ASCP RECALLS 7-28-16 ==== PICTURE Blood Smear Pic of stomatocytes Ans: Liver Disease == Blood smear pic of retics and heinz bodies (focus on heins bodies) Retics count= 18% What to do next? Note: Bite cells are also seen in the picture Ans: Heinz body staining Also in the choice: Report retics count Do Prussian blue staining == Blood smear pic of echinocytes: Ans: Uremia == Blood smear pic of (orange red spiky cells) Ans: faulty drying == Blood smear pic of Target Cells: WBC count: High WBC count using another diluent: Normalized What can be the possible explanation? Ans: Lyse resistant RBC == Blood smear pic of agglutination, whats causing it? Ans: cold agglutinins == Same Blood Smear picture of agglutination:caused by what org? Ans: Mycoplasma Pneumoniae == Picture of T. trichuira == Picture of Penicillium == Picture of crithidialuciliae Ans: dsDna ==== Patient with lesions in his arms, given description what is seen in culture? Ans: SporothrixSchenkii ==== About 4 items of Automated Coagulation Studies: please read on PT and APTT reagents and corresponding effect of the values on the test sample
==== Around 7 to 10 Blood bank prob and discrepancies all situational Ex: O neg Rh pos patient Dat positive Screen cell - all neg 37 deg control - pos Rh control - neg (Remember rh control is BSA - serve as neg control) ==== Given: mother of blood type AB neg and baby type O pos. what should u do? Ans: Get a new heel stick from baby ( for me getting new sample is the best answer) it might be sample switching or px misidentification since its impossible for an AB mom to have a O baby Other Choices: Administer Rh Ig Get sample from father (blood bank staff dont go look for the father of the baby to counter check result)lol ==== Titer of EBV, IM, Toxoplasmosis Choices: primary infection EBV -( my answer) Coinfection with Toxo Secondary infection IM ==== Values of the following blood chem were re-run (2 values have significant difference) BILI, CREA, GLUCOSE, TROP I Which should you prioritize for validation? Ans: Trop I Note: normal values are not indicated ==== Sample taken from indwelling catheter. Not on anticoagulant but PT and APTT is elevated: Ans: heparin contamination ==== Second Irreversible step in platelet aggregation studies? Ans: release of ADP ==== Mannitol Positive Ans: Staph Aureus ==== Potassium Permanganate in auraminerhodamine stain for myco Ans: Quenching agent ==== After CSF gram stain, how would you store the CsF for culture the next day? Ans: Incubate @ 35 deg C === Patient with Rheumatic Disease develop AGN. What org do u expect to see in Renal biopsy? Ans: S. Pyogenes ==== Group D strep BE positive, NaCl negative Ans: S. Bovis
==== Parathyroid hor level: Normal Ionized calcium: increased Ans : metastatic Carcinoma (not sure) or hypoalbuminemia === Primidone monitoring: Suspected to have primidone overdose but the serum concentration is within the normal range, what should you do next? Ans: Measure phenobarbital concentration === Suspected deficiency when a patient exhibits prolonged apnea and paralysis after injection of anesthesia Ans:Pseudocholinesterase deficiency ==== Specimen for diagnosis of rotavirus Ans: Stool After being diagnosed with walking pneumonia, a patient is given penicillin. After a few days, the penicillin did nothing to treat the disease because: Ans: The bacterial agent has no cell wall ==== Hair perforation test is used to differentiate Ans: Trichophytonrubrum and Trichophytonmentagrophytes ==== Mature trophozoites and schizonts are not seen in the blood smear: Ans: Falciparum ==== Initial ELISA for HIV testing: reactive Repeat ELISA (In duplicate): Non-reactive Ans:Report as nonreactive ==== Blood group that deteriorates on storage Ans: P (thats the only P in the choices) ==== Urine pH of less than 4.5 is possible in the case of: Ans:Renal Tubular Acidosis ==== Reagent strip test for glucose: Positive Clinitest: Negative Ans:Glucose is positive ==== A patient is suspected to have DM FBS: 130 mg/dL 2 hour glucose: 242 mg/dLWhat to do next? Ans:Diagnostic for DM ==== FBS: 120 mg/dL
