ASCP recalls (corrected) updated 2024 questions & answers 2024/2025 (A+ GRADED 100% VERIF, Exams of Nursing

Download ASCP recalls (corrected) updated 2024 questions & answers 2024/2025 (A+ GRADED 100% VERIF and more Exams Nursing in PDF only on Docsity! pg. 1 1 ASCP recalls (corrected) updated 2024 questions & answers 2024/2025 (A+ GRADED 100% VERIFIED) wordsology ASCP made EASY EXAM RECALLS Many folks have been asking for exam recalls to be emailed to them. Fortunately, your colleagues have previously posted – and continue to post – recall questions from recent exams. These are located throughout the discussion areas. I continue to compile them all in this area. If you have additional questions to contribute, please do so and you will be credited. Pay it forward and be a good human citizen! Thank you! Many thanks to: King Bego, SS, Zsa, Yohannes, Jord, CloFro, Adrienne Salazar, Kk, Adrienne, Choneng, Oliver A, Aleesha, Yeng, Christian, Caroline, may, Gab, Ipassed, RufioSD619, PassitForward, student in USA, LM, Ergo, Michi, JB, Veronica, Chellezy78, Sniper, CC, Nancy, ariel acaylar, Ginger, ge02015, anna, Nika, Danny Lyons, Kobe, Valen, Yoro, Dee, Jean, Ruby, DeeCee, FM, John, newmt, CG, Forlornd, Diana, Paralumann, K, Charles, Ryan, Nicole, Sekonie, Kbrown, asdfgaill, Itina, Nicole, Klynn, Liv, TB, Jan, Zinnia, Samsam, SueS, Saro, Violeta, Sukhi, Maricel, Jamaica, mllerena, Bernadette, DoraDExplorer, annu, Shiela, RJ Baclagan, Kuki, Kaneulchan, Mr IT, Maria, Violeta, Anonymous, tao tao, Alexis, Krabbypatty, lead, Jordan, miroslavafh, Roela GV, Tazeen5, Rondrae, Sal, Sarah, Sam, Jen, Charita, Daniel, liwa Here are my recalls: pg. 2 2 -Steno maltophilia- multi-drug resistant and maltose fermenter -Wilson‘s Dse- confuse between increase CK and ceruplasmin (my answer) or increase ALT and ceruplasmin. I pg. 5 5 -characteristics of each especially kell, duffy, mns lewis, and kidd also anti i and anti I -urine reagent strip (principles, causes of false positives and false negatives) -tumor markers (acute pancreatitis, breast cancer, hepatic ca, etc) -PSA for prostate (I was given a scenario where one month after surgery PSA was high so what happened?) -so many blood serology questions -leukemia and markers -transfusion reactions and causes -casts, crystals and where they are found -hepatitis markers -PT AND PTT studies -warfarin and heparin -diabetes and how to diagnose it, Conn‘s syndrome, Sushing syndrome and the lab values I had no textbook so I read polansky flash cards, harr‘s review book tho i didn‘t finish it b/c I had less than two months to prepare. Anyway I‘m going to share some points. Try to study Harr questions and also BOC for BB. Some of the questions in the BB actual exam were taken from BOC. Try to focus on A bottomline approach by theriot and also the book of ciulla -reasons for falsely dec/inc PT and PTT. -how is Ca affted by PTH? -Relevance of sodium and glucose? -T.mentagrophytes/T.rubrum: Hair shaft pg. 6 6 -overdose of salicylate, what chem test is to be tested? -olive oil: M.furfur -Degradation of reagent in PT/PTT reason for the qc to fail -arrange by protein:lipid ratio (hdl, vldl, ldl, idl) i forgot my answer here -patient is A positive but no A positive is available only O negative what will you do? -Burr cells is an indicative of? -what urine cast will appear in patients with nephrotic syndrome? -Rbc cell seen in patient with mycoplasma pneumoniae? -BB: remember the abo discrepancies and also the antibody identification. -Memorize by heart the high yield notes of Sohail for Enterobacteriaceae and for gram positive cocci and bacilli it can definitely save your life from micro questions. They asked about Stenotrophomonas maltophilia which are = Rapid oxidizers of maltose The asked about the stain used for Cryptosporidium parvum= Modified trichrome stains Here are some questions I remember: 1. Markers absent in Acute promyelocytic leukemia: CD13, 34 (I picked) – Don‘t know if its right 2. Group A, Le (a+b-) person: Lea only in saliva [Because no Leb = no secretor gene = no A & H antigens in saliva] 3. Burr: uremia, Stomatocytes: Liver disease, Acanthocytes: inadequate slide drying. [Picture shown for these so know what these look like under the microscope] 4. ANA pattern that looked smooth but had orange fluroscence along with green. and had mitotic cells that did not pg. 7 7 stain [―keyhole‖ ]: picked Anti-mitochondrial – [Don‘t know if its right] 5. PT, PTT, and Pt. samples all run together were abnormally high – Choices: CaCl2 added, thromboplastin added, controls deterioration, incubation temp. too low (I picked this one because the others didn‘t make sense to me) 6. catheter tip – PT and PTT were high: Heparin contamination 7. %saturation = [Fe/(Fe+UIBC)] X 100 8. Antigen that deteriorates: P group 9. Procainmide toxicity, levels within range, what to do next: Repeat test on same sample, Recollect and repeat, Test NAPA levels (What I picked, don‘t know if its right), Test phenobarbital levels 10. LF, ODC (+), Lysine (-): Enterobacter cloacae 11. Gram pos. bacilli: Cat (+), Nonmotile: B. antracis, corynebacterium jeikeium (probably right answer), Erysipelothrix 12. Lesions – Tissue: weird description -, microscope: Septate hyaline hyphae with microconidia: I put Sporothrix schenckii. Other options: Coccidiodes, Microsporum, Epidermophyton 13. RBCs on strip but none in microscope: Dilute alkaline urine {I think} 14. Autoabsorption done – ScI & ScII pos: Choices: Repeat autoabsorption, Selected panel cells, Antibody ID of enzyme treated cells (What I picked – I don‘t know if its right) 15. PPT abnormal for normal and abnormal controls: I picked replace thromboplastin reagent 16. 18.5% retics, shows pic of pappenheimer bodies: Stain with Prussian blue 17. What happens in ―Adrenal‖ Cushing disease: Increased Cortisol, Decreased ACTH [I picked this because it said adrenal cushing disease so I thought it meant ―primary‖ – dont know if right] 18. Elevated Ca, Normal PTH: Metastasized carcinoma 19. pt. jaundiced with pancreatic mass: AFP, CA-19-9, [Picked AFP but not sure] 20. Deferral: Hospital workers received HB vaccine few days ago (I think) 21. Normo, Normo anemia, WBC & PLT normal, retic 0.1%: Pure red cell aplasia 22. Calibration of blood gad analyzer: 2 buffers and constant temperature pg. 10 10 Hey guys. Just took the MLS ASCP like20 mins ago and got a pass. Want to say thanks to wordsology and everyone who posted their recall, especially the most recent exam recalls. I got around 15 or more of the questions posted…This is all I can remember: -Patient showing symptoms of toxicity to primodone. However, measured value was in control range. what should the the next step? a. request new sample. b. napa c. phenobarbital (chose this). -csf electrophoresis with anodal albumin…what should be done? a. report results b. report as contaminant c. request new sample d. repeat test -western blot of HIV-1 showing neg cont, weak cont, and strong control. a patient‘s test was showing bands for 160,120 and 66. how should the result be interpret. a. reactive (chose this not sure) b. nonreactive c.intermediate d. cannot be determined -the use of potassium permanganate in the staining of mycobacterium. (not sure but i chose it is a counterstain) -mycobacterium stained with carbol fuchsin and counterstained with methylene blue. However no acid fast was observed. whats the cause? a. wrong counterstain. b. wrong primary stain…etc -antibody that deteriorate with storage. I chose P system. -Got a lot of blood bank related questions minus the antibody panels. more related to discrepancies and screening cells with DAT -which antibody is most likely not to show dosage? Jka, E, M, or Lea(chose this) -False positive blood urine reagent strip. a. high level of ascorbic acid. b. dilute alkaline urine -Got a picture twice of RBC agglutination. a. PCH, b.warm antibodies c.PNH -Given result: DAT poly = 0, DAT C3= 3+, what should the tech do? Report DAT positive. -second irreversible step of platelet aggregation. a. Platelet factor 3 b. release of ADP c. platelet shape change. -Given result of antibody ID, All 11 tubes AHG= Negative, then added Check cells, 4 tubes did not given agglutination. The wash machine did not dispense correctly volume of saline. – donor deferral -Blood donation stops at 390 mL. Used as packed red cells. pg. 11 11 Review the exam recalls and the high yield notes. I guarantee they will play a great role to your exam as they did for mine. Good luck. I got so many Exam recalls qestions: difference between p. aeruginosa and p. putida – growth at 42‘C Ran controls and PT was normal, PTT was abnormal. Replaced controls and got same results. What should you do next? A) Change out the Recombiplastin B) Change out the CaCl C) Rerun controls D) Run patient tests Histoplasma capsulatum –tuberculate macroconidia amniotic fluid cannot be tested for bilirubin on regular chemistry analyzer as serum bilirubin because A) they are demanding, B) they are biochemically different something about 2 types of bacteria found in agar one was gram + and another one