Collection of Blood

Specimen Collection
) (

. Basal Condition

.
.

) (

.
: Collection of Blood
....

%8 4
6 1
24 48.
Capillary Puncture
Blood Gases

Syringe : Disposable
.
Nozzle
) 20 1 ( Tuberculin 0.1

) 25 - 18(
20 .

.

)(
.Puncture
%70
2- 1
.
15
Isotonic
.
Venipuncture




2
10 5

.
Arterial Puncture

.

.
(1 ) ( Serum
20 10

Hemolysis


Vacutainer
Gel

Centrifuge


)
Anticoagulants
Whole Blood
) (
) ( Glycolysis
.


.
Plasma

%1

.

24
.
8
42 ) (
.
:
- 1

.
- 2

.
- 3



) ( .
:


.

 ) ( Anticoagulants


.


.

.
Acid Phosphatase
Alkaline Phosphatase LDH

.
1 Heparin


Muccoitin
Polysulphouric Acid Sodium
Heparin Potassium Heparin Lithium Heparin
Antithrombin Prothrombin Thrombin
Fibrin Fibrinogen
Cofactor .
%20

. 110 /
0.2 / .
2 Potassium Oxalates
20 10
10 2 %30
PH = 7.4 0.1
10 .
- 3 Sodium Fluoride
) (
2 1 /
Glycolysis 4
12 200 1
100 .
Reagent
) ( Urease .
4
(Ethylene Diamine Tetra Acetic Acid (EDTA
Hematology
2 - 1 /
.

Vacutainer Tube
:
- 1 : Red Tube
) Gel (
Serology 10 2
0.7
15 .
- 2 : Lavender Tube EDTA EDTA
2 2 EDTA 5
C.B.C Differential
EDTA
.
- 3 : Green Tube Li. Heparin
10 Cytogenetic PH
-6- G6PDH
- 4 : Blue Tube Sodium Citrate 2.7
2.7 4.5 Coagulation
Fibrogen Factor PT PTT

 - 5 : Yellow Tube 5
0.3 EDTA
- 6 : Gray Tube
.

Skin Puncture

PH Po2 Pco2
6 7 7 100 / )
0.39/( .
Hemolysis
Invivo Invitro
:
-1 Osmotically

Hypotonic
.
2 :
- Hemolytic Anemia Jaundice
- Paroxysmal Hemoglobinuria
- 3 :
Quinine Phenacetin Nitrites
Chlorates
4
Saponin

5
Grinding
Stirring Shaking Thawing

20 100 /
Slightly Hemolysis
Server Hemolysis
)
... LDH(
Aldolase LDH

) (GOT, GPT %2 10 100 /
LDH %10 10 100 /
.


4 2

 .
) 20-(


.
:
- 1 .
-2
.
- 3
- 4
.
- 5 )(
- 6

Sex Hormones
:
) (Germ Cells ) .(Sex Hormones
.
) (Estrogens ) (Progesterone
) (Testosterone
) (Suprarenal Gland )
(Pituitary ) (Hypothalamus ) .(Nuclear Level
.
) (1 :
)( ) :(Testosterone

) (Dihydrotestosterone - DHT
) .(LH
:
) (Testosterone
.
" "

" ".



.
) (

 ) ( .
.
:
38-9 /.
3.8 - 0.35 / ) (.
3.5 /.
) 1.4 (.
: ) (LH .
:
) (.
.
.
- ) .(Stein - Levinthal Syndrome
:
.
) .(Kleinflter Syndrome
.
.
) (2 ) :(Female Sex Hormones
)( ) :(Estrogens
) (LH ) (FSH
) (Estradiol

.
) (Estradiol :
) ) (Follicular Phases 440-70 /.
) ) (Luteal Phases 620 - 220 /.
130.000 - 20.000 /.
330 -70 / ) (.
70 /.
: ) (Estradiol ) (FSH )
.(LH
)( ) :(Progesterone
) (Corpus Luteum
) (


.
:
) ( 6.4 -0.8 /.
) ( 80-8 /.
3.18 / ) (.

 1.2 - 0.95 /.
1166 - 243 /.
: ) .(LH
)( ) (HCG ) :(Human Chorionic Gonadotropin
) (Pregnancy Test
) (HCG .

.
3
14 .
:
) ( 15 .
) (.
) (HCG :
.
) (Abortion ) (Imminent Abortion ) Incomplete
(Abortion ) (Inevitable Abortion ) (HCG .

) (Vesicular Mole ) (HCG )

( 14
) .(Chorioepithelioma
) (HCG .
) (HCG :
).(%10
.
) (HCG :
.
.

