MICROBIOLOGY REVIEWER

Necator americanus

New world hookworm

Opistorchis vivirini

South east Asian liver fluke

Schistosoma mansoni

Intestinal schistosoma

Fasciolopsis buski

Giant intestinal fluke

Chlonorchis sinensis

Chinese liver fluke

Schistosoma japonicum

Oriental blood fluke

Schistosoma haemotobium

Urinary schistosome

Plasmodium falciparum

Malignant tertian malaria

Hymenolepis nana

Dwarf tapeworm

Paragonimus westermani

Lung fluke

Diphylidium caninum

Dog tapeworm

Ascaris lumricoides

Giant intestinal roundworm

Naegleria fowleri

Primary amoebic meningo- encephalitis

Acanthoamoeba specie

Contact lenses associated

Hymenolepsis diminuta

Rat tapeworm

Strongyloides stercoralis

Thread worm

Enterobius vermincularis

Pinworm

Diphyllobothrium latum

Fish tapeworm

Echinococcus granulosus

Hydatid worm

Capillaria philipinensis

Pudoc worm

Trypanosome brucei gambiensie

West African sleeping sickness

Trypanosoma brucei rhodesensie

Acute form of African sleeping sickness

Taenia solium

Pork tapeworm

Trypanosome cruzi
American trypanosomiasis

Trichuris trichiuria

Whipworm

Taenia saginata

Beef tapeworm

Wuchecheria bancrofti

Bancroftian filarial

Dracunculos medinensis

Fiery serpent of the Israelites

Trichenella spiralis

Muscle worm

Brugia malayi

Malayan filariasis

Entamoeba hystolytica

Flask shaped intestinal ulcer

Loffler’s syndrome

Ascaris pneumonitis

Anopheles mosquito

Malaria

Drug of choice of filariasis

Diethylcarbamazine

Causes anaphylactic shock

Ruptured Hydatid cyst

Inflammation at the site of inoculation

Changoma

Cervical lymphadenopathy

Winterbottoms sign

Trichomonas vaginalis

Strawberry cervix

Schistosoma

Onchomelania quadrasi

Leishmania donovani

Visceral leishmaniasis/ kala-azar

Trichuris trichuria

Associated with rectal prolapse

Gardia lamblia

Falling leaf motility

Series of proglottids

Strobila

Strongyloides stercoralis

Chochin china diarrhea

Ancyclostoma braziliensis

Cutaneous larvae migrans

Enterobiasis

Associated with pruritis ani

Bancroftian filariasis

Elephanthiasis

Head of the tapeworm

Scolex
Toxocara canis infection

Visceral larvae migrans

HIV virus

Retroviridae virus Infection is contained by CD8+ cells

Hydrophobia in rabies infection

Inspiratory muscle spasm

Mumps

Causes parotitis

Rabies virus

Causes pain Pruritis and paresthesia at the site of wound

Hermann’s rash

Dengue fever rash

Herpes zoster

Causes shingles

Varicella

Chicken pox

Roseola

Nagayama spots

Measles

Kopliks spots

Rubella

Forscheimer spots
Coxsackie virus A16

Hand-foot and mouth disease

Paul Bunnel antibodies

Known as heterophil antibodies

Splenic rupture

Dreaded complication of kissing disease

Fifth disease

Erythema infecctiosum

Coxsackie virus A

Herpangina

Epstein barr virus

Causes infectious mononucleosis

Cytomegalovirus

Most common cause of congenital infection

Hermoconcentration

Increasing hematocrit count

thrombocytopenia

Decreasing platelet count

Recall ASCP ’07- ‘08- Must to know

•
Needs long chain fatty acid- M. furfur
•
Gram (-) diplococci; (+) lactose, maltose,dextrose, sucrose= N. lactamica
•
Scotch tape method- E. vermicularis
•
No sugar fermented, gram (-) diplococci,Oxidase (+) = Moraxella catarrhalis
•
RPR next test for Treponemes = FTA-ABS
•
Rotavirus specimen= stool
•
Resistant to Optochin= viridans streptococci
•
Gliding motility- Capnocytophaga sp
•
Yellow smooth colony on EYA, AFB = M.gordonae
•
Rapid grower AFB= Arylsulfatase (+)
•
Virulence factor for B. anthracis= capsule
•
S. maltophilia difference from other NF gramnegative rod = Oxidase (-), Dnase (+)
•
NFO, not fluoresce, non motile- B. mallei
•
P. aeruginosa like organism in cystic fibrosis=B. cepacia
•
H. pylori= gastritis, rapid urease
•
S. paratyphi= lysine (-), H2S (-)
•
Cryptospridium stain = Kinyoun AFB
•
Walking pneumonia, resistant to antibiotics,without cell wall= M. pneumoniae
•
E. cloacae= indole (-), citrate (+), lysine (-),ornithine (+), xanthine (+)
•
Butcher’s cut, H2S (+), gram (+) rod, alphahemolytic, non motile= E. rhusiopathiae
•
High risk to lab personnel- C. immitis
•
Motility of Listeria is seen at temp= roomtemp
•
Hair perforation test= T. mentagrophytes
•
Fusiform macroconidia= Fusarium
•
Vancomysin (S), Penicillin (R)= MRSA
•
CSF storage after inoculation= 35’C
•
Bile esculin positive spp = group D strep
•
Biochemical profile of Moraxella catarrhalis=Dnase (+), tributyrin HOH (+), reduce nitrate,Oxidase (+)
•
Favic chandelier growth of molds= T.schoenleini
•
Modified acid fast stain = Nocardia spp
•
Microbiology QC
Daily = Oxidase, GS, Catalase

Weekly= Antibiotics, Biochem

Basic Bacteriology

Sodium hypochlorite (bleach)=

spillage d.

