Media Lab: Everything

Patients may sometimes develop antibodies to which antigen without having a red cell stimulation?

Patients may sometimes develop antibodies to which antigen without having a red cell stimulation?

Lu^a (May sometimes be seen as a naturally occurring antibody)

How does the laboratory immunologic assessment of Waldenstrom’s Primary Macroglobulinemia differs from other monoclonal gammopathies?

Overproduction of IgM antibodies

Suppose a patient with stiffness in her fingers has a positive ANA test with a centromere pattern at a 1:1280 titer. What is the most likely diagnosis?

CREST syndrome (centromere antibodies are present in over half of patients with CREST syndrome)

The mediator cell type that binds to IgE antibodies is the:

Basophil

What is a benefit of the RPR and VDLR tests?

Monitoring course of treatment

Delayed hemolytic transfusion reactions are usually caused by antibodies directed against what blood group system?

Kidd

Which type of molecule is most likely to be antigenic/immunogenic?

Proteins

Nephelometry and turbidimetry measure different properties of:

Light transmission and scatter by particles in suspension

What markers should be ordered for a patient suspected of RA?

Anti-IgG (rheumatoid factor)

Serum ALP activity is derived from which organs?

Bone, intestine, kidney, liver and placenta

What is the earliest biochemical marker of a myocardial infarction?

Myoglobin

What marker would you expect to find in the serum of a patient who has recently recovered from Hep B infection?

Anti-HBs

Which modified PCR technique or other method of amplification is used to detect M. tb

Transcription-Mediated Amplification

Serum proteins can be separated by cellulose acetate electrophoresis into how many basic fractions?

5 fractions

Which immune elements are involved in a positive TB skin test?

T cells and macrophages

What is the bacitracin results for Enterococcus and S. pyogenes?

Enterococcus: resistant

S. pyogenes: Sensitive

Pheochromocytoma is a tumor of the adrenal medulla that results in elevated urinary levels of what?

Free catecholamines, metanephrines, and VMA

What would creatinine clearance be used in for assessments?

Assessment of glomerular filtration

What form of immunity is expected to provide long-term protection after hepatitis B vaccine is administered to an immunocompetent person?

Active

Does troponin as a marker of MI rise sooner than CK-MB?

No, they both rise about 3 hours after MI

The MHC I genes encode for:

HLA-A, B, C

MHC II genes encode for:

HLA-DR, DQ, DP

MHC III genes encode for:

Complement and cytokines

Which D variant has the best likelihood to receive D positive RBCs without any adverse effects?

C in Trans to RHD because it has complete D antigen structures

Does prostate cancer have association with increased alpha-fetoprotein?

No, it is not increased in patients with prostate cancer

What conditions have an associated increased AFP level?

Hepatocellular carcinoma, viral hepatitis, testicular tumors, liver cirrhosis and gastric cancers

Are anti-Lua and anti-Lea significant?

No

What procedures utilize leukapheresis to collect Buffy coat from whole blood?

Photopheresis

What are the main functions of the distal convoluted tubules?

Maintain water-electrolyte and acid-base balances

In what trimester is there the greatest risk for the manifestation of complications in maternal rubella infection?

First trimester

An antibody to which platelet antigen is most commonly encountered in blood bank?

HPA-1a

What is the primary functions of antibodies?

Binds with antigen to facilitate clearance of that antigen?

Describe the characteristics of T lymphocytes

• CD4 and CD8 positive

• Production of cytokines and chemokines

• Recruitment of inflammatory cells to site of inflammation of infection

• Assist B lymphocytes to make antibodies

The serum protein electrophoresis scan most likely represents which condition?

Chronic inflammation

Nephelometry is based on the principle of:

Turbidity resulting from specific antigen-coated latex particles agglutinated by corresponding antibody

When evaluating the patterns of FANA testing, cytoplasmic patterns may demonstrate what?

Anti-mitochondrial antibodies seen primary biliary cirrhosis

What is the difference of nephelometry and turbidimetry?

Nephelometry directly measures the amount of light scattered by particles in solution and turbidimetry measures the decrease in incident-light intensity

What is the expected serological response in an immunocompetent patient who has been vaccinated for HepB?

HBsAG (neg), Anti-HBc (neg), anti-HBs (pos)

What molecular technique is appropriate for HIV-1 genotyping?

Reverse transcriptase PCR

What are the diseases associated with a dysfunction of PMNs?

Chediak-Higashi syndrome, Chronic granulomatous disease and myeloperoxidase deficiency

What is required for a diagnosis of hereditary hemochromatosis?

• >50% transferrin saturation in females or >60% saturation in males

• Presence of HFE mutations or other genetic mutations associated with iron metabolism

• Increased ferritin

Which apolipoproteins contributes the greatest mass to the structure of HDL?

Apo A

Uric acid is the final breakdown product of what two purines?

Adenine and guanine

This assay would be used to help rule out heparin contamination in a coagulation sample:

Thrombin time

Which antigens are found on organisms from streptococcus anginosus?

A, F and G

The purpose of C3a and C5a is to:

Cause increased vascular permeability, contraction of smooth muscle and release of histamine from basophils

What has happened in an antibody titer, if tubes 5-7 show a stronger reaction than tubes 1-4?

Prozone reaction

Which tests confirms the presence of Bence-Jones proteinuria?

