‫أسئلة مقابالت مختبرات طبيه‬

2023

Microbiology:
1. 4 bacteria cause eye infection?
a. Haemophilus influenzae a. Staphylococcus aureus
b. Moraxella catarrhalis b. Streptococcus pneumoniae
2. 3 viruses that infect the blood or are transmitted through the blood?
Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus
(HCV), Dengue.
3. Three viruses infect the respiratory system?
Influenza, RSV, Parainfluenza, adenovirus
4. 3 Bacteria cause otitis media?
Streptococcus pneumoniae, followed by Haemophilus influenzae and Moraxella.
(When a respiratory infection occurs, the eustachian tube swells, preventing mucus
elimination and allowing bacteria to proliferate in the mucus and produce pus, which
accumulates in the middle ear.)
5. What is the morphology S.aureus on blood agar?
Clear zone around colony due to beta hemolysis
6. What is the morphology S.aureus on mannitol salt agar MSA media?
Mannitol salt agar (MSA), which is used for selectively and differentially recovering
isolates of S. aureus, which will appear yellow on this agar(The Staphylococcus aureus
ferments mannitol and turns the medium yellow.)
7. What is the uses of Vitek machine?
Is a fully automated system in bacteriology lab that performs bacterial and yeast
identification and antibiotic susceptibility testing by use ID card contain dry substrate
and AST card contain a number of antimicrobials.
8. What is the use of BACTEC device?
In bacteriology lab this device for Blood culture is used to detect aerobic and anaerobic
bacteria and yeast by measure the production CO2 released by organism.
9. What are indicator for UTI in uranalysis?
Either nitrites or leukocyte esterase +
10. What is one way you can distinguish between a Streptococcus and a
Staphylococcus infection?

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The catalase test is important in distinguishing streptococci (catalase-negative)
staphylococci, which are catalase positive.
(Convert hydrogen peroxide into water and oxygen)
11. What is the main cause of a UTI?
Urinary tract infections (UTIs) caused by a range of pathogens, but most commonly
by Escherichia coli.
(Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and
Staphylococcus saprophyticus.)
12. What color is Salmonella on MacConkey agar?
Salmonella doesn't utilize lactose (Colorless colonies).
13. What is the color of Salmonella on Xylose lysine deoxycholate agar XLD Agar?
Is a selective growth medium, which is used for isolation of Salmonella spp. and
Shigella spp. Salmonellae metabolize thiosulfate to produce hydrogen sulfide, which
leads to the formation of colonies with black centers,
(Before culture on XLD agar, put stool in Selenite F broth (enrichment media) that have
high salts concentration to enhance salmonella and shigella growth and inhibit other.
E.coli (lactose fermenter) show yellow colony > report as flora, Proteus same as
salmonella, but show swarming and fishy smell.
14. The most commonly used media selective for Salmonella?
a. SS agar
b. bismuth sulfite agar
c. Hektoen enteric (HE) medium
d. brilliant green agar
e. xylose-lysine-deoxycholate (XLD) agar
15. Primary cause pharyngitis of bacteria?
Group A beta-hemolytic Streptococcus (GABHS), commonly referred to as strep
throat.
16. What is the main cause of bacterial tonsillitis?
The most common bacterium causing tonsillitis is Streptococcus pyogenes (group A
streptococcus)
17. What are the four serological markers of hepatitis B?

Serological markers for HBV infection consist of HBsAg, anti-HBs, HBeAg, anti-HBe,
and anti-HBc IgM and IgG.

18. What is TORCH?

Is screening test help diagnose infections that could harm the unborn baby during
pregnancy, for women who have recurrent abortion.

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These tests check for several different infections, toxoplasmosis,
rubella, cytomegalovirus, herpes simplex, and HIV.
19. What is hepatitis B envelope and what is the specific job?
In serology if the anti-HBe positive mean the virus in active stage
and highly infectious.
20. Confirmatory test of HIV?
Western blot
21. What are the types of malaria?
There are 5 Plasmodium parasite species that cause malaria in humans and 2 of these
species – P. falciparum and P. vivax – pose the greatest threat. P. ovale, and P. malariae.
In addition, P. knowlesi.
22. Why plasmodium falciparum is more dangerous than other species?

