MLS (ASCPi) Recalls : June 2017

NOTE: The following questions may not be similar to the one we had during the
exam, but the thought/construct of the question is the same. 
Anti- Anti- A B D D Screen
A B cells cells Antigen control cells
4+ 4+ 0 0 0 0 0

What to do?
a. Do nothing
b. Perform Du testing
c. Report as D positive
d. Perform Ab screen

Anti- A Anti-B A cells B cells

4+ 0 1+ 3+

a. Test patient serum with subgroup of A1

b. Test patient red cells with subgroup of A2

Transudates are usually

a. Purulent
b. Has bacteria
c. Non inflammatory

Description: Broad base budding “mother and son….” - Blastomyces dermatitidis

PBS photo: full of stomatocytes,cause of:

a. Liver disease
b. IDA

Common error in PCR

a. Nucleic acid contamination
b. Low temperature in machine

3 tubes negative to AHG. When check cell is added, negative parin. Error?
a. Insufficient saline from automated cell washer
b. Serum was omitted from the reaction

AHG3+ 3+
After auto adsorption, the result become 2+ AHG. What to do next?
a. Do another auto adsorption
b. Cell panel
c. Ab identification with enzyme

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 1

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
RBC: 3.9
Hct: 33%
Hb: 12.5

What is the problem?

a. Lipemic
b. Clotted
c. Release result

*Check with the rule of 3

(Hbx3=Hct must be + or -3)

FBS = 120, RBS, OGTT = 140

a. hyperglycemia
b. normal
c. impaired glucose

Test to diagnose DM
RBS FBS OGTT
Normal <200 mg/dL <100 mg/dL <140 mg/dL
Impaired 100-126 mg/dL 140-199 mg/dL
Diabetic >200 mg/dL >126 mg/dL >200 mg/dL

Wash RBC with saline solution

Anti-A Anti-B A cell B cell
4+ 4+ 2+ 2+

Cat scratch disease: Bartonella henselae

Rapid test for Legionella - urine antigen

Failed Streptokinase therapy–D-dimer(+)

Anti IgG (-) ; C3d (+)–Pre-warm

Polyspecific IgG (+); Anti-IgG (-), anti-c3d (+) – pre-warm

Polyspecific IgG (+); Anti-IgG (+), anti-c3d (+) - Elution

Plasmodium falciparum:
no trophozoite and merozoite

Sensitivity Formula –[TP/(TP + FN)] x 100 Specificity Formula - [TN/(TN + FP)] x 100

CA-19.9 – monitoring bilirubenemia with Pancreatic mass

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 2

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
Cocci in chains, bile esculin + ; Catalase - ; no growth in 6.5% NaCl - Streptococcusbovis (Pic was given with the
biochemical test)

SSA (+) ; Rgt strip (-) - Other protein than albumin

Differentiate Pseudomonas aeruginosa from other Pseudomonas - Growth at 42°C

Hair Baiting Test - T. rubrum and T. mentagrophytes

Serum erythropoietin below normal - Polycythemia vera

Normal PTH; IncreasedCa2+ - metastatic carcinoma

Favic chandelier - T. schoenleinii

Normal WBC, platelet retics 0.1% - Pure red cell aplasia

Hepatitis present in in acute infection - IgM Anti-Hbc remember that anti-Hbc is a lifetime marker of Hepa B
Infection

Picture na maraming echinocytes

a. Severe anemia
b. Improper pH of buffer
c. Overly dried smear
d. Hemoglobinopathy yata

Picture of ANA staining pattern. Centromere

a. SLE
b. Sjogren’s
c. Chronic liver disease
d. Scleroderma with CREST

18% reticulocytes were observed on a Wright-stained smear. What should you do next?
a. Report retic count
b. Heinz body stain
c. Siderocyte stain

Latex agglutination for Staphylococcus aureusdetects:Protein A and clumping factor

Lupus anticoagulant causes: Thrombosis

Cause of false negative ABO?

a. Rouleaux
b. Red cells positive to DAT
c. 37°C

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 3

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
Anti-A: 0
Anti-B: + (mf)
Acells: +
Bcells: 0

a. Polyagglutination
b. Bx group (B3 dapat to kaso wala sa choices!)

