Mintyskate.com



Chemistry: know the picture of protein electrophoresis: importantNephrotic SyndromeHepatic CirrhosisCortisol ?—— ?inc in Cushing syndrome, dec in Addison’s dse.Acid base balance: remember the NV and you can easily answer the question. IF Respiratory acidosis, resp. alkalosis, metabolic acidosis, metabolic alkalosisph ? ? ? ?= 7.35 – 7.45p CO2 = 35 – 45HCO3 = ?22-26computation: How many ml of 95% alcohol are needed to prepare 100 ml of 70 % alcohol? ? answer = ? ?73.7 ml ? ?use the formula VI C1 = V2 C2reason for synovial fluid turbidity: crystalproteinimmunoglobin9.Breast CA tumor marker: For advanced CA : They may pick one from this marker, remember this.CA 15-3CA 27-27Truquqnt R/AFor ?Primary Breast CA, Recurrent or metastatic:Estrogen and progesterone receptorsHER -2 – Neu10) Alpha HCG marker of malignancy:a) choriocarcinoma ?——- Bb) testicular CA ——- alpha & Bc)??pancreatic CA ?——– alpha ?If CHON elevation from BI B2 and gamma are to be merge together what immunoglobulin will itindicate? a) IgM , b) IgA, c) IgD, d) Ig E ? ? Which one of the following would change if remove out the buffy coat in lipemia? sorry i don’t know the answer.I guessed ?triglycerides.What is located between beta and gamma fraction? ? CRPHow does ISE measure CO2? ?gas sensing electrodeWhat is osmolality? a measure of what look for the answerHypothyroidism ? ? ?—- know the result of ? ? ? ? ? T4 ?dec ? , ? T3 ?dec, ? ? ? TSH ? inc.Transferrin – glycoproteins that binds with iron.What is the result of transferrin in Hemolytic anemia? ? INCREASERemember this decrease in iron deficiency and chronic illnessesHaptoglobin – proteins that binds with free HGB What is the result of haptoglobin in hemolytic anemias? ?Decreaseknow how to compute LDLEmphysema ——- alpha 1 antitrypsin deficiencypheochromocytoma——– inc in ACTHeffect of blood sample exposure to airEffect of refrigeration to blood glucoseMicrobilology:What is the biosafety level and biologic safety cabinet used for poxvirus?answer: Biosafety level III and Safety cabinet IIColumbia colistin- nalidixic acid agar is a———– selective typeEnrichment medium for isolation of Legionella ? ? ———– Buffered charcoal yeast extract agarsome of the choices Regan lowe, tindale agar , Loeffler medium ,read what is this for they might change the question to this.Ampicillins are beta – lactam that act on: cell wallquality test for autoclave———– spore test weekly with B . stearothermoSchuffner dots , where do you see this?Vi antigen ——Salmonella typhiEpstein – Barr Virus- ?Infectious mononucleosisCytomegalovirus ( CMV)- disease of immunocompromised hostsBerkholderia cepacia ————- associated wt pneumonia in CYSTIC FIBROSIS pts.Borrelia burgdorferi ? ————– causes Lyme diseaseRicketsia ? ? ?———————— ? Weil Felix ReactionCryptococcus neoformans ? —— India inkVirion —— ? ?complete virus particlewhat is interferon?What is the meaning of beta and gamma zone merge? hemolysis, complete rupture of RBCspecific test for E. Coli———– Indole testread what organism seen in CSF as to age of the patient . this is a case which you will identify the organism .picture of sporothrix schenckiiHematology:auer rods seen in —————–AML (acute myelocytic leukemia) KNOW THE PICIdentify the picture ?and know the disease ass wl it:hypersegmented neutrophilpappenheimerDohle bodiepromyelocytesickle celltear drop cellspseudo pelger huet pictureBasophilic stippling picture and ? ass diseaseSmudge cells ——- seen in what kind of leukemia (CLL)HgB electrophoresisALL ( acute lymphocytic leukemia) ———-most common in childrenAcute leukemia ——— ?many blast cellsESR inc —– tilted tubemanual white blood cell count——– acetic acid is used as diluentosmotic fragility—— inc in hereditary spherocytosisPT-detects deficiencies in extrinxic and common pathways; use to monitor coumadin theraphyAnti thrombin III ? ——- heparin co factor; deficiencies ass. wl thrombosisInc LAP -seen in polycythemia vera and leukemoid reaction ? -dec in CMLWhat is Bernard – Soulier SyndromeWhat is Von Willebrand diseaseAML- Sudan Black (+), CAE (+), peroxidase (+); Auer rods - AdultALL- (+), Oil