American Society for Clinical Pathology

2006 Resident In-Service Examination

Item Descriptors

Anatomical Pathology
CYTOPATHOLOGY
1) Pleural cavity fluid; idiopathic cause
2) Pleural cavity fluid; interpret reactive mesothelial cells
3) CSF plasma cells; multiple sclerosis
4) Recognition of signet ring carcinoma in a body fluid
5) Sputum cytology; asbestos exposure
6) Cervicovaginal smear; diagnose low-grade squamous intraepithelial lesion
7) Thyroid, fine-needle aspiration; identify specimen sampling error
8) Neck nodule; diagnose epidermal inclusion cyst from Papanicolaou stain
9) Fine-needle aspiration of thyroid nodule; diagnose papillary carcinoma
10) FNA thyroid nodule; high-grade transitional cell carcinoma
11) Left parotid mass; identify adenoid cystic carcinoma
12) Fine-needle aspirate, breast mass; identify fibroadenoma
13) Fine-needle aspirate, breast mass; identify lobular carcinoma
14) Fine-needle aspirate, liver mass; metastatic carcinoid tumor
15) Fine-needle aspirate from liver mass; diagnose hepatocellular carcinoma
16) Neck mass smear, Diff-Quik stain; diagnose lymphoma
17) Pancreatic lesion smear; interpret reactive / reparative epithelium
18) Pancreatic head lesion fine-needle aspirate; interpret adenocarcinoma
19) Fine-needle aspiration, left parotid mass; interpret pleomorphic adenoma
20) DELETED
21) Identification of lymphocytic thyroiditis
22) Lung fine-needle aspirate; positive markers for chordoma
23) Fine-needle aspirate lung; diagnose adenocarcinoma of the colon
24) Pelvic washing; interpret adenocarcinoma of the ovary
25) Uterine cervix smear; identify atrophy
26) Cervical smear; identify benign cellular changes
27) Cervical smear; identify high-grade squamous intraepithelial lesion
28) Cervical Pap smear; identify Trichomonas
29) Cervical cases; legality of reporting of informational notes
30) Identification of cytomegalovirus
31) Cytologic description of ciliocytophthoria
32) Cytologic finding sputum; diagnosis well-differentiated squamous cell carcinoma
33) Appropriate sites for fine-needle aspiration
34) Sputum smear, Papanicolaou stain; interpret pollen
35) Identification of Curschmann spirals
36) Sputum; identify poorly differentiated small cell carcinoma
37) Urine Papanicolaou stain; diagnose high-grade carcinoma
38) Identify urinary cholesterol crystals
39) Cytologic findings; malacoplakia
40) Cells associated with catheterized neobladder urine
41) Urine; diagnose polyomavirus

FORENSIC PATHOLOGY
42) Munchausen syndrome by proxy; illness produced by that child’s caregiver
43) Identify causes of subdural hemorrhage
44) Identify scalp; laceration
45) Identify brain injury; fall backward from a standing position
46) Manner of death
47) Impact injury with a sharp-edged object; incision
48) Incised wound of the neck; lung findings
49) Multiple pinpoint marks around the wounds; stipple marks, impact with gunpowder
50) Gunshot wound of entrance; identify
51) Define adipocere
52) Identify cerebral contusion from fixed brain
53) Drowning deaths; diagnosis of exclusion
54) Fire-related death findings artifact; epidural hemorrhage
55) Electrical injury; identify
56) Hypothermia; lesions of the gastric mucosa
57) Identify petechiae; lower eyelid
58) Patau syndrome (trisomy 13); facial effects
59) Acute subarachnoid hemorrhage; identify
60) Medical artifact; medical intervention
61) Cause of death on a death certificate
American Society for Clinical Pathology
2006 Resident In-Service Examination
Item Descriptors

62) Identify severe chronic obstructive pulmonary disease

63) Identify pulmonary foreign-body granulomas from forearm
64) Sudden infant death syndrome; 2-4 months
65) Identify mural thrombus; heart chamber
66) Postmortem decomposition
67) 6-monoacetylmorphine; antemortum use of heroin
68) Vitreous fluid; hyperglycemia