Ans: Impaired plasma glucose ===== Reactive monocytosis Ans: Tuberculosis ==== Marker for pancreatic carcinoma Ans: CA 19-9 ==== Different Fecal fat tests are affected similarly by: Ans:Weight and extraction ==== HBa1C are not to be done in Ans:patients with condition that shortens the RBC lifespan ==== Post prandial turbidity of the serum is due to the presence of Ans: Lipoproteins ==== Comparison of two means t-test (theres a word before ttest in the choices still itsttest) ==== Urine bilirubin : None Urine Urobilinogen: High Unconjugated bilirubin: High Ans: hemolytic Anemia ==== Treated Prostate cancer patient....after 9 months, PSA level is above normal Ans: Recurrence ==== Antibody detection for HTLV I/II : positive What should you do next? Ans: Repeat test ==== Lifetime marker of MBV infection Ans: Anti-HBc ==== 33. Interpret: Anti-A - Anti-B MF A cell - B cell Ans: Bx subgroup ==== What blood type should be transfused to the baby? Mother: Type “O”, Rh Negative, with anti-D, antiC, anti-I, anti-Lea Child: Type “A”, Rh Positive, DAT + Ans: Type “O”, Rh negative without C, I, and Lea antigen ==== Only 390mL were collected after bleeding, what component can still be used? Ans: Only Packed RBC
==== 38. Which one should be deferred: Ans: Donor who received HBsAg immunization 6 months ago ==== Le (a+b-) Ans: Lea ==== PT: Prolonged APTT Prolonged TT: Prolonged Fibrinogen: 150 mg (Normal valued not given) Acute DIC ==== Normal WBC Normal Platelets Reticulocyte count 0.1% (age of patient not indicated in the problem) Pure red cell aplasia ==== Falsely decreased ESR can be due to: Ans: Eight hours standing before testing ===== Enzyme test controls: within 3 SD Non-Enzym test contro: within 2 SD What is the possible explanation? Ans: Instrument temperature too cold ==== PT: Normal APTT: Prolonged Mixing studies: APTT + Normal plasma : Prolonged Ans: Factor IX (encountered this prob in harr, kindly verify) ==== Blood collected into sodium citrate tube for coagulations studies, after centrifugation, packed red blood cells comprise 80% of the whole blood. What should you do next? Ans: Recollect blood in a tube with less amount of citrate ==== 53. TSI: Acid slant, Acid butt Oxidase positive Ans:Aeromonas ==== Indole negative MR negative LDC negative ODC positive ADH positive Ans:Enterobacter cloacae ===== How can you differentiate P. aeruginosa from other Pseudomonas species? Ans:Growth at 42degC ==== Rapid test or Legionella Ans:Urine antigen test
==== Cat-scratch disease Ans:Bartonellahenselae (Be careful P multocida is in the choice, disease is caused by cat BITE) ==== Major problem in PCR caused by: Ans: Contamination with nucleic acid ==== Computation on CSF rbc Formula =( cells counted ) (dil) / 2 (0.9) x (0.1) Ans: 222 (Forgot the given) ==== Adrenal Cushing Ans: increased cortisol, decreased ACTH ==== 2 Urine analysis (choose the disease that correlates with the UA result) Ans: Acute tubular necrosis Ans: renal calculi ==== Lupus Anticoagulant Ans: increase thrombosis ==== Pheochromocytoma Ans: test for metanephrines ==== TB testing for PPD Ans: t cell mediated type 4 hypersensitivity ==== Decreased in Sodium but all other electrolyte and serum osmolality were normal. Ans: Perform Sodium ISE ==== Carbon Dioxide in ISE measures? Ans: CO2 content ==== Cushing Syndrome Ans: Hyperglycemia ==== Iron studies ( tibc , ferritin , s iron) Ans: Anemia of Chronic Disease
==== Enzyme with 9.8 ph. What disease associated with ALP? Ans: Pagets disease ==== Cofactor to 300 enzyme Ans: magnesium ==== Description of Tap water bacillus M. Gordonae ==== DISCLAMER: the items above might come out on your exam and It would be better to verify if the answers are correct or if you have the best answer ===> (means higher points)
ASCP RECALLS: 8-08-2016
ASCP RECALLS: 08-12-2016 ASCP STUDY GUIDE:
*ACTS NOTES & RECALLS (IS/BB RECAP, HEMA, CM, INTENSIVE RECAP, MICRO-ASCP POINTERS, CBT) *POLANSKY:Quick Review Cards *QUICK COMPENDIUM of Clinical Pathology by Daniel D. Mais,MD 2nd edition *A CONCISE REVIEW OF CLINICAL LABORATORY SCIENCEby JOEL HUBBA*RD *CLS: A Bottomline Approach by Patsy Jarreau *BOC –ASCP *BAILEY & SCOTTS-MICRO-PARA-MYCOLOGY PICTURES ONLY
ASCP RECALLS: 08-12-2016 CLINICAL CHEMISTRY 1. Electrolytes serve as cofactor to more than 300 enzymes? A: MAGNESIUM 2. HBA1C result is affected in what condition? A: Hemolytic Anemia 3. Increase level of 5-HIAA, associated in what condition? A: Carcinomoid tumors / M____ Carcinoma 4. What condition associated with an enzyme has a of PH 9.8 using P-nitrophenylphosphate ? A: Pagets disease of the bone (ALP) 5. Test use to separate LDL and HDL? A: Enzyme Hydrolysis (Lipase??) 6. BUN determination measures? A: NAD 7. Albumin first to migrate at anode? A: Normal 8. Test use for Hepatic Encephalopathy? A: Ammonia (Other choices: BUN, Creatinine, Uric acid) 9. Enzyme use to distinguish Hepatiobillary disease? A: ALP 10. Tumor marker for Hepatocellular Carcinoma? A: AFP 11. TP / TP+ FN A: Sensitivity
