January 2020 ASCP Exam Study Document:

BB, Chem, Heme, Micro(17-22%), UA/BF, Immuno, LabOps (5-10%)

BLOOD BANK (17-22%):

1. Adult volume  4-6L
2. TFR  any adverse event associated with TF of blood components
3. Antibodies of ABO afe unique  they are naturally occurring
4. Thawed deglycerolized, reconstituted in open system  must be used within 24hr (14days if closed)
5. First marker after exposure to HepB  HBsAg
6. Maximum WBC in leukocyte-reduced unit  5*10^6
7. Chronic transfusions  may lead to iron overload
8. Reaction at IS, variable dosage  P2 antibodies (enzymes inc activity  ABO, LIP, Rh, Kidd)
9. A2B POS  reaction at anti-A/B/D, partial reaction at A1, no reaction at B
10. Most Factor VIII concentration  cryoprecipitate
11. Reaction 5 days later than TF by Jka antibody  DHTR
12. Rejuvenation for RBC  influences the 2,3-DPG
13. Occurrences during HTR of Rh  AHG phase, Preference to double Rh, DAT+ (Rh not complement)
14. Administer RhIg  Therapeutic abortion, ectopic pregnancy, Rh+ fetus
15. Whole blood storage  temperature in 1-6C
16. Papain  Two Fab with light chain and partial heavy chain (Pepsin makes a Fab2 and Fc)
17. Post-TF, has bruising and very low platelets  PTP
18. Differentiation with Bombay and group O  done by Anti-H (Ulex europaeus)
19. FFP should be transfused within 24hrs of thawing
20. Ab/Ab  AA, BB, AB
21. For Rh- mother and Rh- fetus  check with weak D that fetus is Rh-
22. Lub  high frequency antigen!
23. AHG sera  may be Monoclonal, Polyclonal, Complement
24. Resistance to P. vivax  Those with Fy(a-b-)
25. Danger to TF patient (group O) with A blood  Patient’s anti-A destroys donor cells with consequences
26. Maximum number of WBC in 95% apheresis platelets  5*10^6
27. Which is screened only using questioning?  Malaria
28. Elder patient with no reaction on anti-A/B or A/B cells  depressed antibody production
29. Allergic reaction from RBC can be reduced  by washing the RBC
30. AB blood  not anti-A/B
31. P-value for 95% by antibody ID  3 rule ins, 3 rule outs
32. Phenotype  expression of traits
33. Acute intravascular hemolysis most associated with  TF of ABO RBC
34. When notified that donor unit tests positive for disease  look back
35. Universal donor  Group O
36. HDFN/HTR/AIHA from ab/complement to RBC  In vivo sterilization
37. For Ab screening, phase of most importance of reactivity  AHG
38. Vials of RhIg = volume of fetal blood /30mL
39. Most common infective agent through TF that results on morbidity/mortality  bacteria
40. Most associated with anti-I  CAD
41. Antibody found in virtually all sera  anti-I
42. Infant vs adult antigen  i decreases as a person matures, and I increases through adulthood
43. Most implicated in bacterial contamination  platelets
44. In newborns with reaction to Anti-A,B and NT with RBC  AB typed
45. Platelet concentrates  must maintain a pH of 6.2 or above
46. Most common type of AIHA  WAIHA
47. Non-invasive method to predict anemia in fetus  Color Doppler MCA-PSV
48. RBC gains most of its energy by  glycolytic pathways
49. Most likely to cause circulatory overlead  whole blood
50. RBC units with CDPA-1  can be stored at 35 ( 21 for CPD, 42 for AS)
51. DHTR  caused by antibodies against Kidd
52. A2 vs A1  A2 antigens are linear whereas A1 antigens are branched
53. Person that lived in the UK from 1980-1996 for 3+ months permanently deferred  from CJD/vCJD
54. AHTR based into categories  Fever, Allergic, Pulmonary involvement ( not liver failure)
55. Rejuvenation can be used  up to 3 days post-expiration date
56. Recommended by FDA to replace HIV-1 p24  HIV-1 NAT (Anti-HIV1/2 still required)
57. Basic technique to detect unexpected antibodies with reagent cells  IAT
