S. Pyogenes

ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018

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CLINICAL CHEMISTRY 1. What organ-disease has 5x increase in ALP: BONE Pronounced elevation (≥5 times) Bile duct obstruction Biliary cirrhosis Paget's disease Osteogenic sarcoma Hyperparathyroidism

Moderate elevation (3-5 times) Granulomatous or infiltrative disease of liver Infectious mononucleosis Metastatic tumors of the bone Metabolic bone disease (rickets, osteomalacia)

2. What enzyme decreases in liver disease? 3. Lamp used in UV spectrophotometry

4. NFPA hazard symbols (4 items)

Slight elevation (up to 3 times) Viral hepatitis Cirrhosis Healing fracture Pregnancy Normal growth patterns in children

Cholicesterase Deuterium lamp and Mercury Arc lamp Visible spectrophotometry: tungsten lamp Atomic absorption spectrophotometry: hollow cathod lamp 0 - No hazard 1 - Slight 2 - Moderate 3 - Serious 4 - Extreme No SMS Ex

5. Complication of phlebotomy?

6. Cell separation for glucose test is done within how many minutes 7. What disease is associated with group A Streptococcus 8. Causes of hyponatremia (Morse type)

9. Causes of increase anion gap (Morse type)

10. What electrolyte maintains neutrality? 11. If vacutainer is stored at low temperature, what will be the effect to the draw volume?

A. Dermatological B. Neurological C. Cardiovascular D. All of the above 30 minutes Gray tube (sodium fluoride) - prevents glycolysis by inhibiting enolase S. pyogenes 1-Metabolic acidosis 2-Cushing disease 3-Addison’s disease 4-Metabolic alkalosis Methanol Uremia Diabetic ketoacidosis Paraldehyde Intoxication, iron, inhalants Lactic acidosis Ethanol Salicylate Chloride Sodium - counter-ion of chloride Potassium - countercurrent ion of chloride Increase in draw volume If vacutainers are stored at low temperature, pressure of the gas inside will decrease. This will lead to

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018

12. Order of draw

13. What is the effect of the hemoglobin and bilirubin to ACP

14. Effect of cryogenic material (Morse type)

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increase draw volume Altitude ↑ altitude = ↓ draw volume Humidity Affects plastic vacutainers only Affects lyophilized additive duw to m igration of water vapor inside the tube Yellow - blood culture (SPS) Light blue - coagulation (Sodium citrate) Red - serum Green - blood gas (heparin) Lavender - most hematology studies (EDTA) Gray - blood glucose (NAF) a. increases b. decreases c. unaffected d. Indeterminate Only ALP will be falsely elevated by high Hb and bilirubin Only TRAP (not total ACP) falsely decreases due to high bilirubin 1- Thermal burns 2- Vasoconstriction 3- Pressure build-up

Cryogenic materials - used for certain medical treatment at temp -67 C 15. What is an enzyme? Enzymes are biological catalysts that lowers the activation energy 16. Analytical Sensitivity and Analytical Specificity Analytical Sensitivity Analytical Specificity lowest concentraction of substance that measure only one analyte can be detected by the test method no interference from other analyte Less false negative Less false positive and cross reaction for screening test for confirmatory test 17. Diagnostic Sensitivity and Diagnostic Specificity Diagnostic Sensitivity % of population w/ disease that test positive (TRUE POSITIVE) TP x 100 / (TP + FN) 18. Ability to repeat test sample yielding close results

19. Instrument for identifying and quantitating drugs

20. TREND OF MYOCARDIAL INFARCTION Elevation Myoglobin 1-3 h Troponin I 3-8 h Troponin T 3-8 h

Diagnostic Specificity % of population w/o disease that test negative (TRUE NEGATIVE) TN x 100 / (TN + FP) a. Accuracy b. Precision c. Sensitivity d. Reproducibility Accuracy - closeness to the true value (control) MS/GC (gold standard) Mass spectrometry - identification Gas chromatography - quantitation Fluorometry - used in drug and hormone measurement Nephelometry - quantitation of ab-ag reaction Peak 6-9 h 24-48 h 2-3 days

Duration/Decline 24 h 3-5 days 5-10 days

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018 CK-MB 4-6 h 12-24 h 2-3 days AST 6-12 h 24-48 h 4-6 days LD 8-12 h 4-6 days 8-14 days 21. Patient has increase BNP, what to Decrease in sodium level (inverse relationship) expect with the patient's electrolyte Effects of BNP: vasodilation, natriuresis, inhibition of panel? RAA 22. Sources of error in ABG ↓ PCO2 ↑ pH ↑ PO Hyperventilation/ specimen exposed to air ↓ PO2 ↓ pH ↑ PCO2 Specimen at RT for >30 mins 23. Formula for anion gap

24. What is an enzyme 25. Of the total serum osmolality, sodium chloride, and bicarbonate ions normally contribute approx what percent? 26. Criggler Najjar defect CALCULATION 3 mL of serum is added to 12 mL saline 1. What is the dilution of the solution?

