Professional Documents
Culture Documents
Contents
Body fluids ................................................................................. 2
Clinical Chemistry .................................................................... 5
INSTRUMENTATION AND GENERAL ......................................................................................5
BLOOD GASES, PH AND ELECTROLYTES. .............................................................................8
GLUCOSE, HEMOGLOBIN, IRON AND BILIRUBIN. .............................................................12
CALCULATIONS, QC AND STATISTICS ................................................................................17
CREATININE, UA, BUN AND AMMONIA ...............................................................................19
PROTEINS, ELECTROPHORESIS AND LIPIDS .......................................................................20
CLINICAL ENZYMOLOGY........................................................................................................24
CLINICAL ENCOCRINOLOGY .................................................................................................26
General ..................................................................................... 32
Hematology .............................................................................. 35
BASIC HEMATOLOGY CONCEPTS / LABORATORY PROCEDURES ................................35
NORMOCYTIC NORMOCHROMIC ANEMIAS .......................................................................38
HYPOCHROMIC MICROCYTIC ANEMIAS .............................................................................45
MACROCYTIC NORMOCHROMIC ANEMIA .........................................................................47
QUALITATIVE / QUANTITATIVE WBC DISOREDERS ........................................................49
LYMPHOPROLIFERATIVE / MYELOPROLIFERATIVE DISORDERS .................................52
COAGULATION AND PLATELETS ..........................................................................................62
Immunohematology ................................................................ 68
Immunology ............................................................................. 74
Microbiology............................................................................ 79
ANTIBIOTICS, ANTIMICROBIALS, STERILIZATION AND DISINFECTION .....................79
BASIC TECHNIQUES .................................................................................................................82
BASIC BACTERIOLOGY............................................................................................................86
GRAM POSITIVE COCCI ...........................................................................................................90
GRAM NEGATIVE COCCI .........................................................................................................94
GRAM POSITIVE BACILLI ........................................................................................................95
ENTEROBACTERECIAE & PSEUDOMONAS .........................................................................96
RICHETTSIAE, CHLAMYDIA AND MYCOPLASMA ...........................................................102
SPIROCHETES ...........................................................................................................................103
BORDETELLA & BORRELIA ..................................................................................................104
ANEROBIC BACTERIA ............................................................................................................105
BRUCELLA ................................................................................................................................106
MYCOBACTERIA .....................................................................................................................107
MISCELLANEOUS ....................................................................................................................108
MYCOLOGY ..............................................................................................................................111
PARASITOLOGY .......................................................................................................................112
VIROLOGY ................................................................................................................................118
5/3/2014
mohammad_emam@hotmail.com
BODY FLUIDS
Body fluids
1
1.
dipalmitoyl lecithin
2.
3.
******Regarding Albustix:
a. Useless if infected urine.
b. Gives red color.
c. Not useful if acid is added to urine.
d. Depends on acid precipitation of urinary proteins
3.
mohammad_emam@hotmail.com
d.
BODY FLUIDS
multiple sclerosis
4.
4.
5.
5.
6.
6.
7.
7.
8.
8.
a.
mohammad_emam@hotmail.com
BODY FLUIDS
9.
9.
10.
10.
See 7.
Urine becomes black on standing in cases of
alkaptonurea (homogentesic acid) and
methemoglobinurea.
11.
11.
a.
c.
d.
mohammad_emam@hotmail.com
CHEMISTRY
Clinical Chemistry
INSTRUMENTATION AND GENERAL
1.
1.
2.
2.
a.
3.
3.
4.
4.
5.
5.
6.
6.
7.
7.
8.
8.
mohammad_emam@hotmail.com
CHEMISTRY
d.
a.
d.
d.
a.
b.
b.
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CHEMISTRY
d.
c.
cholesterol
H2O2
heparin is:
a. protein
b.enzyme
c. polysaccharide
d.oligosaccharide
e. non of the above
c.
cosnider ketose:
a. glucose
b.fructose
c. mannose
b.
b.
pyrimidin base:
a. adenine
b.guanine
c. thymine
d.uric acid
e. urea
c.
2 purine bases (adenine and guanine)
2 pyrimidin bases (thymine and cytosine)
mohammad_emam@hotmail.com
CHEMISTRY
c.?
To get serum
a.
a.
9.
11.
11.
12.
12.
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CHEMISTRY
13.
13.
e.
****pH means:
14.
15.
15.
16.
16.
17.
17.
18.
pH of the blood.
18.
7.35 to 7.45
19
19
19.
19.
New
mohammad_emam@hotmail.com
New
CHEMISTRY
20,
21,
22,
24,
25,
26.
20,
21,
22,
24,
25,
26.
Na is the main?
a. intra cellular anion
b.intra cellular cation
c. extra cellular cation
c.
c.
23.
23.
27.
27.
28.
28.
Hypocalcaemia.
Causes of renal damage include; hypovolemia
(hemorrhage or dehydration), myoglobulinurea,
hypercalciurea, uricosuria, and drugs e.g.
aminoglycosides and ACE inhibitors.
See 23.
(d) Hypernatremia occurs with:
* body Na : due to extrarenal water loss or
renal diuresis.
* Normal body Na: due to extrarenal loss e.g.
hyperthermia or renal loss e.g. DI.
* Na retention e.g. steroids or Na intake.
c.
c.causes hypokalemia
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10
CHEMISTRY
28.
New
1
28.
New
2
28.
New
3
28.
28.
28.
New1
New
2
New
3
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11
CHEMISTRY
c.?
Potassium, serum: 3.5 - 5.0 mEq/L
Urine K 25-125 mmol/L
Sodium, serum: 135-145 mEq/L
Sodium, urine: 40-220 mEq/day
metabolic alkalosis
blood gases
29.
30.
