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Question Bank Flashcards

1
Q

A slide stained with Masson Trichrome technique shows blue collagen and muscle, yellow red blood cells, and black nuclei. What is the most appropriate next step?

a.
report the results directly to the patient file

b.
send the slide to the pathologist for interpretation

c.
notify the microtomist that another block needs to be cut

d.
evaluate the staining reagents

A

d.
evaluate the staining reagents

Collagen/ Connective tissue = blue
Nuclei = dark purple
Muscle/ Cytoplasm = red/pink

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2
Q

What is the identity of an organism from a bloody stool culture given these results?
MAC: 2+normal flora, 2+ non-lactose fermenting colonies
indole: neg
H2S: pos
urease: neg
Hektoen: 4+ blue-green colonies
motility: pos

a.
Proteus spp.

b.
Salmonella spp.

c.
Shigella spp.

d.
Escherichia spp.

A

c.
Shigella spp.
- wh on MAC = lactose fermenter
- if H2S pos, then TSI = K/A

NOTE: salmonella is blue-green colonies with a black center on Hektoen

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3
Q

How should a technologist proceed when a labeling error is discovered on a sample for a stat fibrinogen from the operating room?

a.
correct the error on the tube by referring to the test request / requisition

b.
spin the sample immediately to avoid a delay in testing

c.
document the error on a non-conforming event form

d.
call the operating room and ask for the correct information

A

c.
document the error on a non-conforming event form

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4
Q

Which request should be processed first?

a.
PT, PTT from the operating room

b.
crossmatch from the pre-admission clinic

c.
liver function tests from the surgical ward

d.
urine culture from the emergency department

A

a.
PT, PTT from the operating room

PT stability: 24 hours
PTT stability: 12 hours
- considering tests were ordered from operating room, patient is probably bleeding

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5
Q

Which statement describes a 2-2s error?

a.
the affected control values are consecutive

b.
it is considered a warning flag

c.
it is considered a random error only

d.
the precision and CV would be affected

A

a.
the affected control values are consecutive

NOTE: you need a larger dataset to affect standard deviation/ CV/ precision

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6
Q

When woudl a class II biosafety cabinet be used?

a.
aliquoting plasma

b.
pouring acetone

c.
pipetting blood for manual cell counts

d.
plating patient specimens for culture

A

d.
plating patient specimens for culture

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7
Q

What is the best way to ensure that patient results are correctly received when given over the telephone?

a.
ask the receiver to read back the information given

b.
speak loudly and quickly

c.
ask for the name of the person receiving the information

d.
speak clearly and slowly

A

a.
ask the receiver to read back the information given

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8
Q

What is the best way to deal with conflict in the laboratory?

a.
avoid conflict in order to maintain harmony in the workplace

b.
involve as many people as possible to increase the likelihood of a resolution

c.
involve management as soon as possilbe in order to ensure a fair resolution

d.
have a one-on-one discussion about the problem with the co-worker

A

d.
have a one-on-one discussion about the problem with the co-worker

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9
Q

What is the most likely explanation of the results provided from a surgical patient?

Glucose: 56 mmol/L
Na: 169 mmol/L
Cl: 118 mmol/L
K: 1.7 mmol/L
HCO3-: 5.0 mmol/L

a.
lactic acidosis with increased anion gap

b.
lab error in measurement of electrolytes

c.
diabetic ketoacidosis

d.
sample drawn above an IV line

A

d.
sample drawn above an IV line

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10
Q

In a single urine specimen, which of the following situations could result in a count of 0 rbc/lpf on a microscopic urinalysis examination and a positive test for blood on the urine dipstick.

a.
the specific gravity of the urine sample is 1.020

b.
the pH of the urine is below 7.0

c.
extravascular hemolysis

d.
the urine sample is hypotonic

A

d.
the urine sample is hypotonic
- water moves from urine into RBCs = lysis

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11
Q

How should a technologist proceed when a DAT tests positive for IgG on a post-transfusion sample?

a.
repeat the ABO testing

b.
perform an elution

c.
send the blood bag for culture

d.
check the sample for visible hemolysis

A

b.
perform an elution
- removes Ab from RBC for Ab identification

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12
Q

How should the technologist proceed when a quantitative D-dimer result of 2.5 mg/L is obtained from a citrate tube?

a.
repeat the test

b.
check for a clot

c.
report the result

d.
cancel the test

A

b.
check for a clot

Ref: D-dimer <0.50 mg/L
- high results can indicate clotting/ DIC ?

