RMT NOTES

1. Creatinine 88.4
2. Bilirubin 17.1
3. Thyroxine ug/dL to nmol/L 12.9
4. TP/albumin/globulin 10
5. Ig from mg/dL to mg/L 10
6. from mg/dL to g/L
7. Nitrogen to Protein 0.01
8. BUN from mg/dL to mmol/L 0.357
9. BUN to Urea 2.14 (60/28)
10. Urea to BUN 0.467 (28/60)
11. Uric acid 0.0595
12. Glucose 0.0555
13. TG 0.0113
14. Cholesterol 0.026 (0.02586)
15. Na/K/Cl/Li/HCO3 1
16. Ca 0.25
17. Mg 0.50
18. Normal BUN:Crea ratio 10-20:1
19. Normal HCO3:H2CO3 ratio 20:1
20. Anion Gap = Na – (Cl + HCO3) 7 to 16 mmol/L (average of 12 mmol/L)
21. Anion Gap = (Na + K) – (Cl + HCO3) 10 to 20 mmol/L
22. Anion Gap (AG) difference between unmeasured anions and unmeasured
cations.
AG is useful in indicating an increase in one or more of the
unmeasured anions in the serum and as a form of quality
control for the analyzer used to measure these electrolytes
23. Increased AG (>16 mmol/L) uremia/renal failure, (PO4 and SO4 retention); ketoacidosis
(starvation or diabetes); methanol, ethanol, ethylene glycol
poisoning, or salicylate; lactic acidosis; hypernatremia; and
instrument error.
24. Low AG (<10mmol/L) hypoalbuminemia (decrease in unmeasured anions) or severe
hypercalcemia (increase in unmeasured cations)
25. Osmolal gap 5–10 mOsm/kg (0-10 mOsm/kg)
26. Normal Adult Serum osmolality 2 75-295 mOsm/kg water
27. Osmolal gap The difference between the measured osmolality and the
Calculated osmolality. It indirectly indicates the presence of
osmotically active substances other than Na+, urea, or glucose,
such as ethanol, methanol, ethylene glycol, lactate, or B-
hydroxybutyrate

28. 92% serum osmolality Electrolytes Na, Cl, HCO3

29. 8% serum osmolality Other ECF electrolytes, serum proteins, glucose, urea
30. Increased osmolality dehydration
31. Icteric serum Bilirubin approaches 430 umol/L (25 mg/L)
32. Hemolyzed specimen Pink: Hb = 20 g/L or Red: Hb = 100 g/L
33. Lactescent serum Triglycerides exceed 4.6 mmol/L (400 mg/dL)
34. Clear plasma Triglycerides < 200 mg/dL
35. Hazy or turbid plasma Triglycerides > 300 mg/dL
36. Opaque or milky plasma Triglycerides > 600 mg/Dl
37. Standing plasma test Creamy layer on top: Chylomicrons
Turbid: VLDL
38. Dilution Expression of relative concentration of the components of a
mixture
39. Ratio Amount of something in proportion to the amount of something
else
40. Concentration Amount of solute in a given volume of solution
41. Molarity Gram-molecular weight of solute per liter of solution
42. Normality Number of equivalent weights of solute per liter of solution
43. Osmolality Number of osmoles of solute per kg of solvent
44. Least affecting the anion gap Potassium
45. Routinely measured electrolytes Na, K, Cl, HCO3 (as total CO2)
46. <400 nm Ultraviolet
47. 400-700 nm Visible range
48. >700 nm Infrared
49. UV light source Mercury/Sodium vapor lamp
Xenon lamp
Deuterium/Hydrogen lamp
 50. Visible to near infrared Tungsten light bulb
51. Visible and UV Mercury/Sodium vapor lamp
Hollow cathode lamp (AAS)
52. Panic values/ Critical values Life-threatening values; Report IMMEDIATELY
Na, K, Ca, Mg, P, Total CO2, Total Bilirubin (neonates), blood
gases
53. STAT (Latin statim) “Immediately”
Glucose in diabetic ketoacidosis, amylase in suspected
pancreatitis, CK in suspected MI, Hct, K+, Blood gases, some
drug levels (theophylline)
54. Trend Gradual change in the control sample results
55. Shift Abrupt change from the established average value
56. Dispersion Increased frequency of outliers
57. Measures of dispersion SD, CV, Range
58. DEGREE OF HAZARD / NFPA DIAMOND 0: NO OR MINIMAL
1. SLIGHT Blue: Health
2: MODERATE Red: Flammability
3: SERIOUS Yellow: Reactivity
4: EXTREME White: Special hazards
59. Spectrophotometry Measurement of light at a specific wavelength by use of
monochromatic light diffraction gratings
60. Mass spectrometry Based on ionization and fragmentation of molecules
61. Fluorometry Measurement of emitted fluorescence 2 monochromators
62. Double beam in space spectro 2 photodetectors
63. Quenching of fluorescence Decrease in fluorescence due to the excited molecule’s
interaction with other components of the reaction system
resulting to loss of energy
64. Fluorescence emitting light energy of a longer wavelength and lower energy
than the exciting wavelength
65. Absorbance (A) / Optical Density A = abc = 2 – log%T
66. Beer-Lambert’s law The concentration of an analyte is directly proportional to
amount of light absorbed and inversely proportional to the
logarithm of light transmitted
67. Random error Error that does not recur in regular pattern;
No trend or means of predicting it: mislabeling
a sample, pipetting errors improper mixing of samples and
reagent, voltage fluctuations not compensated for by the
instrument circuitry, temperature fluctuations

68. Systematic error Recurring error inherent in test procedure; Seen as a trend or
shift in data: improper calibration (shift), deterioration of
reagents (trend), sample instability, instrument drift or changes
in standard materials
69. NPN’s in plasma Urea > amino acids > uric acid > creatinine > creatine >
ammonia
70. Azotemia Retention of nitrogenous wastes such as UREA and
CREATININE in the blood
71. Uremia Toxic condition of very high plasma urea concentration
accompanied by renal failure
72. Colorimetric, endpoint Assay for urea that is inexpensive but lacks specificity.
73. Enzymatic Assay for urea that measures ammonia formation
74. Colorimetric, endpoint Simple, nonspecific method for creatinine
75. Colorimetric, kinetic Assay for creatinine that is rapid with increased specificity
76. Enzymatic Assay for creatinine that measures ammonia colorimetrically or
with ISE
77. Colorimetric Assay for uric acid that has problems with turbidity
78. Enzymatic, UV Assay for uric acid that needs special instrumentation and
optical cells
79. Enzymatic, H2O2 Assay for uric acid with interference from reducing substances
80. Lloyd’s reagent (SAS) Increases specificity and sensitivity of Jaffe reaction for
creatinine Fuller’s Earth (AMS)
81. Nesslerization Chemical method for ammonia determination. Double iodides
(potassium and mercuric) form a colored complex (yellow) with
ammonia in alkali (Henry’s)
82. Lithium heparin Heparin most commonly used in chemistry tests
KIDNEY FUNCTION TESTS

83. Glomerular filtration Cystatin C, Creatinine clearance, Inulin clearance, radioisotopes

84. Concentration Mosenthal test, Fishberg test, specific gravity, osmolality
85. Renal blood flow p-aminohippuric acid (PAH) test
86. B2-microglobulin Test for tubular function of the kidney
LIVER FUNCTION TESTS
87. Synthetic TP, Albumin, Globulin, Prothrombin Time, Bile salts,
 Ceruloplasmin, AAT
88. Excretory/Conjugation Serum/Urine bilirubin, bile salts
89. Detoxification Ammonia
90. Storage Glycogen
91. Hepatocellular damage and necrosis Serum aminotransferases
92. Cholestasis ALP, GGT (most sensitive), 5’-NT(most specific)
93. Test for the patency of bile/biliary duct Ratio of direct bilirubin to total bilirubin Fecal color and fat
content Fecal and urine urobilinogen Urine bilirubin
94. Overall patency of bile/biliary duct Serum bile acids and bile salts
95. Overall ability to transport/secrete bile and serum bilirubin
conjugate bilirubin
96. Abnormality/function of the biliary epithelium ALP and other “obstructive enzymes”
97. BSP excretion (rarely used) Hepatocellular uptake, conjugating and secretory capacity;
patency of the bile ducts
98. HEPATITIS >80% liver damage High: AST, ALT, LD, ALP, bilirubin Normal: TP, albumin,
ammonia
99. CIRRHOSIS 80% liver tissue damage Low: TP, albumin
High: Bilirubin, Ammonia
Normal: AST, ALT, LD
Normal to slightly high: ALP
100. BILIARY OBSTRUCTION High: ALP, GGT, 5’-NT, Bilirubin
Normal: TP, albumin, AST, ALT, LD
101. Cirrhosis Fibrosis and scarring leading to destruction of normal liver
architecture
102. Pathognomic cause of increased GGT Increased alcohol intake
GGT is often increased in alcoholics even without liver disease; with a rough correlation between amount of alcohol
intake and GGT activity. The highest values, often greater than 10 times the upper limit of normal, may be found in
chronic cholestasis due to primary biliary cirrhosis or sclerosing cholangitis. (Henry’s)
103. Bilirubin Direct: Van den Bergh reaction at 540nm Indirect methods (with
accelerator): Evelyn-Malloy (50% methanol, 540nm),
Jendrassik-Groff (Caffeine-benzoate, with stopper Vit. C, 600nm
104. Indirect Bilirubin (BI) Unconjugated; Water-insoluble; Non-polar; bound to albumin;
High affinity for brain tissue; reacts with diazo reagent only in the
presence of an accelerator
105. Direct Bilirubin (B2) Conjugated to glucuronic acid; Water-soluble; Polar; Found in
urine; reacts with diazo reagent directly
106. Delta Bilirubin Conjugated bilirubin covalently bound to albumin; contributes to
B2 fraction
107. Bilirubin interference Hemolysis: Falsely decreased Lipemia: falsely increased
108. Transport/Uptake deficit Gilbert’s syndrome (deficient ligandin)
109. Conjugation deficit Crigler-najjar syndrome (deficient UDPGT)
110. Excretion deficit Dubin-Johnson (IEM), Rotor syndrome (viral origin)
111. Physiologic/Neonatal jaundice Increased unconjugated bilirubin in the first 3-5days of life due to
immature liver’s inability to synthesize UDPGT. Normalize within
7-10days. Treatment is phototherapy
112. Bilirubin > 20 mg/dL Danger of kernicterus
ENZYMES
113. Lock-and-key (Emil Fischer) The enzyme active site (lock) and the substrate (key) have the
exact same shape
114. Induced fit (Daniel Kochland) Substrate binding to the active site induces a shape change so
as to fit the substrate
115. Fixed time/End point assay Reactants are combined; reaction proceeds for a designated
time; reaction is stopped and absorbance is measured
116. Continuous monitoring/kinetic assay Involves the continuous measurement of change in
concentration as a function of time; Multiple measurements of
absorbance are made as the reaction takes place; more
advantageous
117. Zero order kinetics Reaction rate is dependent on enzyme conc
118. First order kinetics Reaction rate is dependent on substrate conc
119. Forward reaction of CK Tanzer and Gilvarg
120. Reverse reaction of CK Oliver-Rosalki-Hess
121. Forward reaction of LD Wacker/Wrobleuski-Cabaud
122. Reverse reaction of LD Wrobleuski-LaDue
123. Most specific substrate for prostatic ACP Thymolphthalein monophosphate (Roy)
124. Non-anticoagulated tube False increase in ACP (hemolysis, bilirubin)
125. Reference substrate for ALP p-nitrophenylphosphate (Bowers and McComb)
126. Substrate in Cherry-Crandall (Lipase) Olive oil/Triolein
127. Destroyed by heat Bone ALP (inhibited by Urea), LD2 to LD5
128. Inhibited by L-phe Intestinal and Placental ALP
129. Order of ALP migration from most anodic Liver, Bone, Placental, Instestinal ALP
130. Increased ALP Hyperthyroidism, hyperparathyroidism
131. Low temperature storage prior to testing LD4 and LD5 decrease, ALP increases
132. Decreased value is significant Cholinesterase (pesticide poisoning, liver dse.)
133. Least specific enzyme LD (all tissues)
134. Moderate specificity AST (Liver, Heart, skeletal muscle) CK
(Brain, Heart, Skeletal muscle)
135. High specificity ALT (liver), LPS (pancreas), AMS (salivary gland, pancreas),
ACP (RBC, prostate)
136. Transferases CK, AST/SGOT, ALT/SGPT, GGT
137. Hydrolase LPS, AMS, ALP, ACP,
138. Oxidoreductase LD, MD
139. Food rich in VMA or HMMA Banana, vanilla, tea, coffee
(OH-3-Methoxymandelic acid)
140. Food rich in serotonin banana, pineapple, tomato, avocado
141. Glucose is metabolized at room temp 7 mg/dL/hr
142. Glucose is metabolized at 4℃ 2 mg/dL/hr
143. Hypoglycemia Blood glucose < 50 mg/dL
144. OGTT Patient should be ambulatory; fasting 8-12hrs,
Unrestricted diet of 150g CHO for 3 days
145. Performed routinely to monitor glucose Glycosylated Hemoglobin (HbA1c)
control
146. Sodium concentration in patient with DM Decreased due to polyuria
147. 10% contamination with 5% dextrose will 500 mg/dL or more
increase glucose by
148. Whole blood fasting blood glucose level is 10-15% lower
______ than plasma
149. Glucose measurement by reduction method 5-15 mg/dL higher than enzymatic methods
150. Copper reduction methods Nelson-somogyi (arsenomolybdate)
Folin-Wu (phosphomolybdate)
Neocuproine
151. Gestational diabetes develops into DM Within 5 to 10 years post partum
152. Type 1 DM Juvenile onset; Insulin dependent (IDDM);
ketosis prone; B cell destruction; decreased Cpeptide; HLA
DR3 and DR4
153. Type 2 DM Adult onset; Non-insulin dependent (NIDDM);
Insulin/receptor intolerance; Normal C-peptide
154. Von Gierke disease Most common congenital form of glycogen storage disease
NCEP Guidelines
155. Cholesterol CV ≤ 3%
156. Triglycerides CV ≤ 5%
157. LDL, HLD CV ≤ 4%
158. Total cholesterol: moderate risk >170 mg/dL; high risk >185 mg/dL 2-19 years old
159. Total cholesterol: moderate risk >200 mg/dL; high risk >220 mg/dL 20-29 years old
160. Total cholesterol: moderate risk >220 mg/dL; high risk >240 mg/dL 30-39 years old
161. Total cholesterol: moderate risk >240 mg/dL; high risk >260 mg/dL 40yrs and above
162. if CHD is present LDL ≤ 100 mg/dL
163. if no CHD with 2 or more risk factors LDL ≤ 129 mg/dL
164. no CHD LDL ≤ 159 mg/dL
165. TOTAL CHOLESTEROL <200 Desirable
200–239 Borderline high
≥240 High
166. LDL CHOLESTEROL <100 Optimal
100–129 Near optimal/above optimal
130–159 Borderline high
160–189 High
≥190 Very high
167. TRIGLYCERIDES <150 Normal
150–199 Borderline high
200–499 High
≥500 Very high
168. HDL ≥60 mg/dL Negative risk factor for CHD
≤40 mg/dL Positive risk factor for CHD
169. One step direct method for cholesterol Liebermann-Burchardt
170. Reference method for cholesterol Abell, Levy and Brodie (Hexane extraction)
171. Reference for Triglyceride Modified Van Handell
172. Reference for lipoproteins Ultracentrifugation (based on TG and protein content of
lipoproteins)
173. Order of migration from the anode to origin HDL  VLDL  LDL  Chylomicrons (origin)
174. Minor lipoproteins IDL and Lp(a)
175. Abnormal lipoproteins B-VLDL and LpX