SURGICAL PATHOLOGY
69) Stomach biopsy; recognizing metastatic lobular carcinoma
70) Staging
71) Pancreatic mucinous cystic neoplasm
72) Stomach, identification of gastrointestinal stromal tumor
73) Pancreatic intraepithelial neoplasia; express MUC1, MUC5AC, and MUC6
74) Recognition of sessile serrated adenoma
75) Recognition of normal colonic mucosa
76) Recognition of appendiceal mucinous tumor
77) Rheumatoid nodule; identify
78) Chondroblastoma; characteristics
79) Common malignant tumor of bone in adults; metastatic carcinoma
80) Identify; chondroblastic variant of osteosarcoma
81) Intraductal papilloma; diagnosis
82) Ductal hyperplasis of the breast; risk for invasive carcinoma
83) Prognostic factor for invasive breast carcinoma; axillary lymph node
84) Inflammatory breast carcinoma; characteristics
85) Describe breast tubular carcinoma; fine-needle aspirate of breast
86) Breast lobular neoplasia; characteristics
87) Micromedullary carcinoma; identification from thyroid nodule
88) Wermer syndrome; hyperparathyroidism due to multigland hyperplasia
89) Pheochromocytoma; identification
90) DELETED
91) Surface epithelial tumor of the ovary; serous tumors
92) Recognition of adenomatoid tumor
93) Distinction between endometrial and endocervical carcinoma
94) Identification of dysgerminoma
95) Lesions positive immunohistochemistry; alpha-methylacyl-CoA racemase(P504S)
96) Immunohistochemistry of germ cell tumors
97) Prostatic nodular hyperplasia; testerone dihydrotestosterone (DHT)
98) Metaplastic changes in the bladder
99) Xanthogranulomatous pyelonephritis; identify
100) Identification of low-grade papillary bladder cancer
101) Identification of radicular cyst
102) Myospherulosis; characteristics
103) HPV 6 and 11; recurrent respiratory papillomatosis
104) Common site of occurrence of polymorphous low-grade adenocarcinoma
105) Paraganglioma; characteristics
106) Identification and characteristics of mucoepidermoid carcinoma
107) Recognition of primary biliary cirrhosis
108) Liver disease; toxin overexposure
109) Fibrolamellar variant of HCC; chronic infection with hepatitis B risk factor
110) Liver biopsy; Mallory bodies
111) Identification of toxoplasma
112) Features of polyarteritis nodosa
113) Metastatic carcinoma, myelophthisic anemia
114) Cancer staging
115) Conditions associated with Paget disease
116) CD117/c-Kit antibodies; melanoma and fibromatosis
117) Positive immunostaining for S100 protein; distinguishing neoplasms
118) Meningioma; epithelial membrane antigen immunoreactivity
119) Chromosomal abnormalities of oligodendroglioma
120) Verocay body; characteristics
121) Ependymoma; identification
122) Identification of pulmonary hamartoma
123) Nonspecific interstitial pneumonia; characteristics
124) Distribution of sarcoidosis
American Society for Clinical Pathology
2006 Resident In-Service Examination
Item Descriptors

