AJCP Journal CME/SAM
The ASCP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The ASCP designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ per article. Physicians should claim only
the credit commensurate with the extent of their participation in the activity. This activity qualifies as an American Board of Pathology Maintenance
of Certification Part II Self-Assessment Module.
To complete an exam, go to www.ascp.org/ajcpcme. Call 800.267.2727 for ASCP Customer Service.
Ohgami (page 150)
1. In a reactive lymph node, PD-1 expression is seen predominantly in which?
A. B cells
B. Follicular helper T cells within germinal centers
C. Stromal cells
D.Neutrophils
4. Cases of large B-cell lymphomas poor in B cells and rich in PD-1+ T cells
A. demonstrate a positive T-cell clonality study.
B. can contain morphologically and immunophenotypically atypical T cells.
C. are most commonly seen in the elderly.
D. are associated with poor prognosis.
2. Which best describes the subcellular expression of PD-1?
A.Nucleus
B.Cytoplasm
C. Cell membrane
D. Cytoplasm and nucleus
5. Which statement best describes the most useful approach for distinguishing a
PD-1+ T-cell lymphoma from a large B-cell lymphoma poor in B cells and rich in
PD-1+ reactive T cells?
A. Assessing for T-cell clonality
B. Immunophenotyping by flow cytometry
C. Morphologic assessment alone
D. Morphologic evaluation, immunophenotyping, and molecular studies for T-cell receptor
gene rearrangements
3. The T cells in T-cell histiocyte–rich large B-cell lymphoma are most frequently
what?
A. Reactive PD-1+ T cells
B. CD8+ T cells
C. Neoplastic T cells
D.CD4–/CD8– γδ T cells
Ishiguro (page 157)
1. Which of the following was shown to express glucocorticoid receptor (GR)
most highly?
A. Nonneoplastic urothelium
B. Papillary urothelial neoplasm of low malignant potential
C. Noninvasive low-grade urothelial carcinoma
D. Muscle-invasive (MI) high-grade urothelial carcinoma
2. Strong (3+ only) GR expression in bladder tumors was shown to significantly
(P < .05 by log-rank test) correlate with which of the following?
A. Recurrence of non–muscle-invasive (NMI) tumor
B. Grade or stage progression of NMI tumor
C. Progression (development of local recurrence or metastatic tumor) of MI tumor
D. Disease-specific death in patients with MI tumor
3. Multivariate Cox regression analysis showed that dichotomized GR
expression (0/1+ vs 2+/3+) in bladder tumors was an independent prognosticator
for which of the following
A. Recurrence of NMI tumor
B. Grade or stage progression of NMI tumor
C. Progression (development of local recurrence or metastatic tumor) of MI tumor
D. Disease-specific death in patients with MI tumor
4. Which of the following was most likely to be GR-positive?
A. Androgen receptor–positive bladder tumor
B. Androgen receptor–negative bladder tumor
C. Estrogen receptor α–positive bladder tumor
D. Estrogen receptor β–positive bladder tumor
5. The immunohistochemical findings shown in this article strongly support
experimental evidence suggesting what?
A. Androgens promote bladder cancer growth
B. Estrogens promote bladder cancer growth
C. Glucocorticoids promote bladder cancer growth
D. Glucocorticoids inhibit bladder cancer growth
McCulloch (page 165)
1. Which sentence best describes the relationship between rhinovirus (RV)
species and the severity of clinical illness in adult patients?
A. RV-C is consistently associated with more severe clinical illness in adult patients.
B. The relationship between RV species and severity of clinical illness has yet to be
clearly defined.
C. In adults, RV-A and RV-B are associated with more severe asthma exacerbation.
D. RV-A infection is more severe in adult patients with pulmonary comorbidities.
2. In adults, RV has been associated with more severe clinical illness among
which of the following?
A. Patients with sinonasal malignancies
B. Populations living in colder climates
C. Patients with seasonal allergic rhinitis
D. Elderly patients, immunocompromised patients, and those with chronic lung disease
3. A child presents to the emergency department with an asthma exacerbation
in the middle of winter; the episode is thought to have been provoked by an RV
infection. Which of the following is true about this scenario?
A. RV infections cause 80% of pediatric asthma exacerbations and over 90% of adult
asthma and chronic obstructive pulmonary disease exacerbations.