NALC =
liquefy mucus

BSL III=
M. tuberculosis

Autoclave-
121’C at 15lbs/psi , 15-20 mins

HEPA filter, negative pressure - BSC

Pasteurization –
milk disinfection

Incineration –
waste disposal

Wayson stain=
polar bodies of Y. pestis

Negative stain=
capsule

Gimenez =
Rickettsiae

Iodine stain =
inclusion body with glycogen

Wright/ Giemsa stain=

Borrelia
GRAM POSITIVE COCCI
•
Novobiocin resistant test = differentiate CNS
•
MRSA= 35’C, 2% NaCl BAP, Vancomycin Tx
•
Bile esculin HOH = group D Strep
•
Tube Coagulase test= free and bound
•
Sheep blood agar= Streptococci
•
Optochin, bile solubility = Strep. pneumoniae
•
PYR HOH = S. pyogenes , Enterococci
•
SXT sensitive= Group C, F, G beta strep
•
CAMP and Hippurate HOH = Grp B strep
•
Modified Oxidase, OF test = Micrococcus
•
Catalase = 3% H2O2; Staph and Strep
•
Dnase (+) = clear zone/pink zone ( S. aureus)
•
Vancomycin resistant= Pediococcus andLeuconostoc
•
Dick’s test = scarlet fever
•
Abiotrophia = NVS ( Vit B6)
•
UTI = Staph. saprophyticus, Enterococci
•
Prosthetic heart valve inf.= S. epidermidis
•
# 1 skin, wound infection= Staph. aureus
•
# 1 sore throat = Strep. pyogenes
•
# 1 neonatal meningitis= Strep. agalactiae
•
# 1 bacterial pneumonia, # 1 meningitis, # 1otitis media = Strep. pneumoniae
Gram stainGram stain
Gram positiveGram positivecoccicocci
CatalaseCatalase

StaphylococciStaphylococci
Streptococci or Streptococci or EnterococciEnterococci
((--))
•
CLASSIFICATION:Smith and Brown’s Classification2.
β
eta streptococcus
à
Complete (Colorless zone)
à

S. pyogenes, S. agalactiae
, Grps C, F &G3. Gamma streptococcus
à
no hemolysis ( no zone)
à
E. fecalis, E. faecium, S. bovisGRAM NEGATIVE COCCI
•
Oxidase test = Screen test for Neisseria
•
Catalase test (Superoxol) = 30% H2O2
•
Sugar Utilization test = Speciate Neisseria
•
Nasopharyngeal swab = Carrier of meningococci
•
SPS = inhibits Neisseria
•
Waterhouse Freidericksen = meningococci
•
Dnase test = Moraxella
•
JEMBEC system = transport for Neisseria
•
BAP and CAP= (+) growth N. meningitidis
•
CAP = (+) growth N. gonorrhea
•
Modified TMA = VCN + trimethoprim \
GRAM POSITIVE BACILLI
•
Niacin test = Yellow (+) for M. tuberculosis
•
Red color (+) = Nitrate red., Tween 80 HOH,

Arylsulfatase test
•
MAC = AIDS mycobacterium
•
TCH susceptible= M. bovis
•
Arylsulfatase test= Rapid growers Mycobacteria
•
42’C = M. xenopi
•
Swimming pool granuloma= M. marinum
•
Potassium tellurite medium= Corynebacterium
•
Medusa head, bamboo, square end, groundglass=B. anthracis
•
Antibiotic associated enterocolitis- C. difficile
•
Terminal spore= Clos. tetani
•
Lecithinase= Clos. perfringes
•
Gray to black colonies= Corynebacterium
•
Double zone hemolysis= theta and alpha toxin
•
Botulinum toxin = canned goods
•
10u Penicillin disk test= B. anthracis
Gram negativeGram negativecoccicocciGrowth onGrowth onThayer-MartinThayer-
Martinagar agar PathogenicPathogenicNeisseria spp.Neisseria spp.Other Other Neisseria
spp.Neisseria spp.
((--))
•
Gas gangrene= C. perfringes
•
Blood culture contaminant- P. acne
•
SPS disk test = P. anaerobius
•
Peptone yeast extract glucose (PYG)= anaerobes
•
GLC = analysis of acid prod. by anaerobes
•
BACTEC 9240/9120 = Fluorescence
•
Actinomyces= lumpy jaw
•
Brick red fluorescence= Veillonella, Prevotella
•
KV agar, KVC resistant, 20% bile= B. fragilis
•
Lactobacillus = Catalase (-), Doderlein bacilli
TB complexPhotochromogensScotochromogensNon photochromogens
(MAC)Non photochromogens (MTC)Rapid growersGram Negative Bacilli
•
Methyl red test opposite reaction with VP test
•
PAD (+), Urease (+), LD (+)= tribe Proteeae
•
Oxidase negative = Enterics
•
Dnase (+) = Serratia
•
Yellow pigment = E. sakazakii
•
E. coli = bacteuria
•
Non motile = Klebsiella, Shigella, Tatumella
•
Sulfanilic acid, alpha napthylamine= NO3-NO2
•
Campylobacter = microaerophiles
•
Bile lactose media= enterics
•
H2S producer = Salmonella, Proteus, Edward.Arizona, Citrobacter
•
ONPG = slow lactose fermenter
•
Salmonella related to Citrobacter
•
Shigella related to E.coli
•
Traveller’s diarrhea= Enterotoxigenic E. coli
•
O129, Oxidase test = Vibrio and Aeromonas
•
Lysine (-), H2S (-) = S. paratyphi A
•
Rice water stool, string test (+) = V. cholerae
•
Green TCBS= V. parahemolyticus
•
Moeller’s medium = LOA test
•
Mineral oil on LOA medium= anaerobic
•
IMViC = E. coli vs Enterobacter, Klebsiella
•
Urease test= Helicobacter & Campylobacter
•
Hippurate HOH = C. jejuni
•
Sorbitol (colorless) on MacConkey= O157:H7
•
Red (+) = Indole, MR, VP, Urease, NO3-NO2
•
Blue (+) = Citrate, Acetamide, Acetate,