125) Identification of carcinoid tumor

126) Scalp lesion; lymphoepithelioma- like carcinoma
127) Identification of angiofibroma
128) Vacuolar interface change; lupus erythematosis, erythema multiforme
129) Lichen sclerosus; vulvar plaque identification
130) Lymph node metastases; epithelioid sarcoma
131) Myxoid liposarcoma; characteristics
132) Identification of nodular fasciitis
133) Staining C4d in kidney peritubular capillaries; acute humoral rejection
134) Collapsing variant of FSGS; HIV infection
Clinical Pathology
CLINICAL CHEMISTRY
135) Diagnose diabetes mellitus; best approach
136) Cocaine metabolite; benzoylecognine
137) Methyl alcohol and ethylene glycol poisoning; antidote
138) Chemical reaction; nonenzymatic glycation of proteins
139) DELETED
140) Copper as a trace element; function
141) Gilbert syndrome; chemical pathology
142) Ethylene glycol; chemical pathology
143) TSH, T3 , and T4; result interpretation
144) Acute porphyria; spot urine porphobilinogen
145) Soluble transferrin receptor; chemnical pathology
146) Methanol ingestion; formate formation
147) Troponin I and T; differences
148) Hyponatremia; correlation with triglycerides
149) Pituitary tumor; prolactin high-dose hook effect
150) Anorexia nervosa; hypokalemia
151) Germ cell tumors; monitor with lactate dehydrogenase
152) B-type natriuretic peptide (BNP); clinical characteristics
153) Aminotransferases; clinical significance
154) DELETED
155) Hodgkin lymphoma; membranous glomerulonephritis
156) Drug testing; opiates
157) Drug testing; opiates
158) Major intracellular cation; K+
159) Transthyretin; nutritional status
160) Methanol ingestion; serum osmole gap
161) Know highest protein content in lipid fractions
162) Statistical graphs; comparing two distributions
163) Monitor cholesterol therapy; LDL cholesterol
164) Differences between NT-proBNP and BNP
165) Bland-Altman plots; variables used to compare two methods
166) DELETED
167) Linearity graphs; interpretation
168) Calibration verification; linearity
169) Coefficient of variation; definition
170) Serum compared to plasma; chemistry results
171) Direct bilirubin; Dubin-Johnson syndrome
172) Alcoholic hepatitis; interpretion of chemistry results
173) Hormone assay falsely elevated; heterophile antibody interference
174) Screening of newborns for genetic disease; tandem mass spectrometry
175) Direct LDL; clinical usefulness with triglycerides
176) Vitamin B12 deficiency; serum methylmalonic acid
177) Transferrin; calculate percent saturation
178) Iron overdose; child
179) Immunosuppressive drug, 6-mercaptopurine (6-MP); metabolism
180) Pheochromocytoma; diagnostic tests

HEMATOPATHOLOGY
181) PTT and mixing studies; factor VIII inhibitor
182) Abnormal coagulation profile; workup
183) Laboratory screening tests of coagulation
184) Anticoagulation
American Society for Clinical Pathology
2006 Resident In-Service Examination
Item Descriptors

185) Disseminated intravascular coagulation

186) Diagnose dysfibrinogenemia in cirrhotic patient
187) DELETED
188) Coagulation testing; blood sample
189) Factor XII; clinical presentation
190) Subtype of von Willebrand disease; interpretation of a multimer analysis
191) Automated cell counters; falsely low platelet count
192) Falsely high automated platelet counts; spurious automated cell counts
193) Hemoglobinuria; diagnostic laboratory tests
194) Chronic lymphocytic leukemia; identify good prognostic features
195) Mantle cell lymphoma versus chronic lymphocytic leukemia (CLL)
196) Hereditary spherocytosis; osmotic fragility
197) Cold agglutinins; technique to obtain valid red blood cell parameters
198) Type IIB von Willebrand disease; diagnostic tests
199) Morphologic and immunophenotyping features of leukemias
200) Chronic myelomonocytic leukemia; absolute monocytosis, dysplasia, blasts
201) Anemia workup
202) Hemolytic anemia; schistocytes
203) Peripheral smear, positive iron stain; identify red blood cell inclusions
204) TTP, blood
205) Human ehrlichiosis
206) Acute myeloid leukemia (AML) with 11q23
207) Hairy cell leukemia (HCL), immunophenotype
208) International Prognostic Scoring Index for Myelodysplastic Syndromes
209) 5q-syndrome; associated characteristics
210) Chronic myelogenous leukemia; clinical history
211) Bone marrow aspirate; Gaucher disease
212) Acute promyelocytic leukemia (APL), cytochemistry
213) Russell bodies
214) Ringed sideroblasts; iron stain
215) Ringed sideroblasts; drug-induced
216) Lymph node biopsy; positive markers for classical Hodgkin lymphoma
217) Marginal zone lymphoma
218) Follicular lymphoma
219) Classical Hodgkin lymphoma; phenotype
220) Castleman disease
221) Chronic idiopathic myelofibrosis; characteristics