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13
Q

In an ELISA reaction, what happens to a result when a well is inadequately washed after addition of the enzyme-antibody conjugate?

a.
the result will be unaffected

b.
the result cannot be determined

c.
the result will be falsely increased

d.
the result will be falsely decreased

A

c.
the result will be falsely increased
- unbound enzyme-Ab conjugates will bind non-specifically

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14
Q

Legislation that defines the governing framework for health professions is best described as which of the following concepts?

a.
certification

b.
regulation

c.
ethics

d.
licencsing

A

b.
regulation

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15
Q

A PCR analysis of a vaginal sample for Chlamydia trachomatis gives a negative result. What action should be taken when the internal control result is negative but positive and negative controls produce acceptable results?

a.
preliminary negative can be reported and confirmed by another method

b.
dilute the sample and repeat the PCR

c.
do not report the result and repeat the PCR

d.
report the test as negative

A

c.
do not report the result and repeat the PCR
- a negative internal control can mean an inhibitor is present

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16
Q

What parameter is most likely to be affected on an automated cell counter when a specimen is grossly lipemic?

a.
RBC count

b.
hemoglobin

c.
hematocrit

d.
MCV

A

b.
hemoglobin
- measured spectrophotometrically

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17
Q

Which situation indicates the need to calibrate an automated cell counter?

a.
a new reagent pack has been loaded onto the analyzer

b.
the hemoglobin lamp has been replaced

c.
a patient result has failed a delta check

d.
a single level of control is -3 SD from the mean

A

b.
the hemoglobin lamp has been replaced

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18
Q

What is the likely Rh genotype given the phenotype results:

D = 0
C = +
E = +
c = +
e = +

a.
r”r

b.
r’r

c.
r’r”

d.
rr

A

c.
r’r”

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19
Q

Which results would require further investigation prior to reporting?

a.
3 nucleated red blood cells per 100 WBCs are seen on the blood film of a neonate

b.
hemoglobin is 162 g/L while hematocrit is 0.45 L/L

c.
plasma urea is 4.6 mmol/L while creatinine is 138 umol/L

d.
plasma glucose is 13.9 mmol/L while urine glucose is negative

A

c.
plasma urea is 4.6 mmol/L while creatinine is 138 umol/L

Urea = 2.5 - 8.0 mmol/L
Creatinine = Female: 40 - 100 μmol/L AND Male: 50 - 120 μmol/L

NOTE: neonates can have <10 nRBCs/100 WBCs

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20
Q

What action is taken when anti-D is identified in a woman’s prenatal sample?

a.
notify the patient immediately by telephone

b.
notify the phsician immediately by telephone

c.
report result to the supervisor

d.
report result in the usual manner

A

b.
notify the physician immediately by telephone
- fetus may be in danger of HDFN
- mother cannot be given RhIg

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21
Q

Which of the following quality system essentials includes processes for selecting and installing laboratory instruments ?

A). Equipment
B). Assessments
C). Continual improvement
D). Process management

A

A). Equipment

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22
Q

Which of the following actions is used for the disposal of alcohol?
A). Pour down the drain
B). Dilute the water
C). Neutralize with saline
D). Send for distillation

A

D). Send for distillation

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23
Q

Which of the following actions should be taken when it is observed that a technologist unreasonably criticizes another coworker?

A). Accept the criticism
B). Confront the technologist
C). Ignore the situation
D). Seek assistance from direct supervisor

A

D). Seek assistance from direct supervisor

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24
Q

Which of the following conditions correlates with a hemoglobin solubility test result when the solution is turbid and lines are NOT visible ?

A). Hemoglobin SC disease
B). Beta Thalassemia minor
C). Alpha Thalassemia minor
D). Hemoglobin H disease

A

A). Hemoglobin SC disease
- sickle cell

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25
Q

Which of the following microbiology results is critical ?

A). Bacterial vaginosis positive smear
B). Wound with Clostridium perfringens
C). Stool with Proteus species
D). Sputum with Haemophilus influenzae

A

B). Wound with Clostridium perfringens
- gas gangrene

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26
Q

Which of the following actions can account for gram positive kidney bean shaped organisms from a blood culture?

A). Omission of the counterstain step
B). Drying the smear priory to staining
C). Omission of the decolorization step
D). Over decolonization of the smear

A

C). Omission of the decolorization step
- “kidney bean” shape indicates Moraxella catarrhalis
- gram negative diplococci

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27
Q

Which of the following culture media can be used to isolate a gram positive organism from a urine specimen which initially grew swarming Proteus species?

A). Sorbitol MacConkey
B). Colistin nalidixic acid
C). Sheep blood
D). MacConkey with crystal violet

A

B). Colistin nalidixic acid
- only grows gram positive organisms

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28
Q

Which of the following tests is affected by hemolysis ?

A). Na
B). Cl
C). AST
D). CRP

A

C). AST
- hemolysis = falsely elevated AST from RBCs

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29
Q

Which of the following actions should be completed when blood culture specimens are being improperly collected ?

A). Evaluate the collection process first
B). Perform employee evaluations
C). Reprimand employees
D). Implement a solution

A

A). Evaluate the collection process

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30
Q

Which of the following results is expected when a yeast produces blastoconidia, pseudohyphae, and chlamydospores on corn meal agar ?

A). Capsule positive
B). Germ tube positive
C). Mold at 22°C
D). Black pigment

A

B). Germ tube positive
- “when a yeast produces blastoconidia, pseudohyphae, and chlamydospores on corn meal agar” = C. albicans

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31
Q

Which of the following microscopes is used for examining joint fluids for the presence of crystals ?

A). Polarizing
B). Inverted
C). Fluorescence
D). Bright field

A

A). Polarizing
- birefringence is easily detectable

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32
Q

What peak is the M+1 in a mass spectrum ?