58. Shelf life with blood and CPDA-1  35 days
59. Biggest concern for newborn infant suffering from HDFN  accumulation of bilirubin
60. Used to determine paternity  HLA
61. Question on Weiner/Fisher-Race (R0/1/2/z, r/’/”/y)
62. Control system from AHG tests  IgG sensitized red cells
63. Indications of anemia  pulse>100bpm, >30breaths/min, Hb<7g/dL
64. Offspring of AA/BB  AB
65. TRALI characterized by  respiratory distress, pulmonary edema, acute onset
66. Primary Ab response  takes about 5-10 days
67. Former patient with anti-E 4 years ago, but no longer detected  still crossmatch E negative units
68. HDFN does not occur with  mom and dad both Rh-negative
69. Ab that can agglutinate RBC in AHG phase  IgG
70. Patient with TF history of 3 units is DAT+ with IgG specificity. To ID phenotype  PCR-assay
71. Common characteristic of anti-Jka/Jkb  shows dosage
72. Positive reaction of CC after a negative AHG  validates reaction
73. Most severe type of of HTR  Anti-A, B, AB
74. Leukocyte-reduced blood product used to reduce febrile reactions  and CMV
75. Screen for FMH indicated for  weak D+ infant, D+ infant, D-negative mom
76. M. pneumoniae infections  anti-I
77. In type A blood  Anti-B
78. IS of IAT  detects clinically insignificant cold antibodies
79. Section of Ig responsible for classes  heavy chains
80. Rejuvenated blood  must be washed before administration
81. Patient sample for compatibility testing  72 hours
82. Bombay  Two h at H locus
83. 300uG of RhIg  30mL of fetal WB
84. To detect Ab on newborn RBC  perform DAT on cord blood
85. RhIg in postpartum  Passive protection
86. Bombay can’t receive Type O  due to anti-H
87. TFR work up  perform clerical check, hemolysis/icterus, pre/post TF specimens
88. RhIg  used for Rh- moms and Rh+ baby
89. HDFN monitoring and intrauterine transfusions  cordocentesis
90. Platelet refractoriness/poor response  perform HLA typing for therapeutic effect
91. Platelet antigen most encountered  HPA-1a
92. FNHTR patients should receive blood components  that are leukoreduced
93. In an emergency  give Type O, Rh negative
94. Frozen RBC can be stored for 10 years  at -65C or lower
95. Transfusion associated GVH disease  caused by lymphocytes
96. Storage of RBC  1-6C
97. TFR work up  first check for clerical errors
98. RhIg administered  prevent fetal cells from sensitizing mom
99. Computer crossmatch is acceptable if  no history and Ab screen is negative
 100. Know Fisher-Race and Weiner nomenclature
101. O+ patient with no reaction at IS has 1+ at AHG. Auto is 1+  likely warm autoantibody
102. Type AB  Reaction with Anti-A/B, no reaction with A/B cell
103. AB blood type  Reaction with Anti-A/B/AB
104. TF reaction work up  clerical checks for errors and mix up of ABO incompatibility
105. Increases concentration of platelet concentrate  centrifuge at lo speed, remove plasma, hi speed
106. Immunohematologists  blood group antigens, histocompatibility antigens, autoantigens
107. If CC is negative  repeat the procedure with new reagent and check washer
108. When making aliquots and there is a breach in tubing  expiration date of the unit is now 24hrs
109. Can an autologous donor donate?  Only when time exceeds 72 between donation/surgery
110. RBC product to prevent TFR-GVH  Irradiated RBC
111. Dolichos bifloris  Anti-A1
112. Kleinhauer-Betke  divide fetal bleed by 30, round, then add 1
113. Decreased in platelets after transfusion  PTP
114. For serologic crossmatch to be omitted  Ab screen is negative and there is no history of Ab
115. HLA matching  used for organ transplants
116. QC testing of donor platelets found  21 CFR 640.25 Platelets – General Requirements
