MOVIE, COFFEE Flashcards by MS ICA

Which of the following bacteria is able to hydrolyze urea via urease production, which results in an increase in urine pH that is toxic to kidney cells and stimulates the formation of kidney stones?

A. E. coli
B. Proteus
C. S. aureus
D. Pseudomonas aeruginosa

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Incubation of which organism at 25°C produces a characteristic yellow pigment?

A. Cronobacter (Enterobacter) sakazakii
B. Plesiomonas shigelloides
C. Enterobacter aerogenes
D. Hafnia alvei

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Which of the following Haemophilus species is an agent of a sexually transmitted disease?

A. H. parainfluenzae
B. H. influenzae
C. H. ducreyi
D. H. segnis

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Campylobacter species should be grown at what optimum temperature?

A. 25° C
B. 37°
C C. 42° C
D. None of the above

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Which organisms are plump coccobacilli that may resist decolorization and may be mistaken for Neisseria spp?

A. Acinetobacter spp.
B. Bordetella spp.
C. Stenotrophomonas sp.
D. Burkholderia sp.

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Which of the following has been recognized in postinfectious complications of a Campylobacter jejuni infection?

A. Guillain-Barré syndrome
B. Chronic pulmonary disease
C. Encephalitis
D. Endocarditis

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Which encapsulated type of H. influenzae is most common?

A. Type a
B. Type b
C. Type c
D. Type d

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All of the following organisms require X and V factors, except:

A. H. influenzae
B. H. haemolyticus
C. H. influenzae biotype aegyptius
D. Aggregatibacter aphrophilus

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A patient presents to the physician with pain and frequency of urination. The urine culture reveals a non–lactose fermenting, gram-negative rod with characteristic swarming on blood agar. The biochemical test that would specifically distinguish this organism from other Enterobacteriaceae is:

A. Lactose fermentation
B. Oxidase
C. Phenylalanine deaminase and H2S
D. Triple sugar iron agar

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What is the specimen of choice for culturing B. pertussis?

A. Throat
B. NP swab
C. Sputum
D. Anterior nose

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Campylobacter are:

A. Small, curved, motile, gram-positive bacilli
B. Small, curved, motile gram-negative bacilli
C. Small, curved, nonmotile, gram-positive bacilli
D. Small, curved, nonmotile, gram-negative bacilli

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A 25-year-old man who had recently worked as a steward on a transoceanic gram ship presented to the emergency room with high fever, diarrhea and prostration. Axilliary lymph nodes were hemorrhagic and enlarged. A Wayson stain of the aspirate showed bacilli that were bipolar, resembling safety pins. The most likely identification of this organism is:

A. Brucella melitensis
B. Streptobacillus moniliformis
C. Spirillum minus
D. Yersinia pestis

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Which of the following organisms can grow in the small bowel and cause diarrhea in children, traveler’s diarrhea, or a severe cholera-like syndrome through the production of enterotoxins?

A. Yersinia enterocolitica
B. Escherichia coli
C. Salmonella typhi
D. Shigella dysenteriae

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A sputum culture from an alcoholic seen in the ER grows gray, mucoid, stringy colonies on sheep blood agar. The isolate grows readily on MacConkey agar and forms mucoid, dark pink colonies. The colonies yield the following test results: ONPG: + Indole: - Glucose: + Oxidase: - Citrate: + VP: + The organism is most likely:

A. Edwardsiella tarda
B. Klebsiella pneumoniae
C. Escherichia coli
D. Proteus vulgaris

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A gram-positive coccus isolated from a blood culture has the following characteristics: Optochin susceptibility: negative Bacitracin (0.04 U) susceptibility: negative Bile esculin hydrolysis: negative Hippurate hydrolysis: positive Catalase: negative This organism is most likely:

A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Streptococcus pyogenes
D. Streptococcus agalactiae

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The best medium for culture of Bordetella pertussis is:

A. Regan-Lowe agar
B. Cystine blood agar
C. Martin Lewis agar
D. Ashdown agar

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An antibiotic that inhibits cell wall synthesis is:

A. Chloramphenicol
B. Penicillin
C. Sulfamethoxazole
D. Colistin

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In order to isolate Campylobacter coli/jejuni, the fecal specimen should be:

A. Inoculated onto selective plating media and incubated in reduced oxygen with added CO2 at 42°C
B. Stored in tryptic soy broth before plating to ensure growth of the organism
C. Inoculated onto selective plating media and incubated at both 35°C and at room temperature
D. Incubated at 35°C for 2 hours in Cary-Blair media before inoculating onto selective plating media

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All of the following bacterial cell walls contains mycolic acid, EXCEPT:

A. Nocardia
B. Rhodococcus
C. Streptomyces
D. Corynebacterium

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When performing a stool culture, a colony type typical of an enteric pathogen is subcultured on a blood agar plate. The resulting pure culture is screened with several tests to obtain the following results: TSI: acid butt, alkaline slant, no gas, no H2S Phenylalanine deaminase: negative Motility: positive Serological typing:Shigella flexneri (Shigella subgroup-B) The serological typing is verified with new kit and controls. The best course of action would be to:

A. Report the organism as Shigella flexneri without further testing
B. Verity reactivity of motility medium with positive and negative controls
C. Verify reactivity of the TSI slants with positive and negative controls for H2S production
D. Verify reactivity of phenylalanine deaminase with positive and negative controls

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BAILEY
Which family of viruses produces one of the most lethal hemorrhagic fevers?
A. Bunyaviridae
B. Filoviridae
C. Flaviviridae
D. Arenaviridae

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BAILEY
Which actinomycete is partial acid-fast, has extensive aerial hyphae, and is lysozyme resistant?
A. Nocardia sp.
B. Rhodococcus sp.
C. Gordonia sp.
D. Tsukamurella sp.

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BAILEY
Sulfur granules in a clinical specimen indicate the presence of:
A. Clostridium spp.
B. Fusobacterium spp.
C. Actinomyces spp.
D. Peptostreptococcus spp.

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BAILEY
Adding specimen scrapings to 10% KOH to show the presence of sclerotic bodies that resemble copper pennies is useful in the diagnosis of:
A. Chromoblastomycosis
B. Phaeohyphomycosis
C. Mycetomas
D. Zygomycosis

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BAILEY Bartonella quintana has been known to cause: A. Carrion’s disease B. Trench fever C. Cat-scratch disease D. Lyme disease

BAILEY Which serovar of Chlamydia trachomatis causes lymphogranuloma venereum? A. A B. C C. H D. L1

BAILEY Which organism causes Rocky Mountain spotted fever? A. Chlamydia trachomatis B. Ehrlichia chaffeensis C. Rickettsia rickettsii D. Coxiella burnetti

BAILEY Pulmonary anthrax is also known as: A. Black eschar B. Woolsorters’ disease C. Legionnaires’ disease D. Plague

BAILEY Which of the following culture characteristics alert the microbiologist to a possible infection resulting from Eikenella corrodens? A. Rapid growth on 5% sheep blood, chocolate, and MacConkey agar B. Pitting of the agar and a characteristic chlorine bleach smell C. Growth with alpha hemolysis on the 5% sheep blood agar and no growth on MAC agar D. Limited growth on 5% sheep blood, chocolate, and MacConkey agar, but improved growth using BYCE media

BAILEY Which of the following organisms is acquired via exposure to infected birds? A. Coxiella burnetii B. Chlamydia psittaci C. Anaplasma phagocytophilum D. Tropheryma whipplei

BAILEY Which fungus is most often acquired by traumatic implantation into the skin? A. Histoplasma capsulatum B. Sporothrix schenckii C. Coccidioides immitis D. Penicillium marneffei

BAILEY A large, aerobic, gram-positive, spore-forming rod is isolated from a blood culture. It can be further confirmed as B. anthracis if it is: A. Hemolytic and motile B. Hemolytic and nonmotile C. Nonhemolytic and motile D. Nonhemolytic and nonmotile

BAILEY Which test can be used to differentiate T. mentagrophytes from T. rubrum? A. Fluorescence using a Wood’s lamp B. In vitro hair perforation C. Red color on reverse side of colony D. Pyriform microconidia

BAILEY Infection caused by non–acid-fast aerobic actinomycetes is usually chronic, granulomatous lesions of the skin referred to as: A. Mycelium B. Necrosis C. Impetigo D. Mycetoma