A

The highest m/z, after the main molecular ion peak

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33
Q

Which of the following analytes is affected when measuring a hemolyzed sample by ion selective electrode ?

A). Magnesium
B). Chloride
C). Carbon dioxide
D). Sodium

A

A). Magnesium

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34
Q

Which of the following analytes is affected when measuring a hemolyzed sample by ion selective electrode ?

A). Magnesium
B). Chloride
C). Carbon dioxide
D). Sodium

A

A). Magnesium

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35
Q

Which of the following infectious agents requires airborne precautions ?

A). Vancomycin resistance enterococcus
B). Clostridium difficile
C). Varicella virus
D). Hepatitis B virus

A

C). Varicella virus

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36
Q

What should be performed first if fluorescent slender bacilli are seen from an inpatient sputum sample ?

A). Set the sample up immediately on Löwenstein-Jensen agar at 35°C
B). Telephone the results to the clinician and infection control
C). Report of the findings in laboratory information system
D). Perform definitive testing for identification before reporting

A

B). Telephone the results to the clinician and infection control
- “fluorescent slender bacilli” = Acid-fast Mycobacterium tuberculosis
- risk group 3 organism

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37
Q

A cyto-centrifugation preparation from a peritoneal fluid demonstrates many large multinucleated cells with a “fried-egg” appearance and basophilic cytoplasm. What is the identification of these cells ?

A). Basophils
B). Large lymphocytes
C). Macrophage
D). Mesothelial

A

A cyto-centrifugation preparation from a peritoneal fluid demonstrates many large multinucleated cells with a “fried-egg” appearance and basophilic cytoplasm. What is the identification of these cells ?

D). Mesothelial

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38
Q

Which of the following factors may cause a delta check flag on a urea result when using the urease enzymatic method ?

A). The patient was pumping their fist during venipuncture
B). Specimen was collected in sodium heparin
C). Specimen was collected in ammonium heparin
D). The patient was in a supine position during venipuncture

A

C). Specimen was collected in ammonium heparin
- method = hydrolysis of urea TO AMMONIA and CO2 but SO testing urea using ammonium heparin causes falsely elevated results
- use lithium heparin instead

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39
Q

Which of the following conditions is most consistent with the following results: BM cytogenetics = t(9;22) positive and PBS = 14% blasts

A). Acute promyelocytic leukemia in remission
B). Accelerated phase of chronic myelogenous leukemia
C). Acute promyelocytic leukemia which has relapsed
D). Chronic phase of chronic myelogenous leukemia

A

B). Accelerated phase of chronic myelogenous leukemia
- chronic phase is <10% blasts
- accelerated phase is 15-20% blasts
- blast phase is >20% blasts

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40
Q

Which of the following devices is used to input data into the laboratory information system ?

A). Software
B). Printer
C). Projector
D). Keyboard

A

D). Keyboard

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41
Q

Which of the following specimens is delivered to cytology ?

A). Urine
B). Bone marrow
C). Toenail
D). Punch biopsy

A

A). Urine
- cytology examines cells in fluids

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42
Q

Which of the following microscopic elements is clinically significant in the urine sediment from an adult patient with vaginitis ?

A). Large flat cell with centrally located nucleus
B). Long thin irregular thread-like structures
C). Slightly tapered oval head structure with a long flagella-like tail
D). Small refractive oval structures with mycelial forms

A

D). Small refractive oval structures with mycelial forms
- Candida

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43
Q

Which of the following factors may cause a delta check flag on a urea results when using the urease enzymatic method ?

A). Specimen was collected in sodium heparin
B). Specimen was collected in sodium fluoride
C). The patient was pumping their first during venipuncture
D). The patient was in supine position during venipuncture

A

B). Specimen was collected in sodium fluoride
- grey-top (sodium fluoride/ potassium oxalate) only for lactate and glucose
- urea should be collected in lithium heparin

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44
Q

Which of the following actions may be taken prior to the collection of a blood specimen for prothrombin time when the HCT is 0.65 L/L ?

A). Increase volume of sodium citrate in the tube
B). Collect in an EDTA tube
C). Decrease volume of sodium citrate in the tube
D). Collect in a lithium heparin tube

A

C). Decrease volume of sodium citrate in the tube
- If the patient HCT 0.55 - 0.65 L/L = less plasma = volume of anticoagulant should be reduced

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45
Q

In a PT measurement, which of the following factors causes an increase in turbidity ?

A). IV
B). IX
C). I
D). VIII

A

C). I
- fibrinogen

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46
Q

Which of the following antibodies is most likely responsible when 2/10 donors are found to be incompatible in a group O patient’s serum ?

A). Anti-A1
B). Anti-K
C). Anti-e
D). Anti-Fya

A

B). Anti-K

K antigen = 9%
k antigen = 99%

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47
Q

Ingestion of which of the following substances may produce false test results for fecal occult blood testing ?

