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    ClinPath Finals March2014

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    Mara Medina - Borleo

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    © All Rights Reserved
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    Faculty of Medicine and Surgery Department of Laboratory Medicine CLINICAL PATHOLOGY FINAL EXAMINATION March 19, 2014 GENERAL INSTRUCTIONS 4. There are 12 different pages. (120 pts.) 2. Transfer all final answers to the Answer Sheet. Please read the instructions in the Answer Sheet carefully. Mark your Answer Sheet and Identification Sheet with your assigned set, i.e., A or B. 3. White your name, section and class no. on the square blank provided in the Answer Sheet 4, Use Mongol pencil when writing on the Answer Sheet. |. CHOOSE THE BEST ANSWER. CASES CASE 1. A 50 y/o, female, businesswoman, came in because of frequent_urination, accompanied by increased thirst and appetite. Physical examination showed yellowish discoloration of skin and mucous membranes. Ultrasound of the abdomen showed_a radiodense irregular mass predominantly seen at the area of the [pancreatic head,/~ Endoscopic retrograde cholangiopancreatography (ERCP) with biopsy of the mass re an adenocarcinoma. os __C4Aivnich tumor marker will you request for in this case? ‘A. Carcinoembryonic antigen (CEA) B. CA125 C. CA19-9 D. Alpha fetoprotein (AFP) 4.2. in which ofthe folowing is this tumor marker mainly used for? A. screening B. diagnosis C. detecting presence of ectopic tumor markers D_ monitoring treatment response 3, What laboratory test do you take into consideration when you interpret tumor marker values, because of its effect on the half-life of the tumor marker? A Alanine aminotransferase (ALT) B Alkaline phosphatise (ALP) C. high-sensitivity C-reactive protein (hs-CRP) D. albumin CASE 2. An 85 y/o, retired colonel, came in for his annual executive check-up, Presently, he did not complain of any particular symptoms except for an occasional dry cough and itchy throat, Physical examination showed a BP 140/90, HR 86 bpm, CR 18 cpm, T 36.5C; pink palperbfal conjuntivae, anicteric sclera; symmetrical chest expansion, no retractions.. lear breath sounds; adynamic precordium, apex beat at 5° LICS MCL, no murmurs; gfobular abdomen with no palpable masses. 3 (Which tumor marker is appropriate to requestferirthis tase? <= ApS _®. Prostate specific antigen (PSA) * C. HER2ineu D. Fecal occult blood test (FOBT) NEXT PAGE PLEASE. AGE 2 ~ CP FINAL EXAM. SET A ___5,/What is the advantage of using this tumor marker for this particular case? 2 ‘A__cancer sensitivity 3. tissue specificity C. metabolic activity D. biologic activity In which of the following is this tumor marker mainly used for? A__ diagnosis screening C. detecting the presence of ectopic tumor markers D. monitoring treatment response CASE3 A 35 ylo, female, came in with a chief complaint of a diffusely enlarged thyroid gland. The patient likewise complains of feeling warm despite being in an air-conditioned room. On physical examination, you see a patient with wide staring gaze and lid lag with the following vital signs: BP 140/90, PR 110 bpm, RR 20 opm, T 37.5 C. Thyroid function tests showed the following values: TSH= 0,002 miU/mL\T4= 30 ug/dL) T3= 174 ugidl positive for thyroid receptor antibodies (TR Abs) [aka thyroid stimulating immunoglobulins (TS!)