ELECTROLYTES
176. Routinely measured electrolytes Na, K, Cl, HCO3 (as total CO2)
177. Counterion/Counterbalance of Na Chloride
178. Maintains electric neutrality Chloride
179. The only known anion enzyme activator Chloride
180. Sweat inducer in Sweat Chloride test Pilocarpine
181. Most common cause of hyperkalemia in IV K+ infusion
hospitalized patients
182. Most common cause of hyperkalemia Artifactual from hemolysis
183. Most abundant cation in the ECF Na
184. Most abundant cation in the ICF K
185. Integral part of transmission of nerve impulses K
(Calbreath)
186. Pseudohyponatremia Seen in hyperlipidemic/hyperproteinemic patients when Na+ is
measured by ISE
187. Pseudohyperkalemia Thrombocytosis
188. Pseudohypokalemia Leukocytosis
189. Hypernatremia DEHYDRATION, RTA, Diabetes insipidus, Severe burns,
Hyperaldosteronism (Conn’s disease)
190. Hyponatremia Diuretics, SIADH, Diabetes mellitus, Addison’s disease, Renal
failure
191. Hyperkalemia RENAL FAILURE, Dehydration, Addison’s dse., Acidosis,
Tacrolimus and cyclosporine, ORAL/IV INFUSION, Parenteral
transfusion of extended stored blood
192. Hypokalemia Diuretics, Cushing’s/Conn’s Dse., Leukemia, insulin overdose,
Alkalosis
193. Hyperchloremia Metabolic acidosis, dehydration, primary hyperparathyroidism
194. Hypochloremia Prolonged vomiting, Addison’s, metabolic alkalosis
195. Hormones involved in Calcium regulation PTH
Vitamin D
Calcitonin
196. Increased ADH Fluid retention, low Na
197. Decreased ADH Fluid loss, high Na
198. Increased Renin results to Hypertension (Increased Na, plasma volume, and blood
pressure)
199. Factors that cause increased renin Hypotension due to decreased plasma volume and plasma Na
200. Respiratory acidosis Excess CO2 accumulation (hypoventilation)
201. Respiratory alkalosis Excess CO2 loss (Hyperventilation)
202. Metabolic acidosis Excess H+ production
203. Metabolic alkalosis Excess H+ loss or excess alkali intake
204. Fever will decrease pO2 by 7%
205. Fever will increase pCO2 by 3%
206. Potentiometry pH (Sanz electrode), pCO2 (Severinghaus)
207. Amperometry/Polarography pO2 (Clark electrode)
208. Normal bicarbonate to carbonic acid ratio 20:1
209. Less than 20:1 Metabolic acidosis
210. Greater than 20:1 Metabolic alkalosis
211. Driving force of the HCO3-H2CO3 buffer system CO2
212. T4 and T3 uptake in hypothyroidism Both decreased
213. T4 and T3 uptake in hyperthyroidism Both increased
214. Indirect test for TBG T3 uptake
215. Increased in non-thyroidal illnesses rT3, TBG
216. Best screening test TSH
217. Confirms hyperthyroidism in normal T4/TSH T3
218. Assess borderline conflicting results rT3
219. Calculated estimate of FT4 FTI or T7
220. Cortisol Peak: 6-8 am (8-9am)/Trough: 10-11pm
221. Primary hypogonadism Hypergonadotropic hypogonadism
High FSH & LH, low testosterone
Klinefelter’s syndrome, Testicular Feminization Syndrome
(most severe)
222. Secondary hypogonadism Hypogonadotropic hypogonadism
Low FSH, LH and testosterone
Kallman’s syndrome, Prader Willi
223. Hyposecretion of gonadotropins Infertility
224. Conditions related to female hormonal Infertility, PCOS, Hirsutism
imbalance
225. Hypersecretion of GH in adults Acromegaly
226. Hyposecretion of thyroxine in children Cretinism
227. Highest elevation of B-hCG 1 st trimester of pregnancy
CONDITION SCREEN CONFIRM
ACROMEGALY Somatomedin C / Insulin-like GF1 Glucose suppression test (75g)
GH DEFICIENCY Exercise test Insulin tolerance test
(Dwarfism Arginine) stimulation test
CUSHING’S SYNDROME 24 hour urine free cortisol Corticotrophin RH stimulation test
/ HYPERCORTICOLISM Overnight dexameth supp test Low dose dexameth supp test
*BUFFALO HUMP Midnight salivary cortisol Midnight plasma cortisol
ADDISON’S DISEASE / ACTH stimulation test Insulin tolerance test
 HYPOCORTICOLISM Cosyntropin stimulation test
CONN’S DISEASE / Plasma aldosterone / Saline suppression test
HYPERALDOSTERONISM Plasma renin ratio Oral sodium loading
Fludrocortisone suppression
Captopril challenge test
HYPOALDOSTERONISM Furosemide stimulation test: (+) low aldo
Saline suppression test: (+) high aldo
228. Monitors menstrual cycle FSH, LH, estrogen, progesterone
229. Pheochromocytoma Catecholamine-secreting tumor
230. Neuroblastoma Increased Dopamine and Norepinephrine
Metabolite Test Positive result
17-hydroxycorticosteroids Porter-Silber Reaction Yellow
17-ketosteroids Zimermann Reaction Red-purple
Metanephrines/Normetanephrines Pisano method
231. TDM Serum or heparinized plasma
Immunoassay or HPLC
232. Drugs of abuse Urine
TLC (screen); GC-MS (Gold standard)
233. Whole blood specimen Cyclosporine and Tacrolimus
234. Metabolite of Cocaine Benzoylecgonine
235. Metabolite of Marijuana/Cannabinoids THC (tetra-hydrocannabinoids)
236. Metabolite of Heroine Morphine
237. Ethosuximide Drug of choice for absent seizure
238. Measures Salicylates Trinder’s reaction
239. Acetaminophen/Paracetamol Hepatotoxic/poison (>4g/day)
STAGES OF IMPAIRMENT BY ETHANOL
BLOOD ALCOHOL SIGNS AND SYMPTOMS
(% W/V)
0.01-0.05 No obvious impairment, some changes observable on
performance testing
0.03-0.12 Mild euphoria, decreased inhabitations, some impairment of
motor skills
0.09-0.25 Decreased inhibitions, loss of critical judgment, memory
impairment, diminished reaction time
0.18-0.30 Mental confusion , dizziness, strongly impaired motor skills
(staggering, slurred speech)
0.27-0.40 Unable to stand or walk, vomiting, impaired consciousness
0.35-0.50 Coma and possible death
240. Two control observations consecutively 2(2s)
exceeding the same +2s or -2s.
241. One control exceeding the +2s and another R(4s)
exceeding the -2s
242. Purity of reagents from most to least pure UltrapureAnalytic GradeChemically pureUSPCommercial
grade
243. Positive displacement pipet Operates by moving the piston in the pipet tip or barrel like a
hypodermic syringe
244. Horizontal head/Swinging bucket centrifuge Vertical when at rest, horizontal when rotating
45. Standard/Calibrator Highly pure reference material of fixed and known chemical
composition
246. Control Material that is similar to patient samples, with a known
concentration of analyte and is assayed in the same manner as
patient samples
247. Semilogarithmic paper %Transmittance against concentration
248. Linear graph paper Absorbance against concentration
249. X-axis (HAXI) Horizontal, abscissa, independent variable
250. Y-axis (VOYD) Vertical, ordinate, dependent variable
251. t-test Means of 2 groups, accuracy
252. f-test SD of 2 groups, precision
253. Alternate sites of venipuncture Wrist, back of the hand, foot
254. Specimen for newborn screening Dried capillary blood spot
255. Chemical spill on skin Wash with running water for at least 15mins
256. Random access Ability of an instrument to analyze only those tests ordered on a
sample and can access stat samples by interrupting the normal
sequence of Now faith is confidence in what we hope for and
assurance about what we do not patient samples
257. Anaerobic condition 5% CO2, 10% H2, 85% N2
258. Anaerobic broths Chopped/cooked meat, Thioglycolate broth, Peptone yeast
extract
259. Microaerophilic Reduced oxygen 5-10%, 8-10% CO2
Campylobacter, Helicobacter
260. Capnophilic Requires 5-10% CO2, 15% O2
Pathogenic Neisseria, HACEK
61. Aerobic) 21% O2, 0.3% CO2
 Obligate aerobe: Pseudomonas, Brucella, Francisella,
Bordetella,
Neisseria (non-patho
262. Carrier harbors the organism without manifesting symptoms, but is
capable of transmitting infection (carrier state)
263. Sterilize culture media Autoclave, membrane filtration
264. Storage of viral specimen 4 deg C
265. Transport of viral specimen -70 deg C
266. Iodophore Iodine and detergent
267. Tincture 70% alcohol and 2% iodine
268. Iodine should remain on the skin at least 60 seconds / 1 minute
269. Biphasic transport media Stuart, Amies
Cary-Blair
Transgrow
270. Viral transport media With added nutrients such as fetal calf serum or albumin and
antibiotics: Hanks balanced salt solution with bovine albumin,
Stuart transport media, Leibovitz–Emory media
271. specimen in the wrong transport medium Reject
272. Blood collection for culture 2-3 sets within 24 hours, at least 1hr interval
273. purpose of enrichment fluid media when extends lag phase of normal flora, decreases lag phase of
culturing Enterobactericeae pathogens
274. Do not use growth from broth culture Overgrowth
275. PRAS culture media Prereduced anaerobically sterilized
276. Toxic to Herpesviridae Calcium alginate swab
277. Toxic to Neisseria Cotton swab (fatty acids)
Cold temperature (inhibitory)
278. Inhibitory to Chlamydia Wood on swab
279. Nasopharyngeal swabs Neisseria, Haemophilus influenzae,
Bordetella pertussis, MRSA (carriers)
280. isolation of Bordetella pertussis Charcoal-Cephalexin Agar
281. Acid fast stain Primary stain: Carbol fuchsin (red)
Secondary stain: MB or MG
282. Acid- Fast rods in a specimen from nasal Are not a diagnostic point
mucosa
283. Gram’s stain Primary stain: Crystal violet
Secondary stain: Safranin O
284. Stains pink in Gram’s stain WBCs and RBCs, cellular debris
285. Best stain for AFB in tissues Kinyoun
286. Acridine orange stains nucleic acids detect bacteria in body fluids in which numbers of bacteria may
be few (blood, CSF) or with increased cell debris. It is very