(Na+ + K+) - (Cl- + HCO3-) or Na+ - (Cl- + HCO3-) Osmolality = 2Na + (Glucose/20) + (BUN/3) 1.86 Na + (Glucose/18) + (BUN/2.8) + 9 Enzymes are biological catalysts that lowers the activation energy for a reaction to occur A. 8 B. 45 C. 75 D. 92 Deficiency of the enzyme system required for conjugation of bilirubin 3/15

2. What is the ratio of serum to saline?

3/12

3. What is the ratio of the total volume to serum?

15/3

There are 3 tubes with 9 mL NSS. In the 1st tube, 1 mL of the 0.1 N NaOH was added. From the 1st tube, 1 mL was transferred to the 2nd tube. The 2nd tube was mixed and 1 mL of solution 4. What is the dilution of the 1st tube? 5. What is the dilution of the 2nd tube? 6. What is the final concentration of NaOH in tube 3?

1:10 1:100 0.0001 N NaOH

MICROBIOLOGY AND PARASITOLOGY 1. Ova found in concentrated sputum Paragonimus westermani

2. Use to differentiate Stenotrophomonas and Burkholderia

3. QC for sterilization

Larva - Ascaris lumbricoides Cyst - G. lamblia Oxidase S. maltophila Burkholderia Oxidase NEG POS Catalase POS NEG Gelatin liq NEG POS DNAse POS NEG Biological QC (B. stearothermophilus) Dry heat - Bacillus subtilis

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018 4. Safest method which no living organism/ infectious organism can survive 5. Nontuberculous, noncultivable Mycobacterium infecting mucous membranes, skin, and nervous system 6. M protein is associated with what organism 7. What organism causes blue-green pus 8. What organism is motile at 25℃ 9. K/A H2S with gas A/A Klebsiella E. coli Enterobacter P. Vulgaris (H2S) KEEPS

K/A Shigella Providencia Serratia

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Moist heat/ autoclaving Incineration - destruction of prions M. leprae

S. pyogenes Pseudomonas aeruginosa Yersinia enterolitica (nonmotile at 37℃) Yersinia pestis - non-motile K/A, gas Morganella

K/A, gas, H2S Salmonella Proteus mirabilis Edwarsiella

SPS

10.Aside from Shigella, what causes watery diarrhea, electrolyte loss, and bloody stool? (from Harr) 11.Causes of food spoilage in unopened bacon slices in plastic bag 12.Beta hemolytic gram positive cocci is identified, what test must be further done? 13.Storage temperature of serum for longer storage 14.Why is serum tested again after 1 week? (2) 15.False about indirect bilirubin? Structure Bound to protein Type of compound Soluble in water Present in urine Reaction with diazotized sulfanilic acid Affinity for brain tissue

SaME Campylobacter jejuni Lactobacillus - anaerobic Bacitracin test - for S. pyogenes (Group A) CAMP - for S. agalactiae (Group B) -70 degree Celcius 4 C - shorter time of storage Check for rise of titer (four-fold) Detect acute infection due to rise of titer Indirect bilirubin Unconjugated Yes (albumin) Nonpolar No No Indirect (needs accelerator) High

Direct bilirubin Conjugated with glucuronide No Polar Yes Yes Direct Low

Frequently, smaller-gauge (23 gauge or 25 gauge) needles are used. Syringes or butterflies may be advantageous with some infants' vein (Rodaks) The 23-gauge needle is preferred for pediatric draws, hand veins, or veins that appear fragile or problematic (Dennis) 17.Venipuncture site if pattient has a fistula in right arm - draw at the left arm 16.Gauge for pediatric venipuncture