penicillin, kanamycin resistance anaerobe gram neg. bacilli answer was Bacteroides fragilis eluate had sc one pos., SC two pos., SC three negative…..you would do what…a) repeat eluate b) do a panel on eluate Burr cells-uremia Bartonella- cat scratch curved gram neg cushing syndrome- increased cortisol, decreased acth I got question about billirubiner ans ass. Disease pg. 12 12 I used was U C B U ―yoU C(see) Bulls**t‖ U- unconjugated billirubin: Elevated in pre hepatic and post hepatic or billary obstruction C- conjugated billirubin: elevated in hepatic and post hepatic B- billirubin: elevated in hepatic and post hepatic U- urobillinogen: Elevated in pre-hep and hepatic. Decreased in billiary obstruction One question they ask what increase in hemolytic disease I answered Urobillinogen and unconjugated bilirubin. Know your PT APTT ranges and MIXING STUDIES! and lupus anticoagulant. ABO DISCREPANCIES and how to remedy them. Anti-a and Anti-b. Both 4+. A and B cells both 2+. How to resolve this discrepancy? But there was no prewarm in the option so I choose room temperature. Cause of low NA? (Hypoproteinemia, Diabetes insipidus Two days old infant glucose strip positive. Clinitest negative. I answered Glucose pos. (not sure) Galactosuria was also an option. Metabolite of PHENOBARBITAL : PROCAINAMIDE Cut off absorbance for HBEAG was 0.734 something. Specimen was 0.3. Interpret result (Positive, Indetermine Stomatocytes associated with Liver disease urine refrigerated becomes turbid because of: I answered Amoruphous phosphates (not sure) Monocytosis seen in what? TB MI patient who was treated with streptokinase. Which of the results sugesst that treatment wasn‘t successful. PT 12, PT 25,PTT 200 or D-dimer + Rotavirus specimen- stool Blastoconidia: budding b/w mother daughter Legionella test: testing in urine Ag What is in the saliva of a Le(a+b-) individual?Le a What does CO2 electrode measure?PH what does the hair test confirm : T. rubrum / T menta pg. 15 15 Lupus anticoagulant causes: thrombocytosis Whole blood donation stops at 390ml:PRBC Antibody that deteriorates in storage: P1 Table. Choose positive controls to test for anti-c and negative control to test anti-Fy(a): C+c+ for the positive control and Fy(a) for the negative control Detection of ab where 11 tubes resulted negative in AHG, but when added CC 4 of them didn‘t agglutinated. Machine didn‘t dispense correctly the saline in the wash Table. IS 37 AHG CC SCI 0 0 0 2+ SCII +/- +/- 0 2+ Add 4 drops of serum Baby A+, DAT-, Mother O- before birth: Do rosette test Which donor should you differ? donor received Hep B immunoglobulin 8 weeks ago A panel that anti-Fy(a) was present but can‘t rule out anti-E, so the answer to the panel was: anti-Fy(a), anti-E Patient with Hct 62%, the sodium citrate tube was centrifuged and noticed that de blood plasma ratio was low. What should the MLS do? take sample with more anticoagulant. Coagulation machine, controls and patient where run in duplicate. Controls where normal, patient 1 PT normal PTT abnormal, patient 2 PT abnormal PTT normal a. CaCl2 b. Thromboplastin c. something about a light (chose this one, check) Instrument linearity something about comparing means: Paired T-test Calibration of blood gases analyzer: 2 buffers with known pH and constant temperature Absorbance formula: 2-log%T Patient with fasting blood 155mg/dl and random 225mg/dl I choose Repeat FPG Enzyme controls resulted in 3SD below the mean and the controls with no enzyme resulted in 2SD below mean. What is causing this? pg. 16 16 a. controls where left at room temperature Patient with elevated Ca and normal PTH: Metastasized cancer What increases in Cushing? ACTH and Cortisol Patient had dyspnea caused by anesthesia, what should be measured? Pseudocholinesterase June 2017 ASCPi RECALLS Sezary Syndome – T-cell lymphoma Affected in Coumadin Therapy – II, VII, IX,X ABO Discrepancies Donor‘s Requirement RBC panels 5 HIAA- Carcinoid Tumor A man with elevated BHCG & AFP but normal PSA & CEA – Testis LDL computation Anion Gap computation RBC maturation picture Proglottid of T. Saginata Biochem result of P.vulgaris Hepa A sequence of ag, IgM & IgG Rh Neg mother pre natal & post natal results Cold agglutinins Results of decreasing bilirubin- due to phototherapy Results of cbc hgb/hgb on the 3rd day increased by 2.0g- due to prolong tourniquet application pg. 17 17 Levey jennings chart- what error Measure precision- SD Px with lyme disease- False positive with Syphilis Hi!!! I just want to say Thank you, I did on saturday MLS test and i did PASS it… Im so happy it was kind of hard because for me blood bank was my weakest and i got mostly ABO grouping discrepancies and Antibody screen probs, i had about 9 panels, some bacter, Some questions I remember, by now is kind of hard to remember. 1.-Procainamide: NAPA 2.-ABO discrepancie I remember.A4+B0 O0 A0 B0 O0 3.- how differentiate Proteus Mirabilis and P Vulgaris. 4.-cloride shift-HCO3-Cl- 5.- A sample that was collected in gray tube for chemistry. what to expect. 6.- which anticoagulant should I use for coagulation studies. 7.- malaria in blood. 8.- peppenrhimer bodies 9.- Falciparum 10.-AFT as cancer marker 11.-what is increased in Hemolytic anemia? its as Unconjugated billirubin, iron, TIBC 12.-Gram + Bacili, Branching, CATALASE – partially acid fast— that was easy– Nocardia 13.-Oxidase -, Catalase+ Indole – H2S+ i thought it was Salmonella 14.- difference between primary and secondary thyroidism —TSH 15.Cushing sydrome-cortisol increased 16.- ALP increased when pg. 20 20 5. Given result: DAT poly = 0, DAT C3= 3+, what should the tech do? Report DAT positive. 6. Given result of antibody ID, All 11 tubes AHG= Negative, then added Check cells, 4 tubes did not given agglutination. What happened? the wash machine did not dispense correctly volume of saline. 7. What causes this donor defer? He had HB immunoglobulin injection 6 week ago. 8. The rouleaux can‘t detect at what phage? AHG phage. 9. ABO discrepancy: anti-A anti-B A1 B 4+ a+ 1+ 1+ what should tech do? incubation at room temperature. 10. Given table results: Screen I and II positive, DAT = 3+, after autocontrol = 4+, after do auto adsorption, auto control = 2+, what should the tech do? do enzyme treatment; report result; do another auto adsorption or do panel selected cells. ( I chose do panel selected cells) 11. Whole blood donation stop at volume of 390ml: What should we use for this? a. do separated for platelet and plasma pg. 21 21 b. use as packed red cell c. use as whole blood cells ( I picked this one) d. separated to plasma 12. Given panel: LeA LeB IS 37 AHG 0 + 0 0 0 0 + 0 0 0 + 0 +/- 0 0 + 0 +/- 0 0 this patient has what? a. Glycolipid absorbed from plasma ( I picked this one) b. patient has antibody. c. do a panel d. run auto control 13. Mother: O Negative has anti-D, anti-C, previously known has anti-LeA Baby: A postive, DAT = 3+ What blood you chose to transfuse to infant? a. Group A negative, D, C, LeA antigen negative b. Group O negative, C antigen negative ( I picked this one) c. Group A positive, D, C LeA antigen negative d. Group O positive, D, C antigen negative pg. 22 22 14. What cells antigen when storage will deteriorate? a. Kidd b. Kell c. C d. P ( I picked this one) 15. Given table panel red cells: choose positive control for anti-c (little c) and negative control for anti-FyA: C+c+ for positive control for anti-c, and FyA- FyB+ for negative control for anti-FyA. 16. ABO discrepancy: anti-A anti-B A1 B 0 2+MF 4+ 0 what happened? Patient received group O transfusion. For laboratory: 1. To calibration of blood gas analyzer, you need what? two buffers with pH and constant temperature. 2. Compare method for control and patient, what method to used? Paired- T test For Micro: you must remember diagram of high yield notes, I have about 10 questions and few they are not from high yield notes such as: 1. patient has cat scratch: GNB, low grade fever, enter ED. a. Pasteurella multocida ( this for cat or dog bite) b. Bartonella henselae ( I picked this one) pg. 25 25 Questions recalled: Procainamide: NAPA BHCG tumor marker for what? Not sure but I answered chorocarcinoma. Cos the three choices were pancreatic, colon and lungs MCV calculation 5HIAA carcinoid tumors I had 5 bb panels (was thinking maybe this was the reason I failed. Although I did understand but the questions were a bit confusing. Not sure with my answers) Proteus vulgaris and mirabilis indole tests Bb and Heme Case studies Hydatid cyst fluid Rh stuff ABO descripancies Antacid overdose? What lab test should you conduct? Ouchterlony reading I took the ASCP MLS exam yesterday for the third time and passed. I went through quite a few recalls and did a lot of lab CE (scoring around 80 for the regular 100 question mode and 75 on the adaptive tests) Here is what I can remember: -coagulation -Prolonged PT, PTT, and thrombin after collecting from catheter= heparin contamination – Question with mixing study that was performed with a prolonged PTT that couldn‘t be corrected= pg. 26 26 DRVVT -Another question with two pt‘s ran in duplicate (PT and PTT). The PTT seemed to always be prolonged but PT looked ok= I picked check the CaCl/phospholipid reagent delivery – Patient is on coumadin therapy, what will be affected= Decreased protein C -Hematology- -Lot‘s of stomatocytes= liver disease -Burr cells= uremia -Picture of target cells with hemoglobin C crystals. The white count was high on instrument 1, so a second instrument was used with a stronger lysing agent, and the white count was corrected= I picked anti-lysing target cells are what increased the white count. -A sodium citrate tube was drawn for a HCT on a pt but the hematocrit was abnormal. Options were recollect in heparin (what I picked), recollect with increased anticoagulant, recollect with decreased anticoagulant, etc. -Question that gives a red blood cells count, HGB, and HCT. I did the rule of 3 and found that the HGB didn‘t meet the rule of 3 because it was too high= I picked check for lipemia (elevates HGB) -Picture of PBS with an elevated reticulocyte count and howell jolly bodies in the RBC‘s.