) (1 ) (Gonadotrophins
) (Anterior Pituitary Gland
) (Sex Hormones ) (.
)( ) (LH ) (Luteinizing Hormone
) (LH ) (Hypothalamus

) (Glycoprotein ) (Estrogens ) (Progesterone

.
) (LH ) (Testosterone
.
) (LH 20-2 / .
80-15 /

 ) (LH 8.4-1 /
) (LH 0.4 /.
) (LH :
) (Normal Menopause ) .(Premature Menopause
.
) (LH :
.
.
.
) .(Shihan Syndrome
)( ) (FSH ) (Follicle Stimulating Hormone
) (FSH ) (LH
.
) (FSH .
) (FSH ) (LH :
) (Infertility .
.
.
) (FSH .
) (FSH :
) .(Menopause
.
) .(Seminiferous Tublar Failure
) . (Climacteric
) .(Ovarian
) (FSH :
) (.
) .(Panhypopituitarism
) .(Anorexia Nervosa
) .(Hypogonadism
) (FSH ) (Follicular & Luteal Phases
12-2 /.
) (Ovulation 22-8 /.
) (FSH 10.5-1 /
) (FSH 2.5 /.
) (2 ) .(Prolactin


.
) (Follicular Phases ) Luteal
.(Phases


.
:
.
) (Amenorrhea ) .(Oligomenorrhea
) .(Oligospermia
.
) (Galactorrhea ) .(Gynecomastia
) .(Galactorrhea
.
.
.
25-4 /.
25 600 /.
17-6 /.
.
:
.
.
.
.
) (Phenothiazine
) (Haloperidol .
) (3 ) (GH ) :(Growth Hormone

.
) :(GH
) (Anabolic .
) (Lipolysis .
.
.
) (GH 0.48 /.
) (GH ) (Stress
) (GH .
) (GH :
) (Dwarfism
.
) (Gigantism 10 / ) (GH
.
) :(GH
) (Stress ) - - (.
.

 ) .(Gigantism
) -(.
) :(GH
.
.
.
) (Glucocorticoids .

Thyroid Hormones
:
) (Thyroid Gland
) (Follicular Cells -:
) T4( ) (Tetraiodothyronine-Thyroxine
) T3 ( )(Triiodothyronine

.
) T3 (T4 :
.1 :
.
.2 :
) (Bile Acids
.
.3 : ) (Anabolic Protein
) (Catabolic Protein
) (Negative Nitrogen Balance
.
.4 ) (.
.5 ) (Cretinism
.
.6 :
) (Thermogenesis
""
"".
:
)( ) (Hypothyroidism
T4


T4 T3
) (Myxoedema


.
) (Primary ) (Secondary

) (TSH .
) (TSH .
)( ) (Hyperthyroidism
)( %60-40
) (Hypocholesterolaemia ) (Hyperglycaemia )
.(Glucosuria
T4
T3 T4 ) (Thyrotoxicosis
) (Graves Disease .
------------------------------------------------------------------------------- :
.1 T3 T4
) (T4
) (Thyroxine- Binding Globulin and Prealbumn
.
T4 12-5 100/ ) 156-65 /(.
T3 0.17-0.07 100 / ) 2.2 - 0.91/(
T3 T4 :
T3 T4 :
)( .
)( ) ( Thyroxine - Binding Protein TBG
)( .
)( .
)( T3
T3 T4 :
)( .
)( .
)( .
.2 ) (Free T4
) ( T4 ) (T4 ) (.
2.4-0.8100/ ) 0.03-0.01/(.


.
T3 (Resin ( Resin T3 uptake - RT3 U
) (T3
) ) (Resin (
) (T3 ) (Resin .

 %35-25

.

.
T4 ) ( Free Thyroxine - FT4I
) (T4 ) (T4 ) (T3 (Rein ( RT3 u

.
.3 ) :(TSH) ( Thyroid Stimulating Hormone
) (Anterior Pituitary Gland
) ) (Hypothalamus - (

T3 T4 .
5-0.5 /.
TSH
.
) (TSH :
. . ) (. . Parathyroid Hormone

.
Parathyroid Hormone-PTH
).(Chief-Cells
) (PTH
) (PTH ) (++Ca .
) :(PTH
) (PTH
:
-1 :
) (PTH )(+HCO3,Pi,K
).(H+,NH4
) (Distal Renal Tubule

) (Proximal Renal Tubule .
-2 :
:
)( ) (Collagen ) (Osteogenesis
).(Osteobiast

( .
)
( ) (Osteolysis ). (Osteoblast
)
( ) (Osteoclast
)
) .(osteoblast
) (.
-3 ) (Gastrointestinal Tract

"".
) (RIA
83-30 /.

) (PTH .
) (PTH :
.1 ) .(Hyperparathyroidism
.2 .
:
.1 .
.2 .
.3 ) (Alkaline Phosphatase
) (PTH
.

) (Insulin
:
) (
)( ) (Proinsulin ) (C-peptide
) / (Diabetes Mellitus
.

) (Ca++ .
:
:
.
) ( :
. . . ) 25 - 5 /(
) 0.5 - 0.05 /(.
) (C-peptide ) 4 - 1 /(.
.
:

 ) .(Insulinoma
.
:
.
.
.
.

) (1 ) (Aldosterone
) (Zona Granulosa

:
) (Renin - Angiotensin
) (ACTH ) (Adreno - Corticotrophic Hormone
.
) 9 - 4 100 / (
18 - 2 24 /.
) 24 ( .
:
.
.
.
:
.
.
.
:
) .(Carcinoma
:
) .(Salt Losing Nephritis . . . :
.
.
:
.1 ) ( )
(Conn's Disease .
.2 .
) (2 ) (Cortisol


.