IV

Situations

Fistula, mastectomy

Appropriate Course of Action Use opposite arm or perform fingerstick, if possible Have nurse turn off IV for 2 min, collect below the IV line (but disgard the first 3-5 mL of blood) Draw at opposite arm

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018 Indwelling lines & catheters, heparin locks, cannulas Sclerosed veins, edema, scars, burns, tattoos Hematoma Streptokinase/ TPA

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Usually not drawn by lab First mL is discarded May draw below the heparin lock id nothing is being infused Select other site

Draw below Minimize pucture sites Hold pressure until bleeding stopped Patient refuses Try to persuade. If unsuccessful, notify the nurse Unidentified patient Ask nurse to ID befor drawing 18.Stain for quantitaing parasitic Giemsa stain infection 19.If the stool specimen is small, what Kato-Katz and Kato thick (semi-quantitative) technique you will use for ova quantification In the choices NSS - for motility, not the best method for ova count Iodine - for qualitative only 20. Medium for Vibrio spp APW - enrichment medium TCBS - selective medium 21.What is detected in Slide Coagulase Bound coagulase/ clumping factor test Tube Coagulase - free coagulase 22.E.coli Diarrhereic Group EHEC

Hemorrhagic colitis, HUS Most common cause of renal failure in children Vertoxin/Shiga toxin E.coli 0157:H7 ETEC Traveller’s diarrhea/ watery diarrhea Toxins EIEC Bloody diarrhea/ Dysentery like Polyps, RBCs, mucus EPEC Diarrhea in infants (major pathogen in infants) Adherent-attachement EAEC Chronic diarrhea in HIVinfected patients Adherent-attachement DAEC Diarrhea and UTI Adherent-attachement 23.Egg is flattened at one side and bulging at the other side 24.Patient suffering from gallbladder obstruction, is positive for brown ova with opercular shoulder. 25. Earliest form seen in blood picture in malaria infection

Undercooked meat, raw milk, apple cider

RBCs in stool but no polyps

Contaminated food/water

No polyps or RBCs

Contaminated water/foode Contaminated formula/food

No polyps/RBCs

Nosocomial/community acquired

No polyps/RBCs

No current studies

No current studies

E. vermicularis C. sinensis adult resided at the bile ducts, gallblader, and pancreatic ducts (high probability for obstruction) Trophozoite (immature)/ ring form

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018

26.Which of the following is a normal flora 27.Anaerobes’growth requirement 28.Biosafety cabinet HEPA filtered exhaust air BSC I 100% BSC II A1 30%

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Corynebacterium amycolatum Most frequently recovered Corynebacterium spp from human clinical material but part of the normal skin microbiota 5-10% CO2, 5-10% H2 and 80-90% nitrogen Recirculated HEPA filtered air 0% 70%

Velocity (FPM) 75

BSC II A2

30%

70%

100

BSC II B1

70%

30%

100

BSC II B2 BSC III

100% 100% HEPA filtered supply and exhaust air

0% 0%

100

CLINICAL MICROSCOPY 1. Positive color of bilirubin in reagent strip Purple

2. Imparts orange brown color in urine, and produce red fluorescence in UV 3. Meaning of E in RACE

Purple (+): bilirubin and leukocyte esterase False (-) due to ascorbic acid: BB LNG (blood, bilirubin, leukocyte esterase, nitrite) False (-) due to nitrite: BB U (blood, bilirubin, urobilinogen) False (-) due to high SG: B(l)NG (blood, nitrite, glucose False (+) due to highly pigmented urine: PLUNK Bi (pH, leukocyte esterase, urobilinogen, nitrite, ketones, bilirubin) Urobilin Urobilinogen - colorless Rescue Pull pin Alarm Aim at the bottom Contain Squeeze Extinguish/evacuate Sweep from side to side 1 million cells/ejaculation

4. Sperm count calculation (per ejaculation) Volume: 2 mL Dilution: 50 5 RBC squares: 200 5. CSF cell ount 11, 800 cells/ mm3 2 WBCs squares: 58 and 60 Dilution: 1:20 6. Urine grading: few particles , print seen and no distortion

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018 Clear Transparent Hazy Few particles, print easiliy seen Cloudy Many particles, blurred print Turbid Print cannot be seen Milky Precipitated/clotted 7. SSA protein grading: Turbidity with granulation with no flocculation Neg Trace 1+ 2+ 3+ 4+