Malonate Utilization test

•
Purple (+) = LOA, Hippurate, LIA, Oxidase
•
Yellow (+) = ONPG, TSI, V. cholerae TCBS
Coliforms (Rapid LF)Arizona, CitrobacterP-M-P Group
(Proteeae)Salmonella, Shigella, SerratiaNon Fermentative Orgs ( NFO)
•
Growth on BAP & MacConkey
•
TSI = K/K
•
Oxidase test, Motility, O-F test, Pigment
•
Decarboxylation of amino acid (LOA)
•
TSI K/K= NFO except Shewanella (H2S)
•
OF medium = Inc. CHO, Dec. CHON
•
Oxidase (-) = Stenotrophomonas, Acinetobacter
•
MacConkey (-)=Eikenella,Kingella,Mora., Flavo
•
Pyocyanin (+), Grape like = P. aeruginosa
•
Growth at 42’C = P. aeruginosa, B. pseudomallei
•
Wrinkled colony= P. stutzeri, B. pseudomallei
•
Cetrimide agar = P. aeruginosa
•
Pits agar= Kingella, Eikenella
•
Oxidase and MacConkey = Acinetobacter
and Chryseobacterium
•
Swimmer’s ear, Burn, Nosocomial = P.aeruginosa
•
Cystic fibrosis – P. aeruginosa, B. cepacia
•
Glander’s, Non motile = B. mallei
•
Melioidosis = B. pseudomallei
•
Oxidase (-), Dnase (+) = S. maltophilia
O-F test
•
Indicator: Bromthymol blue
•
Positive: Acid (Yellow); Negative: No acid(Green)
MetabolismTube w/o oil(open)Tube w/oil (closeO/F result
O x i d a t i v e Y e l l o w g r
e e n + / -
Fermentative Yellowyellow+/+NonFermentativeG r e e n g
r e e n - / -
PARVOBACTERIA
•
GRAM NEGATIVE COCCOBACILLUS
•
FASTIDIOUS ORGANISMS
•
Haemophilus

Require X (hemin) and V ( NAD)

Satellitism (H. influenzae)

Media of choice: CAP (horse blood)

•
X and V, Satellitisim = H. influenzae
•
Cysteine require= F. tularensis (BSL-III)
•
Thionine and Fuchsin = Brucella
•
Oxidase, Urease, Motility= Bordetella
•
(-) BAP, (-) Mac , (+) CAP = Haemophilus
•
XV and V strips = H. parainfluenzae (V factor)
•
CAP= CSF
•
Porphyrin test = X factor require, Red (+), ALA
•
Motile, Oxidase, Urease (+)= B. bronchiseptica
•
CO2, H2S, thionine inhibited= B. abortus
•
NOT inhibited by thionine-fuchsin= B. melitensis
•
Whooping cough = B. pertusis
•
Endocarditis, Castaneda = Brucella
•
Epiglotitis, Meningitis,Otitis media, Pneumo.= Hib
•
Soft chancre = H. ducreyi
•
Safety pin, animal bite wound = Pasteurella
•
Pits agar, human bite wound = Eikenella
•
Intracellular = Brucella (undulant fever)Francisella(deerfly fever)
•
Tumbling motility at 25’C = Listeria
•
Butcher’s cut, H2S (+) , Catalase (+),Gram(+) rod = Erysiphilothrix
•
BCYE, air conditioner, Pontiac f.= Legionella
•
Neonatal meningitis, still birth, food poisoning(cheese), septic abortion = Listeria
•
Jaundice, urine of rat in flood = Leptospirosis
•
Darkfield microscopy= spirochetes
•
Hard chancre = Treponema
•
McCoy = C. trachomatis
•
NGU, PID, Conjunctivitis, LGV = C.trachomatis
•
Weil-Felix = Rickettsiae
•
Inclusion body = Chlamydia
•
Giemsa/Wright stain = Borrelia ( relapsingfever)
•
Iodine stain = C. trachomatis (glycogen)
•
DFA = Chlamydia antigen
•
Vincent’s angina = Borrelia andFusobacterium
•
L forms, haverhill fever, rat bite fever, SPSsensitive = S. monoliformis
•
Violet colony- Chromobacterium
•
Whipple’s disease- Trophyrema
•
Granuloma inguinale = Callymatobacterium
•
Oroya fever, infects RBC = B. bacilliformis
•
Cat scratch dse= B. henselae
•
Infects WBC , morulae body= Ehrlichia
•
Wall less, hemadsorption, PAP = M.pneumoniae
•
Fried egg, NGU, urease (+) A7 medium, Tstrain.= Ureaplasma
•
TWAR strain= Chlamydia pneumonia
•
Tick transmit= Lyme, RMSF, Ehrlichia
•
Chigger = Orientia tsutsugamushi (ProteusOx-K )
•
Louse = Epidemic typhus
•
Rat flea = Endemic typhus
•
DFA = Chlamydia antigen
•
Fletcher’s = Leptospira
•
Periodontal = Capnocytophaga
•
Clue cell, HBTA, V agar, 10% KOH test = G.vaginalis
•
Star like colony= Actinobacillus
•
Gliding motility- capnocytophaga
MYCOLOGY
•
Hyphae and spore – basic structure of fungi
•
SDA – general culture media
•
Czapek’s medium – Aspergillus
•
Germ tube & Chlamydospore= C. albicans
•
Malassezia furfur – Tinea versicolor
•
Cell membrane – target of ketoconazole,amphoteracin B
•
Trichophyton – skin, hair and nails
•
Hair Baiting test – T. mentagrophytes
•
Red color and tear drop conidia – T. rubrum
•
Favic chandelier (antler) – T. schoenleinii
•
Club shape macroconidia- Epidermophyton
•
Coenocytic hyphae- Class Phycomycetes orZygomycetes
•
Ascospore – Saccharomyces cerevisiae
•
Niger (birdseed) seed agar (+) , urease (+),phenol oxidase (+), India Ink = C. neoformans
•
Germ tube & arthrospore-Geotrichum candidum
•
Arthrospore – Geotrichum, Coccidioides ,
•
Trichosporon, Aureobasidium
•
Blastospores – yeast
•
Pseudohyphae- Candida,Geotrichum, Trichosporon
•
Germ tube (+) – C. albicans, C. stellatoidea
•
Swab – unsuitable for fungal culture
•
10% KOH – direct microscopic, clearing agent
•
Slide culture (microculture) - save media
•
LPCB = common fungal stain
•
PAS = histologic fungal stain
•
Wright/Giemsa- H. capsulatum
•
Dematiaceous – Phaeohyphomycosis agent
•
Dichotomous branching hyphae-Aspergillus
•
Thrush, Diaper rash, Moniliasis- CandidaMeningitis, encapsulated yeast-C. neoformans
•
Pink yeast, Urease (+), blastospore- Rhodotorula
•
Fusiform, sickle cell shape- Fusiform
•
Actinomyces- sulfur granules
•
Nocardia – partial acid fast
•
Macroconidia, microconidia- dermatophytes
•
Sputum- common specimen systemic mycoses
•
CHO assimilation- ID of yeast, free of CHO
•
BHIA – dimorphic fungi
•
High risk to lab personnel, spherule withendospore- C. immitis
•
Chloramphenicol and cycloheximide- Inhibitoryagent for mycosel/mycobiotic
•
Cigar shape, flowerlike, sleeves, asteroid- S.schenckii
•
Pigeon’s droppings- C. neoformans
•
Guanos, bats, starlings dropping- H. capsulatum
•
Granules, mycetoma- P. boydii
•
Sclerotic, chromomycosis- Fonsecae, Phialophora,Cladosporium
•
Mariner’s wheel, multiple buds- P. brasiliensis
•
Broad based budding yeast- B. dermatitidis
•
Fusiform macroconidia= Fusarium
VIRUS
•
Either DNA or RNA
•
Obligate intracellular pathogen
•
Filtrable agent; nanometer
•
Electron microscopy
•
Cell line or tissue culture
•
Not sensitive to antibiotic
•
a nucleic acid genome (RNA or DNA)
•
Capsid - a protective protein coat
•
Envelope - lipid derived from the host cell m.
•
Viral morphology ( electron microscope)