10.
c.
c.
29.
- 25-30 g/dl
In newborn babies, glucose tends to be lower than
in adults. Critical low level in newborn is 30mg/dL
70 - 140 (random)
d.
a.
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30.
c.
12
CHEMISTRY
31.
c.
31.
d.
32.
33.
33.
mohammad_emam@hotmail.com
34.
13
CHEMISTRY
c.
a.
35.
35.
36.
36.
lipase
37.
38.
38.
39.
(ketones in urine)
c.?
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14
CHEMISTRY
d.?
b.
glycolysis done in :
a. nucleus
b.endoplasmic reticulum
c. mitochondrion
d.cytoplasm
e. non of the above
a.
40.
40.
41.
41.
d.
42.
**AST (SGOT)
ALT (SGPT)
*specific diagnostic liver enzyme:SGPT
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15
CHEMISTRY
c.
c.more than 3
c.
all of the following can asses the liver function except :a-AST
b-ALT
c-ALP
d-creatinine
d.
c.
c.
a.
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16
CHEMISTRY
d.
b.and (e)
c.
43.
44.
44.
45.
45.
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17
CHEMISTRY
46.
46.
47.
47.
48.
48.
49.
49.
50.
50.
51.
51.
52.
52.
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18
CHEMISTRY
53.
54.
54.
55.
Diagnosis of RF
55.
56.
56.
57.
c.
a.
a.
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57.
19
CHEMISTRY
58.
58.
c.
c.
d.?
galactosemia
59.
60.
60.
cystic fibrosis
61.
62.
62.
mohammad_emam@hotmail.com
20
CHEMISTRY
d.
62.
64.
64.
65.
65.
. LDL
66.
66.
(b)
67.
67.
Albumin.
68.
68.
On electrophoresis;
Chylomicrons and its remnants stay at the
origin.
VLDL at pre (=2 globulin region)
IDL at broad
LDL at (= globulin region)
HDL at (= 1 globulin region)/
69.
69.
70.
70.
71.
71.
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21
CHEMISTRY
LDL
HDL
12-14h
72.
72.
74.
74.
75.
Chylomicrons:
a. Can cause thrombosis.
b. Cannot cause thrombosis.
75.
76.
Nature of apoproteins.
76.
77.
77.
e.g.
Presence
Suffix
Significance
Chemistry
78.
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78.
79.
Saturated
Oleic a (50% of
body fat)
Palmitic a (25%
of body fat)
Stearic a (5% of
body fat)
Acetic a.
Butyric a.
Adipose
Anoic
No double
bonds
Unsaturated
Linoleic a
Linolenic a
(both are
Essential)
Arachidonic a.
Vegitable oils.
Enoic
Arachidonic
acid is precursor
of Pgs.
Although not
essential, it
depends on
essential FA
Double bonds
CHEMISTRY
79.
80.
80.
82.
82.
type ll B hyperlipidemia
c.
c.
b.
fibrinogen
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23
CHEMISTRY
CLINICAL ENZYMOLOGY
83.
83.
(b) Lipase elevation is of a greater magnitude (210 xN) and duration than amylase in acute
pancreatitis. When lipase method is optimized,
the test is more sensitive and specific than
amylase for detection of acute pancreatitis.
84.
84.
85.
85.
(d)
**Isoenzymes:
a. Are physical types of one enzyme.
b. Have different electrophoretic mobility.
c. All of the above
86.
86.
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CK
CK-MB
AST
LDH
Onset (h)
Peak (h)
6-12
3-10
6-12
6-12
20-30
12-24
20-30
24-72
Duration
(d)
2-6
1.5-3
2-6
7-14
24
CHEMISTRY
87.
88.
87.
c.
in myocardial infection?
a. level of LDH high
b. level of GOT high
c. level of CK-MB high
Creatinine
Serum protein electrophoresis
88.
hemolysis increase
a. ALP
b.ACP
c. LDH
d...
****Myoglobin in injury of:
a. muscle.
b. Liver
89.
(a) CK-MB is specific for cardiac muscle, CKBB for brain and CK-MM for skeletal muscle.
89.
protein electrophoresis
c.
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25
CHEMISTRY
c.
c.
c.
d.
CLINICAL ENCOCRINOLOGY
90.
******ADH is?
a. Produced by posterior pituitary
b. Produced in the hypothalamus
90.
91.
91.
92.
92.
93.
hypoglycemia
hyperglycemia hormone
glucagon
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93.
26
CHEMISTRY
a.
94.
(b) Water intake is restricted the patient loses 35% of body weight or until 3 consecutive hourly
determination of urine osmolarity are within
10% of each other. Measure urine osmolality,
plasma vasopressin and increased urine
osmolality with exogenous vasopressin.
Normal
DI
Nephrogeni
c DI
Urine
osmol
>800
<300
<300
Pl. VP
After VP
>2
Undetectab
le
>5
No change
95.
95.
96.
96.
c.
b.
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27
CHEMISTRY
97.
97.
All.
In diabetes, 2 types of coma may occur, DKA
and nonDKA. Glucose levels in nonDKA are
typically <800 mg/dL. Once hyperglycemia is
established, ketonurea & pH should be looked
for to differentiate.
98.
98.
98.
98.
New
New
b.
phemchromocytoma
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28
CHEMISTRY
cushing
in cushing syndrome
a. decrease glucose
b.lipolysis
c. decrease k
b.(decrease K is rare)
c.
b.
e.
b.
prolactin is produced by
Sheehan syndrome
b.
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29
CHEMISTRY
c.
d.
function of estrogen:
a. increase oogenesis
b.stimulate contraction of uterus
c. increase basal metabolic
a.
estrogen is produced by
ovary
function of cortisol :
a. increase oogenesis
b.stimulate contraction of uterus
c. increase basal metabolic
c.
b.
b.
c.
b.
