June 21, 2017

Hi, i just passed my mlt exam. I had a lot of micro and blood bank on it. These are my recalls. I
apologize for the bad spelling.
1) Elevated amayalse in whtat? Some of the options were acute pancreatitis and chronic
pancreatitis, i choose acute pancreatitis.

Polansky:
Amylase (AMS) - ↑ in acute pancreatitis, other abdominal diseases, mumps; Breaks down
starch to simple sugars. In acute pancreatitis, levels ↑ 2–12 hr after attack, peak at 24 hr, return to
normal in 3–5 days.

Success:
Clinical significance
1) Increased serum levels in acute pancreatitis occur in 2-12 hours after the onset of pain,
with peak values in 24 hours, and return to normal in 3-4 days.
2) Increased: Mumps, perforated peptic ulcer, intestinal obstruction, cholecystitis, ruptured
ectopic pregnancy, mesenteric infarction, acute appendicitis

2) Proteus and providencia are similar to salmenolla and shigells how? i choose urease + but its
probably wrong

Polansky:
Proteus – Urease (+)

Page 184:
Proteus vulgaris & Mirabilis – (+)H2S, MR, PD, urease, motility (-)Lactose; Swarming. Burned
chocolate odor.
P. mirabilis is most common & indole neg. P. vulgaris indole pos, A/A on TSI because of sucrose
fermentation.
Providencia – (+)Indole, MR, citrate,PD, motility (-)Lactose, H2S, VP ; Providencia rettgeri is urease
pos.

Page 182:
Shigella – (+) MR, (-)Lactose, gas, H2S,VP, citrate, PD,urease, motility

Page 183:
Salmonella – (+)H2S, MR, motility,lysine decarboxylase (LDC) ; (-)Lactose, indole, VP, PD,
urease, ONPG

LACTOSE NEGATIVE – proteus, providencia, salmonella, shigella

H2S (+) – Salmonella, Proteus
PD (+), urease (+) – proteus, providencia
Non-motile – shigella
3) I Had 3 abo discrepencies questions, some asking what is the blood type and some asking how
i can fix it

4) A micro question about a/a on tsi and options where edwardsella, shigella, salmonala and
klebsella. I choose klebseilla (sorry for the bad spelling).
POLANSKY: Quick Cards Page 185
Edwardsiella - K/A, gas, H2S
Shigella -K/A
Salmonella - K/A, gas, H2S
Klebsiella - A/A, gas

5) A question about how we deferntiate an upper uti from a lower uti

6) where are wbc casts made? bladder or distal conveloted tubules or proximal tubules or loop of
henle
SUCCESS: Page 924
Casts
a. Of all the formed elements in the urine, only casts are unique to the
kidney.
1) Different casts represent different clinical conditions.
2) Cylindruria is the term for casts in the urine.
3) Casts are formed within the lumen of the distal convoluted tubule
and collecting duct, taking on a shape similar to the tubular lumen.
Their formation is favored when there is urinary stasis.
4) Casts may have formed elements (such as bacteria, WBCs, RBCs, etc.)
contained within them or attached to their surface.
5) Uromodulin (Tamm-Horsfall glycoprotein) is the major constituent
of casts and is poorly detected by reagent strip methods. Uromodulin is
made by the renal tubular epithelial cells that line the DCT and upper
CD. Casts also consist of some albumin and immunoglobulins.

Hubbard page 330:

C. Urine casts (Figure 9–2)
1. Urinary casts are formed in the distal and collecting tubules. Except for a few hyaline or
granular casts, which can accompany strenuous exercise (athletic pseudonephritis) or
severe stress, casts are not normally present in the urine. The presence of urinary casts
is termed cylindroiduria and their appearance is often accompanied by proteinuria.
Acid pH, urinary stasis, elevated protein, and concentrated solutes in urine all favor
the formation of casts. Renal disease or damage along with these factors will produce
different types of urinary casts. Casts are better identified with the use of a supravital
stain and are typically reported as number of casts per low power field through the
microscope