}. (reference values: TSH= 0.5 — 5 mlU/mL; T4= 5 — 12.5; T3= 60 — 160ug/dL). ‘What is the diagnosis of this case? A. Thyrotoxicosis factitia G. Papillary thyroid carcinoma B. Hashimoto thyroiditis _B. Graves disease 8, What is the first step in thyroid hormone synthesis? / active transport of iodide into the cell iodination of tyrosyl residues on thyroglobulin C. coupling of iodotyrosine molecules D. release of thyroid hormones into the circulation _____9 Which among the following thyroid function tests is most useful in the diagnosis of 7 hyperthyroidism and hypothyroidism? ‘A. Free thyroxine (fT4) C. Thyroid releasing hormone (TRH) B. Free triiodothyronine (fT3) _®B: Thyroid stimulating hormone (TSH) CASE 4. A 22 ylo, female, came in because of generalized body malaise accompanied by cold intolerance and weight gain. Thyroid function test was done which demonstrated the following values: TSH= 26 mIU/mL,jT4= 1.2 ug/dby T3= 15 ugidL (reference values: TSH= 0.5 - 5 mlU/mL; T4= 5 — 12.5 ugidL; T3= 60 - 160ug/dL). ees rere the laboratory values given in this case. A. Hyperthyroidism C. Thyroid hormone resistance “Hypothyroidism D. Nonthyroidal tliness (NTI) In addition to the given thyroid function test values, the detection of thyroid peroxidase antibodies (TPO Abs) in this patient will point to which of the following diagnosis? / 2c Hashimoto thyroiditis C. Riedel thryoiditis, / “B. Graves disease D. De Quervain thyroiditis, et aes among the thyroid hormones has the greatest biologic activity? 7 A. Thyroxine (T4) C. Reverse triiodothyronine (rT3) Triiodothyronine (T3) D. None of the above NEXT PAGE PLEASE. ro 3 CP FINAL EXAM. SETA 4 CASE 5. A 52 ylo, male, came in with a palpable anterior-heck mass, with no other Tone aug Symptom. Thyroid function test was doné and revealed the following values TSH= 2.5 mlU/mL#T4= 7.8 ug/dL, T3= 78 ug/dl_ (reference values: TSH= 0.5 — 5 miU/mL; T4= 5- 12.5 ug/dL; T3= 60 — 160 ug/dL) 13Anterpret the laboratory values given in this case. _- 7 A. Hyperthyroidism @-Euthyroidism B. Hypothyroidism D. Thyroid hormone resistance 14. Given the clinical and laboratory picture of this patient, which of the following is the most likely cause? AC Pituitary adenoma C. Thyrotoxicosis factitia B._lodine deficiency D. Adenomatous goiter 18/1 this is @ malignancy, which of the following wil suggest thal itis of thyroid origin, / because its serum concentration reflects thyroid mass? ; A. Thyroxine-binding globulin (TBG) — _-€-" Thyroglobulin (Tg) B. Urinary iodine measurement D. Transthyretin (TTR) CASE 6. A newly certified clinical pathologist decides to put up and head a Clinical Laboratory along Quezon Avenue. 46MWhich of these statements about the importance of a clinical laboratory is NOT true? A. It play a central role in health care, ‘ = 830% of all medical decisions are based on lab. results (Silverstein, 2003) C. Itis a facility where clinical specimens from the human body are examined . D. The list of tests done include those in Ciinical Chemistry, Hematology, Immunology and more ——17/‘This is an important trait of an effective “Leader” (Lab Head) A. He's the implementer. ~~ B. He maintains control ~&* He is the organizer and developer. D. He is a good “soldier”. 18 hese are indications for ordering lab. examinations, EXCEPT: 7 A Toconfirm a clinical impression / B. To establish a definite diagnosis _&To predict future complications D. To monitor therapy (management guide) He decides to put up another free-standing lab. near the comer of Dapitan and Lacson streets doing just routine test, ie. CBC, Rt. Urinalysis and Rt. Fecalysis This lab is classified as_ “General-Primary C. General-Tertiary B. General-Secondary D. Special 29. He wants both labs to be accredited by the DTI-Phil Accreditation Office, What specific scheme should he apply for initially? A PNS ISO 15189: 2010 B. PNS ISO 22870:2010 C. PNS ISO/TS 22367:2010 D. PNS ISO/TR 22869:2010 NEXT PAGE PLEASE. Vien. — CP FINAL EXAM. SET A (CASE 7. A 40-year old. G2P2, woman sought consultation because of right-sided abdominal pain accompanied by, (ee iY Lar/She also complains of yellowish discoloration of her skin. Most likely, she has this ciinicai condition: Acute Appendicitis _A*Foute Cholangitis Acute Peritonitis \~ D. Acute Cystitis 22. Invany of the choices in above , she would most likely have this WBC count A 1X10% G-15 X 107 B. 