PT: 50
PTT: 100
TT: Prolonged rin
Fibrinogen: 150 mg/dl (Normal)

a. Congenital hypofibrinogenemia
b. Acute DIC
c. Forgot

PT: 12 (normal) patient is for gall bladder surgery

PTT: 50
Mixing studies (normal plasma): 47.9

a. Factor XII assay

b. Factor VIII assay
c. Fibrinogen level
d. DVVT

HBA1c- RBC life span dependent

PBS: Burr cells/echinocytes –uremia

Antibody panel
Lewis Antibody (adsorbed by plasma)
Lumabas sakin Leb and ang tanong is anong characteristic nung antibody so ang sinagot ko is glycoprotein
adsorbed in the plasma

Lab Results: Sodium: Low; all other analytes are within normal range. What to do?
a. Measure indirect Na using ISE
b. Hemolyzed spx
c. Lipemic

In multichannel analyzer, controls of enzymatic assays are lower than expected values while non-enzymatic assays
controls are within normal limits. What is the probable cause?
a. Outdated control reagent
b. Instrument temperature may be low

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 4

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
False decrease ESR in?
a. Tube at an angle
b. Vibration
c. 8 hr delay in set up

Specimen for rotavirus- STOOL

Results consistent with Cushing’ssyndrome:

a. Hyperglycemia
b. Hypoglycemia
c. Hypercalcemia
d. Hypocalcemia

Pink colonies in MAC

LOA -++
Indole Negative
Citrate Positive
a. Klebsiella pneumoniae (LOA +--)
b. Klebsiella oxytoca(Indole +)
c. Enterobactercloacae
d. Enterobacteraerogenes(LOA ++-)

Monocytosis is seen in:

a. Allergic reaction
b. Mononucleosis
c. Tuberculosis

Walking pneumonia- have no cell wall kaya di tumatalab antiboiotic/penicillin sa pasyente

After several weeks of pharyngitis what can be found in kidney biopsy?Streptococcus pyogenes

TSI A/A oxidase positive isolated in wound?Aeromonas

Decrease ratio of plasma:anticoagulant in sodim citrate with hematocrit of 0.7 - what should be done?
a. Decrease anticoagulant
b. Increase anticoagulant
c. Collect in heparin
d. Report the result

A patient with procainamide should be tested in parallel with what drug?

a. Digoxin
b. NAPA

Carbon dioxide ion selective electrode measure?

a. pCO2 – CO2 content
b. total CO2
c. pH

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 5

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
pH measurement needs?
a. pH with known buffer at constant temp
b. 2 pH buffer

CBC results: Instrument A is repeated with the use of instrument B. Not sure of values. The discrepancy is due to?
a. Lyse resistant target cells
b. Lyse sensitive target cells
c. Fragility of Hgb C
d. Lyse resistant Hgb C – binigay yung mga values and nakatable sya. Remember that Hgb C are “bar
of gold” appearance while Hgb SC is “Washington monument” appearance

Deteriorates upon storage?

a. P – pati si Lewis pero walang Lewis sa choices so ang sagot ay P
b. Lw
c. Lu
d. MNs

A patient is suspected of DM, fasting glucose ay 137 tapos 2 hrs post prandial ay 225. What to do next?
a. OGTT
b. No further testing need

Sample of “adrenal”cushing syndrome?

TSH decrease, cortisol increase

A patient is from West Africa. He is positive in the test of HIV 1 and HIV 2 combination. HIV 1 Western blot is
performed – indeterminate, what to do next?
a. Repeat western blot
b. EIA in HIV 1
c. EIA in HIV 2
NOTE: Diagnosis for HIV – 2 positive ELISA and 1 positive WESTERN BLOT. Check picture of how to
read a western blot, may tanong na lumabas sakin, sabi “what is the reporting of the western blot of patient
8, then may line sa gp140/160 pero wala sa p24 and p40. Ang sagot at INDETERMINATE kase dapat may
line either p24 or p40.