= I picked stain with prussian blue stain in order to see the retic nuclei -what is composed of DNA?=howell jolly bodies -what falsely decreases ESR=vibration -ESR is increased, what is NOT a cause=I picked macrocytes because macrocytes don‘t rouleux. Other options were rouleux, increased globulins, inflammation, etc. -Chemistry- -Question about lactic acid collection=separate from serum and put on ice -Question about coefficient of variation -Carbon dioxide electrode measures what?= pH -Question about patient that had a random glucose >200 and an FPG >126. What do you do next?= I picked pg. 27 27 repeat the FPG. Other options were diagnose with diabetes mellitus, perform OGTT, etc. -Immunology- -Man tested positive for syphilis 2 years ago but may have again, how would you test him?-RPR -Question with a graph with 3 peaks related to a bacterial infection= I picked that the first peak was the antigen in the stool, the second peak was IgM (goes up and then down quickly), and the third peak was IgG (goes up and levels off a little). -Person tested positive for HIV-1 and HIV-2 but western blot was indeterminate. What do you do?= I picked do CD4 count. Other options were repeat western blot, repeat HIV-2, etc. -Blood Bank- It felt like I had a lot of questions – 1 small antibody ID panel. The antibodies that matched up were Lewis A Lewis B. Question asked about the characteristics of the antibodies.= I picked that they are lipids absorbed onto RBC from plasma. – There was a positive DAT on cord blood; mother is Rh pos, baby is Rh neg. What is most likely coating the baby‘s red cells?= I picked K (kell). Other options were A&B, D, Lewis, etc. -Picture of what looks like cold agglutinins (I got this picture 2 different times during the test).= The first time I picked cold reacting antibody. The second time the options were different so I went with Paroxysmal cold hemoglobinuria. Mycoplasma infection was an option but there wasn‘t a lot of WBC‘s in the picture so I didn‘t pick Mycoplasma. -What phase can rouleux not be detected in?= I picked AHG phase because a positive 37C, negative AHG, and positive auto=rouleux -Picture of ABO type with mixed field reaction in the forward type= I picked that patient was transfused with O blood -Picture of AB in forward reaction, and weak reactions in back type= I picked incubate at room temp because probably cold agglutinins -Question about an adsorption that had been done twice, and antibody screen is positive=I picked perform antibody ID panel pg. 30 30 8. Dce/dce – R0/r 9. QC +/- of bacteria question- I picked oxidase- E.Coli and pseudomonas 10. Cell line question with multiple listed, anisocytosis and ovalcytes stuck out to me – anemias and myelofibrosis 11. Bile Eschulin and 6.5% NaCL pos– distinguishes Enterococcus species from the group D strep 12. Strep pneumo hemolysis- Alpha 13. Picture of strep pneumo in respiratory found here (http://textbookofbacteriology.net/S.pneumoniae.html) 14. ALP seen in—- Liver and Bone 15. Someone comes in after 4hours of MI symptoms gave results of CK CKMB and troponin- I picked troponin it was most elevated. 16. PT elevated in—Gave various factors I choose VII 17. Intrinsic has which factor- I picked Von Wilebrand(VIII) 18. Enterobacteria broad question- can‘t remember the question but I chose Ferments Lactose 19. Someone who expresses immunity and acquired Hep B will have- HbsAg 20. Blood EDTA given to the lab 6hrs after draw will most effect– I chose platelets 21. What tube quantitates the determination of Calcium- Sodium heparin? (Red/Gold was not avail) 22. Electrophoresis question 23. Description of immature cell no picture 24. Differentiation by description no picture of myelocyte and promyelocyte 25. When using a blutterfly for coag study – Discard a blue top then use 2nd blue 26. Description of Football shaped egg with hyaline plugs at each end- Trich Trich 27. 4 nuclei may have chromatoidal bars large, round glycogen vacuole.- E. Histolytica 28. Hypersegmented neutrophils seen in vitamin B12 or folate deficiencies 29. Picture of Triple phos in urine 30. ALP elevation seen in- Hepatic Carcinoma? 31. Colon tumor marker- CEA pg. 31 31 32. trough level is the lowest concentration in the patient‘s bloodstream, therefore, the specimen should be collected just prior to administration of the drug. 33. Peak Levels drawn 2-3hrs after drug is given 34. bacitracin test can also be used to differentiate the bacitracin-resistant Staphylococcus from the bacitracin- susceptible Micrococcus. 35. Increased bili in urine will appear- Dark yellow color 36. WBC casts seen in pyelonephritis (kidney infection) 37. Waxy Cast- a higher refractive index 38. Metabolic acidosis- Vomiting I just took the exam 4 hours ago and failed. I thought I‘ll do just fine considering I read ciulla, Polanski, BOC, Recalls (from your site). I even went to a review class and signed up for the passascp just in case they weren‘t enough. Although I had 5 recall questions, the rest were just idk… 1. Role of a supervisor A. Democratic B. Autocratic C. Laissez-faire 2. Colony stimulated factor is composed of? 3. Picture of histoplasma capsulatum 4. Hodgkins cell- I guessed reed stern berg 5. Giant platelets- since there was no Bernard, I chose the may hagglin. 6. What it means to have a high plt count-essential thrombocytopenia 7. Procainamide-NAPA pg. 32 32 8. A histogram ? 9. What does it mean if the organism is resistant? (This is the sensitivity) A. Too little agar B. Too much organism in the innoculum. 10. Basket cells/smudge cells. Where do you see them in? 11. Low serum ferritin, high tibc, low iron. What disorder? 12. Picture of a tube that had white organism inside. (Thought ithat was the Kansasii one but I was most likely wrong) 13. ABO discrepancies 14. Oligoclonal band-multiple sclerosis 15. Electrophoresis 16. Something about a chromosome. So I assumed t15:17 17. Rotavirus. If the EIA is positive, what do you do next? 18. picture of a cell A. Dohle bodies B. Auer rods 19. A graph with something on the left ( I forgot) and on the bottom is time. The question is about enzyme. A. Enzyme concentration B. Substrate concentration 20. Another graph with plt, wbc, rbc. 3 different graphs but the question was about the WBC. 21. A/A niacin postive 22. Ionized cal was left to stand for a while. What would happen? A. Change in pH B. Evaporation 23. A line graph of glucose and time. Which line would be a normal glucose level. pg. 35 35 i calculated using 50 as factor, the answer was on the choices. Study antibodies of HAV. RPR negative FTABS +? Release positive. Cryoprecipitate and FFP allowable time of use if Ref. temp is 4 degree celcius. Based on AABB standard. CK MB normal, Tn I is high? Myocardial infarct. First to increase in MI? Myoglobin. Study electrophoresis: Albumin, alpha 1, alpha2, beta, globulin.. Which is high given the disease, or the other way around. There was a fungal colony which is violet to purple in color on the plate. Im not sure, i chose Fusarium. Biochemicals of Salmonella typhimurium and Kleb. oxytoca I had one simple BB panel. it was positive for Anti-Fya and anti-E. Majority of lymphocytes. T Cells Premature new born was transfused? why? I answered to compensate to the loss blood becoz of frequent phlebotomy. Not sure though.. Pheochromocytoma : Metanephrines coccaine metabolite? Benzoylecgonine.. Passed my ASCP exam! I would like to thank Sohail for creating this amazing site, and to all the people who commented and shared their thoughts and recalls here. I highly recommend this site to everyone who will be taking their exams soon. I almost shouted at my testing room because i cannot contain my happiness after I saw the word PASS, all other sentences just went out of focus. Haha! Thank you so much, Sohail! Here are some of the questions i remembered during my exam: 1. Transudates are a. purulent b. has many bacteria c. usually noninflammatory pg. 36 36 2. All about DAT and ABO discrepancies. I recommend you study all the discrepancies the cause and solutions of each 3. difference between p. aeruginosa and p. putida – growth at 42‘C 4. S. epidermidis in catheterized patients 5. Microccus 6. Pictures of ANA patterns and dse association 7. Picture of Curvularia 8. Geotrichum candidum 9. Levey-Jennings chart 10. Random and systematic error 11. aggregating substances 12. picture of poikilocytes 13. Hbnopathy assoc w naphthalene poisoning 14. Blood pictures and ds associations 15.electrophoresis question. 