B. Pediatric RV infections tend to manifest clinically only as the common cold.
© American Society for Clinical Pathology
C. In children, RV-A and RV-C have been associated with more severe outcomes.
D. RV tends to cause more severe illness in adults than in children.
4. Which of the following best characterizes sex differences in RV infection?
A. Women have a higher risk of severe illness with RV-C but not with other viral types.
B. Adult male patients tend to have more severe clinical illness from RV infection.
C. Sex differences in the immune response to RV may arise from hormonal influences
on the immune system.
D. The effect of sex on RV immunity is mediated by the patient’s smoking status.
5. How might sex differences impact the pathogenesis of reactive airway
disease in RV infection?
A. RV may play a role in the pathogenesis of reactive airway disease via hormonal
influences on immune and inflammatory responses.
B. Due to the greater severity of RV infection in female patients, girls are more likely
than boys to develop asthma.
C. Male and female patients are equally affected by asthma because RV infection
affects both sexes equally.
D. Hormonal influences on airway hyperresponsiveness are thought to reduce the risk
of asthma in female patients.
Am J Clin Pathol 2014;142:273-277
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AJCP Journal CME/SAM
The ASCP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The ASCP designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ per article. Physicians should claim only
the credit commensurate with the extent of their participation in the activity. This activity qualifies as an American Board of Pathology Maintenance
of Certification Part II Self-Assessment Module.
To complete an exam, go to www.ascp.org/ajcpcme. Call 800.267.2727 for ASCP Customer Service.
Mohanty (page 173)
1. In what scenario would use of immunohistochemistry for evaluation of a
poorly differentiated carcinoma involving the bladder neck generally not be
indicated?
A. To evaluate a poorly differentiated tumor in a patient with history of both urothelial
carcinoma and prostatic adenocarcinoma
B. To characterize a high-grade carcinoma with papillary and invasive morphology in
patient postprostatectomy for adenocarcinoma of the prostate
C. To characterize a high-grade carcinoma with mixed morphology, including prominent
papillary and squamous patterns and flat in situ component of the bladder mucosa
D. To further characterize a poorly differentiated carcinoma in a patient with elevated
prostate-specific antigen (PSA) and abnormal urine cytology
2. Which of the following immunohistochemical markers does not show a
high prevalence of positivity in and specificity for urothelial carcinoma in the
differential with adenocarcinoma of the prostate?
A.GATA3
B.p501S
C.S100P
D.p63
3. Which immunostain, to be counted as positive, requires identification of a
punctate perinuclear dot-like positivity?
A.NKX3.1
B. Cytokeratin CK5/6
C.p501S
D. Prostate-specific membrane antigen (PSMA)
4. Which of the following immunohistochemical markers used to support
prostatic origin may also be positive in some cases of poorly differentiated
urothelial carcinoma involving the bladder and neck?
A. Androgen receptor
B.PSA
C.NXK3.1
D.ERG
5. Which of the following markers is least sensitive for high-grade prostatic
adenocarcinoma among high-grade carcinomas of the bladder and neck?
A.NKX3.1
B.p501S
C.PSMA
D.PSA
Hackenmueller (page 184)
1. Which of the following fractionated arsenic results would exceed the
American Conference of Governmental Industrial Hygienists (ACGIH)
biological exposure index?
A. Inorganic arsenic, 12 μg/L; methylate arsenic, 18 μg/L; organic arsenic, 25 μg/L
B. Inorganic arsenic, 15 μg/L; methylate arsenic, 28 μg/L; organic arsenic, 20 μg/L
C. Inorganic arsenic, 11 μg/L; methylated arsenic, 20 μg/L; organic arsenic, 73 μg/L
D. Inorganic arsenic, 10 μg/L; methylated arsenic, 23 μg/L; organic arsenic, 35 μg/L
2. What is the most appropriate interpretation of a total arsenic result of 53
μg/L?
A. This result exceeds the ACGIH biological exposure index for organic arsenic.
B. This result is not elevated and there is no additional follow-up required.
C. This result warrants fractionation to identify the species of arsenic present in the
sample.
D. This result reflects only nontoxic arsenic species and does not require additional
investigation.
3. When investigating a suspected toxic exposure to arsenic, what is the most
appropriate test to order?
A. Total urine arsenic screen with reflex to fractionation
B. Arsenic fractionation directly
C. Serum arsenic
D. Organic arsenic only
4. Which of the following statements is true regarding dietary arsenic?
A. All dietary sources of arsenic are toxic.
B. All dietary sources of arsenic are nontoxic.
C. There are no sources of dietary arsenic exposure.
D. Both seafood and rice are common dietary sources of arsenic.
5.Which of the following statements is true regarding seafood and arsenic?