.
) 744 - 165 /(.
) 358 - 83 /(.
:
:
.
.
.
.
.
)(
.
) .(Encephalitis
.
.
:
:
) .(Addison's Disease
.
.
) (3 ) :(ACTH) ( Adreno Corticotrophic Hormone
.
.
) (ACTH) ( Adreno Corticotrophic Hormone
.
) (ACTH ) 40 - 7 /
.
.
.
) :(ACTH
.
) .(Feed Back
) .(Congenital Adrenal Hyperplasia
- ) .(Lysine - Vasopressin
) :(ACTH
) .(Panhypopituitarism
.

"

:
.
110 70 100 12 8
150 120 100
) (Physiological Hyperglycaemia
.
) 18 12( 70 60 100
" " ) .(Physiological Hypoglycaemia
)( ) (:
) (Insulin )Anti-
(Insulin . ) (Glucagon ) (Adrenaline )
(Glucocorticoid ) (Growth Hormone ).(Thyroxine
.
.
)( .
:
) (Diabetes Mellitus :
.
:
.
.
" ".
:
:
- ) :(Hyperglycaemic Coma

.
:
-1 .
-2 ) ( .
-3 .
-4 .
) ) (Ketones Bodies
( .
.
- ) :(Hypoglycaemic Coma

60
100 .
:
-1 .
-2 .
-3 .

 -4 .
.


) 24( .
( ):(Diabetes Mellitus
)

.
:
) (1 ) (Insulin Dependent Diabetes Mellitus ) :(IDDM
) (Type 40 30
) (IDDM .
) (2 ) (Non- Insulin Dependent Diabetes Mellitus
) :(NIDDM
) (Type

.
.

) ( .
)( :
-1 :
:
) ( ) (Fehling ) (Benedict
.
) (Strips ) (Glucose Oxidase .
) (Glucose Analyzer )(Glucose Oxidase
) (Oxygen Electrode
.
-2 ) :(Random Blood Glucose

.
-3 ) : (Fasting Blood Glucose
12 8
110 70 100 120
130 3
.
-4 ) :(Post Prandial Blood Glucose
) 75 (
.
140 .
-5 ) (Glucose Tolerance Test

 ) :(GTT
.
12 8 75
) 1 ( 3
.
110 70 130 120
2 3
" " ) (Insulin Shot .
130 180
.
3 2
.
-6 ) (Glycosylated Haemoglobin - HbA 1c
)( ) (Haem ) (
A1c
%10 - 5 ) .(HbA1c
) (HbA1c

120 %8 - 5
.
-7 ) :(Fructosamine
20 - 15 .
) (Glycosylated Proteins
.
)( :
-1 .
-2 .
-3 )
103 105 (
.
-4
.
-5 .
-6 .
-7 ) (.

Liver Function Tests

 :
-1 .
-2
. .
-3 .
: :
)( :

.
.

.
8 - 6 100 ) 80 - 60 / (.
.
)( :
.
5.5 - 3.5 100 / ) 55 - 35 / ( .
:

. . . . :
. . . . . .)( :
:

.
3.6 - 2 100 / ) 36 - 20 / ( .
:
:
. :

 :
)( :
.
.
0.6 - 0.2 100 / ) 6 - 2 / ( .
:
:
:
:
: ) ( :
=

=

) - + (
=

-

2 1
.
) ( A/G .
) (2 :
) (Y.GT ) (ALT/GPT ) (AST/GOT .
) ( :

)( ) (AST/GOT ) (ALT/GPT
.
) (GPT 45 / .
) (GOT 41 / .

 .
) (GPT ) (GOT
) (GOT .
" " 6 .
)( . ) : (Y - GT

30
25
50 .
-:
)() (3 :
)( )(ALP

" " .
) (PH 7
71 - 24 /
) 30( 350 /
:
-:
. . :
)( :


) ( ID - BIL )
( D - BIL .
) ( T- BIL
19 - 3.5 /
7 /.
-:
:
-

 " " .
" "
" "
" "
" " .
:
.
- .

Kidney Function Tests

:
) (1 ) : (Urea

.
) (NH3 .

%50

.
40 - 20 100 / ) 7 - 3.5 / (
(Blood Urea Nitrogen ( BUN 25 - 8 100 / ) 8.9 - 0.9
/ (
40 - 20 100 / 15 - 5 100 /
20 - 5 100 / .
:
:







:
:

 Hepatic Coma

Hemodialysis
.
Cachexia Malnutrition Starvation
:

.
:

.
) (2 : Creatinine
Anhydrous
Creatine Phosphocreatine
24
.
1.5 - 0.5 100 ) 123 - 60 / (
1.5 24 /
1.0 24 /
:
0.5 100 / .
) (3 :Creatinine Clearance Test
24
24 .
140 - 90 /
125 - 80 /

Creatinine Clearance :
Uc Tv
=C
Sc 60 24

Uc
Sc
Tv 24
24
60
:
Water Depletion -

 ) (4 ) ( ) ( Uric Acid
Purine
Adinine .Guanine

.
7 - 3 100 ) 0.53 - 0.18 / (
6 - 2 ) 0.45 - 0.15 / ( .
% 80
.
700 - 300 24 / ) 3.6 - 2.1 24 / (
) ( ) (
24 .
:
Gout Pre - Eclampsia &Eclampsia Leukaemia Glycogen Storage Disease - Type 1 Alcoholism :
Allpurinol Probenicid .

