Blood Bank
A donor who has just donated 2 units of Apheresis Red Blood Cells will be deferred from further blood donation for a minimum of how many weeks?
A. 8 weeks
B. 12 weeks
C. 16 weeks
D. 24 weeks
What is C. 16 weeks
Others to remember:
Whole Blood Donation Deferral = 8 weeks
Apheresis Platelet Donation Deferral at least 2 days (often set by collection facility at 2 weeks)
Apheresis Plasma Donation (recurring donor) = 4 weeks
Which of the following would be affected by allowing a urine specimen to remain at room temperature for 3 hours before analysis?
A. occult blood
B. specific gravity
C. pH
D. protein
What is C. pH?
Consider whether a substance can increase or decrease outside the body: no more blood can be produced although the RBCs may rupture, they will still make a positive result on a biochemical strip. The amount of solutes will not change, so specific gravity will not change. The pH is affected by metabolism or the urine components by bacteria, and room temperature is warm enough for this to occur. Protein will not increase or decrease.
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
What is C. peptide bonds - this is the principle of the biuret reaction.
A. pancytopenia and macrocytosis
B. leukocytosis and elliptocytosis
C. leukocytosis and ovalocytosis
D. pancytopenia and microcytosis
What is A. pancytopenia and macrocytosis
Patients with pernicious anemia have fewer of all types of blood cells, but they are abnormally large.
Gram-positive cocci in chains are seen on a Gram stain from a blood culture. The organism grows as a beta-hemolytic colony. Further tests that could be performed include:
A. PYR, bacitracin, and hippurate
B. catalase and agglutination test for Protein A
C. oxidase and mass spectrometry
D. Voges-Proskauer and methyl red
What is: A. PYR, bacitracin and hippurate are biochemicals/tests used in the presumptive or definitive identification of beta-hemolytic streptococci such as Streptococcus pyogenes, and S. agalactiae.
What antigenic substances would be found in the saliva of an individual with the genotype: Sese, Lele, AO, Hh?
A. A, H
B. Leb, A, H
C. Lea, A, H
D. Lea, Leb, A, H
What is D: Lea, Leb, A, H
Need Le (one at least) for any Le antigens
Secreter need at least one Se = both Lea and Leb antigens are present, serologic phenotype only shows Lea neg, Leb pos
ABO/H If secretor - type is A therefore both A and H are present
A urine tested with Clinitest exhibits a pass-through reaction and is diluted by adding 2 drops of urine to 10 drops of water. This is a dilution of:
A. 1:4
B. 1:5
C. 1:6
D. 1:8
What is C. 1:6
When 2 drops of urine are added to 10 drops of water, it is a 2/12 proportion. 12 drops is the total volume. This is the same as a 1:6 dilution.
Increased concentrations of alpha-fetoprotein (AFP) in adults are most characteristically associated with:
A. hepatocellular carcinoma
B. alcoholic cirrhosis
C. chronic active hepatitis
D. multiple myeloma
What is A. hepatocellular carcinoma
AFP is an oncofetal glycoprotein marker for hepatocellular carcinoma. Elevated levels of AFP (<200 ug/L) are seen in hepatitis and cirrhosis. However, in hepatocellular carcinoma, the levels can be greater than 1000 ug/L.
Thalassemias are characterized by:
A. structural abnormalities in the hemoglobin molecule
B. absence of iron in hemoglobin
C. decreased rate of heme synthesis
D. decreased rate of globin synthesis
What is D. decreased rate of globin synthesis - this is the definition of thalassemia
Which one of the following results is typical of Campylobacter fetus subspecies fetus?
A. optimal growth at 42C
B. oxidase negative
C. growth at 35-37C
D. catalase negative
What is: C. growth at 35-37C
Most Campylobacter grow at 42C except C. fetus. C. fetus grows best at 35--37C and is oxidase and catalase positive.
The rosette test will detect a fetomaternal hemorrhage (FMH) as small as:
A. 5 mL
B. 10 mL
C. 20 mL
D. 30 mL
What is B. 10 mL
Bacteria are considered significant in the urine sediment when the:
A. nitrite is positive
B. protein is positive
C. specimen is cloudy
D. leukocytes are present
What is D. leukocytes are present
Based on the time between collection and analysis of a urine specimen, and the method of preservation, bacteria can be a heavy contaminant of urine. A positive leukocyte esterase test indicating the presence of white blood cells confirms the actual presence of an infection.
Bromcresol purple at a pH of 5.2 is used in a colorimetric method to measure:
A. albumin
B. globulin
C. Bence-Jones protein
D. immunoprotein
What is A. albumin
The common albumin method uses bromcresol purple at pH 5.2 as a dye binding method. Bromcresol green dye is also used. Globulins do not react well due to the pH used and the higher affinity of the dyes for albumin. Globulins are measured individually with specific immunoassay methods such as immunonephelometry. Bence-Jones protein are immunoglobulin fragments of light chains and are screened for by boiling the urine to precipitate the protein but colling which allows them to redissolve. Definitive testing is with immunoelectrophoresis and immunoassay.
The RDW is elevated on a CBC report. The smear would show:
A. hypochromia
B. anisocytosis
C. poikilocytosis
D. macrocytosis
What is: B. anisocytosis
The RDW is a quantitative estimate of erythrocyte anisocytosis.
A young girl cuts her foot on a rock, while swimming at the ocean. Her foot begins to show signs of infection and her parents take her to the ER. A culture grows a non-lactose fermenting Gram-negative rod that produces copious amounts of hydrogen sulfide, and gas, is indole positive and motile. The organism most likely isolated is:
A. Shigella spp.
B. Escherichia spp.
C. Edwardsiella spp.
D. Klebsiella spp.
What is: C. Edwardsiella spp.