red O (+);? ChildrenCML - ?Low LAP score; 10% blasts in the BM, plenty of tear drop cellsCLL???? -????? presence of?smudge cellsPictures of abnormal inclusions in RBCPlatelet disorderBLOOD Banking:Know how to detect antibodies in BLOOD Panel: I got 1 question onlyFormula how to give Rhogam1 vial of Rhogam = 30 IU of fetal blood ; 1 vial of Rhogam = 15 IU of whole bloodto covert ug to IU ————- ug x 5 = IUEx: 6 ug x 5 = 30 IUAntigens destroyed wl the use of enzymes: ? ? ? ?M ? ?N ? ?Ss ? DuffyAntigens enhanced ?? ? ? ? RH ? ? Kidd ? ?Lewis ? ? Pphenotyping of Rh antigensKnow the cold antibodies and warm antibodiesLeukocyte reduced RBC’s ———— given in pt wl history of febrile reactionRead changes in stored blood what happen?Read blood donor requirement?panel shown cells 1-10 ?were positive, but cell 3 & 6 were enhanced and agglutinated, what antibody is it: a) fya*B) EC) MN, S etcII) this panel was very confusing b/c from Coombs it was anti-C , but in AHG all cell were reacting (+), except 1cell ?(-) in middle probably cell 6 or 7. But it didn’t ask which antibody it is , rather which cells should be used.Cold agglutinationin syndrome ( I, P1 etc)>how mucin clot in synovial fluid—– I chose acetic acidwhat does H??EK group includeImmunology:Auto – antibodies :anti smooth muscle ——– auto immune heaptitisanti -ds DNA ?—————- ? SLEanti -Mitochondrial ?——– billiary cirrhosisInterferonsProzoneOuchterlony TechniquenephelometryNon treponemal test for SYIndirect Flourescent Antibody ——– T. pallidumHeterophile Antibodies —— test for infectious mononucleosisAnti HBs ———- recovery and immunityWester blot ———— confirmatory test for HIV11) Know serial dilution :: ? ?1:2 ? ? ? @ 6th test tubeWhat is anamnestic?Croprecipitate —— know expiry date , a case study to answer when to give when pooled.what is hh?what causes false + to HIV?13)Principle of agglutinationfloccullationprecipitationENA + , what does it indicaterheumatoid diseasedetect extractable ?antibodies (ant-sm, anti- RNP, anti-ssa etc)confirm SLEUrinalysis:Read about ClinitestCase study: how to know the dx as ?—-pyelonephritis, cystitis, glumerulonephritis,crystal in acidic and alkaline urine: pictureWhat causes alkalinity of urine?Lots of Question on ISERead on synovial fluid——- what causes turbidity?READ on principle of instrumentations: Spectrophotometry, Nephelometry,Coulometry, etctotal Bilirbin——– increase #Serum bilirubin—-increaseUrine bilirubin——increaseUrine urobilirubin——absentFecal urobilirubin—–absentAST. ? ——– increaseALP ————increasehepatocellularhemolyticobstructiveTroponin T normal, LD abnormal: MIPicture of Monoclonal Gammopathy in electrophoresisBeta HCG marker of malignancyAnion GapTCBS – V. choleraPositive control has weak result, Neg control has negative result, patient result is positive, what to do? – My answer: Perform titer on positive control to identify valuesResult of haptoglobin in hemolytic anemia: DecreasedEffect of blood sample exposure to air: dec CO2 inc pHP. vulgaris- indole pos; P. mirabilis- indole negCystic Fibrosis associated with: BulkholderiaPicture of normocyte in Di Guglielmo’s SyndromeCell seen in myelofibrosis: Teardrop cell (Dacryocyte)Hemoglobin electrophoresisMany blast cells present in bone marrow: AML?Anti-thrombin III: Heparin co-factor; deficiencies assoc. with thrombosisI got 2 blood panelsRhogamAnti-I: Cold agglutinin diseaseQuestion about Kidd antibodyKnow cold and warm antibodiesFFP after thawing: 6 hours expiry at 4 degree C.Cryoprecipitate after pooling: 4 hours expiryAutoantibodiesOuchterlony techniquePresence of anti-HBc only, what will be the problem? My answer: repeat HBsAgAddition of Bromthymol blue, which substance will become positive? My answer: Reducing sugarsUse of caffeine benzoate/methanol in bilirubin: AcceleratorIncreased anion gap due to: Metabolic? acidosisABO discrepancyRIST: total IgE; RAST: specific IgEStudy about fluorescenceBirefringent crystal in synovial fluid causes what: Pseudogout (Calcium pyrophosphate)What to add to check mucin clot in synovial fluid: Glacial acetic acidMay CSF infection, sensitive naman