sensitive and can detect small numbers of bacteria that are
living or dead.
287. Stains used for CSF smear Grams stain and India ink
288. HEA, Mac, Campy-BAP, CNA primary and differential media of choice for recovery of most
fecal pathogens
289. Deoxycholate agar (DCA) For isolation of Enterobacteriaceae
290. Pour-plate method for colony counts Amount of agar does not affect dilution
291. Growth on plated medium are quantitatively CFU
reported as
292. The lowest concentration of antibiotic that Minimum inhibitory concentration
inhibits growth of a test organism
293. Acetamide test 35 deg. Celsius for up to 7 days (+) P. aeruginosa
294. Positive MUG test Electric blue fluorescence or yellow (+) coliforms, (-) E.coli
O157:H7
295. Negative malonate test Green, yellow
296. Positive Malonate, Citrate, Acetamide, Acetate Blue
297. Positive Hippurate, Oxidase Purple
298. positive for CAMP test Group B strep, Listeria
299. Dnase (+) Clearing around the colony
S. aureus, S. pyogenes, S. marscecens, M. catarrhalis
300. Capsules Used for serotyping by swelling (Quellung)
Slimy colony on blood agar, Seen in media containing milk or
seru
01. Group D Enterococci Bile esculin hydrolysis (+), PYR(+), Growth on 6.5% salt,
multidrug resistant strep
302. S. pneumoniae Lancet/Bullet shaped, Encapsulated, alpha-hemolytic,
Capnophilic,
Taxo P (S), Soluble in 2% Na desoxycholate (bile soluble)
Community-Acquired Lobar Pneumonia, Rust colored sputum
303. Staphylococcal Protein A Coagglutination
304. Incubation of suspected beta-hemolytic Both at aerobic and anaerobic conditions
organism
305. Golden yellow colonies on BAP S. aureus
 DNase (+), Coagulase (+), Beta hemolytic
306. Most common cause of UTI in sexually active S. saprophyticus
young females Novobiocin (R) >16 mm
307. Slime layer on respiratory equipment Staphylococcus epidermidis
308. Transluscent with large zone of beta hemolysis Group A strep
PYR (+), Bacitracin/Taxo A (S)
309. Transluscent with small zone of beta hemolysis Group B strep
CAMP (+), Hippurate hydrolysis (+)
310. Optochin test Taxo (P); Ethylhydrocupreine HCl
(S) <14 mm
311. Group A and B strep Resistant to SXT
312. Most common URT normal flora Alpha-hemolytic Strep (Viridans)
313. Most common URT pathogen Beta-hemolytic Strep (S. pyogenes)
314. Differentiate Listeria from S. agalactiae Catalase, Motility, Gram stain morphology,
Bile esculin hydrolysis
315. Anton agent Listeria
Gram(+) to gram-variable coccobacillus
316. Corynebacteria growth BAP: narrow zone of beta-hemolysis
LSS and Pai: Enhanced pleomorphism and metachromatic
granules
Tellurite medium: Brown-black
Tinsdale agar: Brown-black with tinsdale halo
317. Biotypes of C. diphtheriae 4 (gravis, mitis, intermedius, belfanti)
318. Diphtheria toxin Encoded by the tox gene acquired by the bacteria from a
bacteriophage (mutation by transduction)
319. Woolsorter’s Disease Respiratory Anthrax
320. N. gonorrhea (T1&T2) Grows on chocolate agar-based media only
321. N. meningitidis gram negative cocci in pairs
A, B, Y, W-135 requires increased CO2 and humidity for growth able to grow
on BAP & CAP
Catalase and oxidase positive
322. Specimen for gonococc should be collected from infected sources (cervix, urethra,
rectum, or throat)
Swab of urethral discharge, Endocervical swab, Vaginal
discharge, Rectal swab, Discharge from eyes
323. Urethral discharge from symptomatic males The appearance of gram negative diplococci inside
polymorphonuclear leukocytes is diagnostic in this situation
(Bailey).
Because the normal vaginal and rectal flora are composed of gram-negative coccobacilli, which can resemble Neisseria
spp., direct examination of endocervical secretions in symptomatic women is still only presumptive evidence of gonorrhea
and the diagnosis must be confirmed by cultur
324. Specimen for Meningococci CSF, blood, and joint fluid.
325. Neisseria and Hemophilus Chocolate agar
326. Beta-lactamase Test Presumptive test for the identification of Branhamella
catarrhalis if the isolate is a gram negative diplococcus that is
oxidase-positive, and isolated from middle ear fluid
327. Beta-hemolysis of Hemophilus Demonstrated on horse blood
328. Agent of Lockjaw Clostridium tetani
Terminal spore:“Drumstick/Tackhead bacillus” Tetanospasmin
(spastic paralysis)
329. Confirms diagnosis of tetanus Demonstrate toxin production
330. Floppy baby/Infant botulism C. botulinum
Lipase (+), Botulinum toxin
331. Most potent exotoxin Botulinum toxin
332. Gas gangrene/food poisoning C. perfringens
Boxcar shape, Lecithinase (+)
Reverse-CAMP (+), Double hemoysis
333. Antibiotic-associated pseudomembranous C. difficile
colitis (clindamycin) CCFA: yellow colonies, chartreuse fluorescence
334. To view spirochetes Dark Field microscope or Fluorescent MS
335. In sterilizing wire loops used in AFB smear dip in sand or glass beads before flame sterilization
336. Differential test for Corynebacteria and Listeria Motility and esculin hydrolysis
337. (+) Niacin accumulation and nitrate reduction, MTB
338. Acid-fast bacilli are killed by Moist heat: Boiling for 10mins, Pasteurization, Steam under
pressure (autoclave)
Enterobacteriaceae
339. All Enterobacteriaceae “CPON NO GF FA”
340. (-) Vogues-Proskauer Yellow
341. (+) MR and VP Red
342. Enterobacteriaceae give what type of Methyl Opposite
Red and Voges-Proskauer Reactions
343. most common cause of cystitis Enterobacteriaceae
344. E. aerogenes (+) LDC and ODC
345. E. cloacae (+) ADC and ODC
346. K. pneumoniae (+) Lysine decarboxylase only
347. Bismuth sulfite agar Salmonella typhi are black colonies surrounded by a black zone
of precipitate
348. Brilliant green agar Proteus colonies are red to pink
Salmonella colonies are red to pink
Shigella is inhibited
349. Gram-negative broth The growth of most gram-negative rods is inhibited, whereas
Salmonella and Shigella growth is enriched
350. Hektoen enteric agar Escherichia coli and lactose/sucrose fermenters are orange to
salmon pink colonies; Proteus is usually inhibited Salmonella
colonies are blue to blue-green, with black centers if hydrogen
sulfide is produced Shigella colonies are green
351. Salmonella-Shigella agar E. coli colonies are red
Proteus colonies are colorless, with black centers Salmonella
colonies are colorless, with or without black centers
Shigella colonies are colorless
352. Selenite broth Salmonella stool specimens are enriched
Gram-positive organisms are inhibited
53. Xylose-lysinedeoxycholate agar E. coli colonies are yellow
Proteus colonies are clear or yellow with black center
Salmonella colonies are red with black centers Shigella
colonies are clear
354. Eosin-methylene blue agar Escherichia coli colonies are dark, with a green metallic sheen
Gram-positive organisms are inhibited
Lactose fermenters show pink to red colonies Lactose
nonfermenters have colorless colonies
355. MacConkey agar Gram-positive organisms are inhibited
Lactose-fermenter colonies are pink to red Lactose-
nonfermenter colonies are colorless
356. ONPG (+) Beta-galactosidase: Serratia and Shigella sonnei
357. Urease (+) Citrobacter, Klebsiella, Enterobacter, Yersinia, Serratia
(CKEYS)
Rapid: Proteus, Providencia, Morganella (PPM)
358. VP (+) Klebsiella, Enterobacter, Serratia, Hafnia (KESH)
359. Non-gonococcal urethritis Chlamydia trachomatis (L1, L2, L3) Lymphogranuloma
venerium (+) glycogen inclusions with Iodine stain
360. TRIC Trachoma, Inclusion conjunctivitis
361. Culture Chlamydia Cycloheximide-treated McCoy cells
362. Legionella Requires cysteine and iron for growth
363. Brucella Requires erythritol and increased humidity
3-4weeks incubation
364. Francisella Requires cysteine, cystine and thiosulfate
365. Rat bite fever Streptobacillus moniliformis (fluff ball/bread crumb colonies)
Spirillium minus/mino
366. Cat bite infection Pasteurella multocida
367. Cat scratch fever Bartonella henselae
368. Dog bite infection Staphylococcus intermedius, S. hyicus
AMOEBAE
369. E. histolytica trophozoite Small, delicate central nuclear karyosome; Fine, evenly spread
peripheral chromatin; Progressive motility w/ hyaline
pseudopods “clean-looking cytoplasm” w/ ingested RBC
370. Mistaken for E. histolytica E. hartmanni, E. dispar, E. moshkovski
371. D. fragilis No cyst form, “parasite of parasite” because it can be
transmitted with E. vermicularis ova
372. E. gingivalis No cyst form; cytoplasm with ingested WBCs Inhabits the
tonsillar crypts
373. Naegleria fowleri Amoeba has 2 forms: trophozoite or flagellate form; can be
infected by Legionella spp.
374. Acanthamoeba castellani Double-walled cyst form
375. Iodine mount Trophozoites are destroyed
Cyst cytoplasm colored yellow-brown, chromatoidal bodies
unstained
376. Trichrome staining Bright red: Chromatoidal bodies, Charcot-Leyden crystals
Red-purple: nucleus
Plasmodium spp
377. 90% of cases of malaria P. falciparum and P. vivax
378. Specimen for diagnosis of malaria Finger prick/Capillary blood
379. MalaQuick Falciparum Histidine-Rich Protein 2 (HRP2)
380. OptiMal Parasitic LDH; Differentiates Falciparum from non-falciparum
malaria
381. Gold standard for detecting malaria Thick and thin smea
382. P. falciparum Multiple ring forms in one RBC, not all developmental stages

