Clinical Laboratory Science Review Questions a bottom line approach
Call Kai
Learn
Practice Test
Spaced Repetition
Match
Flashcards
Knowt Play1/156
There's no tags or description
Looks like no tags are added yet.
Name | Mastery | Learn | Test | Matching | Spaced | Call with Kai |
|---|
No analytics yet
Send a link to your students to track their progress
157 Terms
The following samples were obtained when testing a sample from a 20 year old first time donor:
anti-A: 3+
anti-B: 0
A1 cell: 1+
B cell: 3+
O cell: 0
The most likely cause of this discrepancy is
subgroup of A
3 multiple choice options
A group A patient needs blood and FFP. The small rural hospital is out of both A blood and A FFP. Which of the following would be your first choice to transfuse to this patient?
RBC-O; plasma-AB
3 multiple choice options
For which of the following blood groups is it NOT necessary to run an Rh control if you are using a monoclonal/polyclonal blend anti-D?
A pos
3 multiple choice options
Red blood cells which are to be tested with AHG are washed to
remove unbound serum globulins
3 multiple choice options
An antibody screen gave no reactions at immediate spin or 37C, but showed a 2+ reaction when AHG was added. The most likely antibody causing these results would be
anti-Jka
3 multiple choice options
Which of the following would cause an individual to be rejected as a blood donor?
donor had chicken pox vaccination 3 weeks ago
3 multiple choice options
Over a two week period, the reactions of your QC antibody show a gradual decrease from 2+ to a very weak positive with your antibody detection cells (screening cells). These results most likely indicate
deterioration of QC antibody
3 multiple choice options
The following reactions were obtained on testing maternal serum and infant cord cells
Maternal sample:
O-
D test: mf
D control: -
negative antibody screen
Infant cord cells:
A+
DAT:-
The most likely explanation is
fetal-maternal hemorrhage
3 multiple choice options
Based on the following results, select the best conclusion
Mother: MM R0R0
Alleged father: MM rr
Child: MN R0r
the alleged father is
excluded by his M antigen
3 multiple choice options
A 24 year old A negative female was transfused with approximately 65 CC of an A positive RBC unit. How many vials of RhIG should this woman receive?
5
3 multiple choice options
The transfusion component of choice for a bleeding patient with a prolonged bleeding time, increased aPTT, decreased levels of factor VIII antigen and impaired aggregation of platelets in response to ristocetin would be
cryo
3 multiple choice options
How many units of platelet concentrates would be needed to raise the platelet count 150,000/mm^3 in an average sized adult
15
3 multiple choice options
A patient experienced febrile reactions following 2 red cell transfusions. The best component to use if subsequent transfusions are needed would be
leukocyte-reduced red cells
3 multiple choice options
Cord bloods are washed prior to ABO and Rh grouping to
remove Wharton's jelly
3 multiple choice options
four units of platelets were pooled and issued at 2:00 pm. at 7:00 pm, the ward called, said they had never transfused the platelets, and wanted to know if the platelet pool could still be used?
no, they outdated at 6pm
3 multiple choice options
A specimen is tested for antibodies to varicella resulting in a titer of 320. Two weeks later another specimen is drawn from the patient and the resulting titer is 640. A third test is done on a specimen drawn 4 weeks after the first specimen and the titer is 320. What is the disease status of the patient?
antibody levels are increased but titers indicate a past infection with chicken pox
3 multiple choice options
A patient is immunized for rubella, what type of immunity does this patient have
active
3 multiple choice options
An immunofluorescence procedure is performed to test for specific antibodies to EBV. The following antibodies were found:
anti-VCA
anti-EA
anti-EBNA
How would these results be interpreted
past infection
3 multiple choice options
ANA fluorescent techniques were performed and a speckled pattern appeared with a titer of 640. What would you do next?
