibody against TSH? - Ans - Graves Disease = TSHR (thyroid stimulating hormone receptors) antibody causes thryoid hyperactivity and suppression of TSH normal or increase T3 and T4 decrease TSH Which of the following causes antibody against Thyroglubulin and Thyroid cells? - Ans - Hashimotos = Anti-thyroglobulin decrease T3 and T4 increase TSH What RBC inclusion can be seen on blood smear of a child who accidentally ingested moth balls? - Ans - Heinz Bodies Which of the following causes decrease HbA1c? - Ans - Sickel cell or any chronic Hemolytic Anemia Which of the following cells releases histamine/heparin? - Ans - Eosinophil and Basophil Which of the following Mycobacteria we can acquire from tap water? - Ans - Mycobacterium Gordonae Which of the following analytes is cofactor for most of 300 enzymes? - Ans - Magnesium (Zinc too) reference range: 1.7-2.4 mg/dl Which of the following condition is the most common cause of increase anion gap? - Ans - Uremia (Renal failure), Lactic acidosis, Ketoacidosis, Hypernatremia, ingestion of Methanol, Ethylene Glycol or Salycilate (SLUMPED) Double zone of hemolysis bacteria... how to confirmation? - Ans - positive reverse CAMP test. Gram negative anaerobes after a Jaw surgery - Ans - Veillonella reduce nitrate to nitrite, does not ferment carbohydrates. Gram negative, beta hemolytic, oxidase positive organism isolated from wound. A/A on TSI - Ans - Aeromonas ONPG negative - Ans - N. meningitis Non lactose fermenter (ONPG Negative): Salmonella spp; Shigella spp; Proteus spp; Providencia spp and Morganella spp do not produce B-galactosidase so can not ferment lactose. What requires oil or olive oil - Ans - Malassezia furfur (Tinea Versicolor) Spaghetti and meatballs appearance Following a throat infection, patient is having kidney problems. What bacteria causing it? - Ans - Streptococcus pyogenes Patient has walking pneumoniae and is prescribed penicillin. 2 weeks later, still sick. What happened? - Ans - Bacteria has no cell wall Potassium permanganate in auramine-rhodamine stain for Mycobacterium - Ans - Quenching agent Specimen of choice for rotavirus? - Ans - stool Took a swab sample from a wound and incubated on three different medias (including anaerobic media). Nothing grew. What happened? - Ans - Swab material inhibited the sample. Latex agglutination for Staphylococcus Aureus detects what? - Ans - Protein A and clumping factor Different between Staphylococcus aureus and other Staph. Spp? - Ans - Staphylococcus Aureus is Coagulase Positive How to differentiate between Staphylococcus aureus and Micrococcus - Ans - Micrococcus arranged in tetrads Colonies are yellow and none hemolytic on SBA most importantly Micrococcus is Furazolidone resistant Burr cells blood picture - Ans - uremia (uremia and liver disease, artifact (alkaline glass effect) Stomatocytes blood picture - Ans - Liver disease Badly discolored blood picture with very spiky cells. What caused this? - Ans - Slide not dry Looks like dark Burr cells latrogenic anemia is due to what? - Ans - excessive blood draws (latrogenic anemia = means lowered hematocrit and hemoglobin count) What cell type is increased in Infectious mononucleosis? - Ans - lymphs B cells infected T cells reactive (pictured) Lupus anticoagulant causes what? - Ans - Increased risk of thrombosis Sample taken from indwelling catheter. Patient isn't on any anticoagulants yet PTT and TT are way elevated. - Ans - Heparin contamination from the catheter Anti-Thrombin Ill - Ans - It is a Heparin Co-factor deficiency is associated with thrombosis In which case is Magesium monitored? - Ans - Pre-eclampsia (eclampsia) (Twitching, cramping, arrhythmias) Patient taking primidone showing toxicity, but blood levels normal. What do you do next? - Ans - Test phenobarbital level (primidone is the inactive form of phenobarbitol) Sperm count can be done on semen sample when - Ans - Liquefaction is complete (30- 60 minutes) Liquefaction time is a measure of the time it takes for the semen to liquefy. anti-sperm antibodies - Ans - causes agglutination in the form of attached sperms. Head to head, tail to tail or head to tail. Tumor marker seen in pancreatic cancer - Ans - CA 19-9 (and Carcinoembryonic antigen (CEA)) Fasting glucose 120. What's the diagnosis? - Ans - Impaired fasting glucose. 