daw sa antibiotic (I forgot what antibiotic), pero bakit hindi daw gumagaling? My answer: low MICBest method to diagnose Rickettsia infectionMucor: No rhizoidsFungus that resembles chandelierBacteria present after jaw surgery: VeilonellaDescription of NocardiaPrinciple of fluorometryMeaning of coefficient of variationSperms attached to each other, either head to head, head to tail, etc. What discrepancy?Collection of blood gas sampleDifference between Citrobacter and SalmonellaHemoglobinuria will only be seen if: Haptoglobin is depletedContact lens parasite: AcanthamoebaConsistent SG in urine of 1.010: Diabetes InsipidusSG of 1.050 presence of: Abnormal solutesProteins nearest to cathode: Gamma and BetaClinical findings of patient with Lactic AcidosisHow to resolve if RBCs are stained blue in Wright’s Stain?Parasite that causes autoinfection in an immunocompromised patient: S. strercoralisRBC morphology of Hookworm infectionCSF with increased Neutro: BacterialTap water bacillus: M. gordonaeBiochemical reaction of Aeromonas hydrophiliaDecreased Iron and decreased TIBC but normal iron stores?? My Answer: Anemia of chronic diseaseAlpha Thalassemia may consist of what: Bart’s HgBCofactor of more than 300 enzymes: Magnesium and Zinc (if both present, answer Mg)Zinc protoporphyrin is never tested in children on lead poisoning, why? My answer: low sensitivityMeaning of creatinine clearanceParameters for accurate monitoring of Phenytoinaerobic gram negative cocci isolated after jaw injury .veillonellawhat is seen in chronic active hepatitis? anti-smooth muscle antibodywhat is true about B lymphocytes?has immunoglobulin surface markerin cases of pancreatitis, normal amylase maybe seen indecreased triglyceridesafter ingestion of napthalene balls, what should be the expected blood picture? {oxidizing agent} HEINZ BODIESpicture of microsporum or epidermophytona zygomycetes without rhizoids mucorHbA1c is decreased in what case? iron deficiency ?anemiawhat is measured if your substrate is p-nitrophenyl phosphate in paget’s disease? ALPwhat is measured in the urease method in determination of BUN? NADthe sputum of patient with cystic fibrosis should be cultured forburkholderia cepaciawhat tests that will differentiate morganella from providenciaswarmingthe virulence factor of neisseria meningitides: polysaccharide capsule, pili, endotoxinLAP score=0 chronic myelogenous leukemiaacute pancreatitis- lipase remains elevated up to seven days, amylase =normalin doing LAP score you see eosinophilia what should you do?do not include eosinophils in LAP score1.How is Calcium measured in ISE? Ionized CalciumKnow the picture of:E. coli:E. nana:E. histolytica:Maximum interval which a recipient sample maybe used for crossmatching if the patient has been recently transfused, has been pregnant???3 daysRefrigeration of blood samples what is affected? inc potassium, ?dec glucose ,? dec enzymes tryglicerides not affectedRgt strip (-), Ictotest (+), What does this mean?Difference in sensitivity levelsRgt strip can detect? 0.5 mg /dl of bilirubin while Ictotest from 0.05 -0.1 mg/ dl.Ictotest? is a tablet test based on diazotization;? (+) blue or purple color in 60 seconds6.What is affected in lactic acidosis?a form of metabolic acidosisdec PH,? inc Lactate,? dec Oxygendeep and rapid breathing , vomiting, and abdominal paincaused by diabetic ketoacidosis, liver or kidney diseases, medication ( phenformin), HIV??drugs ( antiretrovirals) , arsenic poisoning7.Procedure for Lactic Acid testused as an indirect assessment of oxygen level in tissues and to determine the cause of ????lactic acidosis8. Culture media for Legionellabuffered charcoal-yeast extract (BCYE) agar media9. CPT blood was drawn @ 10 Am, pooled @ 11:30 am. Patient has xray @ 2 pm, what will you do with the product?transfuse the blood before xrayEnzymes:Destroy? =???M??? N??? S??? DuffyEnhance =???Rh?? Lewis?? I?? KiddCold Antibodies:??? ??????M ???N? ??????Pi ???????I?? ??????Lewis? SWarm Antibodies : ?????RH? Kell???? Duffy? Kidd11.False (+) for RPR? ( Rapid Plasma Reagin ) –?Non treponemal test for RickettsiaLERFIMInfectious HepatitisLeprosyMalariaPregnancyAging processPneumococcal pneumoniaRead about PCRRead? about RIA – radioimmunoassayStudy ANA test Pattern with picture:This is an example of a mix of?homogeneous?and?speckled ANA patterns.In this sample notice the speckled ANA is the dominant pattern in the interphase cells (a) and some speckling in the area outside of the chromosomal area of the mitotics (b).Also notice the smooth staining of the chromosomal area of the metaphase mitotic cells (c). This represents the presence of a homogeneous ANA pattern.Peripheral (rim)?