Identify the large nucleated cell that is not a typical segmented neutrophil. MEDT A495 Urine Q22.jpg

Based on this India Ink prep of a spinal fluid what is the most probable diagnosis for this patient? MEDT A395 Urine Q16.jpg

Identify the crystal in this acid urine MEDT A395 Urine Q23.jpg

Sediment seen during microscopic urinalysis stains positively with Sudan III stain but does not polarize. This is most likely a:

Urine pH can be modified by all of the following except

A 62-year-old patient with hyperlipoproteinemia has a large amount of protein in his urine. Microscopic exam shows moderate to many fatty, waxy, granular and cellular casts. Many oval fat bodies are also noted. This is most consistent with:

Identify the object indicated by the arrow in this urine sediment. MEDT A395 Urine Q27.jpg

In FPIA, the amount of fluorescence is inversely related to the amount of analyte in the sample. 

You and Jayson Clarke are doing TDM testing. Jayson’s sister, Jaysonella is working today as a phlebotomist.  At 06:00 this morning Jaysonella drew a blood sample from Joe Clark for a Vancomycin Trough (VANT). She brought the specimen back to the Specimen Processing area and put it in the fridge. At 10.00 later this morning Jaysonella went back and drew another blood sample from Joe Clark for a Vancomycin Peak (VANP). She centrifuged both the peak and trough serum tubes, poured them off into 4 mL specimen transfer tubes, put computer barcode labels them, and brought them to Jayson for analysis. Jayson has just performed these two assays and he is ready to verify the results – – – you just happened to look at his work and found: VANT  = 38.3 ug/mL – Critical Value  (Therapeutic Range is 5.0 – 10.0, above 20.0 is Critical)  VANP  = 8.8 ug/mL (Therapeutic Range is 30.0 – 40.0, above 80.0 is Critical) What are you going to tell Jayson regarding verifying those results and calling-in the Critical value?

You and Jayson Clarke are performing assays on your Fusion 5.1 analyzer. You have received a lot of TDM specimens for Tegretol and Dilantin, and you are just about out of reagent slides for these two tests.  You asked Jayson Clarke to go back to the reagent freezers and get another pair of reagent packs of Tegretol and Dilantin slides. Jayson tried to find them, but he came back and said that he couldn’t find any of those slides in any of the freezers. What should you tell Jayson?    (Be nice – – –  just tell him something that will help him find the slides).