0-50 mg/dl = hypoglycemia 50-100 mg/dl = normal 100-125 mg/dl = impaired >126 mg/dl = diabetes What increase in Pheochromocytoma ? - Ans - Metanephrines in urine (24 hours collection) sensitivity is - Ans - TP/TP +FN X 100 Sensitivity: probability that a test result will be positive when the disease is present (true positive rate) specificity is - Ans - TN/TN+TP X 100 Main metabolite of cocaine - Ans - Benzoylecgonine Type 1 hypersensitivity stimulated by - Ans - IgE Blood product that has highest capability of transmitting hepatitis - Ans - Needle stick during a procedure Heinz bodies - Ans - Heinz bodies: denatured HB, need supervital stain, seen in G6PD, thalassemia and unstable hemoglobins Child swallowed naphthalene ball, what is expected to be seen on peripheral blood smear ? - Ans - Heinz Bodies Stomatocytes - Ans - liver disease Urine Bilirubin crystals - Ans - liver disease brownish in color (acidic urine, liver disease) Urine Tyrosine crystals - Ans - liver disease (acidic urine, liver disease) Urine Leucine crystals - Ans - Liver disease Eosinphils in urine - Ans - Interstitial nephritis Chopped meat agar (iron and glycerol) - Ans - Anaerobes Anaerobes causing jaw abscess - Ans - Veillonella (gram - cocci) and Peptostreptococcus (gram + cocci) - they are normal flora of the oral cavity t(15;17) for - Ans - Acute Promyelocytic leukemia -APL, or M3 hypergranular Promyelocytes in bone marrow apirate Retics stain with .... - Ans - New methylene blue wrights (polychomactophilic) Howell jolly bodies stain with - Ans - Wrights and new methylene blue Papperheimer bodies stain with - Ans - Wrights, new methylene blue, and confirm with Prussain blue Heinz bodies stain with - Ans - new methylene blue supravital stain How do yo differentiate 1. Yersinia enterocolitica vs 2. Yersinia pestis? - Ans - Y. Enterocolitica: ODC positive MR + urease +; Lactose negative, H2S negative, VP negative, citrate negative, PD negative Y. Pestis: ODC negative Differentiate between Echinocyte and Acanthocyte - Ans - echinocyte: equal acanthocyte: crazy looking the action of Caffeine for Diazo reaction. - Ans - acts as an accelerator to measure unconjugated bilirubin?? Jendrassik-Grof total bilirubin test Bilirubin + sodium acetate + caffeine-sodium benzoate + diazotized sulfanilic acid —» purple azobilirubin + alkaline tartrate —* green-blue azobilirubin (600 nm) Conjugated bilirubin will react with diazo reagent: in water and in caffeine benzoate Unconjugated bili requires an accelerator. Enzyme that uses p-Nitrophenylphosphate (pnp) as substrate @ pH of 9.6 - Ans - Alkaline Phosphatase (ALP) Enzyme that uses p-Nitrophenylphosphate (pnp) as substrate @ pH of 9.6 is highest at what disease - Ans - Paget disease (bone destruction disease) Estrogen increase in pregnant women = - Ans - Estriol Increased right before ovulation - Ans - Luetinizing hormone-LH estraDlol “di-ing from cramps" Nucleolar pattern ANA is seen in ... - Ans - scleroderma and Sjogren's What is used to evaluate fetal lung maturity? - Ans - phosphatidylglycerol (preferred method) and lecithin/sphingomyelin (L/S) ratio which should be 2:1 Sezary syndrome is - Ans - T cell lymphoma A variant of Mycosis Fungoides Patient has walking pneumonia but treatment shows penicillin resistance because ..... - Ans - no cell wall (will not work on mycoplasma with no cell wall as penicillin acts on cell