383. P. vivax
384. P. ovale
385. P. malariae
386. P. knowlesi
387. Disinfection of evacuated tubes
388. Unholy 3/Triad of infection
389. Migrating nematode larva recovered in sputum
390. S. stercoralis
391. Visceral larva migrans
392. Cutaneous larva migrans
393. Hookworm eggs
394. Bile-stained with clear bipolar mucus plugs
395. Steatorrhea
396. Parasite most prevalent in orphanages
397. Sabin-Feldman dye test
398. Mycosel
399. Dermatophyte fluoresce under Wood’s lamp
400. Site of virion assembly
401. First step in Viral Replication
402. CMV isolation is best accomplished using
403. KOPLIK SPOTS
404. FORCHHEIMER SPOTS
405. WARTHIN-FINKELDEY CELLS
406. T. saginata
407. T. solium larvae in tissues
408. T. asiatica
409. D. latum
410. “Double pore” tapeworm
411. Armed scolex
412. scientific name of the body of a tapeworm
413. Separate sexes
414. Stool preservatives
415. Preservative for trichrome staining
416. Echinococcus granulosus
417. Concetration Techniques
418. Flotation technique
419. Sedimentation
420. Formalin Ether/Formalin Ethyl
Acetate Conc. Tech.
seen
Crescent/banana-shaped gametocytes, infects all ages of
RBCs
Subtertian/Malignant Tertian Malaria/Blackwater Fever (36-48
hours)
Ameboid trophozoites in young RBCs; Shuffner’s dots,
Tertian/Benign tertian malaria (48 hours)
Infected RBCs show irregular shape with fimbriated edges
Infects young RBCs, James dots and Schuffner’s dots
Benign tertian/Ovale Malaria (48 hours)
Band trophozoites, merozoites in rosette form, Ziemann’s
dots in old RBCs
Quartan/Malarial Malaria (72 hours
fifth human malaria parasite; Microscopically
indistinguishable from P. malariae; infects RBCs of all ages;
Fever follows quotidian/non-relapsing pattern; common in
Southeast Asia
Gamma radiation
Hookworm, Ascaris, Trichuris
Ascaris, Strongyloides, Hookworm
Facultative parasite, rhabditiform larva in stool Chinese
lantern shaped eggs
Toxocara cati, T. canis
A. brazilienze, A. caninum
Oval, thin-shelled containing an embryo in 2-8 cell stage of
cleavage
Whipworm
G. lamblia, C. philippinensis
Pinworm/E. vermicularis
For Toxoplasmosis; based on inhibition mechanism;
(+) Trophozoites did not absorb the dy
SDA with Chloramphenicol and Cycloheximide -used for
contaminated specimens
Microsporum canis
Nucleus or cytoplasm
Attachment and penetration
Human embryonic fibroblasts
clustered, white lesions on the buccal mucosa and are
pathognomic for MEASLES (RUBEOLA)
small red spots on the soft palate seen in 20% of the patients
with GERMAN MEASLES (RUBELLA)
a type of giant multinucleate cell found in hyperplastic lymph
nodes early in the course of measles
numerous regular uterine branches resembling those of a
tree
Cysticercosis
Third taenia species
IH: liver of pigs, wild boars, monkeys, goats, cattle
“Cysticercus viscerotropica”
First IH: Copepods; 2nd IH: Freshwater fish
Dipylidium caninum (cucumber tapeworm or the doublepore
tapeworm)
Dog tapeworm, Pork tapeworm, dwarf tapeworm, Hydatid
worm
Proglottid
Nematodes and Blood flukes
Formalin, PVA, Buffered glycerol saline, Shaudinn’s, SAF,
Merthiolate Iodine Formalin
PVA
Definitive host: Dog; Intermediate host: Sheep Infective stage
to Dog: Hydatid cyst
Accidental Host: Man Infective stage to man: Egg
Formalin or SAF preservative
2 ways: Flotation or Sedimentation
Brine flotation technique (NaCl),
Zinc Sulfate Flotation technique (sp. Gr. 1.18)
For protozoan cysts and nematode eggs
(Except T. trichura, C. philippinensis)
Acid ether conc. tech.
Formalin Ether/Formalin Ethyl Acetate Conc. Tech.
Best for protozoan cysts and eggs,
Best for Schistosomal and operculated eggs, trematode and
cestode eggs,
 T. trichura and C. philippinensis eggs
Most widely used
421. Operculated, mature eggs Clonorchis, Heterophyes, Opistorchis
422. Operculated, immature Fasciola, Fasciolopsis, Echinostoma
423. Operculated with aboperculum, immature Paragonimus
424. Non-operculated, mature Schistosoma
425. Smallest but deadliest fluke Heterophyes sp
426. Hermaphrodites Cestodes and Flukes (except blood flukes)
427. the passing of Ascari’s Eggs are due to Drinking alcohol
428. Not considered as strictly antibiotics Sulfonamides
429. Vector for Ascaris lumbricoides Cockroaches
430. Vector for African sleeping sickness Tsetse fly, Glossina spp
431. Causative agent of crabs Ectoparasite
432. Grade A milk ≤15,000 bacteria per mL when pasteurized; ≤75,000 when
raw
CLINICAL MICROSCOPY
433. RBC, OFB, WBC, RTE Average per 10 HPF
434. Casts, Abnormal Crystals Average per 10 LPF
435. Transitional epith. cells, Trichomonas Rare, Few, Moderate, Many per HPF
436. Bacteria, Yeast, Normal crystals
437. Mucus strands, SECs Rare, Few, Moderate, Many per LPF
438. Sperm Report accdg to lab protocol
Reporting Mucus (LPF) Crystals (HPF) Epithelial (LPF) Bacteria (HPF) R
Rare 0-1 0-2 0-5 0-10
Few 1-3 2-5 5-20 10-50
Moderate 3-10 5-20 20-100 50-20
Many >10 >20 >100 >200
439. CSF WBC count WBC x 1/9 x 10 x 20
440. CSF Total Cell count diluent NSS
441. CSF WBC count diluent 3% acetic acid with Methylene Blue
Appearance of CSF
Clear Undiluted
Slightly Hazy 1:10
Hazy 1:20
Slightly cloudy 1:100
Cloudy 1:200
Bloody/Turbid 1:10,000
442. Sperm concentration (sperm/mL) #sperm ct x Dil.F (20) x AF (1/2) x DF (10) = sperm/uL
Sperm/uL x 1000 = Sperm/mL
443. Sperm count Sperm conc. x Specimen volume (mL) = sperm/ejaculate
444. Lens system of microscope Oculars, Objectives Coarse and fine adjustment knobs
445. Illumination system Light source
Condenser
Field and iris diaphragm
446. Phase contrast microscope Enhances visualization of elements with low refractive index
such as hyaline casts, mixed cellular casts, mucous threads
and Trichomonas
447. Polarizing microscope Aids in identifying cholesterol, oval fat bodies, fatty casts and
crystals
448. Dark-field miscroscope Aids in identification of Treponema pallidum
449. Fluorescent microscope Allows visualization of naturally fluorescent microorganisms
or those stained by a fluorescent dye
450. Interference contrast microscope Produces a 3D microscopic image and a layer-by-layer
imaging of a specimen (Nomarski/Hoffman microscope)
451. Drug testing Urine volume: 30-45 mL (60 mL container) Temperature:
32.5-37.7 deg. C
452. Routine MSCC urine, 10-15 mL (ave. 12 mL)
453. 24 hour urine Quantitative chem tests (protein, creatinine)
454. MSCC Routine, bacterial culture
455. Suprapubic aspirate Anaerobic culture, cytology
456. Afternoon (2-4pm) Urobilinogen
457. Cloudy red urine Hematuria
458. Blue diaper syndrome Hartnup’s disease, indicanuria
459. Barium enema Gray stool
460. Bismuth Black stool
461. Rancid butter odor of urine Tyrosinuria
462. Rotting fish odor Trimethylaminuria
463. Cabbage/hops odor Methionine malabsorption
464. Swimming pool odor Hawkinsinsuria
465. Rotting egg odor Cystinuria
466. Sweet/fruity odor Ketoacidosis
467. Odorless urine Acute tubular necrosis
468. Urine color and clarity View well-mixed urine against a white background with
adequate light source
469. Percentage of SSA reagent in SSA test 3% (3mL)
470. Ascorbic acid False (-) Blood, Bilirubin, LE, Nitrite, Glucose
471. 11th pad in the reagent strip Ascorbic acid
472. C-stix Phosphomolybdates ≥5 mg/dL ascorbic acid 10 sec
473. Stix Methylene green ≥25 mg/dL ascorbic acid 60 sec
Causes of Acid and Alkaline Urine
Acidic Alkaline
Emphysema Hyperventilation
Diabetes mellitus, High protein diet Vomiting
Dehydration, Diarrhea Vegetarian diet
Starvation Old specimen
Presence of acid-producing bacteria (E.coli) Renal tubular acidosis
Cranberry juice Presence of urease-producing bacteria
Medication (Mandelamine, fosfomycin tromethamine)
Correlation of urine turbidity
474. Acidic urine Amorphous urates, radiographic contrast dye
475. Alkaline urine Amorphous phosphates, carbonates
476. Soluble with heat Amorphous urates, uric acid crystals
477. Soluble in dilute acetic acid RBCs, amorphous phosphates, carbonates
478. Insoluble with dilute acetic acid WBCs, bacteria, yeast, spermatozoa
479. Soluble in ether Lipids, lymphatic fluid, chyle
Preservatives
480. Formaldehyde Addis count (12 hour urine: 0 to 500K RBCs, 0 to 1.8M WBCs
and Epithelial cells, 0 to 5000 hyaline casts)
481. Concentrated HCl Catecholamins, VMA, steroids, ammonia, urea, total nitrogen
482. Glacial acetic acid (pH 4.5) Aldosterone (or preserve with chloroform)
483. Glacial acetic acid (pH 2.0) Serotonin
484. Sodium carbonate Porphyrins, urobilinogen (to ensure alkalinity)
485. Sulfuric acid Calcium, other inorganic constituents
486. Sodium fluoride or benzoic acid Glucose analysis
Differentiate Uric Acid from Cystine crystals
487. Color UA is typically yellow or reddish-brown; Cystine
is colorless
488. Solubility Both soluble in ammonia; only Cystine is soluble in dilute HCl
489. Birefringence UA is positive; cystine is negative birefringence
490. Cyanide-nitroprusside UA is negative; Cystine is positive (red-purple)
Normal crystals Abnormal crystals (acidic urine)
1. Uric acid - alkali soluble 1. Cystine – ammonia, dilute HCl
