فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

13 февраля 2024 19:05

سوالات بعدی شامل ایمنی از 46 تا 60 می شود :

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

13 февраля 2024 18:04

سوال 44 :
در صفحه 1339 از تکس داریم :
In most areas, microfilariae circulate in peripheral blood with a nocturnal periodicity that corresponds with feeding activities of the usual vectors—Culex, Aedes, and Anopheles mosquitoes. Of note, infections originating in the South Pacific may be without periodicity, or subperiodic. The microfilariae are sheathed, although this may not always be obvious with Giemsa staining, in which the sheath may appear only as a negative outline. However, a hematoxylin stain will stain the sheath and allow for its ready identification (Mathison et al., 2019). The tail is pointed, and no nuclei are present in the tip. The cephalic space is not as long as it is wide, and the nuclei in the nuclear column are distinct (Figs. 65.22B and 65.23). Concentration procedures may be necessary for recovery because microfilariae may be present in small numbers.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

13 февраля 2024 17:55

در صفحه 1343 داریم :
Echinococcus vogeli produces a polycystic hydatid cyst in humans that is invasive but, unlike E. multilocularis, produces both brood capsules and protoscoleces. The disease is limited to▶️ Latin America, where rodents, specifically the paca, and bush dogs complete the life cycle (D’Alessandro et al., 1979). Polycystic hydatid disease in South America may also be caused by E. oligarthrus, a parasite of felids and rodents. This species is similar morphologically to E. vogeli and cases have been misidentified (D’Alessandro et al., 1995). Treatment is not well defined for infection with these species.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

09 февраля 2024 11:34

Dipylidium caninum
Dipylidium caninum is a common tapeworm of dogs and cats in most parts of the world that not infrequently infects humans, especially children Detection is based on the finding of characteristic eggs, egg packets, or proglottids in the feces. The proglottids are rather hardy and are usually passed intact. As such, eggs or egg packets are less commonly detected in O&P examinations but can usually be expressed from proglottids in the laboratory. Spherical eggs, each containing a six-hooked embryo, measure from 24 to 40 μm in diameter and occur singly or in packets (Fig. 64.18D). The scolex is somewhat elongate, with four suckers and a small, retractable rostellum. Proglottids are barrel shaped and possess two genital pores, one on each lateral margin, which give rise to the common name double-pored tapeworm (see Fig. 65.19). They are commonly likened to a “grain of rice” or “cucumber seed” when seen intact in stool (Fig. 65.18G). Because they are often motile when passed, they are commonly noted by the child’s caregiver.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

09 февраля 2024 11:28

در صفحه 1303 از کتاب تکس 2022 داریم :
Therapy and prophylaxis of malaria have become highly complex topics because of the widespread appearance of resistance by P. falciparum to chloroquine and other antimalarials and, to a lesser extent, resistance by P. vivax to chloroquine. Artemisinin combination therapy is now recognized as the preferred treatment by the WHO for treatment of P. falciparum infection and chloroquine-resistant P. vivax infection (WHO, 2018). Persons with P. vivax or P. ovale malaria should receive treatment with primaquine phosphate or tafenoquine in addition to standard primary treatment in order to eradicate hepatic hypnozoites and to prevent relapse. Use of primaquine or tafenoquine may be dangerous in patients who have G6PD deficiency.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

09 февраля 2024 11:10

در صفحه 1347 میخوانیم :

Bed Bugs and Kissing Bugs
...
Kissing bugs (Triatoma, Rhodnius, Panstrongylus) have a cone-shaped head on a narrow neck and an abdomen that is widened in the middle. These insects are black or brown, and some have orange and black markings on the abdomen. They average 1 to 3 cm in length and, unlike bedbugs, have well-developed wings for flight. Similar to bedbugs, kissing bugs are relatively painless feeders on vertebrates and produce similar skin reactions. In Mexico and Central and South America, they transmit the agent of Chagas disease, T. cruzi, in the feces, which is secondarily inoculated into the skin by the human host while scratching (

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

08 февраля 2024 13:13

در صفحه 1312 تکس هنری 2022 داریم :
Cutaneous leishmaniasis of the New World is caused by many species, including Leishmania mexicana, Leishmania braziliensis, Leishmania amazonensis, Leishmania venezuelensis, Leishmania peruviana, Leishmania panamensis, and Leishmania guyanensis, among others (Bruckner & Labarca 2019). Lesions produced by L. mexicana often involve the earlobe (Chiclero ulcer), are self-limiting, and are not known to metastasize to the mucosa. However, L. mexicana and L. amazonensis may produce diffuse cutaneous lesions similar to those produced by L. aethiopica.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