A. Seafood contains no arsenic.
B. Seafood contains toxic arsenic only.
C. Seafood contains nontoxic arsenic species only.
D. Seafood contains both toxic and nontoxic arsenic species.
Weinberg (page 190)
1. In the 2008 World Health Organization classification, presence of complex
karyotype is used to define which subtype of acute myeloid leukemia (AML)?
A. Therapy-related AML
B. AML with myelodysplasia-related changes
C. AML with monocytic differentiation
D. AML with recurrent genetic abnormalities
2. An older patient presents with marked pancytopenia and circulating blasts.
Bone marrow was performed and showed 70% blasts with few maturing myeloid
and erythroid cells. Flow cytometry performed on the bone marrow shows that
blasts express CD34, CD13, CD33, HLA-DR, CD117, CD4, and myeloperoxidase.
Cytogenetic study showed loss of chromosome 7 and 17 as well as other
abnormalities. Molecular studies for NPM1 and FLT3 were also performed.
What is the most likely finding?
A. NPM1+, FLT3–
B. NPM1+, FLT3+
C. NPM1–, FLT3–
D. NPM1–, FLT3+
3. A patient presents with pancytopenia. Bone marrow was performed and
showed 40% blasts. Flow cytometry showed that the blasts have amyeloid
phenotype. Background erythroid cells and megakaryocytes show marked
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dysplastic changes. Cytogenetic study showed numerous unrelated
abnormalities including loss of two autosomal chromosomes. What is the proper
classification of this acute leukemia?
A. AML with recurrent genetic abnormalities
B. AML with myelodysplasia-related changes
C. AML, not otherwise specified
D. Therapy-related AML
4. A 46-year-old man presents with AML. Cytogenetic study showed complex
karyotype. How does his overall survival compare with another 46-year-old
patient with AML but with normal cytogenetics?
A.Same
B.Worse
C.Better
D. Depends on NPM1 status
5. What is the most predictive factor of overall survival in patients with AML?
A. Presenting WBC count (high or low)
B. Older age (>60 years)
C. Unfavorable cytogenetics such as complex karyotype
D. Presence of FLT3
© American Society for Clinical Pathology
AJCP Journal CME/SAM
The ASCP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The ASCP designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ per article. Physicians should claim only
the credit commensurate with the extent of their participation in the activity. This activity qualifies as an American Board of Pathology Maintenance
of Certification Part II Self-Assessment Module.
To complete an exam, go to www.ascp.org/ajcpcme. Call 800.267.2727 for ASCP Customer Service.
Dvorscak (page 196)
1. Which of the following is usually a peripheral blood smear finding in fulminant
hantavirus cardiopulmonary syndrome?
A.Thrombocytosis
B. Toxic changes in neutrophils
C. Decreased immunoblasts comprising <10% of the lymphocytes present
D. Increased hematocrit
2. Why are rapid screening techniques essential to identify patients at risk for
fulminant hantavirus cardiopulmonary syndrome?
A. US patients are in urban locations where rapid dissemination to others may occur.
B. Hantavirus infection presents with a unique and characteristic prodrome.
C. A specific treatment exists that requires specific diagnosis.
D. The clinical syndrome can be rapidly fatal and refractory to standard intensive
support measures.
4. What is the gold standard for diagnosis of acute hantavirus infection?
A. Peripheral blood smear analysis
B. Immunoblot IgG
C. Immunoblot IgM
D. Quantitative immunoglobulin levels
5. The use of ECMO for hantavirus is most useful for patients with which of the
following?
A.Lymphadenopathy
B. Chronic obstructive pulmonary disease with superimposed acute infection
C. Positive IgG immunoblot results
D. Pulmonary capillary leakage and early thrombocytopenia
3. For a case that fulfills 3 of 5 peripheral blood smear criteria, which of the
following is true?
A. IgG and IgM serologic testing is required before treatment is initiated.
B. The diagnosis of hantavirus cardiopulmonary syndrome is confirmed.
C. The most sensitive single criterion is hemoconcentration.
D. Extracorporeal membrane oxygenation (ECMO) should be initiated.
Mahe (page 202)
1. An obstetrics resident worries that she might be confused regarding the
appropriate terminology and pathologic manifestations of intra-amniotic
infections. Which statement is correct?
A. Maternal pyrexia, tachycardia, and neutrophilia are seen in the context of a fetal
inflammatory response, histologically seen as neutrophilic infiltrates in the placental
membranes.
