Recall-1

CBT 5 1. Failure to observe RBC cast in a urine specimen can be caused by? Answer: CENTRIFUGING AN UNMIXED SPECIMEN 2. The creatinine clearance is reported in? Answer: ml/min 3. While performing analysis a baby’s urine the technologist notice the specimen to have a mousy odor? Answer: PHENYL PYRUVIC ACID 4. The fluid leaving the glomerulus normally has a specific gravity of? Answer: 1.010. 5. Excess urine in the reagent strip can turn a normal PH result into a falsely acidic PH with which of the following reagents runs into the PH pad? Answer: CITRATE BUFFER 6. CLUE cells are form of? Answer: SQUAMOUS EPITHELIAL CELLS 7. The urine microscopic constituents that best differentiate between cystitis and pyelonephritis are? Answer: WBC CAST 8. Cast with brittle consistency? Answer: WAXY CAST 9. Exhibits rapid motility in the urine sediments? Answer: TRICHOMONAS VAGINALIS 10. During sweat collection a consideration that can result in a falsely high result is? Answer: EVAPORATION 11. Calculation used to determine if there is a breach in the blood brain barrier? Answer: CSF/ALBUMIN INDEX 12. Following an overnight fasting hypoglycemia in adults is defined as glucose of? Answer: 45 mg/dl ( 2.5mmol/L)

13. The glycated hemoglobin ( HBA1C ) value represents the integrated values of glucose concentrations during the preceding? Answer: 6-8 WEEKS or 1 ½ - 2 MONTHS 14. Blood samples were collected at the beginning of an exercise class and after 30 mins. of aerobic activity which of the following be most consistent with the post exercise sample? Answer: elevated LACTIC ACID and elevated PYRUVATE 15. At blood PH 7.40 What is the ratio of bicarbonate to carbonic acid? Answer: 20:1 16. A blood gas sample was sent in the lab on ice and a bubble was present in the syringe. The blood had been exposed to room air for at least 30 mins. The following change in the blood gas will occur. Answer: Increase PO2 / Decreased HCO3 17. What battery of test is most useful in elevation an anion gap of 22meq/L (22mmol/L)? Answer: BUN, CREA, URINALYSIS, SALICYLATE and METHANOL. 18. Decrease concentration of serum phosphorous is commonly found in? Answer: PATIENT WHO ARE RECEIVING CARBOHYDRATE HYPERALUMENTATION. 19. The problem has protein has the highest dye binding capacity? Answer: ALBUMIN 20. Decrease serum iron associated with increase TIBC in compatible with which of the following disease state? Answer: IRON DEFFICIENCY ANEMIA 21. 90% of the Copper present in the blood is bound to? Answer: CERULOPLASMIN 22. Principle of occult blood test depends in the. Answer: PEROXIDASE like activity of HEMOGLOBIN 23. A serum sample was assayed for bilirubin at 10am and the result was 12mg/dl (205.6umol/L) The sample was retested at 3PM The result now is 8mg/dl (136.8umol/L) The most likely explanation for the discrepancy is? Answer: The sample was EXPOSED to LIGHT 24. In which of the following conditions would a normal level of Creatinine Kinase be found? Answer: HEPATITIS

25. In familial hypercholesterolemia , the hallmark finding is an elevation of? Answer: LDL 26. A fasting serum specimen from an asymptomatic 43 years old red woman examined usually and chemically with the following results. Initial appearance of serum: (milky ). Appearance of serum after overnight refrigeration: (creamy ) layer over turbid serum. Triglyceride level - 2000mg/dl (22.6mmol/L) Cholesterol level – 550mg/dl (14.25mmol/L) The sample contains predominantly? Answer: CHYLOMICRONS and VLDL 27. Detection of which of the following substances is most useful to monitor the course of patient with testicular cancer? Answer: ALPHA-FETO PROTIEN 28. Blood received in the laboratory for blood gas analysis must meet which of the following requirements? Answer: ON ICE, NO CLOT, NO AIR BUBBLES 29. Unless blood gas measurement are made immediately after sampling in VITRO glycolysis of the blood causes: Answer: FALL in the PH and RISE in PCO2 30. Most automated blood gas analyzers directly measures? Answer: PH, PCO2 and PO2 31. In the assay of LD, the reaction is dependent upon which of the following coenzyme synthesis? Answer: NAD/NADH 32. The international federation for clinical chemistry (IFCC) recommends the use of methods such as Bessey Lowry- Brock Method for determining ALKALINE PHOSPHATASE activity. The substrate use in this type of method is? Answer: PARA-NITROPHENYL PHOSPHATE 33. After removal of RBC from the circulation HGB is broken down into? Answer: IRON, PROTOPORPHYRIN and GLOBIN 34. The direct anti globin test is often perform in? Answer: ACQUIRED HEMOLYTIC ANEMIA 35. All of the findings listed below may be seen in Acquired Hemolytic Anemias of the autoimmune variety. The one considered to be the most characteristics is?