08 февраля 2024 13:06

در صفحه 1296 تکس هنری میخوانیم :
Iron Hematoxylin Stain.
The traditional iron hematoxylin stains are technically more difficult to perform than the trichrome stain; thus, they are becoming increasingly rare in the United States. However, results
generally are superior owing to enhanced definition of key nuclear and cytoplasmic characteristics, and most of the original descriptions of protozoan morphology are based on slides stained by these methods. A modified iron hematoxylin stain that incorporates carbol fuchsin has been described, which allows concurrent staining of acid-fast organisms such as Cryptosporidium, Cyclospora, and Cystoisospora (Garcia, 2010, 2016; Garcia et al., 2018). Specimens fixed in Schaudinn, PVA, or SAF fixative may be stained with iron hematoxylin stains (the preferred stain for SAF).
Modified Acid-FastStains.
Oocysts of Cryptosporidium, Cyclospora, and Cystoisospora are difficult to recognize on concentrated wet preparations, trichrome-or iron hematoxylin–stained smears, but their presence may be detected by using an acid-fast staining technique such as the modified Kinyoun method, modified acid-fast dimethyl sulfoxide, or auramine-O or staining with safranin (hot method) (Cama & Mathison, 2015). Acid-fast stains are sensitive and cost-effective for detection of these protozoa, but they lack specificity. Close attention must be paid to defined morphologic criteria when these stains are used, and the use of positive control material is mandatory. For laboratories in which Cryptosporidium is rarely encountered, use of the highly specific and sensitive commercially available immunoassay reagents is recommended. Stool, sputa, biliary tract, and other appropriate specimens that are fresh, formalin fixed, or SAF fixed may be used with acid-fast
stains.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

05 февраля 2024 12:16

قسمت بعد سوالات 16 تا 30 درس انگل‌ شناسی‌

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

05 февраля 2024 12:06

٣٠- Regarding the contents of your reference book for this exam, which of the following (whether scientifically or grammatically) is correct?

A) . No universally accepted guidelines indicates which assays should had critical values, what the thresholds should be, and what is acceptable time from result availability to caregiver’s notifcation.

B) There are many universal agreements regarding the types of caregivers (e.g., physician, physician assistant, registered nurse, etc.) who fulfill these defnitives.

C) It is generally established that critical values must be called in to a caregiver who has the ability to act on the information.

D) A critical value (also known as panic values) is a laboratory result that may represent a life- threatening situations.

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

05 февраля 2024 12:00

پاسخ سوال 28 :
در BOX 1.7 : امسال از این جدول دو سوال طراحی شد سوال 18 و 28
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

05 февраля 2024 11:54

پاسخ سوال 26 :
هر چند این سوال میتواند گزینه صحیحی نداشته باشد ولی از سوی وزارت بهداشت گزینه ج صحیح اعلان شده است
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

04 февраля 2024 13:47

پاسخ سوال 24 : در صصفحه 106 کتاب در TABLE 9.2

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

04 февраля 2024 13:36

پاسخ سوال 22 :
همانطور که در صفحه 5 کتاب تکس 2022 میخوانیم :
قسمت reports ها در 6 سیگما قرار ندارد
این سوال یکی از پرتکرارترین سوالات چند دوره اخیر بوده است .
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

01 февраля 2024 17:54

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

13 февраля 2024 18:35

در صفحه 1342 میخوانیم :

The diagnosis is suggested on the basis of clinical presentation and history plus the use of radiography, CT scans, and ultrasonography. Serologic tests are very useful in confirming a diagnosis and usually involve a screening test such as EIA or IHA followed, if positive, by a confirmatory assay such as immunoblot or gel diffusion
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

13 февраля 2024 17:59

در صفحه 1330 از کتاب تکس هنری 2022 داریم :
immediately to the clinical team (Sheorey et al., 2019).
Examination of duodenal aspirates or ▶️ string test specimens may be helpful in suspicious cases in which routine stool examinations are nonproductive, although they are not commonly used. The agar culture method (see Fig. 65.3) or one of the coproculture techniques (see the Laboratory Methods section earlier in the chapter) may also demonstrate the infection and provide highest sensitivity for detection of S. stercoralis from fecal specimens (Ash & Orihel, 2007; Garcia, 2016). Serologic tests are useful when infection is suspected but cannot be demonstrated by other methods; they are also useful for detecting evidence of prior infection. EIA and other tests display good sensitivity and specificity, although cross-reactions may appear with filariasis and some other nematode infections. These tests generally do not differentiate between past and current infection but may be useful in monitoring therapy (Wilkins & Nutman, 2015).
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

13 февраля 2024 17:50

در صفحه 1338 بخش انگل شناسی هنری 2022 میخوانیم :
Schistosoma intercalatum and S. guineensis
These species occur in parts of central and western Africa and produce intestinal schistosomiasis. Schistosoma guineensis (formerly the “Lower Guinea strain” of S. intercalatum) occurs generally in central and western Africa while S. intercalatum proper (formerly the Zaire strain) is endemic to the Democratic Republic of the Congo. Eggs have a ▶️terminal spine, resembling those of S. haematobium, but they occur primarily in the feces and are larger (140–240 μm by 50–85 μm) (Webster et al., 2006).
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