A. Schizonts can contain between 8 and 24 merozoites. Normally, mature

schizonts occupy approximately 2/3 of infected red blood cells, which
leads to an increase in the percentage of parasites in the blood
(parasitemia).
B. Unlike other Plasmodium species, P. falciparum infects all types of RBCs
found at different stages of development (from immature to old RBCs).
With additional hemolysis of noninfected RBCs by host immunity, the
likely occurrence of severe anemia
C. Cytoadherence is the property of Plasmodium falciparum-infected RBC to
adhere to various host cell types, such as endothelial cells and uninfected
red cells, causing the parasite to sequester in deep vascular beds infected
red blood cells within inner organs such as the brain and renal, which can
lead to cerebral malaria and renal dysfunction, and also to avoid splenic
clearance.
D. This species is also the most affected by resistance to antimalarial drugs,
which constitutes a major challenge in the fight against malaria.

23. Principle ANA test, and bio marker?

The antinuclear antibody (ANA) is a defining feature of autoimmune connective tissue
disease, a class of antibodies that bind to cellular components in the nucleus, including
proteins, DNA, RNA, and nucleic acid-protein complexes Indirect
immunofluorescence assay (IFA) using HEp-2 cells as a substrate is the gold standard
for detecting antinuclear antibodies (ANA) in patient serum. Antinuclear Ab Profile, 9-
biomarker Profile, RNP (ribonucleprotein) Sm, dsDNA, SS-A, SS-B, Scl-70,
Chromatin, Jo-1, and Centromere B by Multiplex Immunoassay.
A. juvenile arthritis A. Lupus
B. polymyositis and B. Scleroderma
dermatomyositis. C. Sjögren's syndrome
24. Name machine for ANA?

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 There are two types of EIA or ELISA methods currently used for ANA testing.
25. What is CRE?

Carbapenem-resistant Enterobacteriaceae. Commonly used antibiotics are generally

inactive against Enterobacteriaceae. due to the production of beta-lactamases that are
able to inactivate carbapenems. Carbapenems are similar to penicillins but have the
addition of a carbapenem ring.

26. What is cellulitis ?

Cellulitis is simply defined as an acute infection of the skin involving the dermis and
subcutaneous tissues generally group A streptococcus (i.e., Streptococcus pyogenes),
followed by methicillin-sensitive Staphylococcus aureus.
27. What is normal to see in urine microscopy?
WBCs 2-5 /hpf or less
RBCs 3-5/hpf
Epithelial cells
Hyaline casts 0-1/lpf
28. What are the tests of immunology? What are the common tests of immunology?
Immunological tests contain specific antibodies that bind to the substance in the body
in some tests this reaction is visible to the naked eye. For example, in tests to determine
blood group, the blood coagulates (clumps together) on the test card.
29. What you know about Serology lab ?
Serology blood test is performed to detect and measure the levels of antibodies,
Precipitate, agglutination (blood grouping), ELISA (Enzyme-Linked Immunosorbent
Assay)
Agglutination test:
a. Brucella: for Brucella abortus a. CRP:c-reactive proteins
b. RF:rheumatoid factor b. ASO: antistreptolysin O
c. Widal: for salmonella (enteric
fever)
Flocculation test:
a. RPR: rapid plasma regain
30. When the stool sample arrives, a micro-section culture is required, as well as a
stool analysis for parasites. Which one will you start with?
According to the source of the sample, if the sample is from an emergency, then we
start with the para section and then the micro section, but if the source of the sample is
not an emergency, we start with the micro section first to avoid contamination.
31. What is the immunoassay principle?
Immunoassays testing used for test immune system, These methods are based on a
competitive binding reaction between Ag and Ab mixed with reagents and incubated to

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form an immune complex. Analysis is achieved by measuring the activity (e.g.,
radiation, fluorescence, or enzyme).enzyme immunoassay (EIA), radioimmunoassay
(RIA), fluoroimmunoassay (FIA), chemiluminescent immunoassay (CLIA) and
counting immunoassay (CIA).

32. What are the difference between gram positive and negative?

+ve: Retain crystal violet dye and stain dark violet or purple; they remain colored.
blue or purple with a gram stain when washed with absolute alcohol and water.
Peptidoglycan layer: Thick (multilayered)
membrane: Absent
Antibiotic Resistance: More susceptible to antibiotics.

-ve: Can be decolorized to accept counterstain (Safranin or Fuchsine); stain red or

pink, they don't retain the Gram stain when washed with absolute alcohol, and
acetone.
Peptidoglycan layer: thin (single-layered)

Antibiotic Resistance: more resistant to antibiotics

33. Flow cytometry, for which disease?

Technology that provides rapid multi-parametric analysis of single cells in solution.
Flow cytometers utilize lasers as light sources to produce both scattered and fluorescent
light signals that are read by detectors such as photodiodes or photomultiplier tubes. It
is very effective for the study of the immune system and its response to infectious
diseases and cancer. In HIV disease quantification, T cells.
34. What are the differences between PCR and NGS ?
Next-generation sequencing (NGS) Polymerase chine reaction (PCR)

Is a new technology used for DNA and RNA Is a technique used in molecular biology to
sequencing and variant/mutation detection. amplify a single copy or a few copies of a
segment of DNA across several orders of
magnitude, generating thousands to millions of
copies of a particular DNA sequence.