Answer: POSITIVE DIRECT anti-GLOBIN TEST 36. A 50 year old patient was found to have the following lab results: HgB- 7.0 g/dl (70g/L) Hct- 20% RBC- 2.0 x 106 u/L (2.0 x 1012/L) It was determined that the patient was suffering from pernicious anemia which of the following sets of result most likely was obtained from the same patient? Result : WBC APC RETICS A 17,500 350,000 5.2 % B 7,500 80,000 4.1 % C 5,000 425,000 2.9 % D 3,500 80,000 0.8 % Answer: D 37. A patient has the following blood values : RBC - 6.5 x 10 6 /uL (6.5 x 1012 /L) HGB – 13 g/dL (130 g/L) HCT- 39 % MCV- 65 um3 ( 6.5 fl) MCH-21.5 pg MCHC- 33 % The result is comapatible with? Answer: THALASSEMIA MINOR 38. Which of the following is most closely associated with Erythrolukemia ? Answer: RINGED SIDEROBLAST, NUCLEAR BUDDING and HOWELL JOLLY BODIES 39. HgB H decrease results from? Answer: Absence of 3 of 4 ALPHA GENES. 40. A native of Thailand has a normal HGB level . HGB electrophoresis in cellulose acetate shows 70% HgBA2 approximately 30% of a Hgb with the mobility of HgB A2 this is most consistent with? Answer: E trait 41. Calculate MCV:

Compute: MVC = HCT x 10 = 20 x 10 = 133pg Given: HCT - 20% RBC 1.5 6 RBC - 1.5 x 10 /uL HGB - 6 g/dL Recall : MCV, MCH and MCHC formula.

42. Term that means varying degrees of leukocytosis with a shift to the left and occasional nucleated red cells in the peripheral blood is? Answer: LEUKOERYTHROBLASTOSIS 43. Associated with pseudo-pelgerhuet anomaly? Answer MYELOGENOUS LEUKEMIA 44. The following were obtained. WBC – 5.0 x 10 3 /uL (5x109 /L) RBC – 1.7 x 106 /uL ( 1.7x1012/L) MCV – 84 um3 (84 fl) APC – 89 x 103 /uL Lap – 142 Philadelphia chromosomes negative Differential:

Seg – 16% Band – 22% Lymph – 28%% ` Mono – 16% Eos – 1 % Baso – 1 % Metamyelocyte – 4 % Myelocyte – 3% Promyelocyte – 4 % Blast – 5% with 1 megakaryoblast, 30 nucleated erythrocyte, teardrop cells, schistocyte, polychromasia, giant platelets noted. (NUCLEATED RBC and TEARDROP CELLS) Answer: LEUKOERYTHOBLASTOSIS in MYELOFIBROSIS 45. Hemorrhage in polycythemia vera is the result of? Answer: ABNORMAL PLATELET FUNCTION 46. Hairy cell leukemia (Leukemic reticuloendotheliosis) Answer: LEUKEMIA of the LYMPHOCYTIC ORIGIN 47. Associated with Alder-Reily inclusion? Answer: MUCOPOLYSACCHARIDOSIS 48. Blood smear shows 80 N RBC cells per 100 leukocytes the total count is 18 x 10 3 /uL (18x109/L) the true white cell count expressed in SI unit? Compute: 100 x 18 = 1800 = 10 recall formula: 80 + 100 180 49. A mean cellular Hgb concentration (MCHC) 36 g/dL (36g/L) is frequently found in? Answer: HEREDITARY SPHEROCYTOSIS, LIPEMIA, ACTIVE COLD AGGLUTININ DISEASE 50. In flow cytometry analysis right angle (90 0) or side scatter of a laser beam provides information that pertains to a celL? Answer: GRANULARITY 51. Which of the following is characteristic of platelet disorder? Answer: MUCOUS MEMBRANE HEMMORRHAGE note: 3mm hemorrhage is typical of platelet disorder. 52. The following LABORATORY data were obtained from a 40 year old woman with a long history abnormal bleeding: Prothrombin time – Normal Activated PTT – Prolonged Factor VIII coagulant activity – Decreased Factor VIII related antigen – markedly Decrease Platelet ct – Normal Template BT – Prolonged

