Medical Technology Assessment Program 2: QA and QC in Microbiology

Questions and Answers

The final phase of degeneration that granular casts undergo is represented by which of the following?

Homogentisic acid

Hydatidiform mole

Waxy (correct)

Orthostatic proteinuria

Presence of human chorionic gonadotropin in urine specimen indicates?

Ketone bodies

Homogentisic acid

Orthostatic proteinuria

Hydatidiform mole (correct)

Increased amounts of the metabolite para-hydroxyphenyllactic acid are excreted in the urine in which disorder?

Diabetes mellitus

Tyrosinosis (correct)

Alkaptonuria

What does the presence of nitrite in a urine specimen suggest?

Bacteria Signup and view all the answers

Which of the following statements does not follow the media quality control in microbiology laboratory?

The medium should be selected for QC using one criterion on sterility Signup and view all the answers

Preventive maintenance from heat in microbiology operations indicates maintenance performance in which of the following intervals?

Monthly Signup and view all the answers

QC performance on staining procedures in microbiology laboratory should be done in which of the following intervals?

Daily Signup and view all the answers

Which of the following can be the test organism used in the QC testing for chocolate agar?

Neisseria meningitidis Signup and view all the answers

Which of the following content in the Mueller-Hinton agar for antimicrobial susceptibility testing increases the sensitivity of the test to sulfonamides and trimethoprim antimicrobials when added in reduced amounts?

Thymidine Signup and view all the answers

Which of the following is considered a primary reason for a failed QC testing result in microbiology laboratory?

Stock culture failure Signup and view all the answers

What is the optimum temperature of a cryostat?

-20°C Signup and view all the answers

What is used for the staining of the myelin sheath of brain tissues?

Luxol Fast Blue Signup and view all the answers

Spirochetes can be demonstrated by the Grocott Methamine Silver stain.

True Signup and view all the answers

What does Von Kossa's Silver Nitrate method demonstrate?

Calcium Signup and view all the answers

The stain that requires the use of sulfuric acid is Gram’s ____________.

Iodine Signup and view all the answers

Match the following histopathologic techniques with their descriptions:

Thick film of specimen with teasing = Spreading Rapid diagnosis = Neither Fixing agent not incorporated = Nonadditive fixation Recommended for cutting paraffin-embedded sections on a rotary microtome = Biconcave knife Remove water = Fixation, Clearing Signup and view all the answers

Which of the following phenotypes show natural resistance of red cells against P. vivax infections?

Fy (a-b-) Signup and view all the answers

In which immunoglobulin is the transport piece component found?

IgA Signup and view all the answers

Who discovered the human ABO blood group?

Landsteiner Signup and view all the answers

What component is selected for the treatment of Hemophilia B?

Factor IX concentrate Signup and view all the answers

The common cause of hemolytic transfusion reaction. Error in ________.

crossmatching Signup and view all the answers

Which of the following is the only complement receptor found on erythrocytes?

CR1 Signup and view all the answers

Rh factor is an antibody.

False Signup and view all the answers

Match the following blood types with the statements:

RBCs have antigen A and serum has antibody B = Type A RBCs have no antigens and serum has antibodies A and B = Type O Commonly used blood type in emergency cases = Type O Least common blood type = Type AB RBCs have antigen B and serum has antibody A = Type B Signup and view all the answers

Glassware is usually calibrated at?

20°C Signup and view all the answers

A template is used to make a 1 mm puncture wound in the forearm for an IV bleeding _________.

time Signup and view all the answers

What is the characteristic of erythrocytes that causes them to settle out first?

Greater specific gravity Signup and view all the answers

What are the characteristics of a plasma cell?

Dark blue cytoplasm, eccentric nucleus, and a halo or quarter moon Signup and view all the answers

What is the most predominant leukocyte in acute myelogenous leukemia?

Myeloblast Signup and view all the answers

What is a markedly decreased platelet count called?

Thrombocytopenia Signup and view all the answers

What are siderocytes?