– the central protein of the nucleus is only slightly? stained or not stained at all , but nuclear margins fluoresce strongly and appear to extend into the cytoplasmi.e.? anti – DNAassociated? with?SLE?in the active stage of the dis. and in?Sjogren’s dis.?Homogenous ( diffuse)?– the whole nuicleus fluoresces evenlyi.e.? anti – DNAanti – Histoneanti – DNPtypically seen in Rheumatoid disordersInc. titres are suggestive of SLEDec. titres maybe found in SLE, RA, Sjogren’s syndrome and Mixed Connective Tissue Dis. ( MCTD)Speckled? -?? a grainy pattern? with numerous round dots of nuclear fluorescence, without staining of the nucleolii.e. anti – RNPanti – Sm??? ……. Specific for SLEoccurs in the presence of antibody to any extractable nuclear antigen? devoid of DNA or histonethe antibody is detected against the saline extractable nuclear antigensantiobodies to Sm? antigens is highly specific for SLE and as a “ marker “ antibody.Nucleolar?-? a few round, smooth nucleoli that vary in size will fluoresce when examined with UV.i.e. anti- nucleolarpresent in 50% with Scleroderma, Sjogren’s syndrome, SLEAnti centromere? -?? discrete and speckledHighly selective for CRESTPrimary Billiary CirrhosisIn order to understand the ANA test (antinuclear antibody test), it is first important to understand different types of antibodies.Antibodies?are proteins, produced by white blood cells, which normally circulate in the blood to defend against foreign invaders such as bacteria, viruses, and toxins.Autoantibodies, instead of acting against foreign invaders, attack the body’s own cells. This is an abnormality.Antinuclear antibodies?are a unique group of autoantibodies that have the ability to attack structures in the nucleus of cells. The nucleus of a cell contains genetic material referred to as DNA (deoxyribonucleic acid).An ANA test (antinuclear antibody test) can be performed on a patient’s blood sample as part of the diagnostic process for certain autoimmune diseases.How the Test Is PerformedTo perform the ANA test, sometimes called FANA (fluorescent antinuclear antibody test), a blood sample is drawn from the patient and sent to the lab for testing. Serum from the patient’s blood specimen is added to microscope slides which have commercially prepared cells on the slide surface. If the patient’s serum contains antinuclear antibodies, they bind to the cells (specifically the nuclei of the cells) on the slide.A second antibody, commercially tagged with a fluorescent dye, is added to the mix of patient’s serum and commercially prepared cells on the slide. The second (fluorescent) antibody attaches to the serum antibodies and cells which have bound together. When the slide is viewed under an ultraviolet microscope, antinuclear antibodies appear as fluorescent cells.If fluorescent cells are observed, the ANA test is considered positive.If fluorescent cells are not observed, the ANA test is considered negative.ANA TiterA titer is determined by repeating the positive test with serial dilutions until the test yields a negative result. The last dilution which yields a positive result (fluorescence observed under the microscope) is the titer which gets reported. Here is an example:1:10 positive1:20 positive1:40 positive1:80 positive1:160 positive (reported titer)1:320 negativeParts of an ANA ReportAn ANA report has three parts:Positive or negativeIf positive, a titer is determined and reportedThe pattern of fluorescence is reportedSignificance of ANA PatternANA titers and patterns can vary between laboratory testing sites, perhaps because of variation in methodology used. These are the commonly recognized patterns:Homogeneous?