25 hydroxycholecalciferol synthesized in
a. liver
b.kidney
c.
b.
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30
CHEMISTRY
b.?
a. Hypophosphatemia
b. 1ry hyper parathyroidism
c. 2ry hyper parathyroidism
15 q deletion syndrome
21-hydroxylase deficiency
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31
General
General
1.
1.
2.
2.
3.
3.
b.
4.
4.
5.
5.
6.
6.
7.
****Hemolysis causes?
a. Increased serum K
b. Increased serum Na
c. Increased HCO3d. Decreased K
7.
a.
a.
8.
After hemolysis:
a. Sodium leaks out of RBCs.
b. K leaks into cells.
c. Bicarbonate gets into RBCs.
8.
c.
9.
Effects of fasting
9.
mohammad_emam@hotmail.com
32
General
10.
10.
a. Blood sugar
d.
11.
Fluoride
12.
13.
14.
vit retinol
vit A
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33
General
digitalis toxicity
a. hypocalcemia increase its effect
b.hypokalemia increase its effect
c. hyperkalemia increase its effect
d..
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34
Hematology
Hematology
BASIC HEMATOLOGY CONCEPTS / LABORATORY PROCEDURES
1
b.
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35
Hematology
normal
b.Hct=MCVRBC
a. 18 gauge.
10
**RDW is increased in
10
11
11
12
13
13
14
**Perl's stain
14
BM iron stores
14.
14.
12
New
mohammad_emam@hotmail.com
New
4-11 x 10^9
36
Hematology
leukocyte
reticulocyte is immature:
a. RBC
b.WBC
c. Platelet
**anisocytosis
erythropoietin
GM-CSF
oxidative phosphorylation
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37
Hematology
15
16
16
17
17
Salmonella.
In sickle syndrome, infarctions in the spleen
leads to autosplenectomy causing more
predisposition to pneumococcal infections.
Infarctions in the intestine leads to passage of
salmonella which infect the bones causing
osteomyelitis.
18
18
Fanconi syndrome.
Fanconi syndrome consists of:
- Congenital aplastic anemia.
- Skeletal and urinary tract anomalies.
- Microcephaly.
- Altered skin pigmentation.
19
Fanconi's anemia
19
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38
Hematology
20
20
e.
21
22
a. Aspirin.
23
23
24
24
d. Thrombocytosis
25
25
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39
Hematology
26
Normal haptoglobin.
In intravascular hemolysis serum haptoglobin is
decreased or absent due to consumption.
haptoglobin
haemosidrinurea
27
27
28
28
G6PD.
In favism, hemolytic anemia develops whtn the
RBCs are exposed to oxidant stress e.g. drugs,
infection and favism.
29
29
d.
a.
In hereditary spherocytosis
30
30
Splenectomy
31
31
A2
32
(c).
40
Hematology
33
33
34
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34
41
Hematology
35
35
G6PD
G6PD
c.
36
36
37
37
pancytopenia.
aplastic anemia
Barvovirus B18
all cause pancytopenia except
a. aplastic anemia
b.acute leukemia
c. hypersplenism
d.
b.?
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42
Hematology
38
RAEB
38
39
**Manifestations of HbSS
a. Ischemia to femoral artery.
b. Infarction of phalanges.
39
*****Major adult Hb is
41.
New
BM
<5%blasts
<1%blasts
<5%blasts
>5%
20-30%
monocytes
promonocytes
Peripheral blood
<1%blasts
41
Hb A2 is consisting of:
a. 3 chains and 2 chains
b.2 chains and 2 chains
c. 2 chains and 2 chains
d.2 chains and 3 chains
e. 3 chains and 2 chains
HbA
Hb F
infant heamoglobin
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43
Hematology
d.
e.
d.
a.
d.
b.
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44
Hematology
42
hypochromic, microcytic
in iron deficiency anaemia :
RBCS are smaller than normal
43
43
a.B-thalassemia major
44
44
45
**Normal Hb pattern?
45
HBA ( 2, 2)
Other Hb patterns: HbA2 (2, 2), HbF (2,2)
46
46
b.
Iron absorption is adjusted to body needs. It is
increased in iron deficiency anemia and
pregnancy.
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45
Hematology
****Regarding iron
47
48
48
49
49
Thrombocytopenia.
Actually there is raised platelet count in IDA
50
50
51
***Hb H disease.
51
51.
New
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46
Hematology
e.
all occur in .thalss.major except
a. -hair on end X ray skull
b.-isch.neck of femur
c. -easily bone fracture
d.-frontal bossing
e. -decrease susceptibility of infection
the defect of thalassemia occur in:
a. cycle of heme
b.glubin chain
b.
b.
b.
TIBC.which is true
a. decrease in females taking oral contraceptives
b.more labile than plasma iron
c. done only with normal serum iron
d.used as indirect indicator to plasma transferrin
saturation
e. it equals 6 times plasma iron con
d.
52
2-4 months.
Fr vitamin B12, stores are enough for 2-4 years.
53
53
Defective Hb synthesis.
Megaloblastic anemia is associated with delated
nuclear development due to defective DNA
synthesis not defective Hb synthesis.
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47
Hematology
54
**Folate is affected by
54
Cooking
Steaming and frying causes loss of 90%, boiling
for 8minutes causes loss of 80% of folate.
55
55
IF deficiency.
Total or partial gastrectomy causes vitamin B12
defeciency.
56
56
Megaloblastic.a
Hypersegmentation = shift to the right. Other
causes include;
- liver disease.
- Uremia.
- Infection and toxemia.
Hyposegmentation = shift to the left occurs in;
- Leucocytosis.
- Thyroid disease.