Leukocyte esterase is 1+ but in microscopic exam no WBC seen. What is the cause?
A. Present of reducing agent
B. LysedWBC
C. Bacteria acted in reagent strip
D. Present of ascorbic acid

Group A Le (a+b-). Ano ang meron sa saliva ng patient? - Lea

Anti Anti Weak Rh A cells B

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 6

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
 a b D contro cells
l
4+ 4+ 2+ 0 0 0

a. ABO grouping is wrong

b. Rh grouping is wrong
c. Rh control is wrong
d. Do nothing, interpret the results

EBV titers
Anti-VCA IgM <1:10
Anti-VCA IgG >1:10
Anti-EBNA >1:10
(presence indicates past infection)
CMV titer: 1:128 (eto ung talagang lumabas!)
Toxoplasma titer: <1:10

a. Primary CMV infection

b. Primary EBV infection
c. CMV and EBV co-infection
d. Toxoplasma infection
Description: Sporothrix (cigar-shaped – pls read about this fungi)

Magnesium – monitored in eclampsia

NOTE: Most of the questions are I encountered are HEMA, BB and MICRO. For HEMA and BB questions are in
tabular form with normal values and patient result. For BB, pls read on DAT and IAT results and interpretation. For MICRO,
most of them are biochemical reactions. And pictures were also given for hema and micro 

ADVISE: MOST ARE RECALLS, but don’t settle for recalls only. TANDAAN MO LANG UNG KEY WORD for
every question.  PRAY and CLAIM THE MLS(ASCPi) title.

 Chronic Hemolytic Anemia: Urine hemoglobinuria

 INCREASED Unconjugated Bilirubin, Negative Urine Bilirubin, Increased Urobilinogen
:Hemolytic Anemia Bilirubin Assay Result
 Glucose is present: Glucose reagent strip (+), Clinitest (-)
 Dilute Alkaline Urine: Reagent Strip RBC (+), RBC absent on microscopic examination
 Acute Tubular Necrosis: Urinalysis result given. Take note the presence of RTE which is
increased.
 D-dimer (+): Streptokinase Therapy
 Aeromonas: TSI-A/A, Oxidase (+)
 Streptococcus pyogenes: Seen in Renal biopsy and Pharyngitis, Sequelae:
Glomerulonephritis
 Mycoplasma pneumoniae / Presence of Cold Agglutinins / PCH (???): Blood picture of
Agglutination
 A, H, Lea : Present in the secretions of a Blood type A patient with Le(a+b-)
 CA 19-9 : Marker of Pancreatic Carcinoma