A). Bran cereal
B). Vitamin C
C). Acetaminophen
D). Red meat

A

B). Vitamin C

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48
Q

Which of the following stains is used to demonstrate Mycobacterium leprae ?

a). Fite
b). Gram
c). Brown and Brenn
d). Grocott methenamine silver

A

a). Fite

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49
Q

Which of the following specimens should be processed first ?

a). Stool for Clostridium difficile testing
b). Sputum for mycology
c). Joint fluid C & S
d). STAT urine C & S

A

c). Joint fluid C & S*
- fluids should be processed within 1 hour of collection

*NOTE: culture and sensitivity

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50
Q

Which of the following actions should be taken when a paraffin tissue section is splitting at right angles ?

a). Soak tissue in alcohol
b). Decalcify the surface of the tissue
c). Change the knife
d). Trim the block

A

b). Decalcify the surface of the tissue

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51
Q

Which of the following microbiology specimens should be collected if hemolytic uremic syndrome is suspected?

a). CSF
b). Preserved stool
c). Renal tissue biopsy
d). Mid-stream urine

A

b). Preserved stool
- HUS is caused by shiga toxin from Shigella and E. coli O:157:H7

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52
Q

Which of the following pieces of equipment is used to measure urine solute concentration?

a). Refractometer
b). Hemacytometer
c). Volumetric pipette
d). Counting chamber

A

a). Refractometer
- indirectly assesses osmolality/ specific gravity
- measures refractive index of urine, affected by [solutes]

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53
Q

Which is the first reagent used when manually staining a slide with hematoxylin and eosin?

a). 95% alcohol
b). 100% alcohol
c). Xylene
d). Distilled water

A

c). Xylene
- bring slides down to water

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54
Q

Which of the following conditions correlates with a plasma phosphorus of 0.35 mmol/L?

a). Diabetic ketoacidosis
b). Acromegaly
c). Rhabdomyolysis
d). Hypoparathyroidism

A

a). Diabetic ketoacidosis
- urinary loss of phosphate occurs due to transcellular shift, osmotic diuresis and reduced renal phosphate reabsorption

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55
Q

Which of the following conditions best correlates with the culture results below?

Aerobic blood agar colonial morphology: large, beta-hemolytic colonies
Gram stain: Gram positive spore forming bacilli

a). Atypical pneumonia
b). Meningitis
c). Brucellosis
d). Food poisoning

A

d). Food poisoning
- Clostridium perfringens
- Bacillus cereus

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56
Q

Which of the following situations will cause mast cells to turn blue during metachromatic staining?

a). Tissue improperly fixed
b). Decreased pH of toluidine blue
c). Alcohol used in dehydration
d). Increased pH of toluidine blue

A

c). Alcohol used in dehydration

57
Q

Which of the following microscopic findings may be seen when the pH of formalin fixative < 5.0 ?

A). Background stain
B). Pale nuclear stain
C). Pigment production
D). Pale eosin stain

A

C). Pigment production

58
Q

What is the novobiocin disk test used for ?

A

Test for presumptive ID of Staphylococcus saprophytics

59
Q

Which of the following procedures is most appropriate after sectioning intestinal tissue in a cryostat ?

A). Decontaminate with tuberculocidal disinfectant
B). Defrost and decontaminate with iodine
C). Defrost and decontaminate with sodium hydroxide
D). Decontaminate with alcohol

A

D). Decontaminate with alcohol

60
Q

Which of the following reactions will occur when using indirect anti globulin test reactive anti-Jka to phenotype patient cells with a positive direct antiglobulin test ?

A). Anti-Jka will be unable to bind due to positive DAT
B). Antihuman globulin will be neutralized by the antibody causing the positive DAT
C). Antihuman globulin will react with the antibody causing the positive DAT
D). Anti-Jka will trigger complement mediated hemolysis

A

C). Antihuman globulin will react with the antibody causing the positive DAT
- false positive

61
Q

Which of the following staining problems results from omitting 1% periodic acid solution in the Jones Methenamine Silver technique ?

A). Nuclei will take up silver stain
B). Increased non-specific staining will occur
C). Over impregnation of basement membrane
D). Failure to stain basement membrane

A

D). Failure to stain basement membrane

62
Q

Which of the following items are included in a document management system ?

A). Equipment maintenance logs
B). Approved procedures
C). Patient reports
D). Quality control results

A

B). Approved procedures

63
Q

Which of the following requirements must be included in the setup of laboratory information systems ?

A). Instrumentation interfaced with the LIS
B). Identification code and password to each user
C). Specimen assigned a unique barcode label
D). LIS interfaced to electronic medical record

A

B). Identification code and password to each user

64
Q

Which of the following will be decreased in a patient with hemolytic uremic syndrome ?

A). Haptoglobin
B). Lactate dehydrogenase
C). Creatinine
D). Unconjugated bilirubin

A

A). Haptoglobin
- hemolysis

65
Q

What property of Taq polymerase is required for detection of the hydrolysis probe ?

A). 3’-5’ exonuclease
B). 3’-5’ polymerase
C). 5’-3’ polymerase
D). 5’-3’ exonuclease

A

D). 5’-3’ exonuclease

66
Q

Which of the following tests is required for the proper interpretation of a parathyroid result ?

A). Magnesium
B). Potassium
C). Calcium
D). Sodium

A

C). Calcium
-low blood [calcium] stimulate PTH release, whereas high blood [calcium] prevent PTH release

67
Q

Which of the following procedures must be completed before using a new lot number of aPTT reagent ?