117. For kidney transplants  ABO type is the most important factor
118. Storage temperature of whole blood  4C
119. When shown signs of fainting or syncope  apply a cold compress to the back of neck
120. If parent are group A and B  possible offspring can be A/B/AB/O
121. neonatal alloimmune TC-penia  destruction of neonate platelets by mom’s alloantibodies
122. First step of suspected TFR  step the transfusion but keep IV line open with saline
123. Associated with TF of patient lacking IgA  anaphylaxis
124. When a pack of RBC’s are split in an open system  unit expires in 24hrs
125. HLA antibodies responsible for  TRALI
126. Bombay anti-H  from Ulex europaeus
127. A person previously with a hemophiliac can donate  if last sexual contact was more than 1 year
128. Febrile NHTR increate of >1C temperature about 37C during transfusion
129. Most common cause of severe HDFN  Anti-D
130. Which is acceptable to be returned to inventory  temperature-controlled for 2 hours
131. For a 450-500mL unite  63mL of anticoagulant-preservative is used
132. Storage for FFP  -20C
133. Interval between whole blood donation  8 weeks
134. Autologous blood  tests for ABO, Rh
135. Dura mater transplant donors are permanently deferred due to  CJD vCJD
136. Positive DAT in newborn  HDFN
137. Plasma frozen within 8 hours  retain Factor VIII
CHEMISTRY (17-22%):
1. Hemoglobin Synthesis  ALA synthase, PBG synthase, protoporphyrinogen oxidase, ferrochelatase
2. Reducing sugars  anomeric C/aldehydes free [lactose, glucose, ribose’
3. 17-ketosteroid production  measures androgen production
4. Increased serum osmolarity  diabetes insipidus
5. Aldoses  sugars with terminal carbonyl group (aldehyde)
6. Hb AS  hald Hb S half A
7. Insulin  responsible for glucose entry into cell
8. GGT function  transfers GG peptides, AA, water, other peptides
9. Elevation in LD-1 vs LD-2  AMI (LD flip)
10. Respiratory acidosis  inc pCO2 and acidosis
11. Pancreas hormones  lipase and amylase
12. LDL  total cholesterol – HDL – TG/5
13. When collecting ethanol sample  avoid alcohol wipes
14. Haptoglobin  decreases when IV hemolysis
15. Hepatic disease evaluation  ALT/SGPT
16. Tumor markers  CEA(colon), PSA(prostate), b-hCG(testes), AFP(liver)
17. A1C  measures average glucose levels over 2-3 months
18. Costisol  diurnal, higher at daytime
19. Coenzyme for LD for conversion of lactate to pyruvate  NAD+
20. Renal function panel  Glucose BUN, Creatinine, Na, K, Cl, CL, CO2, Ca, Albumin, P
21. Hepatic Function Panel  ASP, ALT, ALP, TP, Albumin, Total bili, Direct bili
22. Electrolyte panel  K, Na, Cl, CO2
23. Lipid panel  Cholesterol, lipoprotein, HDL, TG
24. Transferrin  decreased during APT
25. Valpro  administered roally
26. Vitamin A  transported by retinol binding protein
27. Peak digoxin  8-10 hours after oral dose (for CHF)
28. Aminoglycoside half life  2-3 hours
29. End product of bilirubin catabolism  urobilinogen
30. Tyrosine  catecholamine and thyroid hormone precursor
31. Creatinine clearance  (UV/P)* 1.73/SA = 72mL/min/m2
32. Exchange mechamism in RBC  chloride and decarbonate
33. Hemoglobin  8 ALA
34. Thrapeutic Drug monitoring  perform in heparin tube
35. Chylomicrons  formed by TG
36. Metabolic alkalosis  elevated pH, inc bicarbonate, normal PCO2
37. Treatment for COPD and athsma  theophylline
38. Alipoproteins  essential for lipid metabolism
39. Isoelectric point  when pH below, protein will be positively charged and move to cathode
40. Cyclospoirine elvels  measured with whole blood
41. Diabetes  Mellitus (fasting >126mg/dL, post-prandial >200mg/dL)
42. Wilson’s disease  decreased serum copper, low plasma ceruloplasmin