Edwardsiella spp. are commonly isolated from reptiles and freshwater fish. Infections can occur during an aquatic accident resulting in an infected wound. Key biochemical characteristic is the production of hydrogen sulfide otherwise presents similarly to E. coli.
In chronic granulomatous disease (CGD), granulocyte function is impaired. An association exists between this clinical condition and a depression of which of the following antigens?
A. Rh
B. P
C. Kell
D. Duffy
What is C. Kell
RBCs of individuals with the McLeod phenotype lack Kx and Km Kell antigens. The McLeod phenotype has been found in patients with CGD (and MS, e.g.)
Which of the following CSF results would strongly suggest damage to the blood-brain barrier has occurred?
A. total protein of 40 mg/dL
B. CSF/serum albumin index of 17
C. IgG index of 0.4
D. CSF/plasma glucose of 0.6
What is B. CSF/serum albumin index of 17
The reference interval for CSF total protein is 15-45 mg/dL, and a ratio of 0.6 for CSF plasma/glucose is considered normal. The CSF IgG index is used to identify increased intrathecal synthesis with a reference interval of 0.3 - 0.7. Albumin is not synthesized in the CSF, therefore the CSF/serum albumin index is useful in detecting damage to the blood brain barrier. Rations greater than 9.0 indicate some damage has occurred.
An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state?
A. respiratory acidosis
B. respiratory alkalosis
C. metabolic acidosis
D. metabolic alkalosis
What is A. respiratory acidosis
Many microspherocytes, schistocytes and spherocytes with budding cytoplasm can be seen on peripheral blood smears of patients with:
A. hereditary spherocytosis
B. disseminated intravascular coagulation (DIC)
C. acquired autoimmune hemolytic anemia
D. extensive burns
Patients who have suffered severe burns to more than 15% of their body generally show evidence of intravascular hemolysis. RBCs show changes including fragmentation, budding and microspherocytes formation.
Which one of the following features of Taenia saginata helps distinguish it from T. solium?
A. egg with a radially striated wall
B. pork tapeworm
C. proglottid with <13 uterine branches
D. unarmed rostellum
What is: D. unarmed rostellum
The Taenia species have several features to distinguish them from each other. T. saginata is the beef tapeworm, and has an unarmed rostellum as opposed to T. solium which is the pork tapeworm which has an armed rostellum. The proglottid of the beef tapeworm, T. saginata, has >13 uterine branches as visualized by India ink injection, where the pork tapeworm (T. solium) has <13 uterine branches. In addition, the pork tapeworm can cause cysticercosis while the beef tapeworm does not. The eggs of both tapeworms are identical with thick radially striated walls.
A group B, Rh-negative patient has a positive DAT with polyspecific AHG and anti-IgG reagents. Which of the following situations would occur in this case?
A. the weak D test and control would be positive
B. the antibody screening test would be positive
C. the forward and reverse ABO groupings would not agree
D. all major crossmatches would be incompatible
What is A. the weak D test and control would be positive
A positive DAT will interfere with weak D testing causing both the patient and control to demonstrate positive results. Any positive result in the control tube invalidates any results. In this case, patient RBCs are coated with IgG immunoglobulin, so this would not impact the antibody screening test unless it was caused by a strong autoantibody, would not impact ABO forward/reverse as they are tested at IS, and major crossmatches include any crossmatches using recipient plasma/serum with donor RBCs (including IS compatibility testing).
Laboratory characteristics of malabsorption syndrome due to pancreatic insufficiency include:
A. increased fecal fat
B. fecal leukocytes
C. positive Clinitest
D. fecal occult blood
What is A. increased fecal fat
Pancreatic insufficiency can lead to increased fecal fat and to the finding of undigested muscle in the stool. Fecal leukocytes are associated with pathogenic bacteria, and a positive Clinitest is due to the presence of sugars, usually from an osmotic diarrhea, as in lactose intolerance. Fecal occult blood is associated with colorectal cancer, and is positive in other gastrointestinal bleeding. It is not associated with pancreatic insufficiency.
The following serum laboratory results were obtained: decreased albumin decreased calcium increased creatinine increased phosphorus increased magnesium
These results are compatible with:
A. multiple myeloma
B. primary hyperparathyroidism
C. secondary hyperparathyroidism
D. chronic renal failure
Mineral results in chronic renal failure.
Which of the following best describes the bone marrow criteria for the diagnosis of acute myelomonocytic leukemia (AMML)?
A. 20% blasts, 20% monocytes, 20% neutrophilic precursors
B. 20% blasts, 50% monocytes, 50% neutrophilic precursors
C. 20% blasts, 90% monocytes, 10% neutrophilic precursors
D. 30% blasts, 10% monocytes, 90% neutrophilic precursors
What is A. 20% blasts, 20% monocytes, 20% neutrophilic precursors
Nonimmunophenotypic criteria for the diagnosis of AMML include (in bone marrow) blasts at =/>20% of nonerythroid cells, monocytic cells =/> 20% of nonerythroid cells, and granulocytic cells =/> 20% of nonerythroid cells. Other characteristics include number of monocytes in peripheral blood and ancillary tests (such as serum or urine lysozyme).
This parasite has the following characteristics:
banana shaped gametocytes in RBCs multiple ring forms in RBCs all RBCs are infected
The identification of the parasite is:
A. Plasmodium falciparum
B. Plasmodium malariae
C. Plasmodium ovale
D. Plasmodium vivax
What is A: Plasmodium falciparum
Plasmodium vivax and P. ovale are found in enlarged (young) RBCs only and P. malariae usually invades older RBCs. P. falciparum invades RBCs of any age and multiple ring forms in a single RBC are common. The banana shaped gametocyte is produced by P. falciparum.