(M) Sebia (question-bank) Flashcards by ASHLEY JARED DEFENSOR

3MT-7

A patient’s capillary electrophoresis profile showed an increased level of Beta 2. An
increased level in the Beta 2 area will have a bridging effect. With this pattern, our
interpretation will be:
a. Alpha-1 antitrypsin deficiency / Alpha Gamma Bridging
b. Hypergammaglobulinemia / Alpha Beta Bridging
c. Liver Cirrhosis / Beta Gamma Bridging
d. Nephrotic Syndrome / Beta Gamma Bridging

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3MT-7

True or False: Pool of lyophilised sera is stored at room temperature.
a. True
b. False

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3MT-7

Before any analysis, it is advisable to observe serum aspects to detect the following
except:
a. Hemolysis
b. Specific gravity
c. Turbidity
d. High viscosity

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3MT-7

Which of the following statements is TRUE regarding the interpretation of serum protein
electrophoresis (SPE) results?
a. A normal SPE always rules out multiple myeloma
b. An increase in alpha-2 globulin is characteristic of nephrotic syndrome
c. Beta-gamma bridging is commonly seen in nephrotic syndrome
d. Albumin levels remain unchanged in nephrotic syndrome

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3MT-7

Which of the following proteins migrates the farthest towards the anode (positive
electrode) during serum protein electrophoresis?
a. Albumin
b. Alpha-1 globulin
c. Beta globulin
d. Gamma globulin

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3MT-7

What is the main reason why hemolyzed samples should be avoided in serum protein
electrophoresis?
a. It artificially increases albumin levels
b. It causes hemoglobin interference, affecting globulin fraction
measurements
c. It enhances the clarity of the protein bands
d. It increases the resolution of monoclonal proteins

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3MT-7

Which pathological condition is associated with a decrease albumin, and polyclonal
increase of beta and gamma globulins,.
a. Acute inflammation
b. Chronic Inflammation
c. Nephrotic syndrome
d. Cirrhosis

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3MT-7

True or False: The control for quality assurance is lyophilized and needs to be
reconstituted with distilled water.
a. True
b. False

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3MT-7

What is the purpose of serum protein electrophoresis?
a. To differentiate different serum proteins
b. To detect abnormalities in serum proteins
c. To detect the presence of serum proteins
d. To identify the molecular weight of serum proteins

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3MT-7

Which immunoglobulin abnormality is associated with free light chains disease or
non-secreting myeloma
a. Hypogammaglobulinemia
b. Hypergammaglobulinemia
c. Oligoclonal profile
d. Polyclonal increase

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3MT-7

Result of Nephrotic syndrome on serum protein electrophoresis
a. Increased gamma globulin
b. Increased total protein
c. Decreased albumin
d. Decreased alpha-2 globulin

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3MT-7

How many samples can Minicap Protein 6 run?
a. 25 samples/hour
b. 30 samples/hour
c. 15 samples/hour
d. 20 samples/hour

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3MT-7

What is the reference range of Albumin in g/l
a. 1.75 - 5.04 g/l
b. 20.33 - 36.72 g/l
c. 38.01 - 45.85 g/l
d. 4.55 - 8.05 g/l

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3MT-7

The control is lyophilised and needs to be reconstituted with 1ml of distilled water. Wait
30 min. at room temperature before mixing.
a. First statement is true, second statement is false
b. First statement is false, second statement is true
c. First and second statement are both true
d. First and second statement are both false

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3MT-7

What samples can be used by the MINICAP Flex Piercing
a. Fresh whole blood samples
b. Fresh Plasma
c. Hemolyzed samples
d. Fresh serum samples

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3MT-6

This has a big hole for the buffer anodic tank and could run 2 samples
simultaneously.
a. Reagent Compartment machine
b. Reagent Cup
c. Filter
d. Water Solutions

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3MT-6

What is the purpose of Serum protein Electrophoresis?
a. To detect abnormalities in serum proteins
b. To depolymerize a monoclonal immunoglobulin
c. Both A & B
d. Neither A & B

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3MT-6

Decreased Albumin, Increased Alpha 1, Increased Alpha 2
a. Acute Inflammation
b. Chronic Inflammation
c. Both A & B
d. Neither A & B

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3MT-6

A Medical Technologist is doing Serum Protein Electrophoresis and wants
to put the protein buffer together with the washing solution and water,
where in the reagent compartment, he/she should put it?
a. Farthest right side of the reagent compartment.
b. Farthest left side of the reagent compartment.
c. Nearest right side of the reagent compartment.
d. Nearest left side of the reagent compartment.