5X 10% “D. 150X107 ¥ +23. Ifyou chose Acute Appendicitis , she would most likely have this WBC Diff count: A. Segmenters = 0.10, Lymphocytes = 0.90 Segmenters = 0.50, Lymphocytes = 0.30, Eosinophils = 0.20 _&xMyelocytes = 0.05, Stabs = 0.10, Segmenters 0.75 Blasts = 0.10, Metamyelocyte = 0.02, Myelocytes = 0.03, Stabs = 0.05, Segmenters = 0.70, Lymphocytes = 0.10 24. If you chose Acute Peritonitis , she would most likely have this peritoneal (ascitic) fiuid Total Protein level: A. 1.0 mg/dL C.2.5 mg/dL _B; 2.0 mg/d D. 5.0 mg/dL. 2A, you chose Acute Peritonitis , which particular leucocyte would most likely ei predominate in the Diff. Count of her peritoneal (ascitic) fluid White Blood Cell Count? ‘Segmenters C. Monocytes B. Lymphocytes D. Basophils you chose Acute Cholangitis , aside from yellowish skin decoloration, she also x passes out tea-colored urine. What substance is most likely responsible for this abnormal urine color? A. Acid hematin _-©: Bilirubin _ B. Urobilinogen “Hemoglobin you chose Acute Cholangitis, what would most likely be the etiology of her ee clinical condition? , A. Urvlithiasis C. Otolithiasis / -B Choledocholithiasis D. Fecalithiasis 28/{f you chose Acute Cholangitis, which particular blood (chemistry) test would be / determined as abnormally elevated? A. Acid Phosphatase} C. Gamma-globulin Bilirubin, direct D. CK-MB Sv 29. ih you chose Acute Cystitis, which of these Rt. Urinalysis findings would be considered as most compatible with her clinical condition? A. Squamous Cells ++++, Pus Cells 50-S0/HPF; Bacteria +++ 8: Transitional Cells +++; Pus Cells 50-GO/HPF; Bacteria +++ /- ©. Renal Cells ++++; Pus Cells 50-SO/HPF; Bactaria +++ / 4D. Squamous Cells few; Pus Cells 50-S0/HPF; Bacteria few 31 If you chose Acute Cystitis, which urine reagent strip test would guide you as to the Gram Stain reaction of the microorganism causing her clinical condition? A. Esterase C. Urobilinogen BE Nitrite D. Bilirubin NEXT PAGE PLEASE. he. 5— CP FINAL EXAM. SET A ‘CASE 8. A 50-year old male executive is admitted at the USTH for his annual “executive’ check up. 31, How long does he have to fast for hig FBS, BUN, Blood Uric Acid, Total Protein, / Albumin, Globulin (TP A/G) and A:G Ratio determination? A. 3-4hrs C. 12-14 hours J.B 6-8 hours D. 24 hours __32/ Which type of evacuated collecting test tube should be used by the Med. Tech to collgct blood for the above tests? UX Red Top ©. Blue Top BR __/ “B. Lavander Top D. Green Top ~1_321 What's the ideal urine specimen that he should collect for his check-up? A Random sample C. Second-morning sample ‘ Fitst-Morning sample__D-24-hr sample “ 34, His urine reagent strip test for albumin was determine to be "TRACE". How would /_ you interpret this? = _AC Physiological proteinuria C. Tubular proteinuria B. Glomerular proteinuria D. Overload proteinuria __35/is urine reagent strip test fopr protein was read as 4+. What laboratory procedure should his attending MD request for next? “K. 24-hr Quantitative Urine Total Protein C. Serum Protein Electrophoresis B. Micral Test D. Urine Test for Bence Jones Protein CASE 9. A 5 year old child of Asian descent with tonsilitis consulted physician for protonged PII — a E 26/(s the prolongation significant? Me Yes + __/ ZBONo 37. What is the usual cause of prolongation of PTT in this case? ac Factor 8 deficiency C. Factor 10 deficiency B. Factor 9 deficiency _B-Factor 12 deficiency 2 £6 38. Is a deficiency of contact factors resulting to prolonged PTT occurs as an in-vivo event? - AcYes B. No CASE 10, A75 year old male with Pulmonary Adenocarcinoma presented with petechiae and the following laboratory findings: ‘e * PTT, PT: prolonged, D-dimer positive (+ Platelet count 25,000/cu.mm. : Positive schistocytes in the blood smear / 29/ Are the findings consistent with DIC? 1 AC Yes JB. No 49/ The reason for prolongation of PT in DIC is: A. Decreased fibrinogen _G°Alll of the above 8. Decreased Factor 2 D. Due to an unknown reason 44 The reason for prolongation of PTT in DIC is: A. Multiple factor deficiencies C, Decreased Factor 8 ; B. Decreased fibrinogen A. All of the above Vv 42. The presence of schistocytes in DIC is seen in: A A0% C. 50% B. 30% i rege dieitare aie ae Y (GE 6 — CP FINAL EXAM. SETA (_45/ The matignaney highly associated with chronic DIC presenting with gum bieeding ts: Jp A. Lymphoma ae er 8° Acute Promyelocytic Leukemia . The reason for decreased platelets in DIC is: Consumption B. Sequestration C. Low production The soon that can mimic the clinical and laboratory findings of DIC is liver disease: True oe B. False CASE 11. A 5 year old boy with a past history of URT//a month ago presented with the following, Platelet 20,000/cu.mm = PT normal PTT normal BC normal except low platelets (7K Route ITP B. Chronic ITP 47/ The spleen is big in Acute ITP: ALYes No A 48. The platelet destruction in Acute ITP is due to: 2 A. Across reaction _B: A specific anti platelet antibody ae ITP is characterized as Asche above signs and symptoms are associated with: ‘A. Presence of prodromal illness -B™ Absence of prodromal iliness 59 Chronic ITP is more common in: ‘A. Males A Females CASE 12, Awoman\with fatigue and marked pallor _CsyFhe best diagnostic parameters to request to support above condition A. Hab, Ho}RBC Ct G-Higb, Het, RBC Ct, blood indices B. Hgb, Hel, WBC Ct “D. RBC Ct, WBC Ct with differential Ct B52 trthe cause of the pallor i secondary to macrocytic anemia, the MCV level should be A 89ft Cty a AME A D.70f 3 -A_ 53. Expected laboratory findings, EXCEPT: ' Hypersergmentation of nuiclei more than § lobe in 6% neutrophils B, Mean corpuscular hemoglobin level of 20pg €. Bone marrow examination characteristically shows megaloblastid activity ae D. Variation in shape (poikilocytosis) Cy fe These te tener _AX Impaired absorption of cobalamine secondary to defective gastric intrinsis factor B. Severe intestinal malabsoption secondary to tapeworm Both Neither _/+58. What is your impression?\ : _A. Megaloblastic anemia JE. Both ~B. Iron deficiencty anemia D. Neither NEXT PAGE PLEASE. ye 7 OAGE 7 - CP FINAL EXAM. SET A CASE 13. A 65 year old man with 2 10 year history of type 2 diabetes mellitus was brought to the Emergency Room because of loss of consciousness. At the scene, her blood glucose level Was measured using capillary glucometer as, 17 mg.dK (0,5 mmol/L). Patient regained consciousness. She stated that she took her méming insulin dose at 10:30 am. A diagnosis of e hypoglycemia disorder was given 56, What type of hypoglycemic disorder does the patient have? Je Post absorptive hypoglycemia B. Post prandial hypoglycemia C. Both D. Neither 57. The following are possible causesof the above disorders: A. Ethanol abuse B._ Secondary to excessive insulin or oral hypoglycemic administration _& Both D. Neither 58/What diagnostic testis is/are needed to came up with a definitive diagnosis? A. Insulin ©. Both Expected laboratory findings if the cause of the above disoder is secondary to / an organic disease such as insulinoma: increased insulin with increased C peptide B. Increased insulin with normal or decreased Cpeptide \Y C. Both -_ D. Neither 60. The 5 hour OGTT is the appropriate test for fasting hypoglycemia: ‘Yes “B No we B. C peptide D. Neither << CASE 14, A 57 year-old male, business executive, was rushed to the ER due to (L) sided chest pain. History startéd 2 hours PTA, patient while checking his emails in his office suddenly experience (L) sided pain that radiates to.the lower jaw and (L) shoulder. He is a known /hypertensive, ron-diabetic, He is smoker and non-alcoholic drinker. Patient was admitted for further evaluation and observation 61. Which ofthe folowing ancilary procedures should inital be done to evaluate the chest pain? _-A- Electrocardiogram C. Angiography / ~B. Electroencephalogram D. Scintigraphy ____6¢ Which of the following cardiac markers would be elevated given the history ¢ of the patient? / SAC Creatine kinase, total ©. Troponin T /58-CK-MB, \soporins D. Lactate dehydrogenase 63. What would be the specimen of choice that will be collected to determine the cardiac marker? A Serum C. Whole blood B. Citrated plasma D. All of the above ___64, The relative index of the cardiac marker that you chose above should be __ to confirm yorardial damage. A > 5% Ro> 6% / B. <5% D. <6% ____65/Precaution/s with the cardiac marker above includes: ‘A. interpretation as cardiac and skeletal muscle tissue values overlap B. Avoidance of excessive physical acitivity prior to collection Both D. Neither (PAGE 8 - CP FINAL EXAM. SET A CASE 15. A6S year old female, retired school principal, on routine annual PE had the following {ipid profile result: Total Cholesterol -258 mala.’ (150-250 mg/dL) HDL-C- 20 mg/dl Y, (30-90 mg/dL) LDL-C- 180 mg/dL 4 (66-178 mg/dL) Triglycerides 236 mg/dL. Ap (10-190 mg/dL) ___ 66/The recommended patient preparation for the examination is: A. 8 hour fasting 2012 hour fasting B, 10 hour fasting D. None of the above )) —_-87. Based on the lipid profile result, which of the following managementitreatment schemes for CHD should be given to the patient? A. Repeat test after 5 years —_C. Diet and exercise A® Diet, retest after 1 year D. Diet and/or drug 68. The following can interfere during the analysis of lipid in the specimen, EXCEPT _-& Use of plain tube X C. Hemolyzed speicmen / | B. Lipemic specimen D. None of the above . Which of the following is cardioprotective: . AC HOL eC. VLDL . % B. LOL D.IDL dD ___70. The following are risk factors for ce EXCEPT: . A Smoking - HDL-C 40 mgiaL <¥E B, Hypertension SON None of the above CASE 16. Jill, 24 year old female, consulted because of easy fatigability and profuse menstruation. CBC on scree showed — Hgb: 70 g/L WBC Un cent Y Neutrophils: 20% Lymphocytes: 80% Platelets: 20 X 101 v D 71. The following are considered as differential diagnosis, EXCEPT: A. Aplastic anemia ‘Acute lymphocytic leukemia _-B® Acute Myelogenous leukemia D. Chronic lymphocytic leukemia’ 73, ‘do we need to request for to make a definitive diagnosis? A. Peripheral smear __-&Bone marrow biopsy B, CT scan ~D. Flow cytometry ___73. Which component will help arrest Jill's profuse menses? A. Platelet concentrate C. Fresh whole blod BO FFP, D. Cryosupemate __74, After transfusion of your choice component, Jill developed fever) The following are your considerations, EXCEPT: ‘A. Transfusion of the wrong blood type B. Transfusion associated sepsis C. Febrile non-hemolytic transfusion reaction _DeTRALI CASE 17. Mark, 60 year old male consulted because of weight joss and frequent headaches. FE: pink palpebral conjunction with palpable\ CBC: Hgb: 150 g/l. Het: .48;, WBC: 160 /"/ X 10%; Neutrophils: 60%; Lymphocytes: 15% Monocytes: 5%; Basophils: 5% Blast: 2%, Promyelocyte: 4%; Myelocytes: 4%; Metamyelocyte: 5%; Platelets: 600,000/eumm $ 75. What is your impression? Myeloproliferative neoplasis C. Essential thrombocytosis i aaa: D AML "AGE 9 — CP FINAL EXAM. SET A 76. The ieucocytosis in the above disorder, is usually due to the following, EXCEPT: A. Increased rejease from marginal pool , B._Increased proliferation ~ Decreased apoptosis D. Increased activity of tyronine kinase < E Hee definite diagnosis of the above condition, we need to demonstrate the following, EXCEPT: : _Ac(+) Myeloperoxidase staining _- ~'B. Philadelphia chromososme by cytogenetics ~ C. Hypercellular marrow with myeloid hyperplasia D. BCR-ABL by FISH 78. What biochemical abnormality can we expect from this patient? A. Hyper uricemia C. Increased ALT, AST + B. Increased creatinine _--Br increased alkaline phosphatase CASE 18. A 5 year old boy was confined because of generalized edema) History started about 2 weeks