Detect known and unknown mutation Detect known sequences

35. What are the difference between Neisseria gonorrhoeae and meningitidis?

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 36. What are panic values in microbiology?
Values that are outside the normal range to a degree that may constitute an immediate
health risk to the individual or require immediate action on the part of the ordering
physician.
a) Positive direct examination from sterile body fluids
b) Positive cryptococcal antigen test
c) Positive blood cultures
d) Blood smear positive for malaria (Plasmodium spp)
e) AFB smear-positive
f) Isolation of Mycobacterium tuberculosis
37. What is the confirmatory test for HCV?
Detection of HCV RNA in serum by polymerase chain reaction (PCR) assay is the
gold standard for the diagnosis of HCV infection.
38. Example on acidic and alkaline crystals ?

39. What causes false positive blood culture?

In blood cultures, false positives arise due to contamination, which occurs when
organisms that are not actually present in a blood sample are grown in culture.
false-positive when the automated blood culture system produces a positive signal but
no microorganisms are detected on Gram-stained smears and no microorganism growth
is observed in blood subcultures.
40. What are the difference between CREs and ESBLs?
Both carbapenemases and extended-spectrum beta-lactamases (ESBL) are enzymes
produced by bacteria that can break down (hydrolyse) beta-lactam antibiotics.

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ESBLs: produce an extended spectrum enzyme than breaks
down and destroys most of the beta-lactams antibiotics such
as penicillin and cephalosporins it will be resistance against this antibiotic, so
carbapenems are used to treat ESBLs, but the bacteria produced stronger beta-
lactamases (carbapenemases) and these break down and destroy the remaining
beta-lactam and carbapenem ring.

41. what types urine specimen?

1. First morning specimen, best for pregnancy testing, bacterial cultures and
microscopic examinations. measuring the urine albumin-to-creatinine ratio
(ACR).
2. Single random specimen (taken at any time of the day or night, for urinalysis,
which can screen and diagnose metabolic disorders and urinary tract infections.)
3. Timed short-term specimens, timed long term specimens: 12 or 24 hours.
(Timed specimens range from short-term 2-hour collections to 24-hour
collections. For renal disease.
4. Catheterized specimen or specimen from an indwelling catheter, for culture
5. Double voided specimens (test for sugar and acetone).
6. Clean-catch (midstream) specimen for urine culture and cytological analyses.
42. How differentiate between amorphous urate and phosphate?
1. Amorphous urates appear as dark or yellow red granules while phosphates are
white or colorless.
2. The pH of the urine determines the type of amorphous crystals present. They
may be urates in acid urine or phosphates in alkaline urine.

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Hematology
43. What do you do if the MCHC is high?more than 40g/dl
Incubate the sample in water path at 37c for 30 min and then re-run the sample, if stil
above 40 re-incubate (cold agglutinin suspected.)
44. What is the classification of anemia in terms of RBC size?
Normocytic normochromic, microcytic hypochromic, macrocytic hyperchromic
45. Example on MACROCYTIC Anemia?
Megaloblastic anemia (Deficiencies of vitamin B12 and folic acid)
46. What do you know about electrophoresis?
Hemoglobin electrophoresis is a blood test that measures different types of a protein,
separate the hemoglobin based on ionic strength and then measured the levels, help
diagnose anemia, sickle cell disease, and other hemoglobin disorders.
47. Inappropriate tests performed on EDTA?
Potassium and calcium, magnesium and alkaline phosphatase.
The Ethylenediamine tetra acetic acid tube contain anticoagulant inhibited the clot
form by they chelate minerals (e.g. calcium) and interfere with the tests.
48. Specific test for EDTA ?
a. For most hematological disease
b. HbA1c
c. Adrenocorticotropic hormone (ACTH) ( Cushing's syndrome, a disorder
in which the adrenal gland makes too much cortisol)
d. Ammonia: it is most commonly used to diagnose and monitor hepatic
encephalopathy, a severe liver disease.
49. Reasons for rejecting samples?
Some of the pre-analytical errors in the laboratory that lead to sample rejection include:
e. Inadequate blood volume a. labeling errors
f. Improper sample tube b. No test stated on the request
g. Hemolysis form
h. Incorrect temperature during c. Illegible requests
sample transport or storage d. Clotting
50. Inappropriate test on Overnight EDTA sample ?
a. Not use for blood smear
Blood smear will only be done from EDTA tubes, heparin (green top tube) is
not recommended as an anticoagulant for cell counts, because the cells clump
in heparin, invalidating counts, Citrate (blue top tube) is not recommended due
to the dilution of the blood by the liquid citrate.
EDTA whole blood samples must be run within 1 hour at room temperature+,
and may be stored refrigerated for up to 12 hours.