16. CPDA-1 expiry date 17. coagulation pathways and dse correlations 18. metabolic acidosis 19. pappenheimer bodies 20. CLL, leukemoid reaction 21. Mixing studies 22. graph abt asp, collagen, epinephrine 23. Donor deferrals 24 Hepatitis markers I also studied Ciulla book and took labce quiz games just for me to practice some questions. I highly recommend pg. 37 37 that you study the high yield notes created by Sohail especially the bacteriology and hemtology part. the tables and flow charts made it easy for me to familiarize the bacteria and also how to identify them. Big thanks to this site, really! Gosh the exam was hard and I was pretty sure I failed. It was purely blood bank based; wanna say at least 60-70% Q from bb, no parasitology, no UA identification, some heme, some mycology, some bacteriology and some lab management (no specificity or sensitivity ; which i studied and understood) Some recalls: child ate mothball accidentally: Heinz bodies M. furfur: olive oil gave 4 different equation with SD & mean; asked which would be more productive CV (So know how to calculate) something to do with LDL and HDL: heparin manganese solution 5HIAA test: Carcinoid tumors same effect as Procainamide:NAPA Zygomycetes (from mycology) (Not sure what were the options or what I chose) A picture of Histoplasma Capsulatum: identify A picture of Blastomyces dermatitis: ( i think thats what it was; don‘t know for sure) Cryo was pooled; when is the new expiration?: 4 hrs FFP was thawed at 11:15 am and left for the OR: came back to blood back at 11:40 and the temp was 11degC; what should the tech do? I chose accept and return to the inventory as it was less than 30 minutes with improper temp Lots of DAT and Elution question Lots of panel (please please and super please listen to the ab identification lectures by the BBGUY) Something about dosage effect of antiE pg. 40 40 alpha 2.. A 70 year old man will donate, what will be the grounds of deferral given the following screening tests: BP 140/90, Pulse 70, Temp 37 degrees the other choice is HBG of 120 or 125 I forget.. Donor will donate plasma. What will be the reason for deferring the donor; choices: Donor received penicillin(I think?) for last week, confirmed Hep B infection last year I forget the other choices.. Pt and ptt controls were abnormal qc repeated ptt was normal what will you do? – replace thromboplastin or replace activator What process will you do for Weak D? choices: DAT, IAT, elution/adsorbtion etc.. Choriocarcinoma Picture of P. falciparum (identify) Biochemical tests identifying Shigella (IMVIC, motility etc) Question about immunodiffusion arcs: Ouchterlony (identity, partial, non-identity) First step in agglutination? Choices: flocculation, sensitization, lattice formation Graph of lag phase micro what are the IgG and IgM? Elizabethkingia meningoseptica – meningitis is premature NBs pg. 41 41 A result of CBC: increase WBC, the rest are normal. Platelets is 20. What is the blood picture? (choices ranged from the normal or abnormal status of the ff PT, PTT, Fibrinogen, D-Dimer) A picture of bone marrow smear. Is it normal or abnormal blood picture? A LOT of antibody identification, discrepancies and resolution (3-7 questions) 2mL of blood was filled only for a 5 mL of anticoagulant tube; what would happen for results of apt? (decreased? Increased? Normal?) O positive man had a strong anti-e, he will be incompatible with what percent of what blood Rh type? (choices; it‘s something like: 97% of O positive? 25% of A positive? I forgot the others) If the PT controls were okay and the aptt controls were okay, what do you do next? Choices were replace thrombin, replace activator, etc. What is the cv is the 80-100 mmol/L is within 2SDs (choices: 5.5% , 10%, 20%) What is the purpose of Protein C and S? (choices: act as natural anticoagulant, activates protein coagulants.. etc..) What bacteria will show positive and negative for the following. Bile esculin, 6.5na, Camp, bacitracin. (choices: S. pyogenes, S. agalactiae, Viridians, Enterococcus) Slight agglutination only on RPR test. What to do next? (choices: Repost as positive, re-calibrate and re-test, replaced new lot number, repeat testing using same kit) Effect of increased/decreased aldosterone on Na and K pg. 42 42 What‘s wrong with this stain? blood smear shows pink buff on rbcs (choices: acid alcohol is too strong, carbolfuchsin is used instead of safranin etc.. I forgot the other choices) Know common markers for B and T lymphs (CD 19, 20/ CD 2,3,5,7, 4/8 mature Graph of 650 nm? What does ISE measures? How do you differentiate Yersinia enterocolitica vs Yersinia pestis? (I choose motility but not sure) What is the specific gravity of the 3mL urine diluted with 3mL H2O? Specific gravity is 1.024 before dilution. (choices: 1.024, 1.072, 1.048 etc..) How do you know if the plasma used for PT has been contaminated with heparin? (choices: test for PT, perform mixing studies.. etc.. I forgot the other choices) Memorize mnemonics for IMVICs, TSIs, H2S producers, Oxidase and Urease producing bacteria and others etc. aHCG – Pacreatic CA or testicular? Where does ALP is increased? (I choose the associated with bone disease; no Obj. Jaundice in the choices) Bernard Soulier syndrome – The question is long but the main differentiation that caught my eye is ―giant platelets‖ . The rest of the choices are not in sync with the question. (No May-Hegglin in the choices so I choose Bernard S.) pg. 45 45 Howell Jolly inclusion picture –what is it composed of? DNA- One with Pappenheimer Bodies – what do you stain it with? –Confirm with Prussian Blue Know what anemias are considered normochromic normocytic Hemoglobin C disease—Target cells Picture of a peripheral blood smear with Plasmodium falciparum COAGULATION APTT; PT – Disseminated intravascular coagulation—Correlating the APTT: PT FIBRINOGEN results [prolonged or not] Know what factors are in the Intrinsic and Extrinsic Pathway, mixing studies Blood Bank: Felt like I had a lot of blood bank questions (my weakest subject) Know how to do panels, DAT/ELUTION/ Subgroups of A Criteria for Allogenic Donor Selection CDPA-1 know its advantage Microbiology/Mycology Wordsology‘s Gram Positive Cocci Chart! Had a question deal with +/- controls for Bile Esculin; CAMP; NACL; Bacitracin picture of Kansassi Sterilization – 15 lbs –121C ESBL TSI reactions for Enterobacteriaceae –Bottom Line Approach Yellow & Purple book Ziehl-Neilson—hot stain Rotavirus – stool pg. 46 46 Histoplasma capsulatum –tuberculate macroconidia Sporothrix schenckii—Cigar bodies Laboratory management: One question about quality assurance Here are my exam recalls…..I guessed a few…cannot remember how I answered on a few..but just sharing… 1) amniotic fluid cannot be tested for bilirubin on regular chemistry analyzer as serum bilirubin because???A) they are demanding, B) they are biochemically different, or C) it is just too turbid. I guessed B (not sure if correct). 2) picture of Aued rod 3) picture of sideroblasts. 4) iron deficiency anemia question. 5) I had many electrophoresis questions…HGB C disease picture. 6) Many panels, including enzyme panels, RT, 37 degree reactions, 7) lectins are used in blood bank to…a) find an antigen on rbc b) enhance reactions. there were 2 more choices. 8) blood from newborn had high PT, high PTT and TT, bleeding from cord also…reason…is a) afibriginogemia b) lupus inhibitor c) factor 8 deficiency d) factor 10 deficiency…..I guessed A (not sure if correct) 9) long slender gram neg rods from plueral fluid..tapered ends and long…I chose bacteriodes fragelis (not sure if correct) 10) how would you differentiate morganella and providencia. 11) question about TIBC low, serum iron low…I chose anemia due to chronic inflammation (not sure if correct) 12) question about a discrepancy (subgroup of A) another one about patient had emergency transfusion in past..front type had mixed field reactions. 13) unusual band between gama and beta band on serum electrophoresis is due to what…. pg. 47 47 14) Spike in gamma region on serum electrophereisis is due to what… 15) If plts are pooled just before transfusion in room temp in open system…when do they expire 16) type I hypersensitivity reactions are due to …. 17) patient is diagnosed with hepatitis B 5 months ago…only thing positive is anti-HBc..what will the med tech do….a) report it as is..b) repeat the negative HBsAG c) report the anti-HBc as false positive d) suggest HCV testing. 18) Donor had anti-Lea, what is the best product for the blood inventory…a) rbc 2) FFP..there were 2 more choices. 19) Myelofibrosis picture. 20) enzymes tests that are needed for muscle dystrophy. 