BAILEY Pregnant women and immunocompromised patients should avoid eating which of the following foods to prevent Listeria infection? A. Feta cheese B. Peanuts C. Pickles D. Ice cream

BAILEY Spirillum minus also causes rat-bite fever in humans and is referred to as: A. Haverhill fever B. Legionnaire’s disease C. Hantavirus D. Sodoku

BAILEY Loeffler’s agar slant is a special culture medium used to recover which organism? A. Streptococcus pyogenes B. Corynebacterium diphtheriae C. Bordetella pertussis D. Neisseria meningitidis

Germ tube formation is seen with which two yeasts? A. C. albicans, C. neoformans B. C. albicans, C. parapsilosis C. C. glabrata, C. parapsilosis D. C. albicans, C. dubliniensis E. C. glabrata, C. dubliniensis

Clinical Laboratory Standard Institute (CLSI) recommends that: A. Bands should be included within the eosinophil count B. Bands should be included within the basophil count C. Bands should not be included within the neutrophil count, and reported as separate category D. Bands should be included within the neutrophil count and not reported as separate category

Clinical signs and symptoms commonly include low birth weight (<2,500 g), skin hyperpigmentation (café au lait spots), and short stature. Other manifestations can include skeletal disorders (aplasia or hypoplasia of the thumb), renal malformations, microcephaly, hypogonadism, mental retardation, and strabismus. A. Diamond-Blackfan anemia B. Fanconi anemia C. Sideroblastic anemia D. Thalassemia

1. Which Brucella species may require CO2 for growth, is urea positive in 2 hours, and is inhibited by thionine dye? A. Brucella abortus B. Brucella melitensis C. Brucella suis D. Brucella canis 2. Brucella isolate that does not produce H2S, does not require CO2, and is not inhibited by thionine and basic fuchsin is probably which species of Brucella? A. Brucella canis B. Brucella abortus C. Brucella suis D. Brucella melitensis

A, D

1. Access to the laboratory is limited or restricted, and there must be a biohazard sign posted at the entrance of the laboratory: A. BSL-1 B. BSL-2 C. BSL-3 D. BSL-4 2. Access to the laboratory is limited when work is being conducted. The laboratory director is ultimately responsible for determining who may enter or work in the laboratory. A. BSL-1 B. BSL-2 C. BSL-3 D. BSL-4 3. Laboratory should be separated from the other parts of the building and be accessed through two self-closing doors. An ANTEROOM may be used for access. A. BSL-1 B. BSL-2 C. BSL-3 D. BSL-4 4. The BSL facility either is located in a separate building or is in an isolated zone within a building. A. BSL-1 B. BSL-2 C. BSL-3 D. BSL-4

A, B, C, D

1. In the laboratory, a program that monitors the total testing process with the aim of providing the highest quality patient care: A. Quality systems B. Quality control C. Quality assessment/assurance 2. A system that verifies the reliability of analytical test results through the use of standards, controls, and statistical analysis: A. Quality systems B. Quality control C. Quality assessment D. Quality assurance 3. In an institution, a comprehensive program in which all areas of operation are monitored to ensure quality with the aim of providing the highest quality patient care: A. Quality systems B. Quality control C. Quality assessment D. Quality assurance

C, B, A

Which animals were immunized that led to the discovery of the Rh blood group? A. Rhesus macaque monkeys B. Mice and rats C. Frogs D. Guinea pigs and rabbits

1. A solution used to clean the site before routine venipuncture is: A. 5.25% sodium hypochlorite B. 70% isopropyl alcohol C. 70% methanol D. Povidone–iodine 2. This antiseptic has been traditionally used to obtain the high degree of skin antisepsis required when BLOOD CULTURES are being collected: A. 70% Ethyl alcohol B. 70% Isopropanol C. Hydrogen peroxide D. Povidone–iodine

B, D

BOC A Gram-negative bacillus with bipolar staining was isolated from a wound infection caused by a bite from a pet cat. The following characteristic reactions were seen: Oxidase: positive Glucose OF: fermentative Motility: negative MacConkey agar: no growth Which of the following is the most likely organism? A. Pseudomonas aeruginosa B. Pasteurella multocida C. Aeromonas hydrophila D. Vibrio cholerae