09 февраля 2024 11:32

در صفحه 1328 از کتاب تکس هنری 2022 داریم :
Although adult hookworms can be differentiated on the basis of their mouthparts and the copulatory bursa in males, eggs of human hookworms are indistinguishable. In direct wet mounts, egg counts of fewer than five eggs per coverslip denote light infection that is unlikely to result in anemia, whereas more than 25 eggs per coverslip denotes heavy infection that is likely to be associated with symptoms.

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

09 февраля 2024 11:25

پاسخ سوال 37 : در صفحه 1309 از کتاب تکس هنری 2022 داریم
.. . Babesia parasites multiply in erythrocytes by binary fission, producing morphologically indistinguishable trophozoites and gametes. Although trophozoites of many species may be highly variable in size and shape, those of B. microti usually appear as delicate ring forms that may be easily confused with those of malarial parasites, especially P. falciparum (see Fig. 65.6C) (Westblade et al., 2017). Babesia can be differentiated from those of malarial parasites by1️⃣ the presence of a tetrad (Maltese cross) formation of the merozoites and the absence of large ameboid trophozoites and morphologically distinguishable gametocytes; extracellular forms may be seen in heavy infections. Also, Babesia species usually have a heterogeneous appearance with round, oval, spindled, and “racket” forms coexisting on the same peripheral blood smear. Finally, Babesia-infected 2️⃣ cells lack hemozoin pigment, which is present in Plasmodium-infected cells. History of residence in or travel to endemic areas, or of a recent tick bite, might suggest Babesia infection. NAATs for Babesia species are available from the CDC on referral from state health departments and from some commercial laboratories. Serologic tests (e.g., IFA) may also be available but are generally not useful for detection of acute disease. However, they may be useful for screening blood donors in endemic settings. Serology tests for malaria are negative in babesiosis, although patients with malaria may cross-react in the Babesia serologies
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

08 февраля 2024 13:17

در صفحه 1325 تکس هنری 2022 داریم :
Sarcocystis spp.
Sarcocystis spp. are two-host coccidians in which the sexual phase develops in the intestinal mucosa of carnivorous animals and the asexual, extraintestinal phase occurs in the muscles and tissues of various intermediate hosts. Humans may serve as definitive or intermediate hosts depending on the species of Sarcocystis. Intestinal infection with Sarcocystis hominis and Sarcocystis suihominis is acquired by the ingestion of raw or incompletely
cooked beef or pork, respectively, which contains tissue cysts (sarcocysts). Infection usually is asymptomatic, but occasional patients have transient Figure 65.13—cont’d G, Oocyst of C. cayetanensis demonstrating autofluorescence (400×). H, Oocyst of C. belli demonstrating autofluorescence (400×). I, Oocyst of Sarcocystis spp. demonstrating autofluorescence. Note that sporocysts glow but the oocyst wall does not (400×). (G-I courtesy of Henry S. Bishop, DPDx Team, Centers for Disease Control and Prevention, Atlanta, GA.) diarrhea, abdominal pain, or anorexia. Intestinal infection is self-limited because asexual multiplication occurs in the intermediate host and is not repeated in the definitive host. Treatment is not routinely recommended (Drugs for Parasitic Infections, 2013). The diagnosis of intestinal infection is established by detection of sporulated 25 × 33 μm oocysts in stool; detection can be enhanced by using IV autofluorescence (Fig. 65.13I). Each mature oocyst contains two sporocysts, each of which contains four sporozoites. The oocyst wall is thin and often is not detectable, or has already ruptured, releasing the two sporocysts. These forms, best seen in wet mounts, appear larger than oocysts of Cryptosporidium. Trichrome stains are of little value in detecting these parasites. Humans also may serve as intermediate hosts for several unnamed animal species of Sarcocystis, in which cysts are found in skeletal and cardiac muscles (Fayer et al., 2015).
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

08 февраля 2024 13:10

پاسخ این سوال در صفحه 1301 تکس هنری 2022 است : TABLE 65.6
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

