This patient is most likely suffering from an immediate-acting coagulation inhibitor; most commonly, lupus anticoagulant. Notice that the addition of normal pooled plasma does not correct upon initial or incubated mix, which means that the inhibitor is not time or temperature-dependent.
Factor VIII is not the correct answer as a factor deficiency would have corrected upon the addition of normal pooled plasma. Factor VII is not the correct answer, as the aPTT assay does not account for factor VII activity or concentration.
The laboratorian completed the mixing study ordered for John Doe. The results are as follows:
Initial aPTT result: 167 seconds
Initial 1:1 Mix with Normal Pooled Plasma: 158 seconds
Incubated 1:1 Mix with Normal Pooled Plasma: 150 seconds
Which of the choices below would most likely explain the results for this patient?
What is the cell that is indicated by the arrow in this field?
As magnification DECREASES, the opening of the iris diaphragm will...
Fibers can be mistaken for casts on occasion, especially hyaline casts. Fibers, however, are usually thinner and appear less uniform in structure than casts do.
Urinalysis & Other Body Fluids
Which of the following artifacts may be mistaken for casts?
Howell-Jolly bodies are composed of DNA and appear as small round ball-like inclusions inside the red cells. Usually only one Howell-Jolly body will be present in each red cell.
Single erythrocyte inclusions which are large, round, smooth and purplish-blue staining are most likely:
Alkaline over acid, or K/A, in TSI reactions is associated with the fermatation of glucose alone and the utilization of peptone.
Which of the following sugars has been fermented by a gram-negative rod that has produced an alkaline slant and an acid butt on triple sugar iron agar (TSI).?
The electrolyte panel consists of potassium, sodium, chloride, carbon dioxide. These analytes are also typically ordered within other panels as well, including the basic metabolic and complete metabolic panels.
An electrolyte panel (lytes, chem-4) consists of:
Glucose positive, Maltose positive, Lactose negative and Sucrose negative is the correct answer since Neisseria meningitides causes Waterhouse-Friderichsen syndrome and it is positive only for glucose and maltose.
An autopsy of a 1-year-old female admitted to the emergency room 4 hours prior to her death revealed Waterhouse-Friderichsen syndrome. Blood and nasopharyngeal cultures taken prior to her death should reveal an oxidase-positive, Gram-negative diplococcus with the following biochemical reactions:
1 SD = 68.3%, 2 SD = 95.5%, 3 SD = 99.7
As defined by a Gaussian distribution curve, what percentage of values would be expected to fall within two standard deviations of the mean:
Triglyceride blood concentrations change significantly when you eat, as opposed to relatively stable levels of cholesterol, HDL, or LDL circulating in the blood. Whenever you eat a meal that contains fat, your triglyceride levels rise, which is why it is important to have a patient fast before the sample is collected.
Which of the following lipid results would be expected to be FALSELY elevated on a serum specimen from a non-fasting patient?
What are the certification requirements for clinical laboratory professionals?
The correct response is option B: The Hepatitis B "e" Antigen (HBeAg). This antigen indicates the virus is actively replicating and therefore the patient is very infectious. The hepatitis B "e" antigen is present when the virus is actively replicating. In cases of unintentional needlesticks, infectivity is of highest concern. The risk for infection is greatest during phases of increased HBeAg serology. The Hepatitis B surface antigen is the first detectable marker, but if the patient is known to have Hepatitis B already, it would be relatively unhelpful to confirm the condition with another HBsAG test. The core antigen is not detectable because it is covered by the nuclear envelope. Antibody response patterns would not be very helpful either as the patient has already been diagnosed with acute Hepatitis B. IgG antibodies would indicate recovery, which is not the case for this patient and IgM antibodies indicating a recent or acute infection would only confirm what is already known. Recall, in cases of unintentional needlesticks, infectivity is of highest concern.
A phlebotomist at a local hospital recently had an accidental needle stick while drawing blood from a patient being treated for acute hepatitis B. Which serological marker from the patient would be of most value to the physician evaluating the phlebotomist's possible infection status?
Basophilic stippling is strongly associated with lead poisoning the lead toxicity can affect the bone marrow; causing this phenomenon.
Hematology
What is a prominent morphologic feature of lead poisoning:
The purpose of protective isolation is to protect:
HLA-DR is a class II MHC.
HLA-A, HLA-B, and HLA-C are all class I MHC.
Which of the following antigens is classified as a Major Histocompatibility Complex
Class II antigen (MHCII)?
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