TN/ TN+FP A: Specificity
12. Quality Assurance plan in the laboratory? A: Program that extend to the interactions of other healthcare professionals
13. RESULT of patient, What condition? Serum B1: Normal Urine Urobilinogen: Decrease Serum B2: Increased Urine Bilirubin: Increase A: Billary Obstruction
ALP: also given
14.RESULT of patient in numerical form: (Reference range given in Conventional & SI Units) Serum B1: Increase Urine Urobilinogen: Increase Serum B2: Normal Urine Bilirubin: Positive What is inconsistent with the result? A: Urine Bilirubin (should be Negative) Patient Hemolytic Anemia (Condition not given) 15. Laboratory DATA results: all INCREASE results for BUN:39+ CREATININE:400+ NA+:146, K+:__, Glucose: 46mmol/L, Osmolality: 300 ? (Consistent for Renal Dialysis patient NA+: 146? Edematous patient should have hyponatremia? ) What is inconsistent with the result? Choices: A. Na+, B. Osmolality C. BUN … 16: Test for glucose collected using a heparin anticoagulant, specimen not tested within 3hrs? what should the technologist do? Choices: A: Wrong anticoagulant use B: Separate plasma within 1 hr after the collection C: Hemolysis occurs within 3hrs D: Do nothing run the test 17: Female patient: TSH result of 0.2 __ (RR: 0.5-2.___), What is the next test should be tested? Choices: A: Free T3 B: Anti-TSH receptor (Hyperthyroidism, Graves) C: Anti-microsomal antibodies (Hypothyroidism, Hashimotos) 18: SD/mean x100 = Coefficient of Variance Data are given in tabulated form I-II-III-IV. What is the best precision? A: IV- 2. 3 (other choices: 2. 5, 2.8, 3.9) lowest CV good precision. 19: Reference range in laboratory results are from? Choices: A: Quality control sera B: Calibration of the machine C: Manufacturer package insert 20: A drug (Phenytoin) that is best evaluated at? Choices: A: peak and through state
B: Time of collection and _______ 21. Female pale patient with chronic menstrual bleeding for the past months… What result is consistent? Choices: Study Increase and Decrease ofFERRITIN, TIBC, TRANSFERRIN
MICRO-PARA-MYCOLOGY 1. Tap water bacillus? A: M. gordae 2. Organism associated with Gentamicin? A: Enteroccocusfaecium 3. Standardization of MH agar? A: adjust PH to 7.2 4. Presumptive gram stain test for Neisseria will be accepted if? A: growth of colony from Chocolate Agar Plate 5. Description of growth: 3weeks , Lowenstein agar. A:Mycobacterium tuberculosis 6. AFB STAIN PICTURE A: Mycobacterium Tuberculosis 7. A blood culture no growth for 24hrs? what to do next? A: Incubate for 21days (Organism not indicated Brucella spp.) 8. Staph. Aureusfrements? A: Mannitol 9. Butcher’s Disease, H2s+ , gram + bacilli? A: Erysiphelothrix 10. Best screening use for Rotavirus? Choices: A: Electron Microscope B: EIA 11. PCR Sequence? A: Denaturation, Annealing, Elongation/Extension 12. Description for yeast uses OLIVE OIL to enhanced structure? A: Malassezia furfur 13. Description for Micrococcus? A: Lysostaphin RESISTANT 14. Description for Zygomycete? A: Aseptate&Hyaline _____?
15. No rhizoids, description? A: Mucor 16. Description & PICTURE from Bone marrow? A: Histoplasmacapsulatum 17. Mold and yeast are best evaluated at? A: petridish growth? 18. Parasite causes autoinfection? A: Strongyloidesstercolaris 19. PICTURE of trophozoite with ingested RBC? A: Entamoebahistolytica 20.Recommendation to use/Advantage of IGRAS? Interferon-Gamma Release Assays for Mycobacterium tuberculosis? A:person who have received BCG vaccine
CLINICAL MICROSCOPY 1. PICTURE of RBC Cast? Condition associated? A: Glomerulonephritis 2. Picture A:WAXY cast 3. Final degenerative form of cast? A: Waxy Cast 4. Urinalysis results A: Nephrotic Syndrome 5. Sperm count is done? A: After liquefaction 6. Increase gram – bacilli, Nitrite: Negative, what is probable cause? A: Increase in bacteria due to nitrate reduction to Nitrogen gas
HEMATOLOGY 1. PICTURE of Spherocytes Condition associated: Hemolytic anemia, WAIHA, HTR HDN (Not included in the choice) 2. PICTURE A: Heinz bodies (please focus on Heinz bodies smear is consistent with rbc, wbc) 3. PICTURE Blood smear no platelet seen? Inconsistent?