21) ANA detects what… 22) what is chloride shift? 23) what disorder leads to hypertension…when Na is high and K is low… 24) teacher was exposed to Rubella 5 days ago…but she had IgG in her serum…was she immune ? 25) Gram neg coccobacilli grows on chocklate agar and grows around staph aureus colonies on SBA as satellites… does it need a) X and V factor b) X only c) V only d) doesnot need either. 26) presumptive id of Neisseria gonorrhea had be made when it is seen in a) male urethral discharge b) female urine…. there were 2 more choices…. 27) question about what method is it when light is emitted and expanded and transmitted at different wavelength.. 28) something about mycobacteria…and Kinyoun Stain…. 29) wright stain was too pink..what would you do…increase ph…decrease ph…add more wright stain.. 30) cat bite wound culture grew gram neg…the choices were pastuerlla multocida, toxoplasma and 2 other.. 31) question about what antibody causes HDFN when dad was O neg rr, and mom is A pos, R1R1…choices were antibody…. D, c, A, or B pg. 50 50 Positive (100) Negative (100) Method 1 50 100 Method 2 60 88 • Formula of sensitivity Sensitivity = (TP/TP+FN) 100% • Lewis Antibody – if Le and Se gene is inherited, one has Leb adsorbed unto RBC Le (a-b+) • Carbon dioxide ion selective electrode measure?pCO2 • Metabolic acidosis • Result of lipase increased at Normal amylase (given reference value) saan daw associated ? Choices : acute AP, colon cancer, Duodenal obstruction etc. • Why is it that serum bilirubin is preferably measured than amniotic fluid? Choices: amniotic fluid exceeds linearity of the machine being used , amniotic fluid is more difficult to extract, amniotic fluid has different biological components • Characteristics of transudates at exudates The question was clear yellowish peritoneal fluid with results ofRBC,WBC(Lymphocytes 80%)Glucose,Lipase,Amylase,LDH,Potassium Choices: Viral transudate,Bacterial exudates etc etc etc (super detailed question and I don‘t know the answer ) • Hepatitis B marker • Urolbilinogen :Colorless product of bilirubin metabolism • HIV: repeat EIA • Storage of virus: Lyophilized pg. 51 51 • Sorage of CSF for culture • Niacin pos w/ picture M.TB • CML-diff count result • Group O isoagglutinins • Blood to be transfused to a GVHD pxmother to child -irradiated • Dss association pseudo pelger huet anomaly • Chronic heap-auto abs- anti smooth muscle • Picture of teardrop cells:myelofibrosis of the newborn • Partial D: structure protein altered • Delta Check:comparison of present data with previous result • Result increase potassium cause: tourniquet left for more than 10 mins • Phase contrast microscope : living cells,ustained spx • Diff morganella and providencia • Acinetobacter • Aeromnas • Differentiate mature and immature blood cells: chromatin clumping • Light hit, emit power: fluorometry • Cloudy urine: hematuria • Picture spherocytes:mild anemia • Low in serum iron, low tibc, normal ferritin:anemia of chronic disease • Homogenous pix: ssDNA • Electrophoresis protein • Thermistor • Half life • Encapsulated yeast seen in DM: C neoformans pg. 52 52 • Haptoglobin • Protein C and Protein S • Causes thrombosis:C3 • S. aureus ferments: Mannitol • Heparin-Manganese • Specimen collection for uine • Sperm collected for 2 hous-repeat collection • Hgb electrophoresis • MCV MCH MCHC • BB Pannel • Tap water bacilli- M. gordonae • Kleihauer Betke Disk • Ouchterlony Study materials: Checkpoint notes, BOC, Polansky and Harr LabCE(free quizzes), Ciulla wordsology.org ( high yield notes), for blood bank bbguy.org Study well but pray harder! Prayers can move mountains seas and skies. Be positive. God will grant the desires of your heart . GOOD Luck Passed the ASCP MLS exam last week. I would like to thank Sohail website, it helped me a lot to pass the exam especially the micro diagrams and recalls, i got like 10 questions from the recalls. Here are the questions that I could remember: mycoplasma pneumoniae 2 weeks titer, RhIg 50 mL fmh what is the dosage? Howel jolly pic, diazo caffeine what is unconjugated and conjugated? 395 glucose, 4.2 K, what is the K after insulin if the glucose is pg. 55 55 Finally know basic laboratory procedures. MOST IMPORTANTLY however is that you are able to think critically. A lot of questions are not just based on pure facts, you have to think and act upon your knowledge. This is what would happen in real life, you will somtimes be caught in a situation where you know the theory but have to apply it in another situation. So, relax, breathe and make sure you spend your time on what you know. If you have no idea about a question, PICK B and move on! you could use that time and brain power on things that will require you to think based on knowledge you already have. All in all I used all of the resources: BOC, Lab CE, HARR, this site, Bottoms line, Success, and Polansky cards. If you study enough you should be just fine. If you are scoring between 60 and 70ish on lab CE thats a good indicator, but as alwasy stick to this website and bttom line. Good luck! I took my ASCPi exam and passed! Thank you wordsology for being one of the reasons why I did it!!!!! Here are my recalls: 1. DAT Interpretation, what to do next if it has 3+ on c3d only 2. night shift reconstituted controls using water from the water purifier. Why? (Expired reagents) and volumetric pipette results were bad – why? (Improper calibration of pipette) 5. Bx subgroup +mf on anti B 6. ABO DISCREPANCIES and how to remedy them. Anti-a and Anti-b. Both 4+. A and B cells both 2+. How to resolve this discrepancy? (Report? Prewarm? Wash the cells and retype?) 6. medtech performed AUTO ADSORPTION because of 4+ auto control But after adsorption it has still 2+ what to do? 7. Decreased free PSA is associated with? 8. ANA PIC associated with which of the following choices: were anti ssa anti dsdna anti mitoch anti smooth muscle, the pic was speckled pg. 56 56 9. Cause of low NA? (Hypoproteinemia, Diabetes insipidus) 10. Exchange transfusion. Mother was AB NEG AND HAS ANTI D, C, I AND LEWIS. BABY WAS O POS. What blood to be transfused on baby? O RH NEG NEGATIVE FOR D C I ANTIGENS forgot other choices 11. if you are testing for MRSA, what to do? (Decrease the level of salt in the media increase the methicillin conc of the disk, forgot other choices) 12. TIBC computation 13. cause of lack of agglutination after adding check cells on negative results Two days old infant glucose strip positive. Clinitest negative. Cause? (Galactosuria, Excess ascorbic acid, expired strip) CA 19 9 Metabolite of PHENOBARBITAL PROCAINAMIDE SLEEP APNEA- Associated with pseudocholinesterase Flurometer Valinomycin- K Cut off absorbance for HBEAG was 0.734 something. Specimen was 0.3. Interpret result (Positive, Indetermine, Negative) Stomatocytes associated with? (Burr cells) Days before exam focus on how to resolve discrepancies and panel. Read recalls here. A big help. I studied harr and polansky and my notes. The high yield notes here were a big help too. Thanks again, wordsology! pg. 57 57 Thank you Sohail for creating this site..More blessings to come as you continue sharing your knowledge and experience. I just took my ASCP MLS today and passed!!! This wordsology site, LABCE, Quick review cards by polansky, BOC book and review book by Anna Ciulla are the books that tremendously helped me. 45 days of reviewing for 2 hours in morning and 2 hours in afternoon. Here are my recalls…I will add more- thank you again and good luck to everyone 1. valinomycin-antibiotic use for potasium 2. anion gap calculation (2 question) 3. antibody reaction of kidd,kell,duffy (3 question) 4. what is interferon? 5. Stap.aureus reaction in mannitol and how to report (2 question) 6. antibody panel reaction (situational) 4 question 7. ABO discrepancy and DAT 8. Fletchers media is for??? 9. Magnesium test is for?? 10. Lactic acid test for ??? 11. Study ESR increase/decrease 2 question 12. picture of biochemical reaction 13. how to identify Necator americanus? 14.Prevotella media and identification? 