43. Centrifugation delay: Increased (K, ALT, AST, creatitine)
44. Centrigue delay: Decreased (Glucose, Ionized Ca, Bicarb, Folate)
45. Pernicious anemia  from lack of IF, cobalamin deficiency
46. Hemoglobin electrophoresis  separated by electrical charges
47. NaF  inhibits glycolysis
48. CYP450  able to make compounds more water soluble and enhance excretion
49. Uric acid  gout
50. Vitamin def  A(blindness), E(hemolytic acemia, RBC frag, D(rickett’s/osteomalacia), K(hemorrhage)
51. Hemolysis  increase K, Mg, Iron, TP
52. Marasmus  calorie deprivation (Kwashiokor is protein deprivation)
53. Diabetes  HbA1C>6.5^, FPG>126mg/dL, GTT>200mg/dL (sheen over 45 every 3 years)
54. Glucose  in whole blood is 11% lower than in plasma
55. Macroamylasemia  inc serum amylase and N/low urine amylase
56. NHLBI/AHA metabolic syndrome  FBG, TG, HDL-C, waistline, high BP
57. Down’s syndrome  assessed by hCG, inhA, AFP
58. Hemiacetyl  carbonyl and alcohol group
59. LD polypeptides  LD2(HHHM), LD3(HHMM), LD4(HMMM), LD5( MMMM)
60. Blood buffer  from bicarbonate and chloride
61. Immunoassay for hCG  tests for the beta subunit of hCG
62. Acute phase protein  A1A, CRP, Fibrinogen
63. Elevation of CK  DMD, CV accident, or exercise
64. Cutaneous porphyria  porphyria cutanea tarda, (congenital) erythropoetic proto/poryphia
MICROBIOLOGY [[[internally screaming]]] (17-22%):
Preanalytic Procedures:
1. Specimen Collection/Transport:
a. Malasezzia furfur  laid in EVOO
b. Haemophilus  need to be grown on chocolate, not SBA!
c. Acridium orange  AO powder + Na acetate buffer, determines bacteria in smears
d. OK for anaerobes recovery  swabs from deep sub-cuts, needle asp (ana-E-swab), Syringe asp
e. C. dificile culture  needs CCFA, culture is forever, doesn’t differentiate
f. Protozoal parasites that do not produce disease  commensal
g. Coccidioies immitis  cobweb mycelium, irregular sized spherules into tissue
h. Cyst lacking chromatin  E. nana and I. bustchlii
i. Scistosoma mansoni  lateral spine, causes bilharziasis
j. Microsporum auduoinii  Wood’s lamp florescence from tinea ciptis
k. Vibrio cholerae  gray-yellow colonies, curved G- bacteria
l. Pinworm  30x5-um with flattened bean egg
m. Gardnerella vaginalis  HBT agar
n. Fusarium  macroconidia banana shaped, orange/rose color
o. Capnocytophagia ocharcea  gingivitis fingerlike projections
p. KOH prep  fungal elementa (A. fumigatus)
q. Bordatella pertussis  Bordet gengou
r. Protoxoa  stained by trichrome
s. Enterobact  G- bacilli, glu ferm, motile (exc KSY), CTC ox (exc ples), nitrai (ex photo/zeno
t. Anaerobis panel  SBA, chocolate, MacConkey (not CNA)
u. Kinyoun acid fast  mycobacteria via mycolic acids
v. Indicators  MAC(neutral red), XLD(phenol red), EMC(myosin Y), HE(BB)

IMMUNOLOGY (5-10%):
1. Zones  Prozone(Ab excess) and Postzone (Ag excess)
2. Innate immunity  skin, mucus membranes
3. Vaccination of HBV  HBsAg-, Anti-HBc-, anti-Hbs+
4. Breast cancer  tumor markers of estrogen/progesterone receptors
5. Light chains  kappa and lambda
6. RPR syphilis tests FP  caused by infectious mononucleosis
7. ANA  SLE, speckled (with high titer)/homo// CREST: speckled, Scleroderma: nucleolar, Sjogren: peri
8. IgG  half life of 20days, binds with neonatal Fc
9. AIDS  decrease in CD4
10. Flow cytometry  HIV, leukemia, lymphoma
11. MHC  1(HLA-A/B/C, CD8), II(HLA-DR/DP/DQ CD4), III (complement/cytokines)
12. TORCH panel  T. gondii, Other viruses, Rubella, CMV, Herpes
13. Syphilis confirmatory  FTA-ABS
14. Humoral immunity  antibody production
15. Treponemes  darkfield microscopy
16. Hapten  nonimmune material that can elicit immune response when bound to carrier protein