7) my first question was about lyme disease and i don remember exactly what it was about but
some of the answers were tick antibody and antigen against tick
SUCCESS Page 655:
Borrelia burgdorferi
a. Causes Lyme disease, also known as Lyme borreliosis
b. B. burgdorferi is the most common tickborne disease in the U.S. It is transmitted by the
deer tick (Ixodes damninii).
c. Stages of Lyme disease
1) Early localized (stage I): A rash at the bite site (erythema migrans) produces a
characteristic "bull's eye" pattern in many patients.
2) Early disseminated (stage II): Bacteria enter the blood stream (producing flulike
symptoms) and then can go to the bones (arthritis), CNS (meningitis, paralysis), or heart
(palpitations, carditis).
Patients present with fatigue, malaise, arthralgia, myalgia, and headaches.
3) Late stage (stage III): This stage is characterized by chronic arthritis and acrodermatitis that
can continue for years.
d. Diagnosis
1) Serologic tests are sensitive in diagnosing Lyme disease. Western immunoblotting is
considered the most accurate method for antibody detection.
2) Difficult to culture and too few bacteria to detect by direct microscopy

Medical Laboratory Science Examination review by Linda Gaeter Page 188:

Lyme disease
• Vector-borne illness, typically carried by a tick
• Caused by the spirochete Borrelia burgdorferi
• Symptoms
• Rash, initially localized known as erythema migrans (bulls’ eye or target)
• Joint involvement
• Neurologic and heart involvement if left untreated
○ A classic sign of neurologic involvement includes facial palsy
• Early clinical symptoms are most useful in early diagnosis of Lyme disease
• Early serologic tests are not useful
• Antibody response to Lyme disease does not occur for approximately 3 to 6 weeks
• IgM and IgG response in Lyme disease is somewhat atypical
○ Both antibody responses, when detected, can be detected together
• When patient diagnosis occurs early and antibiotic treatment has begun, serologic findings may
be limited
• Centers for Disease Control and Prevention recommends specific algorithm for laboratory
diagnosis of
Lyme disease
• First step - test patient serum using IFA or EIA for antibodies as a screening measure
• Second step - confirmation must be made using a Western blot test (because of cross
reactivity using these tests)

8) question about rbcs that were left out at 1-6 c how long before you have to dispose of them i
put 24 hours.

9) I had a question about a mom with a 2+ weak D and how much would we give her rhig if we
give her any

10) a question about haemophilius and it said something like requires y but not x factor and i
choose parahaemophilis

Polansky:
V factor (NAD) requirement – H. parainfluenzae & H. parahaemolyticus

11) a question about a bacteria and how much co2 it requires to grow i put 5-10%

Organisms Requiring Incubation

in Increased CO2
Clinical Microbiology Review 156
• Campylobacter
• Haemophilus
• Helicobacter
• Moraxella catarrhalis
• Mycobacterium
• Pathogenic Neisseria

Page 200:
Anaerobic Environment - Ideal atmosphere - 80%–90% N2, 5% H, 5%–10% CO2

12) a patient with von willebrand disease what would you give them? I put platlets not sure if its

13) a question about passive immunity

Polansky Pg 374:

14) which is suseptible to novabiocin

Polansky page 158:
Coagulase-negative staphylococci (CNS) – susceptible (sensitive) to novobiocin
Page 160:
Novobiocin susceptibility - S. saprophyticus is resistant Other CNS susceptible; Performed on
CNS isolated from
urine.

15) a question about factors that are affected by warfarin

Polansky pg 349:
16) a question about factor 7 i put pt as answer
Polansky:

17) which is affected by hemolysis the most? Options were LD, Sodium, chloride and calcium
(potassium was not an option) i guessed calcium but not sure if its right
Polansky:
18) a question about s, aureus i choose coagulase pos and ferments mentol as answer

19) a picture of sickle cell and target cells, one of the options was inhereted condition,

20) results from a cbc and asked what would i do? The mchc stood out because it was high and i
choose warm and retest because thats what we do at work.

21) I had one recall question that remember and that was about Philadelphia chromosome and i
put cml like i saw in the recalls here.
22) a question about urine drug screen. What to test for to make sure its not a fake specmien
some of the options were bun, protein.

23) a pictures with a bunch of white cells ( lots of myelos and blasts) i chose ALL as the answer.
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