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3MT-6

A Medical Technologist uses a machine that has performances and throughput of: Launch: 14 mins; 2 first results in 10 mins; High throughput:
20 samples/Hour; Shut down: 26 mins. What machine is being described?
a. MINICAP Protein 7
b. MINICAP Protein 8
c. MINICAP Protein 5
d. MINICAP Protein 6

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3MT-6

In complementary immunofixation when is it recommended to repeat
electrophoresis if there are no clinical signs of gammopathy?
a. Within next 3 months
b. Within next 4 months
c. Once a year
d. Every month

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3MT-6

During electrophoresis, what does a migration out-of-range or red triangle alarm indicate, and how should it be addressed if it occurs in only one sample?
a. It indicates a delay in albumin migration; the sample should be treated
with Beta Mercaptoethanol (BME).
b. It suggests a complete failure of the electrophoresis process; all samples
must be re-run.
c. It means the gel is defective and should be replaced.
d. It indicates contamination of all samples, requiring a new batch of
samples.

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3MT-6

In the quality control of MINICAP Protein 6, how should the pool of lyophilized sera be stored?
a. At room temperature (20-25°C)
b. Frozen at -20°C
c. Between 2-8°C
d. At 37°C

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3MT-6

Serum protein electrophoresis is utilized for the purpose of:
a. Detect qualitative abnormalities in serum proteins
b. Detect quantitative abnormalities in serum proteins
c. Detect presence of peaks or distortions in qualitative abnormalities
d. Only A and B
e. All of the above

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# 3MT-6 Low Albumin, High a-2 (alpha 2), Low y (gamma) a. Liver Cirrhosis b. Nephrotic Syndrome c. Hypergammaglobulinemia d. Hypogammaglobulinemia

# 3MT-6 Hypergammaglobulinemia is due to the decrease of several subclasses of immunoglobulins that give the multiple monoclonal bands. Hypergammaglobulinemia is observed in autoimmune reactions associated with transplants, patients under immunosuppressive treatment during autoimmune diseases, and infections. a. First statement is true. Second statement is false. b. First statement is false. Second statement is true. c. Both statements are true. d. Both statements are false.

# 3MT-6 A 60-year-old male with a history of chronic alcohol use and hepatitis C presents with fatigue, abdominal swelling, and jaundice. Laboratory tests show hypoalbuminemia, elevated liver enzymes, and increased gamma globulins. Serum protein electrophoresis (SPE) reveals the loss of separation between the beta and gamma regions, forming a β-γ bridge. Based on the findings, what is the most likely pathophysiological mechanism behind the β-γ bridge in this patient? a. Excessive protein loss through the kidneys, leading to compensatory globulin production b. Increased production of IgA, which migrates into the beta region, blending the beta and gamma zones c. Massive overproduction of albumin by the liver, causing a shift in protein fractions d. Suppressed immune function leading to decreased globulin production and fusion of protein bands

# 3MT-6 What order of protein fractions is correct (from left to right) in Sebia Protein Electrophoresis? a. Albumin - Beta 1 - Alpha 2 - Gamma b. Albumin - Alpha 2 - Beta 1 - Gamma c. Albumin - Gamma - Beta 1 - Beta 2 d. Albumin - Alpha 1 - Kappa - Gamma

# 3MT-6 Lyophilized control must be reconstituted in… a. NSS b. PBS c. Hypertonic Solution d. Distilled Water

# 3MT-6 You can only run one sample in a reagent cup. The Sebia Serum Protein Electrophoresis has a throughput of one sample in 3 minutes. a. The first statement is true. The second statement is false b. The first statement is false. The second statement is true c. Both statements are true d. Both statements are false

# 3MT-5 Lyophilised sera used as the quality control for the MINICAP PROTEIN(E) 6 KIT should be stored between which of the following temperatures? a. 37OC b. 22-27OC c. 2-8OC d. 25-32OC Lyophilized sera should alw

# 3MT-5 Which of the following is TRUE about the purpose of serum protein electrophoresis when it comes to detecting the abnormalities in serum proteins? a. Quantitative Abnormalities: Increase or decrease of fractions b. Quantitative Abnormalities: Presence of peaks or distortions c. Qualitative Abnormalities: Absence of peaks or distortions d. Both A and C e. Both B and C

# 3MT-5 One malignant cell is over-proliferating and the result is the excess of a single immunoglobulin in the serum. a. Monoclonal immunoglobulin b. Polyclonal immunoglobulin c. Both of the choices are correct d. Neither of the choices is correct

# 3MT-5 Which of the following statements is correct? a. In polyclonal immunoglobulin patterns, there is an increase in a single peak in the gamma region, often associated with inflammation. b. A monoclonal peak in the gamma, beta 2, beta 1, or alpha regions could indicate a monoclonal immunoglobulin or multiple myeloma. c. If you observe three bands or peaks in the gamma region, this suggests a polyclonal pattern. d. An oligoclonal pattern is characterized by a single peak in the gamma region