- total nuclear fluorescence due to antibody directed against nucleoprotein. Common in systemic lupus erthematosus (SLE).Peripheral?- fluorescence occurs at edges of nucleus in a shaggy appearance. Anti-DNA antibodies cause this pattern. Also common in SLE.Speckled?- results from antibody directed against different nuclear antigens.Nucleolar?- results from antibody directed against a specific RNA configuration of the nucleolus or antibody specific for proteins necessary for maturation of nucleolar RNA. Seen in patients with systemic sclerosis (scleroderma).Positive ANA Test Result ExplainedAntinuclear antibodies are found in patients who have various?autoimmune diseases, but not only in autoimmune diseases. Antinuclear antibodies can be found also in patients with infections,?cancer,?lung diseases, gastrointestinal diseases, hormonal diseases, blood diseases,?skin diseases, and in elderly people or people with a family history of rheumatic disease. Antinuclear antibodies are actually found in about 5% of the normal population, too.ANA test results are just one factor considered when a diagnosis is being formulated. A patient’s clinical symptoms and other diagnostic tests must also be considered by the doctor. Medical history is also significant because some prescription drugs can cause “drug-induced antinuclear antibodies”.Incidence of ANA in Various DiseasesStatistically-speaking, the incidence of positive ANA test results (in percent per condition) is:Systemic lupus erythematosus (lupus or SLE)?- over 95%Progressive systemic sclerosis (scleroderma)?- 60-90%Rheumatoid arthritis?- 25-30%Sjogren’s syndrome?- 40-70%Felty’s syndrome?- 100%Juvenile arthritis?- 15-30%Subsets of the ANA tests are sometimes used to determine the specific autoimmune disease. For this purpose, a doctor may order anti-dsDNA, anti-Sm, Sjogren’s syndrome antigens(SSA, SSB), Scl-70 antibodies, anti-centromere, anti-histone, and anti-RN.The ANA test is complex, but the results (positive or negative, titer, pattern) and possible subset test results can give physicians valuable diagnostic information.Several different serum tests are used to detect autoimmunity.? These are conditions where the immune system acts directly against the bodys own tissues.? One test, the ANA, or anti-nuclear antibody test, detects antibodies that are directed against various components of the nucleus of the cell.? These include antibodies that have been formed against double-stranded or single-stranded DNA (two ways in which the cells DNA can be found in the serum after being released from old and dying cells).? Other components of the nucleus such as histones are also released from old cells and can also become targets of the immune response.? When they appear they may be markers for excess or inappropriate immune responses directed against ones own tissues.? Physicians in our group test for various autoantibodies in order to characterize patients as those who might have a tendency for autoimmune responses.? Those who test positive have been found to have a higher risk for recurrent pregnancy loss and are more likely to benefit from therapeutic interventions?(see diagram).Consequences-Antinuclear Antibody (ANA) positive, speckled pattern.-Autoantibody to DNA leads to inflammation in the placenta.-Autoimmune disease screening in the woman is negative (No evidence of lupus or rheumatoid arthritis).A blood test determines the presence of antibodies to polynucleotides, histones and DNA. This process involves running 27 different tests on a sample of blood.The presence of antibodies is also tested for by doing the ANA test. This is a less sensitive test but one that many doctors have already done on their patients before we ever see them.The test is reported as a titer and a pattern. Any titer above 1:40 is significant. The titers can get into the thousands such as 1:2,500. This simply means that the test is positive when the blood serum is diluted many times.The pattern is reported as homogeneous, nucleolar or speckled:-Homogeneous: the antibody is to the ss DNA or ds DNA.