15.Frozen plasma temp. after thawing? and how many hours should be use after thawing (2 question) 16 .releaux formation,spherocytes and cells abnormality(3question) pg. 60 60 probable identification of this isolate would be: a. Bacteroides b. Fusobacterium c. Clostridium d. Porphyromonas 3. Picture of Taenia proglottid a. Taenia saginata b. Taenia solium c, Dypilidium Caninum 4. Plate of Auer rods, where do you see them a. AML b. CML 5. A beta-hemolytic, catalasa positive, gram-positive coccus is coagulase negative by the slide coagulase test. Which of the following es the most appropriate in identification of this organism? a. Report a coagulase-negative Staphylococcus b. Report a coagulase-negative Staphylococcus aureus c. Reconfirm the hemolytic reaction on a fresh 24-hour culture d. Do a tube coagulase test to confirm the slide test 6. Hairy Cell plate, the picture looked blurry a. atypic linfocite b. hairy cell leukimia c. normal linfocite 7. Plate of toxic granulation 8. During the past month, Staphylococcus epidermidis has been isolated from blood cultures at 2-3 times the rate from the previous year. The most logical explanation for the increase in these isolates is that: pg. 61 61 a. The blood culture media are contaminated with this organism b. The hospital ventilation system is contaminated with Staphylococcus epidermidis c. There has been a break in proper skin preparation before drawing blood for culture d. A relatively virulent isolate is being spread from patient to patient 9. Which test differentiates E coli O157:H7 a. Manitol b. Sorbitol c. Lactosa 10. A clean catch urine sample was taken: TSI: acid slant/acid butt; no H2S gas produced Indole: positive Motility: positive Citrate: negative Lysine decarboxylase: positive Urea: negative VP: negative This organism most likely is: a. Klebsiella pneumoniae b. Shigella dysenteriae c. Escherichia coli d. Enterobacteria cloacae 11. A gram-negative bacillus has been isolated from feces, and the confirmed biochemical reaction fit those of Shigella. The organism does not agglutinate in Shigella antisera. What should be done next? a. Test the organism with a new lot of antisera b. Rest with Vi antigen pg. 62 62 c. Repeat the biochemical test d. Boil the organism and retest with the antisera 12. Asacarolitic organism, DNasa + Oxidasa +- Moraxella catarrhalis 13. Propionibacterium acnés – Blood culture contamination 14. The reverse CAMP test, lecithinase production, double zone hemolysis, and Gram stain morphology are all useful criteria in the identification of: a. Clostridium perfringens b. Streptococcus agalactiae c. Propionibacterium acnes d. Bacillus anthracis 15. CNA and PEA 16. Case: From a pleural liquid it was recoverd a vancomycin, clindamycin (I think and another antibiotic, can‘t remember) susceptible. On sheep blood agar was chewy or sticky and in McK it was pink, they concluded that it was Klebsiella, what do you do next? a. Report Klebsiella b. It‘s not a common site for klebsiella to grow c. The plates does not match klebsiella 17. A patient with Meningococci in peniciline treatment. A Gram was made and there where Gram- cocci. It was cultured and at 48 hours there where no organism. What happened? a. The diagnostic was erroneous b. Antibiotic inhibit the bacteria c. Patient created antibodies against the bacteria d. Bacteria produced Betalactamasa 18. when you prepare sheep blood agar, what do you do next? 19. Urine for culture and routine completely spilled- obtain a new sample pg. 65 65 45. Histogram, they presented WBC, RBC y platelets. What is the cause of interference in the WBC a. NRBC- b. Retics c. platelet clott 46. Breast cancer marker- CA 15-3 47. Antibodies against TSH a. Carcinoma- b. Graves c. Hashimoto 48. What should you do to a pregnant woman that in the 2hpp had 500mg of glucose in fasting a. Give glucola b. Do another fast blood c. Change to 5 hpp 49. If a particle has the same isolectric point as the pH a. It moves slowly b. It moves faster c. doesn‘t move at all 50. Control fall out 3 standard deviations, which rule is broken? 51 Why ANA test is good? a. Array immuno disease b. Diagnose of SLE c. Descartes Sjorgrens 52. Patient with anti-HCV + y anti-HBs +, what does he have? a. Hep A b. Hep B pg. 66 66 c. Hep C d. Hep D 53. ELISA was HIV +, What should you do next? a. Report to the dr HIV + b. Repeat ELISA with original sample c. Obtain a new sample 54. Case of a patient that had everything elevated and platelets super high, RBC, Hct a. Polycythemia vera b. Polycythemia vera absolute c. other types of PV that can‘t remember 55. Bands of IgG to what their associate? 56. Howell Jolly plate 57. NRBC exercise 58. A plate of a lot of platelets, what do you do? a. Repeat in the machine b. Ask for a new sample and process it in the machine c. Dilute and do a manual count 59. What is RDW 60. 2ml of blood is collected in a .5ml citrate tube, how is affected the pt a. Decreases because of the inadequate ratio b. Increases because of the inadequate ratio c. Normal 61. Aspirin affects? 62. Why RBC in saline are better than those in CPDA-1? a. Less glucose pg. 67 67 b. More donor plasma 63. Girl with menorrhagia and elevated ptt a. DD b. Afibrinolemia c. Ristocetin 64. Mother with mf agglutination a. do kleihauer to mother‘s cell b. do kleihauer to baby cell 65. Who is the best donor? a. Patient that received a transfusion 8 months ago b. Woman that gave birth 4 weeks ago c. Man that donate blood 10 weeks ago d. Patient with Hgb in 12 66. To prevent Graft vs Host Para evitar Host vs Graft que le das a. Irradiated b. Leukocyte reduce 67. Temperature for thawing FFP 68. Patient in operating room, intraoperative blood a. Transfuse the patient in24 hrs if it was maintain at 1-6C b. Do a crossmatch and then transfuse c. can give to other patients 69. Lectin use 70. Blood bank panels pg. 70 70 destroyed by enzymes, sialo (or something like that) antigens, and glycoproteins adsorbed onto RBC. As the panel reviewed perfect reactivity in Lewis and mixed reactivity with M & N, I chose the glycoproteins adsorbed as that is definition of Lewis. Another was exact definition of FV Leiden. But I was getting hard questions toward the end, like figuring out the most likely antibody for a certain Rh phenotype – by then I was just tired, not that I couldn‘t figure it out. I had to remember the Rh antigen frequency (D, c E, C e most frequent to least) . Also my test had a good third of questions all from these recalls, I had read the recalls back in August but forgot about them, but they must have sunk in, after all. So my bit of advice, yes yes, do go over the high yield notes on this site‘s strategies, do know as much as you can about the highest yielding stuff, be well rested! Write down reminders on your white- board to clear your mind. I got a TP/FN question, wrote down the equation provided just in case and got a similar question later with no equation provided! I had the same slide 2x of cold agglutinin, asking what might this reflect (Mycoplasma) and then again, what condition might lead to this cold agglutinin (PCH as Mycoplasma was not a choice this time). I had at least 6 questions using babies as patients so I had to really know what might affect babies differently from adults, their normal clinical ranges. I‘d say, because of all these recalls, the high yield notes, my own note taking, my test was not actually hard, and there were only 5 questions where I had never heard of condition/situation and had to guess. My own problem is I‘m used to a ton of information in case studies, and it was hard for me to just look at the question as is. Dino C: I took my MLS Oct 14,2016 for first time & passed. I agree with you on hard questions persisting toward the end. I found that a good one-third to half of my total questions actually reflected most of the recalls posted on Wordsology. I had read the recalls back in Aug, wrote many of them down figuring I‘d double-check their answers but forgot, as I was deep in studying for everything else. So most of the recalls must have sunk in, after all. Anyway, I got a few easy questions toward the end, like the no-brainer: what is the analyte for GFR. But question #100 was analyzing 4 donors for a patient with DCeDCe phenotype, and which antibody most likely causing Rx in 2 of the donors. I had to take time working that out because by then I was tired, not because I didn‘t know how to do it. And had run out of space on my white board. My really ―hard‖ questions in hematology, micro & BB were pg. 71 71 around questions 10 -50. Because of all the recalls occurring in my exam, I never found the MLS to be that hard overall. Not a single leukemia, acid-base or which agar to choose. I was more than prepared for those Where are urine crystals formed? Options 1)where distaled tubules, proximal tubules, loop of henle or bladder. 2) 2 questions about someone who had Duffy antibody but no longer has it. They need blood what do you do? Options where cross match only or do pannel are the ones I remember. 3) which is used as control in micro? It was something for ecloi vs something else for indole test. options for urease, lysine? 4) question about adh in chemistry and water 5) questions about sodium and chloride 6) question about Mcv 7) coefficient of variation formula 8) what is Tsh used for? Some of the options were to detect thyroid cancer, something about t4 9) where is lymphocyte from? Not bone marrow but another one I forgot but bone marrow was option. 10) something about Sudan stain and what‘s it used for? Options were lipids, fats, proteins and something else I had a lot of micro and blood bank questions more than anything else. Resources I used to study: this site, labCE, Harr, Polansky review cards, sketchymicro, bottom line approach (highly recommended!!!) Questions I remember: 1) Transudate definition (is it purulent, high cellular WBC count, etc?) pg. 72 72 2) Urine color matching choose which one is correct ( I put port wine- porphyrin) 3) Which is more significant found in urine (pH 8.0, +1 protein, bilirubin +) 4) Know how to read immunodiffusion arcs (identity, partial, non-identity) 5) If you see band at start of serum protein electrophoresis what should you do? A. report as abnormal B. perform immunodiffusion C. check to make sure it‘s serum 6) Low serum iron, low TIBC, normal ferritin? anemia of chronic disease 7) beta-hCG 8) picture of enterobius vermicularis egg- use cellophane tape 9) Sensitivity vs specificity 10) several metabolic/respiratory alkalosis and acidosis questions 11) correlate RBC morphology with disease 12) hyaline casts may be confused with? mucus, fats or crystals (I put mucus) 13) semen analysis (abstinence, lubrication?) 