Clinical Chemistry
What type of reaction occurs at the anode?
Oxidation
Remember: An Ox
An O neg mother delivers an O pos baby. The antibody screen is positive for a passive Anti-D (from RhIG at 28 weeks). Is this mother a candidate for Rhogam?
Yes:
The 28-week Rhogam dose only protects for a limited time and against small exposures.
Delivery can cause a significant fetal-maternal bleed, requiring another Rhogam dose to prevent maternal sensitization.
The positive antibody screen is expected after Rhogam and does not mean she's sensitized.
What Anaerobe has a boxcar GPR appearance without spores?
Clostridium perfringens
What mutation is known as the "Philadelphia chromosome" and what disease is it associated with?
t(9;22); CML
CK-MB, troponin, myoglobin, BNP
Name three factors to consider when implementing automation in the laboratory.
Throughput, Walk away capacity, Access, Carryover, Sample volume, Dead volume, Test menu, Reagent types
What does a strong positive reaction look like in solid phase methods?
Diffuse RBCs, no button.
What are capnophilic organisms? List an example.
Organisms that require high levels of CO2 for growth (5-10%). An example would be Neisseria spp.
Is thalassemia a quantitative or qualitative defect? And of what specifically?
A quantitative defect in globin chains
What rapid test would you use to determine resistance to penicillin and other beta-lactamase medications?
Nitrocefin test (also known as the β-lactamase test)
a1- antitrypsin is a…
protease inhibitor involved in neutrophil regulation
What preventive measure is used to prevent TRALI?
No plasma donations from females who have been pregnant. Screen plasma for Anti-HLA
What media is used for the growth and recovery of Francisella tularensis?
BCYE. Francisella tularensis has the best chance of recovery when using media that contains cysteine. BCYE contains cysteine, which is why it is used for the growth of Francisella and Legionella
A bone marrow aspirate is positive staining for MPO, SES, and NES. What is the likely diagnosis?
Acute Myelomonocytic Leukemia
What are the 3 most common causes of bacterial pneumonia?
Strep pneumo, Kleb, Pseudomonas
What causes samples to be lipemic? What sort of spectral interference does this typically cause? How can you process these specimens to reduce interference?
VLDL/trigs, falsely high results to do increased absorbance/decreased transmittance, dilute or centrifuge specimen
Anna wants to donate her blood. Is she able to do so? Why or why not?
She is 18 years old and weighs 150 lbs.
She tutors a 15 year boy who has HIV once a week
She got the hepatitis vaccine before a trip to the Philippines (Region with malaria endemic) 5 years ago.
She had a butterfly tattooed on her arm 3 weeks ago
No, she cannot donate her blood due to her new tattoo. She has to wait for the 3 month deferral policy.
What is the causative infection of the disease that mimics appendicitis?
Yersinia enterocolitica
What does desmopressin (DDVAP) do in the treatment of bleeding disorders
Stimulates the release of vWF
What are the reference ranges for arterial blood pH, pCO2, and bicarbonate?
pH: 7.35-7.45
pCO2: 35-45 mmHg
HCO3-: 22-27 mmol/L
Increased TSH and decreased T3/4; thyroid is not working properly in primary hypothyroidism
Which (5) antibodies show dosage?
MN, Lutheran, Rh (other), Kidd, Duffy
What class of drugs are erythromycin and azithromycin?
Macrolides, which inhibit bacterial protein synthesis by binding to the 50S ribosomal subunit
What is the pathophysiology behind TTP?
Mutation or autoantibody to ADAMTS13 causing ultra large von Willebrand factor
A patient presents with anemia and >20% blasts in the bone marrow. Flow cytometry shows TdT-negative lymphoblasts with vacuolated cytoplasm. What is the most likely diagnosis?
Burkitt-type leukemia/lymphoma