AHG must be added immediately after washing to prevent the possibility of a false negative; a false negative can occur in this situation because previously bound globulins may dissociate from red cells, leaving insufficient antibody coating on the red cells to produce a reaction, or free antibody may directly neutralize antiglobulin reagent.
Blood bank
A false-negative reaction while performing the DAT technique may be the result of:

• A. AHG addition delayed for 40 or more minutes
• B. Blood collected in tube containing silicon gel
• C. Saline used for wash stored in glass or metal container
• D. Red cell/AHG tube is over centrifuged

High triglycerides may be caused by disorders such as type 2 diabetes, hypothyroidism, Cushing's sydnrome, liver disease, uremia, dysglobulinemia, nephrotic syndrome, and alcoholism can cause hypertriglyceridemia.
A 46-year old known alcoholic with liver damage is brought in the ER unconscious. One would expect his lipid values to be affected in what way?

• A. Increased
• B. Unaffected by the alcoholism
• C. Normal
• D. Decreased

The correct answer for this question is 1300 mg/dL. The laboratorian performed a 1:4 dilution by adding 0.25 mL (or 250 microliters) of patient sample to 750 microliters of diluent. This creates a total volume of 1000 microliters. So, the patient sample is 250 microliters of the 1000 microliter mixed sample, or a ratio of 1:4.
Therefore, the result given by the chemistry analyzer must be multiplied by a dilution factor of 4. 325 mg/dL x
4 = 1300 mg/dL.
After experiencing extreme fatigue and polyuria, a patient's basic metabolic panel is analyzed in the laboratory. The result of the glucose is too high for the instrument to read. The laboratorian performs a dilution using 0.25 mL of patient sample to 750 microliters of diluent. The result now reads 325 mg/dL. How should the techologist report this patient's glucose result?

• A. 1300 mg/dL
• B. 325 mg/dL
• C. 1625 mg/dL
• D. 975 mg/dL

P. vivax characteristically displays Schuffner's dots and often enlarged RBCs along with brownish granules. P.
vivax can also have 12-24 merozoies in each cell, actually filling the entire RBC. This parasite also has very irreglar shapes often referred to as "Ameboid".
P. falciparum and P. malariae do not display Shuffner's dots, therefore could not be the correct choice.
P. ovale does display Shuffner's dots in all stages, but characteristically has about 8-12 merozoites in rosettes or irregular clusters inside the RBC. Also, P. ovale characteristically shows enlarged, ovoid RBCs with fimbriated edges.
Identify the parasite of a patient with suspected malaria who demonstrates the following findings on a blood smear:
- Enlarged RBCs, some with fine brownish granules
- > 15 parasites in some cells
- Ameboid structures
- Schuffner's dots

• A. Plasmodium vivax
• B. Plasmodium falciparum
• C. Plasmodium ovale
• D. Plasmodium malariae