A). Verify lot number specific ISI
B). Verify geometric mean has been established
C). Recalibrate instrument
D). Verify heparin therapeutic range has been established

A

D). Verify heparin therapeutic range has been established

68
Q

Which of the following conditions correlates with the results: Hgb A = 83%, Hgb F = 2%, Hgb A2 = 15%

A). Normal
B). Alpha-Thalassemia
C). Newborn
D). Beta-Thalassemia minor

A

D). Beta-Thalassemia minor

69
Q

Which of the following chemicals can be used to reduce bacterial contamination in a water bath ?

A). Sodium azide
B). 70% alcohol
C). Phenolic detergent
D). Hypochlorite

A

C). Phenolic detergent

70
Q

Which of the following scenarios may conceal a large fetal-maternal hemorrhage ?

A). Mother is group A Rh negative and baby is group O Rh positive
B). Mother is group O Rh negative and baby is group O Rh positive
C). Mother is group O Rh negative and baby is group A Rh negative
D). Mother is group O Rh positive and baby is Group O Rh negative

A

C). Mother is group O Rh negative and baby is group A Rh negative

71
Q

Which of the following can leave behind explosive crystals if it condenses in the lining of the fume hood duct ?

A). Perchloric acid
B). Nitric acid
C). Acetic acid
D). Picric acid

A

A). Perchloric acid

72
Q

Which of the following agents can combine with the copper in a drain resulting in a potentially explosive compound ?

A). Picric acid
B). Ether
C). Mercury
D). Sodium azide

A

D). Sodium azide

73
Q

T or F: WHMIS labels are not required on hazardous wastes

A

TRUE; WHMIS labels are not required on hazardous wastes

74
Q

Radioactive waste is regulated:

A). Federally
B). Provincially
C). At the municipal level
D). None of the above

A

A). Federally

75
Q

An emergency eye wash should be located:

A). Within 10 feet of eye hazard
B). Within 10 seconds walking distance of eye hazard
C). Within 100 feet of the eye hazard
D). All of the above

A

B). Within 10 seconds walking distance of eye hazard

76
Q

Biological safety devices use what type of filter to remove aerosols ?

A

HEPA filters

77
Q

Which of the following items is required on a WHMIS SDS ?

a). Composition of ingredients
b). Transport information
c). Ecological information
d). Disposal considerations

A

a). Composition of ingredients

78
Q

What is the relationship between crossing point and copy number in qPCR ?

a). Inverse
b). Direct
c). Inverse and logarithmic
d). Direct and logarithmic

A

c). Inverse and logarithmic

79
Q

Which of the following situations should occur after a technologist undergoes initial minor action?

a). Improve performance
b). Report to regulatory body
c). Seek legal counsel
d). Terminate employment

A

a). Improve performance

80
Q

Which of the following actions describes maintenance?

a). Monthly scheduled activities
b). Repair parts when failure occurs
c). Daily scheduled activities
d). Steps performed at specific intervals

A

b). Repair parts when failure occurs

81
Q

What is the order of draw for a CBC, fasting glucose and a lipid panel?

a). Sodium fluoride, EDTA, SST
b). EDTA, SST
c). SST, EDTA, Sodium fluoride
PST, Sodium fluoride
d).

A

c). SST, EDTA, Sodium fluoride

SST = serum separator tube (gold-top)

Sodium fluoride = grey-top

82
Q

Which of the following ionization techniques is most commonly used for drug screening using gas chromatography mass spectrometry?

a). Inductively coupled plasma
b). Matrix-assisted laser desorption
c). Electron ionization
d). Chemical

A

c). Electron ionization

83
Q

Which of the following disorders correlates with an absolute reticulocyte count of 250 x 10⁹/L?

a). Hereditary spherocytosis
b). Pernicious anemia
c). End stage renal disease
d). Aplastic anemia

A

a). Hereditary spherocytosis

NOTE: pernicious and aplastic anemia both have low retic counts

84
Q

Which of the following collection techniques can result in specimen hemolysis?

a). Patient pumping fist during venipuncture
b). Filling an EDTA tube before a sodium citrate
c). Transporting tubes on their side
d). Collecting without a tourniquet

A

c). Transporting tubes on their side

85
Q

How to calculate diagnostic specificity ?

A

(true negatives) / (true negative + false positive)*

*NOTE: individuals unaffected by the disease

86
Q

What environmental conditions are ideal for the isolation of an organism that causes thrush?

a). Buffered charcoal yeast extract agar, CO₂
b). MacConkey agar, O₂
c). Thayer-Martin agar, CO₂
d). Sabouraud’s agar, O₂

A

d). Sabouraud’s agar, O₂

87
Q

What action should be taken first when a liter of pleural fluid is spilled on the bench top?

a). Pour disinfectant around the spill
b). Cover the spill with paper towels
c). Don an N95 mask
d). Evacuate the area

A

d). Evacuate the area

88
Q

Which of the following disinfectants is appropriate for the corresponding situation?

a). A 1:10 dilution of sodium hypochlorite after using the microtome
b). Concentrated sodium hydroxide for benchtop after handling a sample with prions
c). A 1:100 dilution of sodium hypochlorite for a biohazard spill control on the benchtop
d). Quaternary ammonium compound for mycobacteria