-Nucleolar: the antibody is directed to the polynucleotides.-Speckled: the antibody is directed against the histones.Some women demonstrate a mixed pattern of speckled/homogeneous. These same antibodies appear positive in women with lupus, rheumatoid arthritis, Crohn’s disease and other autoimmune diseases. They are usually in high titers. Pregnancy losses, infertility and IVF failures cause the titers to be much lower and a low positive titer does not mean that you have or are getting an autoimmune disease; however, this is ruled out during the testing.In women with autoimmune diseases these antibodies cause inflammation in joints and organs. In women with no autoimmune diseases but a positive antibody, the antibody causes inflammation around the embryo at the time of implantation or in the placenta after implantation. This inflammation is exactly the same as occurs if you get a splinter under your fingernail. The tissue around the splinter gets hot, red and swollen and it happens quickly.15. Read about MIC for susceptibility test to report in microbiology16. Epstein Barr Virus, How to detect? Know the procedure.infectious? mononucleosistest to detect:Mono spotCBCEBV serologycan help detect if an individual has an infection due to EBV, and if they are proneto future? infections due to dormant virus.VCA-IgMVA-IgG? Tests ———- help to identify current infectionEA-DEBNA Test ————– help to dx? future infection due to an existing dormant virus.throat cultureLiver profile17.HgA1c 5, blood gluscose 200 gm/dl. What does this mean?Glucose normal for the past month, currently high.18. Know how to answer acid /gas case study.19. 10% sodium hypochlorite –?for cleaning surfaces20. Know how to identify pictures of LeukemiasALLAMLCLLCMLIdentify ABO discrepancy case studywhat to do next-what is causing the discrepancyIdentify Enterobacteria organism.:??Use the flash cardEKE?? ESCP?? KES?? PMP?? PMPK?? SKY?? YESC?? KEEPS?I?? M? V? C:coli?????????????? +? +?? -??? -KES???????????????????? -?? -??? +?? +Shigella???????????? +? +?? +?? +Salmonella?????? -??? +?? -??? -Edwardsiella??? +??? +? -??? -Identify picture of microorganism.Gram (+)? or gram (-)Effect of exposure of blood to air– C02? dec, PCO2 dec,????? PH incdec Ca,? dec acid phosphatase,? dec? glucose,? dec bilirubin17 ketosteoid is produced inAdrenal glandRead on Weil Felix Reactiontest for Rickettsia—— Typhus feverthis test involves testing of certain strains of Proteus vulgarisRead on SyphilisTreponema pallidumReagin? – non treponemal antibodiesDarkfield? Microscopy? -? test of choice for patient with SY-? Non Treponemal Method:??? -? a flocculation ( or agglutination ) test1)????? VDRL?? -??? can be used to test for CSF2)?????? RPR??? -??? contains charcoal ; can’t be used for CSF ; Causes of False (+)LERFIMInfectious HepatitisLeprosyMalariaPregnancyAging processPneumococcal pneumoniaSteps ?in agglutinationSensitization=? 1st?step in agglutination=? physical attachments of antibody molecules to antigens on the RBC membranesLattice Formation=? establishments of cross – links between sensitized particles and antibodies resulting in aggregation (clumping), is a much slower process thant the sensitization phaseDilution:1st?tube????????????? 2nd?tube???????????? 3rd?tube??????????? 4th?tube?????????? 5th?tube??????????? 6th?tube0.1? Serum????????????? 0.5 serum0.9 diluent???????????? 0.5 diluentWhat is the dilution in the 6th?tube??????1:320What causes synovial fluid turbidity?Choices:???? a)???? Fibrinogen ??????????b) crystals????????????c) immunoglobulins?????? d) fibrinogen IIISF — Increase? content of hyaluronic acid ( mucin) ?Mucin clot test — precipitation of SF with weak acetic acidImmunoglobulins , immune complexes, complement? —— produced by cells in the imflamed jointsNormal SF does not clot , viscous, and clearSF that clots suggests the presence of synovitis and is cause by fibrinogenGreen top tube , blood is collected and refrigerated for 3 hours. Should you not accept?My answer:???plasma