Immunoelectropheresis

The recommended temp/time/pressure for routine steam sterilization of media is:

121C for 12-15 minutes at 15 psi

The course of multiple sclerosis can be monitored by measuring which CSF analyte?

Myelin basic protein (MBP)

The majority of Lewis antibodies are of which Ig class?

IgM

The most common methods for measuring bilirubin are based on the reaction of bilirubin with:

Diazo reagent

What is used to determine if a person has had a recent infection with strep pyogenes?

Antistreptolysin O (ASO)

What does the M:E ratio in a bone marrow evaluation represent?

Myeloid cells to erythroid cells

What protein, in CSF, can be used to monitor the integrity of the blood-brain barrier?

Albumin (by comparing it to serum albumin because it should not really be in the CNS)

Enzymes can enhance which antigens?

Rh, Kidd, Lewis, I, P and ABO antigens

Increased concentrations of AFP in adults are most characteristically associated with:

Hepatocellular carcinoma

For the diagnosis of SLE, which of the following test principles provides the highest specificity?

A. FANA

B. ELISA

C. LATEX ANA

D. CRP

b. Elisa

What are the primary sites used to obtain a capillary specimen?

Middle (3) and ring (4) fingers of the nondominant hand

Sulfosalicylic acid (SAA) can be used to confirm the results of which test included on a urine chemical reagent strip?

Protein

Phagocytic neutrophils and macrophages are which lines of defenses?

Second line of defense

What is glomerulonephritis?

A type of kidney disease in which the glomerulus (filters waste and fluids from the blood) is damaged. Damage to the glomeruli causes blood and protein to be lost in the urine

What is the preferred solution for general disinfection of work surfaces in the clinical lab?

10% sodium hypochlorite (household bleach)

Why is it necessary to irradiate the blood products for a low birth weight infant?

To prevent transfusion-associated graft vs host disease (TA-GVHD) which occurs when donor lymphocytes from transfused blood engraft in the recipient and cause disease

How should an ammonia specimen be transported to prevent alteration of the ammonia level in the blood plasma?

Place it into an ice slurry

What is the primary target of HIV?

T-helper cells

What is the best method for examination of synovial crystals?

Polarized light

IgA deficiency with anti-IgA would benefit from what type of blood products?

Washed red cells which will reduce the number of leukocytes and platelets that are often responsible for febrile reactions and also eliminates plasma proteins, such as IgA

Describe avidity

The strength with which multivalent antigens and antibodies bind

What is the procedure for the proper preparation of platelet concentrate from random whole-blood donors?

Light spin followed by a hard spin

What lab assay is a highly specific indicator and the most sensitive assay for a diagnosis of RA?

Cyclic citrullinated peptide

What is the IAT usually used to detect?

Antibodies in the plasma

What is the DAT usually used to detect?

Antibodies already coating RBCs in vivo

Nephrotic syndrome is associated with which clinical findings?

Increased proteinuria, decreased serum albumin, edema

Total iron-binding capacity measures the serum iron transporting capacity of:

Transferrin

The purified protein derivative (PPD) test is also known as:

Targeted tuberculin testing

What is the primary cause of Waterhouse Friderchesen syndrome?

Neisseria meningitidis

Why is bacterial contamination most likely to occur to platelets?

Because they’re stored at room temp

Which of these factors may be deficient if both the PT and aPTT are prolonged?

a. Factor II

b. Factor VII

c. Factor VIII

d. Factor XI

Factor II

What is the cause of the most severe life-threatening hemolytic transfusions reactions?

Anti-A, Anti-B and Anti-A,B

What does “pH will be normal with a decrease in PCO2” describe?

Fully compensated metabolic acidosis

What are the two polypeptide chains that comprise the LD molecule?

M and H

What are the 2 main compartments of the bone marrow?

Vascular sinuses and hematopoietic cords

A patient who demonstrates a history of an allergic reaction from RBC transfusions will benefit from receiving which red cell component?

Washed RBCs (removes the excess plasma proteins to decrease or prevent the reaction)

What type of kinetic reactions are reactions in which the enzyme is in excess and the substrate concentration is the limiting factor?

First order

The CD markers, CD7, CD3 and CD5 are present on which cell marker?

T cell marker

A standard blood donation of 400-500mL requires a minimum anticoagulant-preservative solution volume of:

63 mL

The stage of viral replication where the envelope is being acquired and the HIV is leaving the host cell is known as:

Budding

What is the MOST common cause of acute hemolytic transfusion reactions?

Clerical errors

What is the INR calculation used for?

Standardize PT results between different reagent sensitivities

Blood lactate concentration is an indicator of impaired circulation and tissue oxygenation in critically ill patients. If circulation and tissue oxygenation are impaired:

Blood lactate concentration will increase

Ampicillin and vancomycin resistant is found more frequently, E. faecium or E. faecalis

E. faecium

In Hb methodology using potassium ferricyanide the following measurable reaction occurs?

Ferrous iron is oxidized to ferric iron to form methemoglobin

When is the trough level assessed?

By collecting a blood sample right before the next dose of the drug is given

What is the identifying characteristic of Aureobasidium pullulans?

The production of a black yeast-like colony

One risk associated with patients that require chronic transfusion is:

Iron overload

Which Corynebacterium species is lipophilic?

Corynebacterium jk

Which test is considered a more reliable method of monitoring long-term diabetes control?

HbA1C

Which finding best distinguishes immune hemolytic anemia from other hemolytic anemias?

Positive DAT