2. Amorph. Urates – soluble in alkali and heat 2.Cholesterol – chloroform
3. Ammonium biurate – soluble in acetic acid with heat 4. 3. Bilirubin – acetic acid, HCl, NaOH, ether,
Calcium oxalate – soluble in dilute HCl chloroform
5. Calcium phosphate – dilute acetic acid 4. Leucine – hot alkali or alcohol
6. Triple phosphate – dilute acetic acid 5. Tyrosine – alkali or heat
7. Amorph. Phosphates – dilute acetic acid 6. Sulfonamides – acetone
8. Calcium carbonate – forms gas in acetic acid 7. Radiographic dye – 10% NaOH
8. Ampicillin crystals form bundles when refrigerated
491. Amorph. Urates Yellow-brown granules microscopically, “pink dust”
macroscopically
492. Uric acid crystals Yellow-brown Rhombic, whetstones, wedges, rosettes
493. Calcium Oxalate Dihydrate: envelope or two-pyramid–shaped (most common)
Monohydrate: oval or dumbbell-shaped (anti-freeze
poisoning) Major component of renal calculi 494. Triple
phosphate Colorless, prism, or coffin-lid shape
495. Amorph. Phosphates Heavy white precipitate after refrigeration
496. Calcium phosphate Flat rectangles and thin prisms in rosettes
497. Calcium carbonate Small, dumbbell, and spherical shapes (gas with HOAc)
498. Cystine Colorless hexagonal, thin and thick plates
499. Cholesterol Rectangular plates, characteristic notched corners, staircase
pattern
500. Bilirubin Yellow clumped needles or granules (+ rgt strip for bilirubin)
501. Tyrosine Fine, yellow needles in clumps or rosettes (Seen with leucine
crystals)
502. Leucine Yellow-brown spheres with concentric circles and radial
striations
503. Ampicillin Colorless needles that form bundles after refrigeration
504. Sulfonamide Variety of shapes, sheaves of wheat
505. Radiographic dye Similar to cholesterol crystals, polarize (very high sp.gr. in rgt
strip)
Renal calculi
506. Phosphate stones Pale and friable
507. Uric acid and urate stones Yellow to brownish red, moderately hard
508. Calcium oxalate stones Very hard, dark, rough surface
509. Cystine stones Yellow-brown, greasy, resembling old soap
510. RBCs 0-3 or 0-5/hpf (may resemble lymphocytes,
yeast cells, air bubbles)
511. WBCs <5/hpf (more in females) 0-5 or 8 per LPF
512. Eosinophils >1% per 100-500 WBCs is already significant
513. Hyaline casts Most common, 0-2/lpf is normal, ↑ CHF, stress, dehydration,
fever
514. Lipiduria Nephrotic syndrome, acute tubular necrosis, diabetes, crush
syndrome
515. Goodpasture’s syndrome Macroscopic hematuria, proteinuria, RBC cast, Anti-
glomerular basement membrane antibodies
516. Wegener’s granulomatis Macroscopic hematuria, proteinuria, RBC cast, Anti-
neutrophil cytoplasmic antibody
517. Henoch-Shonlein purpura Macroscopic hematuria, proteinuria, RBC cast, seen in
children after respiratory infection
518. Nephrotic syndrome Heavy proteinuria, hematuria, RTE cells, Oval fat bodies,
fatty and waxy casts
519. Acute insterstitial nephritis Hematuria, proteinuria, WBC casts, urine eosinophils, no
bacteria
520. Acute pyelonephritis (+) LE, nitrite and WBC casts (tubular infection)
521. Chronic pyelonephritis (+) LE, nitrite, WBCs, granular, waxy and broad casts
522. Cystitis (+) LE, nitrite, elevated pH, WBCs and bacteria, no WBC
casts
523. Fanconi’s Syndrome Loss of proximal tubular function; inherited with cystinosis
and Hartnup disease or acquired through exposure to toxic
agents; Glucosuria, possible cystine crystals, aminoaciduria
524. Hemolytic disease (+) Urine urobilinogen
525. Bile duct obstruction (+) Urine bilirubin
526. Total renal blood flow 1200 mL/min
527. Total renal plasma flow 600-700 mL/min
528. Normal urine output 600-2000 mL/day (ave. of 1200-1500 mL/day)
529. Polyuria >2.5 L/day (adult) 2.5-3.0 mL/kg/day (children)
530. Oliguria <400 mL/day (adult)
<1 mL/kg/hr (infants), < 0.5 mL/kg/hr (children
531. Isosthenuria Sp.gr. ~ 1.010
532. Urine pH ≥6.5 Add 0.005 to specific gravity reading
533. Glomerulus can filter moleules less than 70,000 Daltons
534. Estimate of GFR not needing the urine crea COCKCROFT AND GAULT formula for creatinine clearance
Other body fluids
535. Prostatic infection 3 glass procedure (leukocyte count)
536. 2nd glass - Control for detecting kidney or bladder infection
WBC/hpf and bacteria of 3rd glass should be 10x higher than the 1st glass
537. Florence test Test for choline (+) dark brown rhombic crystals Rgt: Iodine,
KI
538. Barbiero’s test Test for spermine (+) Yellow leaf-shaped crystals Rgt: Picric
acid, TCA
539. Acrosomal cap of sperm ½ the head, 2/3 the nucleus
540. Seminal fluid fructose Sperm motility and concentration
Should be tested within 2hours or frozen
541. WBC diluent for synovial fluid NSS, Hypotonic saline, Phosphate buffered solution
542. Gout crystals Monosodium urate monohydrate crystals with negative
birefringence
543. Pseudogout Calcium pyrophosphate crystals with positive birefringence
544. RA cell/Ragocyte Neutrophils with precipitated RF in cytoplasm
545. Onchronotic shards Pepper-like particles that are pigmented cartilage
546. Reiter cell Macrophage with ingested neutrophil (reactive arthritis)
547. Rice bodies Macroscopically resembles polished rice grains (Tubercular
arth.
548. Pentagastrin Most preferred stimulant of gastric acidity
549. Insulin Stimulant in assessing successful vagotomy procedure
550. Zollinger-Ellison Syndrome Highest serum gastrin level
551. Pernicious anemia Patient shows no response to gastric stimulation
552. Basal Acid Output Based on a one-hour collection of gastric secretion: 4
individually segregated 15-minute samples
553. Maximal Acid Output Sum of acid secreted in one hour (four 15-minute samples)
after injection of histamine, pentagastrin, or betazole
(Histalog)
554. Maximum amniocentesis 30 mL (first 2-3 mL is discarded)
555. Fetal lung maturity Specimen should be placed on ice for delivery to the
laboratory and refrigerated or frozen up to 72 hours
556. Cytogenetic studies Maintained at room temp or 37 deg.
557. Liley graph Zone 1 – mild HDN
 Zone 2 – Moderate hemolysis and requires careful monitoring
Zone 3 – Severe HDN and requires intervention by induction
of labor or intrauterine exchange transfusion
558. Neural tube defects AFP (screening); Acetylcholinesterase (confirmatory)
559. FLM L/S ratio, Amniostat FLM (phosphatidylglycerol) Foam
stability index, microviscosity test, Lamellar body count, OD
650
560. Serous fluids EDTA tube: for cell count
Sterile heparinized tube: microbiology and cytology
Chemistry tests: plain or heparinized tube pH: maintain
specimen in anaerobically iced condition
561. Adenosin Deaminase (ADA) ≥40 U/L is indicative of tubercular peritonitis
562. Bacterial peritonitis ≥500 WBC/uL
563. Blunt trauma injury ≥100,000 RBCs/uL in peritoneal lavage
564. Neutral fat Readily stained with Sudan III (direct fat stain) Large orange-
red droplets located near the edge of the cover >60
droplets/hpf = steatorrhea
565. Fatty acids and soaps Requires acetic acid and heat for staining
(split fat stain)
Normal = 100 droplets/hpf <4um diameter
Slight increased = 100 droplets/hpf 1-8 um diameter
Increased = 100 droplets/hpf 6-75 um in diameter
566. Increased in direct fat stain Inc. triglycerides and neutral fats = maldigestion
567. Increased in split fat stain Inc. fatty acids = malabsorption
568. Quantitative stool specimen 3-day collection; for van de Kamer titration
569. Carbohydrate disoders Stool pH < 5.5
570. Pathologic bleeding > 2.5 mL/150 grams stool (not visible to naked eye)
571. Invasive diarrhea ≥3 neutrophils/hpf or atleast 1/OIF
Salmonella, Shigella, Campylobacter, Yersinia, EIEC
572. Diarrhea without WBCs Toxigenic bacteria (Vibrio, S. aureus), parasites, viruses
573. Blastocystis hominis Mistaken for fat globules or leukocytes
574. Blastomyces Mistaken for myelin globules
575. Bronchial asthma Dittrich plugs, Curschmann’s spirals, Charcot-Leyden
crystals, Creola bodies
HEMATOLOGY
RUBRICYTE NORMO/ERYTHRO DESCRIPTION
NOMENCLATURE NOMENCLATURE
RubriBLAST PROnormoblast/ Earliest RBC, N:C ratio of 8:1, Chromatin is fine and
PROerythroblast uniform, and stains intensely
PROrubriCYTE BASOphilic Last stage with a nucleolus
normoblast/erythroblast Cytoplasm is less blue but intensely basophilic (RNA)
RubriCYTE POLYchromatic Last stage capable of mitosis
normoblast/erythroblast Begins to produce hemoglobin, resulting in “muddy blue
pink cytoplasm”
METArubricyte ORTHOchromic Last stage with nucleus
normoblast/erythroblast small, fully condensed (pyknotic) nucleus
Reticulocyte Polychromatic Last stage to synthesize hemoglobin
erythrocyte no nucleus but has mitochondria and ribosomes
Mature erythrocyte Size range is 6-8 um, round, biconcave discocyte,
Salmonpink with central pallor; Lifespan: 120 days
576. Macrocytosis and poikilocytosis is graded when more than 10%/HPF
Macrocytosis
1+ (i.e., slight) if there are approximately 25% macrocytic RBCs present per high-power field
2+ to 3+ (i.e., moderate) if there are 25% to 50% macrocytic RBCs present per high-power field
4+ (i.e., marked) if there is >50% macrocytic RBCs per high-power field