No increase in turbidity (<6 mg/dl) Noticeable turbidity (6-30 mg/dl) Distinct turbidity (30-100 mg/dl) Turbidity with granulation (100-200 mg/dl) Turbidity with granulation and flocculation (200-400 mg/dl) Clumps of protein (>400 mg/dl)

8. What solution preserves sperm cell in the sperm diluting fluid?

Formalin

9. Most common round cells seen in sperm count 10. What happens in RBCs in diluted urine?

Other diluting fluids: 10% NAHCO3, cold/chilled water, tap water, saline 1. Spermatid 2. WBC Swell/ becoems ghost cells

11. What cell exhibit brownian movement?

Neutrophil/ Segmenter

12. What type of urine which glitter cells are seen? 13. What causes blue-green color urine?

Diluted urine

14. True in POCT

POCT uses the principle of immunochromatography and gives qualitative results Escherichia coli, Proteus spp., Klebsiella pneumoniae Can’t reduce nitrate: Enterococci, Staphylococci, or Adenovirus Decrease in urine pH/ urine becomes acidic

15. What bacteria can reduce nitrate to nitrite (2 questions) 16. Effect of excessive phenol in urine? 17. Most common cause of negative urine bilirubin 18. 4th tube of CSF

Pseudomonas

Exposure to light Microbiology

19. What tube for bacteriological studies in synovial fluid is used of 3 tubes are collected? 20. What microscope is used for cast?

1st tube: Chemistry/ serology 2nd tube: Microbiology 3rd tube: Hematology/Cell count 1st tube: Chemical examination (1-3 mL) 2nd tube: Microscopic examination (2-5 mL) 3rd tube: Microbiological studies (3-10 mL) Phase-contrast microscope (Brunzel)

21. Urine constituent unique in kidneys 22. Why first morning urine is preffered? (2 question)

Cholesterol: Polarizing/bright-field 3D images of high contrast and resolution: 1. Modulation contrast (Hoffman) 2. Differential-interference (Nomarski) 3. Bright-field - can be adapted for both methods Cast First morning urine is the most concentrated urine throughout the day therefore able to detect

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018 23. What type of bilirubin reacts with bilirubin strip

24. False negative in bilirubin 25. Seen in preeclampsia

26. In renal tubular acidosis, the pH of urine: 27. Limulus lysate test 28. Crystals seen in gout 29. 2 or more RTE cells indicate 30. Speckled patter in blood reagent strip 31. Birth defects test 32. Evaluate urine clarity and color

NOTE: Read Chemical Test (for cases study analysis)

small abnormal constituents Direct bilirubin Principle: Azo coupling reaction with ___ bilirubin with diazonium salt in an acid medium to form an azo dye 1. Old specimen 2. Ascobic acid (>25 mg/dl) 3. High concentrated nitrite Preeclampsia occurs only in pregnancy and precludes gestational hypertension Mild preeclampsi: high blood pressure, water retention, and proteinuria Severe preeclampsia: oliguria, upper right abdominal pain, and tendency to bruise easily Consistenly alkaline Gram negative endotoxin Uric acid/ Monosodium urate Pseudogout: calcium pyrophosphate Acute renal necrosis Hematuria Homogenous patter: hemoglobinuria Triple test: AFP, HCG, and estriol Quad test: AFP, HCG, estriol, and inhibin A. Check the urine with a white background B. Check urine with a newsprint C. Check the urine with black background D. Check urine with a polarizing light

HEMATOLOGY 1. In the cell cycle, what phase requires 8 hours duration where DNA is synthesized G0 - resting phase G1 - gap phase before S phase (accumulates needed in DNA synthesis G2 - post DNA synthesis (checking) 2. How long is the neutrophil life span in the 6-10 hours (average 8–12 hours) circulation? <1 day 3. Time for the last myelocyte mitotic Myelocyte - last dividing cells division to the emergence of mature eosinophils from the marrow 4. Associated with giant platelet syndrome  Bernard-Soulier (Morse type)  Alport Syndrome  May-Hegglin 5. What is/are increased in compensated Choices: thrombocytopenia? (Morse type) 1 – Circulating 2 – Resting 3 – Stress

6. Vitamin K dependent factors

Resting platelets - activated platelets Stress platelets - produced under conditions of stimulated platelet production differ from normal circulating platelets (volume and functional characteristics II, VII, IX, X (and protein C, S, Z)

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018

7. Manual-wedge smearing angle

Calcium dependent factors: XII, XI, PK, HMWK Consumed factors during clot formation: (I, II, V, VIII, XIII (fibrinogen group except II) Labile factors: V and VIII Activated in cold temp: VII and XI 30-45°

Smearing angle for px sample with PCV: 25° 8. What are the characteristics of an immature cell?