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 Smears were made immediately as well as 1hr apart for 6 hrs, stained and
examined under oil immersion microscope
51. Normal red blood count but low hemoglobin?
This situation occurs with iron-deficiency anemia, in which red blood cells have less
hemoglobin than normal. Iron deficiency anemia is also referred to as hypochromic
anemia.
52. What is the full name of ESR?
Erythrocyte sedimentation rate (ESR) The ESR result may establish the presence of an
inflammatory condition within the body, but the test is not specific to any disease
process.
53. What is the INR?
International normalized ratio (INR)
It is used in patient care to diagnose diseases of coagulation, assess the risk of bleeding
in patients undergoing operative procedures, for patients taking vitamin K antagonists
(VKA).
54. What are the differences between thalassemia and sickle cell anemia?
Thalassemia and sickle cell disease are both hemoglobinopathies
Sickle cell disease affects only the beta Thalassemia can affect either the alpha
chain. considered normochromic- or beta chains and is microcytic
normocytic, and the RBCs in the form hypochromic, diagnosed by
of a crescent . diagnosed by electrophoresis with elevated Hgb A2
electrophoresis to demonstrate no HbA, and F.
2-20% HbF, and the predominance of
HbS.
55. Causes for a prolonged PT include?
a) Liver disease or liver dysfunction leads to a decreased production of most
coagulation factors.
b) Vitamin K deficiency.
c) Factor deficiency.
d) Disseminated Intravascular Coagulation (DIC)
e) Antiphospholipid antibodies.
56. What is left shift in hematology?
Abnormal rise in the proportion of circulating neutrophil precursors, high number of
immature neutrophils due to infection.
Right shift” is often applied when the number of immature neutrophils is low
and can indicate chronic infection.

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 57. Define the mixing study and what’s the
factor associated?
Mixing tests may have utility to help identify the pathway
of follow-up testing (ie, towards investigation of factor
deficiencies, or else inhibitors) and are also useful for
investigation of lupus anticoagulants (LA).
a) Absorbed plasma (2, 7, 9, 10)
b) Aged plasma (5.8)
c) Serum (1, 5,8)
58. What you will do if the platelets result is very low?
Platelets (less than 30,000/ul)
a) Check for clots, if present reject if not rerun sample on other device
b) If still low we do blood film to decide if it platelets aggregation (clumping) or
confirmed thrombocytopenia.
c) If under microscope there is platelets aggregation (because patient have EDTA
allergy) we order new sample with sodium citrate tube
d) if platelets are low under microscope so it is confirmed thrombocytopenia
59. Drug causes prolonged PTT?
Heparin
60. What is coagulation test ?
Used to measure the amount and function of coagulation factors in the blood
and to diagnose inherited blood clotting disorders such as hemophilia.
a) Partial thromboplastin time (PTT) is the time it takes for a patient's blood to
form a clot as measured in seconds.
b) A prothrombin time (PT) test measures how long it takes for a clot to form in a
blood sample.
c) An INR (international normalized ratio) is a type of calculation based on PT test
results.
d) platelet count.
61. What are the lab findings for hemophilia?
Hemophilia A factor VIII , Hemophilia B factor IX prolonged in PTT, normal in PT
and platelet count.
62. What are the differences between intrinsic extrinsic and common pathway?
The function of the coagulation pathway is to keep hemostasis, which is the blockage
of a bleeding or hemorrhage. The intrinsic pathway is activated by factors in the blood,
while extrinsic is activated by tissue factor
The intrinsic pathway consists of factors I, II, IX, X, XI, and XII. Respectively
The extrinsic pathway consists of factors I, II, VII, and X. Factor VII is called stable
factor.
63. What are the tests in thrombophilia?

