RATIONALE: High anion gap metabolic acidosis is caused generally by the body producing too much acid
or not producing enough bicarbonate. This is often due to an increase in lactic acid or ketoacids, or it
may be a sign of kidney failure. More rarely, high anion gap metabolic acidosis may be caused by
ingesting methanol or overdosing on aspirin.
Which of the following enzymes has the longest elevation after Myocardial Infarction (MI)?
CK-MB
Myoglobin
,Troponin
AOTA - ANSWER-C. Troponin
RATIONALE: Troponin is elevated up to 10-14 days after Myocardial Infarction.
Lactic acid specimen:
Chilled and separated from cells
Heated
Room temperature
Request EDTA sample only - ANSWER-A. Chilled and separated from cells
RATIONALE: Special Handling: No tourniquet. Place on ice immediately and deliver to lab or aliquot
within 15 minutes. DO NOT FREEZE WHOLE BLOOD SPECIMEN.
Specific gravity measured by refractometer: 1.035. Protein and glucose both trace in reagent strip:
Presence X-ray medium
Albuminuria
Glucosuria
Normal - ANSWER-A. Presence X-Ray medium
,RATIONALE: Xray medium/Radiographic dye can cause erroneous results in urine specific gravity
measurement.
A patient with walking pneumonia is being treated with penicillin. State one possible condition why the
patient is not recovering:
The organism produces beta lactamase
The organism has no cell wall
The organism has capsule
The organism produces an enzyme that neutralizes the antibiotic - ANSWER-B. The organism has no cell
wall.
RATIONALE: Pneumonia caused by Mycoplasma pneumoniae is routinely treated with antibiotics,
although the disease is usually self-limiting. The disease is treated with macrolide, tetracycline, or
fluoroquinolone classes of antibiotics. All mycoplasmas lack a cell wall and, therefore, all are inherently
resistant to beta-lactam antibiotics (e.g., penicillin).
What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48?
2.75
6.09
5.68
30 - ANSWER-B. 6.09
, RATIONALE: CV= SD/meanX100,
(5.48/90)X100= 6.09.
Blood smear below denotes Hairy Cell Leukemia (HCL), which of the following test is used to identify this
type of leukemia?
Image. 1
Myeloperoxidase
Tartrate-resistant acid phosphatase
Tartrate-resistant alkaline phosphatase
Sudan Black - ANSWER-B. Tartrate-resistant acid phosphatase
RATIONALE: Hairy cells demonstrate strong positivity for tartrate-resistant acid phosphatase (TRAP)
staining. The hairy cells are larger than normal and positive for CD19, CD20, CD22, CD11c, CD25, CD103,
and FMC7.
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