Blood Banking
The transport temperature for Red Blood Cells Leukocytes reduced is ?
a. 1-6°C
b. 1-10°C
c. 18-20°C
d. 20-24°C
B. The transportation temperature for all red blood cell products is 1-10°C. BOC, 7th ed, p. 70 #23
Cerebrospinal fluid for glucose assay should be:
a. Refrigerated
b. Analyzed immediately
c. Heated to 56°C
d. Stored at room temperature after centrifugation
b. Glycolysis may occur more quickly on glucose in CSF due to presence of bacteria or cells so it should be analyzed immediately.
From – BOC, 7th ed, p. 110 #7
After the removal of red blood cells from the circulation hemoglobin is broken down into:
a. iron, porphyrin, and amino acids
b. iron, heme, and globin
c. heme, protoporphyrin, and amino acids
d. heme, hemosiderin, and globin
iron, heme, and globin
heme, protoporphyrin, and amino acids
heme, hemosiderin, and globin
b. Normal degradation products of red blood cells include iron, heme, and globin
(BOC pg 282 Destruction:Question 19)
Which selective medium is used for for the isolation of gram-positive microorganisms
a. Columbia CNA with 5% sheep blood
b. Trypticase soy agar with 5% sheep blood
c. Eosin methylene blue
d. Modified Thayer-Martin
a. Columbia CNA agar contains colistin and nalidixic acid, which inhibit most facultative gram-negative organisms. Eosin methylene blue is selective and inhibits gram-positive organisms, gram-negative bacilli and yeast. Trypticase soy agar with 5% sheep blood is not a selective medium.
BOC, 7th ed, p. 414 #11
Which of the following collection methods would yield the most sterile urine samples?
a. Random
b. Catheterization
c. Suprapubic aspiration
d. Clean-catch midstream
c. Clean-catch midstream urine samples and those collected by catheterization should provide a sterile urine specimen, but there is risk of contamination if collection procedures are not followed correctly. Suprapubic aspiration would yield the most sterile urine sample as the specimen is collected directly from the bladder avoiding potential contamination from the skin of genital region.
From – BOC, 7th ed, p. 199 #5
To prevent graft-versus-host disease, Red Blood Cells prepared for infants who have received intrauterine transfusions should be ?
a. saline-washed
b. irradiated
c. frozen and deglycerolized
d. group- and Rh-compatible with the mother
b. Blood selected for intrauterine transfusions and transfusion to premature infants should be irradiated to prevent transfusion-associated graft-versus-host disease as these transfusion recipients are immunocompromised. BOC, 7th ed, p. 86 #201
The anion gap is useful for quality control of laboratory results for:
a. Amino acid and proteins
b. Blood gas analyses
c. Sodium, potassium, chloride, and total CO2
d. Calcium, phosphorus and magnesium
C. The anion gap is the sum of Cl- and HCO3- subtracted from the Na+, the difference, or “gap,” averaging 12 mmol/L in healthy subjects
BOC, 7th ed, p. 153 #272
Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria?
a. Autosomal dominant inheritance
b. Red cell membrane defects
c. Positive direct antiglobulin test
d. Measured platelet count
b. Red cell membrane defects are common to these disorders
(BOC Pg 285 Disease States: Question 40)
The primary isolation of Neisseria gonorrhoeae requires:
a. anaerobic conditions
b. starch media
c. carbon dioxide
d. blood agar
c. Neisseria gonorrhoeae requires an enhanced CO2 atmosphere for optimal growth
BOC, 7th ed, p. 417 #32
The presence of biliverdin may cause a urine sample to appear:
a. Black
b. Dark red
c. Blue-green
d. Bright orange
c. Hemoglobin is degraded into heme and globin by the reticuloendothelial system. Heme is then metabolized into biliverdin by heme oxygenase then reduced to bilirubin by biliverdin reductase. Bilirubin is light labile and urine samples should be protected from light. If exposed to light, bilirubin is photo-oxidized forming biliverdin which causes the sample to appear yellow-green or blue-green.