Hypochromia
1+(i.e., slight) if RBCs show a central pallor is one third to two thirds of the cell’s diameter
2+ to 3+ (i.e., moderate) if RBCs show a central pallor is more than 2/3rd of the cell’s diameter
4+ (i.e., marked) if RBCs show only a thin rim of hemoglobin on the periphery of the cell

Polychromasia should be quantitated in the following manner:

1+ if 1–3 polychromatic cells are found per microscopic field
2+ if 3–5 polychromatic cells are found per microscopic field
3+ if more than five polychromatic cells are found per microscopic field

Basophilic stippling
Slight if one stippled RBC is noted in every other microscopic field
Moderate if 1–2 stippled RBCs are noted in every microscopic field
Marked if three or more stippled RBCs are noted in every microscopic field

Rouleaux formation
Slight, if one to two RBC chains are found per thin microscopic field
Moderate, if three to four RBC chains are found per thin microscopic field
Marked, if five or more RBC chains are found per thin microscopic field (Hubbard)
577. Homozygous Pelger-Huet Round neutrophil nucleus
578. Heterozygous Pelger-Huet Bilobed neutrophil nucleus (pince-nez) – common
579. Acquired or pseudo-Pelger Huet Found in CML, MMM and chemotherapy
Round, centrally located nucleus
580. Two most widely used test for anemia Hemoglobin and hematocrit
581. RDW Increased in IDA, normal in thalassemia
582. Anemia of chronic disorder Decreased transferrin due to being a negative APR
583. Anemia of endocrine disease Due to tissues decreased demand for oxygen
584. Anemia of chronic renal insufficiency Failure of the kidneys to produce EPO
585. Leukoerythroblastosis Increased immature granulocytes and NRBCs
586. Increased LDH and fecal urobilinogen Hemolytic anemia (intravascular)
Ineffective erythropoiesis (megaloblastic anemia)
587. Differentiate microcytic anemias Serum Iron and Iron Binding Capacity (TIBC)
IDA: Low Serum Fe, Increased TIBC
588. Fecal urobilinogen Total excretion of breakdown products of heme
589. Zinc erythrocyte protoporphyrin test Measures unused protoporphyrin
Increased in IDA, Lead poisoning, Porphyria
590. Plasma Iron turnover Uses radioactive 59Fe intravenously to measure rate of
disappearance
Measures total erythropoiesis
591. Red cell turnover Measures effective erythropoiesis
Measures 59Fe radioactivity for 2-3 weeks
592. RBC lifespan/survival Uses 51Chromium
593. Measures of Total Erythropoiesis M:E ratio (3:1 to 4:1)
Fecal urobilinogen
Plasma Iron turnover
594. Measures of effective erythropoiesis RBC Iron turnover Reticulocyte count RBC lifespan
(RBCs that reach the circulation)
595. Normal adult iron level About 4000 mg
60% in circulation, 40% in Ferritin/Hemosiderin
596. 1 mL RBC 1 mg Iron
597. IDA Microcytic, hypochromic, Dec. iron, Inc. TIBC and FEP
Smaller platelets with normal platelet count Normal
reticulocyte count; Inc. reticulocytes after Iron therapy and
hemorrhage; Decreased sideroblasts
598. Sideroblastic anemia Defective iron loading = accumulation in mitochondria of
erythroid precursors; Hereditary or acquired
Deficiency of ALA synthetase
599. Hereditary sideroblastic anemia Hct = 20%, severe anemia
Dimorphic population of RBCs: Normocytic, normochromic
and microcytic-hypochromic RBCs (+) Target cells and
basophilic stippling
Inc. Fe and % transferrin saturation
Erythroid hyperplasia with Ringed sideroblasts in 10-40% of
late normoblasts
600. Siderocytes are red cells containing iron granules and are visible when
stained with Prussian blue
601. Primary Idiopathic Sideroblastic anemia More common, moderate anemia Hct = 25-30% (+)
normocytes and macrocytes with few microcytes
Erythroid hyperplasia with Ringed sideroblasts in all stages of
development
602. Secondary Sideroblastic anemia Due to toxins and drugs that interfere with heme synthesis.
Alcoholism, lead poisoning, Tuberculosis drugs,
Chloramphenicol
603. Hemosiderosis Iron accumulation in macrophages causing little parenchymal
cell injury
604. Hemochromatosis Excessive iron accumulates in the blood and tissues
605. Hereditary hemochromatosis Rare autosomal recessive disease in middle aged men
Disorder of iron absorption from food irrespective of the iron
stores
Iron accumulates in the liver, pancreas, spleen, Bronze
colored skin (melanin deposits); Causing heart abnormalities,
cirrhosis, hair loss
Inc. Iron and transferrin saturation, dec. transferrin Normal
H&H, blood film, RA test
606. Iron overload Seen in: Massive blood transfusions, chronically transfused
anemias, increased dietary intake (>100 mg/day), alcohol
abuse, liver disease
607. Fanconi’s anemia Congenital pancytopenia
608. Pure RBC aplasia Congenital erythroid hypoplasia/Diamond Blackfan Syndrome
Defective/reduced CFU-E
Tests for Primary Hemostasis
609. Bleeding time Template BT: 6-10 mins
Duke’s (finger/earlobe): 2-4 mins
Ivy (40mmHg, forearm): 3-6 mins
610. Clot retraction time (Test for thrombosthenin) Castor oil/Hirskboech: dimpling within 15-45 mins Stefanini:
2-3 mL sample at 37℃, complete within 18-24 hours
Macfarlane: 3-5mL sample at 37℃ for 1 hour; Normal: 44-
67% clotted
611. Platelet count Normal: 150,000 to 400,000/L
Direct: RBC pipet (1:200) allow to sit for 10 mins, charge
chamber and allow to stand fro 10-15 mins in humid petri dish
(allows platelets to settle) Count the center primary square
(1mm) Platelets/cumm = plts counted x 1 x 10 x 200
612. Reese-Ecker Sodium citrate, Bromcresol Green
613. Guy and Leeke’s Sodium oxalate, crystal violet
614. Brecker-Cronkite 1% ammonium oxalate, Phase contrast microscope
615. Unopette 1:100 dilution (1.98 mL 1% ammonium oxalate & 0.02 mL
blood)
616. Indirect Smear estimate of platelets
Methods: Fonio, Damesheck, Olef
Platelets/cumm = Platelets in 10 OIF x 20,000 Normal: 8-20
platelets/OIF
617. Salzmann Platelet Adhesiveness Normal: 26-60%
Decreased in von Willebrand’s disease
618. Aggregation studies Citrated blood centrifuged at 60-100g for 10 mins = PRP
Abnormal Ristocetin, Normal with ECA: VWD and BSS
Normal Ristocetin, Abnormal with ECA: Glanzmann
thrombasthenia
619. Capillary Resistance test Rumpel-Leedes Test/ Tourniquet test
100mmHg for 5 mins, then count petechial spots after 15-30
mins
0-10 spots (few on arm) : 1+
11-20 spots (many on arm) : 2+
21-50 (multiple on arm and hand):
3+ >50 (confluent spots on arm&hand): 4+
620. Citrated blood Centri 60-100g for 30 mins = PRP
(aggregation studies)
Centri 2000-2300 , 10-15 mis = PPP
(coagulation studies)
621. Platelet aggregometry Gold standard test for platelet function
Tests for Secondary Hemostasis
622. Clotting time Capillary method/Dale & Laidlaw: 2-4 mins
Lee & White’s Tube mtd: 3 glass tubes 13x100mm Normal: 7-
15 or 5-15 mins
623. Prothrombin time Test for extrinsic and common pathway
Normal: 10-12 sec; Reported as INR
Used for monitoring patients on warfarin
PPP + thromboplastin + CaCl2 (incubated at 37℃)
624. aPTT Test for intrinsic and common pathway
Normal: 25-35 sec
Used to monitor patients on heparin
PPP + activator + phospholipid + CaCl2 (incubated at 37℃)
625. Stypven time Russel Viper venom time: test for common pathway
Venom from Vispera russeli activates factor X Normal: 6-10
sec
626. Thrombin time Test for fibrinogen
Increased in hypofibrinogenemia, FSP, Streptokinase,
Heparin Normal: 10-14 sec
627. Reptilase Time Rgt: Bothrops atrox venom
Increased in fibrinogen/deficiency, dysfibrinogenemia, FSP
NOT AFFECTED BY HEPARIN
628. Duckert’s Test 5M Urea test: test for factor XIII
Rgt: 5M urea or 1% monoacetic acid or 2% acetoacetic acid
Normal: clot not dissolved in 2 hours
629. Fibrinogen assay Quantitative fibrinogen test
Rgt: thrombin, plot on standard curve
Normal: 200-400 mg/Dl
630. Bethesda assay Test for circulating factor VIII inhibitor
631. DRVVT Diluted Russel Viper Venom Time

Test for circulating lupus anticoagulants

Tests for tertiary hemostasis
632. WBCLT Whole blood clot lysis time
 WB clot stable up to 48 hours at 37℃
633. ECLT Euglobulin Clot Lysis Time
Normal: clot stable up to 2 hours or more
634. Protamine sulfate test Screens for fibrin monomers in plasma (+) fibrin strands or
gel-like clot
635. Ethanol gelation test Screens for fibrin monomers in plasma
636. D-dimer test Latex agglutination
Confirmatory test; most specific for DIC
Positive after 4hours on-set of DIC
637. Manual cell count [Number of cells × dilution factor × depth factor (10)] ÷ area
638. RBC count RBC count = number of cells counted × dilution
factor × depth factor (10), divided by the area
RBC x 5 x 10 x 200 (0.2 mm2)
639. WBC count Number of cells counted × dilution factor × depth factor (10)
divided by the area
WBC x 0.25 x 10 x 20 (4 mm2)
640. Leukocytosis >11x109/L WBC
0.5-1.5% normal (adults)
641. Reticulocyte count
(Retics counted/1000 RBCs) x 100 = % retics
642. Corrected reticulocyte count = reticulocytes (%) × Hct ÷ 45
Adult: ≥5 NRBCs/100 WBC Neonate: ≥10
NRBCs/100 WBC
643. Correction for WBC count WBC x 100
Corrected ct =
NRBC + 100
Isotonic electrolyte solution
644. Detergent in Cyanmethemoglobin method
Improves lysis of red cells, decreases turbidity
645. Best way to make smear (Wedge tech) SMOOTH and RAPID
Modulation of cellular and chemical activities in
646. Biologic role eosinophils
immunologically-mediated inflammation
647. Predominant cell in the bone marrow Metamyelocyte (juvenile)
648. Visible thrombocytes Metamegakaryocytes
649. Outer surface of platelets Glycocalyx

650. Alpha and dense granules, mitochondria Organelle zone

651. Thrombosthenin, microtubules Sol gel zone
652. Deletion of 3 of 4 alpha genes Hb H disease (pitted golf ball appearance)
653. Deletion of all 4 alpha genes Bart’s Hydrops Fetalis
Decreased solubility
654. Hb S and Hb C
(+) turbidity in Dithionite solubility test
655. Prolonged PT Fibrinogen ≤100 mg/dL (Rodak); ≤80mg/dL
656. Prolonged aPTT Fibrinogen ≤100 mg/dL (Rodak); ≤60-80 mg/dL
657. Prolonged TT ≤80 mg/dL fibrinogen
658. Total number of cells on each side of the Should agree within 10% of each other
counting chamber
659. pH for blood and BM smears pH 6.8
660. pH for malarial smears pH 7.2
661. 3 degrees angle tilt of the ESR tube 30% error (Henry)
662. X axis on histogram Size of cell
663. Y axis on histogram Number of cells
664. RBC dilution in coulter counter 1:50,000
665. WBC dilution in coulter counter 1:500
666. Cyanmethemoglobin 1:251 (read at 540 nm)
667. Computed values Hct, MCH, and MCHC
668. Derived from RBC histogram MCV and RDW
669. Cold agglutinins Increased MCV, decreased RBC ct and MCHC
670. Hypercoagulable state Deficiency of anti-thrombin III, Protein C & S
CYTOCHEMICAL STAINS
SPECIMEN: AIR DRIED BLOOD OR BONE MARROW SMEARS (except LAP and Peroxidase/MPO)
LAP Stains ALP in neutrophils and in certain B cells FRESH CAPILLARY BLOOD
(+) Blue color, KAPLOW ct >10%
Diff. CML from Leukemoid reaction or PV
Peroxidase/ Diff acute myelogenous and monocytic FRESH CAPILLARY BLOOD
MPO leukemias from ALL EDTA or heparinized fresh WB
(+) REDDISH-BROWN ppt: PMN, Eos, Mono