MICROBIOLOGY
222) Aspergillus glactomannan enzymatic immunoassay; false-positive
223) Disseminated Mycobacterium avium complex; antibiotic treatment
224) Methicillin-resistant Staphylococcus aureus; vancomycin
225) Vibrio cholerae; growth characteristics
226) Pseudomonas aeruginosa; growth characteristics
227) Skin lesions for mycobacterial culture; use of chocolate agar
228) Identify Proteus mirabilis; agar plate
229) General clinical microbiology
230) Gram stain; reagent effects
231) Gram stain; methanol
232) Antimicrobial susceptibility testing; Mueller Hinton broth lysed horse blood
233) Soft tissue mass; identification of Actinomyces
234) Media used for stool cultures
235) Organisms with extended-spectrum beta-lactamases
236) Klebsiella pneumoniae; extended-spectrum beta lactamase
237) Yersinia pestis; etiology
238) DELETED
239) Pasteurella multocida; laboratory identification
240) Clostridium perfringens, laboratory identification
241) Mycobacterium fortuitum; clinical characteristics
242) Mycobacterium marinum ; growth characteristics
243) Pneumonia; empiric antimicrobial therapy
244) Human papillomavirus (HPV); clinical pathology
245) Borrelia burgdorferi; antibody development
246) Virus detection; rapid shell vial culture
247) Rapid RSV antigen tests; procedure to increase sensitivity
American Society for Clinical Pathology
2006 Resident In-Service Examination
Item Descriptors

248) Isolation of cytomegalovirus (CMV); cell culture type

249) Hepatitis C virus infection; CDC diagnosis guidelines
250) DELETED
251) Anaerobic abscess culture; method of collection
252) Mycobacterium tuberculosis; transmission route
253) Streptococcus agalacticae; infant meningitis
254) Cerebrospinal fluid bacterial meningitis; clinical findings
255) Acute uncomplicated cystitis; most common cause
256) Stool assay; post-antibiotic diarrhea
257) Yeasts; resistant to fluconazole
258) Inhibitory mould agar; chloramphenicol
259) Coccidioides immitis, pulmonary disease geographical
260) Yeast cells in cytoplasm macrophages and histiocytes; Histoplasma capsulatum
261) Penicillium marneffei; etiology
262) Toxoplasma IgM by indirect fluorescent antibody positive; follow-up
263) Strongyloides larva; clinical symptoms and indentification
264) Entamoeba histolytica; characteristics
265) Plasmodium falciparum; sub-Saharan Africa
266) Toxoplasmosis; clinical characteristics
267) Anisakiasis; clinical characteristics
268) Cutaneous myiasis with human botfly larva; identification

TRANSFUSION MEDICINE
269) Antibody identifications; Donath-Landsteiner test
270) Parvovirus B19–related blood group antigen; P
271) Blood group phenotype; resistant to lysis by 2M urea
272) D-positive; production of allo-anti-D
273) Blood group substances; sources
274) Passive maternal antibody from mom; neonate antibody screen positive
275) Patient death during transfusion; timing of FDA notification
276) Antibody panel; interpretation
277) Antibody panel; interpretation check and control cells
278) Red cell panels treated with proteolytic enzymes; actions
279) H antigen; blood groups
280) Red cell phenotypes; corresponding morphological abnormalities
281) Alloantibody to E antigen; crossmatch compatibility
282) Emergency uncrossmatched blood transfusion; group and type selection
283) Common Rh phenotype; white population
284) Autologous blood donors; reasons for deferral
285) Allogeneic whole blood donor; blood pressure
286) Donor requirements; interval
287) Donor deferal; CJD risk
288) Transfusion procedural error; regulatory reporting
289) Rh immune globulin therapy; idiopathic thrombocytopenic purpura
290) Cryosupernatant plasma; factors depleted
291) Paternity tests; ABO, H
292) Transfusion practices; therapeutic plasma exchange with Fresh Frozen Plasma
293) Hematopoietic stem cell allograft; transfusion ABO type selection
294) Cytomegalovirus leukoreduction
295) Recombinant factor VIIa; indicated uses
296) Platelet alloimmunization
297) Plasma volume plasma exchange; 5% albumin
298) Shelf life of RBC, adenine saline (AS) Added
299) Transfusion circulatory overload and transfusion-related acute lung injury
300) Graft versus host disease
301) Transfusion-associated graft versus host disease; prevention
302) Autologous transfusion; testing required
303) Red cell transfusion; delayed hemolytic transfusion reaction
304) Directed donations; irradiation
305) Plasma products; expiration
306) Cryoprecipitate; minimum factor
307) Nucleic acid testing; infectious agents
American Society for Clinical Pathology
2006 Resident In-Service Examination
Item Descriptors