: Total Lipids

) ( )
(
:
) (Triglyceride ) (Fatty Acids ) (Waxes ) (Steroid
) (Terpenes
) (Cholesterol
) (Triglyceride ) (Phospholipids ) (Fatty Acids

1000 - 450 100 / ) 10 - 4.5 (

.
)( " :"CHO


"" ) . (Bile Acids
) (Lipoproteins
.

 )( .
:
:
:

.
( " : "TG
% 90 ) ) (Chylomicron
( % 10 ) Very Low Density
(Lipoprotein - VLDL
.
:
:
) LDL ( -:
) (Fatty Liver
: Lipoproteins Analysis





:
) (Chylomicrons ) (VLDL ) (LDL- Low Density Lipoproteins ) (HDL - High Density Lipoproteins -:
)( ) (HDL - High Density Lipoproteins
HDL ) ( - lipoprotein 45 - % 25
%
HDL HDL
.
HDL HDL
HDL
.
HDL .
HDL 40 100 / ) 0.83 2.5 /(
)( )(LDL- Low Density Lipoproteins
) ( - Lipoproteins
% 75 - 50 LDL
LDL HDL .
LDL 180 100 / ) 3.88 - 0.5 /(
LDL :
LDL Cholesterol (mg/dl) = Total Cholesterol - HDL Cholesterol - Triglyceride

5
Triglyceride mg/dl 400
LDL :
LDL Cholesterol (mmol/L) = Total Cholesterol - HDL Cholesterol - Triglyceride

22
:
Triglyceride
LDL Cholesterol
HDL Cholesterol
Total Cholesterol

the method of hemoglobin measuerement requires the conversion of hemoglobin to

--- cyanmethemoglobin --which of the following will result in afalsely decreased erythrocyte sedimmentation rate
--presence of codocytes
the " rule of three means that theHCT is
three times the HB
After staining aperipheral blood smear with wright'stain and a buffer with correct pH the RBC's appear
pale pink and the WBC's stian very weakly with little - to- no nuclear deatail One possible explanation is
. There was excessive washing of the smear
Which of the following conditions would introduce a source of error into amanual WBC count
Uneven distribution of leukocytes in the counting chamber- -False positive results may occur in the screening solubility test for
hemoglobin S due to
. adding more blood to the reagent than called for by test procedure An increase in ****myelocytes , myelocytes , and promyelocytes in the peripheral blood can be referred to
? as
a shift to the left
While performing a WBC differentia count on a capillary blood smear ,no platelets were observed . What
? action should be taken
Look at the edge of the smear for platlet clumping --.
A falsely elevated hematocrit is obtained on adefective centrifuge . Which of the following values will not be
? affected

MCH
? What effect would the use of abuffer with a PH of 6.0 have on a Wright stained smear
. RBC's would be too pink --Which of the following red - cell inclusions can be detected with a supravital perparation that uses new
methylene -blue Nas the dye reagent but are not visible with Romanowsky stain
Heinz bodies --Which of the following contain RNA and are usually identified by staining with brilliant cresyl blue or new
methylene blue
. Reticulocytes --: Astudent cosistently makes peripheral blood smears that are too thin . you instruct the student to try

increasing the angle of the spreader slide --which characteristic differentiates

the myelocyte from other myelocytic cells
Appearance of specific granules --vigorous mixing of a whole -blood specimen collected with EDTA results in
---a falsely decreased hematocrit
During the examination of a
cerebrospinal- apecimen from a 45- years old man . the clinical laboratory techinican noted the presence of
? rare choroid plexus cells in a total WBC count . these results are indictive of
. normal state ---

Blood collected for anticoagulation testing should be collected in

sodium citrate with a 9:1 blood to anticoagulant ratio 3.2% --?ALL of the following conditions may cause an increased thrombin time except
decreased prothrombin --The APTT is a screening test for all
? coagulation factors in the intrinsic pathway except which of the following
X111 --the coagulation factor that is decreased in hemophilia A is factor
V111 --Thawing of platelet - poor plasma that has been stored at -- 40C for coagulation studies should be
- performed at what temperature
C38- C35 Which two plasma coagulation factors are the least stable in vitro
V and V111 --A clinical laboratory techncian notes that aspecimen for an APTT has been stored at room temperature for
: five hours prior to testing . the CLT should
. request anew sample --Plasma is diluted in afibrinogen activity determination to decrease the
influence of inhibitors --WHich of the following is appropriate
in preparing an EDTA anticoagulated specimen for analysis when it has been standing in arack and not on
? a mechanical rotator
. Invert gently at least 60 times --A patient has an RBC count of 2.70 *10
L ahemoglobin of 5.5 g/dl , and ahematocrit of 0.19 L/L . what erythrocyte morphology would you/ 12"
? expect to see on the periphal blood smear
microcytic hypochromic cells When reviewing a peripheral blood smear. the clinical labratory scientist notes many macrocytes . the MCV
? has been reported as 85 FL . This appearent discrepancy may indicate that