Red blood cells with inorganic iron-containing granules Signup and view all the answers

What is poikilocytosis?

Variation in shape of red blood cells Signup and view all the answers

What is the largest mature cell in normal circulating blood?

Monocyte Signup and view all the answers

What is leukocytosis?

Elevated WBC count over 10,000 WBCs per cubic mm Signup and view all the answers

What does the mean corpuscular hemoglobin measure?

The weight of hemoglobin in the average erythrocyte Signup and view all the answers

What is the formula used for the Westergren erythrocyte sedimentation rate?

Mixing 2 mL EDTA blood and 0.5 mL of sodium citrate or 0.5 mL of 85% sodium chloride Signup and view all the answers

In what condition are nucleated RBCs most likely to be seen?

Erythroblastosis fetalis Signup and view all the answers

What are Howell-Jolly bodies?

Nuclear remnants stained by Wright stain in the erythrocyte Signup and view all the answers

What is the purpose of sodium metabisulfite in the demonstration of sickle cells?

To produce oxygen Signup and view all the answers

What is the test type for a Westergren ESR test?

1 hour Signup and view all the answers

What does an electronic particle counter always exclude when performing red blood counts?

Nucleated red blood cells Signup and view all the answers

When is the hemoglobin known as oxyhemoglobin?

Each heme group is associated with one molecule of oxygen Signup and view all the answers

What affects sedimentation rates?

A and B Signup and view all the answers

What does a quality control plot showing a shift downward indicate?

Deteriorating reagent Signup and view all the answers

What should be closely observed in a white blood cell differential when there is absolute lymphocytosis?

Lymphocytes with deeply basophilic cytoplasm Signup and view all the answers

What does thrombin aid in?

Fibrinogen to convert to fibrin Signup and view all the answers

What is the difference between serum and plasma?

Serum lacks fibrinogen Signup and view all the answers

What is the process of stopping or controlling the flow of blood?

Hemostasis Signup and view all the answers

What is required for APTT?

Fresh plasma and thromboplastin Signup and view all the answers

What is a method for testing platelets?

Lee White Signup and view all the answers

What is thrombocytopenia?

A decrease in platelets Signup and view all the answers

What are the two outstanding characteristics of leukemia?

Leukocytosis and immature WBCs Signup and view all the answers

What is seen in multiple myeloma?

Reversed A/G ratio and positive Bence-Jones protein Signup and view all the answers

What is characteristic of Hodgkin's disease?

Reed-Sternberg cells Signup and view all the answers

What is not a cause of DIC?

Anemia Signup and view all the answers

What are the normal values for PT and PTT?

10-14 and 22-31 Signup and view all the answers

What is characteristic of hemophilia?

Decreased amount of Factor VIII Signup and view all the answers

What medications are monitored by PT/PTT?

Coumadin and Heparin Signup and view all the answers

What is the cause of hemorrhagic disease of the newborn?

Deficiency of vitamin K Signup and view all the answers

What is brilliant cresyl blue used to stain?

Reticulocytes Signup and view all the answers

How many WBCs are normally seen in a malarial smear?

1-10 Signup and view all the answers

What causes LE cells?

Gamma-globulin reaction on WBCs Signup and view all the answers

What is a retic count an indication of?

RBC production in marrow Signup and view all the answers

What is the absolute retic count if the RBC is 4,000,000 and 16 reticulocytes are seen?

16% Signup and view all the answers

What is not found in normal blood?