BOC The microscopic structures that are MOST useful in the identification of DERMATOPHYTES are: A. Septate and branching hyphae B. Racquet and pectinate hyphae C. Chlamydospores and microconidia D. Macroconidia and microconidia

Which of the following Mycobacterium is most noted for being associated with patients with acquired immunodeficiency syndrome? A. M. avium-intracellulare complex B. M. marinum C. M. kansasii D. M. bovis

1. Fluorescence on Wood's lamp, growth in rice medium: A. Microsporum canis B. Microsporum gypseum C. Microsporum audouinii D. Epidermophyton floccosum 2. Fluorescence on Wood's lamp, no growth in rice medium: A. Microsporum canis B. Microsporum gypseum C. Microsporum audouinii D. Epidermophyton floccosum

A, C

BOC TAKE NOTE ORGANISM IS OXIDASE POSITIVE While swimming in a lake near his home, a young boy cut his foot, and an infection developed. The culture grew a nonfastidious gram-negative, oxidase positive, beta hemolytic, motile bacilli that produced deoxyribonuclease. The most likely identification is: A. Enterobacter cloacae B. Serratia marcescens C. Aeromonas hydrophila D. Escherichia coli

BOC Fluid from a cutaneous black lesion was submitted for routine bacterial culture. After 18 hours of incubation at 35°C there was no growth on MacConkey agar, but 3+ growth on sheep blood agar. The colonies were nonhemolytic, nonmotile, 4-5 mm in diameter and off-white with a ground glass appearance. Each colony had an irregular edge with comma-shaped outgrowths that stood up like “beaten egg whites” when gently lifted with an inoculating needle. A Gram stain of a typical colony showed large, gram-positve rectangular bacilli. The organism is most likely: A. Clostridium perfringens B. Aeromonas hydrophila C. Bacillus anthracis D. Mycobacterium marinum

BOC A young girl cuts her foot on a rock while swimming at the ocean. Her foot begins to show signs of infection and her parents take her to the ER. A culture grows a non-lactose fermenting gram-negative rod that produces copious amounts of hydrogen sulfide and gas, is indole positive and motile. The organism most likely isolated is: A. Shigella spp. B. Escherichia spp. C. Edwardsiella spp. D. Klebsiella spp.

BOC The Gram stain of drainage from a pulmonary sinus tract shows many WBCs and 3+ branching gram-positive bacilli. Colonies grow only on anaerobic media after 3 days incubation. They are yellow-tan and have a molar tooth appearance. The most likely genus is: A. Actinomyces B. Bacteroides C. Fusobacterium D. Nocardia

A patient with a Wood’s lamp positive, dermatophytic infection has a skin scraping taken for culture. The organism grows on SDA agar with a light-tan front and salmon-colored reverse. Microscopically the organism produces rare distorted macroconidia and rare microconidia. Additionally, there was no growth on sterile rice medium.What is themost likely organism? A. Microsporum canis B. Microsporum gypseum C. Microsporum audouinii D. Epidermophyton floccosum

BAILEY Repression of normal flora by the intake of antimicrobials often results in a gastrointestinal infection with: A. Enteropathogenic E. coli B. Pseudomonas aeruginosa C. Clostridium difficile D. Candida albicans

Yellow ground-glass colonies on cycloserine cefoxitin fructose agar (CCFA): A. Bacillus anthracis B. Bacillus cereus C. Clostridium difficile D. Clostridium perfringens

A stool sample is sent to the laboratory for culture to rule out Clostridium difficile. What media should the microbiologist use and what is the appearance of the organisms on this media? A. CTBA: black colonies B. Brucella agar: red pigmented colonies C. CCFA: yellow, ground glass colonies D. CNA: double zone hemolytic colonies

A gram-positive bacillus was isolated from a wound specimen and had the following characteristics: double zone of β hemolysis, lecithinase positive, lipase negative, spot indole negative. What is the most likely identification of this organism? A. Clostridium perfringens B. Clostridium ramosum C. Clostridium septicum D. Clostridium tetani