Capsid symmetry
o
Icosahedral – DNA, some RNA viruses
o
Helical – RNA viruses
o
Complex ( Poxvirus)
VIROLOGY
1 . E t h e r r e s i s t a n t –
n a k e d v i r u s 2. Et her s en s it i v e –
e n v e lo pe d vi r u s 3 . A c i d l a b i l e -
r h i n o v i r u s 4 . A c i d s t a b l e -
e n t e r o v i r u s 5. I nf a nt il e d i ar r h ea -
r ot a v ir us 6 . M y x o v i r u s e s –
h a s H a n d N 7 . H e m ag g lut i nat i on/ Hem a ds or pt i o n
- 8.Reye’s syndrome- Chickenpox,
influenza9 . Br o nc h io l it is in c h i l dr e n -
R S V 10.Hepatitis – Yellow fever, Hep B,
C M V 11.Pancreatitis –
Mumps, Coxsackie B40 virus1 2 . R e s e r v o i r o f T o g a v i r u s -
birds1 3 . D - S R N A - R e o v i r u s 1 4 . S - S D N A -
P a r v o v i r u s 1 5. T Z AN C K s m ear –
HS V a nd V ZV 16. Latent Infection -
Herpesvirus1 7 . Ru be ol a v ir u s - m e as le s 18.Rubella
virus – german measles1 9 . S S P E –
m e a s l e s v i r u s 20. P ML –
J C v i r u s ( p o l y o m a ) 21.Prion-
Spongiform encephalopathy2 2 . V i r o i d - R N A ( H D V )

23. Human embryonic fibroblast cell-

CMV24.PMKC, MDCK, hen’s egg-
Influenzae2 5 . 5
th
disease - Parvovirus2 6 . 4
th
disease – Duke’s disease2 7 . K a p o s i s s a r c o m a – H H V -
8 28.Filoviridae – Marburg and Ebola2 9 . C o r o n a v i r u s
– S A R S 30.Influenzae virus – H5:N1 ( bird’s flu)31.Use
cotton, dacron, nylon swab – virus32. Delay of 3 days=
4’C (refrigerator)3 3 . De la y o f 4 d a ys = - 7 0 ’C n o t -
20’C3 4 . C P E – t i s s u e c u l t u r e 3 5 . 3 3 ’ C -
r h i n o v i r u s 36. Negative stain / gold,
s i l v e r / p h o s p h o t u n g s t i c acid – Electron microscope3 7 . R o l l e r d r u m –
hold cell culture tube
DNA Viruses (HHAPPPy)
HerpesvirusHepadnavirusAdenovirusPoxvirusPapovavirusParvovirus
Rule: RNA viruses
1 . A l l a r e S - S R N A e x c e p t R e o v i r u s 2.All are enveloped except PCR -
Picornavirus,Calicivirus, Reovirus3 . A l l a r e n o n s e g m e n t e d e x c e p t R O B A – Reovirus,
Orthomyxovirus, Bunyavirus,Arenavirus4.Generally helical except the positive senseRNA
viruses5.Positive Sense- Call Pico and Flo To ComeRight6.Negative Sense – Pairing
OF Rats at Bunny’sArea

A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY

nd

Floor Sommerset Bldg., Lopez Jaena St. Jaro, Iloilo City Tel No.: (0 ! 20"2#2$ %mail &ddress:
a'n rsingre)ie*i+ ya-oo.+om

Blood Banking and S !olog"

1.

Isoimmunisation to platelet antigen (PI

A1

) and the placental transfer of maternal antibodies would bexpected to cause newborn:

a.

Erythroblastosis

b.

eu!ocytosis
c.

eu!openia

d.

T#!o$%o "'o( nia

".

#ollowing plasmaheresis$ how long must a person wait before being eligible to donate a unit of
%hole&lood'

a.

wee!s

b.

" wee!s

c.

)* #o+!

d.

" hours

*.

Each unit of whole blood will yield approximately how many units of cryoprecipitated A+#'

a.

b.

*-

c.

1*,

d.

"-,

.
Addition of which of the following will enhance the shelf life of whole blood'

a.

+eparin

b.

Ad nin

c.

+ydroxyethyl starch

d.

actated /inger0s solution

-.

Pretransfusion compatibility testing must include:

a.

An'i%od" ! ning %" an'iglo%+lin ' '

b.

Autocontrol

c.

inor crossmatch

d.

2 test on recipient

3.