# 3MT-5 Why are albumin and alpha 1 and 2 decreased in the cirrhotic profile of liver cirrhosis? a. Malabsorption b. Hepatocellular insufficiency c. Malnutrition d. Inflammatory bowel disease

# 3MT-5 What is NOT associated with hypogammaglobulinemia? a. Total immunodeficiency b. Free light chains disease c. Immunosuppressive treatment d. Chronic infections

# 3MT-5 Which of the following is NOT true about nephrotic syndrome? a. Increase of albumin b. Decrease of Alpha-2 globulins c. Both A and B d. Neither A or B

# 3MT-5 Which of the following is NOT a main protein in Serum Protein Electrophoresis? a. Albumin b. Alpha 1 c. Beta 3 d. Gamma

# 3MT-5 Monoclonal component quantification is required for the following, EXCEPT: a. Myeloma classification b. Monitoring the evolution of nonmalignant state of gammopathy to a malignant state c. Observing autoimmune reactions associated with transplants d. Follow up of treatment efficiency

# 3MT-5 Why should hemolyzed samples be avoided in the Serum Protein Electrophoresis test? a. It causes false decrease in beta 1 fraction through the release of free hemoglobin. b. The hemoglobin released from the lysed red blood cells binds to haptoglobin, forming haptoglobin-hemoglobin complex. c. Both d. Neither

# 3MT-5 A 45-year-old male patient was requested by his physician to undergo Serum Protein Electrophoresis. During blood collection, the phlebotomist accidentally pulled the syringe, exposing the bevel and introducing air to the blood collected. After the blood has been allowed to clot and then centrifuged, the medical technologist noticed that the serum appears reddish in color. Which of the following actions should the medicaltechnologist execute? a. Proceed with SPE since hemolysis does not affect protein analysis b. Proceed with SPE, but inform the physician that the sample was hemolyzed. c. Request a new blood sample, as hemolyzed sample causes gamma fraction distortion and falsely decreased haptoglobin d. Request a new blood sample, as hemolyzed sample causes false increase in beta 1 fraction and forms a haptoglobin-hemoglobin complex

# 3MT-5 Which of the following serum protein electrophoresis (SPE) patterns is MOST characteristic of liver cirrhosis? a. Increased albumin and decreased alpha-2 globulins b. Polyclonal increase in gamma globulins with a beta-gamma bridge c. Monoclonal peak in the gamma region with decreased albumin d. Decreased alpha-1 and alpha-2 globulins with normal albumin

# 3MT-5 A 55-year-old male patient presents with fatigue, bone pain, and recurrent infections. Serum protein electrophoresis (SPE) reveals a distinct peak in the gamma region. To further characterize this peak, the laboratory performs a second SPE on the same sample, but this time treats it with beta-mercaptoethanol (BME) before analysis. What is the primary reason for using BME in this scenario? a. To increase the overall protein concentration in the sample. b. To break down a potential monoclonal immunoglobulin, if present. c. To stabilize the proteins in the sample and prevent degradation. d. To enhance the binding of antibodies in any subsequent immunofixation testing.

# 3MT-5 Which of the following conditions are associated with the presence of an oligoclonal pattern? a. Patient that has Multiple sclerosis b. Patient that was given azathioprine for treatment c. Both d. Neither

# 3MT-5 Which of the following laboratory findings and situations are usually associated with the appearance of oligoclonal bands? a. Presence of three or more faint narrow, homogeneous bands in electrophoresis b. Increased monoclonal immunoglobulin from a single B-cell clone c. Decreased immunoglobulin production in cerebrospinal fluid d. None of the above

# 3MT-5 Used in Minicap Protein(E)6 Kit EXCEPT: a. Wash Solution b. Protein(E)6 Buffer c. 70% Alcohol d. Reagent Cups

# 3MT-5 In Minicap Protein(E)6 Kit, the control is lyophilised and needs to be reconstituted with: a. 1mL distilled water b. 2mL saline solution c. 1mL sodium chloride d. 2mL patient’s serum

# 3MT-5 Proper storage for samples a. At 2-8 degree Celsius up to 10 days b. At 18-30 degree Celsius up to 3 months c. Either d. Neither

# 3MT-5 Which of the following is INCORRECT about the tests utilized for the provision of the Most Comprehensive Solution for Multiple Myeloma? a. Screening Test: Serum Protein b. Screening Test: Bence Jones Typing c. Confirmatory Test: Immunofixation d. Complementary Test: Serum Free Light Chain Test