Acid-fast staining of a smear prepared from a digested sputum showed slender, slightly curved, beaded red mycobacterial rods. Growth on Middlebrook 7H10 slants produced buff-colored microcolonies with a serpentine pattern after 14 days at 37C. Niacin and nitrate reduction tests were positive. What is the most probable presumptive identification? A. Mycobacterium tuberculosis B. Mycobacterium kansasii C. Mycobacterium ulcerans D. Mycobacterium avium complex

1. Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease? A. Cathepsin-D B. CA-15-3 C. Retinoblastoma gene D. Estrogen receptor (ER) 2. Which tumor marker is used to determine the usefulness of TRASTUZUMAB (HERCEPTIN) therapy for breast cancer? A. PR B. CEA C. HER-2/neu D. Myc

B, C

An elevated anion gap may be caused by all of the following except: A. Uremia/renal failure B. Ketoacidosis in case of starvation or diabetes C. Alcohol or salicylate poisoning D. Hypoalbuminemia

Identify the result that is NOT electrolyte balanced. (compute the anion gap, results are in mmol/L) A. Na+ 125, K+ 4.5, Cl- 100, CO2 content 10 B. Na+ 135, K+ 3.5, Cl- 95, CO2 content 28 C. Na+ 145, K+ 4.0, Cl- 90, CO2 content 15 D. Na+ 150, K+ 5.0, Cl- 110, CO2 content 30

An order for blood products for a recent recipient of a bone marrow graft was received in the transfusion service. Because these patients are especially susceptible to GVHD from a transfusion, which blood product would best prevent GVHD? A. Leukocyte reduction of the unit B. Washing the unit with normal saline C. Irradiation of the blood product D. Providing HLA-matched blood products

CHECK YOUR HARMENING ISBT BEGINNING WITH 030: A. ABO B. Scianna C. John Milton Hagen D. Rh-associated glycoprotein (RHAG)

What is the most common cause of male infertility? A. Mumps B. Klinefelter’s syndrome C. Varicocele D. Malignancy

The crystal associated with ETHYLENE GLYCOL poisoning has which characteristic appearance: A. Envelope, pyramidal B. Dumbbell C. Thorny apple D. Lemon-shaped

RENAL STONE yellow-brown resembling an old soap and feel somewhat greasy: A. Phosphate B. Urate C. Cystine D. Calcium oxalate

Paroxysmal nocturnal hemoglobinuria is characterized by flow cytometry results that are: A. Negative for CD55 and CD59 B. Positive for CD55 and CD59 C. Negative for CD4 and CD8 D. Positive for all normal CD markers

This T cell defect is a congenital anomaly that represents faulty embryogenesis, which results in aplasia of the parathyroid and thymus glands: A. DiGeorge syndrome B. Ataxia telangiectasia C. Bruton agammaglobulinemia D. Wiskott-Aldrich syndrome

1. Major structural protein in VLDL and LDL: A.Apo-A1 B.Apo-A2 C.Apo-B48 D.Apo-B100 2. Structural protein in chylomicrons: A.Apo-A1 B.Apo-A2 C.Apo-B48 D. Apo-B100

D, C

A 1-month-old infant underwent a spinal tap to rule out bacterial meningitis. The CSF was cloudy, and the smear showed many pus cells and short gram-positive rods. After 18 hours, many colonies appeared on blood agar that resembled Streptococcus spp. or L. monocytogenes. Which of the following preliminary tests should be performed on the colonies to best differentiate L. monocytogenes from Streptococcus spp.? A. Hanging-drop motility (25°C) and catalase B. PYR and bacitracin C. Oxidase and glucose D. Coagulase and catalase

1. What is MOST SERIOUS complement deficiency? A. C1 B. C2 C. C3 D. C4 2. What is the MOST COMMON complement component deficiency? A. C1 B. C2 C. C3 D. C4

C, B

Individuals with a _________ are prone to developing severe, recurrent life-threatening infections with encapsulated bacteria such as Streptococcus pneumoniae and may also be subject to immune complex diseases; such complexes can lodge in the kidney and result in glomerulonephritis: A. C1 deficiency B. C2 deficiency C. C3 deficiency D. C5 deficiency

Stains the nucleus: A. Acidified eosin B. Non-acidified eosin C. Acidified hematoxylin D. Non-acidified hematoxylin

First step in automated tissue processor: A. Cold formalin B. Hot formalin C. Cold ethanol D. Hot ethanol