PTA. When the patient developes:pharyngitis) This was accompanied by decreased in urine output, however the urine was noted to be red sometimes. Accompanying signs and symptoms were: anorexia, nausea, he hypertensive. Routine urinalysis revealed: morphic red blood cells, red cei casts leukocytes and proteinuria of (+++). Ve 79(the most probable diagnosis is: A. Nephrotic syndrome C. Multiple myloma /_ B. Pyeronephritis _B Post-streptococeal glomerulonephritis — The most important findings in the routine urinalysis would be the presence of: A. Protein _GeRed renal call casts B. Sugar D. White blood cell casts —sy' his disease is usually diagnosed by: / _& Clinical and serologic basis C. Both sh B. Renal biopsy D. Neither 9 82. Most patients would show positive for: _-AC Anti streptolysin O C. Anti-NAD B. Anti-deoxyribonuclease B D. All of the above ___8% The mode of management would include: A. Antibiotics C. Antihypertensive B. Diuretics. _-BrAll of the above 1@, vomiting, malaise. PPE: patient was slightly CASE 18. A 20 year old nursing student was admitted because of fever) History started 2 years prior to admission, when the patient complained of joint pains in the knees and both shoulders. This was accompanied by mild to moderate grade fever that was relieved temporarily by intake of paracetamol. No consult was done. One year PTA, the patient suddenly noticed the development of facial rash that begin to have a somewhat "t tetiy” shape. The arthritis became more severé and the patient was naw noticed to have become more pale._ Pertinent PE findings include: pale palpebral conjunctival, Fever of 39.5°C, and an indurated rash on the face. Heart, lungs abdomen are all unremarkable. Extremities: pale beds Lae pathologic basis of this case would most probably be: A. Bacterial C. Fungal / SE Viral _B_ immunologic = most probable diagnosis in this case would be: A. Rheumatoid arthritis C. Dermatomyositis Ze ‘Systemic Lupus Erythematosus D. Mixed Connective Tissue Disease A GE 10 — CP FINAL EXAM. SET A 86. The basic laboratory test/s that should be done in this patient would be: A. CBC C. Urinalysis B. Chest X-ray _BYAII of the above ____87 Af this were Auto-immune disease, the screening test would be: /e&® Antinuclear antibody C. Anti-centromere antibody / 8. Anti-mitochondrial antibody D. None of the above ____86/The confirmatory test therefore would be: 2 / A, Anti-Nuclear antibody &. Anti-dsDNA antibody ‘Anti-ssDNA antibody D. Anti-ss-A antibody i. CHOOSE THE BEST ANSWER. 89. The following are disorders associated with thrombosis, EXCEPT A. Activated protein C resistance B. Essential thrombocytosis C. Antiphospholipid antibody syndrome _- |B: High hemocysteine levels A bleeding disorder associated with congenital factor deficiency: A LTP. Se Hemoptitia B. Post transfusion purpura — D. Hypersplenism 91. Which of the following is/are expected finding/s of fibrinogen deficiency? D A. Prolonged PT _-€=Prolonged thrombin time B. Prolonged PTT D. All of the above . 92/ In von Willebrand's disease, this coagulant factor is decreased A. Factor 2 &- Factor 8 / _B. Factor5 D. Factor 10 93. A prolonged PT is usually due to adeficiencyof: y= 9 1 A. Factor il C. Factors * ua B. Factor 9 Factor 7 94 Which of the ff. statement is CORRECT regarding antigen presenting cells ofthe immune system? A, These calls act directly directly against foreign antigens. _&. Are crucial for cell-to-cell communication during the direction of an immune response. / _»C. Differentiate into plasma cells responsible for the humoral immune response. “ND. Synthesize immunoglobulins that combine with foreign antigens 15. These cells are drawn to regions of inflammation by chemo-attractants such as IL-8, releasing toxic substances and enzymes by degranulation ‘A. Basophils and Mast cells B. B-Lymphocytes C. Natural Killer T Lymphocyte _D-Neutrophils and eosinophils be 96. Set of