A

b). Concentrated sodium hydroxide for benchtop after handling a sample with prions

89
Q

What parasite appears in urine sediment as large, colourless, thick-walled and flattened on one side?

a). Giarda lamblia
b). Ascaris lumbricoides fertilized
c). Enterobius vermicularis
d). Ascaris lumbricoides unfertilized

A

c). Enterobius vermicularis

90
Q

Which of the following actions should be taken first when the room temperature rises from 22°C to 28°C in the hematology department?

a). Document temperature change and store hemostasis samples at 22°C
b). Call facilities services and store hemostasis samples at 4°C
c). Call facilities services and stop analyzing hemostasis samples
d). Stop analyzing hemostasis samples and ship to a different laboratory

A

a). Document temperature change and store hemostasis samples at 22°C

NOTE: PLTs must be kept at RT

91
Q

Which of the following scenarios causes falsely prolonged prothrombin time and partial thromboplastin time results?

a). Underfilling tube
b). Mixing tubes four times
c). Overfilling tube
d). Tissue factor contamination

A

a). Underfilling tube

NOTE: sodium citrate (light blue-top) prevents premature clotting by binding Ca2+

92
Q

Which of the following actions should be taken if a unit of packed red blood cells is returned to the blood bank at a temperature of 0°C?

a). Reissue the unit to the same patient
b). Quarantine the unit
c). Reissue the unit to a different patient
d). Discard the unit

A

d). Discard the unit

NOTE: packed RBCs must be stored at 4ºC

93
Q

Which of the following actions should be taken when ethylenediamine tetraacetic acid induced platelet clumping is observed on a peripheral blood smear?

a). Warm and reanalyze the sample
b). Recollect in sodium citrate
c). Reject the sample as clotted
d). Perform plasma replacement

A

b). Recollect in sodium citrate

94
Q

Which of the following statements is given the results below?
G6PD: Normal
Reticulocytes: 50 x 10⁹/L

A). G6PD result is valid
B). G6PD result is invalid
C). Reticulocyte count falsely increased
D). Reticulocyte count falsely decreased

A

A). G6PD result is valid

95
Q

Which of the following tests may be used to identify a short, pale-staining Gram-negative bacilli from a grey colony on an anaerobic blood plate?

a). Reverse CAMP
b). SPS disk
c). Lipase
d). 20% bile

A

d). 20% bile
- short, gram negative anaerobe = Bacteroides

96
Q

Which of the following flow cytometry results correlates with chronic lymphocytic leukemia?

a). CD5 positive B lymphocytes
b). CD19 positive B lymphocytes
c). CD20 positive B lymphocytes
d). CD5 positive T lymphocytes

A

a). CD5 positive B lymphocytes

97
Q

What is the next step when an untransfused open unit of packaged red blood cells is returned?

a). Check for hemolysis
b). Return to inventory
c). Discard the unit
d). Return to the supplier

A

c). Discard the unit

98
Q

Which of the following actions should be taken first when a specimen suspected of containing Clostridium botulinum is received?

a). Notify public health laboratory
b). Discontinue processing
c). Perform toxin assay
d). Culture the specimen anaerobically

A

b). Discontinue processing
- causes lethal toxin = stop processing
- then notify public health laboratory

99
Q

A technologist is overwhelmed for repeatedly having to leave their laboratory work to assist the phlebotomist. Which of the following actions is appropriate?

a). Request hiring an additional phlebotomist
b). Request a review of work load
c). Request changing the job description
d). Refuse to leave the department

A

b). Request a review of work load

100
Q

Which of the following actions are taken given: (Freshly voided urine with
pH = 8.0 and Tyrosine crystals present

a). Report results
b). Repeat urine dipstick and microscopy
c). Review the protein result for pH interference
d). Add sodium hydroxide and repeat microscopy

A

b). Repeat urine dipstick and microscopy

NOTE: Tyrosine crystals present only in ACIDIC urine (pH <7.0)

101
Q

Which of the following storage conditions is optimal for purified ribonucleic acid?

a). -80°C
b). -40°C
c). 4°C
22°C

A

a). -80°C

102
Q

Which of the following statements explains how lipemia may affect hemostasis testing?

a). Fat particles interfere with all detection methods
b). Turbidity shortens mechanical detection methods
c). Optical density is masked by the colour of the plasma
d). Turbidity prolongs photo-optical detection methods

A

d). Turbidity prolongs photo-optical detection methods

103
Q

Why should venipuncture from a paralyzed arm be avoided?

a). Impaired blood flow from sclerosed veins
b). Skin is often fragile and easily injured
c). Increased chance of vein thrombosis
d). Increased chance of hematoma

A

c). Increased chance of vein thrombosis

104
Q

Which of the following situations falsely increases K levels?

a). Specimen clotted before centrifuging
b). Specimen received in an ice slurry
c). Specimen contaminated with interstitial fluid
d). Specimen exposed to light

A

b). Specimen received in an ice slurry

  • in cooler temperatures, potassium diffuses out of cells into plasma, leading to the reading being artefactually higher
105
Q

Which of the following tests can be used for organism identification given these findings?