Convert 9.5 µg/dL thyroxine to SI unit: A. 123 µmol/L B. 123 nmol/L C. 125 nmol/L D. 145 µmol/L

1. Which of the tubules is impermeable to water? A. Proximal convoluted tubule B. Descending loop of Henle C. Ascending loop of Henle D. Distal convoluted tubule 2. Which part of the renal tubule is HIGHLY PERMEABLE to water and does not reabsorb sodium and chloride? A. Proximal convoluted tubule B. Descending loop of Henle C. Ascending loop of Henle D. Distal convoluted tubule

C, B

1. Hyponatremia can be classified according to: A. Chloride B. Glucose C. Plasma/serum osmolality D. Urine osmolality 2. Which of the following measurements is necessary to evaluate the cause of hypernatremia? A. Chloride B. Glucose C. Plasma/serum osmolality D. Urine osmolality

C, D

The ETHANOL SHOCK procedure is used to differentiate: A. Actinomyces and Bifidobacterium spp. B. Prevotella and Porphyromonas spp. C. Clostridium and Bacteroides spp. D. Bacteroides and Actinomyces spp.

Rapid antigen detection for HISTIDINE-RICH PROTEIN II (HRP-II) is specific for: A. Plasmodium falciparum B. Plasmodium malariae C. Plasmodium ovale D. Plasmodium vivax

The intestinal nematode considered capable of vertical transmission and the potential cause for congenital infections is: A. Ascaris lumbricoides B. Enterobius vermicularis C. Trichuris trichiura D. Ancylostoma duodenale

For each degree of fever in the patient, pO2 will ____ and pCO2 will ______. A. pO2 and pCO2 will fall 7% and 3% respectively B. pO2 and pCO2 will rise 3% and 7% respectively C. pO2 will rise 7% and pCO2 will fall 3% D. pO2 will fall 7% and pCO2 will rise 3%

In an iodine preparation of feces, an amebic cyst appears to have a basket nucleus and a large glycogen mass that stains reddish-brown. The most probable identity of the cyst is: A. Entamoeba histolytica B. Iodamoeba butschlii C. Naegleria fowleri D. Entamoeba hartmanni

AUTOFLUORESCENCE requires no stain and is recommended for the identification of: A. Entamoeba histolytica cysts B. Toxoplasma gondii tachyzoites C. Dientamoeba fragilis trophozoites D. Cyclospora cayetanensis oocysts

Critical to ovum penetration is the enzyme-containing acrosomal cap located at the tip of the sperm head. The acrosomal cap encompasses approximately: A. Half of the head and cover approximately two-thirds of the sperm nucleus B. Half of the head and cover approximately one-half of the sperm nucleus C. Two-thirds of the head and cover approximately one-half of the sperm nucleus D. Two-thirds of the head and cover approximately two-thirds of the sperm nucleus

Normal sperm morphology, EXCEPT: A. Oval-shaped head B. Head approximately 5 μm long and 3 μm wide C. Flagellar tail approximately 45 μm long D. Acrosomal cap should encompass one-fourth of the head

Normal stool pH A. pH 6 to 7 B. pH 7 to 8 C. pH 8 to 9 D. pH 9 to 10

Smudge cells are seen in increased proportions in: A. AML B. ALL C. CML D. CLL

Antigens are related to human leukocyte antigens (HLA) on RBCs: A. Bg B. Di C. Sd D. Xg

Which of the following blood gas disorders is most commonly associated with an abnormal anion gap? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

Type of necrosis resulting from release of activated PANCREATIC LIPASES into the substance of the pancreas and the peritoneal cavity: A. Coagulation necrosis B. Liquefaction necrosis C. Fat necrosis D. Caseous necrosis

A special form of cell death produced by the tubercle bacillus: A. Liquefaction necrosis B. Coagulation necrosis C. Fat necrosis D. Caseous necrosis

A 49-year-old man develops an acute myocardial infarction because of the sudden occlusion of the left anterior descending coronary artery. The areas of myocardial necrosis within the ventricle can best be described as: A. Coagulative necrosis B. Liquefactive necrosis C. Fat necrosis D. Caseous necrosis E. Fibrinoid necrosis