17. Cytokines from activated T-cells  IL-2, 3
18. Representative assays in trepenomal methods  Chemiluniescent, ELISA, FTA-ABS
19. Syphilis stages  1(chancre, contagious), 2 (rash), latent (non-symptomatic), 3 (destruction)
20. Central tolerance  cloncal eletion (T-cells) and editing (B-cells)
21. Immunogenic  proteins, carbs, lipids
22. PPD testing  targeted tuberculin testing
 23. Activation unite in classical complement  C4/2/3
24. SCID  reduction/dusfunction or T-cell, B-cell, NK
25. Monoclonal antibody production  fusion of Ab specific lymphocute and myeloma cell
26. Best diagnosis for RMSF  IFA testing
27. Cytokines  soluble protein that regulated immune response
28. Second line of defense  phagocytic cells, complement
29. Sepsis  inc HR, leukocytosis, inc temperature
30. Blood specimen collection for Ab conc of infectious diseases  2 weeks apart
31. H50  CH50 (classic, 50%RBC lysis) and AH50(alternative) ) pathways
32. For FANA testing  may demonstre anti-mito Ab in primary biliary cytosis
33. SLE  positive ANA, circulating immune complexes, increased ESR, dec complement
34. Tuberculin skin test  read after 48-72
35. Binds IgE antibodies  basophil
36. PCR hybridization  comp bases link (H-bond), annealing, ssNA ds, can happen between D/RNA
37. Risk factor GVHD  source of immunocomp lymphs, HLA differences, inability to reject donor lymph
38. CA-125  ovarian cancer (CA15-4/27-29 is breat cancer)
39. CEA  fetal, colorectal, lung, breast, GI tumors
40. Specific allergens  RAST
41. Vaccine types non-experimental  live attenuates, inactivated, toxoid (Experimental, RV)
42. Gaucher’s disease  monocyte-macrophage
43. CD5 antigen  from mature T cells
44. HepB timeline: HBsAg  HBeAg  anti-HBe  anti-HbC
45. HepB: Vaccine (anti-HbS only), Infection (HBs/cAg) and anti-Hbc
46. Hep B markers  HBc(exposure), HBs(infection)
47. Graft rejection  actue (7-21d), hyperacute(mins), accelerated(2-5d), chronic(3mo)
48. Bruton’s agammaglobulinemia  congenital B-cell disorder
49. Effector lymphs  (TH2 regulates Ab) (TH1 regulates IFM) (CD8 destroys viral)
50. Real time PCR  microbe ID, genotype of HLA, ID DNA sequences,
51. Purpose of C3/5a and split products  inc vasc permeability, smooth muscle contraction, histamine rel
52. Screening for retroviruses  Ab to HIV1/2, HTLV1/2, NA for HIV-1 RNA
53. Disorders of primary immunodeficiency  B-cell disorders
LAB OPS (5-10%):
1. Reasons failed internal control for qPCR  sample high load, not adding IC to MM, amp not occurring
2. Blood cultures  volume important, do not draw >1 from same site, iodine prep
3. Coefficient of Variation  (STDEV/mean)*100
4. Lab supervisor duties  tech duties, admin duties of director, overseeing operations
5. Procedure to monitor precision of assay  run duplicate samples
6. Low/high controls run for 30 days  determines precision and acceptable range
7. rtPCR graph needed for absolute quantification  standard curve
8. Steps in NGS  template prep, amplification, sequencing, data analysis, imaging
9. Unsatisfactory specimens  hemolysis, insufficient volume, improper ID
10. Consider for workspace  contamination error, steps in different spaces, amplicon contamination
11. Laboratory acquired bacterial infection  Brucella species
12. Increase from delay  K, ALT, AST, creatinine
13. Decrease from delay  glucose, ionized Ca, bicarbonate, folate
14. Time to clot before centrifuge  20 minutes
15. Westergard rules  22S (both controls exceed 2SD, twice in succession) 13S (1 of 2 QC is >3SD), R4s
(range of controls >4SD), 41S (4 results >1SD on same side can be both controls), 10x(same side)
16. Draw tube order  Sodium citrate, Serum, Heparin, EDTA, NaF/Oxalate