The smear was made from the wrong

sample
In the performance of amodified Westergren ESR . what is the recommened dilution
( volume diluent +4 volumes blood ) 1/5 --: many schizocytes are seen on aperiphral blood smear . one of the most common causes for these cells is
microangiopathic anemia --Which of the following procedures is not necessary to confirm the majority of iron realted anemias
Bone marrow evulation
? Afalesly elevated G- 6- PD assay using the fluorescent spot test may be seen in patieants with
the presence of many reticulocytes
The presence of microorganisms, increased protein and a high leukocyte count in CSF will cause the CSF to
: appear
cloudy or turbid --In selecting material for smears of bone marrow cell morphology the clinical labratory scientist should
:select
gray particles floating in blood and fat droplets --Which of the following would be an acceptable specimen for semen analysis
Collected at the office without a --condom and eximened in 1 hour
The coagulation factor defiency
that can display both an abnormal PT and APTT is factor
X --A patient has an abnormal thrombin time and normal reptilase time .Which of the following can produce
: this results
Heaparin --The most frequent hereditary condition predisposing to venous thrombosis is
activeted protein C resistant --: anexpectedly small anticoagulant response to heparin therapy may be caused by decreased levels of

anti thrombin ---

Un fractionated heparin must have

which one of the following coagulation inhibitors present in normal amounts in order for it to properly
: anticoagulate a patient
Anti thrombin 111 --: The formation of D-dimeris the by- product of the effect of plasmin on
across- linked fibrin --In the performance of platelet aggregometry on patient samples the instrument should be set to 100%
: transmittance using

(patieant platelet - poor plasma (PPP --Which is the following conditions can cause a prolonged thrombin
clotting time
Pro thrombin deficiency --The most common generalized
: hemostiatic disorder is
liver disease --Red blood cells morphology characteristic of multiple myeloma
Rouleaux --All of the peripheral blood smears made by a certain clinical laboratory technician are too thick . Which of
the following corrective actions should be
:taken
Lower the angle of the spreader slide to 45 degrees --Which of the following cells may be found only in ascitic fluid
Mesothelial cells --The first of 3 tubes of CSF appearspink
and cloudy the remaining 2 tubes appear to be clear and colorless This is indicative of a/an
traumatic tap --secondary granules first appear in which stage of neutrophilic development
Myelocyte --A supravital stain must be used to demonstrate the presence of
reticulum
An erroneously high spin hematocrit can be caused by
reading the buffy coat as the part of the packed -cell portion

align=left]- Which of the following usually requires concentration before]

?analysis
.Cerbrospinal fluid for protein electrophoresis Which of the following situations indicates that an instrument problem is -2
? present and requires further investigation
A series of anion gabs A trough blood sample for routine therapeutic drug monitoring is usually -3
? obtained
Just before the next scheduled dose : The turbid of lipemic serum is due to an elevated level of -4
Triglycerides In a coupled enzymatic method for measuring serum cholesterol the color -5
change observed during the indicator reaction is dependent upon the generation
of:- Hydrogen peroxides
: PH 8.6 is used for serum protein electrophoresis so that -6
. All serum proteins will have a net negative charge -

When quantitating serum protein using the biuret reaction , the biuret -7
: reagent is reacting with
Peptide bonds in proteins Which one of the following protein fractions , when separated in serum by -8
? electrophoresis on cellulose acetate , contains a single protein
Albumin : Osmolality measurements determine the -9
Moles of dissolved solutes per kilogram of solvent When using an automated instrument , the amount of carryover between -10
: consecutive samples is not affected by
Using a serum plank A serum sample is diluted 1 to 3, 1:3 before analysis and the following -11
: results obtained
Total protein 4.1 g /dl
Albumin - 1.5 - g/dl
? Which total protein concentration should be reported
g/dl 12.3 : In an adult , a blood glucose level of 35 mg /dl is -12
Dangerously low Measurements of urinary human chorionic gondotropin (HCG) in men can be -13
: used
Detect testicular tumors :Xanthochromic cerebrospinal fluid is an indicator of -14
Cerebral hemorrhage A creatinine clearance result below the normal reference range most likely -15
: indicates a decrease in
Renal glomerular filtration A physician suspects that a patient has Cushing syndrome . Based on this -16
? information , which of the following tests would assist in this diagnosis
Cortisol level Identify the results that are not in electrolyte balance . ( Results are in -17
( mmol/L
Na : 145 K : 4.0 CL :90 CO2 :15 Which of the following urine specimens is most useful when screening for -18
: glucoseuria
hour postprandial specimens 2 What is the longest time that a urine specimen can remain at room -19
? temperature before it is no longer considered acceptable for analysis
hour 2 Which of the following situations requires corrective action before -20
? proceeding with specimen testing
Reagent strip protein result is trace when using negative control material Which protein test is not able to detect immunoglobulin light chains in -21
? urine
. Reagent strip protein test Which of the following sets of the urinalysis results , physical appearance -22
and SG is physiologically possible and indicates a concentrated urine
SG = 1.030 , Color = yellow -