4e5ere intra5ascular hemolysis is most li!ey caused by antibodies of which blood group system'

a.

ABO

b.

/h
c.

6ell

d.

2uffy

7.

8nder extreme emergency conditions when there is no time to determine A&9 group for transfusion$
thetechnologist should:

a.

/efuse to release any blood until the patient0s sample has been typed

b.

/elease 9$ /h negati5e whole bold

c.

R l a O, R#. n ga'i/ ! d %lood ll

d.

/elease 9$ /h positi5e red blood cells

An obstetrical patient has had three pre5ious pregnancies. +er first baby was healthy the second
was ;aundiced at birth and re<uired an exchange transfusion$ while the third was stillborn. %hich of the
followingis the most li!ely cause'

a.

A&9 incompatability

b.

Immune deficiency disease

c.

=ongenital spherocytic anemia

d.

R# in o$(a'i%ili'"
>.

%ith regard to inheritance$ most blood group systems are:

a.

4ex lin!ed dominant

b.

4ex lin!ed recessi5e

c.

Autosomal recessi5e

d.

A+'o o$al odo$inan'

1,.

?he optimum storage temperature for =ryoprecipitated A+# is:

a.

""

b.

c.

1"

d.
. 0-

11.

?he optimum storage temperature for Platelets is:

a.

00

b.

c.

1"

d.

",

1".

?he optimum storage temperature for /ed blood =ells$ #ro@en is:

a.
o

b.

1"

c.

",

d.

*-

1*.

?he optimum storage temperature for %hole &lood is:

a.

b.

1"

c.
 ",

d.

1 .

Buality control tests must be performed daily on:

a.

R ag n' ! d %lood ll

b.

9ral thermometers

c.

&an!ed whole blood

d.

=entrifuge timers

1-.

=riteria determining /h immune globulin eligibility include:

a.

other is /h negati5e

b.
Infant is /h negati5e

c.

Mo'# ! #a no' % n (! /io+ l" i$$+ni2 d 'o '# D an'ig n

d.

Infant has a positi5e direct a antiglobulin test

13.

%hich of the following constitutes permanent re;ection status of a donor'

a.

A tattoo - months pre5iously

b.

/ecent close contactwith a patient with 5iral hepatitis

c.

?wo units of blood transfused months pre5iously

d.

Con3i!$ d (o i'i/ ' ' 3o! HB Ag 1- " a! (! /io+ l"

17.

?he ma;or crossmatch will detect a(n):

a.

Croup A patient mistyped as group 9

b.

Irregular antibody in the donor unit

c.

/h negati5e donor unit mislabelled as /h positi5e

d.

R i(i n' an'i%od" di! ' d again ' an'ig n on '# dono! ! d ll
1 .

=ells of the A

subgroup will :

a.

/eact with 2olichos biflorus

b.

Dot be agglutinated by anti A

c.

Gi/ a $i4 d 3i ld ! a 'ion 5i'# an'i. A, B

d.

Dot be agglutinated by anti +

1>.

ixed field reactions with anti A and anti A$ & and negati5e reactions with anti & and anti A

lectin(2olichos biflorus) are obser5ed. %ithout further testing$ the most li!ely conclusion is that the
patient isgroup:

a.

1b.

"c.

d.

A
 ",.

Anti #y is:

a.

8sually a cold reacti5e agglutinin

b.

ore reacti5e when tested with en@yme treated red blood cells

c.

Ca(a%l o3 a+ ing # $ol"'i '!an 3+ ion ! a 'ion

d.

9ften an autoagglutinin

"1.

A patient recei5ed two units of /ed &lood =ells and had a delayed hemolytic transfusion
reaction.Pretransfusion records indicate a negati5e antibody screen. /epeat testing of
the pretransfusion specimendetected an antibody at the antiglobulin phase. %hat is the most
li!ely explanation for the original results'

a.

/ed cells were o5erwashed

b.

=entrifugation time was prolonged

c.

Pa'i n'7 !+$ 5a o$i'' d 3!o$ '# o!iginal ' 'ing

d.

Antiglobulin reagent was neutrali@ed

"".

%hich one of the following is an indicator of polyagglutination'

a.

/&=s typing as 2 positi5e

b.

Presence of red cell autoantibody

c.

2ecreased serum bilirubin

d.

Aggl+'ina'ion 5i'# no!$al ad+l' ABO. o$(a'i%l !a

"*.

Anti 4d is strongly suspected if:

a.

?he patient has been pre5iously transfused

b.

T# aggl+'ina' a! $i4 d. 3i ld and ! 3!a 'il

c.

?he patient is group A or &

d.

9nly a small number of panel cells are reacti5e

" .

ixed field agglutination at the anti human globulin phase of a crossmatch may be attributed to:

a.

/ecently transfused cells

b.

Intrauterine exchange transfusion

c.

An an'i%od" + # a an'i. Sd

d.
#etomaternal hemorrhage

"-.

In suspected cases of hemolytic disease of the newborn$ what significant information can be obtained
fromthe baby0s blood smear'

a.

Estimation of %&=$ /&=$ and platelet counts

b.

ar!ed increase in immature neutrophils (shift to the left)

c.

A differential to estimate the absolute number of lymphocytes present

d.

D ' !$ina'ion o3 '# (! n o3 (# !o "' and l /a' d n+$% ! o3 n+ l a' d ! d %lood ll 7

"3.

As a pre5enti5e measure against graft 5ersus host disease$ red blood cells prepared for infants who
ha5erecei5ed intrauterine transfusions should be:

a.

4aline washed

b.

I!!adia' d

c.

#ro@en and deglyceroli@ed

d.

Croup and /h compatible with the mother

"7.

%hich of the following is the preferred specimen for the initial compatibility testing in exchange
transfusiontherapy'
a.

Ma' !nal !+$

b.

Eluate prepared from infant0s red blood cells

c.

Paternal serum

d.

Infant0s postexchange serum

" .

%hen the main ob;ecti5e of an exchange transfusion is to remo5e the infant0s antibody sensiti@ed red
bloodcells and to control hyperbilirubinemia$ the blood product of choice is A&9 compatible:

a.