# 3MT-5 In MYELOMA, Monoclonal Gammopathies on SPE has: a. One malignant cell that is over-proliferating and the result is the excess of a single immunoglobulin in the serum b. Polyclonal Immunoglobulins c. Monoclonal Immunoglobulin d. A & C

# 3MT-5 Without an inflammatory context or hepatic disease, what is the additional distortion present in the beta globulins? a. Beta 2 < Beta 1 b. Beta 1 > Beta 2 c. A Only d. None of the above

# 3MT-5 The SPE results showed; Decreased Albumin, Increased Alpha 1 & 2 Globulins with an additional note of an Increase in Haptoglobin. Which pathological conditions on SPE is associated with the given results? a. Acute Inflammation b. Chronic Inflammation c. Both are correct d. None of the above

# 3MT-4 A patient presents the following changes in capillary electrophoresis: an increase in alpha-1 and alpha-2 globulins, a decrease in albumin, and a polyclonal increase of beta and gamma globulins. Which of the following conditions does this profile most likely indicate? A. Acute inflammation B. Chronic inflammation C. Nephrotic syndrome D. Cirrhotic profile

# 3MT-4 A patient has been diagnosed with hypogammaglobulinemia. Which of the following steps should be prioritized in the diagnostic workup to identify the underlying cause? A. Conduct a complete blood count (CBC) B. Administer immunosuppressive treatment C. Check levels of alpha-2 and beta globulins D. Perform immunotyping or immunofixation

# 3MT-4 Acute inflammation A. Decreased albumin levels B. Decreased orosomucoid C. Both A and B D. Neither

# 3MT-4 All B lymphocytes produced their immunoglobulins at the same level A. Monoclonal Immunoglobulins B. Polyclonal Immunoglobulins C. Both A and B D. Neither

In myeloma, ___ malignant cell is/are over-proliferating and the result is the excess of ___immunoglobulin in the serum. A. One, single B. Two, double C. Three, triple D. Four, quadruple

# 3MT-4 All are positions of a monoclonal immunoglobulin in SPE except: A. Isolated increase of alpha-2 without inflammatory context B. Presence of a peak or distortion in gamma area C. Beta 2 is less than beta 1 without an inflammatory context or hepatic disease D. None of the above

# 3MT-4 In hypergammaglobulinemia, the gamma portion is ___? A. Increased, pointed B. Decreased, pointed C. Decreased, rounded D. Increased, rounded

# 3MT-4 Associated with hypogammaglobulinemia: A. Free light chains disease or non-secreting myeloma. B. Partial or total immunodeficiency. C. Immunosuppressive treatment. D. The alpha-2 and beta fractions must be checked carefully for a potential monoclonal abnormality. E. All of the above

# 3MT-4 Complementary immunofixation/immunotyping is not required every time you see a monoclonal immunoglobulin. Immunotyping will determine what kind of myeloma or cancer the patient has. A. First statement is true, Second statement is false. B. First statement is false, Second statement is true. (Complementary immunofixation/immunotyping is REQUIRED every time you see a monoclonal immunoglobulin.) C. Both statements are false. D. Both statements are true.

# 3MT-4 Used for treatment when there is a delay of albumin migration. A. BME B. SDS C. TEMED D. DTT

# 3MT-4 A decreased albumin and gamma globulins and an increased α-2 globulins due to an increased α-2 macroglobulin is associated with what condition? A. Hypogammaglobulinemia B. Chronic inflammation C. Nephrotic syndrome D. Cirrhotic profile

# 3MT-4 A strong monoclonal peak in the gamma region is most commonly associated with what condition: A. Acute Inflammation B. Multiple Myeloma C. Nephrotic Syndrome D. Cirrhosis

# 3MT-4 How many samples can the MINICAP Protein 6 run per hour? A. 20 samples B. 25 samples C. 30 samples D. 36 samples

# 3MT-5 In MINICAP Flex Piercing, how many samples does the reagent cup can run simultaneously? A. 10 samples B. 5 samples C. 2 samples D. 20 samples

# 3MT-5 What is considered a qualitative abnormality in serum proteins? A. An increase or decrease of protein fractions B. A change in albumin concentration C. Presence of peaks or distortions D. A decrease in total protein concentration

# 3MT-5 What is the primary purpose of Serum Protein Electrophoresis (SPE)? A. To measure red blood count B. To detect abnormalities in serum proteins C. To identify bacterial infections D. To determine blood sugar levels

# 3MT-5 What is the name of the machine used for SPE? A. MINICAP flexing Piering B. Hydrashift C. Semi-automated hemostasis analyzer D. YUMIZEN G400

# 3MT-5 The control is lyophilised and needs to be reconstituted with 1 ml of distilled water. Wait for 30 minutes at room temperature before mixing. A. First statement is true, Second statement is false B. Second statement is true, First Statement is false C. Both statements are true D. Both statements are false