Urine sediment that contains red blood cells , red blood cell cast , protein , is -23
: characteristic of
. Acute glomerulonephritis Hyaline casts are found in increased numbers in the urine sediment -24
Following strenuous exercise Which of the following urinalysis findings include contradictory results that -25
[: should not be reported
PH 6.0 - bilirubin: Positive - ammonium biurate crystals The following crystals are observed in a randomly collected urine specimen -26
: with a pH of 7.0
Triple phosphate When present in the urine . which the following substances could cause -27
: false- positive reagent strip blood results
Myoglobin Which of the following analytes can deteriorate if a blood specimen is -28
: exposed to light
Bilirubin Which of the following collection tubes is the specimen of choice for the -29
: determination of glycated hemoglobin
EDTA tube Which of the following serum samples is satisfactory for alkaline -30
phosphatase measurement
. Sample maintained at room temperature for 2 hours Which of the following changes occurs in a serum specimen that is -31
: maintained at 4 C for 8 hours
Alkaline phosphatase activity increased A centrifuge is loaded with patient samples and turned on . it begins to -32
vibrate and dance across the table top . which of the following statements best
?accounts for this observation
. The tubes are not balanced in the carriers Which of the following enzymes catalyzes the conversion of glucose to -33
: hydrogen peroxide and gluconic acid
Glucose oxidase Which of the following constituents has the greatest effect on serum -34
: osmolality
Sodium When iontophoresis is used to collect sweat for chloride analysis , -35
:pilocarpine is used to
Induce sweat secretion :Which of the following methods is not used to quantitate serum albumin -36
Sulfosalicylic acid (SSA) precipitation If moderately hemolyzed serum specimen is used for protein -37
: electrophoresis , which of the following protein fractions will be elevated
Beta globulin : the normal ratio of bicarbonate ion to carbonic acid in arterial blood is 38
1 : 20 : Increased serum uric acid is found in each the following conditions except -38
Hypothyroidism -

If LDL receptors are nonfunctional due to disease .the plasma level of which -39
?lipid would increase the most
Cholesterol Which of the following enzymes provides the best indication of obstructive -40
liver disease
Alkaline phosphatase : Urine preservation by refrigeration can cause -41
. Increased turbidity due to precipitate of solutes Which of the following tests is not used to assess the kidney ability to -42
? concentrate the urine
PH Which of these sugars cannot be detected in urine using the copper -43
: reduction test
Sucrose All of the following substances can affect the detection of urine glucose -44
:using reagent strips except
Galactose The presence of waxy casts in urine sediment and a fixed urine SG of 1.010 -45
: correlates best with
renal failure urine sediment that contains free fat globules and fatty casts is -46
:characteristic of
. the nephritic syndrome serum total protein results obtained using the biuret reaction can be falsely -47
: increased it
. The specimen is hemolyzed : An enzyme assay that shows substrate depletion should be repeated using -48
Less sample Which of the following urinalysis results is considered " abnormal" clinically -49
: significant
Bilirubin === small Which of the following terms is considered in appropriate for reporting urine -50
: color
[Bloody [/align -

Types of the media and samples

Mac Conkey Agar
Selective medium
" stool , sputum , Eye , Ear , wound , vagina sample"
selective for G -ve bacteria and also Group D in G+ve bacteria can
grows on this media
and differential between lactose fermentation bacteria and non lactose

fermentation bacteria

CLED Agar
Used on Urine samples
for G+Ve and G-Ve bacteria
properties:- Inhibition Proteus Swarming Species on this media like
Mac Conkey media
CLED in the upper part of the media which seen in the picture below
and the other one is Horse blood agar

XLD medium
Used on stool sample
XLD selective media for G -ve bacteria
and differential for lactose ferment and non lactose ferment

Chocolate Agar
for Haemophilus & Neissria
and also another bacteria which grow in blood agar can grow in this
agar easily
" sputum , Eye , Ear , blood , nasal , csf sample "

Blood Agar
"sputum , Eye , Ear , nasal , blood , wound , vagina"
Most of the bacteria can grow in this media
and we dont use this media in stool sample

Manitol salt Agar

Used in suspected (Nosocomial infection) " MRSA" (Eye , nasal , throat
( samples

Mueller Hinton agar

Used for sensitivity tests

DNase Agar
Biochemical test
used for differentiate between Staph.aureus and Staph species

T.C.B.S medium
for Vibrio Species
The high of PH in this media allows growing of vibrio SSP

Thyer Martin Medium

For Neisseria gonorrehea
samples from vagina and penis
and in uncommon area like oral cavity and anal canal
The real picture here is Chochlate agar and there is no diffreince in the color between Thyer Martin and
Chochlate agar

Types of the media and samples

Mac Conkey Agar
Selective medium
" stool , sputum , Eye , Ear , wound , vagina sample"
selective for G -ve bacteria and also Group D in G+ve bacteria can
grows on this media
and differential between lactose fermentation bacteria and non lactose
fermentation bacteria

CLED Agar
Used on Urine samples
for G+Ve and G-Ve bacteria
properties:- Inhibition Proteus Swarming Species on this media like
Mac Conkey media
CLED in the upper part of the media which seen in the picture below
and the other one is Horse blood agar

XLD medium
Used on stool sample
XLD selective media for G -ve bacteria
and differential for lactose ferment and non lactose ferment

Chocolate Agar
for Haemophilus & Neissria
and also another bacteria which grow in blood agar can grow in this
agar easily
" sputum , Eye , Ear , blood , nasal , csf sample "

Blood Agar
"sputum , Eye , Ear , nasal , blood , wound , vagina"
Most of the bacteria can grow in this media
and we dont use this media in stool sample

Manitol salt Agar

Used in suspected (Nosocomial infection) " MRSA" (Eye , nasal , throat
( samples

Mueller Hinton agar

Used for sensitivity tests

DNase Agar
Biochemical test
used for differentiate between Staph.aureus and Staph species