should be separated before refrigerationMalabsoption test????????????Fecal fatFungus picture?? My answer?penicilliumGroup of organism for HACEKHaemohilus? ( H . parainfluenza, aphrophilus, paraphrophilus )-? Actinobacillus?? ( actinomycetemcomitans )Cardiobacterium hominisEikenelle corrodensKingella? ( K. kingae)Prevents replication of virus? InterferonResult of hemodilution?low serum electrolytesAs a result of hemolysisfreezing can cause hemolysisdec K, dec LDH, dec AST, normal uric acidautomated method for measuring Chloride which generates silver ions in the reaction.cystic fibrosisCoulometryDiagnosis of a case study:GlomerulonephritisPyelonephritisCystitisFetal lung maturityWhich of the following methods is?MOST reliable for determining the appropriate dosage of Rh immune globulin to?give?to an identified Rh immune globulin candidate after delivery?Flow cytometry?is the most reliable method of those listed. It is a quantitative method, whereas Keihauer-Betke and the rosette test are very subjective tests.Hemoglobin electrophoresis?uses an electric field to separate hemoglobin molecules based on differences in net electrical charge. The rate of electrophoretic migration is also dependent on the ionic radius of the molecule, the viscosity of the solution through which it is migrating, the electrical field strength, temperature, and the type of supporting medium used.Thin-layer chromatography?is particularly useful as a tool in the identification of:DrugsKnow Blood PanelKnow Paternity TestingStudy Weak D in Blood BankingMachines set @ 150 wavelenght, then wavelength @ 0 when used. What is the problem?Read on immunoassayB lactam Test ?——??? grm (-)Study Anion GapTroponin –? enzyme? in MI? elevated the longestStudy MI enzymesStudy Ferritin and transferring levels in :HemochromatosisIron deficiency anemiaAnemia of chronic diseasesThalassemiaMonoclonal? graph . What to do next?multiple myelomapresence of Bence jones protein in the urinemonoclonal gammopathyBone marrow cytology in a dog with multiple myeloma. There are large numbers of plasma cells (*) in the aspirate, some of which are binucleate. Hematopoietic cells (both myeloid [M] and erythroid [E]) are found in normal numbers and maturation sequence.Myeloma Cells?? with rouleax cellsLabs: FindingsChemistry panel with?Serum CalciumSerum Protein Electrophoresis?and?Urine Protein?electrophoresis for Monoclonal PeakM Protein in either serum or urine: 97% of patientsSerum M Protein by electophoresis (82%) or immunofixation (93%)Urine M Protein by electrophoresis: 75%HypercalcemiaSerum Calcium?>11 mg/dl (present in 13% of patients)Renal Insufficiency.?????Serum Creatinine?>2 mg/dl (present in 23% of patients)Complete Blood Count?with plateletsNormochromic?Normocytic Anemia.?????Hemoglobin?<12 grams/dl (present in 65% of patients)Bone Marrow Aspiration?and biopsyPeripheral SmearMyeloma CellsRouleaux of?Red Blood Cells (ESR)-Increased >50 mm/hour in most cases (except bence-jones Myeloma)Serum ViscosityUrinalysis Bence-Jones ProteinRouleaux of?Red Blood CellsSuggested sequence of immunologic testing :?? M spike on serum protein electrophoresisSerum:-Immunoelectrophoresis-Immunofixation-Quantitation of immunoglobulins by radial immunodiffusion or nephelometryScreening for croglobulinsDetermination of serum viscosity of IgM, IgA, or IgG , or signs and symptoms suggestive ofHyperviscosityUrine:Screening of urine for increased protein, e.g. sulfosalicylic acidTotal protein assay? of a 24 hour urine specimenUrinary protein electrophorsisUrinary immunoelectrophoresisImmunofixation58. Salmonella in the diarrhea. Know how to ID.Providencia organism60. Proteus Vulgaris organism61. ?Culture media for Legionella?Hematology: Target Cells, DIC, CLL, PAS(+)&SUDAN (+)? Smudge cells,?Big PlateletInc. ESR? causes:??? Study othe causes My answer ; Inc Plt65. Rouleaux formation?? due to ?Slow or fast smearingAngle of the smearFerritin : Increase Ferritin , Normal TIBC??? ——– inflammatory process??Hereditary Chromatosis;?DNA analysis of? the following: C282Y, H63D, S65CKnow the cases for ?Deferral of blood donors: My answer:??? Pt with CMVTests affected by blood hemolysis?