test for extractable nuclear antibodies
3 multiple choice options
multiple homogenous narrow bands are present in the gamma zone on electrophoresis of a patient's CSF on agarous gel. immunofixation indicates that the bands are primarily IgG. this may indicate which of the following diseases
multiple sclerosis
3 multiple choice options
Assess the disease state of the patient with the following results:
HBsAg positive
HBeAg positive
anti-HBc positive
anti-HBe negative
anti-HBsAg negative
highly infectious stage of hepatitis B infection
3 multiple choice options
After exposure to measles, a patient is tested and has a titer of 1:20. This indicates
test should be repeated in 10 days to 2 weeks
3 multiple choice options
The best method for screening CSF for syphilis is
VDRL
3 multiple choice options
A patient has a T helper:T cytotoxic ratio of 1:2. What disease state might you expect
AIDS
3 multiple choice options
Multiple myeloma most commonly involves the following class of immunoglobulin
IgG
3 multiple choice options
To test for antibodies to specific allergens the following procedure would be performed
RAST
3 multiple choice options
A patient suspected of having syphilis had various tests performed with the following results
RPR- reactive
FTA-ABS- nonreactive
VDRL (CSF)- nonreactive
biologic false positive
3 multiple choice options
Listed below are the results for a patient who had a positive ANA on initial testing:
anti-Sm -
anti-SSA +
anti-SSB +
anti-Scl-70 -
anti-RANA -
Sjogren's syndrome
3 multiple choice options
The most sensitive and specific assay for all staged of syphilis is
ELISA
3 multiple choice options
The following test is the most accurate indication of the presence of inflammation
CRP
3 multiple choice options
The major iron storage compound is
ferritin
3 multiple choice options
How would the following results be interpreted on a 32-year-old female:
HGB: 9.0 g/dL
MCV: 74fL
MCH: 27 pg
MCHC: 30 g/dL
RDW: 19%
ferritin: 4
iron: 29
TIBC: 590
% saturation: 5
iron deficiency anemia
3 multiple choice options
How would the results on a 72-year-old female be interpreted:
HGB: 6 g/dL
MCV: 114fL
MCH: 39 pg
MCHC: 34 g/dL
RDW: 18.5%
Oval macrocytes on Wright stain
retic count 1.2%
B12: 55
folate: 7
anti-IF antibodies: positive
pernicious anemia
3 multiple choice options
Which of the following results from decreased synthesis of globin chains
beta-thalassemia
3 multiple choice options
The normal M:E ratio for an adult is
3:1-4:1
3 multiple choice options
A patient with a negative dithionite solubility test has a band in the A region and a band in the S region on cellulose acetate hemoglobin electrophoresis at a pH of 8.6. On citrate agar, there is only a band in the A region. Which of the following is compatible with these results
Hb AD
3 multiple choice options
The failure of granulocytes to develop past the "band" or two lobed-stage is characteristic of
Pelger-Huet anomaly
3 multiple choice options
A patient with an elevated WBC count with neutrophilia, a left shift, toxic granulation, vacuoles, dohle bodies, and an increased LAP probably has which of the following
bacterial sepsis
3 multiple choice options
The following results were obtained on an automated CBC:
HGB: 11.2
HCT: 2.1
RBC: 2.1
MCV: 128
MCH: 53.3
MCHC: 41.5
RDW: 19
All results are flagged, the tech found no clots in the sample. What should be done next
warm the sample to 37C and rerun
3 multiple choice options
Plasma cells evolve from which cell line
lymphocytic
3 multiple choice options
In performing a manual wbc, 0.02 mL of blood was diluted with 1.98 mL of ammonium oxalate. An average number of 50 cells were counted using a Neubauer hemocytometer. What is the patients white count
5,500 u/L
3 multiple choice options
A 4 ml EDTA was received in the lab containing ~ 1 mL of whole blood. If performed on this sample, which of the following manual lab tests would most likely be affected
ESR
3 multiple choice options
A peripheral blood smear stained with Prussian blue demonstrates siderocytes. On a Wright stained smear what would you expect
pappenheimer bodies
3 multiple choice options
A bone marrow differential performed on a patient showed 20% blasts. Flow cytometry studies demonstrated the blasts to be positive for CD10, CD19, CD22, and negative for CD13 and CD33. Which of the following diseases is most compatible with these findings?