wall) Normocytic, normochromic, normal WBC, normal platelet, but retics is 0.1% - Ans - pure red cell aplasia (retic reference range in adults = 0.5-1.5%) The meaning of Creatinine Clearance ... ... - Ans - itis used to access the Glomerular Filtration Rate (GFR) and one of the renal function test. normal Creatinine clearance is 120 ml/min for adult and it decrease with age Adrenal cushing syndrome causes: - Ans - Decreased ACTH, ¢ cortisol increased (causes would be adrenal gland tumors, these are lab results consistent with cushing syndrome) syndrome: increase cortisol disease: decrease cortisol Apolipoprotein A - found in ..... - Ans - HDL The stain being too blue and what do you do? - Ans - Decrease pH buffer (due to stain too alkaline, Decrease pH of stain is correct. Referring to wright staining) How is LDL extracted from HDL? - Ans - Heparin-manganese What's the purpose of the caffeine in bilirubin? - Ans - Take the albumin off (probably wrong, correct response should be solubilize and measure unconjugated bilirubin) accelerate the diazo reaction Difference between yersinias? - Ans - All Yersinia Species are motile at 25C but not at 37C except, Yersinia Pestis is not motile at both temperature? Y. enterolitica only one that is ODC positive Increased in cathecolamines in what disease? - Ans - Pheochromocytoma Elevated level of aminolevulinic acid in urine is due to presence of ....... - Ans - Lead poisoning Purpose of AHG : - Ans - Detect immunoglobulins present on surface of RBC and serum (correct, detect sensitized RBCs) Blastoconidia are the beginning of ... - Ans - Pseudohyphae (Pseudohyphae are the result of a pinching-off process, blastoconidiation, with the growth of filaments with constrictions.) Liver cancer Marker - Ans - Alpha-Fetoprotein may be significant in ovarian or testicular cancer as well. Breast cancer Marker - Ans - CA 15-3 Pancreatic cancer Marker - Ans - CA 19-9 Ovarian cancer Marker - Ans - CA 125 Colorectal cancer - Ans - CEA B-hCG marker for malignancy - Ans - BETA SUBUNIT of Human chorionic gonadotropin (unique to hCG) increase in trophoblastic tumors If there is a Rouleaux formation on the blood what will you do? - Ans - Saline replacement How to determine true from false agglutination - Ans - add normal saline RIST-Radioimmunosorbent test- test detects what? - Ans - Measures total IgE (used in allergy testing, while RAST measures specific IgEs) Enzyme controls run on amachine give results around -3 standard deviations. Samples run on the same machine give results of less than 1 standard deviation. What could be the problem? - Ans - Controls were left at room temperature for several days HIV-1 & HIV-2 combination ELISA test is positive in a patient with symptoms of immune deficiency. Western blot was inconclusive for HIV-1. What do you do next? - Ans - do EHIV-2 western blot What are the steps of PCR? - Ans - Denaturation, Annealing, Transcription (denaturation, annealing, extension) RAST test detects what? - Ans - IgE to particular Antigens After collecting a blood sample in an EDTA tube for CBC, you find that the Hematocrit is very high (67%). What should you do next? - Ans - report these results, look to see if there is cost testing. if yes, have to redraw patient and adjust amount of citrate. (Ratio of plasma to citrate is important. High HCT means less plasma, causes excess anticoagulant and affects coag results.) Blood was collected on Nov 1. Blood was then frozen in glycerol on Nov 5. What should the expiration date read? - Ans - Nov 1; 10 years from now (40% glycerol used) When you conduct a procedure using fluorescence, it's important to protect yourself from the: - Ans - Excited light fluorescence polarized immunoassay (competitive inhibition) - Ans - The amount of analyte in the sample is inversely proportional to the amount of fluorescence polarization. That