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Hypercoagulability or thrombophilia is the increased tendency of blood to thrombose.
Antithrombin, Protein C, and Protein S.
64. What the stain do you use for blood smear?
a) Giemsa stain is a gold standard staining technique that is used for both thin and
thick smears to examine blood for malaria parasites.
b) Leishman stain it is generally used to differentiate between and identify white
blood cells, malaria parasites, and trypanosomas.
c) Wright's stain frequently provides important clues in the diagnosis of anemias
and various disorders of leukocytes and platelets.
65. What is the name of white blood cells and it is types.?
a) Known as leukocytes
b) Granulocytes (neutrophils, eosinophils, and basophils), and agranulocytes
(monocytes, and lymphocytes (T cells and B cells)).
66. list the order of blood draw?
67. Did you do VBG? What machine?
The peripheral venous blood gas (VBG) is an alternative method
of estimating systemic carbon dioxide and pH that does not
require arterial blood sampling. ABL800 FLEX blood gas
analyzer
68. What are the differences between CRP and ESR?
C-reactive protein (CRP) it is measures the level of a plasma
protein, is a substance produced by the liver in response to
inflammation.
Erythrocyte sedimentation rate (ESR) is a type of blood test that measures how quickly
erythrocytes (red blood cells) settle at the bottom of a test tube that contains a blood
sample. Normally, red blood cells settle relatively slowly. A faster-than-normal rate may
indicate inflammation in the body.
C-reactive protein is a better indicator of inflammation than the erythrocyte
sedimentation rate. It is more sensitive and responds more quickly to changes in the
clinical situation.
69. What are the analytes affected by hemolysis?
Is the rupture of RBC, effect on HCT,aPTT,PT,potassium, ammonia ,magnesium,
AST,ALT,LDH.
70. What is the most popular type of anemia in Saudi Arabia?
The most common cause of anemia, especially among females.

71. What are the causes that make sickle cell anemia and thalassemia most popular
in Saudi Arabia?

The high incidence of consanguineous marriages.

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 72. How diagnose sickle cell anemia in lab?

a) Complete Blood Cell Count.

b) Peripheral Blood Smear.
c) Solubility Sickling Test.
d) Hemoglobin Electrophoresis.

73. G6PD…?

G6PD deficiency is a genetic disorder, it happens when the body doesn't have enough
of an enzyme called glucose-6-phosphate dehydrogenase (G6PD). G6PD helps red
blood cells work. It also protects them from substances in the blood that could harm
them.

74. What is the confirmatory test of sickle cell test and how to differentiate between
the trait and dominant ?
hemoglobin electrophoresis is used to confirm the diagnosis. The hemoglobin
electrophoresis gives a percentage of each hemoglobin type that is present in a sample
sickle cell trait are 60% of Hb A and approximately 35–40% of Hb S

75. Can citrate tube be used for CBC?

EDTA is still the best choice for a complete blood count, but sodium citrate and heparin
anticoagulants can be used as alternatives for testing. the results can be reported after
multiplying the selected parameter results (WBC count, RBC count, Hb, Hct, and PLT
count) by the dilution factor of 1.1. The MCV, MCH, MCHC, and RDW values do not
require correction.
76. Underfilling blood collection tubes causes?
Red cells shrink, As a result, decreasing the mean cell volume, hematocrit, and
increasing the mean cell corpuscular hemoglobin concentration).
77. When rejected sample in case of prothrombin PT test?
a) QNS
b) Clotted
c) severely hemolyzed specimen
d) specimen greater than 24 hours old.
e) wrong tube.
78. Does hemolysis effect on CBC test?

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 Inaccurately decreases the red blood cell (RBC) count and the hematocrit (when
calculated), while the hemoglobin (Hgb) and MCV values remain the same.

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Chemistry
79. How do you know if the liquid you have is serum or plasma?
By measure the calcium level
in plasma no calcium or low due to anticoagulant It inhibits clotting by
removing or chelating calcium from the blood, in serum it will give normal
result.
80. If you did an analysis and the calcium in the sample was zero, what would you
do?
a) Check the device control and no contamination in the sample
b) If I have another device I will repeat the test, if the result still same
c) I will request new sample.
81. What to do if the sample result is above the measurement range?
Dilute the sample.
82. How do you dilute a 1:5 sample of 250 micro?
1/5 *250 = 50
1:4 (1 from sample and 4 from diluent ) = 50:200
83. What is Creatinine clearance?
Creatinine is a chemical waste molecule that is generated from muscle metabolism.
Creatinine is produced from creatine, importance for energy production in muscles.
Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out
the creatinine.
Creatinine clearance :
a. Helps estimate the glomerular filtration rate (GFR).
b. Provide information about the severity of kidney disease.
Measured by collecting a 24-hour urine sample and then drawing a blood sample. The
creatinine levels in both urine and blood are determined and compared using a formula.
Decreased creatinine clearance indicates decreased glomerular filtration rate (GFR).
This can be due to conditions such as progressive renal disease.