B. Maternal pyrexia, tachycardia, and neutrophilia are seen in the context of a fetal
inflammatory response, histologically seen as neutrophilic infiltrates in the placental
membranes.
C. Maternal pyrexia, tachycardia, and neutrophilia are seen in the context of a maternal
inflammatory response, histologically seen as neutrophilic infiltrates in the umbilical
cord.
D. Maternal pyrexia, tachycardia, and neutrophilia are seen in the context of a maternal
inflammatory response, histologically seen as neutrophilic infiltrates in the placental
membranes.
2. Regarding intra-amniotic infections, which of the following statements
is most accurate?
A. Intra-amniotic infections are usually from an ascending source and are a frequent
cause of maternal and neonatal mortality.
B. Preterm deliveries are more likely to be affected by intra-amniotic infection than
those at term.
C. Maternal uterine dysfunction is a potential complication of intra-amniotic infection,
as are maternal neurologic sequelae.
D. Current term births complicated by intra-amniotic infection are associated with a
10% neonatal mortality rate.
3. Which statement is accurate regarding the diagnosis of intra-amniotic
inflammation?
A. Histologic evaluation of placental tissues is the gold standard test to confirm or
refute the presence of an intra-amniotic inflammatory response.
B. In the context of intra-amniotic infection, culture techniques remain the gold standard,
especially given the lack of specificity of polymerase chain reaction (PCR) analyses.
C. In the context of intra-amniotic infection, PCR-based techniques should be considered
the gold standard ancillary test, as they are specific for pathogenic microorganisms.
D. Ancillary testing in the context of potential intra-amniotic infection is not recommended, since the sensitivity and specificity of clinical assessments are superior to all
other forms of diagnostic testing.
© American Society for Clinical Pathology
4. A postpartum patient had a recent history of recurrent but otherwise
uncomplicated urinary tract infections. She noted 2 days of increased
discharge prior to her recent scheduled cesarean section and was noted to
have a slight fever perioperatively, without any other changes in her vital
statistics. The baby was born without complications (with APGAR scores of 8
and 8) and, with the exception of tachycardia six hours postdelivery, appeared
well. The neonatologist has a relatively low index of suspicion for intra-amniotic
infection but wishes to reassure the anxious mother that her baby does not
require admission to the neonatal ICU. The placenta remains on hand but was
fragmented upon removal and accidentally dropped on the floor after delivery.
What is the best next step?
A. Culture swab of the placental membranes
B. Collection of placental tissues for PCR analysis for microorganisms
C. Histologic assessment of the umbilical cord and placental membranes for
the presence of inflammation
D. Collection of maternal vaginal discharge postpartum
5. What lines of evidence support the use of the Redline system for
the histopathologic assessment of intra-amniotic infection?
A. The Redline system of histologic assessment is used only to better define
the subjective nature of pathologists’ interpretation of the degree of inflammation.
B. The Redline system of histologic assessment is used for its simplicity and
ease of use by pathologists and pathology assistants.
C. The Redline system correlates histologic findings with the presence of
infectious microorganisms by culture of vaginal effluent.
D. The Redline system reflects the biology of inflammation in the context
of intra-amniotic infection and has been shown to provide prognostic value.
Am J Clin Pathol 2014;142:273-277
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AJCP Journal CME/SAM
The ASCP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The ASCP designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ per article. Physicians should claim only
the credit commensurate with the extent of their participation in the activity. This activity qualifies as an American Board of Pathology Maintenance
of Certification Part II Self-Assessment Module.
To complete an exam, go to www.ascp.org/ajcpcme. Call 800.267.2727 for ASCP Customer Service.
Hammer (page 209)
1. Lymphoplasmacytic cholecystitis (LPC) was first thought to be a specific
finding associated with what disease?
A. Autoimmune pancreatitis
B. Primary sclerosing cholangitis
C.Cholangiocarcinoma
D.Choledocholithiasis
4. The most notable radiologic difference between obstructive and sporadic
LPC is the presence of what?
A. Extrahepatic biliary dilatation
B.Gallstones
C. Pericholecystic fluid
D. Sonographic Murphy sign
2. The typical pattern of inflammation seen with LPC consists of what?
A. Mucosal neutrophils with scattered eosinophils, lymphocytes, and plasma cells
B. Lymphocytic inflammation typically involving the muscular layer
C. Mucosal plasma cells with aggregates of lymphocytes, usually limited to the mucosa
D. Lymphocytes and plasma cells infiltrating the perimuscular arterioles
5. Compared to patients with obstructive LPC, patients with the sporadic form of
LPC are more likely to have which finding?