Gram stain: Gram positive cocci
Blood agar: small grey, beta hemolytic
MacConkey: no growth
Catalase: negative

a). Coagulase, PYR
b). Optochin, bacitracin
c). Spot indole, oxidase
d). Latex agglutination, hippurate

A

d). Latex agglutination, hippurate

NOTE: S. agalactiae is hippurate pos

106
Q

Which of the following actions is taken to perform proficiency testing?

a). Ensure proficiency samples are analyzed by senior technologist
b). Analyze proficiency samples without any patient samples
c). Repeat controls after analyzing proficiency samples
d). Analyze proficiency samples within a patient batch

A

d). Analyze proficiency samples within a patient batch

107
Q

Which of the following conditions correlates with the results given:

Iron: 45 µmol/L
TIBC: 18 µmol/L
Ferritin: 552 µg/L
% Saturation: 100%

a). Anemia of chronic disease
b). Chronic infection
c). Hemochromatosis
d). Iron deficiency anemia

A

c). Hemochromatosis

  • iron overload = organ damage
108
Q

Which of the following situations may result in cellular distortion during cytocentrifugation?

a). Inadequate centrifugation time
b). Specimens with a low cell count
c). Specimen with low protein
d). Low centrifugation speed

A

b). Specimens with a low cell count

109
Q

Which of the following actions should be taken first when the room temperature rises from 22°C to 28°C in the hematology department?

a). Stop analyzing manual ESR samples and store at 37°C
b). Ship manual ESR to a different laboratory for analysis
c). Stop analyzing manual ESR samples and store at 4°C
d). Reject all ESR samples

A

c). Stop analyzing manual ESR samples and store at 4°C

  • proper RBCs storage temp
110
Q

Which of the following ionization methods may be used for gas chromatography mass spectrometry?

a). Inductively coupled plasma
b). Electrospray
c). Matrix-assisted laser desorption
d). Chemical

A

d). Chemical

111
Q

Which of the following products can be issued to a patient with a potent anti-IgA?

a). Platelet apheresis made from Anti-IgA deficient donors
b). Frozen plasma made from Anti-IgA deficient donors
c). Deglycerolized packed RBCs
d). Irradiated packed RBCs

A

c). Deglycerolized packed RBCs

112
Q

Which of the following procedures can be used to verify the quality of Schiff reagent?

a). Add 3 drops into 40% formaldehyde
b). Add 3 drops into 10% formaldehyde
c). Add 3 drops into 30% formaldehyde
d). Add 3 drops into 20% formaldehyde

A

a). Add 3 drops into 40% formaldehyde

113
Q

What parasite appears in urine sediment as small, ovoid and with a cytoplasm filled with nuclear material?

a). Schistosoma haematobium
b). Enterobius vermicularis
c). Giardia lamblia
d). Trichomonas vaginalis

A

c). Giardia lamblia

114
Q

Which of the following findings is commonly seen in a patient diagnosed with severe liver disease?

a). Abnormal factor I synthesis
b). Abnormal platelet function
c). Abnormal levels of fibrin split products
d). Abnormal factor VII synthesis

A

a). Abnormal factor I synthesis

Factor I = fibrinogen

115
Q

Which of the following antibodies is commonly implicated in cases of delayed hemolytic transfusion reaction?

a). Anti-P₁
b). Anti-Leᵃ
c). Anti-E
d). Anti-D

A

c). Anti-E

116
Q

Which of the following red blood cell morphologies correlates with a diagnosis of chronic alcoholism?

a). Macrocytic normochromic
b). Normocytic hypochromic
c). Normocytic normochromic
e). Microcytic hypochromic

A

a). Macrocytic normochromic

  • non-megaloblastic anemia
117
Q

Which of the following actions should be taken when tissue sections stained with hematoxylin and eosin show pale cytoplasmic staining?

a). Use heat during the staining process
b). Check the pH of the eosin and adjust with acetic acid if necessary
c). Return the slides to the bluing reagent
d). Check the pH of the eosin and adjust the sodium hydroxide if necessary

A

b). Check the pH of the eosin and adjust with acetic acid if necessary

  • eosin pH too high/ alkaline (contaminated by bluing reagent ?)
118
Q

Which of the following circumstances presents the greatest danger for a patient who will be transfused with packed red blood cells?

a). Patient is Rh positive and has been inly grouped as Rh negative
b). Patient is group B and has been inly grouped as AB
c). Patient has anti-Leᵃ and received a Leᵃ positive unit issued as compatible
d). Patient is Rh negative and has been inly grouped as Rh positive

A

b). Patient is group B and has been inly grouped as AB

119
Q

Which of the following factors may be helpful in differentiating Plasmodium falciparum from Babesia species on a peripheral blood smear?

a). Ring forms
b). Travel history
c). Multiple parasites per RBC
d). Duffy phenotype

A

b). Travel history

  • P. falciparum = Asian/ African mosquitoes
  • Babesia sp. = North American ticks
120
Q

How should a urine specimen at room temperature be handled when it has been received in the lab at 1900 for urinalysis and culture and sensitivity when the collection time states 1500?