SBB Diff myelogenous and myelomonocytic from ALL Fixed with torn up filter paper
(+) BLACK GRANULES: lipid vacuoles of Burkitt’s moistened with 37% formaldehyde
lymphoma cells
Chloroacetate Stains esterases in granulocytes
esterase Diff granulocytic cells from monocytic cells EDTA or Heparin anticoagulant
(+) BLUE GRANULES UNFIXED SMEARS may be
Nonspecific Stains esterases in monocytes, macrophages stored in the dark at RT up to 2
Esterase megakaryocytes, and platelets weeks
Diff monocytic from granulocytic leukemias
(+) DARK RED GRANULES
PAS Stains HMW carbohydrates present in almost all Old wright-stained smears may
blood cells except Pronormoblasts still be stained
Helps diagnose DiGuglielmo’s syndrome Reagent is stored in brown bottle
(+)RED ppt at Ref temp; Schiff’s rgt (Basic
fushsin) is stored in the dark at 4 ℃
ACP Diagnosing Hairy Cell Leukemia Heparinized WB
(L-tartaric acid resistant ACP or TRAP) FIXED SMEARS can wrapped in
(+)RED ppt parafilm and frozen -20℃ up to
2 weeks
IMMUNOLOGY & SEROLOGY
671. Precipitation Soluble antigen + soluble antibody
672. Oudin Single Diffusion Antigen diffuses
Fahey-McKelvey: read after 18-24 hours
673. Radial immunodiffusion (single diffusion) d = log(Ag conc)
Mancini: end point assay read after 24 hrs (IgG) or 72 hrs
(IgM) d2 = Ag conc
Cross: non-identity
674. Ouchterlony Double diffusion
Spur: partial identity
Arc: identity
Rocket immunoelectrophoresis (Laurell)
Immunoelectrophoresis: monoclonal gammopathies,
675. Immunoelectrophoresis separate serum proteins into separate fractions
Immunofixation electro: anti-sera layered on medium
Counter-current electro: Ag and Ab placed on opposite
sides
676. Agglutination Particulate Ag aggregate to visible agglutination
Kauffman & White (Salmonella O & H
677. Direct Agg
antigen) ABO forward grouping
(Hemagglutination)
678. Passive agg Antigen + carrier
679. Reverse passive agg Antibody + carrier
680. Coaglutination Protein A + IgG1,2 or 4
(+) result is no agglutination
681. Agglutination inhibition
hCG test, Hemagglutination inhibition tests for viruses
DAT: detection of in-vivo sensitization in cases of HDN,
682. AHG-mediated agg HTR, AIHA, and Drug-induced hemolytic anemias
IAT: detects in-vitro sensitization done in cross matching,
Antibody detection & identification, RBC Antigen
phenotyping
683. Monospecific AHG From mice, IgG or C3d
684. Polyspecific AHG From rabbits, IgG and C3d
685. Cytokines are important in the diagnosis of
Viral and fungal diseases
686. T cells and NK cells A major group of lymphocytes according to function
687. Passive immunity Antibody production is not done by the body
Advantage: Immediate / Disadvantage: short
term
688. Passive natural Transfer in vivo (Ab)
689. Passive artificial Immune serum Ig’s administration (Ab) Ex. anti-rabies
690. Active natural Infection (Ag)
Vaccinatio
n (Ag)
Vaccine:
691. Active artificial 1. Live = smallpox
2. Attenuated = BCG (M. bovis)
3. Dead = cholera, typhoid
4. Toxoid = C. tetani
5. Modified virus = poliovirus
692. Active immunity Antibody production is done by the body
Advantage: Long term Disadvantage: slow response
The normal kappa/lambda ratio in serum is 2:1. A
693. 2:1 kappa/lambda ratio outside of 2:1 is an indication of
monoclonal gammopathies.
The ASO is usually utilized to determine whether a
694. ASO previous group A Streptococcus infection has caused a
poststreptococcal disease, such as rheumatic fever,
scarlet fever, or glomerulonephritis.
 The anti-DNase test is utilized to determine whether a
695. anti-DNase
previous infection of group A beta-hemolytic Streptococcus
has occured.
696. Fibronectin opsonizes bacteria and promotes their rapid
phagocytosis
infectious mononucleosis, SLE, antiphospholipid
697. False (+) RPR
antibody syndrome, hepatitis A, leprosy, or malaria
The strength with which a multivalent antibody binds a
698. Avidity multivalent antigen. It is influenced by both the valence of
the antibody and the valence of the antigen.
occasionally isolated as causative agents of opportunistic
699. Rhodotorula spp
mycoses in vulnerable hosts, including patients with AIDS.
700. Gold standard for detection of ANA
Slide-based ANA tests using HEp-2 or HEp-2000 cells
requires the demonstration of IgM antibody, or the
701. Active or recent infection demonstration of a fourfold rise in the titer of specific IgG
antibody
702. PCR Denaturation: The DNA is heated to break the
hydrogen bonds resulting in single stranded DNA
Annealing: The DNA primers attach to the DNA strands.
Extension: The DNA polymerase synthesize new strands
of DNA.
703. HbsAg Active acute or chronic Hepatitis B infection
hepatitis B viruses are replicating, indicating an active
704. HbeAg
infection and high infectivity/contagious
705. Anti-HBc IgM First antibody developed from infection
706. Anti-HBs Recovery and immunity
707. Fc portion defines the class and subclass of each antibody
708. IM heterophile antibodies Not adsorbed by guinea pig kidney cells
709. Frossman antibodies Not adsorbed by beef erythrocytes
710. Serum sickness antibodies Adsorbed by both guinea pig and beef cells
T cell development
711. Double negative thymocytes Lacks CD4 and CD8, rearrangements for the genes for
TCR (CD3/Tcell receptor)
712. Double-positive thymocyte Express both CD4 and CD8
713. Mature T cells Either CD4 or CD8, migrate to the medulla
714. Activated T cells Express receptors for IL-2
Differentiate into small lymphocytes that secrete
715. Sensitized T cells
cytokines and memory T cells
B cell development
CD19, CD45R, CD43, CD24 and c-Kit; intracellular
716. Pro-B cells/ Progenitor B cells
proteins are TdT and recombination-activating genes
RAG-1 and RAG-2, which code for enzymes involved in
gene rearrangement
First heavy chains synthesized are the 𝜇 chains of
717. Pre-B cells
IgM; the 𝜇 chains accumulate in the cytoplasm
718. Immature B cells Complete IgM molecules; CD21, CD40 and MHC class II
molecules
719. Mature B cells In addition to IgM, all mature B cells exhibit IgD
Antigen-dependent activation of B cells takes place in the
720. Activated B cell
primary follicles of the peripheral lymphoid tissue; exhibit
CD25 (a receptor for IL-2)
Abundant cytoplasmic immunoglobulins and little to no
721. Plasma cells surface immunoglobulin; represent the most fully
differentiated lymphocyte, and its main function is antibody
production
722. Anaphylactic reactions (Hypersensitivity Most common agents are drugs (e.g. systemic penicillin)
Type I) and insect stings
723. C3 deficiency Severe recurrent infections
724. C2 deficiency Lupus-like syndrome, recurrent infections, atherosclerosis
725. DAF, CD59 (MIRL) deficiency PNH
726. HLA-B27 Ankylosing spondylitis
727. Mixed lymphocyte reaction Cellular assay
728. Anti-dsDNA Most specific antibody for SLE
729. Sjogren’s syndrome A chronic inflammatory disease of unknown cause that
affects lacrimal, salivary and other excretory glands; HLA-
B8 and HLA-DR3
Celiac disease, Addison’s disease, Myasthenia gravis,
730. HLA-B8 dermatitis herpetiformis, chronic active hepatitis, Sjogren’s
syndrome, diabetes mellitus (insulin dependent),
thyrotoxicosis
Blocking test in which an antigen is fist exposed to
731. Inhibition immunofluorescent assay
unlabeled antibody and then to labeled antibody, and is
finally washed and examined
732. HCV RNA Viral load
733. HRP-2 antigen P. falciparum
Direct phagocytosis
734. PPRP, PPRR
Primitive pattern recognition receptors
Gk. “taking away”
735. Apheresis Early developments: Dr. Edwin J. Cohn
First continuous flow apheresis machine: Freirich & Judson
736. Four different forms of H antigen Unbranched straight chain (H1, H2)
Complex branched chains (H3, H4)
737. Greatest to least H antigen O>A2>B>A2B>A1>A1B
LEWIS BLOOD GROUP
 Le antigens are not synthesized by the RBCs
 Le antigens are adsorbed from the plasma onto the RBC membrane
 Le gene is needed for the expression of Lea; Le and Se gene are needed to form Leb
 Le antigens are poorly expressed at birth
 Le antibodies are generally IgM (naturally occuring) made by Le(a-b-) individuals
 Le antibodies are frequently encountered in pregnant women
 Le antibodies are not considered significant for transfusion medicine
P BLOOD GROUP
 Consists of the biochemically related antigens P, P1, Pk and LKE
 P1 antigen expression is variable; P1 antigen is poorly developed at birth
 Anti-P1 is a common naturally occuring IgM antibody in the sera of P1 (-) individuals; it is usually a weak,
cold-reactive saline agglutinin and can be neutralized with soluble P1 substance found in hydatid cyst fluid
 Anti-PP1Pk is produced by the rare p individuals early in life without RBC sensitization and reacts with all RBCs
except those of other p individuals. Antibodies may be a mixture of IgM and IgG, efficiently bind complement,
may demonstrate in vitro hemolysis, and can cause severe HTRs. It is associated with spontaneous abortions
 Alloanti-P is found as a naturally occurring alloantibody in the sera of Pk individuals and is clinically significant
 Autoanti-P is most often the specificity associated with the cold-reactive IgG autoantibody in patients with
paroxysmal cold hemoglobinuria (PCH)
 The autoanti-P of PCH usually does not react by routine tests but is demonstrable as a biphasic hemolysin only in
the Donath-Landsteiner test
I AND i ANTIGENS
 I and i antigens are not antithetical; they have a reciprocal relationship
 Most adult RBCs are rich in I and have only trace amounts of i antigen
 At birth, infant RBCs are rich in i; I is almost undetectable; over the next 18 months of development, the
infant’s RBCs will convert from i to I antigen
 Anti-I is typically a benign, weak, naturally occurring, saline-reactive IgM autoagglutinin, usually detectable
only at 4℃
 Pathogenic anti-I is typically a strong cold autoagglutinin that demonstrates high-titer reactivity at 4℃ and
reacts over a wide thermal range (up to 30℃-32℃)
 Patients with M. Pneumoniae infections may develop strong cold agglutinins with autoanti-I specificity
 Anti-i is a rare IgM agglutinin that reacts optimally at 4℃, potent examples may be associated with infectious
mononucleosis
MNSs BLOOD GROUP
 Anti-M and anti-N are cold-reactive saline agglutinins that do not bind complement or react with enzyme-treated
cells; both anti-M and anti-N may demonstrate dosage
 Anti-S and anti-s are IgG antibodies, reactive at 37℃ and the antiglobulin phase. They may bind complement
and have been associated with HDFN and HTRs
 The S-s-U- phenotype is found in blacks
 Anti-U is usually IgG antibody and has been associated with HTRs and HDFN
KELL BLOOD GROUP
 Antigens are well-developed at birth and are not destroyed by enzymes
 Antigens are destroyed by DTT, ZZAP and glycine-acid EDTA
 Anti-K is usually an IgG antibody reactive in the antiglobulin phase and is made in response to pregnancy or
transfusion of RBCs; it has been implicated in severe HTRs and HDFN
 The McLeod phenotype, affecting only males, is described as a rare phenotype with decreased Kell system
antigen expression. Some males with the McLeod phenotype also have the X-linked chronic granulomatous
disease
DUFFY BLOOD GROUP
 Fya and Fyb antigens are destroyed by enzymes and
 Fy(a-b-) RBCs resist infection by the malaria organism P. vivax and P. knowlesi
 Anti-Fya and anti-Fyb are usually IgG antibodies and react optimally at the antiglobulin phase of testing; both
antibodies have been implicated in delayed HTRs and HDFN
KIDD BLOOD GROUP
a b
 Anti-Jk and anti-Jk may demonstrate dosage, are often weak, and found in combination with other
antibodies; both are typically IgG and reactive in the antiglobulin test
 Antibodies may bind complement and are made in response to foreign RBC exposure during pregnancy or
transfusion
 Antibodies are a common cause of delayed HTRs
 Kidd system antibody reactivity is enhanced with enzymes, LISS and PEG
LUTHERAN BLOOD GROUP
 Lua and Lub are antigens produced by codominant alleles; they are poorly developed at birth
 Anti-Lua may be a naturally occuring saline agglutinin that reacts optimally at room temperature
  Anti-Lub is usually an IgG antibody reactive at the antiglobulin phase; it is usually produced in response to foreign
RBC exposure during pregnancy or transfusion
 Lu(a-b-) phenotype is rare and may result from three different genetic backgrounds; only individuals with the
recessive type Lu(a-b-) can make anti-Lu3
738. Landsteiner and Levine injected rabbits with Divided human RBCs into two groups: P+ and P-
human RBCs and produced an antibody called
anti-P
Bg (Bennett- Goodspeed)
739. HLA on red cells
740. Associated with C4 Chido, Rodgers
741. Leach phenotype (GE: -2, -3, -4) Elliptocytosis
742. An antigenic characteristic of the red blood cell
membrane that is unique to an individual or a Private antigen
related family of individuals and therefore is not
commonly found on all cells (usually less than 1%
of the population)
743. Cold agglutinins in the serum of normal individuals
and in the patients with acquired hemolytic anemia; Anti-I
Wiener and coworkers gave a name to one such
agglutinin, calling its antigen I for “individuality”. The
antibody reacted with most blood specimens tested
744. Found in renal patients dialyzed with formaldehyde Anti-N-like antibody
sterilized equipment
745. Produced by S-s-U(-), Blacks Anti-U
a. instruct the donor to breathe slowly
746. If the donor starts to feel nauseated or vomits b. apply cold compresses to the forehead
c. Turn the donor’s head to one side and provide an
appropriate receptacle
d. Give water after vomiting has ceased
747. Reaction observed during apheresis: bleeding Remove needle if light pressure will not control it then apply
from the venipuncture site (heparinized donors) pressure and cold. If unusually troublesome, administer
protamine
Chemicals in anticoagulant solutions
748. Citrate (sodium citrate/citric acid) Chelates calcium, prevents clotting
Maintains pH during storage, necessary for maintenance
749. Monoblastic sodium phosphate
of adequate levels of 2,3-DPG
750. Dextrose Substrate for ATP production (cellular energy)
751. Adenine Production of ATP (Extends shelf life from 21 to 35 days
Blood Preservation
752. Citrate (1914) Blood anticoagulant; binds calcium, prevents clotting
753. Dextrose (Rous,1916) Provide energy source for the RBCs
754. Citric acid (Loutit, 1943) Decreased pH, prevents caramelization