Myeloblast Signup and view all the answers

Study Notes

Quality Assurance and Control

Quality control in microbiology laboratory: media quality control should not be selected based on one criterion of sterility
Preventive maintenance: heat maintenance in microbiology operations should be performed monthly
Quality control on staining procedures in microbiology laboratory: should be done daily
Test organism used in QC testing for chocolate agar: Neisseria meningitidis
Content in Mueller-Hinton agar that increases sensitivity to sulfonamides and trimethoprim antimicrobials: Thymidine
Primary reason for failed QC testing result in microbiology laboratory: stock culture failure
Specificity: ability of a test to detect only the analyte of interest
Pattern of investigation in microbiology laboratory for identification of isolate: Preliminary, Confirmatory, Definitive

Blood Bank Laboratory

Reagents in blood bank lab that require QC test standards: Blood typing sera
Type of equipment that should undergo calibration and performance checks: Temperature-dependent equipment
Purpose of internal assessment in blood bank laboratory: enable the blood bank lab to comply with its own QA and QC measures at all times
Type of assessment that DOH proficiency testing is under: External assessment

Clinical Microscopy

Reason why first voided morning urine specimen is most desirable for routine urinalysis: most concentrated specimen of the day, therefore more likely to detect abnormalities
Substance responsible for yellow color of urine: Urochrome
Substances that can turn urine dark brown or black: Melanin
pH range of freshly voided urine specimen: 4.5 to 8.0
Effect of bacterial decomposition of urea on urine pH: becomes alkaline
Definition of polyuria: urine volume exceeding 2000 mL in 24 hours
Definition of isosthenuria: fixed specific gravity of approximately 1.010

Urine Sediment

Type of white blood cell most frequently seen in urine sediment: Neutrophil
Procedure used to quantify formed elements: Addis count
Microscopic technique used to identify unstained cellular components and casts in urine: Phase-contrast microscopy
Substances that are more easily distinguished using polarized microscopy: Lipids
Definition of glitter cell: Neutrophil
Final phase of degeneration of granular casts: Waxy

Microbiology

Most useful finding for prompt presumptive identification of Candida albicans: Germ tube
Fungus that is encapsulated, urease positive, produces mucoid, red colonies: Cryptococcus neoformans
Fungus that infects only skin and nails: Produces large thin-walled club-shaped conidia without microconidia
Virus that is best diagnosed by serologic testing: Hepatitis A
Agent of scrub typhus: Rickettsia tsutsugamushi
Test used to differentiate Streptococcus species: Hydrolysis of esculin in the presence of bile
Identification of Streptococcus pyogenes: Susceptibility to 0.04 bacitracin disc
CAMP test: used to identify Streptococcus agalactiae### Medical Technology Assessment Program 2 Rationalization

Germicide and Sterilization

Sterilizers are germicides intended to destroy all microorganisms and their spores on inanimate surfaces.
BSL-2 (Biosafety Level 2) includes organisms such as HBV, HIV, and enteric pathogens.

Blood Culture Collection

General guidelines for collection of blood cultures state that 2-3 sets per 24 hours are usually submitted to diagnose bacteremia.

Quality Control in Microbiology Laboratory

Quality assurance testing requires selecting an organism that will demonstrate a positive reaction on a citrate agar slant, such as Klebsiella pneumoniae.
In capnophilic incubators, the carbon dioxide concentration should be between 5 and 10%.

Parasitology

Methods for concentrating stool specimens include the flotation method, where parasitic forms flow to the top of the solution.
Modified acid-fast stain is used to identify Cryptosporidium and other coccidian.
Trichomonas vaginalis is a pear-shaped flagellate with an undulating membrane extending one-half of the length of its body with 4 recurring flagella, no anterior flagellum.

Hematology and Serology/Blood Banking

Rh factor is an antigen, and Rh HDN (Hemolytic Disease of the Newborn) occurs in an Rh-negative mother and an Rh-positive child.
The Castañeda strip test is used in screening for Leptospirosis.
In the classic pathway of complement activation, C3 is split into C3a and C3b.

Clinical Chemistry

Sodium fluoride acts as an anticoagulant by inhibiting glycolysis.
Serum chloride determinations require serum to be separated from blood samples within 15-30 minutes to avoid adverse effects of bicarbonate.

Hematology

A hypochromic RBC is one with increased central pallor.
Poikilocytosis refers to variation in shape of red blood cells.
Sickle cell testing uses sodium metabisulfite reagent.