8! # W#ol Blood

b.

/ed &lood =ells washed

c.

#resh #ro@en Plasma

d.

+eparini@ed /ed &lood =ells

">.

%hich one of the following histories represents an acceptable

donor' +ct &P ?emperaturePulseAge4exa. *> 11, 7, >>. 7- ,#b. *7 1*- - > .3 ,*-

9 )1 :-;<- ::9)=<=<M

d. - 11- , > .31,"17

*,.

According to AA&& standards$ 7-F of all Platelet$ Pheresis units tested shall contain how many
platelets per G '
a.

-.- x 1,

1,b.

3.- x 1,

1,c.

69- 4 1-

11

d.

-., x 1,

11*1.

#ollowing the second spin in the preparation of Platelet$ Pheresis units tested shall contain how
manyplatelets per G '

a.

Allo5 d 'o i' +ndi '+!% d 3o! 1 #o+!

b.

Agitated immediately

c.

Pooled immediately

d.

?ransfused within hours

*".

%hich of the following is proper procedure for preparation of Platelets$ from whole blood'

a.

Lig#' (in 3ollo5 d %" a #a!d (in

b.

ight spin followed by two hard spins

c.

?wo light spins

d.

+ard spin followed by a light spin

**.

?he purpose of a low dose irradiation of blood components is to:

a.

Pre5ent posttransfusion purpura

b.

P! / n' g!a3'. / ! + . #o ' >GVH? di a

c.

4terili@e components

d.

Pre5ent noncardiogenic pulmonary edema

* .

Platelets prepared in a polyolefin type container$ stored at ""

= "

= in -, m of plasma and gentlyagitated can be used for up to:

a.

" hours

b.

hours

c.
* days

d.

< da"

*-.

?he en@yme responsible for conferring + acti5ity on the red cell membrane is alpha:

a.

Calactosyl transferase

b.

D acetylgalactosaminyl transferase

c.

L. 3+ o "l '!an 3 !a

d.

Clucosyl transferase

*3.

/efer to the following data:

8o!5a!d G!o+(R / ! G!o+( An'i. A An'i. BAn'i. A

L 'in A

1.

ll A

0.

C ll B ll )@ n g )@ n g 0@ )@

?he A&9 discrepancy seen abo5e is most li!ely due to:

a.

Anti A
1b.

/oleaux

An'i. H

d.

8nexpected IgC antibody present

*7.

A "- year old =aucasian woman$ gra5ida *$ para "$ re<uired two units of %hole &lood. ?he
antibodyscreen was positi5e and the results of the antibody panel are shown abo5e. %hich of the
followingantibodies may be the cause of the positi5e antibody screen'

a.

Anti and anti 6

b.

An'i. and an'i. E

c.

Anti s and anti c

d.

Anti #y

and anti c

* .
A "- year old =aucasian woman$ gra5ida *$ para "$ re<uired two units of %hole &lood. ?he
antibodyscreen was positi5e and the results of the antibody panel are shown abo5e. %hat is the most
probablegenotype of this patient'

a.

rr

b.

r0r0

c.

d.

*>.

A "- year old =aucasian woman$ gra5ida *$ para "$ re<uired two units of %hole &lood. ?he
antibodyscreen was positi5e and the results of the antibody panel are shown abo5e. %hich common
antibody hasD9? been ruled out by the panel'

a.

Anti 4

b.

Anti e

ac.

Anti H!

ad.
An'i.

,.

A patient0s serum reacted wea!ly positi5e (1

) with 13 of 13 group 9 panel c*ells at the A+C test phase.?he autocontrol was negati5e. ?ests with ficin
treated panel cells demonstrated no reacti5ity at the A+Cphase. %hich antibody is most li!ely
responsible for these results'

a.

An'i. C#

b.

Anti !

c.

Anti e

d.

Anti Hs

a 1.

8se of E2?A plasma pre5ents acti5ation of the classical complement pathway by:

a.

=ausing rapid decay of complement components

b.

=helating g

ions$ which pre5ents the assembly of =3

c.

C# la'ing Ca

@@
ion , 5#i # (! / n' a $%l" o3 C1

d.

Pre5enting chemotaxis

".

A 6leihauer &et!e stain of a postpartum blood film re5ealed ,.*F fetal cells. %hat is the estimated
5olume(m ) of the fetomaternal hemorrhage expressed as whole blood'

a.

b.

1<

c.

"-

d.

*-

*.

?he most effecti5e component to treat a patient with fibrinogen deficiency is:

a.

#resh #ro@en Plasma

b.

Platelets

c.

#resh %hole &lood

d.

C!"o(! i(i'a' d AH8

.
 An assay of plasma from a bag of cryoprecipitated A+# yields a concentration of > international units
(I8) offactor JIII per m of cryoprecipitated A+E. If the 5olume is >m $ what is the #actor JIII content of
the bag inI8'

a.

>

b.

c.

"7

d.

*1

-.

?he approximate percentage of the original plasma content of #actor JIII reco5ered in cryoprecipitate
A+#is:

a.

1,F ",F

b.

",F ,F

c.

)- . *-

d.

,F 1,,F

3.

A newborn demonstrates petechiae$ ecchymosis$ and mucosal bleeding. ?he preferred blood
component for this infant would be:

a.

/ed blood cells

b.

#resh fro@en plasma

c.

Pla' l '

d.

=ryoprecipitated A+#

7.

A 3- year old woman experienced sha!ing$ chills and a fe5er of 1,*

# approximately , minutes followingthe transfusion of a second unit of /ed &lood =ells. ?he most li!ely
explanation for the patient0s symptomsis:

a.

?ransfusion of bacterially contaminated blood

b.

=ongesti5e heart failure due to fluid o5erload

c.

Anaphylactic transfusion reaction

d.

S / ! 3 %!il '!an 3+ ion ! a 'ion

An acid elution stain was made using a 1 hour post deli5ery maternal blood sample. ?wo thousand
cellswere counted and thirty of these cells appeared to contain fetal hemoglobin. It is the policy of the
medicalcenter to add one 5ial of /h immune globulin to the calculated dose when the estimated 5olume
of thehemorrhage exceeds ", m of whole blood. =alculate the number of 5ials of /h immune globulin to
thatwould be indicated under these circumstances.

a.

