Clinical Correlations

Neutrophilia with a left shift is characteristic of a bacterial infection and inflammation.

Decreased TSH
Increased T3/T4
+ TSI

Large, deep blue-black primary granules

A 10-month-old child of a family from Mexico living in Durham was noted by his mother to have a grand mal seizure with shaking of arms and legs by the description given to the EMT. The EMTs found the child limp and unresponsive. In the emergency room the child’s fever was 39.5°C (103.1°F). Blood cultures and lumbar puncture were performed. CSF findings were as follows:

•cell count of 4000
•95% PMNs
•glucose 20mg/dl
•protein 125mg/dl.

Gram stain showed PMNs and occasional Gram-negative coccobacillary organisms. The organism grew on chocolate agar but not on sheep blood agar or MacConkey’s agar. What is the most likely organism in this case?

What are the reservoirs for Mycobacterium leprae?

Choose the appropriate globin chains for Hb A.

Hgb= 9.4
Hct= 30
RBC= 5.0
Calculate MCHC

Light grayish-blue cytoplasmic inclusions made up of residual endoplasmic reticulum.

I may be stubborn about where I like to grow
But give me some chocolate and then you'll know.
From then on I'll be nice :)
I just wish I didn't smell like mice :(

Hgb= 9.4
Hct= 30
RBC= 5.0
Calculate MCH

H. influenzae is ALA negative.

Select the appropriate reference range for MCHC.

A technologist performed a tissue biopsy and culture and observed the following:
24 hrs. BAP- No growth
24 hrs. MAC- No growth
7 days LJ- No growth
6 weeks Sabouraud-dextrose- No growth
Calcoflour white- no organisms seen
Ziehl-Neelsen- abundant rod shaped bacteria

What is most likely the cause for all these observations?

Antibodies associatied with DHTR. Select all that apply.

Three of the choices below are the most common causes of bacterial meningitis seen in newborns. Select all that apply.

Select all appropriate characteristics of Campylobacter jejuni.

Select the appropriate reference range for MCV.

Gram positive cocci
Hippurate hydrolysis +
CAMP +
Catalase =
Motility =
Resistant to bacitracin

Calculate the anion gap.
Sodium: 138
Chloride: 113
CO2: 23

Hgb= 9.4
Hct= 30
RBC= 5.0
Calculate MCV

This form of Mycobacterium leprae does NOT have an effective cell-mediated immune response. It is very slowly progressive, malignant, and life threatening.

Pernicious means?

The purpose of the _____ indicates that Ab or complement is coating the rbc's.

Treatment for low levels of bilirubin in an infant. Select all that apply.

A 66-year-old man incurs extensive thermal burns to his skin and undergoes skin grafting procedures in the surgical intensive care unit. Two weeks later, he has increasing respiratory distress. Laboratory studies show hemoglobin of 13.1 g/dL, hematocrit 39.2%, platelet count 222,200/mm3, and WBC count 4520/mm3 with 15% monocytes. A chest radiograph shows extensive bilateral infiltrates with patchy areas of consolidation. Cultures of the wound on MacConkey and sheep blood agar (SBA) showed aerobic, lactose-negative, Gram-negative bacterium. What is the likely causative agent?

A newborn has developed Group B strep from contaminated amniotic fluid. Which answer better describes the occurrence of infection?

What organism would be most likely to cause a persistent infection in cystic fibrosis?

An increase in plasma cells indicate what disease?

A positive ALA means a certain species would require X factor.

Most common bacterial cause of diarrhea in the U.S.

Symptoms:
Frequent watery stools
Nausea
Headaches
Symptoms may last beyond 2 weeks but usually self-limiting.

Transmission -human infection probably occurs from ingesting contaminated meat or milk; direct person-to-person transmission may occur

Acid-fast bacteria do not stain on regular gram stain due to their wax coating.

Vitamin B12 deficiency is due to...? Select all appropriate answers.

Gram negative
Non-lactose fermenter
Oxidase positive
Smooth, slightly raised, may be mucoid, usually non-pigmented, strong
earthy odor (may produce bright yellow pigment on iron containing media)

Streptococcus pneumonia is plated to a BAP for susceptibility testing. A "P" disk was placed on the agar and then the agar was incubated overnight. The next day the technologist noticed the zone of inhibition was less than 14 mm. Was this this strain resistant or susceptible? And what should be done next?

Vitamin B12 requires _____ for its absorption.

A sputum specimen from a cystic fibrosis patient grew Gram negative rods on sheep blood agar and MacConkey’s agar. The organism was oxidase positive. What is the most likely organism

PV is highly correlated with what gene?

Gram negative, pleomorphic
Nonmotile
Oxidase and catalase +
Requires both hemin and NAD

Choose the appropriate globin chains for Hb F

Choose the appropriate globin chains for Hb A2

Gram + coccibacillus
Catalase +
"Umbrella" motility @25 degrees C

Select the best answer choice for describing Bence-Jones proteins.

Sites of digestion of phagocytized material. Seen with toxic granulation.

The throat culture obtained exhibited gram positive cocci in chains. It also showed beta-hemolysis on sheep blood agar (SBA) and was catalase negative. What was the most likely organism?

Strep. pneumonia can very easily be confused with Viridans streptococci. What is the correct observation to make when distinguishing between the two when performing biochemical tests?

Select the appropriate reference range for MCH

Mycobacterium leprae is also known as?

Non-megaloblastic anemia can result from? Select all appropriate answers.

A sputum gram stain of an elderly person with cough and fever shows gram positive cocci in pairs. What is the most likely organism?

The differences in strength of reactions are due to ____.