08 февраля 2024 13:00

در صفحه 1315 تکس هنر 2022 میخوانیم :
INTESTINAL AMEBAE
Three genera of amebae inhabit the intestinal tract of humans: Entamoeba, Endolimax, and Iodamoeba. Cysts are ingested and excyst in the small intestine. Resulting trophozoites proliferate by binary fission in the lumen of the colon. Both cysts and trophozoites may be passed in feces, but only mature cysts are infective. Entamoeba histolytica is the only ameba in which the trophozoites can invade tissues and cause clinical disease. The genus Entamoeba, characterized by the presence of chromatin on the nuclear membrane, includes E. histolytica, the etiologic agent of amebiasis; E. dispar, a nonpathogenic species morphologically identical to E. histolytica; E. hartmanni and E. coli, two commensal species; and Entamoeba polecki, which is occasionally found in people who have contact with pigs or primates (Fig. 65.10) (Ash & Orihel, 2007). More recently, E. moshkovskii and E. bangladeshi have also been identified in human stool specimens and are morphologically indistinguishable from E. histolytica. Their potential pathogenicity is unknown at this writing. Entamoeba gingivalis, which does not have a known cyst stage, inhabits the oral cavity of people with poor oral hygiene (Ash & Orihel, 2007). Entamoeba polecki (Fig. 65.10F), E. moshkovskii, E. bangladeshi, and E. gingivalis are seen infrequently and are not described further. Endolimax nana and I. buetschlii are nonpathogenic species. Dientamoeba fragilis is recognized as a flagellate, although it lacks external flagella, and is discussed with the flagellates in the text but may be found with amebae in tables and figures because it is morphologically similar to them (Garcia, 2016).
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

05 февраля 2024 12:10

پاسخ سوال 30 : تک تک گزینه ها در متن علامت گذاری شده است :
صفحه 90 تکس هنری 2022 :
ASSESSMENT OF CLINICAL SIGNIFICANCE
OF RESULTS
CRITICAL VALUES
4️⃣ critical value (also known as a panic value) is a laboratory result that may represent a life-threatening situation that may not otherwise be readily detectable. It must be reported immediately to a health care provider who can provide necessary medical interventions. Federal law, regulatory agencies, and The Joint Commission require rapid communication of such results; it is one of the most common, recurring Joint Commission Laboratory National Patient Safety Goals (The Joint Commission, 2019). To be sure that results are correctly communicated, regulations require the health care provider to read back the critical value and the patient name. The laboratory then has to document the event, including the name and title of the caregiver who is notified, the time and date of notification, and the read-back by the care provider.1️⃣ No universally accepted guidelines indicate which assays should have critical values, what the thresholds should be, whether critical values should be repeated before reporting, and what is an acceptable time from result availability to caregiver notification. Although it is generally established that 3️⃣critical values must be called in to a caregiver who has the ability to act on the information,2️⃣ there is no universal agreement regarding the types of caregivers (e.g., physician assistant, registered nurse) who fulfill this definition. This has caused significant variation in procedures related to critical values at different institutions. It is ultimately the responsibility of the medical director of the laboratory to work with clinical colleagues to develop a critical values policy that meets the needs of patients and staff served by the laboratory.

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

05 февраля 2024 12:03

سوال 29 :
صفحه 11 تکس BOX 1.8
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

05 февраля 2024 11:58

پاسخ سوال 27 :
دقت کنید که این جدول TABLE 1.3 در همه سال های ازمون ورودی و پایان دوره ، همیشه نظر طراحان سوال را به خود جلب کرده است و سوالات زیادی از آن طراحی شده است.

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

04 февраля 2024 13:58

پاسخ سوال 25 "
در صفحه 134 تکس :
ESTABLISHING QUALITY CONTROL TARGET VALUE AND STANDARD DEVIATION THAT REPRESENT A STABLE MEASUREMENT OPERATING CONDITION
page 134 : .... The generally accepted protocol for target value assignment is to use the mean value from measuring a QC material a minimum of 10 times on 10 different days (CLSI, 2015a). If a 10-day protocol is not possible—for example, if an emergency replacement lot of QC material is necessary—a provisional target value can be established with fewer data but should be updated as additional results are available

page 135 : A minimum of 20 observations is recommended for an initial estimate of SD (CLSI, 2015a). It is desirable to have as many of the events that contribute to measurement variability, in particular calibration and maintenance, included during the time interval over which the SD is estimated.
The initial estimate of SD will not include contributions from all expected sources of variability in Table 11.1 and will need to be updated when additional data are available.
page 135: illustrates (with data for a glucose method) the fluctuation in SD that occurs when calculated for monthly intervals compared with the relatively stable value observed for the cumulative SD after a period of 6 months . Note that the cumulative SD is not the average of the monthly values but is the SD determined from all individual results obtained over a time interval since the lot of QC material was first used.

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

04 февраля 2024 13:40

پاسخ سوال 23 :
در box 1.1 صفحه 3 از کتاب تکس هنری دیویدسون 2022
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

04 февраля 2024 13:33

پاسخ سوال 21: همان طور که در صفحه 175 کتاب تکس هنری دیویدسون در box 14.1 میخوانیم :
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

01 февраля 2024 15:26

پاسخ سوال 20 براحتی با حذف گزینه های اشتباه به پاسخ صحیح می رسیم
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