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 7

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
 Do Heinz Staining: Retic is 18%
 Chronic Lymphocytic Leukemia: Blood Picture with many lymphocytes
 Pre-Warm the sample: Table showing Positive reaction in Anti-C3d and Negative reaction on
Anti-IgG
 Tyrosine Crystal: Needle-like
 Bx subgroup: Table of blood typing, forward & reverse, with a mixed field reaction on Anti-B
 A1 subgroup
 Wash with Saline : Rouleaux formation, what to do next? , Given in tabular form, result of
blood typing of reverse and forward reaction.
 A known buffer at a constant temperature: pH electrode
 SSA
 TP/ TP + FN : Sensitivity Formula
 Pure Red Cell Aplasia: Baby has Normal WBC and Platelet but reticulocytes is 0.1%
 Indirect ISE of Sodium: Sodium is low but other parameter including osmolality is within the
normal range
 Recollect using a lesser amount of Citrate: Patient hematocrit is very high about 68%
 Streptococcus bovis: PYR (-), Bile HOH (+), NaCl (+)
 Anti-P : Deteriorates rapidly on storage
 Stool: Specimen for Rotavirus, detected via EIA technique(screening) and IF or Molecular test
(Confirmatory)
 Cushing’s Disease: High Cortisol. Low ACTH
 Ecclampsia: where Magnesium is best measured
 RBC life-span: HbA1c result depends on
 Overly dried smear: picture of echinocytes
 Liver Disease: Picture of Stomatocyte
 Organism has no Cell Wall: Patient is diagnosed with walking pneumonia, no sign of
improvement (due to penicillin resistance).
 Recurrence of Prostate Cancer: Prostate was removed but PSA is still high
 350C : CSF storage for subsequent culture
 Enterobacter cloacae: Pink colonies on MAC. LOA: -++, Indole and citrate negative
 Pseudocholinesterase: Prolonged apneais anesthesized by succinylcholine. Enzyme
Responsible?
 Primary Biliary Cirrhosis: Anti-mitochondrial antibody
 Picture of Scleroderma with Crest: Anti-centromere antibody
 Bartonella henselae: Oxidase (-), Catalase (-), causes Cat-scratch Disease
 Growth at 420C: Differentiates P. aeruginosa from P. puptida
 Carbon dioxide content: What does CO2 ISE measures
 Negative: HIV EIA method: first test is REACTIVE while second test is NON-REACTIVE
 T. mentagrophytes vs T. rubrum: Differentiates by Hair-baiting test
 P. falciparum: NO trophozoites or merozoites seen in PBS
 Urine Antigen Test: Rapid test for Legionella pneumophilia
 Quenching Agent: Function of KMNO4 in auramine-rhodamine stain
 Lip[oproteins: Caused of post-prandial Lipemic sample
 Paired T-test: Compare two sets of means
RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 8
Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM
 Impaired DM: FBS is 120 and OGTT is 140
 OGTT: test to do nest after FBS and 2 hour post-prandial test suggests a DM
 Hyperglycemia: Cushing Syndrome
 Lyse resistant HbC: Picture with HbC and a description
 8-Hr delay in testing: Cause of False-decrease ESR
 Donor who was given Hepatitis B Immune Globulin 6months ago: Deferred because it
should be 1year after
 Factor XII: Patient has undergone Gallbladder sx. Lab result: PT is Normal, APTT is prolonged
 Tuberculosis: Reactive monocytosis
 Release of ADP: Irreverible phase in platelet aggregation
 Lipemic Sample: Rule of Three is not met
 Renal Tubular Acidosis: pH of 4.5
*** All choices given results to an alkaline urine: e.g. High Protein diet, Vomiting and
hyperventilation. And based on the previous recalls they answered Renal Tubular Acidosis. So
do I…..
 Heterophile antibody: Patient has a Primary CMV infection, what test to detect the immune
status of the patient?
***(Not sure of the answer. Other Choices includes: Culture, EIA).
 Picture is Given, Choices includes: Anti-dsDNA, Anti-mitochondrial, Anti-smooth muscle
*** I don’t know the answer.haha
 Results to Thrombosis: Lupus anticoagulant cause
*** But other Recalls regarding this question, they’ve answered ‘it activates fibrinolytic System’.
But I answered Thrombosis.
 Parathyroid Adenoma: Normal PTH but Increased Calcium
*** Not sure of my answer

OTHERS:

o Antimicrobial susceptibility test was done. Growth in tube with 0.1,0.2,0.4 antibiotics but
no growth on tube conating 0.8 antibiotics.
-MBC on 0.4mg/dl
-MIC on 0.4mg/dl
-Susceptible on 0.8mg/dl
-resistant on 0.8mg/dl
*** IDK the answer

o Levey-Jennings Graph
o Antibiotics in Staph Aureus

RECALLS: JUNE 2017 | Rheona Jane L. Viray, RMT, MLS(ASCPi)CM 9

Genesis Gamido Gamurot, RMT, MLS(ASCPi)CM