A. Extrahepatic biliary obstruction
B.Gallstones
C. A pancreatic mass
D. Ulcerative colitis
3. The clinical picture associated with sporadic LPC is what?
A. Middle aged men with fever and leukocytosis
B. Middle aged women with gallstones
C. Men in their 20s to 40s with primary sclerosing cholangitis
D. Asymptomatic middle-aged women
Negri (page 222)
1. What is the rate of women with abnormal cervical smears after bone marrow
transplantation (BMT) in this study?
A.0%-10%
B.10%-25%
C.25%-40%
D.>40%
4. What is the main differential diagnosis of therapy-induced, non-HPV–related
atypia in cervical epithelia after BMT?
A. High-grade lesions and cancer of the cervical epithelia
B. Low-grade lesions of the cervical epithelia
C. Reactive changes
D. Endometrial cancer
2. Which statement is correct regarding the frequency of human papillomavirus
(HPV)–related disease after BMT?
A. This result exceeds the ACGIH biological exposure index for organic arsenic.
A. The frequency is the same as in nontransplanted women.
B. The frequency is lower.
C. The frequency is higher.
D. HPV is not relevant after BMT.
5.The use of ancillary techniques, eg, an HPV test, in the cytologic evaluation of
the cervix uteri after BMT
A. may be useful.
B. is not advisable.
C. is not feasible.
D. is already recommended by the American Society for Blood and Marrow
Transplantation.
3. What is the most important cause of therapy-induced, non-HPV–related
atypia in cervical epithelia after BMT?
A.Radiotherapy
B.Busulfan
C. Depends on the underlying disease
D.Cyclophosphamide
Di Bernardo (page 227)
1. What does Richter transformation (RT) represent?
A. The development of a high-grade lymphoma in the setting of chronic lymphocytic
leukemia (CLL)
B. The development of diffuse large B-cell lymphoma (DLBCL) in the setting of CLL
C. The development of classic Hodgkin lymphoma (cHL) in the setting of CLL
D. The development of composite lymphoma in the setting of CLL
4. RT cases with Hodgkin lymphoma morphology and Epstein-Barr virus
infection may be associated with which of the following?
A. Expression of Zap70
B. Rituximab therapy
C. Cyclophosphamide therapy
D. Fludarabine therapy
2. Which is the most common type of lymphoma observed in RT?
A.cHL
B.DLBCL
C. Anaplastic large cell lymphoma
D. Lymphoblastic leukemia/lymphoma
5. The case discussed exemplifies neoplastic development as an example of
what?
A. Linear neoplastic progression associated with accumulating mutations
B. Microsatellite instability
C. Clonal diversity and selection pressure
D. Histone alterations with epigenetic changes
3. RT cells could derive from what?
A. Transformed CLL/small lymphocytic lymphoma (SLL) cells
B. De novo lymphoma
C. Transformed CLL/SLL cells or de novo lymphoma
D. Myeloid precursors
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© American Society for Clinical Pathology
AJCP Journal CME/SAM
The ASCP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The ASCP designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ per article. Physicians should claim only
the credit commensurate with the extent of their participation in the activity. This activity qualifies as an American Board of Pathology Maintenance
of Certification Part II Self-Assessment Module.
To complete an exam, go to www.ascp.org/ajcpcme. Call 800.267.2727 for ASCP Customer Service.
Abdelhedi (page 248)
1. 9 imprinting disorder characterized by what?
A. Severe intrauterine growth restriction
B. Congenital cardiopathy
C.Microcephaly
D.Hyperglycemia
2. The etiology of SRS is heterogeneous, and most cases are associated with
what?
A. Hypomethylation of the paternally derived differentially methylated region (DMR) on
chromosome 11p15
B. Duplication of maternal chromosomal region 11p15.5
C. Maternal uniparental disomy of chromosome7 [UPD(7)m]
D. Duplication of maternal chromosomal region 7p11.2-p13
4. The phenotype observed in SRS patients with UPD(7)m might result from which of
the following?