9. 10.

11. 12.

Mature Immature Size smaller larger N:C ratio low high Cytoplasm less basophilic basophilic Nucleus smaller/ extruded (RBC)/ larger segmented (granulocytes) Nucleoli absent present Dehydration will cause Hematocrit to TO INCREASE MK I is Megakaryoblast MK II - promegakaryocyte/ basophilic megakaryocyte MK III - mature/ granular megakaryocyte (Rodaks) Anticoagulant to blood ratio in citrate 9:1 tube Area of 1 square in platelet count 0.04 mm2

13. If the APTT is still prolonged even correction studies are performed, what may be the reason for prolonged APTT 14. Target INR in pulmonary embolism treatment

Total area for platelet count: 0.04 mm2 x 25 = 1 mm2 WBC count (1 corner square): 1 mm2 RBC count (1 square): 0.04 mm2 Presence of inhibitor Antibodies against Factor VIII 2.0-3.0 (standard dose of coumarin)

If px have mechanical heart valves: 2.5 - 3.5 (high dose anticoagulant therapy) 15. If there is presence of oral anticoagulant, a. % PT is reported as b. ratio c. INR - standardized manner of reporting d. seconds 16. Acute myelocytic leukemia (AML)/ acute granulocytic leukemia (AGL) M0 Myeloid leukemia w/ minimal M4eo Myelomonocytic leukemia w/ differention eosinophilia M1 Myeloblastic leukemia w/o maturation M5a Monocytic (>30% blast) M2 Myeloblastic leukemia w/ maturation M5b Monocytic (more mature cells) M3 ACUTE PROMYELOCYTIC LEUKEMIA M6 Erythroleukemia M4 Myelomonocytic leukemia M7 Megakaryocytic 17. Erythroleukemia and Acute Lymphocytic PAS (both PAS positive) Leukemia is differentiated from other leukemia using what stain? 18. Last stage in RBC maturation wherein Reticulocyte nucleus is lost Mature RBC (not in the choices) Orthochromatophilic normoblast - last nucleated stage in RBC series PRAY BEFORE, DURING, AFTER YOU STUDY/ TAKE THE EXAM

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018 19. WBC and platelet estimate formula

WBC estimated count (HPO): 10 fields WBC/field x 2,000 Platelet estimated count (OIO): 10 fields Platelet/field X 20,000

20. Objective used in RBC count 21. Platelet zone responsible for aggregation and synthesis of ATP for platelet metabolism

22. WBC that can kill an antigen inside a phagosome because of presence of hydrochlorous acid, peroxidase, and superoxide 23. Result of MPO and SBB are?

24. Pappenheimer bodies can be demonstrated using?

HPO (400x) a. Sol-Gel b. Peripheral c. Organelle d. Open canicular system Peripheral zone consists of glycocalyx coat (mucopolysaccharide and Mg2+ dependent ATPase), cytoskeleton (for aggregation and adhesion) and platelet membrane (ADP receptor) Organelle (dense granules) - storage of nonmetabolic ATP (Harrison IM) Neutrophil

a. Parallel b. Opposite c. Indifferent d. Indefinite Both stains myelocytic lineage Prussian blue Wright stain:  Basophilic stippling  Howell-Jolly bodies  Cabot rings  Pappenheimer bodies  Polychromatophilic RBC New Methylene blue: (SHH(a)RP  Siderotic granules  Howell-Jolly bodies  Heinz bodies  Reticulocytes  Pappenheimer

25. Cold agglutinin will cause RBC count to 26. Use to measure variation of size in RBC 27. Use to measure variation of size in platelets 28. MPV should be based on what age of EDTA specimen 29. Inclusion body composed of ribosomes and RNA, that can be precipitated during staining?