is, the greater the concentration of analyte, the less the amount of polarized light detected A person was successfully treated for syphilis 12 years ago. However, he has just come in again, worried about having been re-infected. What would you look for in his blood? - Ans - VDRL, RPR A patient demonstrates a positive antibody screen. You suspect either Jka, K orc antibodies. You know from a previous history that this patient has Jka antigen on their red cells. You then react the patients serum with cells positive for certain antigens and see the following: Patient serum vs: reagent K cells reagent c cells Reaction strength: 0 4+ What can you conclude about the antigenic makeup of this patients red cells? - Ans - Rule out c antigen but cannot confirm the presence or absence of K antigen on the patients red cells cannot give blood with Jka or K antigens Urine protein chemistry dipstick (Reagent strip) detected no proteins but sulfosalicylic acid (SSA) test did detect proteins. Why? - Ans - Bence jones proteins in urine (proteins other than Albumin) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) would result in what in blood? - Ans - Dilutional Hyponatremia- deficient sodium Fiber strands in urine resemble what under the microscope? - Ans - Hyaline cast HBatc levels cannot always be used to monitor glucose levels in conditions such as: - Ans - sickle cell Which of the following regulates myocyte contraction? - Ans - Cardiac troponins cTnT Increased total bilirubin is in what situations - Ans - liver diease, hemolysis, HDFN In infants with >20mg/dL is kernicterus Increased conjugated (direct) bilirubin is in what situations - Ans - liver disease and obstructive jaundice post hepatic Increased unconjugated bilirubin is in which situations - Ans - prehepatic, posthepatic, and some types of hepatic jaundice ACTH produced by - Ans - Pituitary Gland FSH is production - Ans - sperm and ovum ACTH is regulated by - Ans - corticotropin-releasing hormone from hypothalamus LH regulates - Ans - maturation of follicles, ovulation, production of estrogen, progesterone, and testosterone Prolactin regulates - Ans - lactation Pituitary gland (activated by Hypothalamus) produces - Ans - ACTH When evaluating a patient for a suspected Wilson's Disease diagnosis, low values of plasma ceruloplasmin would be expected along with: - Ans - increased urine copper, decreased serum copper A hemoglobin F concentration of 100% may be seen in which beta thalassemia? - Ans - Delta-beta thalassemia major?? Homozygotes for 68-thalassemia have 100% HbF and, because of the increased synthesis of HbF, may have thalassemia intermedia rather than thalassemia major Pappenheimer bodies are usually seen in patients who have: - Ans - splenectomies sideroblastic anemia Order of draw - Ans - Blue Red Green Purple Gray (other) *Big Red Grosses People Out The half life of IgM and IgA - Ans - are approximately 5-6 days. The half life of IgD - Ans - 2.8 days (1-3)??? 2-3 days Half life of IgE - Ans - 2-3 days Half life of IgG - Ans - 23 days At an alkaline pH, which hemoglobin cannot be separated from hemoglobin S during hemoglobin electrophoresis? - Ans - Hb D (Sad Dog Gets Love) alkaline pH order: C, S, F, A (crawl, slow, fast, accelerate) Which of the following group B antigens is generally associated with a mixed field reaction: - Ans - B3 Which of the following parameters may be affected by the lipemia? - Ans - MCHC. Lipemia and high WBCs count interfere with the light used for measureing MCHC Which of the following hormones increases plasma glucose concentration by converting glycogen to glucose? - Ans - Glucagon and epinepherine Which of the following species of Mycobacterium might be associated with contamination of the hot water system in large institutions such as hospitals? - Ans - Mycobacterium Xenopi Can be either nonphotochromogenic