- Pelger Huet
57
57
58
58
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59
Vit B12 defeciency
Folate deficiency
- Cytotoxic.
- Metformin.
- Colchicin.
- Anticonvulsants.
- Paraaminosalicylic acid.
- Neomycin.
Occurs with;
- Salazopyrine.
- Cholestyramine.
- Triamterene.
- Anticonvulsants.
- Anti TB
48
Hematology
60
e. a and c
Cold agglutinins are IgM, work at 4c. It is anti I
in IMN and in idiopathic type, or both anti I and
anti i in lymphocellular disorders.
61
61
e. Paracortical area of LN
c.
62
62
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Follicles and
germinal center
(B-cells)
Paracortex
(T-cell)
63
B cells (x)
Impaired granulocytes staph. abscesses.
Impaired antibody formation pneumonia by
pyogenic organisms.
Impaired cellular immunity mycobacteria,
nocardia, fungi e.g. pneumocystis carinii &
candida, viruses, parasites.
49
Hematology
64
64
65
65
Neutrophilia.
In IMN there is;
- TLC 12-18
- Atypical lymphocytes.
- Neutrophilia (early) followed by
neuropenia).
- Thromobytopenia.
66
66
Lymphokines
67
Neutrophil deficiency =
67
68
a.
sepsis
c.cause lymphopenia
lymphocyte is elevated in :
a. viral infection
b.acute bacterial infection
c. iron deficiency anemia
d.megaloblastic anemia
e. non of the above
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68
Hematology
69
69
70
Which is wrong :
***. Regarding the function of T-cell, which is correct?
a. IL-1 is produced early in the immune response.
b. T cells donot respond to IL-2 early in the immune
response.
70
71
71
NK cells
These are not B nor T-cells, though are CD8+.
They characteristically have prominent granules
and are often large granular lymphocytes.
72
72
73
IL1 & 2.
73
b.
Which is wrong
a. IL-1 is produced early in immune response
b.T cell donot respond to IL2 early in immune response
74
74
75
75
76
**SAEP cause
76
Giant neutrophils
77
77
GM-CFU
Also G-CFU
78
78
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51
Hematology
**Prognosis of M4 is
79
Poor (x)
Prognostic Factors in AML
Favorable
young age
Unfavorable
older age: Age >60 is usually
considered a poor prognostic
factor because older patients
generally don't tolerate
therapy & higher likelihood
of having unfavorable
prognostic factors e.g. special
cytogenetic abnormalities.
FAB type M7
bnormalities of
chromosome 11 at band q23
80
b. bad prognosis
81
81
82
82
e.Pagets disease
Indications for BMT are:
- ALL.
- AML
- Chronic or accelerated phases of CML.
- Severe aplastic anemia.
- Selected cases of:
MDS, Lymphoma, MM, CLL
Thalassemia major, sickle cell disease.
Severe inherited metabolic disease e.g.
adenosine deaminase deficiency and
Hurler's syndrome.
Not for CML blastic phase
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52
Hematology
83
83
None
Bad prognostic factors in ALL are;
a. TLC > 50x109/L
b. CNS involvement
c. Age <1 or >50 year old
d. Boys.
e. t(1;19)
f. T immunophenotype in children and
myeloid antigen in adults.
g. Blasts in peripheral blood on day 7
h. >5% blasts in bone marrow on day 14
i. No complete response on day 28
84
84
85
85
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53
Hematology
c.
86
Promyelocytic leukemia
FAB
M1
M2
M3
M4
M5
M6
M7
HISTOCHEMISTRY
Occasional peroxidate+ granules, PASStrongly peroxidase+, PASStrongly peroxidase+, PASStrongly peroxidase+, some cells may be
PAS+
Many be peroxidase+ and PAS+,
nonspecific esterase stains are strongly +
and inhibited by NAF
Red cell precursors are PAS+, ringed
sideroblasts are seen with iron stains
Variable, platelet peroxidase can be
demonstrated by electron microscopy
87
87
88
88
CML
NAP occurs in mature neutrophils.
High score (35-100) occurs in normal subjects
and in liver diseases, Down's syndrome, PCV,
aplastic anemia, HD, ALL)
Intermediate score in M5, M4 and CLL.
Low score occur in AML, lymphosarcoma and
PNH
89
89
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54
Hematology
90
90
91
91
92
92
t(15:17)
93
93
b. t(9:22)
d.
94
**HTLV except
94
95
95
CD antigen
96
96
97
****Paraprotiens are?
97
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55
Hematology
98
99
98
c.
a.
***In CLL:
a. RAI classification III is either I or II with hemolytic
anemia.
b. 5% terminate by Richter's syndrome.
c. 30% of lymphocytes agglutinate RBCs
99
?c.
According to RAI classification, III is 0 or I or II
but Hb is < 11g/dl due to marrow failure not
hemolysis.
Richter transformation
d.
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56
Hematology
b.RAI classification
Stage 0: absolute lymphocytosis without
adenopathy, hepatosplenomegaly, anemia, or
thrombocytopenia.
100
101
101
102
102
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57
Hematology
mohammad_emam@hotmail.com
103
58
Hematology
106
106
Haploid transplantation.
107
108
108
109
109
110
Burkitt's lymphoma.
NHL is more common in children than HL.
Burkitt's is a NHL.
112
**Waldenstrom's macroglobulinemia:
a. Proliferation of cells that resemble lymphocytes rather
than plasma cells.
b. They produce IgM molecules and often excess of light
chains.
c. All of the above
112
mohammad_emam@hotmail.com
a.
59
Hematology
113
a.
113
c. Myelosclerosis is characterized by
splenomegally, extramedullary hemopoiesis,
leucoerythrocytic blood picture + replacement of
BM by collagen fibrosis. Hepatomegally is
requent. BM shows cellularity (not
hypocellularity).