Which of the following disorder does this woman most likely have? Answer: VON WILLBRAND DISEASE 53. In an estimate on laser particle cell counter Clumped platelet may interfere with which of the Following parameters? Answer: WBC COUNT 54. In order to isolate Campylobacter jejuni and E coli, the fecal specimen should be? Answer: Inoculated onto SELECTIVE plating media and incubated in reduced oxygen with added CO2 at 420 C *note: E. coli and C. jejuni requires “ microaerophilic ” atmosphere for optimal recovery the used of Selective media is recommended for recovery from fecal specimen. Selective media for Camphylobacter contains antibiotics to inhibit the growth of enteric GRAM (-) flora-unlike other enteric pathogens E. coli and C. jejuni grow well at “ 42 0C “ 55. Production of Beta Lactamase is inducible in which of the following? Answer: S. aureus 56. When using a control strain of S. aureus the technologist notice that the zone around the Oxacillin disk is too small. Which of the following is most likely explanation? Answer: USE of OUTDATED DISK. 57. A 73 years old man diagnose as having pneumococcal meningitis is not responding to therapy which of the following test should be performed in the isolate to best determine this organism susceptibility to penicillin? Answer: OXACILLIN DISK DIFFUSION. 58. Which of the following antimicrobial would be inappropriate (not) to report in an E. coli isolated from “Wound”culture? Answer: NITROFURATOIN *note: Certain antimicrobial such as NITROFURATOIN and NORFLOXACIN are used ONLY! primarily to treat “ UTI “ . These agents should not be reported for pathogen recovered from other site of infection. 59. A pregnant patient is screened at 36 weeks of gestation for Group B Strep ( GBS ). A vaginal Swab is collected and cultured in TODD HEWITT BROTH with 8 grams Gentamicin/mL and 15 grams Nalidixic Acid/ mL. The broth is subcultured into sheep blood agar after 24 hours of incubation No GBS are seen on the subculture and the results are reported as Negative. The patient later goes on to deliver, an infant with easily onset GBS disease. What is the most likely reason for the negative GBS culture?

Answer: A vaginal swab was collected instead of a vaginal / rectal swab. NOTE: GBS colonized both the genital and GIT of pregnant women. Collection of a vaginal and rectal specimen is recommended by the CDC to maximize GBS detection in this population. Patient should be screened @ 35-37 weeks of gestation. In addition, selective broth culture is recommended ( TODD HEWITT BROTH with ANTIBIOTIC) although other selective media are also available when selective broth culture is used, it should be incubated @ 18-24 0 prior to subculture on to blood agar. 60. Gram stain examination from a blood culture bottle shows dark blue, spherical organisms in clusters . Growth in sheep blood agar shows small, round, pale yellow colonies. Further test should be included? Answer: CATALASE test production and COAGULASE test .

NOTE: The Gram Stain and culture growth describe a Staphylococcus spc. Catalase production confirms that the organism belongs to the genus Staphylococcus and Coagulase is used to differentiate S. aureus from Coagulase (-) Staphylococcus. 61. A Beta-hemolytic Strep that is Bacitracin Susceptible and CAMP(-) negative is? Answer: GROUP A NOTE: Group A ( Strep Pyogenes) are Susceptible to Bacitracin and CAMP (-) 62. Characteristically Enterococci are? Answer: RELATIVELY RESISTANT TO PENICILLIN NOTE: Enterococci are Bile Esculin (+), Hippurate(-) have the ability to grow in 6.5% NACL. Enterococci are relatively Resistant to Penicillin and require combination therapy to treat serious infection. 63. The MOST critical distinction between Staph. aureus and other Staphlococcus is? Answer: COAGULASE Production 64. An isolate of an unknown B-hemolytic Strep is streaked perpendicular to a streak of B-lysin producing S. aureus .After incubation a zone of arrowhead hemolysis is noted at the interface of the 2 streaks. Whats is the name of the test and the presumptive ID of unknown Strep? Answer: CAMP test and STREP agalactiae 65. A TSI tube inoculated with an organism gave the ffg: K/A butt, (-) H2S, (+) Gas. Answer: SHIGELLA dysenteriae 66. Which of the following organism can grow in the small bowel and cause diarrhea in children Traveller’s Diarrhea a severe cholera like symdrome. Through the production of enterotoxin.