# 3MT-5 How many main protein fractions are detected in serum protein electrophoresis? A. 7 B. 6 C. 5 D. 3

# 3MT-5 All should be avoided in serum samples for protein electrophoresis, EXCEPT ONE? A. Hemolyzed samples B. Aged samples stored at room temperature C. Fresh Plasma Samples D. Serum samples with albumin concentration

# 3MT-5 What type of sample is used in SPE? A. Whole blood B. Fresh serum C. CSF D. Plasma

# 3MT-5 How long is the launch time for the MINICAP Protein 6 analyzer? A. 2 minutes B. 14 minutes C. 20 minutes D. 30 minute

# 3MT-5 Hypogammaglobulinemia is associated with the ff EXCEPT: A. Partial or total immunodeficiency B. Immunosuppressive treatment C. Free light chains disease or nonsecreting myeloma D. None of the above

# 3MT-5 Monoclonal component quantification is required for A. Monitoring the evolution from a malignant state of gammapathy to a nonmalignant state B. Myeloma classification C. Follow up of treatment deficiency D. None of the above

# 3MT-5 Hypergammaglobulinemia is due to an increase of several subclasses of immunoglobulins that ives a picture of multiple monoclonal bands called ________ A. Oligoclonal profile B. Oligoclonal bands C. Both D. Neither

# 3MT-3 How many samples can MINICAP Flex Piercing process in one run? a. 1 b. 2 c. 3 d. 4

Answer: B. 2 The reagent cup used for the MINICAP Flex Piercing machine has holes for 2 samples as the machine itself has 2 capillaries inside the machine, allowing it to run 2 samples at the same time.

# 3MT-3 For Quality Control, the following are false, EXCEPT: a. The cap of the microtube must be cut after control analysis b. After reconstitution with 1mL of distilled water, mix the control immediately c. Pool of lyophilised sera is stored at ref. temp 2-8°C d. Freezing / thawing cycles have a 30 times maximum

Answer: C. pool of lyophilised sera is stored at ref. temp 2-8°C The cap of the microtube must be cut BEFORE control analysis Wait 30 minutes at room temperature before mixing the control after addition of 1mL distilled water Freezing / thawing cycles only have a maximum of 20 times

# 3MT-3 In Serum Protein Electrophoresis, what is acute inflammation associated with? a. Polyclonal increase of beta and gamma globulins b. Decrease of albumin c. Increase of alpha-1 antitrypsin d. A and B e. B and C

Answer: E. B and C Polyclonal increase of beta and gamma globulins is associated with chronic inflammation

# 3MT-3 The following questions can be answered with SPE, EXCEPT: a. Monitor the evolution of malignant disease b. Allow an early detection of asymptomatic myeloma c. Follow up on the efficiency of an immunosuppressive treatment d. None of the above e. All of the above

Answer: D. None of the above. Monitoring the progression of malignant disease, detecting asymptomatic myeloma early, monitoring the effectiveness of immunosuppressive treatment, confirming a pathological diagnosis in relation to other parameters, such as inflammation, hepatitis, cirrhosis or nephrotic profile, and determining the presence of a monoclonal immunoglobulin when a myeloma is suspected with clinical signs are all made possible by serum protein electrophoresis.

# 3MT-3 Beta-gamma bridge due to polyclonal increase of beta-gamma globulins is best observed in which of the following conditions? a. Nephrotic syndrome b. Liver cirrhosis c. Hypogammaglobulinemiaia d. Chronic inflammation

Answer: B. Liver cirrhosis Reduced albumin, alpha-1, alpha-2, and beta-gamma bridge as a result of polyclonal elevation of beta-gamma globulins are characteristics of SPE of liver cirrhosis. Meanwhile, a reduction in albumin and gamma globulins and an increase in alpha-2 globulins are indicative of nephrotic syndrome. Additionally, the concentration of total protein would be decreased. Hypogammaglobulinemia is caused by a decrease in gamma fractions. Chronic inflammation is distinguished by an increase in alpha-1 and alpha-2 globulins, decreased albumin, and a polyclonal increase in beta and gamma globulin.

# 3MT-3 Alpha-1 and alpha-2 globulin levels rise in response to acute inflammation because of the increase of the following, EXCEPT: a. Albumin b. Alpha-1-antitrypsin c. Orosomucoid d. Haptoglobin

Answer: A. Albumin In Acute inflammation, alpha-1 and alpha-2 globulins increases due to an increase in alpha-1-antitrypsin, orosomucoid, and haptoglobin only. Albumin is decreased in acute inflammation

# 3MT-3 The following are TRUE for sample specifications, EXCEPT: a. Fresh serum sample b. Storage at 2-8oC can last up to 10 days c. Samples should not be hemolyzed and aged d. Fresh plasma sample

Answer: D. Fresh plasma sample Samples used for MINICAP are fresh serum samples. It is noted that usage of plasma must be avoided.