A. The existence of UPD(7)m only
B. The presence of mosaic trisomy 7 in peripheral blood lymphocytes
C. The presence of mosaic trisomy 7 in several tissues only
D. Both UPD(7)m and mosaic trisomy 7
5. Trisomy 7 mosaicism is associated with which of the following?
A. Abnormal fetal outcome in most cases
B. Pigmented skin dysplasia, enamel dysplasia, and developmental delay
C. Hypomethylation of maternally derived DMR on chromosome 11q15
D. Hypomethylation of maternally derived DMR on chromosome 11p15
3. Which one of these biological samples is the easiest source for a diagnosis of
trisomy 7 mosaicism by conventional and molecular cytogenetics?
A. Fibroblasts from skin biopsy
B.RBCs
C. Urinary cell pellet
D. Cerebellar cells
Xia (page 261)
1. A 55-year-old woman with type 2 diabetes and diabetic nephropathy
presents to an outpatient clinic, and hemoglobin A1c (Hgb A1c) testing is
ordered. Which of the following is the most accurate statement?
A. The Hgb A1c level will likely overestimate the recent average glucose level.
B. The Hgb A1c level will likely underestimate the recent average glucose level.
C. The Hgb A1c level may not reflect the recent average glucose level.
D. The A1c-derived average glucose (ADAG) equation can reliably be applied to a patient
with this clinical history.
2. A 74 year old woman with a long history of poorly controlled diabetes and
hemolytic anemia was found to have a Hgb A1c of 50 mmol/mol (range, 48-59
mmol/mol). However, the random glucose from the same clinic visit was 13.6
mmol/L (range, 3.9-5.6 mmol/L). The physician considers using glycated albumin
testing as an alternative method for monitoring blood glucose control in this
patient. Which of the following additional lab findings (if true) would most
significantly limit the utility of glycated albumin testing in this patient?
A. Elevated lactate dehydrogenase and low haptoglobin level
B. Nephrotic range proteinuria
C. Low serum iron and elevated transferrin levels
D. Low erythropoietin and low hemoglobin levels
3. A 2-year-old African-American child is diagnosed with sickle cell disease.
In this patient, the RBC half-life is most likely what?
A. Increased because the child is functionally asplenic
B. Normal because of compensatory reticulocytosis
C. Decreased because of compensatory reticulocytosis
D. Decreased because of hemolysis
4. The ADAG equation can be appropriately applied to estimate recent average
glucose in which one of the following patients?
A. A 24-year-old female college student with iron deficiency anemia
B. A 59-year-old diabetic man who had a splenectomy due to a motor vehicle accident
1 year ago
C. A 80-year-old diabetic man who received two units of blood during a partial
colectomy for colon cancer 1 year ago
D. A 74-year-old diabetic woman receiving erythropoietin therapy for the past year
5. What characterizes paroxysmal nocturnal hemoglobinuria?
A. An inherited mutation in a gene coding for a component of the glycolysis pathway
B. Uncontrolled complement-mediated hemolysis
C. Increased hemolysis in the setting of oxidative stress
D. The presence of alloantibodies coating RBCs
Yusuf (page 269)
1. Which of the following statements best describes what microcalorimetry
measures?
A. It measures the rate of temperature change of chemical processes.
B. It measures the heat produced by bacteria’s binary fission.
C. It measures the heat flow of biological processes.
D. It measures the temperature of the exponential phase of the bacterial growth curve.
2. What is the most important limitation of Gram staining in the setting where
rapid detection of the presence of microorganisms is needed?
A. It produces large number of false positives.
B. It has low sensitivity.
C. It has low positive predictive value.
D. It has low specificity.
3. Microcalorimetry is most useful for accurate and rapid diagnosis for timely
treatment in which of the following settings?
A. Where rapid differentiation between infectious and noninfectious causes of
inflammation is important
B. In settings requiring rapid speciation of infectious bacteria
© American Society for Clinical Pathology
C. When it is important to differentiate anaerobic from aerobic bacterial infections
D. In patients who are poor operative candidates
4. In a case of bilateral breast inflammation, how could someone tell from
microcalorimetry that the bacterial load in one breast is probably higher than
another?
A. Earlier time to positivity
B. Higher peak of the heat flow curve
C. Broader width of the peak of the heat flow curve
D. Larger area under the curve of heat flow curve
5. In which way does sonication of breast implants augment isothermal
calorimetry in detecting the presence of infectious microorganisms?
A. By producing a microbubble that acts as a catalase of chemical processes detected by
microcalorimetry
B. By stimulating bacterial binary fission that increases the sensitivity of detection
C. By slowly increasing the temperature of the fluid withdrawn from the breasts, which
subsequently leads to earlier detection
D. By dislodging biofilm from implants providing a higher inoculum and earlier detection
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