"
b.

c.

d.

>.

?he iley method of predicting the se5erity of hemolytic disease of the newborn is based on the
amnioticfluid:

a.

&ilirubin concentration by standard methods

b.

C#ang in o('i al d n i'" $ a +! d a' )<-n$

c.

/h determination

d.

/atio of lecithin to sphingomyelin

-,.

A unit of #resh #ro@en Plasma was inad5ertently thawed and then immediately refrigerated at

= on onday morning. 9n ?uesday e5ening this unit may still be transfused as a replacement for:

a.

All coagulation factors

b.

#actor J
c.

#actor JIII

d.

8a 'o! I I$$+nolog"

-1.

%hich of the following statements about immunoglobulins is true'a.Immunoglobulins are produced by ?

lymphocytesb.?he IgA class is determined by the gamma hea5y chain

9T# IgA la 4i ' a !+$ and ! 'o!" $ol +l

d.?here are two subclasses of IgC

-".

?he classic antibody response pattern following infection with hepatitis A is:

a9In ! a in IgM an'i%od" d ! a in IgM an'i%od" in ! a in IgG an'i%od"

b.2etectable presence of IgC antibody onlyc.2etectable presence of Ig antibody onlyd.2ecrease in Ig

antibody increase in IgC antibody of the IgC* subtype

-*.

%hich of the following is the ma;or residual split portion of =*'a.=*a

%9C6%

c.= d.=1<

- .

%hich of the following releases histamine and other mediators from basophils'

a9C6a

b.Properdin factor &c.=1<d.=

--.

?he component associated only with the alternati5e pathway of complement acti5ation is:a.= b.=1<

9P!o( !din 3a 'o! B

d.=*a
-3.

%hich of the following is clea5ed as a result of acti5ation of the classical complement

pathway'a.Properdin factor &b.=1<

9C)

d.=*b

-7.

?he en@yme lin!ed immunosorbent assay (E I4A) techni<ue for the detection of +&sAg:a./e<uires
radiolabeled =1<b.Is <uantitated by degree of fluorescence

9 an'i. HB link d 'o #o! !adi # ( !o4ida

d.8ses beads coated with +bsAg

- .

/heumatoid factor is:a.An antigen found in the serum of patients with rheumatoid arthritisb.Identical to
the arthritis precipitin

9IgG o! IgM a+'oan'i%od"

d.=apable of forming circulating immune complexes only when Ig type autoantibody is present

->.

?he presence of immune complexes indicates:a.Polyclonal hypergammaglobulinemiab.Inflammatory

tissue in;uryc.Protection from complement dependent neutrophil chemotaxis

d9No!$al #o ' ! (on 'o an'ig ni 4(o +!

3,.

?he complement component =*:a.Is increased( in plasma le5els) when complement acti5ation occurs

%9Can % $ a +! d %" i$$+no(! i'in a a"

c./eleases histamine from basophils or mast cellsd.Is D9? in5ol5ed in the alternate complement pathway

31.

=hronic carriers of +&J:a.+a5e chronic symptoms of hepatitis

%9Con'in+ 'o a!!" '# HBV

c.2o not transmit infectiond.=arry the +&J but are not infectious
3".

?he antigen mar!er most closely associated with transmissibility of +&J infection is:a.+&s

%9H%

c.+&cd.+&J

3*.

+epatitis = (nonenteric form of non A$ non & hepatitis) differs from hepatitis A and hepatitis &
because it:a.+as highly stable incubation periodb.Is associated with a high incidence of icteric hepatitis

9I a o ia' d 5i'# a #ig# in id n o3 '# #!oni a!!i ! 'a'

d.Is seldom implicated in cases of posttransfusion hepatitis

3 .

%hich of the following mediators is released during ? cell acti5ation'a.Immunoglobulinsb.?hymosin

c.4erotonin

d9L"$(#okin

3-.

?he H chain is associated with which of the following immunoglobulins'

a9IgA

b.IgCc.IgEd.Ig2

33.

Initiation of the acti5ation mechanism of the alternati5e complement pathway differs from that of
the classicalpathway in that:a.Antigen antibody complexes containing Ig or IgC are
re<uiredb.Endotoxin alone cannot initiate acti5ationc.=1 component of complement is in5ol5ed

d9An'ig n. an'i%od" o$(l 4 on'aining IgA o! IgE $a" ini'ia' a 'i/a'ion

37.

?he =*b component of complement:a.Is undetectable in pathologic serab.Is a component of the

=* clea5ing en@yme of the classical pathway

9I l a/ d %" C6 ina 'i/a'o! in'o C6 and C6d

d. igrates farther toward the cathode than =* 3 . ?he serum hemolytic complement le5el (=+

-,

):a.

i a $ a +! o3 'o'al o$(l $ n' a 'i/i'"

b. pro5ides the same information as a serum factor & le5elc. is detectable when any component of the
classical system is congenially absentd. can be calculated from the serum concentrations of the
indi5idual component3>. A "3 year old nurse de5eloped fatigue$ a low grade fe5er$ polyarthritis and
urticaria. ?wo months earlier shehad cared for a patient with hepatitis. %hich of the following findings
are li!ely to be obser5ed in this nurse'a

negati5e hepatitis & surface antigen testb.

l /a' d AST and ALT l / l

c. a positi5e rheumatoid factor d. a positi5e onospot

test 7,. ?he #?A A&4 test for the serologic diagnosis of syphilis is:a. less sensiti5e and specific than
the J2/ is properly performedb.

lik l" 'o ! $ain (o i'i/ a3' ! ad F+a' an'i%io'i '# !a("

c. currently recommended for testing cerebrospinal fluidd. preferred o5er dar!field microscopy for
diagnosing primary syphilis71. ?he hyper5iscosity syndrome is most li!ely to be seen in monoclonal
disease of which of the followingimmunoglobulin classes'a. IgA

%9 IgM

c. IgCd. Ig27". Antibody class and antibody subclass are determined by ma;or physiochemical differences
and antigenic5ariation found primarily in the:a

9 on 'an' ! gion o3 # a/" #ain

b. constant region of light chainc. 5ariable regions of hea5y and light chainsd. constant regions of hea5y
and light chains 7*. %hich of the following complement components is a strong chemotactic factor as
well as a stronganaphylatoxin'a. =*ab. =*bc

9 C<a

d. = a 7 . %hich of the following complement components or pair of componets is a 5iral neutrali@er'a.