# 3MT-3 The purpose of serum protein electrophoresis is to detect abnormalities in serum proteins. Quantitative abnormalities are the presence of peaks or distortions, while qualitative abnormalities are the increase or decrease of fractions. a. Only the first statement is true b. Only the second statement is true c. Both statements are true d. Neither statements are true

Answer: A. Only the first statement is true The purpose of serum protein electrophoresis is to detect abnormalities in serum proteins. Quantitative abnormalities are the increase or decrease of fractions, while qualitative abnormalities are the presence of peaks or distortions.

# 3MT-3 Decreased albumin in the serum protein electrophoresis is associated with what pathological conditions? a. Acute Inflammation b. Chronic Inflammation c. Nephrotic Syndrome d. A and B e. A, B, and C

Answer: E. A, B, and C

# 3MT-3 The characteristics of monoclonal peak in gamma fraction observed in the serum protein electrophoresis are as follows: a. Pointed; Large basement b. Rounded top; Narrow basement c. Pointed; Narrow basement d. Rounded top; Large basement

Answer: C. Pointed; Narrow basement Pointed peak and narrow basement in the case of monoclonal immunoglobulin implies that there is a single malignant cell that is over-proliferating.

# 3MT-3 The following conditions require complementary immunotyping, EXCEPT: a. Beta 2 gamma bridge b. Strong monoclonal peak in gamma c. Polyclonal increase in the gamma area d. Faint distortion in gamma

Answer: A. Beta 2 gamma bridge In cases of known liver disease or positive liver function tests, immunotyping/immunofixation is not required such as in beta-gamma bridging where it is closely associated with liver cirrhosis or chronic liver disease.

# 3MT-3 Acute inflammation is characterized by polyclonal increase of IgA in beta 2 and IgG in gamma. It is also associated with decreased albumin. a. Only the first statement is true b. Only the second statement is true c. Both statements are true d. Neither statements are true

Answer: B. Only the second statement is true Polyclonal increase of beta and gamma globulins is involved in chronic inflammation

# 3MT-3 The following are TRUE for storage of quality control, EXCEPT: a. Reconstituted control can be stored at 2 to 8℃ for a maximum of 1 week b. Reconstituted control can be stored at -18 to -30℃ for a maximum of 6 months c. Freezing and thawing cycles can be done 15 times the maximum d. Freezing and thawing cycles can be done for 20 times maximum

Answer: C. Freezing and thawing cycles can be done for 15 times maximum Freezing and thawing cycles of Quality Control can be done for a maximum of 20 times.

# 3MT-3 In serum protein electrophoresis, nephrotic syndrome is characterized by: a. Increase of albumin and gamma globulins b. Increase of alpha-2 globulins c. Decrease of Total protein concentration (<60 g/L or 6 g/dL) d. A and B e. B and C

Answer: E. B and C In Nephrotic syndrome, there is a decrease of proteins as they are excreted in the urine because the kidneys are not able to filter them, except for alpha-2 macroglobulin. There is an increase of alpha-2 globulins due to an increase of alpha-2 macroglobulin because they are not excreted in the urine due to its large size.

# 3MT-3 Hypogammaglobulinemia is associated with the following, EXCEPT: a. Free light chains disease or non-secreting myeloma b. Partial or total immunodeficiency c. Immunosuppressive treatment d. All of the above e. None of the above

Answer: E. None of the above Free light chains disease or non-secreting myeloma, immunosuppressive treatment, and partial or total immunodeficiency are all associated with hypogammaglobulinemia.

# 3MT-3 16. How many samples per hour “Serum Protein Electrophoresis” can do? a. 10 b. 15 c. 20 d. 25

Answer: c. 20 The machine could run 3 mins. per sample

# 3MT-3 Electrophoresis should be analyzed for qualitative and/ or quantitative abnormalities a. True b. False

# 3MT-3 Treatment used to depolymerize monoclonal Ig a. Alpha Mercaptoethanol (AME) b. Gamma Mercaptoethanol (GME) c. Beta Mercaptoethanol (BME) d. Epsilon Mercaptoethanol (EME)

# 3MT-3 With regards to the Minicap Flex-Piercing, the supplier requires the operator to use ________________ tubes when running immunotyping and CDT techniques. a. Capped b. Uncapped c. Either d. Neither

Answer: B. Uncapped; It is advised to use uncapped tubes so that the needle can directly get the serum sample from the tube.