Supravital stain:  Heinz bodies - BCB, methylene blue, crystal violet DECREASE MCV, MCH, MCHC: increases RDW PDW 4 hours Basophilic stippling Heinz bodies: hemoglobin

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018

31. Corrected WBC count solving

Pappenheimer bodies: iron Howell Jolly bodies: DNA No nucleus (TRICKY QUESTION) Megakaryocyte: multinucleated WBC count x 100/ (#nRBC + 100)

32. Centrifuge speed for microhematocrit

10,000 - 15, 000 xg

30. Nucleus shape of a mature platelet

33. Cell counted for diff count if WBC>40x10 34. Cell counted for dif count if WBC >100x109 35. Centrifugation time of microhematocrit

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36. TIBC test is performed to assess the blood level of: 37. Acute leukemia blast percentage criteria

2, 000 - 2,300 xg : macrohematocrit 200 cell-count 300 cell-count A. 3 minutes B. 5 minutes C. 10 minutes D. 30 minutes - macrohematocrit A. Ferritin B. Hemopexin C. Iron D. Transferrin FAB: 30% WHO: 20%

IMMUNOLOGY, SEROLOGY AND BLOOD BANKING 1. Specific test for SLE Anti-dsDNA 2. Test to detect SLE ANA test 2. 2nd most severe cause of HDN Anti-c 3. Transport temperature of RBC component 4. Storage condition of WBC 5. What is passive agglutination 6. Antibody found in population of African Americans and Carribeans 7. How to prepare cryoprecipitate 8. Blood antigens that are enhanced by enzyme except?

9. Product fragments of papain 10. Component of rejuvinating solution

11. Purpose of agitation in platelet components

D>c>E>C>e 1-10 degree Celcius 20-25 degree Celcius w/o agitation Antibody in the patient’s serum reacts with the antigen attached to a particle Anti-Sm Light spin then hard spin Fya Enhanced (enzyme): Rh, Lewis (Lea, Leb), Kidd (Jka, Jkb) Destroyed (enzyme): M, N, Duffy (Fya and Fyb) React at any phase: Lewis Labile in vivo and in vitro: Kidd (DHTR) Enhanced (acidification): M 1 Fc and 2 Fab’ Pepsin: 1 Fc and 1 Fab(2) PIPA (phosphate, inositol, pyruvate, adenine) Additive solution components: Adsol (AS ) and Optisol (AS-5): MAGS (mannitol, adenine, glucose, saline) Nutricel (AS-3): CPAGS (citrate, phosphate, adenine, glucose, saline) Transfer of CO2 and O2

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ACTS REVIEW CENTER – ILOILO SEPTEMBER 2018 12. SITUATION: RhIg Administration 13. Blood Typing (2 items)

14. Type of discrepancies where the patient has missing antibodies

1. Mother is Rh negative 2. Mother hasn’t produced anti-D Anti A Anti B A cells A + --B -+ + AB + + -O --+ Type 1 discrepancy

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B cells + --+

Type 2: missing antigens Type: 3: plasma discrepancies Type 4: miscellaneous

SITUATIONAL: Blood typing work-up discrepanies First thing to do: check patient’s history then check for techinical discrepancy Type 1 Incubate px serum with regeant A1 and B cell at RT and at 4℃ for 15-30 minutes Type 2 Incubate tets mixture at RT and for at 4℃ for 15-30 minutes Type 3 Saline dilution/ replacement For cord cells: 6-8 times (harmening) or 5 times (turgeon) Type 4 Warm techniquue, DTT treatment 15. Vaccine with the longest deferral HBsIg vaccine (1 year) 16. Deferral for rubella vaccine 1 month (4 weeks) 17. If donor unit seal has been broken, Discard the unit what should you do? 18. First step of laboratory investigation of Check for clerical errors transfusion reacktion 19. Blood component with longest expiry Frozen RBCs (10 years) date 20. Indicates high infectivity in hepatits B HBeg infection HISTOPATHOLOGIC TECHNIQUES, CYTOLOGICAL TECHNIQUES, MT LAWS AND ETHICS 1. Stain for collagen Van Gieson/ Trichrome stain 2. PAS stains what substance Glycogen 3. Destruction of all living organism Sterilization 4. Code of ethics is not based on Conscience 5. Factors to consider when selecting a Brand of fixative good fixative except: 6. Which of the following is not considered Brand of chemical when during quality control 7. Hazardous chemicals should be labeled 1- Poisonous with description of their particular 2- Corrosive hazard such as 3- Carcinogenic 8. Administrative investigation 2 members of the board 1 legal officer NOTE: MOST QUESTIONS ARE SITUATIONAL AND “A COMPILED VERSION OF ALL SUBJECTS”

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