interacting proteins that play a role in enzymatically destroying target cells to which these are directed by antibodies ‘A. Complement _B& Cytokines C. Histocompatibility antigens D. Immunoglobulins __.97,/this molecular complex plays a major role in antigen presentation to T-cells and form the immunologic identity of an individual, which is important in rejection of organ transplantation. A. Cytokines B. Complement _@: Human leukocyte antigen D. ALL OF THE ABOVE | wy 4 2 § MAGE 11- CP FINAL EXAM. SETA 35 This type of hypersensitivity reaction is the basis for immune reaction to protozoa, parasites, and intracellular microbes such as mycobacteri AT Cc. Blt Dov 99. A primary immunodeficiency disease characterized by disorder of leukocytic phagocytosis 2 —— A. Wiskott-Aldrich syndrome _-€DiGeorge's syndrome | B. Chediak-Higashi-disease D. X-linked agammaglobinemia 100. Which of the ff is‘NOT-part of the basic screening studies for immunologic disorders? Complete Blood Count B. Flow cytometry of lymph nodes and lymphoid organs__ C. lsohemaglutinin titers D. Lymphocyte subpopulation analysis 4 ue The presence of schistocytes in the peripheral blood smear is due to: A. Heperin-associated thrombocytopenia B. EDTA related changes / ©. Post-transfusion purpura "_D’ Microangiopathic hemolytic anemia oh. Aprocess by RBC's diferentiate and proliferate: T _AG Exythropoiesis, C. Thrombopoiesis B. Leucopoiesis D. Plasma poiesis 198. Which of the following statements ig true.of verious blood / A. Bright Red due to oxyhemoglabin A B, Hemoglobin with iron associated with one molecule of oxygen _-G-Carries reduced Hgb with iron unassociated with oxygen D. Hgb with an increased amount of H1 in the erythrocytes 104. In Spherotic anemia, the red cell are. / _A-WMore fragile, less resistant to hypotonic solution B. Less fragile more resistant to hypotonic solution, C. Both D. Neither 105. Cell characterized by the presence of fine granules in individual exposed to heavy metals would be having an: _A@ Impaired erytrhopoiesis. C. both B. Effective erythropoiesis D. Neither 1 va Screening tests for disaccharidase deficiency, EXCEPT: 7 x Oral challenge tst @ C. Clinitest ~B* Stool analysis (pH) _DrFEcal Fat 107, Neuroendocrine neoplasm of enterochromaffin cells JX Carcinoid tumor C. Malignant lymphoma B. Bronchoalveolar tumor D. Ewing's tumor 198. Proofof resistance of red cell membrane: v [KR Osmotic fragility test C. Ham's test B. Sucrose hemolysis D. D xylose absorption test JAK-2 mutation is the most common genetic abnormality found in patients with: A. Essential thrombocythemia ~€. Polycythemia vera B. ChronigMyelogenous leukemia _D. Myelofibrosis. 110, WBC: 13 X 10 /L; neutrophils: 20%; Lymphocytes: 80%. ‘Which is true of the above? A, Patient has absolute neutropenia B,_Patient has absolute lymphocytosis . Patient has relative lymphocytosis D. Patient has absolute neutrophilia 111, Normal BUN: Creatinine ratio with elevated BUN and Creatinine is seen in: A. Muscle wasting _& Severe liver disease B. Severe infection D. Acute renal failure |) PAGE 12 CP FINAL EXAM, SET A 1% The most common abnormal urine color is: A. Yellow-green ©. Brown-black /_-B Red D. Blue-green 11. This condition gives the highest level of proteinuria: / A. Multiple myeloma _-G-Nephrotic syndrome B. Toxic nephropathies D. Nephroscierosis ——114,/Parameter/s that are needed in doing the renal clearance test using creatinine: A. 24-hours urine C. Urine creatinine / 8. Serum creatinine in of the above ___118" The requisites for collecting urine for bacleriologic studies: A. Use of sterile container with cap B._Mid-stream portion of the urine collected 2 Both D. Neither p——176. Parameter/s that are needed to differentiate between a bloods IntracranialHemorrhage after centrifugation A. The even distribution of blood in the 3 test tubes _-B

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