14) calcium ion electrode measures what? 15) bronchiolitis in young children and immunocompromised- respiratory syncytial virus 16) Diphtheria- use loeffler and tinsdale tellurite 17) CD definition- antigenic determining characteristics 18) 3-4 antibody panels 19) cross- match unit calculation For example: How many units of group O RBC units should you phenotype, in order to fulfill the request for two cross-matched units? K negative 91%, Fya negative 37% STEP 1: 0.91 x 0.37 = 0.33 pg. 75 75 31. High Hct in coag sample. What should you do? 32. What does CO2 electrode measure? 33. BGA pH controls 34. serum Na while other electrolytes are normal. What should you do next? 35. Pic of stomatocytes 36. Enterococcus vs Group D strep 37. Aeromonas is oxidase pos 38. 1 panel but it asked about the characteristics of the antibody and not just antibody ID 39. Cushing- hyperglycemia 40. 1 mycology 41. Mycoplasma has no cell wall so penicillin is not effective 42. Monitor PA and NAPA 43. What affects HgbA1c? 44. What can cause a in ESR? 45. False positive in UA reagent strips I took the M(ASCP) and passed today. I can‘t really remember all of the questions, as I zoomed through it pretty fast. All said and done, I only used about an hour of my allotted time. As far as my recommendations for study: this website, A Concise Review of Clinical Lab Science, labce, and Sketchy Medical. The BOC book is good for reviewing Acid fast bacilli stuff…..but you don‘t really get many questions anyway. Probably two of the eight questions of AFB were directly from the BOC book. I‘ll try to write what I remember, but they may not be verbatim. pg. 76 76 1(Picture of S. haematobium) From which source are you most likely to see this parasite? A.Urine B. Feces C.Blood D.Sputum 2 This catalase positive, gram positive bacilli with diptheroid morphology is highly resistant to many antibiotics and is associated with immunocompromised patients. A.) C. diptheriae B.) C. jeikeium C.) L. monocytogenes D.) E. rhusiopthiae 3 A chart with susceptibilities (of which I can‘t remember) for K pneumoniae asking how the results should be reported. I‘m pretty sure it was an ESBL producing organism according to the results. 4 Which of the following is most likely to penetrate through unbroken skin? A. Necator americanus B. Trichuris trichura C. Enterobius vermicularis 5. Which is an appropriate specimen to diagnose Dracunculus medinensis? A.Stool pg. 77 77 B. Skin snipping C.Feces 6. Which is the agent of hand foot and mouth disease? A. Herpes B. Coronavirus C. Coxsackie A D. Reovirus 7. A flat colony with green metallic sheen grows on blood. What‘s the likely TSI reaction? (A picture with 4 different tubes) 1. A/A 2. K/A 3. K/K 4.K/A +gas +H2S 8. How would you differentiate Group A from Arcanobacterium? A. PYR B. Catalase C.Oxidase D. Hemolysis studies 9. Most likely species for: Small gray colonies that are gamma hemolytic, bile esculin positive, PYR negative, Gram positive cocci in short chains and small clusters A. Group A B. Group B pg. 80 80 1. what is chloride shift? 2. what will increase in gamma globulin?alpha 1 antitrypsin? 3. what is the best specimen for cmv? 4. a picture of tear drop,correlates with a.vit b12 and folate b.acute inflammation 4. specimen for rotavirus? 5. tsh of 1.2 and t4 18 (high t4 and normal tsh)-secondary hyperthyroidism 6.metabolic acidosis know the normal values 7. Disease in target cell 8. At ph 8.6 beta globulin is faster than? 9. dark brown urine in alkaline,what cells will you see?waxy and granular?glitter cells and hyaline? 10. ketone 1+,bili +1,occult trace.which one is the most pathogenic? 11. nitroprusside test in urine for what? 12. increase in potassium affects what?liver lungs or heart? 13 ionized calcium left in room temp for an hour,it will affect result due to a.change in ph b.evaporation c.consumption of glucose? 14 electrical empedance measures what? 15.fibrinolytic assay-thrombin time 16. dic-prolonged pt,Ptt,ddimer,decrease in fibrinogen 17. anti-ss positive specked Ana at 1:340,is it sle sjogensen syndrome? 18. picture of urine amorphous.microscope used is it bright field,polarized or electron? 20. body fluid I think it was pleural exudate has white count of 500 and is turbid,is it because it‘s purulent,chylous,lipemic? 21. irulence of strep pneumoniae? 22. graph of lag phase micro what are the igG and IgM? 23. increase results in empedance what is the cause?pinching the tubing reagent,compressor? pg. 81 81 24. specimen for t.cruzi? 25.listeria-charcoal yeast 26. ibrio -tcbs seashells 27. picture of fussarium what agar to use? 28. Graph of window,recovery phase of hepatitis,interpret… 29. picture of rbc agglutination,what to do?prewarm sample at 37 degrees 30.menstrual period-decrease in ferritin 31. antacid poisoning,what will you test?ph,ammonia,k? 32. hgb c what test needed?is it hgb electrophoresis? 33. after eating fatty foods what will increase?chylomicrons,ldl hdl no choice of triglycerides 34. hospital is going to buy new equipment how do you know if it is working well?coefficient of variation,sd of difference,regenerating result? 35. gomori agar? 36. cryoptt must contain how many my of fibrinogen? 37. ffp storage 38. enterococcus-peptedoglycan 39. strep pneumoniae-lancet shape-sensitive to what? Bacitracin,Vanco,or penicillin 40. purpose of kbst stain 41. propionibacterium spp-bacterial contamination of the skin while drawing a clot 42. a black clot in a unit of bag means bacterial contamination 43. a picture of an rbc graph,is it normocytic,macrocytic,microcytic 44.treponemal test 45. cfu in immuno is what cell?lymphocyte t,b lymhpocye 46. picture of basophil but the choice was sensitivity to mast cells 48. selective cell pg. 82 82 49. blood typing problems 50.antibody identification 51. picture of western blot hiv,how do you report it according to cdc 52. what is the best for hiv test?is it pcr? To add to these recalls, I would definitely know the micro charts. I could get the choices down to two and then just took a guess. The most common cause of sperm agglutination is presence of sperm antibodies Swarming; indole negative (proteus mirabilis) Swarming; indole positive (proteus vulgaris) Picture of rouleaux; the cause of this can be prom the proliferation of (plasma cells-multiplemyeloma) Picture of csf electrophoresis; what would the tech do next Fresh frozen plasma was thawed at 10am and then stored at 4C to be picked up at 3, what should the tech do 2mL of blood and .5 mL ofanticoagulant; what would happen for results of apt Agar was poured into a 100 mL container instead of the normal 150 mL container. What would happen? LDL calculation hCg can be detected in hemophilia B is a deficiency in factor IX cell lysis in the classical pathway is caused by (know which numbers ex: C8, C5 etc.) urine was delayed in being refrigerated, what happens; increased pH increased amorphous, casts dissolve cause of cloudy CSF- crystals calculate anion gap calculate LDL pg. 85 85 2) Alkali (that was the exact word )what happens co2, co3, ph? 3) Plt pooled at rt, how long held for ? 2,5,12,24 hrs 4) Pic of crystals in acidic urine 5) Antler hypha what bacteria? 6)Prolonged pt, ptt and tt-? 7) First titer till 120 , second till 50, what is it ? Pnh, mycoplasma …? Something in that nature 8) 300 , what gives energy to things? K, copper, calcium ? 9) What grows on chocolate agar? 10)Aldosterone ? 11) Double zone , beta lactase? 