ClinPath

Question 1

The presence of what can indicate that the anemia is regenerative?

Answer 1

nRBCs accompanied by reticulocytes (appropriate metarubricytosis)

if no reticulocytes, presence of nRBCs = bone marrow or splenic dz

Question 2

What changes indicate leukocytosis?

Answer 2

1. Neutrophilia
2. Lymphocytosis
3. Monocytosis
4. Eosinophilia/Basophilia

Question 3

What are the acute phase proteins? Which are positive and which are negative?

Answer 3

Acute Phase Proteins
1. Positive = concentrations INCREASE in response to inflammation (fibrinogen)
2. Negative = concentrations DECREASE in response to inflammation (albumin)

Question 4

Hyperphosphatemia is associated with what function in the kidneys?

Answer 4

Decreased GFR – elevated renal values (BUN, Crea) will support increased P as well.

Question 5

How to calculate corrrected chloride value

Answer 5

[average Na/measured Na] x measured Cl

average = based on RI of lab you are using

Question 6

Bilirubin is made by what?

Answer 6

Bilirubin = a byproduct of heme breakdown
- heme breaksdown -> unconjugated Bi
- unconjugated Bi transformed into conjugated by liver
- most conj. Bi reamins in hepatic circulation; small amt. in urine

Question 7

Exocrine pancreas function

Answer 7

1. Acinar cells: secrete digestive enzymes via trypsin that act on CHOs, fats, proteins
2. Ductal cells: secrete bicarb to neutralize acidic gastric contents in duodenum

Question 8

increased lipase, amylase, TLI and PLI indicate what?

Answer 8

increased acinar pancreatic damage; decreased GFR

acinar cells can’t digest CHOs, fats, protein

Question 9

TLI and PLI decrease with what?

Answer 9

chronic pancreatitis (inappropriate or early activation of digestive enzymes), acinar atrophy

Question 10

EPI

Answer 10

exocrine pancreatic insufficiency: pancreatic acinar cells fail to secrete digestive enzymes -> chronic weight loss despite ravenous appetite

Question 11

Cobalamin and folate pattern in EPI

Answer 11

• Cobalamin decreases
• Folate increases

from E&E

cobalamin absorbed by distal SI and ileum
folate absorbed by proximal SI (duodenum)

Question 12

Reference Interval calculation

Answer 12

the mean +/- two standard deviations

Question 13

What are the 3 categories of sources of lab errors?

Answer 13

1. Preanalytical (pre-lab arrival) Majority
2. Analytical (lab error)
3. Postanalytical (mismatch of results to patient delivery)

Question 14

Preanalytical error

What are the 3 factors of Quality Control/Assurance (QC/QA) for Preanalytical error

Answer 14

1. Standard Operating Procedures
2. Training of personnel
3. Communication with clients

Question 15

What are the 5 factors of Quality Control/Assurance (QC/QA) for Analytical error

Answer 15

1. SOP
2. Training of personnel
3. Automation
4. Monitoring results
5. Certification

Question 16

What are the 4 factors of Quality Control/Assurance (QC/QA) for Postanalytical error

Answer 16

1. SOP
2. Training of personnel
3. Automation
4. Communication w/ clients

Question 17

Cause of artifact hypoglycemia

Answer 17

sample left out too long -> cells in blood consume the glucose

Question 18

Cause of artifact hypocalcemia/no Ca and hyperkalemia

Answer 18

1. incorrect collection tube (K3EDTA)
   - EDTA Chelates Ca
2. K3EDTA tube -> false hyperkalemia due to K3

Question 19

Cause of artifact high anion gap metabolic acidosis?

high AG, low bicarb

Answer 19

tube left open for too long -> CO2 loss

remember: pH is directly related to bicarb concentration

Question 20

What are Heinz bodies

Answer 20

damaged hemoglobin

elevated MCH, MCHC, reticulocytes, platelets

Question 21

artifact changes from EDTA (2)

Answer 21

decreased MCV, decreased HCT

Question 22

what leukon inclusions can be seen in an old sample?

Answer 22

Döhloe Bodies

the small, blue inclusions

Question 23

How does hemolysis affect HCT/PCV?

Answer 23

decreases it

Question 24

delayed analysis of urine sample can cause what artifacts?

Answer 24

falsely basic sample, proliferation of microbes (contamination or pathogens), degradation of formed elements like casts or of chemical analytes like ketones and bilirubin

Question 25

When submitting cytology slides, what is the most important thing you need to include in submission?

Answer 25

Thorough history & precise location of lesion

Question 26

rejecting poorly collected samples, incorrect anticoagulant, or samples not shipped properly is what type of QA procedure?

Answer 26

Pre-analytical

Question 27

discarding expired reagents or rejecting runs when controls are "out" is what type of QA procedure?

Answer 27

Analytical