T.C.B.S medium
for Vibrio Species
The high of PH in this media allows growing of vibrio SSP

Thyer Martin Medium

For Neisseria gonorrehea
samples from vagina and penis
and in uncommon area like oral cavity and anal canal
The real picture here is Chochlate agar and there is no diffreince in the color between Thyer Martin and
Chochlate agar

Types of the media and samples

Mac Conkey Agar
Selective medium
" stool , sputum , Eye , Ear , wound , vagina sample"
selective for G -ve bacteria and also Group D in G+ve bacteria can
grows on this media
and differential between lactose fermentation bacteria and non lactose
fermentation bacteria

CLED Agar
Used on Urine samples
for G+Ve and G-Ve bacteria
properties:- Inhibition Proteus Swarming Species on this media like
Mac Conkey media
CLED in the upper part of the media which seen in the picture below
and the other one is Horse blood agar

XLD medium
Used on stool sample
XLD selective media for G -ve bacteria
and differential for lactose ferment and non lactose ferment

Chocolate Agar
for Haemophilus & Neissria
and also another bacteria which grow in blood agar can grow in this
agar easily
" sputum , Eye , Ear , blood , nasal , csf sample "

Blood Agar
"sputum , Eye , Ear , nasal , blood , wound , vagina"
Most of the bacteria can grow in this media
and we dont use this media in stool sample

Manitol salt Agar

Used in suspected (Nosocomial infection) " MRSA" (Eye , nasal , throat
( samples

Mueller Hinton agar

Used for sensitivity tests

DNase Agar
Biochemical test
used for differentiate between Staph.aureus and Staph species

T.C.B.S medium
for Vibrio Species
The high of PH in this media allows growing of vibrio SSP

Thyer Martin Medium

For Neisseria gonorrehea
samples from vagina and penis
and in uncommon area like oral cavity and anal canal
The real picture here is Chochlate agar and there is no diffreince in the color between Thyer Martin and
Chochlate agar

][align=center

][align/

:
:
:
.
: Bacillus
: Bacillus anthracis
+G
.
:
-1 : - . - 37 .
-2 .
-3 ) (.
-4 ) ) .
: :
-1 ) ( <<<< .
= = = -2 <<< .
) = = -3 ( <<< .
= = = = -4 <<< .
-1:
1 .
-2 .
-3 . H2S
3 :

 -1 -2 . -3 . ) ( .
:
-1 .
-2 +
.
. PCR -4
-5 .
-6 . PA
-7 .
-8 ) ( .
:
-1 .
-2 .
-3 .
-4 .
. PCR -5
-6 .
:
-1 .
-2 .
:
-1 .
-2
: Clostridium
) ( :
-1 .
-2
.
-3

.
-4
.
A : Clostridium tetani
+G
.

 -1 : .
-2 : 9 + = 10
.
:
-1 : - . - ) ( . -
.
-2 .
:
-1 .
-2 .
-3 :
<<< Antitoxin
<<< .
:
-1 -Antitoxin . 2 -3 . .
-B : Clostridium botulinum
+G ) ( .
-1 : .
-2 .
-3 : - . - . - .
-4 ) (
) ( .
-5 .
-6 . A
:
-1 .
-2 . H2S
-3 .
: ) ( .
:
-1 Antitoxin A B . C
-2 .
C Clostridium welchi : Clostridiumperfringe
+G .
-1:
1 ) ( ... .

 -2 .
-3
.
:
-1 .
-2 : - . - .
-3 .
-4 .
:
-1 : + .
-2 : <<< .
-3 ) (
.
-4 <<< .
:
-1 .
-2 .
-3 : .
-4 : .
D : Clostridium difficili
-1 :
1 -2 . .
:
-1 .
-2 ) (

:
:
: .
: Corynebacteria
+G
:
A : Corynebacterium diphtheriae
+G
V L
.
<<<

 ) ( :
<<< +G .
<<< G .
-1 : .
-2 :
: .
- : 3 :
<<< .
<<< .
<<
.
1:
1 <<< .
-2 <<< .
-3 ) ( .
-4 .
-5 <<< .
:
-1 . Antitoxin
-2 .
B : Corynebacterium diphtheroide
+G .

Listria
: Listria monocytogen
+G 37 . 22
:
-1 .
-2 )
(
<<< .
-1 : .
-2 <<< 22 . 37
-3 .
-4 .
-5

= : :

.
:
-1 : +G
) ( +La ) (-La .
-2 ) EMB : ( Ethyl Methyl Blue
.
-3 ) SS ( :
.
G -1 : -2 . -3 . -4 . .
-E.coli . 6 -5 .
* 5 6 +La 1 2 3 4 . - La
* 3 4 5 6 1 2 .
: - G
-1 ) ( ... <<< . -G
-2 :
- . SS
- . EMB

SS :
-1 <<< La+>>> E.coli .
<<< .
-2 <<< <<<- La .
: -La
-1 : ) ( .
-2 : :
- :
.
- : .

-3 : ) ( H2S
.
-4 : H2S
.
.

:
:
-1 ) ( <<< .