There is no anisopoikylocytosis
114
Same
115
115
116
116
117
117
Both
Sezary syndrome is a T-lymphoid leukemia, a
skin lymphoma with leukemic phase. Seizary
cells are small with highly convoluted nucleus.
Epidermis is involved.
c. associated with HTLV I
mohammad_emam@hotmail.com
118
60
Hematology
118
New
1
118
New
2
118
New
3
118
New
1
Hodgkin lymphoma
118
118
New
2
New
3
b.
b.
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61
Hematology
119
Hypofibrinogenemia.
In DIC there is the triad of hypofibrinogenemia,
thrombocytopenia and FDPs.
Hyperfibrinogenemia
DIC is a complication of
shigellosis
120
120
thromboxan.
Thromboxane is a platelet aggregator.
Inhibitors of coagulation include;
Serpentines:
ATIII
Heparin co factor II
1 antitrypsin
C1 estrase inhibitor
2 antiplasmin
2 macroblobulin
Protein C system
Protein C
Protein S
Thrombomodulin
C4b binding protein.
121
121
d. Fanconis syndrome.
Fanconi syndrome is congenital aplastic anemia
with pancytopenia and absent megakaryocytes.
**ITP affects
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122
Females> males
62
Hematology
123
123
Leucopenia
In TTP, there is absence of platelet protease that
cleaves vW macro vW thrombosis in
microcirculation + cell fragmentation (HA) +
fever + liver dysfunction. It occurs in adults +
AI or pregnancy. May be fatal.
124
***ITP in child
124
Mechanism of ITP
a. Antibodies against PL surface antigen
b.Hypersplenism
a.
125
125
126
126
SLE.
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63
Hematology
127
127
Aspirin
Platelet dysfunction are;
adhesion:
- vW
- Pseudo vW
- Bernard Soulier syndrome.
release:
- SPD:
SPD
Wiscott Aldrich syndrome
Hermanskey syndrome
Chediak Hegashi syndrome
TAR syndrome
- granules: Grey platelet syndrome.
- TXA2
aggregation:
- Glanzmans syndrome
- Afibrinogenemia.
Aquired:
- myeloproliferative
- renal
- FDPs
- Drugs: Aspirin
- Chronic hypoglycemia.
d.
128
Increased
129
129
**In purpura:
a. Hemorrhage in deep muscles.
b. Hemorrhage in mucus membrane.
c. Hemarthrosis.
131
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131
64
Hematology
132
b.?
133
a. APTT is prolonged.
All true except normal APTT
134
******Treatment of vW disease:
a. Factor VIII
b. Cryoprecipitate.
c. FFP
134
135
135
PTT
VII deficency
c.
a.
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65
Hematology
PTT
136
136
137
137
c.
138
Regarding protein C.
139
139
140
140
a.
b.
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66
Hematology
c. 10.0 x 109 /L
mohammad_emam@hotmail.com
d. Reticulocytic count.
c.
67
Immunohematology
1.
2.
2.
ABO incompatibility.
3.
3.
4.
Unsuitable donor.
4.
All (see no 5)
Cord Hb (x see 5)
bilirubin and cord haematocrite
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68
Immunohematology
10
10
e. previous pregnancies
Possibly transmissible infections not routinely
tested are:
- B. burgdorferi.
- Y. enterocolitica
- P. falciparum.
(20-24)room temprature
b.
D-antigen
myasthenia gravis
c.
cold agglutination
mohammad_emam@hotmail.com
69
Immunohematology
**RH DU reported as
a. positive
b.negative
b.
c.
in O+ve person
a. no presence of ag
b.no presence of ab
c. .
d.
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70
Immunohematology
Adequate donor
a. Donor with HBV 9 months ago
b.Donor with thalassemia trait
c. Donor with previous 3 or more donation in the calendre
year
d.
b.?
a.
b.
c.
in blood transfusion
a. HLA of donor react with recipient neutrophil MHC l
b.HLA of donor react with recipient neutrophil MHC ll
c. HLA of recipient react with donor neutrophil MHC l
d.HLA of recipient react with donor neutrophil MHC ll
c.
d.
immunoglobulin is:
a. beta globulin
b.alfa globulin
c. gamma globulin
c.
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71
Immunohematology
mohammad_emam@hotmail.com
72
mohammad_emam@hotmail.com
Immunohematology
73
Immunology
Immunology
1.
1.
2.
2.
Prozone phenomenon
a. Excess Ag
b.Excess Ab
3.
3.
b.
4.
4.
5.
5.
c.
In arthus phenomenon, a high antigen
concentration is attacked by a high antibody
concentration excess antigen antibody
complexes followed by local tissue damage.
6.
6.
7.
**All tube for serial dilution for CRP test contain 0.5ml
of saline & 0.5ml of serum is added to Tube 1 & 0.5ml is
transferred through the row of tubes & agglutination is
demonstrate in tube 7, If sensitivity of the test is 6mg/l
the concentration of CRP in serum is?
a. 36mg
b. 42mg
c. 6mg
d. 48mg
e. 384mg
7.
e.
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74
Immunology
8.
8.
9.
9.
Anti (i)
10.
10.
11.
11.
31.
12.
12.
13.
13.
IV hypersensitivity
14.
14.
Candida
Defective CMI candidiasis.
15.
15.
Tuberculin
16.
16.
Tuberculin
17.
17.
31.
d.?
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75
Immunology
a.
a.
e.
Monocyte
= macrophage
c.
c.
a.
a.
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76
Immunology
Heaviest Ig
a. IgG
b. IgM
c. IgA
d. IgE
a. IgD
b.
d.
neutrophil
**pathology of rheumatic fever similar to
a. endocarditis
b.pericarditis
c. pancarditis
d.vasculitis
c.
a.
phagocytosis
? may be a.
b.