Special Topics
IMMUNOPATHOLOGY
308) Rheumatoid arthritis; antibodies to cyclic citrullinated peptides
309) HLA-A3, B27, DR2; clinical symptoms
310) Rheumatic disease
311) Complement pathway
312) Systemic lupus erythematosus; clinical history
313) ANA centromeric pattern; clinical associations
314) IgA charcteristics
315) History of hemoptysis and hematuria; anti-glomerular basement membrane antibody
316) Anti–smooth muscle antibodies; auto-immune hepatitis
317) Scl 70; topoisomerase
318) Allergic bronchopulmonary mycosis; total IgE and IgE against Aspergillus
319) Hepatitis B; serologic interpretations
320) HLA transplant workup; clinical usefulness of past-positive history
321) Infectious mononucleosis; antibody to Epstein Barr nuclear antigen

LABORATORY ADMINISTRATION
322) JCAHO, CLIA'88; directorship requirements
323) CAP storage recommendation; pathology slides and blocks
324) Provider-performed microscopy tests; definition and examples
325) Electronic medical record; approval process
326) Laboratory information system; validation
327) Reporting malaria parasites; enumeration of level of parasitemia
328) Clinical trial studies
329) Fire safety; rescue, alarm, confine, evacuate
330) Know types of fire extinguishers and uses
331) Failure Mode Effects Analysis; reduce excessive preventable error rates
332) Clinical Laboratory Improvement Amendments of 1988 (CLIA 88); method validation
333) DELETED
334) DELETED
335) Capital equipment
336) Laboratory budgets; large expense items
337) Maslow; highest level

SPECIAL TECHNIQUES
338) Chronic lymphocytic leukemia prognosis; ZAP-70, CD38, somatic mutations
339) Monoclonal B cell; chronic lymphocytic leukemia, mantle cell lymphoma
340) Wavelength of flurochrome emission; flow cytometry compensation correction
341) Flow cytometric immunophenotyping; leukemia interpretation
342) Acute promyelocytic leukemia; bone marrow flow cytometric immunophenotyping
343) B-cell acute lymphoblastic leukemia; markers and translocation
344) Mantle cell lymphoma; flow cytometry
345) Flow cytometry; lymphocyte scatter
346) Hybrid capture assay; signal amplification of captured viral DNA
347) Real-time Taqman PCR; target probe cleaved
348) PCR contamination; controls in Taqman PCR
349) Southern blot analysis, alkaline buffer; denature DNA
350) Paroxysmal nocturnal hemoglobinuria; somatic mutation
351) Trisomic first-trimester abortuses; chromosomal complements
352) Acute myeloid leukemia sub-type M2;
353) Indications of chromosome analysis of both partners
354) Karyotype interpretation; amniotic fluid
355) Karyotype interpretation; partial molar pregnancy
356) FISH image; genotype trisomy 21
357) DELETED
358) Methylation of DNA; identify nucleotide base
359) Fanconi anemia;
360) Fanconi anemia; karyotyping; impaired DNA repair, chromosomal instability