-???Increase:???????? K, LD, AST, Plasma Hgb-?? Decrease :????? T4-???F. Elevated:?? Phosphorus, Total CHON, Albumin, Magnesium, Calcium, Acid, PhosphataseAffected? by exposure of lights to blood: ?Decrease?: Vitamin A and B6, Beta-carotene, Phorphyrins,? BilirubinShould be wrapped in aluminum foil immediately after collection.***OK Some are these are Based Only on Mine and Others’ Reports on the Test.?The questions are randomly selected, so you never know you may end up with***You really only need the ref ranges for the common tests, it gives you the ranges for the more esoteric tests.??Know if the value given is above or below the normal values. It will be the same for the hormones & enzymes they will use elevated or increase. The important thing is to interpret them as to the disease process like in thyroid hormones. Most of the time they give the normal values with the question in parenthesis.Know the blood gas normal values.Study most common diseases : Diabetis, Liver Function, Cardiac MarkersKnow your charts enzyme elevation.Make sure you know the disease states really well…i.e. what lab tests (mostly chemistry and hematology) you would expect with various diseases…the exam has tons of questions of that kind.Know Renal water, electrolytes and acid-base balance.Master the physiology renal function.The test often gives example blood gas result and you will need to interpret.Know most common calculations in lab manual like: LDL, Anion gap, FTIThis is seen in alpha thalssemia. choices- increased A2 and F, Barts and H disease, persistence of FI got a question about “dry tap” – MylefibrosisCSF electrophoresis and multiple sclerosis. Choices- IgG Monoclonal, IgM Monoclonal, IgG Oligcolonal, IgM OlicolonalPatient comes in on a sunday and AB screen neg and receives on unit, following wednesday SC III is positive in the AHG phase. Choices- recollect, assume AB and ID for AB, perform autoabsorbtion, re-test sample from sundayknow about acquired B antigenyou perform daily maintenance and you get the message “excessive shift” for K. what do you do? Choices- Assay new control, replace membrane, recalibrate, clean ISE.Patient has been coming in the past 5 days getting blood draw and on 3/19 his hemoglobin suddenly drops. Why? Choices-lipemia, chronic anemia, iron deficiency, wrong patient. Everything else matched just hemoglobin was significantly changed.Automated hematocrit was 33.0 you perform a manual and you get 33.5. Choices- report automated result, redraw specimen, report manual, etc.bacili is seen microscopically in urine, but nitrite portion of strip is neg why?know what causes spherocytes in bloodKnow what causes false positives on urine stripknow what causes?auto?infection- strongyloides1know what enzymes are increased in biliary obstruction, hepatitis, cardiac etc.positive control for hcg is weakly pos and negative is neg. Patient result is positive. choices- release results, rerun controls with new control batch, recollect patient sample.be able to calculate half life for medseffects of sulfa drugs and what’s seen on a smearknow relative and absolute lymphstorage requirements for Cryoknow phenotypingafter getting blood thru IV what do potass levels do? decwhich worm causes autoinfection- had 2 questions, one which increases/or falsley inc hgA1c and what decreased A1c (i think Hgb S is one of the answers)- high pH and something but what enzyme (Pagets was the answer b/c ALP (Alkaline pH)- met acidosis= diabetic ketoacidosis- excess edta causes- what hepatis ag/ab will make sure vaccination has occured- which dermatophyte has antler like pseudohyphae (wtf??) got this wrong- strep a in glomerularnephritis- S. Pyogenes- burn patient w Pseudomonas aeruginosa accompany with ? another bac- moth ball intoxication will see what in RBC – Heinz Body- small qc zones b/c 1.0 mcfarland standard used- diabetes and icto test- baby w RH+ O mom w Rh- O baby need transfusion what blood should give?- teardrop RBC what disease ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download