or scrotochromogenic; Water, especially hot water taps in hospitals; believed to be transmitted in aerosols; Primarily pulmonary infections in adults; less common, extrapulmonary infections (bone, lymph nodes, sinus tract) and disseminated disease. Acute phase proteins generally fall into which category? - Ans - Glycoproteins Rhinocladiella description - Ans - Growth on the side and around the tip Electrical fire is class - Ans - C What is the correct procedure when using a winged collection device (butterfly) to draw a light-blue top tube intended for a coagulation test if this is the first tube that will be collected in the draw? - Ans - Draw and discard a waste light-blue top tube before the tube that will be used for coagulation studies. Which of the following patients is most at risk for hyperosmolar nonketotic coma? - Ans - A 70-year-old type 2 diabetic patient Beta hemolytic spore forming agent is - Ans - Bacillus spp. “box car" GPB also clostridium Non-beta hemolytic, Non Motile, Catalase positive, spore forming agent is ..... - Ans - Bacillus Anthracis Medusa-Head Colonies Black escher ulcers GPB Enterobacteriaceae that is MR negative - Ans - Enterobacter Kleb Serratia How to differentiate between citrobacter and E. coli - Ans - E. coliis citrate negative (IMViC++--) Citrobacter is citrate positive (?+?+) morganella How to differentiate the PAD positive species - Ans - Proteus is the only one that is H2S positive HgbA ‘1c decrease in - Ans - Chronic Hemolysis (hemolytic anemia) also in Sickle cell anemia How to differentiate between providencia and morganella - Ans - Providencia is citrate positive Morganella is citrate negative +morgan can't CIT with us because she doesn't have H2S Of the PAD negative organisms, which one does not produce H2S - Ans - Yersinia How to differentiate Salmonella from edwardsiella - Ans - salmonella is indole negative edwardsiella is indole positive How to differentiate yersinia species - Ans - Y. enterocolitica is ODC + (Orinithin decarboxlase) Y. pestis and pseudoTB are ODC negative How to differentiate Y. pestis and Y. pseudoTB - Ans - Y. pestis is nonmotile at 25C Y. pseudoTB is motile at 25C Selective and differential medium for Y. entercolitica - Ans - CIN Medium = Cefsulodin- irgasan-novobiocin Medium Colonies will ferment mannitol and absorb the dye => clear colonies with pink center Staphylococus on Mannitol Salt agar (MSA) - Ans - Staphylococci can tolerate the high salt concentration (7.5%) of Mannitol salt agar (MSA) Produces Yellow Colonies Different between s.aureus and other staph spp? - Ans - Staph. Aureus is coagulase positive Other Staph. Species Coagulase Negative Micrococcus as a normal flora must be differentiated from Staphylococcus by ........ - Ans - Micrococcus is Furazolidone Resistant Bacitracin Sensitive and oxidase positive non hemolytic on SBA Gram Positive Cocci in chains Catalase Negative Bile-Esculin Positive (BEM positive) No Growth on 6.5% NaCl Associated with Colorectal Cancer - Ans - Streptococcus Bovis/Gallolyticus Group D Streptococcus Optochin Sensitive bacteria - Ans - Streptococcus Pneumonia Polysaccharide capsule Lancet-Shaped diplococci Grame Positive Cocci Catalase: (-) Bile Esculin: positive (+) 6.5% NaCl: positive (+) PYR: Positive (+) - Ans - Enterocuccus Vanocmycin-resistant enterococci is E. Faecium Gram Positive cocci BILE ESCULIN positive 6.5 NACL (+) PYR negative (-) LAP negative (-) - Ans - Leuconostoc Butchers cut (or fishermen, veterinarians) Catalase Negative (-) Esculin Negaive (-) H2S Positive on TSI Test tube brush growth in Gelatin - Ans - Erysipelothrix Rhusiopathiae It is important to differentiate it from Listeria Gram Positive (+) BRANCHING (Filamentous) Bacilli PARTIALLY ACID FAST - Ans - Nocardia asteroides Musty odor of a colony - Ans - Nocardia spp (incorrect) Pasteurella Multocida 