From – BOC, 7th ed, p. 202 #28
Many enhancement media used in blood bank promote hemagglutination in the presence of IgG antibodies by reducing which of the following ?
a. hydrophilic forces
b. low ionic potential
c. van der Waals forces
d. zeta potential
d. Many enhancement media used in blood bank promote hemagglutination by reducing the zeta potential. Reducing the zeta potential allows the more positively charged antibodies to get closer to the negatively charged red cells, facilitating agglutination.
BOC, 7th ed, p.22 #147
The principle of the tablet test for bilirubin in urine or feces is:
a. Reaction between bile and 2,4-dichloronitrobenzene to make a yellow color
b. Liberation of oxygen by bile to oxidize orthotolidine to make a blue-purple color
c. Chemical coupling of bile with a diazonium salt to make a brown color
d. Chemical coupling of bilirubin with a diazonium salt to make a purple color
d. In urine, conjugated bilirubin is reacted with diazo tablet to form a purple color.
BOC, 7th ed, p. 118 #69
A patient has the laboratory results shown in this table:
These results are compatible with: see page 289 Question 62)
a. Iron deficiency
b. Pregnancy
c. Thalassemia minor
d. Beta Thalassemia major
c. Thalassemia minor
Thalassemias are quantitative decreases in the production of globin chains needed for hemoglobin synthesis.
BOC pg 289 Disease States: Question 62)
Which one of these genera is among the least biochemical reactive members of the Enterobacterales
a. Proteus
b. Pseudomonas
c. Citrobacter
d. Shigella
d. Shigella is lactose-negative, most species do not produce gas, are VP, urea, lysine decarboxylase and citration-negative, and they are nonmotile.
BOC, 7th ed, p. 447 #178
Oval fat bodies are:
a. Hyaline casts that contain lipids
b. Squamous epithelial cells that contain lipids
c. Transitional epithelial cells that contain lipids
d. Renal tubular epithelial cells that contain lipids
d. Renal tubular epithelial cells line the proximal and distal convoluted tubules as well as the collecting ducts of the nephron. The renal tubular epithelial cells absorb analytes from the urinary filtrate and secrete substances into the filtrate for excretion. In disorders that result in lipids passing into the filtrate, lipids are absorbed into the renal tubular epithelial cells. When the cells slough from the tubules, they appear in the urine and are designated as oval fat bodies.
From – BOC, 7th ed, p. 211 #82
A patient demonstrates 4+ reactivity with all red cells tested and the auto control is nonreactive. This high incidence antibody is suspected to be related to the P1PK blood group system as the patient is the rare P phenotype. What antibody specificity should be suspected?
a. anti-IP1
b. anti-P2
c. anti-PP1Pk
d. anti-P1
c. Anti-PP1Pk is the antibody to high incidence antigens made by individuals with the P phenotype. This antibody has an association with early spontaneous abortion and is clinically significant. BOC, 7th ed, p. 127 #41
The biuret reaction for the analysis of serum protein depends on the number of:
a. Free amino groups
b. Free carboxyl groups
c. Peptide bonds
d. Tyrosine residues
C. Principle of biuret reaction: copper ions form complexes with peptide bonds in proteins
BOC, 7th ed, p.133 #153
Which electrophoresis pattern shown in this figure is consistent with sickle cell trait?
a. Pattern A
b. Pattern B
c. Pattern C
d. Pattern D
A. In sickle cell trait electrophoresis reveals ~40% of HbS and ~60% of HbA and HbA2
(BOC pg 327 Laboratory Testing: Question 274)
Which of the 2 different antimicrobial agents listed below are commonly used and may result in synergistic action in the treatment of endocarditis caused by Enterococcus faecalis?
a. An aminoglycoside and a macrolide
b. Penicillin derivative and an aminoglycoside
c. A cell membrane activate agent and nalidixic acid
d. A macrolide and a penicillin derivative
b. Enterococcus species are relatively resistant to beta-lactam agents and aminoglycosides. Combination therapy with a beta-lactam agent or vancomycin and an aminoglycoside provide a synergistic combination to effectively treat enterococcal infections.
