Sally is seeing her new primary care provider for the first time. When she signs in, she is asked to sign papers for the release of medical records, including her laboratory results. According to the Health Insurance Portability and Accountability Act (HIPAA), she must authorize release of records before _______________would be permitted to receive and review her records.

A. Her insurance company

B. All answers are correct

C. Her husband

D. Her attorney

Waived tests are those considered to have an insignificant risk of erroneous results. Which of the following is NOT an example of a waived test?

A. rapid strep tests from throat swabs

B. sodium

C. HIV antibodies

D. prothrombin time

This drawing depicts beta thalassemia minor B+/B. In Beta thalassemia minor B+/B, one beta gene locus is partially deleted or inactive.

Hematology
This drawing depicts which beta chain genotype ?

A. Beta thalassemia minor

B. Beta thalassemia intermedia

C. Beta thalassemia major

D. Delta-beta thalassemia minor

1+ reaction has numerous small clumps and cloudy red supernatant
2+ has many medium-sized clumps and clear supernatant.
3+ has several large clumps and clear supernatant
4+ has one solid clump, no free cells, and clear supernatant
BB
Tube-based agglutination reactions in blood bank are graded from negative (0) to 4+. A reaction that has numerous small clumps in a cloudy, red background is:

A. 1+

B. 2+

C. 3+

D. 4+

Once substance H is developed, the addition of the sugar N-acetylgalactosamine to the terminal position of the chain gives the molecule "A" antigenic activity. Which specific terminal sugar causes a red cell to have A antigenic activity?

A. Galactose plus glucose

B. Galactose

C. N-acetylgalactosamine

D. Glucose

Streptococcus pyogenes is the correct answer. Streptococcus pneumoniae is alphahemolytic which demonstrate a green area of partial hemolysis around the colonies. Staphylococcus aureus will produce complete hemolysis but is catalase positive. Streptococcus agalactiae is beta-hemolytic but only produces a partial clearing of the red blood cells in sheep blood agar.
Complete hemolysis of sheep blood agar as demonstrated by the image below would be seen in which of the following catalase-negative isolates?

A. Streptococcus pneumoniae

B. Streptococcus pyogenes

C. Staphylococcus aureus

D. Streptococcus agalactiae

Blood bank
Once the seal on a unit of packed red cells is broken, how long can the unit be stored refrigerated prior to administration:

A. 4 hours

B. 12 hours

C. 24 hours

D. 48 hours

A blood culture to evaluate septicemia is performed in:

A. microbiology.

B. hematology.

C. urinalysis.

D. toxicology.

Which of the following testing options would be classified as waived testing by CLIA standards?

A. Complete blood count (CBC)

B. PCR testing

C. Blood glucose for home use

D. Microscopic examination for the presence of bacteria

A quality control program is to be set up for the following tests:
Phenylalanine deaminase (PAD)
Indole production
Voges-Proskauer (V-P)
Which pair of stock culture organisms would be MOST suitable to verify the performance of these three tests?

A. vulgaris, Escherichia coli Klebsiella pneumonia, Proteus vulgaris

B. coli, Enterobacter aerogenes

C. aerogenes, K. pneumonia Bacillus anthracis, Yersinia pestis

CAMP is the correct answer because the case is typical of Streptococcus agalactiae(Group B strep). The main presumptive identification test is CAMP. Bile solubility is positive for Streptococcus pneumonia. Coagulase would be positive for Staphylococcus aureus. PYR is positive for Streptococcus pyogenes (Group A strep) which is ruled out by the resistance to bacitracin.
Microbiology
Spinal fluid cultures on a 3-day-old infant revealed beta-hemolytic, Gram-positive cocci occurring in pairs and chains. The organism was catalase-negative and bile esculinnegative. Resistance to 0.04 U disk of bacitracin was noted. The other test necessary to identify this organism is a positive test by:

A. Bile solubility

B. CAMP

C. Coagulase

D. PYR

Which of the following legislation was developed to protect the privacy of all patient information in the health care?

A. Health Insurance Portability and Accountability Act (HIPPA)

B. Occupational Safety and Health Administration (OSHA)

C. Clinical Laboratory Standards Institute (CLSI)

D. Clinical Laboratory Improvement Amendments (CLIA)