755. Inorganic phosphate buffer (Gibson, 1957)

Increased ATP production and RBC viability
Improves the survival of stored donor RBCs. Increased
756. Adenine maximum shelf-life of blood from 21 days to 35 days;
provides substrate for RBC to maximize ATP synthesis
and thereby increase RBC viability
757. Modified Whole Blood WB from which cryoprecipitate and/or platelets
758. Used to dilute blood components Isotonic saline (0.9%) or 5% albumin
759. Preparation of leukopoor RBC Centrifugation, filtration, saline-washing
BLOOD TRANSFUSION ON FILTERS FOR BLOOD COMPONENTS
a. First generation filters 170 - 260 microns pore size
Screen filter
Standard blood filter - removes gross debris; used for all
blood components
b. Second generation filters 20 - 40 microns pore size
Micropore screen filter
Removes 75-90% of leukocytes; used only for RBCs
c. Third generation filters Adhesion
An adsorption filter; removes 99 to 99.9% of leukocytes;
used for both red blood cells and platelets
Third generation filters use selective adsorption of leukocytes or leukocytes and platelets. They are made of polyester or
cellulose acetate and will produce a 2- to 4-log (more than 99.9 percent) reduction of the WBCs (<5 x 106) or platelets,
or both. These filters provide a leukocyte-reduced product with normal shelf-life and meet the 85 percent retention of
original RBCs.
minimum 150mg fibrinogen (QC: 250mg), 80U AHF, vWF,
760. Components of cryoprecipitate
Factor XIII
Same as those of FFP, with the exception that it does not
761. Plasma cryoprecipitate reduced
provide physiologic concentrations of all coagulation
Treatment of TTP (ADAMTS13)
factors, thereby lacking fibrinogen and factor VIII
Facilitate oxygen transfer into the platelet bag and oxygen
762. Platelet agitation
consumption by platelets
 A synthetic vasopressin analogue that can stimulate
763. DDAVP (desmopressin)
release of vWF
764. TRALI or Non-cardiogenic Pulmonary Due to anti-leukocyte antibodies (and/or anti-HLA)
Edema Leukoreduced blood components should be used
Iatrogenic, physician-caused
765. Circulatory overload At risk are children, elderly patients, and patients with
normovolemic anemia, cardiac disease, thalassemia
major or sickle cell disease
Transfusion hemosiderosis; accumulation of iron in the
766. Iron overload heart, liver and endocrine glands. At risk are the
transfusion-dependent patients: congenital hemolytic
anemia, aplastic anemia and chronic renal failure
767. Neocytes Young RBCs, longer lifespan/survival within recipient
768. Primary advantage of gel tech Standardization
HISTOPATHOLOGY AND MT LAWS
769. Prions Normal steam sterilization does not inactivate these
Infectious agents that cause spongiforms particles. Tissues can be decontaminated by immersing in
encephalopathies such as Creutzfeld-Jakob disease formalin for 48 hours then concentrated formalin for 48
(CJD), Scrapie and Madcow hours then concentrated formic acid for 1 hour and
additional formalin for 48 hours
Process whereby a selected tissue specimen is immersed
770. Teasing or dissociation in a watch glass containing isotonic salt solution, carefully
dissected or separated, and examined under the
microscope
Process whereby small pieces of tissue no more than 1mm
771. Squash preparation or crushing
in diameter are placed in a microscopic slide and forcibly
compresed with another slide or with a cover glass
With an applicator stick or platinum loop, the material is
772. Streaking rapidly and gently applied in a direct or zigzag line
throughout the slide
773. Spreading Selected portion of the material is transferred to a clean
slide and gently spread into a moderately thick film by
teasing the mucus strands apart with an applicator stick
Useful for preparing smears of thick secretions such
774. Pull-apart as serous fluids, enzymatic lavage samples from the
gastrointestinal tract and blood smears
Special method of smear preparation whereby the surface
775. Touch preparation or impression smear
of a freshly cut piece of tissue (e.g., lymph node) is
brought into contact and pressed on to the surface of a
clean slide
776. Most rapid freezing agent Nitrogen
777. Freezes tissues in frozen microtome Carbon dioxide (CO2)
FIXATIVES ACCORDING TO COMPOSITION
Formaldehyde
a. 10% Formol-saline
778. Aldehyde fixatives b. 10% Neutral buffered formalin or Phosphate-buffered
formalin (Ph 7)
c. Formol-corrosive (formol-sublimate)
d. Alcoholic Formalin (Gendre’s) fixative
Glutaraldehyde
Mercuric chloride
a. Zenker’s fluid
b. Zenker-formol (Helly’s fluid/Kelly’s fluid)
c. Heidenhain’s SuSa solution
d. B-5 fixative
779. Metallic fixatives
Chromate fixatives
a. Chromic acid
b. Regaud’s fluid
c. Orth’s fluid
d. Potassium dichromate
Lead fixatives
a. Methyl alcohol 100%
b. Isopropyl alcohol 95%
780. Alcoholic fixative c. Ethyl alcohol 70-100%
d. Carnoy’s fluid
e. Newcomer’s fluid
a. Bouin’s solution
781. Picric acid fixatives
b. Brasil’s alcoholic picroformol fixative
782. Osmium tetroxide (Osmic acid) a. Flemming’s solution
b. Flemming’s solution without acetic acid
FIXATIVES ACCORDING TO FUNCTION
a. 10% formol saline
783. Microanatomic fixative b. 10% NBF

- it should never contain osmium tetroxide (osmic
acid) because it inhibits hematoxylin
784. Nuclear fixatives
It usually contains glacial acetic acid which destroys
mitochondria and Golgi bodies. pH should be ≤4.6
785. Cytoplasmic fixatives
It should never contain glacial acetic acid which
destroys mitochondria and Golgi bodies. pH should
be >4.6
786. Histochemical fixatives
787. Mercurial and reagents used to dezenkerize
the sections
788. Lipid fixation
3Fs:
Fats/Frozen/Formalin
*Potassium dichromate
*Osmic acid
*Formol-calcium
789. Protein fixation
790. Carbohydrate fixation
791. Glycogen fixation
792. Nucleic acid fixative
793. Nervous tissue (CNS)
794. Fixative for sputum
795. Fixative for electron microscopy
796. Fixation for enzyme histochemistry
797. Fixation
798. Amount of fixative
799. Eyes
800. Brain
801. Hard tissues (cervix, uterine
hyperkeratotic skin, fingernails)
802. Removal of white paraformaldehyde
deposits
803. Preservative to formaldehyde
804. Removal of brown or black crystalline formalin
deposits
805. Removal of black mercurial deposits
806. Removal of excess mercurial fixatives
807. Formaldehyde waste
808. Most common metallic fixative
809. Fixative of choice for tissue photography
810. Zenker’s fluid and Helly’s fluid
c. Heidenhain’s SuSa
d. Formol-sublimate (Formol corrosive)
e. Zenker’s solution
f. Zenker-Formol (Helly’s)
g. Bouin’s solution
h. Brasil’s solution
a. Bouin’s
b. Flemming’s
c. Newcomer’s
d. Carnoy’s
e. Heidenhain’s SuSa
a. Flemming’s fluid without acetic acid
b. Formalin with post-chroming
c. Regaud’s
d. Orth’s fluid
e. Zenker-formol (Helly’s/Kelly’s)
a. 10% formol saline
b. Abs. ethyl alcohol
c. Newcomer’s
d. Acetone
Releases mercury and must NOT go through the drain
disposal. To avoid expensive disposal, mercuric fixatives
may be replaced with zinc formalin or glyoxal solutions
Aldehydes: formaldehyde
Baker’s formol-calcium for phospholipids
Mercuric chloride and potassium dichromate can be
effective for preservation of lipids in cryostat sections
Cholesterol may be fixed with digitonin for ultrastructural
demonstration
Neutral buffered formol saline or formaldehyde vapor
Alcoholic fixatives are recommended for glycogen
Alcohol-based such as Rossman’s fluid or cold absolute
alcohol
Picric acid – excellent for glycogen demonstration
Alcoholic fixatives: Carnoy’s, ethanol, methanol
Preserved with formaldehyde (formalin)
Alcoholic formalin (Gendre’s) fixative – it coagulates mucus
Glutaraldehyde followed by secondary fixation in osmium
tetroxide
Osmium tetroxide, Glutaraldehyde and paraformaldehyde
done at 4℃
Karnovsky’s paraformaldehyde-glutaraldehyde mixture
4% formaldehyde or formol saline, Frozen sections
First and most critical step in histotechnology
Approximately 20 times (10-20) the volume of the tissue
except osmium tetroxide (expensive, 5-10x vol)
Should NOT be dissected before they are fixed since this
may lead to tissue collapse and wrinkling due to escape of
vitreous humor; formol-alcohol must be injected before
immersing the organ whole in fixative
Suspended WHOLE in 10% buffered formalin for 2-3
weeks to ensure fixation and hardening prior to
sectioning
fibroids,
Washed out in running water overnight and immersed in
4% aqueous phenol solution for 1 to 3 days (Lendrum’s
method)
Filtration or by addition of 10% methanol
Methanol prevents its decomposition to formic acid or
precipitation or paraformaldehyde
a. Alcoholic picric acid
b. 1% KOH in 80% alcohol
Saturated iodine solution in 96% alcohol
Dezenkerization: alcoholic iodine
Iodine then sodium thiosulfate then water
Can be recycled by distillation or by drain disposal, can be
detoxified by commercial product or can be disposed of by
licensed waste-hauler
Mercuric chloride
Mercuric chloride
Both are mercurial fixatives. Zenker’s has glacial acetic
acid, Helly’s fluid has formaldehyde
811. Newcomer’s fixative Nuclear and histochemical fixative
Picric acid
812. Fixative for small tissue fragments
Yellow color helps locate tissues easier
813. Excellent fixative for preserving soft and delicate
structures like endometrial curettings Bouin’s solution (Picric acid)
Cover in several layers of gauze to maintain it under
814. Air-filled lungs may float in fixative
surface
815. Decalcification After fixation and before impregnation
816. Optimum temperature for decalcification Room temperature range 18 to 30℃
817. Decalcifying agent that contains HCl Von Ebner’s (HCl, NaCl, distilled water)
818. Embedding medium for electron
Plastic medium
microscopy
819. Double embedding Infiltrate with celloidin, embed with paraffin
820. Simplest microtome Rocking microtome
821. Most common, Minot Rotary microtome
822. Most dangerous, Adams Sliding microtome
823. Releases CO2, Queckett Freezing microtome
Electrically driven refrigerated chamber, where microtome,
824. Cryostat, -20℃ knife, specimen and atmosphere are kept at the same
temperature
825. Recommended knife for cutting paraffin
Biconcave knife
embedded sections on rotary microtome
826. Bevel angle 27° to 32°
Perfect and optimum cutting angle is 15°
827. Clearance angle 5° to 10° angle to prevent uneven sections or alternate thin
and thick sections
Regressive staining, it involves a differentiation step
828. Manual H & E staining
(acid-alcohol)
Acid mucopolysaccharides – black Fungi –
829. Fluorescent acridine orange technique, nucleic
greenish red fluorescence
acids
Background – reddish orange fluorescence
830. Histones and protamines in alkaline fast green
Green
831. Stain for basement membrane PAS, azocarmine
832. Glycongen staining by the PAS procedure and Coulombic attractions, which have also been termed
with the Best’s carmine salt links or electrostatic bonds
Glass pipette and rubber bulb for vaginal aspiration,
833. Equipment for vaginal, endocervical and Ayre’s spatula for swab smear and laryngeal cannula
endometrial aspirations attached to a syringe for endocervical or endometrial
aspiration
REVERSIBLE change from one adult cell type to another
834. Metaplasia
835. Barr bodies, XX chromosome Most of the nuclei of females exhibit conglomeration of
chromatin, demonstrated in the smears from buccal or
vaginal mucosa
836. In situ dissection Rokitansky
837. En bloc Ghon
838. En masse Letulle
839. The Certificate of Death (Municipal Form No. 103) was revised in January 2007 from the orginal blue color to now
white color. Four copies should be sent to the civil registrar
Indentifying goals, evaluate current situation, establish time
840. Planning
frame, set objectives, forecast resource needs, implement
plan, obtain feedback
841. Organizing Formal hierarchy, informal relationships
842. Directing Leadership, time allocation
843. Controlling Instructions, follow-up, modifications
Supervisory responsibility assigned through the
844. Line authority
formal delegation of authority
Influence exerted through the control of support services,
845. Staff authority such as business office and personnel, which provide
recommendations to the line manager and set institution-
wide policies
The power to enforce directives, such as physician’s
846. Functional authority
medical orders, within the context and boundaries of a
clearly defined specialty and span of control
Measures risk by assigning a value, expressed in
847. Probability analysis
percentage to the likelihood of a specific event occurring
848. Linear programming A tool for allocating limited resources among competing
needs
Made on the basis of knowledge obtained from the medical
849. Clinical diagnosis history and physical examination without the benefit of
laboratory tests & radiological imaging
Distinguishes between two or more diseases with similar
850. Differential diagnosis
symptoms by systematically comparing their signs and
 symptoms
851. Laboratory diagnosis Derived from results of laboratory tests
852. Physical diagnosis Supported by both the clinical and the laboratory
diagnoses