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77
Immunology
a.
titration
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78
Microbiology
Microbiology
ANTIBIOTICS, ANTIMICROBIALS, STERILIZATION AND DISINFECTION
1.
1.
.
a.-penicillin
b-erythrocin
c. penicillin
d-ceftriaxone
e- vancomycin
2.
2.
Aminoglycoside
Aminoglycosides act on 30s ribosomal
subunit.as tetracyclines.
a.
Ampicillin is effective in
a. Proteus mirabills
b.Proteus valgaris
3.
3.
Nfcillin or dicloxacillin.
4.
4.
5.
***What is lab safety level you will employ for the culture
of brucella?
a. Routine precaution
b. bio safety level 1,
c. bio safety level 2
d. bio safety level 3
e. no specific measure
5.
Description
Organisms are low risk to lab
workers and community
(common organisms)
Moderate risk to lab workers
limited risk to community e.g.
staph, strept., vibrio
High risk to labo workers,
low risk to community (dont
spread rapidly) e.g. brucella,
TB, Salmonella
Viruses, high risk to lab and
community
Biosafety
level
1
6.
6.
Cloxacillin.
7.
7.
Disinfection
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79
Microbiology
8.
8.
9.
b. Erythromycin.
10
10
b.
11.
11.
b. Ceftriaxone.
12.
12.
b. Extended-Spectrum Beta-Lactamases
(ESBLs) are enzymes that can be produced by
bacteria making them resistant to
cephalosporins e.g. cefuroxime, cefotaxime
and ceftazidime
chloramphenicol
13.
13.
14.
14.
Glutaraldehyde.
Or phenolic
15.
15.
a.
80
Microbiology
16.
Bronchoscope
16.
Glutaraldehyde
17.
17.
Ethanol
70% alcohol cause protein denaturation and
cell membrane damage.
Phenol
c.
e.
a.
c.?
b.
c.? or b.
Centrifugation
chemical sterilization
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81
Microbiology
BASIC TECHNIQUES
18.
18.
19.
19.
a. L.J medium
b. Chocolate agar or Thayer martin media
c. Lefflers media
d. Blood agar
e. chocolate agar
f.bordet gengo medium
c.
d.
c.
f.
20.
**If you forget iodine step in gram stain staph aureus will
be seen?
20.
Red
21.
21.
100,000. (105)
104-105 = Equivocal
<104 and mixed = probable contamination
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82
Microbiology
22.
22.
c.
Also known by abbreviation SPS
23.
23.
e.
c.
25.
24.
b.
a.?
coryenbacterium diphteria
d.
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25.
c. trace of free O2
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Microbiology
26.
26.
b. 0.5%
For solid medium 1.5-2% concentration is
used.
27.
27.
b. 10 seconds
28.
28.
c.
c.
a.
29.
29.
c. Methyl alcohol
best fixative for thin smear is ethyl alcohol
30.
30.
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84
Microbiology
a.
31.
32.
32.
33.
33.
d.
c.
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85
Microbiology
a.
b.
c.
c.
a.
c.
a.
Carry Blair
Pleural fluid and --- abscess
H*E
(histo.plasma and fungi)
lactose
Indole test
disc diffusion
18-24 hr.
3 C
microscopy
one selective plating medium
BASIC BACTERIOLOGY
34.
mohammad_emam@hotmail.com
34.
Microbiology
35.
35.
36.
36.
c.
e.
e.
37.
37.
c. 70s
Bacteria has 70s ribosomes with 30s &50s
subunits.
Mammalian ribosome has sedimentation
coefficient of 80s with 60&40s subunits.
38.
38.
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87
Microbiology
39.
39.
c.
40
40
41.
**Sepsis cause
41.
Toxic granulomas.
41.
New
b. Psuedomonas exotoxin A.
41.
New
b. and osteomilitis
a.
c.
d.
c.
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88
Microbiology
c.
d.
a.
a.
b.
mohammad_emam@hotmail.com
89
Microbiology
a.
a.
CSF
b.
?a.
42.
Teichoic acid
Gram posititve cell wall is composed of
peptidoglycan and teichoic acid (no lipid A or
polysaccharide as in gram negative cell wall)
43.
43.
Enterotoxin
This acts by stimulating relase of IL1 and IL2.
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Microbiology
44.
44.
stable
45.
45.
b.
46.
b.
48.
A & B hemolyticus.
47.
mohammad_emam@hotmail.com
48.
sore throat
Strept pyogenes cause three types of diseases;
- Pyogenic (pharyngitis and cellulites)
- Toxigenic (TSS and scarlet fever)
- Immunogenic (Rheumatic fever and AGN)
staph aureus
91
Microbiology
49.
49.
50.
50.
51.
51.
c.
d.
hyaluronidase
d.
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92
Microbiology
52.
52.
Capsular polysaccharides.
The capsular polysaccharides is antigenic.
Other protective mechanisms of pneumococci
include enzyme IgA protease, toxin and SSS.
53.
53.
54.
54.
55.
55.
Novobiocin.
Novobiocin is used to differentiate staph
epidermidis (sensitive) from staph
saprophyticus (resistant). To differentiate
staph pyogenes
a. Phage typing.
56.
56.
57.
57.
Streptococcus.
Strept fecalis grows on 6% NaCl while strept
bovis dont.
58.
Staph.
58.
Catalase test
Staph is catalase positive.
b.
c.
59.
59.
60.
60.
Strept. pyogenes.
rheumatic fever
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93
Microbiology
d.?
d.
alpha hemolysis (-hemolysis)
Streptococcus pneumonia
Streptococcus viridans
Beta hemolysis (-hemolysis)
Streptococcus pyogenes
Staphylococcus
Streptococcus agalactiae
Clostridium perfringens
Listeria monocytogenes
E. coli
P. aurginosa
Neiseria
Aeromonas
Morganella
gamma hemolysis (-hemolysis).