ALL
3 multiple choice options
Which of the following is diagnostic of APL?
t(15;17)
3 multiple choice options
Plasma cell (multiple) myeloma may be suspected if which of the following is seen on a peripheral smear?
rouleaux
3 multiple choice options
Which parameter is most likely affected by lipemia
hemoglobin
3 multiple choice options
If one performs an aPTT on a patient on high-dose warfarin therapy, we would expect that the result would be:
increased because of other multiple factor deficiencies
3 multiple choice options
Abnormal PFA results and giant platelets best describe
Bernard-Soulier syndrome
3 multiple choice options
A 7-year-old male child is a candidate for ear tube surgery because of repeated ear infections but he has persistent prolonged PT. The aPTT is normal, which condition is most likely
vitamin K deficiency
3 multiple choice options
A 22 year old female was seen in the ER with evidence of a spider bite. Lab results are:
Schistocytes on blood smear
PLT: 50
PT: 20
aPTT: 60
d-dimer: +
The most likely diagnosis is
secondary fibrinolysis
3 multiple choice options
A 4 year old male has a prolonged aPTTof 53. Mixing with normal plasma at a ratio of 1:1 yields an aPTT of 50. Which of the following is most likely
inhibitor of other anticoagulant
3 multiple choice options
Which of the following changes occur when a urine specimen is left at room temp for longer than 1-2 hours
decreased ketones
3 multiple choice options
A urinalysis on a 3 year old revealed a positive copper reduction test and a negative glucose oxidase test. How would these results be interpreted?
galactose is present
3 multiple choice options
Chemical and microscopic analysis of a urine specimen yield the following:
Protein: 4+
RBC: 0-2/hpf
WBC: 0-5/hpf
few hyaline casts
moderate fatty, waxy, and granular casts
many oval fat bodies
nephrotic syndrome
3 multiple choice options
What type of urine specimen is the ideal screening specimen as it is the most concentrated
first morning
3 multiple choice options
The reagent strip reaction used to test for the presence of glucose is based on
double sequential enzyme reactions
3 multiple choice options
An elevated urine urobilinogen and a negative test for urine bilirubin may indicate which of the following conditions?
hemolytic disease
3 multiple choice options
Calculate the creatinine clearance of a 24 hour urine using the following data:
urine creatinine: 500 mg/dL
plasma creatinine: 8mg/dL
urine volume 1.5L
65 ml/min
3 multiple choice options
An L/S ratio of 2.7 indicates
fetal lung maturity
3 multiple choice options
CSF results reveal an increased protein, normal glucose, normal lactate, and increased lymphocytes. This most likely indicates
viral meningitis
3 multiple choice options
A patient is administered with an OGTT with the following results:
Fasting serum glucose: 128 mg/dl
2 hour post load serum glucose: 238 mg/dl
These resutls correlate best with
diabetes mellitus
3 multiple choice options
A physician calls to ask assistance in choosing a test to monitor a diabetic patient's long term control. Which of these would you suggest
glycosylated hemoglobins
3 multiple choice options
Which of the following sets of test results indicates the greatest risk for coronary disease?
A. Cholesterol: 145, HDL: 55, LDL: 90
B. Cholesterol: 165, HDL: 60, LDL: 105
C. Cholesterol: 245, HDL: 60, LDL: 95
D. Cholesterol: 345, HDL: 30, LDL: 205
D.
3 multiple choice options
Elevated conjugated bilirubin in both serum and urine, decreased urine urobilinogen, and a decreased fecal urobilin is characteristic of
obstructive jaundice
3 multiple choice options
Calculate the LDL from the following:
total cholesterol: 250 mg/dL
HDL cholesterol: 40 mg/dL
Triglyceride: 210 mg/dL
168mg/dL
3 multiple choice options
A 65 year old male visits his physician complaining of fatigue, shortness of breath, and difficulty breathing. He is 6' tall weighing 200 lbs for many years but recently gained 30 pounds. His ankles and hands are swollen and he complains of feeling bloated. His blood pressure is markedly elevated. What test should the physician order.
BNP, pro-BNP
3 multiple choice options
Which result is typically not affected by hemolysis
sodium
3 multiple choice options
Which enzyme is decreased in insecticide poisoning due to organophosphates?