84. Inappropriate test on overnight sample?

b. K will be increased a. Glucose will be low
85. Causes high potassium in sample?
Pseudohyperkalemia is most commonly due to hemolysis of the sample excessive
vacuum of the blood draw or by a collection needle that is of too fine a gauge);
excessive tourniquet time.
86. How to detect high potassium levels before analysis?
Presence hemolysis after centrifuge the sample
87. What is ACTH test?

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Adrenocorticotropic hormone (ACTH) is a hormone that stimulates the production of
cortisol. Cortisol is a steroid hormone made by the adrenal glands that is important for
regulating glucose, protein, and lipid metabolism, suppressing the immune system's
response, and helping to maintain blood pressure.
88. What are liver and kidney tests ?

89. What is OGTT?

The oral glucose tolerance test (OGTT), also known as the glucose tolerance test,
gauges the body’s ability to metabolize sugar (glucose) and clear it from the
bloodstream. The test requires you to drink a syrupy solution after a period of fasting.
A blood sample is then drawn to determine whether you are metabolizing glucose as
you should be. The OGTT can be used to diagnose diabetes, gestational diabetes
(diabetes during pregnancy), or prediabetes (elevated blood sugar predictive of type 2
diabetes), among other things.
90. What are the tests affected by non-fasting?
a. Fasting is required before commonly ordered tests for glucose (blood sugar)
b. Triglycerides (part of the cholesterol, or lipid panel) for accurate results.
91. What is the principle of the HbA1c test ?
In general, HbA1c provides a measure of the average glucose concentration over three
months. The glucose-bound (glycated) hemoglobin or HbA1c provides the average
glucose levels in an individual's blood as it becomes glycated with the hemoglobin. It
is important to note that the HbA1c levels are directly proportional to the blood glucose
levels.

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Blood Bank
92. What are the 4 types of ABO discrepancies?
Unexpected reaction occur in forward and reveres .
a) Group I: Weak or absent reaction in the reverse grouping
These discrepancies occur when there are decreased antibodies in the patient's
serum leading to weak or absent reaction in the reverse grouping.
b) Group II: Unexpected reaction in the forward grouping
These discrepancies occur in patients with weakly reacting antigens (due to low
antigen burden on the RBC surface or another antigen similar to AB antigens
on the RBC surface reacting with the antibody)
c) Group III: Unmatched reaction between the forward and reverse grouping due
to plasma abnormalities
d) Group IV: Unmatched reaction between the forward and reverse grouping due
to miscellaneous causes
93. What is antibody identification?
Antibody identification procedure is performed to identify unexpected antibodies
detected in the antibody screen. Antibody screening and identification of specific
alloantibody help in identifying most appropriate blood unit that lacks the
corresponding antigen and prevent alloimmunization.
94. What are cross match tests?
An important test before a blood transfusion to ensure that the blood transferred from
the donor to the recipient is completely identical
95. What are types and cross-matching of blood?
a. Major Cross Match: test pt plasma with donor cells< detect pt Ab that are
directed to the donor cells

b. Minor Cross Match: Pt cells with donor plasma / detect donor Ab directed
against patient cells
96. What are DAT, IAT?
DAT is to detect the presence of antibodies attached directly to the RBCs
Application:, Hemolytic transfusion reaction, HDFN
IAT, by contrast, is used to detect unbound antibodies to RBCs
Application: cross match, Ab detection, Ab identification

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How do you do indirect comb test?

97. How many cells in antibody identification?

To detect the presence of unexpected antibodies, Antibody identification at least 10
vials per set
98. What are the devices in the blood bank?

a) TANGO™ optimo by Bio-Rad

b) IH-500 Fully Automated System for ID-Cards
c) Ortho OPTIX™ Reader
99. What are types gel card that used in blood bank?
c. Complete Rh a. ABO gel card
d. Neutral b. AHG gel card

100. Irradiated RBC shelf life?

Irradiated blood is blood that has been treated with radiation (by x-rays or other forms
of radioactivity) to prevent Transfusion- Associated Graft-versus-Host Disease (TA-
GvHD). not more than 28 days from the date of irradiation.
101. Optimal temperature for packed RBC storage?
Must be maintained between 1 and 6°C
102. How long is cryoprecipitate good for once thawed?
6 hours after thawing, it should be maintained at room temperature (20 - 24°C).
103. What antibodies are destroyed and enhanced by enzymes?
Enzymes enhance reactivity of the Rh, Kidd, Lewis, P, and I system antibodies and
warm-reacting antibodies. Enzymes destroy M, N, S, Duffy and Xga antigens.

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 104. Why is saline used instead of distilled water?
Thus distilled water has higher chance of systemic absorption than normal saline.
Distal water : hypotonic solution
Normal saline: isotonic solution
105. What are anticoagulant used in blood bank?