Enterococcus faecalis
a.?
61.
Maltose
Glucose
Sucrose
N. Gono
+
-
N.Menin
+
+
-
62.
63.
Meningococcemia causes:
63.
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94
Microbiology
64.
64.
vaginintis
Neisseria and mycobacterium
N. gonorrheae
sugar fermentation
65.
Diptheria bacilli,
66.
**Pseudomembrane cause by a
66.
diphtheria
67.
67.
*Schick test
d.
a.
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95
Microbiology
68.
68.
a. Diphtheria.
69.
69.
Listeria.
Something missed in this question; Listeria is
motile at 25c not at 37c. It grows on a wide
range of temperature (3-43c)
70.
70.
L. monocytogens.
b.
Listeria monocytogens.
71.
listeria(intracellular organism)
73.
Actinomyces israelii
& arachnia propionica
74.
72.
**Growth of actinomyces
73.
74.
Clostridium
75.
76.
**Proteus is
76.
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96
Microbiology
c.
77.
a.
78.
78.
79.
79.
80.
b.
80.
mohammad_emam@hotmail.com
81.
mucoid colonies
c.
97
Microbiology
82.
82.
.[++--]
83.
83.
84.
84.
proteus.
Also, Klebsieall and pseudomonas.
c. Not only sh. Sonni, but also Shigella A,B
and C.
85.
85.
86.
86.
Commensals of GIT
87.
E.coli is indole?
87.
Positive
Also proteus is indole positive.
c.
88.
89.
**Psuedomonas is?
89.
90.
90.
91.
91.
pseudomonas.
*pseudomonas aeroginosa is oxidase +ve
92.
92.
c.
93.
93.
94.
94.
Both Fluorescin
Pyocyanin 50% and
pyovirdin
others
pyorubin
pyomelanin
Pseudomonas aeruginosa.
mohammad_emam@hotmail.com
98
Microbiology
c.and e.
e.
d.
all is true about salmonella organism except:a- the main reservoir is human
b-contains O and H antigen
c-urease , KCN and phenylalanine negative
d-H2S positive with gas
e-indole +ve
e.
95.
95.
a. Typhoid fever
96.
96.
Salenite broth
a.
H antigen present in :
a. pilli
b.capsule
c. flagella
d.cell membrane
c.
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99
Microbiology
Salmonella cause
97.
97.
98.
98.
99.
99.
101.
100.
e.NLF
salmonella on XLD, brilliant green, SS (pink)
on bithmus sulfate (silver metalic with black
halo)
lactose
blue
101.
Motility
shigella
a.
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100
Microbiology
102.
102.
d.and c.
motile
E.coli
Salmonella
Vibrio
Proteus
pseudomonas
Enterobactre
Citrobactre
Serratia
Morganella
providentia
O-9,12, H-1,2
Non motile
Shigella
K.pneumoniae
Acenito
Yersenia
anthrax
HLA B 27
Salmonella osteomylitis in
103.
103.
blood culture
104.
104.
105.
105.
106.
106.
G-ve coccobacilli.
107.
107.
a. Pasteurella multucida
108.
108.
a. V. cholera
109.
109.
110.
110.
111.
111.
112.
Vibrio vulnificus.
112.
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101
Microbiology
d.
all is true about enterobacteriaceae except :a-they are hemolytic and sorbitol
b-ferments mannitol
c-grow in methylene blue medium
d-inhibited growth with 6.5 % nacl and/or at temperature
which of the following statements about campylobacter
is false:a-gram negative curved bacilli
b-slow growth
c-grow on xld medium
d-arranged in pairs
d.
Yersenia pestis
Legionella
113.
mites.
Causative organism is R. akari.
114.
114.
Giemsa stain
Giemsa gives rickettsia blue to purple color,
Gimenes stain it red, Machiavillo stain it red
inside blue cells and IF gives better sensitivity
and specificity.
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102
Microbiology
115.
115.
a.Chlamydia pneumoniae
116.
116.
Chlamydia
Sero D-K chlamydia trachomatis
chlamydia trachomatis
conjuctivitis trachoma
117.
117.
antimicrobial.
b.
Mycoplasma media is
PPLO
SPIROCHETES
118.
118.
b.
a.
a.
119.
**Treponema pallidum is a?
120.
119.
c.
Condyloma lata
2ry $
Condyloma accuminata
Papiloma virus
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103
Microbiology
121.
121.
122.
122.
123.
**Yaws disease
123.
124.
Chocolate media.
125.
127.
soft chancre
Soft chancre is also called chancroid. H.
Ducreii dont require V factor
HEMOPHILUS
124.
**Hemophilus grows
uxuriantly on?
125.
126.
127.
Haemophilus Ducrii
Chancroid
128.
128.
H. Influnzae
129.
129.
H. Influenza
130.
130.
children.
1/2 to 4 years old.
131.
131.
H.influenza
132.
Strictly aerobes.
133.
Bordetella exotoxin =
133.
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104
Microbiology
?a
134.
Oroya fever
Bartonella cause
ANEROBIC BACTERIA
135.
136.
Clostridium welchii,
Also called perfrengins.
135.
C. perfringens
C. tetani
C. deficile &
botulinum
137.
138.
**Clostridia are
**Bacteroid is resistant to?
a. Penicillin
b. metronidazole
c. aminoglycoside
d. chloramphenicol.
137.
138.
Lecithinase ve
Saccharolytic
NLF
Lecithinase +ve
Saccharolytic
LF
Lecithinase ve
asaccharolytic
NLF
b.
139.
140.
140.
a. Vincent angina
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105
Microbiology
141.
