Urinalysis & BF
A patient with uncontrolled diabetes mellitus will most likely have:
A. pale urine with a high specific gravity
B. concentrated urine with a high specific gravity
C. pale urine with a low specific gravity
D. dark urine with a high specific gravity
What is A. pale urine with a high specific gravity?
High specific gravity is due to the glucose in the urine. Patients with diabetes mellitus have polyuria, so that the volume of urine dilutes the urochrome (color) making the urine pale.
Which of the following prospective donors would be accepted for donation today?
A. 32-year-old woman who received a transfusion in a complicated delivery 5 months previously
B. 19-year-old sailor who has been stateside for 9 months and stopped taking his anti-malarial medication 9 months previously
C. 22-year-old college student who has a temperature of 99.2F (37.3C) and states that he feels well, but is nervous about donating
D. 45-year-old woman who has just recovered from a bladder infection and is still taking antibiotics
What is C. 22-year-old college student?
Receipt of blood products = 12 month deferral
Travel to malarial-endemic area = 12 month deferral (regardless of anti-malarial prophylaxis)
Person on antibiotics may have bacteremia - cannot donate while on antibiotics
Temperature cut-offs are </= 37.5C or </=99.5F
Pregnant women with symptoms of thirst, frequent urination or unexplained weight loss should have which of the following tests performed?
A. tolbutamide test
B. lactose tolerance test
C. epinephrine tolerance test
D. glucose tolerance test
What is D. glucose tolerance test?
For possible gestational diabetes
The characteristic morphologic feature in lead poisoning is:
A. macrocytosis
B. target cells (codocytes)
C. basophilic stippling
D. rouleaux formation
What is C. basophilic stippling?
Which of the following immunoglobulins is present in the highest concentration in normal human serum?
A. IgM
B. IgG
C. IgA
D. IgE
What is B. IgG?
IgG immunoglobulin is the highest in human sera.
To prepare the reagent used in confirmatory protein testing, a laboratorian would:
A. combine 3 mL of hydrochloric acid and 97 mL of water
B. combine 5 mL of glacial acetic acid and 95 mL of water
C. dissolve 3 g of sulfosalicylic acid in 100 mL of water
D. dissolve 5 g trichloroacetic acid in 100 mL of water
What is C. dissolve 3 g of sulfosalicylic acid in 100 mL of water?
3% SSA is used to confirm positive protein tests. 3% implies 3 g in 100 mL of water.
Thawed plasma must be stored at:
A. </=-18C
B. 1-6C
C. 1-10C
D. 20-24C
What is B. 1-6C?
Frozen FFP is stored at </=-18C
Shipping FFP (transport) temp must be 1-10C
Platelets and thawed cryoprecipitates are stores 20-24C
One international unit of enzyme activity is the amount of enzyme that will, under specified reaction conditions of substrate concentration, pH and temperature, cause utilization of substrate at the rate of:
A. 1 mol/min
B. 1 mmol/min
C. 1 micromol/min (1 umol/min)
D. 1 nanomol/min (1 nmol/min)
What is C. 1 micromol/min (1 umol/min)?
In 1981 the enzyme commission recommended the adoption of an international unit (IU) of enzyme activity. The IU was defined as the amount of enzyme that would convert 1 micromol (umol) of substrate per minute under standard conditions.
Anemia secondary to uremia characteristically is:
A. microcytic, hypochromic
B. hemolytic
C. normocytic, normochromic
D. macrocytic
What is C. normocytic, normochromic?
Anemia caused by uremia is typically normocytic, normochromic but the number of RBCs is decreased.
The following pattern of agglutination was observed in an antibody titration:
tube # 1 2 3 4 5 6 7 8 9 10 11
1+ 2+ 4+ 4+ 3+ 3+ 2+ 1+ 1+ 0 0
This set of reactions MOST likely resulted from:
A. faulty pipetting technique
B. postzoning
C. prozoning
D. the presence of a high-titer, low-avidity antibody
What is C. prozoning?
Prozone: suboptimal precipitation occurs in the region of antibody excess
In a specimen with a large amount of bilirubin, which of the following sediment constituents would be most noticeably bile-stained?
A. squamous epithelial cells
B. white blood cell casts
C. cysteine crystals
D. renal tubular epithelial cell casts
What is D. renal tubular epithelial cell casts?
The renal tubular cells lining the tubules absorb the urinary filtrate, and therefore will appear bile-stained.
A mother has the red cell phenotype: D+ C+ E- c- e+ she has an anti-c titer of 32
The father has the phenotype: D+ C+ E- c+ e+
The baby is Rh Neg and not affected with HDFN.
What is the baby's most probable Rh genotype?
A. r'r'
B. r'r
C. R1R1
D. R1r
What is A. r'r'?