17. Common in both RNA/DNA  sugar, PO4 residue, base
18. Majority of analytical errors  preanalytic
19. LRN sentinel labs  rule out critical biological agents or send to reference
20. Analyzer  RA(OOS), discrete(own space), parallel(all done same ), multi-channel (multiple analysis)
21. ePHI media  records on hospital server HD
22. College coursework and rotation for Bachelor’s  hospital-based MLS/CLS
23. Monitors  20-40 inches away from eyes
24. Gaussian  1SD (67%), 2SD(95%), 3SD(99.7%)
25. Glander’s disease  Burkholderia mallei
26. Violation of billing requirements  perform testing on verbal order of nursing assistant
27. Route of transmission for BF/HIV  blood, CSF, pleural fluid
28. Over budget  (actual-budget)/budgeted *100
29. PCR with failed internal control but positive result  report as positive (IC for TN)
30. Well-designed rating scale  speace for not observed
31. Bioterrorism agents  A>B>C
32. Workload reporting system  helps in plan, develop, maintain lab services with admin/budget control
33. Performance evaluation  from standard, description, and reward
34. Dilution factor in series  product of tube n dilution factor
35. Health care workers with BF contact  offered vaccine for Hep B
36. Risk for transmission of BB pathogens  bloody urine, semen, pleural fluid, sex, needles
37. Lyophilization  freezedrying of bacteria
38. Specimen with no additive should clot  min 30 min, max two hours prior to centrifugation
39. Meters  osmometer(VP), fluorometer (excitation emission), nephelometer(light scatter),
spectrophotometer (light at WL), coulometer (electricity between electrodes)
40. Mercury chloride with KCl  saturated calomel
41. When frozen to live wire  use non-conductive material to separate
42. Objective tests  limited because they only measure cognitive abilities
43. LIS  hardware and software to manage data in lab
44. Taq polymerase  70C
45. OK pneumatics  Alb, ALP, AST, Cl, creatinine, Glucose, Na, Bili, Protein, BuN, UA, TT, WBC
46. Labelled with biohazard  container for needle disposal (blood contact)
47. Microscope  (stage # um *1000)/ ocular um units
48. When 2 consecutive controls are greater than 2SD  recalibrate and releate controls
49. Detection of translocation  break-apart probes
50. Lab infection control plan  goals for surveillance, system to ID infected patients, trained personnel
51. Exposure to TB tested by  TST
52. To report a positive rtPCR sample  sample crosses threshold and peaks within target temp
53. Osmolarity (G/BUN/Na)  2Na + (G/18) + (BUN/2.8)
54. % recovery  (spiked-baseline)/concentration added *100
55. Lean definition for waiting  dependency on other to complete a task before starting task
56. Root Cause Analysis  Collect info, ID reasons, Chart factors, Generate recommendations
57. DMAIC  define, measure (map and analyze current processes), analyze, implement, control
58. Minimum specific resistance for Type I water systems 10.0 (II is 2.0, III is 0.1)
59. Taxonomy  Affective (commitment), cognitive (problem solving), psychomotor(adaptation)
60. Routine phlebotomy sites  antecubital, cephalic, basilic
61. CLIA 1988  2 controls daily for most methods
62. Phlebotomist requires  2 patient ID, did not explain/inform patient, label in presence
63. Large DNA fragments >50kb  use pulsed field electrophoresis
64. Normality  find moles per L *valence
65. Parameter to compare how close two different methods compare  coefficient of variation
66. Ideal disinfectant in lab  10% bleach
67. Types of fire  A (flammables), B (liquids), C(electric), D(combustion)
68. +/- Controls: Indole (E. coli vs. K. pneumonia), b-hemolysis (S. aureus vs. S. pneumoniae), Catalase (S.