a). Place specimen in incubator
b). Place specimen in the fridge
c). Process the specimen
d). Reject the specimen

A

d). Reject the specimen

  • MSU can only be kept in RT < 4 hours
121
Q

Which of the following scenarios may result in a laboratory technologist being criminally charged?

a). Looking at a patient’s medical records without cause
b). Making inappropriate sexual comments to a patient
c). Venipuncture on a patient without consent
d). Reporting erroneous results from a mislabeled specimen

A

c). Venipuncture on a patient without consent

122
Q

Which of the following actions may cause a body fluid cytospin preparation to have a cell button that is too thick?

a). Sample diluted prior to slide preparation
b). Sample stored at 22°C for many hours
c). Sample vortexed prior to slide preparation
d). Sample not mixed prior to slide preparation

A

d). Sample not mixed prior to slide preparation

123
Q

Which of the following reticulocyte values is expected in an untreated patient with Fanconi’s anemia?

a). 10 x 10⁹/L
b). 60 x 10⁹/L
c). 110 x 10⁹/L
d). 160 x 10⁹/L

A

a). 10 x 10⁹/L

  • Fanconi’s anemia has low retic count
124
Q

Which of the following patients is a potential candidate for Rh immunoglobulin injection?

a). O Rh negative female inadvertently transfused with A Rh negative packed RBCs
b). O Rh negative male inadvertently transfused with O Rh positive packed RBCs
c). O Rh positive female inadvertently transfused with O Rh negative packed RBCs
d). O Rh positive male inadvertently transfused with A Rh positive packed RBCs

A

b). O Rh negative male inadvertently transfused with O Rh positive packed RBCs

125
Q

Which of the following anticoagulants inhibits the conversion of prothrombin to thrombin?

a). Citrate
b). Oxalate
c). Heparin
d). EDTA

A

c). Heparin
- cofactor to anti-thrombin

126
Q

Which of the following reagents may be used after the diaminobenzidine step to intensify the reaction in immunohistochemistry staining?

a). 2% cobalt chloride
b). 1% cobalt chloride
c). Imidazole
d). Osmium tetroxide

A

d). Osmium tetroxide

127
Q

Which of the following actions should be performed first for a disk diffusion test when small colonies are observed within the zone of inhibition?

a). Measure zone diameter ignoring small colonies
b). Confirm pure culture
c). Repeat the test
d). Measure the zone diameter inside the small colonies

A

b). Confirm pure culture

128
Q

Which of the following situations may result in a cellular distortion during cytocentrifugation?

a). Fresh CSF specimen
b). Low centrifugation speed
c). High cell count specimens
d). Inadequate centrifugation time

A

c). High cell count specimens

129
Q

What parasite appears as pear shaped, with an undulating membrane and propelled by flagella in urine sediment?

a). Schistosoma haematobium
b). Enterobius vermicularis
c). Trichomonas vaginalis
d). Giardia lamblia

A

c). Trichomonas vaginalis
- urine sediment

130
Q

When should gastrointestinal specimens be pinned to prevent autolysis?

a). Before fixation
b). After saline wash
c). After fixation
d). Before saline wash

A

a). Before fixation

131
Q

Which of the following disinfectants must NOT be placed in autoclave due to generation of unsafe gases?

a). 70% alcohol
b). Hydrogen peroxide
c). Sodium hypochlorite
d). Sodium phosphate

A

c). Sodium hypochlorite

132
Q

An organism grew on MacConkey agar incubated in O₂, but failed to grow on blood agar incubated in CO₂. What is the most probable cause of this finding?

a). The organism was not inoculated on blood agar
b). The organism is fastidious
c). The organism requires lactose
d). The organism prefers an aerobic environment

A

a). The organism was not inoculated on blood agar

133
Q

What is the immediate first-aid reaction taken following a needle stick injury?

a). Allow exposed site to bleed freely
b). Wipe the exposed site with an alcohol pad
c). Cleanse exposed site with soap and water
d). Apply pressure to the exposed site

A

c). Cleanse exposed site with soap and water

134
Q

Which of the following antiseptics may compromise the results of a blood alcohol concentration?

a). Hydrogen peroxide
b). Chlorhexidine gluconate
c). Tincture of iodine
d). Benzalkonium chloride

A

c). Tincture of iodine

135
Q

Differentiate Base peak vs Molecular ion peak vs M+1 peak in Mass Spec

A

Base peak = highest peak

Molecular ion peak = ion peak with largest m:z

M+1 peak: right after molecular ion peak

136
Q

What is the next step when an inpatient specimen arrives in blood bank with a spelling error in the name?

a). Ask the collector to sign a waiver
b). Use if the other identifiers are
c). Call ward to confirm spelling
d). Reject the specimen

A

d). Reject the specimen

137
Q

What reagent is used to perform the first blocking stage when performing immunohistochemistry?

a). Hydrogen peroxide
b). Protein solution
c). Proteolytic enzyme
d). Avidin-biotin

A

a). Hydrogen peroxide

138
Q

Which of the following territorial spaces does a phlebotomist enter when performing venipuncture?

a). Personal
b). Intimate
c). Social
d). Public

A

b). Intimate

139
Q
A

CSMLS (46 decks)

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