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Histopathology
106. What is fixative and its types?
Fixatives perform various functions such as prevention of autolysis and tissue
putrefaction.
d. glyoxal a. Formaldehyde
e. picric acid b. Glutaraldehyde
c. osmium tetroxide
107. What are the frozen section, used for what ? to perform rapid
microscopic analysis of a specimen
108. Cytology sample , use for what ?
Cytology tests use small amounts of bodily tissue or fluid,FNA ( fine needle aspiration)
in order to examine certain types of cells.
109. Preservative for cytology?
The most commonly used fixatives for diagnostic pathology and cytologic specimens
are 10% NBF (neutral buffered formalin) and 95% ethanol.

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Quality
110. What is the calibration in lab, when use ?
Is the process of adjusting an instrument.
Solutions are known values of the company. The solution has a known concentration
and absorption. The device will measure the absorption and then compare it with the
reference value.
A corrective step to eliminate the errors resulting from the device
 Adjust the device reading if the control is not correct or if the control out of
range
 Before using any new device
 When adding new tests
 According to the instructions and requirements of the device manufacturer
(monthly / semi-annual)
111. Control ?
It is known that to check if the machine is correctly calibrated, it substance similar to
patient samples, e.g., if the patient samples serum, the control will be serum. It consists
of normal and abnormal control in the chemistry lab. High and low, normal values in
the hematology.
To ensure the effectiveness of solutions and reagents and the effectiveness of the device
112. Quality control ?
Designed to detect or reduce or correct deficiencies in lab and to ensure both precision
and accuracy of patient sample result.
113. PPE?
Personal protective equipment clothing and equipment that used in order to provide
protection against hazardous substances or environments like gloves, masks, goggles,
lab coat, masks, face shields, gowns.
114. Point-of-care testing (POCT)?
Is the analysis of patient specimens outside the clinical
laboratory, it is able to provide a rapid result under supervision

and calibration by the laboratory staff

115. What is the Closed Systemin blood bank ?
Ensure that air does not enter the bag from the beginning of the drawing process to its
storage and that bacteria do not grow.
116. what's the difference between validation and verification ?

Validation : Conducting studies and tests on a new analysis instrument or a new

analysis is done by the manufacturer.

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Verification: A process to determine performance characteristics before a test system
is utilized for patient testing.
apply it to any new device approved by the Food Authority; it is necessary to check the
performance of the device before approval of any patient results. and it is carried out
by the laboratory employee to see if various conditions affect the performance of the
device or not. heat and humidity, store solutions, and staff competencies
117. What is a MSDS used for in a lab?
M=Material / S=Safety / D=Date/ S=Sheet
Document that provides comprehensive, safety and detailed information about
controlled products, chemicals or hazardous substances.

118. What is the difference between shift and trend in Westgard?

Shift : is a sudden change of values from one level of the control chart to another

A common cause of a shift is failure to recalibrate when changing lot numbers of

reagents during an analytical run.

Trend : is a continuous movement of values in one direction over six or more analytical
runs.

caused by deterioration of reagents, tubing, or light sources.

119. What are the differences between system error, random error ?
Systematic error Random error
Systematic error (called bias) Random error, called imprecision

Usually expressed as the mean difference Can be expressed as the standard deviation of
between measured and true values. measured values.

Affects the accuracy of a measurement, or Mainly affects precision, which is how

how close the observed value is to the true reproducible the same measurement is under
value. equivalent circumstances.

Predictable, constant or proportional to the For example, the device did not withdraw
measurement, ex, the cuvette has been from the sample the required amount, air
damaged and the laser is broken. intake, or anything occurring in one sample.

120. What are the differences between accuracy and precision?

Precision refers to how close measurements of the same item are to each other. There
are two types of precision within a run: simple precision or repeatability. One sample
(control or patient sample) is run 20 times, one at a time, on the same day.

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Between runs = complex precision reproducibility, Run the sample three times a day,
each run repeat it twice for five days.

Accuracy refers to how close a measurement is to the true or accepted value. Run 3 to
5 samples of known value (run each sample four times).

121. What are Westgard Rules and what the corrective role with each rules?
Multirule QC rules to help analyze run is in-control or out-of-control

122. What is a reagent in the lab?

It is the material specific for each test
Reagents may be liquid preparations or in solid form, such as test strips or other devices
(e.g., glucose test strips for diabetics or devices for home
pregnancy tests).
What is critical Value? Critical (panic) results as laboratory
test results that exceed established limit(s) (high or low) life-
threatening results that require immediate inform the doctor.