cholinersterase
3 multiple choice options
The biuret method for determining serum total protein is dependent upon
number of peptide bonds
3 multiple choice options
An arterial blood sample is received in the lab 45 minutes after collection with a bubble in the syringe. The tech should
reject the sample because the pCO2 will be falsely decreased
3 multiple choice options
A patient in diabetic ketoacidosis would exhibit a/an
normal pCO2, decreased HCO3, decreased pH
3 multiple choice options
The best test for detecting cystic fibrosis
sweat chloride
3 multiple choice options
A 25 year old female visits her physician with the following symptoms: feeling tired all the time, recently gaining 15 pounds, swollen neck, dry skin, hoarseness, and delated reflexes. The physician ordered thyroid tests with the following results:
TSH: 3.0
Free T4: 0.4
The physician performed a TRH stimulation test with the following results:
30 minute TSH: 6.0
60 minute TSH: 15.0
The results indicate that the patient is suffering from
tertiary or "hypothalamic" hypoparathyroidism
3 multiple choice options
A blood ammonia level was ordered on a patient with Reye's syndrome. The results on the clotted sample were normal. The most likely explanation for this is
inappropriate sample collection
3 multiple choice options
A patient with elevated serum levels of creatinine kinase, aldolase, and aspartate aminotransferase but normal levels of alanine aminotransferase most likely have
muscular dystrophy
3 multiple choice options
In drug testing using thin layer chromatography, why is a volatile organic solvent mixed with urine specimens?
to extract the drugs
3 multiple choice options
Electrolyte values on 4 patients are as follows:
A. Na: 149 Cl: 102 HCO3: 26
B. Na: 153 Cl: 105 HCO3: 28
C. Na: 150 Cl: 103 HCO3: 25
D. Na: 151 Cl: 104 HCO3: 27
there is a problem with the sodium analysis
3 multiple choice options
Why should potassium levels be monitored prior to and during administration of IV insulin?
insulin causes potassium to move into cells which may cause a drop in potassium levels
3 multiple choice options
According to dosing guidance for warfarin a patient's dose should be based on genotyping for
CYP2C9 and VKORC1
3 multiple choice options
A "rice water stool" is characteristic of
vibrio cholerae
3 multiple choice options
a sample of material from bluish purulent head lesions is submitted for analysis. A gram neg, motile, non-sporeforming oxidase positive rod was isolated. this organism is most likely?
pseudomonas aeruginosa
3 multiple choice options
A gram stained smear from a genital soft chancre demonstrated small gram negative rods arranged in tangles chains. You would suspect the cause of the chancroid be
Haemophilus ducreyi
3 multiple choice options
Organisms of this genus are gram negative, motile rods. A few are chromogenic and produce a red non-water soluble pigment. Some have been implicated in septicemia ,pulmonary, and UTIs. This is most likely
Serratia marcenscens
3 multiple choice options
Which characteristic is most useful in differentiating Citrobacter and Salmonella?
Lysine decarboxylase
3 multiple choice options
A gram stain from a sputum specimen demonstrates many GPC in chains and pairs. Numerous small alpha streptococci are observed on the primary BAP. To determine if these organisms are S. pneumoniae which of the following tests should be performed?
Optochin susceptibility
3 multiple choice options
Loeffler's medium is used as a primary isolation medium for
Corynebacterium diphtheriae
3 multiple choice options
Autoclave sterilization of lab media requires what parameters?
15lbs, 121C, 15 mins
3 multiple choice options
Clinical diagnosis of rabies in infected animals is dependent upon brain tissue observation of
negri bodies
3 multiple choice options
Which of the following results is typical of Campylobacter jejuni
optimal growth at 42C
3 multiple choice options
The use of penicillin/aminoglycoside to treat endocarditis due to streptococci group D represents a
synergistic relationship
3 multiple choice options
Characteristics indicating an appropriate sputum collection would be microscopic findings of
< 10 epis, 10-25 WBCs
3 multiple choice options
A clean catch urine from a female with a suspected UTI showed GPC that were catalase +, coagulase -, and staph latex -. On the microscan panel, growth in the novobiocin panel was noted. The most likely organism is
S. saprophyticus
3 multiple choice options
The treatment of choice for methicillin resistant staphylococcus
vancomycin
3 multiple choice options
the most likely cause of subacute bacterial endocarditis is
streptococcus viridans
3 multiple choice options
The organism known for its stormy fermentation and double zone beta hemolysis under anaerobic conditions causes
gas gangrene
3 multiple choice options
The bacteremic Waterhouse-Friderichsen syndrome is associated with
Neisseria meningitidis
3 multiple choice options
The specimen of choice in a case of suspected epiglottitis is collected from the
blood
3 multiple choice options
The specimen from a female complaining vaginitis emitted a fishy odor when mixed with 10% KOH. A wet prep showed some WBCs and epis covered within small gram variable rods. The most likely organism is
Gardnerella vaginalis
3 multiple choice options
A photochromogenic mycobacterium isolated at 30C is most likely
M. marinum
3 multiple choice options