12) Viewing crystals or urine under microscope , use 10x or 40 more light, less light . Something like that? 13) All analytes were out of wack, due to water not correct for Chem or reagents , something like that? 14) Mother donating rbc to son , what do you do… Wash, irradiate ect… 15) Where heme c and s found… Extrinsic , intrinsic, warfarin, heparin pg. 86 86 Which of the following will 1st to increase after MI? LD CK-MB Myoglobin Trop I Which of the following parasite cause autoinfection in immunocompromised px? S.stercoralis N.americanus A.lumbricoides A.duodenale Which of the following causes antibody against TSH? SLE Hashimoto‘s Dse RF Grave‘s Dse What RBC inclusion can be seen on blood smear of a child who accidentally ingested moth balls? Heinz bodies Pappenheimers Howell Jolly bodies pg. 87 87 Which of the following causes decrease HbA1c? IDA Hemolytic Anemia Sickle cell Which of the following cells releases histamine/heparin? Neutrophil, Eosinophil Eosinophil, Basophil Basophil, Mastcell Mastcell, Eosinophil Which of the following Mycobacteria we can acquire from tap water? M. leprae M. gordonae M. bovis M. tuberculosis Which of the following analytes is cofactor for most of 300 enzymes? Zinc Magnesium Calcium Potassium Which of the following condition is the most common cause of increase anion gap? Metabolic alkalosis Respiratory alkalosis pg. 90 90 35. Alpha thalassemia-hgb Bart and Hgb h 36. Eosinophils in Urine/ intestinal nephritis 37. know the difference CML and AML 38. Questions about multiple myeloma 39. Increase platelet and wbc 40. Issoagglutinin of Type O- anti A, anti B, anti AB 41. Beta and gamma bridge 42. HTLV- confirmatory test- western blot I passed my ASCP exam today. The high yield notes helped! As well as the passing strategy posted. I used Lab Ce did about 1300 questions mainly scoring between 60-70 on the review mode and 52-60 on the adaptive mode. I got mainly hematology and blood banking and just a few chemistry and about one lab management question.. To those who will be sitting the exam my Recall notes are; Blood Bank – make sure you know the antibody panel and how to identify the clinical significant ones I got about 2 panels. Use the one shown here in wordsology. – make sure you know how to interpret ABO blood typing. I got a question asking if Anti A is pos and Anit B neg and A1 cell Pos and B cells Pos. what should the technologist report. Also I got a question asking what should the technologist do if Anti A is mixed feel and Anti B is Pos and A1 cell Pos how would you interpret it. Also got tuns of questions about ABO discrepancies. If there is a autoantibody reacting only at room temperature which would it be. ect pg. 91 91 Clinical Chem I was asked to calculate – Molarity -creat clearance- osmolarity- anion gap, coefficient of variation, and I had to know the metabolic syndrome and the conditions that can cause them. LDL calculation as well. Microbiology – tons of questions! know the different in distinguishing K.pnemoniae from K. oxytoca. know about the differential medias. Thanks to the high yield notes most of the questions surrounded them. Hematology know how to calculate MVC, MCHC, Manual differentials or wcb, rbc, and one of platelet was there too.know the different leukemia CML, ALL and lymphomas and how to distinguish them. those are my recall in a nut shell. HIGH YIELD NOTES HELPED Hello everyone! I took my exam yesterday and passed! This website was super helpful, especially the high yield notes for micro and chemistry. I only studied for two weeks after finishing my program and I used the Harr book, Polansky notecards, and LabCE. BLOOD BANK 1. What antigens are found in the saliva of group A, Le(a+b-) individuals? – Le a (other options included A, H, Le b in different combos) 2. Given a mini panel of antibody reactions. The serum is tested against Group 0 RBCs and cord cells. Reacts with all adult cells, no reaction with cord cells. What antibody? – Anti-I pg. 92 92 3. Given panel of antibody reactions, have to determine which ones are causing the reaction and choose the choice that corresponds to them. – In mine, the antibodies were anti-Le a and Le b, but the answer to the question was ‗Is absorbed from the serum onto red cells.‘ 4. I had 2 questions with the same picture, a cold agglutinin picture. The first question asked what disease/infection it was associated with (Mycoplasma pneumoniae) and the second asked what would cause this blood picture (cold reacting antibodies). 5. Blood comes up positive for HTLV-I/II, what do you do next? – I put repeat the test that was just run. (It said which test in the question, I believe it was EIA, so ‗repeat EIA,‘ but I‘m not 100% sure. Other options were western blot, etc.) 6. O neg, Rh pos patient now has a positive DAT. What will their typing results look like now? Includes Rh control. – I chose the answer where everything was negative except the Rh control was positive. 7. Which antibody degrades upon standing, making it hard to detect? – I didn‘t know the answer. I think I chose Lewis. CW was an option and I don‘t remember the rest. 8. Lots of discrepancies, either due to ABO or reagents/technique, but all situational. I don‘t know how else to prepare yourself for them other than knowing the basics well and being able to apply them to reason your way through. 9. Given mother blood type (AB-) and baby type (O+), what do you do next? – Since O blood type is impossible from AB mom, get a new heelstick from baby. Other options were get a sample from father, administer RhIg. 10. Mixed field reaction observed. What caused it? – I chose transfusion with O cells. 11. Donor deferral question IMMUNO 1. ANA pattern, asked what antibody would make that pattern. 2. Patient comes in with mild flu-like symptoms. Given table with IgG and IgM titer values for EBV, CMV and toxoplasma. Have to determine if primary infection with just one or coinfection of EBV, CMV. pg. 95 95 them. – Acute tubular necrosis and renal calculi. 3. 2 or 3 questions on dipstick false positive/negatives. Make sure you know these pretty well. I studied them because other people mentioned it and still had trouble. – Blood and glucose were the two I know for sure were asked about. 4. Hemolytic anemia/prehepatic issue, choose correct results for unconjugated & conjugated bili, urobilinogen, and urine bilirubin. 5. Patient taking primidone showing toxicity, but blood levels normal. What do you do next? – Test phenobarbital level. 6. Sperm count can be done on semen sample when… – Liquefaction is complete 7. Tumor marker seen in pancreatic cancer – CA 19-9 8. Cortisol and ACTH levels in adrenal Cushing‘s. 9. Given values for fasting glucose and random glucose. What do you do next to diagnose diabetes? – Both are over diagnostic values, so nothing else needed for diagnosis. 10. Fasting glucose 120. What‘s the diagnosis? – Impaired fasting glucose. 11. Pheochromocytoma – Metanephrines Hey guys, this is what I remember so far…my brain is toast, and yours will be too, but it‘ll be worth it.. 1. Burr cell – uremia 2. pyr – know POS and NEG orgs 3. BE and NaCl – know orgs POS/neg for them (entero, Grp D, Viridans) 4. KNOW TSI slants blindfolded – if its A/A and gas productio0n wht is it.. entero, serratia, s bovis, grp D strep (my question, I think those were the choices, or close to it) pg. 96 96 5. CAMP test POS and NEG ctrls (agalac and pyog) 6. 1 ANA – it had things with like 4 colors green yelloow orange and red all over it looked like a f-ing picasso painting so I totally guessed 7. know the thyroidism chart for inc and dec in TSH, t4 and T3 8. know PTH effects on Ca+ 9. Know about aldosterone inc and dec and when it happens, (Conns) and effect on Na and K 10. Cushings is hyperglycemia 11. PTH and Ca+ relationship 12. something about perfringens i think 13. a tough hemoglobin C question 14. rouleaux is undetectable at what phase 15. CMV best to do viral culture (i think, but i guesses) 16. ESRD (1.010 sg and waxy casts predominate) 17. a couple of thrombin/ antithrombin questions 18. no VWF 19. know about heparin contamination and mixing studies and TT/fibrinogen times 20. HBA1C 21. rotavirus – stool 22. HTLV confirmation testing 23. weak D epitope something 24. whats wrong with this stain – acidic so change pH 25. sezary – t cell or congenital t cell (difference) 26. Amylase – mumps 27. something about rubella I forgot 28. enzyme effect on certain Abs (destroy, enhance) pg. 97 97 29. about 4 questions about diabetes ( insipidus, mellitus, the ref ranges for cutoffs for diagnjosing) 30. Conn‘s sydrome Aldo increases 31. jeikiem quesition about somehing idk 32. know different between glom nephritis. Pyelonephritis, nephrotic disesase, (conj, unconj, urobili) 33. had 1 metabolic acidosis question 34. had the PCR question – denature, anneal, extend 35. had a hypo hashimoto question about tsh inc 36. troponin stays in the system longest 37. 1 syphilis question… just know whats POS and NEG for each of he 3 phases ( the rpr and VDRL) 38. an aeromonas question where it gives you the rx it was something like oxi POS, and some other rxns 39. know the TSI slants ( I have a story for common imvic orgs that helps so if you want it let me know) 40. a really crappy grainy picuture of what looks like rbc agglutination/flocculation/some other crap … that sais what should you do next – I chose heinz body stain (actually got this exact pic twice) 41. intrinsic resistances to common drugs (kleb amp R, Micrococcus R furosamide, stenotrophomonas Bactrim Res , etc) 42. a lot of aldosterone related questions (like 5) and diseases associated with them 43. a couple of coag cascade questions like when to do an F8 assay 44. when to do PT (warfarin therapy) 45. TB testing PPD is T-cell mediated type 4 hypersensitivity rxn 46. know common markers for B and T lymphs (CD 19, 20/ CD 2,3,5,7, 4/8 mature) 47. if pt and ptt are inc what do you do next (exactly waht do you do next) 48. a s-load of bilirubin (like 7) know what happens in prehep, hep, post hepatic and nephrotic syndrome, when you would expect to see jaundice associated with what Bilirubin, etc 49. absolutely no parasitology 50. no myocology