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 123. Proficiency testing?
Tests unknown specimens from an outside
source to ensure accurate lab testing results.

124. What are the internals control and external control?

125. If you have received a new lot of reagents or QC, what should you do?
Calibration, re-run QC
126. Situations cannot reject the sample; what do you do?
a) Normally sterile body fluid and Tissue biopsy
b) Blood cultures
c) 24h urine
d) Hemolysis sample if the requested test is not affected by hemolysis
e) unlabeled or mislabeled from the ER or by an invasive procedure (the lab must
be able to identify the collecting department). Contact the collecting department
and have them send someone to the lab to properly identify and label the
specimen.
127. What are SOPs for laboratory safety?

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SOPs are written instructions that detail the steps to be performed during a given
experimental procedure and include information about potential hazards and how these
hazards will be mitigated.
128. If you reported a wrong test result, what do you do?
Inform the doctor, Correct the error and resend the correct result.
129. Turn around time?
The turnaround time (TAT) is the total time it takes from the receipt of the sample in
the Laboratory to the time the result was release in the system.
130. STAT TEST-test which are essential for the immediate management of
the patient and considered to be urgent and should be released in
a timely manner. Turn-Around-Time for STAT/Urgent tests is 45 minutes from
the time it was received in the laboratory to the time it was release in the system.
ROUTINE TEST - test which are considered to be essential as well but are not included
in the STAT lists. Results are not needed on an immediate basis for diagnosis or
treatment. These are test commonly released on the same day or according to running
day scheduled for some test.
REFERRED TEST-test/s shipped or send to outside laboratories with varying Turn-
Around-Times that are established by the Referral Laboratory.
131. What are external Q.C?
The term EQA is used to describe a method that allows for comparison of a laboratory’s
testing to a source outside the laboratory. This comparison can be made to the
performance of a peer group of laboratories or to the performance of a reference
laboratory.
a) Proficiency testing—external provider sends unknown samples for testing to a
set of laboratories, and the results of all laboratories are analyzed, compared and
reported to the laboratories.
132. What do you know about CBAHI or CAP?
a. CBAHI: Saudi Central Board for Accreditation of Healthcare Institutions.
Is the official agency authorized to grant accreditation certificates to all
governmental and private healthcare facilities operating today in Saudi Arabia.
to establish standards for patient safety and healthcare quality for all healthcare
facilities.
b. CAP: College of American Pathologists
Is high quality reservation and improvement of clinical laboratory services for
patient care.
133. What are the types of laboratory error?
a) Preanalytical Errors: including test request, patient identification, collection,
transportation, and preparation for analysis.

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 b) Analytical Errors: occur during the test, and include equipment malfunction,
sample mix-ups, interference, undetected failure in quality control, and
procedure not followed.

c) Postanalytical Errors: happen after the test is conducted, and include failure in
reporting, erroneous validation of analytical data, improper data entry, and
excessive turnaround time.

134. What is the warning rule in westgard ?

According to the Westgard multi-rule QC procedure, one control measurement

exceeding 2 SDs (12S rule) is used as the warning rule, we must find the reason.

135. what does standard deviation means?

A measure of imprecision or dispersion around the mean line.

136. If you get a lipemic sample, accept it or

reject it?

The recommended procedure for treating lipemic samples

is centrifugation using an ultracentrifuge, which effectively
removes lipids, but in cases of severe lipemia, the sample
should be rejected.

137. What is the key performance indicators in

laboratory (KPI)?

Evaluate the performance of the laboratory and then compare it with the target value
(benchmark). Measure of laboratory processes and outcomes. Monitor changes. Detect
potential problems. It is usually done every month, sometimes every 3 months or 6
months, depending on the policy of each lab. It is done on pre-analysis; for example,
how many samples have been mislabeled, rejected, or have blood culture
contamination? In the analytical phase, the most important is TAT for the STAT test;
in the post-analytical phase, critical result report, patient satisfaction; after that, data
collection; then data analysis; data review; and corrective action.

138. What is the carryover?

Two samples, high and low, were divided into 21 samples. The aim is to verify that
the low-concentration sample is not affected by the high-concentration sample.
139. What is the linearity?

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The aim of it is to see if the relationship is direct between the concentration of the
substance and the result. one sample, dilute it to five concentrations.
Many samples were tested, some of them normal and some not normal
1. Linearity is a mathematical relationship between two variable quantities (they
may be of the same unit), which are directly proportional to each other.
2. Graphically it represents a straight line when plotted against each other
3. It is necessary to justify the linearity between LOWER Concentration & UPPER
Concentration.

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