Laws and Ethics in Medical Technology

The latest code of ethics for medical technology profession was organized into a final draft in 2019.
The code of ethics for medical technology profession was signed on September 13, 2022, and amendments were consulted with APO (Association of Philippine Orthodontists).

Note: The study notes are based on the provided text and may not be comprehensive or inclusive of all topics.### Medical Technology Code of Ethics

The first revision of the medical technology code of ethics happened in 1997.
The latest code of ethics for medical technology profession is anchored on the International Code of Medical Technology Ethics.
Confidentiality clause in patient information is under Article 2, Section 4.
The latest code of ethics was published in the Philippine Star of national circulation on September 16, 2022.
Harmonious working relationships with other healthcare professionals is mandated in Article 4, Section 3 of the PRB of MT Resolution No. 72 series of 2022.
The latest code of ethics for medical technology profession takes effect on October 2, 2022.
Revocation of the certificate of registration of the offending medical technologist is penalized under none of the above mandating laws.
Medical technologists may accept professional fees in services rendered by them requiring their expertise under none of the above.

History of Medical Technology

Dr. Alfredo Pio De Roda organized the public health laboratory in 1945.
Dr. Gustavo Reyes opened the medical technology course in UST as an elective course to Pharmacy in 1947.
The study of bacteria under the microscope was first performed using Aniline dyes.
Mrs. Antoinette McKelvey helped Mrs. Willa Hilgert-Hedrick to put up a complete laboratory including histopath section.
The location Quiricada Street, Sta. Cruz, Manila is associated with the Public Health Laboratory.
The history of medical technology is associated with the discovery of intestinal parasites, which was a postulation of none of the above.
Anton van Leeuwenhoek discovered the first functional microscope, which described RBC, protozoa, and bacterial morphology.

Philippine Association of Medical Technologists (PAMET)

PAMET was instituted on a date not specified in the text.
Currently, PAMET has an unspecified number of provincial chapters nationwide.
Former President Ferdinand Marcos declared that the celebration of medical technology profession is every third week of September.
The current official publication of PAMET is PAMETLINK.
PAMET has linkages with unspecified government agencies.
PAMET was recognized as the only accredited professional organization for medical technologists on June 22, 1973.

Medical Technology Practice

Continuing Professional Development in medical technology practice is associated with post-licensure trainings and conferences.
The grounds of removal of the board of members except none of the above.
Clinical Microscopy is not a major professional course in the licensure examination of the medical technology practice.
After 3 unsuccessful board exams, which of the following seek provision to follow up the failed examinee is completing a refresher course.
The professional identification card of the successful examinee shall bear the following details except none of the above.

Medical Technology Education

The technical committee for medical technology education is under the purview of CHED-OPS.
The technical committee for medical technology education is responsible for formulating Policies, Standards, and Guidelines (PSGs).

Laws and Regulations

RA 7719 is the primary subject of voluntary blood donation, safe blood products, and regulating blood banks.
Following organizations are under the purview of RA 7719 in encouraging their members regarding voluntary blood donation except none of the above.
RA 7719 was approved on May 5, 1994.

Histopathologic Techniques

Xylene is considered as the most common clearing agent.
Bouin's solution contains picric acid.
Fixation is done to prevent autolysis and putrefaction.
EDTA when used for bone decalcification acts as a chelating agent.
Fixative for bone marrow biopsies is Zenker's solution.
Carnoy's fluid is recommended for fixing chromosome, lymph glands, and urgent biopsies.

Safety in the Laboratory

Material Safety Data Sheet (MSDS) is a document that indicates the normal use, disposal, and risks associated with spillage of hazardous chemicals.
The flashpoint is associated with explosives.
Liquid nitrogen may cause frost bites.
Infectious agents like prions can be sterilized by formalin and concentrated formic acid.

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Description

This quiz assesses knowledge of quality assurance and quality control in microbiology laboratory, covering topics such as media quality control and preventive maintenance.