2828_FM_i-xvi 21/08/12 2:32 PM Page i Medical Laboratory Science Review Fourth Edition 2828_FM_i-xvi 21/08/12 2:32 PM Page ii Online Resource Center DavisPlus is your online source for a wealth of learning resources and teaching tools, as well as electronic and mobile versions of our products. Visit davisplus.fadavis.com StudentS InStructorS Unlimited free access. Upon Adoption. Sign up today to see what’s Password-protected library of available for your title. title-specific, online course content. Taber’s online resources are now available across many of the DavisPlus resource pages. Look for this icon to find Taber’s resources! explore more online resources from f.a.davis www.drugGuide.com www.Tabers.com www.LabdxTest.com The complete Davis’s Drug Guide The power of Taber’s® Cyclopedic The complete database for Davis’s for Nurses® database with over Medical Dictionary on the web. Comprehensive Handbook of 1,100 monographs on the web. Find more than 60,000 terms, Laboratory and Diagnostic 1,000 images, and more. Tests with Nursing Implications online. Access hundreds of detailed monographs. www.fadavis.com 2828_FM_i-xvi 21/08/12 2:32 PM Page iii Medical Laboratory Science Review Fourth Edition R R. H , , ( ) OBERT ARR MS MLS ASCP Associate Professor of Public and Allied Health Bowling Green State University Bowling Green, Ohio 2828_FM_i-xvi 21/08/12 2:32 PM Page iv F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2013 by F. A. Davis Company Copyright © 2013 by F. A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Senior Acquisitions Editor:Christa Fratantoro Manager of Content Development: George W. Lang Developmental Editor: Dean W. DeChambeau Art and Design Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product infor- mation (package inserts) for changes and new information regarding dose and contraindications before admin- istering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Harr, Robert R. Medical laboratory science review / Robert R. Harr. — 4th ed. p. ; cm. Rev. ed. of: Clinical laboratory science review / [edited by] Robert R. Harr. c2007. Includes bibliographical references. ISBN 978-0-8036-2828-1 — ISBN 0-8036-2828-5 I. Clinical laboratory science review. II. Title. [DNLM: 1. Clinical Laboratory Techniques—Examination Questions. 2. Biomedical Technology— Examination Questions. 3. Chemistry, Clinical—methods—Examination Questions. QY 18.2] 610.72´4—dc23 2012014596 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: / + $.25. 2828_FM_i-xvi 21/08/12 2:32 PM Page v Preface The primary purpose of the Medical Laboratory Science of Certification; and for certification exams sponsored by (MLS) Reviewis to assist candidates who are preparing for the American Medical Technologists (AMT). certification or licensure examinations in clinical labora- The review begins with the Introduction section, which tory science. This review can also be used by those who includes information on the design of the questions, use wish to update their medical laboratory knowledge and of this book to prepare for an examination, and test-taking renew their theoretical skills. In addition, educators in skills. The introductory section is followed by questions medical laboratory science and medical laboratory tech- arranged within 10 content areas. Each area contains a list nician programs may wish to recommend this review as a of references, which are also recommended for further re- study guide for their students as they progress through the view. A mock comprehensive certification examination is curriculum. given at the end of the question sections using questions The MLS Review is designed to facilitate learning. selected from the book. This exam will help the students Unlike other review books, the questions create a progres- to determine their levels of retention and learning from sion of related content. Explanations accompanying each the book. The CD contains a database with over 700 ques- question expand upon the content. The Fourth Edition tions different from those in the book, including over includes 200 new questions for a total of more than 2,250 200 images with accompanying questions. Students can multiple-choice questions grouped into 10 content areas. use the CD program engine to create customized exams Questions appear together with answers, short explana- for specific subjects or exams based upon difficulty. tions, test item classifications, and taxonomy levels. The The materials in the MLS Reviewwere prepared by ed- questions of each section comprise a thorough review of ucators and clinical experts who have national recognition the discipline and are ordered to facilitate the coherent for their accomplishments in medical laboratory science. understanding of the subject. Mock certification exams Materials from recent developments in practice as well as can be created using the accompanying CD to provide major textbooks were used in formulating these questions. additional practice. TheMLS Reviewprovides a rapid and Peer review of the questions was performed as part of the efficient review and self-assessment. It can be used to pre- publication process. The MLS Reviewhas been designed pare for the computer adaptive examinations for medical as an individual guidebook for measuring personal knowl- laboratory scientist (MLS); medical laboratory technician edge and test-taking skills. It should prove to be a valuable (MLT); technologist in blood banking, chemistry, hema- tool for ensuring the success of the student preparing for tology, microbiology, and molecular biology given by the a national certification exam, course exams, or licensure, American Society of Clinical Pathologists (ASCP) Board and for the practitioner updating theoretical skills. v 2828_FM_i-xvi 21/08/12 2:32 PM Page vi 2828_FM_i-xvi 21/08/12 2:32 PM Page vii Reviewers LORRAINE DOUCETTE, MT(ASCP), CLS(NCA) Assistant Professor, Coordinator Medical Laboratory Technician Program School of Health Professions, Wellness and Physical Education Anne Arundel Community College Arnold, Maryland RICHARD H. MILLER, PHD, MBA, MLS(ASCP)CM Former Program Director & Instructor Clinical Laboratory Technology Program Southwest Georgia Technical College Thomasville, Georgia CAMELLIA ST. JOHN, MED, MT(ASCP)SBB Associate Professor Department of Clinical Laboratory Sciences School of Health Professions University of Texas Medical Branch at Galveston Galveston, Texas vii 2828_FM_i-xvi 21/08/12 2:32 PM Page viii 2828_FM_i-xvi 21/08/12 2:32 PM Page ix Contributors THOMAS S. ALEXANDER, PHD, D(ABMLI) ROBERT HARR, MS, MLS(ASCP) Immunologist, Summa Health System Associate Professor Professor of Clinical Immunology Department of Public and Allied Health Northeast Ohio Medical University MLS Program Director Rootstown, Ohio Bowling Green State University Chapter 3 Immunology Bowling Green, Ohio Chapter 5 Clinical Chemistry LYNNE S. GARCIA, MS, CLS, FAAM Chapter 6 Urinalysis and Body Fluids Director, LSG & Associates Chapter 8 Molecular Diagnostics Santa Monica, California Chapter 10 Photomicrographs and Color Plate Chapter 7, Section 7.11 Parasitology Examination DENISE HARMENING, PHD, MT(ASCP) VIRGINIA C. HUGHES, MS, MLS(ASCP)SBB Director of the Online Masters in Clinical Laboratory Assistant Professor and Director Management Medical Laboratory Science Program Adjunct Professor, Department of Medical Laboratory Dixie State College of Utah Sciences St. George, Utah College of Health Sciences Chapter 4 Immunohematology Rush University Chicago, Illinois PAMELLA PHILLIPS, MED, MT(ASCP)SM Chapter 1 Hematology Education Coordinator, Program in Medical Laboratory Science Bowling Green State University Bowling Green, Ohio Chapter 7 Microbiology Chapter 9 Education and Management MITRA TAGHIZADEH, MS, MT(ASCP) Former Assistant Professor (Retired) University of Maryland School of Medicine Baltimore, Maryland Chapter 2 Hemostasis ix