Microbiology
Gram Negative
Increased, Decreased, or Normal
Quality/Safety
More Lab Common Sense
100

Selective medium used for the isolation of gram-positive microorganisms

What is Columbia CNA with 5% sheep blood

100

Infection of the urinary tract is most frequently associated with this organism

What is Escherichia coli?

100

Magnesium 2.0 mg/dL

What is Normal?

Ref Range = 1.6-2.6

100

The lab receives a complaint from the ICU about long turnaround times for stat tests. What should the lab do?

Nothing, since they complain all the time

Run reports and analyze data

Talk to staff about solutions

What is run reports AND talk to staff (in that order)?

100

You are running the chemistry analyzer and you notice your sodium calibration has expired.  You already ran your controls and they are in. Is it ok to have the next shift calibrate? Yes or No

No, you must recalibrate with calibrators that are not expired prior to reporting out results.

200

Three sets of blood cultures were obtained from an adult patient with fever and suspected endocarditis.  The aerobic bottle of one set was positive for Staphylococcus epidermidis on day 5 of incubation.  Would this be considered pathogenic or a contaminant?

What is contaminant?

200

The Enterobacteriaceae family share this characteristic

What is reduce nitrate to nitrite

200

Total Bilirubin 1.4

What is Increased?

Ref Range = 0.3-1.2

200

You overhear two phlebotomists talking about drawing blood and one says they never have the IV paused when drawing blood because it takes the nurse too long to come to the room. What should you do?

Nothing, you're a MLS, not your department

Let your supervisor know (or the phleb supervisor)

What is let a supervisor know?
200

You are running the hematology analyzer and your QC is out for Platelets.  You repeat with new vial of control and QC is within limits. What should you do? Can you report out patient results?

What is you must document your corrective action (repeated QC with new vial).

Yes, you can report out results.

300

Best medium for culture of Francisella tularensis

What is cystine glucose blood agar?

300

This organism isolated from the surface of a skin burn is found to produce a diffusible green pigment on a blood agar plate. What is the most likely identification of this organism?  

What is Pseudomonas aeruginosa?

300

Platelet 400 103uL

What is Normal?

Ref Range = 150-450

300

Name two examples of pre-analytical errors

What are:

not identifying patient

not following order of draw

not following collection instructions (and so many more)

300

You are working in chemistry and monitoring temps. One of the freezers is out of range (temp too high). What should you do?

What is...there are a couple of things to consider.

Some options: 

Take all contents out of the freezer and relocate them.

Defrost freezer if you see ice accumulating

Call Biomed? or Engineering

400

Throat swabs for group A strep should be inoculated on which type of blood agar?

Sheep, rabbit, human or horse blood agar

What is sheep blood agar?

400

Optimal incubator temperature for isolation of the Campylobacter jejuni/coli group

What is 42 degrees C?

400

Sed Rate 40 mm/Hr

What is Increased?

Ref Range= 0-30

400

A friend asks you to look up their recent test results that were done in our lab. Since you have their permission, it is ok to do this....yes or no

What is NOOOOOOOOOOOOO

400

You are having a very busy shift. You have a critical hemoglobin on a patient in the ED. You try calling a few times and no answer. You give up trying to contact the ED because you have other things to do. Is this ok?

What is NO

CAP requirements (and our Endeavor policy) state that we must communicate all critical lab results to a Provider or RN.

500

Test that distinguishes Staphylococcus aureus from other Staph species

What is coagulase?

500

Which one of the following GNR ferments glucose?

Alcaligenes faecalis

Pseudomonas cepacia

Acinetobacter lwoffii

Yersinia enterocolitica

What is Yersinia enterocolitica?

500
D-Dimer 0.30 ug/mL

What is Normal?

Ref range= <0.50

500

You are putting away lab reagents and they need to be refrigerated.  They are cold in the box they came in. You take them out of the box and your MLS friend calls you to meet them in the cafeteria for break.  It is ok to leave those reagents out at room temperature for 30 minutes. Yes or No

What is No?

Some of our reagents cost thousands of dollars. We must respect the storage temps.  Also, if you unpack reagents that are warm and should be refrigerated, you should let a supervisor know so company can be contacted and we can get replacements.

500
You are working in Microbiology and you are running rapid Covid tests. You just resulted several tests.  Two of them are from the ED, one is positive and one is negative. You get a call from the ED that they put the labels on the wrong specimens.  They want you to change the results on each patient since they are certain that the swabs were mislabeled and whats the big deal? What do you do?
What is if specimens come to the lab and are mislabeled, lab staff will invalidate the results and new specimens with correct labels must be obtained. (irretrievable specimens must have someone come to lab and fill out specimen accountability form).