BOC, 7th ed, p. 454 #218
The crystal seen in the photomicrograph would be categorized as (show image from BOC):
a. An acidic crystal that is considered pathologic
b. An alkaline crystal that is considered pathologic
c. An acidic crystal that is considered nonpathologic
d. An alkaline crystal that is considered nonpathologic
d. The photomicrograph shows the presence of a triple phosphate crystal. Triple phosphate (ammonium magnesium phosphate) crystals appear in alkaline urines as colorless prisms, which are often described as “coffin lids.” They are considered to be clinically insignificant (nonpathologic), but usually occur in samples with bacterial overgrowth, which results in an alkaline urine.
From – BOC, 7th ed, p. 217 #119
Based on the results of the panel, which technique would be most helpful in determining antibody specificity? See Image : Pg50 #319
a. proteolytic enzyme treatment
b. urine neutralization
c. autoadsorption
d. saliva inhibition
a. enzyme treatment would allow for differentiation of the remaining antibodies after rule out. The Fya antigen would be denatured, allowing determination of whether anti-Jka and anti-K are present, and to confirm anti-E. BOC, 7th ed, p. 50 #319
In developing the reference for a new EIA for CEA, the range for the normal population is broader than that published by the vendor. Controls are acceptable with a narrow coefficient of variation. This may be explained by:
a. Positive interference by another tumor maker
b. Population skewed to a younger age
c. Improper temperature control during assay
d. Inclusion of nonsmokers and smokers in the study population
d. Increased CEA levels are seen in patients with liver damage, heavy smokers and following radiation and chemotherapy. The normal population used would not likely have another tumor marker in many or any of the samples to cause interference and age has not presented a marked variation in results. Temperature fluctuations would affect the reference materials including controls, thereby invalidating the test results.
BOC, 7th ed, p. 141 #196
A patient presents to his physician with excessive bleeding. He was previously on aspirin, but it was discontinued 3 weeks ago, but he was placed on antibiotics for a streptococcal infection. Coagulation results are as follows:
Bleeding may be due to:
a. Aspirin
b. Platelet dysfunction
c. Vitamin K deficiency
d. Liver disease
c. Vitamin K deficiency can be caused by antibiotics, which alter the bacterial flora within the gut and impact the vitamin-K-dependent factors (II, VII, IX, and X), which are all decreased. The effect of aspirin on platelets last 7-10 days should platelet function should be normal, as reflected in the platelet function screen. Patients with liver disease would demonstrate a decrease in all factors, except FVIII which is normally elevated.
(BOC pg 389 Laboratory Determinations: Question 164)
A liquid stool specimen is collected at 10:00pm and brought to the laboratory for culture and ova and parasite examination. It is refrigerated until 10:10AM the next day, when the physician requests that the technologist look for amoebic trophozoites. The best course of action would be to:
a. Request a fresh specimen
b. Perform a concentration the original specimens
c. Perform a trichrome stain on the original specimen
d. Perform a saline wet mount on the original specimen
a. Protozoan trophies are fragile and begin to disintegrate as soon as they are passed. Liquid stool specimens should be preserved within 30 minutes of passage in order to adequately preserve parasite morphology. If a liquid specimen cannot be properly preserved, another specimen should be collected.
BOC, 7th ed, p. 469 #315
Acetylcholinesterase activity may be measured on amniotic fluid when a positive alpha-fetoprotein result is obtained to evaluate for:
a. Fetal lung maturity
b. Open neural tube defects
c. Respiratory distress syndrome
d. Hemolytic disease of the newborn
b. Acetylcholinesterase (AChE) is an enzyme found in the central nervous system, RBCs, skeletal muscle tissue, and fetal serum. When analyses of maternal serum and amniotic fluid yield elevated AFP results, the amniotic fluid should be tested to determine the AChE activity, as it is a more specific indicator for neural tube disorders.
From – BOC, 7th ed, p. 241 #247