Baby is D neg (rules out C and D) and is c neg to not be affected by maternal anti-c, which rules out r'r
r'r' = Cde/Cde
If the total bilirubin level is 3.1 mg/dL and the conjugated bilirubin level is 2.0 mg/dL, the unconjugated bilirubin level is:
A. 0.5 mg/dL
B. 1.1 mg/dL
C. 2.2 mg/dL
D. 5.1 mg/dL
What is B. 1.1 mg/dL
Total bilirubin = conjugated (direct) bilirubin + unconjugated (indirect) bilirubin so 2.0 + 1.1 = 3.1 mg/dL total bilirubin
Warfarin is classified as a vitamin K antagonist. The factors that are impacted by warfarin therapy are:
A. VIII, IX, and X
B. I, II, V and VII
C. II, VII, IX, and X
D. II, V, and VII
What is C. II, VII, IX, and X?
warfarin interferes with the carboxylation of vitamin K factors by interrupting the enzymatic phase of the reaction. Factors are inhibited according to their half life, with VII having the shortest (6 hours) and II the longest (2-3 days)
Which of the following is NOT a mechanism involved in the complement cascade?
A. apoptosis
B. opsonization
C. inflammation
D. cytolysis
What is A. apoptosis?
Apoptosis is normal, programmed cell death and not involved in the complement cascade.
A sperm count is diluted 1:20 and 50 sperm are counted in 2 secondary squares of the Neubauer counting chamber. The sperm count is:
A. 5,000/mL
B. 50,000/mL
C. 500,000/mL
D. 5,000,000/mL
What is D. 5,000,000/mL?
Use the formula of cells x dilution x 10 divided by the number of secondary squares. Then remember to convert from microliters to milliliters by multiplying by 1,000:
[(50x20x10)/2] x 1000 = 5,000,000/mL
Which of the following is considered a high prevalence (frequency) antigen?
A. Jsa
B. s
C. Vel
D. K
What is C. Vel?
Jsa - low prevalence/frequency antigen
K frequency is approximately 9%
s frequency is approximately 89%
Vel is a high frequency antigen - 1 in 4000 are Vel neg
The presence of C-reactive protein in the blood is an indication of:
A. a recent streptococcal infection
B. recovery from a pneumococcal infection
C. an inflammatory process
D. a state of hypersensitivity
What is C. an inflammatory process?
CRP is an acute phase protein increased in inflammation
What is usually the Factor VIII level in a hemophiliac patient with spontaneous bleeding?
A. <1%
B. 5-10%
C. 20-30%
D. 50-60%
What is A. <1%?
For spontaneous bleeding to occur, there must be a severe deficiency of factor VIII. Even small amounts of factor VIII are protective - patients with factor VIII levels of 5-10% will only present with excessive bleeding following trauma or surgery. The PTT is relatively insensitive in detecting factor VIII deficiency, demonstrating normal values until there is <30% factor VIII.
Which of the following is DECREASED in serum during the active stages of systemic lupus erythematosus?
A. anti-nuclear antibody
B. immune complexes
C. complement (C3)
D. anti-DNA
What is C. complement (C3)
C3 becomes depleted due to the autoantibody called C3-nephritic factor (C3NeF)
During sweat collection, a consideration that can result in a falsely high results is:
A. high ambient temperature
B. evaporation
C. preparation of area with type 1 water
D. high sweat rate
What is B. evaporation?
Evaporation of the sample will concentrate the ions. This can happen with a patient with a slow sweat rate or a prolonged collection time.
A baby's cord blood specimen is tested with the following results:
Anti-A Anti-B Anti-D Rh Control DAT
4+ 0 3+ 0 2+
The FATHER is group B, genotype cde/cde. Of the following antibodies, which one is the most likely cause of the positive DAT?
A. Anti-A
B. Anti-D
C. Anti-c
D. Anti-C
What is C. Anti-c?
Baby types A Rh(D) Pos
Dad is B Neg so baby had to get A and D antigens from Mom = A POS mom. This rules out Anti-A or Anti-D in mother's plasma.
Dad had to give the antigen that Mom made an antibody against, so that leaves c antigen in this set of choices, so maternal anti-c is the cause of the positive DAT.
A. increase in CO2 content and pCO2 with a decreased pH
B. decrease in CO2 content with an increased pH
C. increase in CO2 content with an increased pH
D. decrease in CO2 content and pCO2 with a decreased pH
What is A. increase in CO2 content and pCO2 with a decreased pH?
This is the definition of respiratory acidosis.
B - respiratory alkalosis
C = metabolic alkalosis
D = metabolic acidosis
A patient has been taking aspirin regularly for arthritic pain. Which one of the following tests is most likely to be abnormal in this patient?
A. platelet count
B. PFA-100
C. prothrombin time
D. activated partial thromboplastin time
What is B. PFA-100?
The PFA-100 assesses platelet function and is abnormal in the presence of aspirin. The platelet count only assesses platelet number. The PT and aPTT cannot be used to assess platelet number or function.
Cytokines involved in innate immune regulation include all EXCEPT:
A. IL-6
B. IL-3
C. IL-1
D. TNF-alpha
What is B. IL-3
IL-3 is not part of innate immune regulation, but rather is a player in hematopoietic regulation. It specifically stimulates myeloid cell production.