141.
a. B. fragilis.and streptococcus.
142.
142.
Blood
(selective or non selective), others include;
- Cooked meat broth (CMB)
- Thyoglycolate.
- BHI
143.
143.
144.
144.
Clostridia.
a.
b.
BRUCELLA
145.
145.
Brucella species
Also called undulant fever.
146.
146.
147.
147.
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106
Microbiology
MYCOBACTERIA
148.
**Mycobacterium Leprae
148.
149.
149.
T.B,
150.
150.
151.
151.
152.
d. 3-6 weeks.
153.
Lepromatous
154.
154.
155.
155.
very low.
Almost nil
156.
156.
157.
157.
TB
158.
158.
159.
159.
152.
153.
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107
Microbiology
d.acid fast
All Mycobacteria - M. tuberculosis, M.
leprae, M. smegmatis and atypical
Mycobacterium
Actinomyces (especially some aerobic ones)
with Mycolic acid in their cell wall (note
Streptomyces do NOT have) e.g.
Nocardia
Rhodococcus
Gordonia (Actinomycete)
Tsukamurella
Dietzia
Head of sperm
Leprosy
MISCELLANEOUS
160.
160.
Bacillus anthracis
161.
**Plague is by
161.
rat flea.
162.
162.
163.
163.
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108
Microbiology
164.
164.
165.
165.
166.
166.
167.
167.
b.
a.
a.
**interstitial pneumonia ch by
a. good prognosis
b.respiratory distress
c.
b.
a.
Osteoid osteoma
a.
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109
Microbiology
c.
a.
Sarciniae
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110
Microbiology
MYCOLOGY
168.
*******Candida is identified by
168.
169.
169.
C neoformans
170.
170.
M.Furfur
171.
171.
172.
172.
a. White cells.
a.
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111
Microbiology
PARASITOLOGY
173.
173.
P.vivax.
In P. vivax, infected cells are enlarged with
schuffner's dots. In P. ovale infected RBCS
are enlarged without Schuffner's dots.
P. malariae cause normal or even reduced
sized RBCs. In P. falciparum cells are normal
with Maurer's clefts.
best time for collection of blood for malaria :a-before and after paroxsym
b-shortly after paroxsym
c-later paroxsym
d-just before paroxsym
thin smear
174.
**Leishmania id transmitted by
(leishmanya donovani ) kala zar
174.
Sand fly.
175.
175.
H.Nana
176.
176.
b.
177.
178.
mohammad_emam@hotmail.com
E.Histolytica.
b.
the chromatoid bodies resemble cigar-shaped or sausageshaped in the cyst of :a-entamoeba coli
b-entamoeba histolytica
c-entamoeba gingivalis
d-none of the above
179.
179.
anal swab
112
Microbiology
c.
a.
180.
180.
181.
181.
P. Falciparum (X).
Vivax and ovale due to preerythrocytic
schizogony cause multiple infection.
a.
a.(and oval)
c.
182.
182.
E. Histolytica
183.
183.
a. B//M biopsy
184.
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184.
a. Skin biopsy
113
Microbiology
185.
185.
b. cysticercosis
Loa loa
Parasite in eye
186.
186.
187.
187.
188.
Cryptosporidium
188.
189.
A warm that infects man and pass eggs around the anus is
189.
Oxyurius vermicularis.
adhesion tab around anus and examined for
egg
190.
190.
Cysts or trophozoit
c.
191.
Schistosoma hematobium.
Also ankylostoma duodenal, strongyloides
and N. americanus.
192.
192.
IFAT
Also, CFT, IHA & ELISA.
193.
193.
b. cat
concentration technique
ascaris lumbricoides
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114
Microbiology
Visceral leishmaniasis
c.
c.
which of the following neither lays eggs nor deposites
larvae in the intestinal canal :a-hookworms
b-pinworm
c-trichinella spiralis
d-trichuris trichura
the following parasite doesnt not involve GIT in man?
a. ascaris
b. cysticercosis
c. H.nana
d. tenia
b.
c.
c.
trichomonas vaginalis
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115
Microbiology
a.
c.
wuchereria bancrofti
*specimen blood
intracellular parasite:
oocyst benefited to diagnose:
a. entamoeba.histolytica
b. entamoeba.coli
c. toxoplasma gondii
d. giaradia lamblia
e. typanosoma cruzi
c.
c.
c.
c.
c.
Proglottids present in
cestoda
Signet ring.
F. falciparum.
plasma
Necator americanus.
Helmenth
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116
Microbiology
Flukes
Ribbon like worms (Tape worm)
round
Flagellates except
Hemoflagellates
Most common helminthes are
Largest protozon
Asexual forms of malaria
Ascaris egg
Trematodes
cestodae
Nematodes
S. mansoni
Leishmania and trypanosomes
nematodes
Balantidium coli
Merozoite, asexual cycle in man, sexual cycle
in Mosquito
migrate from lung to small intestine
plasmodium
Fluorescent antibody sera
G. lamblia.
Scotch tape method
P. vivax
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117
Microbiology
VIROLOGY
c.
194.
195.
195.
feaces.
Also from throuat and spinal fluid.
196.
196.
reproduction.
197.
197.
198.
b.
?a.
b.
198.
para influenza
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199.
a.
118
Microbiology
200.
200.
wrong combination.
201.
201.
c. CMV
202.
202.
203.
203.
204.
204.
205.
205.
c. Negri bodies.
206.
206.
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119
Microbiology
c.
?a.
c.
207.
Herpes zoster
207.
Localised
208.
208.
None
Rota virus is a dsRNA virus, it is diagnosed in
feces by ELISA. It causes a significant
proportion of infant diarrohea.
209.
209.
210.
210.
Feco-oral
211.
211.
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120