A: Platelet 4. PICTURE from Bone Marrow stain with PRUSSIAN Blue, what condition? A: Sideroblastic Anemia 5. CBC results of patient 4 results are given Hemoglobin: inconsistently decreasing from 14-12-9.5-9, what cause? A: Lipemic sample? Other choices: wrong patient was exctracted. 6. Hookworm infection? A: Microcytic, hyopochromic 7. PICTURE: of Heinz bodies A:Antimalarial drug effect 8. Young patient ingested naphthalene ball, findings on blood smear? A: Heinz bodies 9. Hemoglobin SA trait negative at solubility test? A: Hemoglobin D (co migratior of HgbS) 10. Protein C and Protein S are? Functions & description Choices: A. Natural occur in the body B. anti thrombin III assay 11. Patient MALE 63 y/o with a CBC result: WBC: 44 Segmenters: 20+ Lymphocyte: 60-70+ Condition associated? A: Chronic Lymphocytic Leukemia? (other choices: ALL,etc., Leukemia associated in children) 12. Coumadin are? Study function & description 13. M7 or Acute Megakaryocytic leukemia? CD MARKERS? A: CD41, CD42, CD61 14. CBC results INCREASE WBC, Neutrophils, almost results are consistent with A: Leukomoid Reaction (other choices ALL, CLL, CML) 15. PLATELET Aggregation curve for Aspirin effect 2 photo optic graphs indicated: Choices: A. NORMAL ADP,Collagen, Epinephrine, etc. B. ABNORMAL ADP, Collagen, Epinephrine etc. 16.Corrected WBC count computation: Answer: 0.5 x 50/ 88+ 50 =25/138 = o. 18
IMMUNOLOGY & SEROLOGY 1. Specific IgE: A: test for direct and particular Antigen 2. CLL are? A: T CELLS 3. Patient result after 5months, What is inconsistent with the results? HBsag: NEG HBeAg: NEG Anti-Hbs:-NEG Anti-Hbe: NEG ANTI-HBC: POSITIVE Choices: A: False positive anti-Hbc, B: False Negative HbsAg, C: False NegativeHbeAg 4. CD 8 are? A: Cyctotoxic cells 5. Anti-Smith pattern? A: SLE 6. Epstein Barr Virus is associated in what condition? Choices: RA, SLE, etc.. 7. Newborn tested for Toxoplasma gondii negative at IG G: What should next thing to do? Choices: A: TEST maternal serum B: Repeat the test using new sample from the newborn BLOOD BANK: 1. D mosaic individuals? A: persons whose rbc lack components of D-antigen 2. Proper storage of FFP given -35C? A: -65C (-18 Not given) etc. 3. CPDA is preferred because? A: 35days storage 4. Anti H reacts LEAST with? A: A1 5. Type O individuals has? A: Anti-A, Anti-B, Anti A-B
6. Enhanced by enzyme? A: anti-Jka (other choices MNS, Duffy destroyed by enzyme) 7. Autologous Donor collection at JANUARY 1 9AM WB was stored at 4 degreeC –At 1PM, then on JANUARY 5technologist added40% glycerol. What is the expiration of the blood? Choices: A. January 1, for 1 year C. January 5, 1 year B. January 1, 10years D. January 5, 10years 8. Screening cells: AT 37C Screening cells I : O Screening cells II: O Anti-A1: + Antib B: +
After washing with LISS Screening cells: O Screening Cells II: O Anti-A1: O Anti B: O
What should the technologist next to do? Choices: a. Report the result b. Repeat the test with new Screening cells c. Use enhancement media 9. ANTIBODY PANEL testing on ANTI-P and Anti-K, ANTI-E 10. Almost 10 QUESTIONS encountered using ADSORPTION, ELUTION, ANTIBODY PANEL TESTING Blood group causes DOSAGE effects 11. Kleihauerbetke test use for? Between Baby and Mother. 12.Mother has High anti-D, Baby was jaundice, HDN? What cause? CHOICES: A. False + DAT, B. False – DAT, C. False: + antibody result etc. D. 13.Administration ofRhogam given to mother who is? A: no anti-D, baby is rh +
DISCLAMER: The items above might come out on your exam and It would be better to verify if the answers are correct or if you have the best answer ===> (means higher points).