 -2 ) ( <<< E.coli .
-3 ) ( <<<
.
:
-1 .
-2 .
-3 .
-4
A : Escherichia Coli
) 1 (10) 10 ( G
)
( ) ( .
O157 :
95% O157 .
:
-1 .
-2 EMB +La
. EMB
-3 ) (
.
-4 : .
:
-1 <<< .
-2 <<< .
-3 + .
B Klebsiella
: Klebsiella Pneumoniae
+G - La <<<
.
:
-1 .
-2 .
-3 <<< ) . (+La
: .

 C : Salmonellae
:
Salmonellae Typhi .1 .
Salmonellae paratyphi A .2 . A
Salmonellae paratyphi B .3 . B
:
:
-1 -O . 2 ) ( . H
:
:
- ) ( :
-1 : .
-2 : .
- : .

: :
-1 -2 . -3 . .
:
-1 .
-2 .
S.Typhi - :
-G H2S
.
:
:
-1 .
-2 <<< EMB . - La
-3 <<< <<< .
-4 O H ) Vi ( .
-5 ) O . ( H
:
-1 -2 . -3 . + .
- : S.enteritidis
:
.

 D : Shigellae
-G - La .
:
) . ( ...
:
-1 .
-2 EMB . -SS >>> La
-3 <<< ) (
. H2S
-4 . O
E ) ( : Proteus
G- La )
( .

.
:
-1 .
-2 .
-3 EMB <<< . -La
-4 ) <<< (TSI ) ( . H2S
-5 . +
F : Pseudomonas
-G ) ( .
: P.aeruginosa :
-1 -2 . .
:
-1 .
-2 EMB <<< . -La
-3 .
-4 +

Vibrio
) ( .
:
-1 ) ( :V. cholerae .

-2 .V.Eltor
-3 . V.Faetus
-4 : V. parahemolyticus
NaCl 8% .
:


.
:
-1 .
-2 ) ( pH = 9 9.5 .
-3
HCL ) ( .
-4 .
:
-1 -H . 2 ) ( . O
:
-1 :
<<<
<<< .
-2 :
- ) ( ,
- <<< .

- ) ( T.C.B.S

.
- )

H2S .

Bacteroides

.
:
-1 .Bacteroides fragilis
. Bacteroides melaninogenicus -2
.
:
-1 -2 . .

 : :

A : Brucellae

.
:
-1 ) %10
( .
-2 ) (
.
.
:
-1 .
-2 .
-3 .
-4 .

B : Yarsinia
:
-1 :Yarsinia pestis
)
(
.
:

.
:
-1 ) ( .
-2 .
-3 .
-4 : ) ( .
: .

-2 : Yarsinia pseudotuberculosis
. 22
-3 :Yarsinia enterocolitica
.

 C : Francisella
:
: F. tularensis
.
:

.
:
-1 : .
-2 :
5-3 .
-3 :
- ) ( .
- .

Laboratory of medical parasites

.
-:
.1 direct examination
.2 indirect examination
-:

.
-:direct stool examination

.
-:
macroscopic examination


.
microscopic examination

-:
.1 normal salin
.2 iodine solution stain

.3 hematoxykin
.
constration method

 .

.
.1)(-:flotation

)( zinc suiphate flotation
)(1.18 .
: 1


.
.2 -:sedimentation

.
-:direct blood examination
) (blood film

.
-:blood film
thine blood film.1

.
thick blood film.2

1
.
-:blood film
.1 .Leishman stain
.2 .Giemsa stain
.3 Field stain
Eosine
-:indirect blood examination

.1 Immunoserological test
.Antibodies
.Complement fixation test.2
.Haemgglutination test.3
.Immunofluorecnt test.4
.Elisa assay.5
-:Culture

) (NNN
(Novy)Mac NealanNicolle
.
.trypanosoma
)

][align/

RBCs Packed Cells
: Principle of the test

Antibodies
Reaction

.
Control





.

Cross Matching
:
: Cross Matching
.1 One Tube )( Blood Unit
.
.2 drops 2 Patient Serum
.3 drops 2 )( Dilution of
Cells (blood) of donor
.4 drops 2 . Bovine Albumin
Patient Control
.1 One Tube Control
Cross Matching
.
.2 drops 2 Patient Serum
.3 drops 2 Patient Cells
.4 drops 2 . Bovine Albumin
:
.1 ) Cross Matching ( Patient
30
) Control ( Incubator 37
.
.2 Washing ) Cross Matching Tube (Patient Control Tube
Normal Saline .
.3 drops 2 Coombs Serum
. (Anti Human globulin (AHG

 .4 Centrifuge 15-10
Mix .
.5
NonAgglutination Compatible Agglutination
. Incompatible
Agglutination Cross
Matching



Cross Matching Warm Technique
) ( Cross Matching
.
37

: Cross Matching
Compatible


Washing
) Anti Human globulin) AHG

Non Agglutination
((Compatible
(Coombs Control Cell (CCC
AHG AHG
(+) Agglutination
Incompatible


Washing
AHG

). Agglutination(+
]]align=center
[[aldl]http://www.moq3.com/pics/up_2007/01_2007/bf42204e45.jpg[/aldl
Agglutination
][aldl]http://www.moq3.com/pics/up_2007/01_2007/0c8a132c70.jpg[/aldl
]aldl]http://www.moq3.com/pics/up_2007/01_2007/20f032b2fc.jpg[/aldl][/align