# 3MT-3 What is/are the control serum/s used in Minicap Flex-Piercing? a. Normal Serum b. Hypergamma Serum c. Both d. Neither

Answer: C. Both; Normal control serum is used to check for norma

# 3MT-3 What type of pathologic screening pattern is seen in malnutrition? Choose all that apply. i. Decreased total protein ii. Positive beta-gamma bridging iii. Decreased alpha-2 globulin iv. Increased albumin a. I only b. i, ii, iii, iv c. i, iii d. i, ii

Answer: C. I, iii; decreased total protein and a-2 globulin is a characteristic pattern of malnutrition but not limited to it. Beta-gamma bridging is seen in liver diseases, while increased albumin contradicts malnutrition.

# 3MT-2 Why is it essential to check the alpha-2 and beta fractions of hypogammaglobulinemia? A) To detect an elevated in gamma fraction B) To detect a potential monoclonal abnormality C) To detect the reduction of free light chains D) To detect an increase in Bence Jones protein

# 3MT-2 A 30 yrs old patient with rheumatoid arthritis is undergoing immunosuppressive treatment. Serum protein electrophoresis (SPEP) shows a pattern of 3 or more faint, narrow, and homogenous bands. What is the most likely interpretation of this result? A) Monoclonal gammopathy B) Oligoclonal pattern C) Polyclonal gammopathy D) Normal serum protein pattern

B Rationale: The presence of 3 or more faint, narrow, and homogenous bands in serum protein electrophoresis (SPEP) is characteristic of an oligoclonal pattern.

# 3MT-2 Oligoclonal pattern is the presence of 3 or more faint, narrow, and homogenous bands which can be observed in all of following, EXCEPT: A. Autoimmune reactions associated with transplants B. Rheumatoid Arthritis, Lupus C. Infections (Viral, Bacterial, Parasitic) D. Nephrotic Syndrome E. None of the above

# 3MT-2 Liver Cirrhosis: I. Increase in albumin area II. Increase in β-2 area III. Increase of γ area IV. Presence of β-γ bridge A. IV only B. I, II, IV C. II, III, IV D. I, II, III, IV

C Rationale: In liver cirrhosis, the total protein, α-1 area, α-2 area, and β-1 are normal. There is a decrease in the albumin area, while there is an increase in both β-2 and γ area. There is also a presence of β-γ bridge.

# 3MT-2 Chronic Inflammatory Disorders: I. Normal β-1 area II. Normal β-2 area III. Increase in β-1 area IV. Increase in γ area A. I, IV B. II, III, IV C. II only D. IV only

A Rationale: Chronic inflammatory disorders Normal: Total protein, β-1 Increase: α-1, α-2, β-2, γ Decrease: Albumin

# 3MT-2 Storage temperature requirements for reconstituted control reagents for Sebia SPE includes: A. -18°C to -30°C for 6 months maximum B. -18°C to -30°C for 6 weeks maximum C. 2°C to 8°C for 1 month maximum D. 2°C to 8°C for 1 day maximum

A Rationale: The correct temperature requirements for reconstituted control reagents for Sebia SPE are -18°C to -30°C for 6 months maximum and 2°C to 8°C for 1 week maximum

# 3MT-2 The maximum amount of freeze-thaw cycle allowable for the quality control reagents of Sebia SPE is A. 10 times B. 30 times C. 20 times D. 40 times

C Rationale: The correct maximum amount of freeze-thaw cycle allowable for the quality control reagents of Sebia SPE is 20 times

# 3MT-2 Interpret the result: lpha-1 and alpha-2 are increased, while the rest are normal. A. Chronic inflammatory profile B. Acute inflammatory profile C. Hypogammaglobulinemia D. Potential oligoclonal profile (or polymerized monoclonal immunoglobulin in gamma)

# 3MT-2 All but one are positions of monoclonal immunoglobulin in serum protein electrophoresis A. Peak in Gamma B. Additional distortion in beta-1/beta-2 C.Isolated increase of Alpha 2 with Inflammatory context D. Beta 2 Beta 1 without Hepatic Disease

# 3MT-2 What is seen in monoclonal immunoglobulin distorsion in Beta 1 on capillary electrophoresis? A. Additional Peak or Isolated Increase without Iron Anemia B. Beta 2 Beta 1 without an inflammatory context or hepatic disease C. Isolated increase of Alpha-2 without inflammatory context D. None

# 3MT-2 What abnormalities can serum protein electrophoresis detect? A. Only quantitative abnormalities. B. Only qualitative abnormalities. C. Both quantitative and qualitative abnormalities. D. Neither quantitative nor qualitative abnormalities.

# 3MT-2 What conditions are associated with acute inflammation? A. Decrease of α1 and α2 globulins. B. Increase of α1 and α2 globulins and decrease of albumin. C. Increase of albumin. D. Polyclonal increase of beta and gamma globulins.