Answer: E. coli 67. > 100,000 CFU/mL of gram(-) bacilli were isolated on the Mc Conkey from urine specimen: Biochemical results: Glucose acid, (+) gas Indole negative Urea positive TDA positive H2S positive Answer: P. mirabilis 68. Which of the following sets of test best differentiate Salmonella and Citrobacter Species? Answer: KCN, MALONATE, B-GALACTOSIDASE, LYSINE DECARBOXYLASE 69. Quality control of the SPOT Indole test require the use of the ATCC cultures of? Answer: E. coli and E. cloacae 70. A small Gram (-) bacilli is isolated from an eye culture. It grows only on Chocolate agar and is Oxidase (-)? Answer: HAEMOPHILUS INFLUENZAE 71. Optimun growth of Camphylobacter jejuni is obtained on suitable media incubated at 42 0 C is an atmospheric containing: Answer: 6% O2, 10-15% CO2, 85-90% NITROGEN 72. An antibiotic gram (-) coccobacilus in Bordet Gengou agar from Nasopharnygeal swab 48hours after culture from a 6 months infant with suspected Pertussis . The organism following characteristic: Mc Conkey agar negative Urea negative @ 4 hours (+) @ 24hours Oxidase negative Catalase positive Answer: BORDETELLA pertussis 73. A stool sample is sent to the laboratory for culture to rule out C. difficile. What media to morphology use and what is the appearance of the organism on this media? Answer: CCFA, yellow, ground glass appearance. 74. Which of the following is the Most useful morphological feature in identifying mycelial phase of H. capsulatum? Answer: 8-14 um TUBERCULATE MACROCONIDIA. 75. In the anti double stranded DNA procedure the antigen Most commonly utilized?

Answer: CRITHIDIA LUCILIAE 76. Antibody directed at native DNA are the Most frequently associated with which pattern of flourecence in the IFA-ANA test? Answer: RIM 77. A (+) ANA with pattern of Centromere Ab is Most frequently seen in patient with? Answer: CREST SYNDROME 78. In an ANA Direct Immonuflorecence test, a sample of patient serum shows (+) speckeled pattern which would be the Most appropriate additional test to perform? Answer: SCREEN for SM and RNP Ab 79. Excess Antigen in precipitation gel reaction well? Answer: DISSOLVE thePRECIPITATE after formation. 80. In a (+) anti-streptolysin O enzyme incubation test the patient’s: Answer: Anti-streptolysin O inhibits the reagent streptolysin O resulting in NO Hemolysis 81. The cold agglutinin test, the tube containing the serum and erythrocytes are allowed to stand overnight in the ref. and the results are read the next morning. If a desk of erythrocytes floats up from the buttom of the tube with only the half of the finger there read as? Answer: 4+ reaction 82. Most important use of non-treponemal Ab test alone is? A Answer: Evaluating the response of Therapy 83. The following procedure has been routinely used in detection of Hepa B surface Ag because of ½ level of sensitivity. Answer: ELISA 84. A bacterial protein used to used to bond human immunoglobulin is? Answer: Staph Protein A 85. 26 years old developed fatigue, low grade fever, polyarthritis and urticaria, 2 months earlier she had cared for a patient with Hepa. Which of the following findings are likely to be observed? Answer: ELEVATED AST AND ALT LEVELS 86. Antibodies are produced by? Answer: B CELLS 87. Polymeral B cell activation?

Answer: Can induce auto-antibody production 88. Membrane bound immunoglobulin molecules? Answer: Are anchored by hydrphopbic sequence of about 26 residues 89. Macrophage phagocytosis of bacteria is enhanced by which of the following? Answer: OPSONINS 90. A patient serum is being analyzed in a sandwich assy. This patient has received mouse monoclonal Ab therapy and shows a false(+) reaction in the sandwich assay which is due to? Answer: Presence of HUMAN Anti-mouse Ab activity. 91. Skin test, a wheal and flare development. Answer: IMMEDIATE HYPERSENSITIVITY

92. Incompatibility by which of the following procedure is absolute contraindication of alloagglutination? Answer: ABO typing 93. A peripheral Blood total leucocyte is 10x10 3 /uL the differential count reveals 55% neutrophil 2% eos 40% lympho 3 % mono Assuming a lymphocytic recovery of 85-95%. What isd the expected number of T cells in normal individual? Answer: 2,500 /uL 94. Bone marrow transplant donor and their recipient must be matched for which Ag system? Answer: HLA 95. A cause for permanent deferral of blood donation. Answer: HEPA history of JAUNDICE of uncertain cause 96. For apheresis donor who donate platelet more frequently than every 4 weeks, a platelet count must be performed prior to the procedure and be atleast? Answer: 150 x 103 u/L ( 150 x 109/L) 97. The Most cauise of post transfusion HEPA detected by?

Answer: HBsAg 98. Rejuvenation of a unit of RBC is a method use to. Answer: Restore 2,3 DPG and ATP to NORMAL levels 99. A unit of RBC is issued @ 9:00am at 9:10am. The unit returned to Blood Bank. The container has not been entered but the unit has been refrigerated during this time span. The cause of action for the technologist? Answer: Record the return and place the unit back into the inventory. 100. Platelet prepared in a polyester type of container stored at 22-240C in 50mL of plasma and gently agitated can be used for up to. Answer: 5 DAYS