aureus vs. S. pyogenes), H2S (P mirabilis and S. typhi vs. E. coli)
 69. Radiation source in AAS  hollow cathode lamp
70. NA amplication techniques  target ampl and signal amp
71. Syphilis  observe under dark field
72. Analytical  specificity (exclusive analyte), sensitivie (change in analyte), range/LoD
73. End Analyzers  Back-end (removal of specimens to storage, disposal, aliquoting), front (ID/label)
74. FISH  direct NA test using RNA northern or DNA southern to detect variations
75. Exposure with greatest risk of HIV  percutabeous injury
76. Electroosmosis  motion of liquid when voltage us applied
77. Trends  results on one side of mean constantly inc/dec
78. Shift  consistent values on one side of mean
79. T-test  comparing two means from matched groups
80. Crying  increases WBC in babies
81. QC cost per test  [[(QC test cost * times per day) *365] + [monthly *12]]/tests done per year
82. Normality  %*10/eq wt[which is mol wt/pos valence]
83. Full-time equivalents  total of productive and non-productive
84. Exposure Control Plan  procedures for handling medical waste
85. Chemical Hygiene Plan  ID chemicals and label and record
86. Hazard Communication Standard  outlines hazard classification and labeling
87. SDS  info about chemicals in library
88. Value steam mapping  document/analyze steps of test to customer
89. Light-blue collection  if use of butterfly, always deaw the waste tube
90. If sample negative and IC is negative  repeat the sample
91. Minimum from possible bioterrorism agents/aerosols  Class II BSC used
92. Standard deviation  sqrt ((sum of square of differences/[#-1])
93. Dermal puncture for capillary blood specimens  ring or middle finger
94. CFR regulations  minimum standards a facility can exceed
95. Freezing point depression  lowered proportional to paricles in solution
96. FMEA  evaluated to analyze risk and highlight aspects for improvement
97. For PPMP  limited to bright-field or phase contsdy semen analysis)
98. dPCR  best to evaluate SNP
99. Normal densiometric PE  albumin band first and largest
URINALYSIS (5-10%):
1. Crystals  Basic pH (Amorph PO4, Amm Biurates, Triple PO4, Ca carbonate, Ca PO4)
2. Crystals  Acid pH (Uric acid, Amorphous/Acid/Sodium urates, Ca oxalates)
3. Acid urine  meat diet, cranberries, high urine glucose, ketoacidosis, diarrhea, starvation, emphysema
4. Basic urine  Meta alkalosis, veggies , kidney failure, UTI, hypervent, R tubular acidosis, old, bacteria
5. BJ Protein Heat Precipitation  Precipitates at 40-60C, Re-dissolves at 100C
6. NRBC  look like fried eggs, dark purple yolk and light purple cytoplasm
7. Myoglobinuria  present in massive muscle trauma
8. Functions of CSF  supply nutrients to NS tissue, protect spinal cord, remove waste from cerebral
9. Routine sperm count  1:20
10. Normal range of urine pH  4.5 to 8
11. Most cerebrospinal fluid is produced  choroid plexus
12. Fluid found in cavity surrounding the lungs  pleural fluid
13. Requires 72 hour stool collection  quantitative fecal fat
14. Increased levels of urine protein can be an early indicator  renal disease
15. Abnormally low sperm concentration  5x10^6 sperm/mL [N=10-20x10^6]
16. Glucose levels in CSF  About 2/3rds blood glucose
17. Tamm-Horsfall protein  hyaline distal casts, produced by/coats/lubricates tubules
18. Yellowish CSF  Xanthochromia
19. Storing/handle of strips  compare with color chart, handle at ends, store at RT
20. Viscosity of synovial fluid is from mucopolysaccharide  hyaluronic acid
21. Urine  should not be centrifuged, must be well-mixed, tested within 2h, at RT
22. Glucosuria  diabetes mellitus, impaired tubular reabsorption/AKF, Fanconi’s
23. Neural tube defects detected  by alpha-fetoprotein
24. Fruity urine odor  from starvation, malabsorption, diabetes mellitus
25. CSF with lymphocytes  viral meningitis
26. QC on strips  as often as needed, on each new lot, when new bottle is opened, when questioned
27. RBC, WBC, proteinuria, casts  formed by acute glomerulonephritis
28. Counted cells on CSF >100  make larger dilution
29. Ketone component measured by nitroprusside  acetoacetic
30. Cystinuria  hexagonal crystals in urine
31. Negative GO test and positive reducing sugars  presence of non-glucose reducing sugar