=1b
9 C1, )

c. ="bd. =*a 7-. %hich of the following acti5ities is associated with =*b'a.

o( oni2a'ion

b. anaphylaxisc. 5asoconstrictiond.
chemotaxis 73. Immediate hypersensiti5ity is most commonly associated with:a. transfusion reactionb.

ana(#"la 'i ! a 'ion

c. contact dermatitisd. bacterial septicemia 77. A transfusion reaction to erythrocyte antigens will
acti5ate which of the following immunopathologicmechanisms'a. immediate hypersensiti5ity

b. arthus reactionc. delayed hypersenti5ityd.

i$$+n "'ol" i

7 . 2elayed hypersensiti5ity is related to a.

on'a ' n i'i/i'" 'o ino!gani # $i al

b. transfusion reactionc. anaphylactic reactiond. bacterial

septicemia 7>. +igh titers of antimicrosomal antibodies are most often found in:a. rheumatoid arthritisb.
systemic lupus erythematosusc. chronic hepatitisd.

'#"!oid di a

,. 4 E patients often ha5e which of the following test results'a.

#ig# 'i' ! o3 DNA an'i%od"

b. decreased serum immunoglobulin le5elsc. high titers of anti smooth muscle antibodiesd. high titers
of antimichondrial body 1. Anti /DA antibodies are are often present in indi5iduals ha5ing an
antinuclear antibodyimmunoflourescent pattern that is a. spec!ledb. rimc. diffused.

n+ l ola!

". Antibodies to which of the following immunoglobulins are !nown to ha5e produced
anaphylacticreactions following blood transfusion'a

9 IgA

b. Ig2c. IgEd. IgC *. ?he latex agglutination titer commonly considered as the lower limit of positi5ity for
diagnosis ofrheumatoid arthritis is a. 1:"b. 1: ,c.

1 1=-
d. 1: 3 . A 13 year old boy with infectious mononucleosis has a cold agglutinin titer of 1: ",,,. An
importantconsideration of this antibody0s clinical rele5ance is the:a.

'# !$al !ang

b. titer at

=c. specificityd. light chain type -. %hich of the following is an important cellular mediator of immune
complex tissue in;ury'a. monocyteb.

n +'!o(#il

c. basophild. eosinophil 3. A serologic test for syphilis that depends upon the detection of cardiolipin
lecithin cholesterol antigen is:a. #?A A&4b

9 RPR

c. +A ?Pd. ?PI 7. In the #?A A&4 test$ the presence of beaded pattern of fluorescence along the
treponeme indicates:a. positi5e identification of treponema pallidumb. presumpti5e diagnosis of acti5e
syphilisc. presence of nontreponemal antibody (D?A)d

9 3al . (o i'i/ ! a 'ion

. ?he most important use of nontreponemal antibody (D?A) test alone is in a. establishing the
diagnosis of acute acti5e syphilisb. establishing the diagnosis of chronic syphilisc.

/al+a'ing '# + o3 '# !a("

d. determining the pre5alence of disease in the general population >. ?he serologic test for syphilis
recommended for detecting antibody in cerebrospinal fluid is a. nontreponemal antibodyb.

CS8. VDRL

c. #?A A&4d. +A ?P>,. ?he initial immune response following fetal infection with rubella is
the production of which class(es) ofantibodies'a. IgCb. IgA

c.

IgM

d. both IgC and IgA>1. %ithin one wee! after exposure to rash illness$ a maternal serum rubella titer
that is e<ual to or greaterthan 1: indicates:a

9 (!o%a%l i$$+ni'" 'o !+% lla

b. e5idence of acute rubella infectionc. susceptibility to rubella infectiond. absence of acute rubella>".
%hich IgC subclass is most efficient at crossing the placenta'a

9 IgG1

b.1gC"c. IgC*d.IgC >*. ?he area of the immunoglobulin molecule referred to as the hinge region is
located between whichdomains'a. J+ and J b

9 CH1 and CH0

c. =+" and =+*d. =+* and J > . %hich class of immunoglobulin is thought to function as an antigenic
receptor site on the surface ofimmune & lymphocytes'a. Ig2

%9 IgM

c. IgAd. Ig2>-. %hich of the following terms describes a graft between genetically unidentical indi5iduals
belonging tothe same species'a. autograftb. isograft

9 allog!a3'

d. xenograft>3. %hich of the following is the Krecognition unitL in the classical complement pathway'a

9 C1F

b. =*ac. = d. =->7. A series of eight tubes are set up with ,.7> m of diluent in each. A serial dilution is
performed by adding1,u of serum to the first tube$ and then transferring 1, u through each remaining
tube. %hat is the serumdilution of tube 7'a. 1:". *1 x 1,

11

b. 1:" 3"1 x 1,

11

9 1 19:0- 4 1-

16

d. 1:".,>7 x 1,

1*

> . Patients suffering from %aldenstrom0s macroglobulinemia demonstrate excessi5ely

increasedconcentrations of which of the following'a. IgCb. IgAc. Ig

d9 IgD
>>. ?he presence of +bsAg$ anti +&c and often +beAg is characteristic of:a. early acute phase +&J
hepatitisb. early con5alescent phase +&J hepatitisc. reco5ery phase of acute +&J hepatitis

d9 a!!i ! 'a' o3 a +' HBV # (a'i'i

1,,. ?he disappearance of +bsAg and +beAg$ the persistence of anti +&c$ the appearance of
anti +&sand often of anti +&e indicate:a. early acute +&J hepatitisb. early con5alescent phase +&J
hepatitisc

9! o/ !" (#a o3 a +' HBV # (a'i'i

d. carrier state of acute +&J hepatitis