# 3MT-2 In the case of hypogammaglobulinemia, which fractions must be carefully checked for potential monoclonal abnormality? A. Gamma and alpha-1 fractions. B. Albumin and beta fractions. C. Alpha-2 and beta fractions. D. Alpha-1 and alpha-2 fractions.

# 3MT-2 What changes in protein levels are characteristic of nephrotic syndrome? A. Increase of albumin and gamma globulins. B. Decrease of alpha-2 globulins. C. Polyclonal increase of beta-gamma globulins. D. Decrease of albumin and gamma globulins, and increase of alpha-2 globulins.

# 3MT-2 Immunotyping is required A. to distinguish oligoclonal profile and polymerized monoclonal immunoglobulin B. to determine the type of cancer/myeloma the patient has C. alpha-2 value is increased but without inflammatory response D. A and B only E. A, B and C

# 3MT-2 Polyclonal immunoglobulins are associated with myeloma and seen with a pointed peak and narrow basement in serum protein electrophoresis. Monoclonal immunoglobulins occur when B lymphocytes are activated during infection and it is seen with rounded top and large basement in serum protein electrophoresis A. Only the first statement is true B. Only the second statement is true C. Both statements are true D. Both statements are false

# 3MT-1 What is the purpose of serum protein electrophoresis? a. To measure blood glucose levels b. To detect abnormalities in serum proteins c. To assess kidney function d. To test for bacterial infections

# 3MT-1 What type of sample is required for serum protein electrophoresis? a. Plasma b. Whole blood c. Fresh serum d. Urine

# 3MT-1 Monoclonal peak in gamma fraction is described as: a. Narrow basement b. Pointed peak c. All of the above d. None of the above

# 3MT-1 Hypergammaglobulinemia is associated with: a. Chronic infections b. Total immunodeficiency c. Immunosuppressive treatment d. Partial immunodeficiency

# 3MT-1 What are the recommended storage conditions for serum samples used in serum protein electrophoresis? a. 2 to 8 °C; preserved up to 10 days b. 18 to 30 °C; preserved up to 2 months c. -2 to 8 °C; preserved up to 2 weeks d. -18 to -30 °C; preserved up to 10 months

# 3MT-1 The following are the performances & throughput of MINICAP Protein 6 except: a. Launch: 15 mn b. High Throughput: 20 samples/h c. Both d. None of the above

# 3MT-1 Presence of 3 or more faint, narrow and heterogenous bands. Hypergammaglobulinemia is due to increase of several subclasses of immunoglobulins, that gives a picture of multiple “polygonal” bands called “oligoclonal profile” or “oligoclonal bands” a. First statement is true. Second statement is false. b. Second statement is true. First statement is false. c. Both d. Neither

# 3MT-1 Which of the following is associated with Hypogammaglobulinemia? a. Cirrhosis b. Chronic infections c. Both d. Neither

# 3MT-1 What is the recommended storage temperature for reconstituted control for a maximum of 6 months? a. -17*C b. -20*C c. Both d. Neither

# 3MT-1 Gammopathy observed in SPE for Myeloma: a. Polyclonal Immunoglobulins b. Incomplete Immunoglobulins c. Monoclonal Immunoglobulins d. Pentameric Immunoglobulins

# 3MT-1 TRUE of Nephrotic Syndrome a. Increase of albumin and gamma globulins b. Decrease of alpha 2 globulins c. Decrease of total protein concentration d. None of the above

# 3MT-1 It is advisable to observe serum aspect before any analysis in order to detect the following except for one: a. hemolysis b. low density c. high viscosity d. turbidity

# 3MT-1 Which of the following is associated with myeloma on serum protein electrophoresis? a. Polyclonal immunoglobulins b. Result is the excess of a single immunoglobulin in the serum c. All B lymphocytes produced their immunoglobulins at the same level d. All of the above

# 3MT-1 Which protein fraction is the largest and most abundant in a Sebia Serum Protein Electrophoresis (SPE) test? a. Albumin b. Gamma globulin c. Beta globulin d. Alpha-1 globulin

# 3MT-1 An elevated level of which fraction in serum protein electrophoresis is associated with inflammation? a. Albumin b. Alpha-1 globulin c. Alpha-2 globulin d. Gamma globulin

# 3MT-1 Which of the following is correct about the pathological conditions on serum protein electrophoresis - cirrhotic profile? a. Decrease of alpha 1, 2 globulins and beta gamma globulins b. Decrease of albumin, hapten and alpha 1 c. Increase of alpha 1, 2 and albumin d. Increase of beta gamma globulins, alpha 1 and 2 e. NOTA