32. Normal casts from exercise  hyaline and granular casts
33. Yellowish CSF  xanthochromia
34. Clinitest  tests for all reducing substances
35. Tyrosine crystals  look like needles
36. Xanthochromic  can be pale orange, pink, yellow
37. CSF used for hematology counts  #3 (1st is for chem/immune, 2nd is micro, 3rd is hematology)
38. FP in bilirubin result  large doses of chloropromazine/Thorazine
39. Casts found in acute pyelonephritis  WBC casts
40. To distinguish RBC, oil drops, yeast  add acetic acid to lyse RBC
41. Xanthocromic in CSF  from hemorrhage
42. Erich-aldehyde reaction  urobilinogen
43. Strip protein tests for mainly  albumin
44. For UTI’s, leukocyte esterase should be evaluated with  nitrite
45. Specific gravity  on strip measured by relationship between ionic concentration and SG
46. Cell with two pink nuclei and light purple abundant cytoplasm  mesothelial cell
47. Crystals that look like rupees  uric acid
48. Nitrite can be used to  monitor AB therapy, detect bladder infection, screen for recurrent infection
49. Confirmation of positive protein from dipstick  Sulfosalicylic acid
50. Diabetic woman with high protein and foamy urine  large albumin concentration
51. Associated with acidic urinary pH  high urine glucose
52. India Ink prep  detect cryptococcus neoformans
53. Recommended method for CSF sample  cytocentrifugation
54. Which causes hematuria and positive blood on strip  glomerulonephritis
55. Clinitest  based on reduction of Copper
56. Confirmatory for urobilinogen  Watson-Schwartz test
57. RBC found in urine  hematuria
58. Glitter cells  PMN
59. Storage of urine samples  store at 4C for 24hrs
60. Positive leukocyte esterase  PMN, basophils, eosinophils (granulocytes)
61. Nephrotic syndrome  oval fat bodies, fatty/waxy casts, renal tubular epithelial cells
62. L/S ration in amniotic fluid assesses  respiratory distress syndrome
63. Strenuous exercise  hyaline casts
64. Protein used to monitor BBB  albumin
65. CSF cell with frilly edges  ependymal/choroid plexus cell
66. Ribbon-like stools  bowel obstruction
67. Kidney functions  acid-base balance, retains nutrients/water, blood filtration
68. WBC count  (# counted * dilution) / #squares*0.1
69. CSF lymphocytosis  from viral/fungal/tuberculous meningitis
70. Sudan III detects  fat
71. In urine, similar size to RBC  yeast
72. Strip handling  compare with chart, handle at ends, store at RT
73. Albuminemia testing  to detect albumin before there is severe renal damage
74. Infant’s negative specimen of glucose  next is to do Clinitest for other reducing substances
75. LE positive test of WBC  PMN, eosinophils, basophils
76. Infective mono  reactive lymphocyte
77. Indicative of kidney disease  renal tubular epithelial cells
78. Testing of urine for poryphyrins  urine stored in dark/foil container
79. CSF meningitis  viral (inc protein), bacterial (dec glucose, inc protein), fungal (N glucose, protein)
80. Large foamy cells in CSF  synovial lining cells
81. When not immediately tested, semen  stored at 37C
82. Sperm motility  Progressive (32%), Total (40%)
83. Normal urine production over 24hr  700ml to 1700ml/24hr
84. Glomerular filtration assessment  creatining clearance (urine conc * volume) / plasma conc
85. Associated with acut pyelonephritis  WBC casts
86. Functions of kidney  exocrine (eliminate waste products), endocrine (hormones, BP, RBC product)
87. High protein in urine  blood in urine, alkaline medication, high bilirubin
88. Prominent vacuolizarion of abnormal lymph cells  Burkitt’s lymphoma
89. CSF collection  L3-4
90. DCT function  maintain water electrolyte balance and acid-base balance
91. Fluid deprivagtion for 12hrs  >800mIsm
92. Nephrotic syndrome  associated with edema, dec serum albumin, inc proteinuria
93. Urine for centrifugation of microscopic exam  10-15mL
94. Lower reference for semen volume  1.5mL (N is 2-5mL)
95. Not detected in Acetest  B-hydroxy butyric acid
96. Amount of adult CSF  90-150mL
97. Nitrates reduced to nitrites by  gram negative bacteria
98. Functions of kidney  glomerulus (filtration) PCT (water reabsorption), DCT (ion pH/electro balance)
99. CSF dilutions: slight hazy(10), hazy (20), cloudy (100), cloudy/slight blood (200), blood (10000)
100. Bacterial urine contramination  more alkaline urine