A universal fixative used for routine purposes: A. Zenker fluid B. Zamboni PAF C. 10% neutral buffered formalin D. Carnoy's fluid

The first and most critical step in histotechnology? A. Fixation B. Clearing C. Infiltration D. Embedding

1. The primary aim of fixation: A. Preserve the morphologic and chemical integrity of the cell B. Act as mordant or accentuators C. Harden and protect the tissue from trauma of further handling D. Inhibit bacterial decomposition 2. The secondary goal of fixation: A. Preserve the morphologic and chemical integrity of the cell B. Act as mordant or accentuators C. Harden and protect the tissue from trauma of further handling D. Inhibit bacterial decomposition

A, C

To maintain an adequate fixation time of 4 to 6 hours, the recommended size of the tissue is: A. 2 cm2, and no more than 2 mm. thick B. 2 cm2, and no more than 4 mm. thick C. 2 cm2, and no more than 6 mm. thick D. 2 cm2, and no more than 8 mm. thick

The connective tissue cells actively involved in wound healing are: A. Plasma cells B. Macrophages C. Mast cells D. Fibroblasts

Malignant tumors of connective tissue are known as: A. Carcinomas B. Sarcomas C. Lipomas D. Fibromas

What type of leukocyte actively participates in acute inflammatory processes and contains myeloperoxidase within its primary (azurophilic) granules and alkaline phosphatase in its secondary (specific) granules? A. Neutrophils B. Eosinophils C. Monocytes D. Lymphocytes E. Plasma cells

There is a strong association between ankylosing spondylitis and: A. HLA-B27 B. HLA-DR3 C. HLA-DR4 D. HLA-A3 E. HLA-BW47

A 52-year-old male presents with symptoms of gastric pain after eat- ing. During workup, a 3-cm mass is found in the wall of the stomach. This mass is resected and histologic examination reveals a tumor composed of cells having elongated, spindle-shaped nuclei. The tumor does not connect to the overlying epithelium and is found only in the wall of the stomach. This tumor most likely originated from A. Adipocytes B. Endothelial cells C. Glandular epithelial cells D. Smooth muscle cells E. Squamous epithelial cells

1. Demonstration of neuron, axons and neurofibrils: A. Bielchowsky's technique B. Luxol fast blue C. Cajal's gold sublimate D. Modified Holzer's method 2. Demonstration of myelin: A. Bielchowsky's technique B. Luxol fast blue C. Cajal's gold sublimate D. Modified Holzer's method

A, B

Rhodanine is used to demonstrate: A. Ferric iron B. Copper C. Calcium D. Urate crystals

Excessive exposure to this clearing agent may be extremely toxic to man and may become carcinogenic or it may damage the bone marrow resulting to APLASTIC ANEMIA: A. Xylene B. Toluene C. Benzene D. Chloroform

Most ideal and most reliable method of determining extent of decalcification: A. Physical test B. Chemical test C. X-ray or radiological test D. Adsorption test

1. Angle formed between the cutting edge of the microtome knife (27 to 32 degree angle): A. Bevel angle B. Clearance angle C. Both of these D. Neither of these 2. Angle formed between the surface of the block and the cutting edge of the knife (0 to 15 degree angle): A. Bevel angle B. Clearance angle C. Both of these D. Neither of these

A, B

Oldest stain: A. Orcein B. Iodine C. Eosin D. Hematoxylin

1. Probably the best vital: A. Nile blue B. Neutral red C. Janus green D. Toluidine blue 2. Vital dye especially recommended for mitochondria: A. Nile blue B. Neutral red C. Janus green D. Toluidine blue

B, C

It is an excellent stain for elastic fibers and is especially recommended in dermatological studies due to its ability to demonstrate the finest and most delicate fibers in the skin. A. Janus green B B. Malachite green C. Night blue D. Orcein

The phosphotungstic acid hematoxylin (PTAH) is useful for demonstrating: A. Edema fluid B. Muscle striations C. Ground substance D. Reticulin network

CHECK YOUR GREGORIOS BEFORE ANSWERING What is the most sensitive lipid stain? A. Oil red O B. Sudan III C. Sudan IV D. Sudan Black B

During the morning rush, your laboratory manager comes into the laboratory and starts explaining a new policy regarding vacation requests. Word spreads of the change throughout the day, and the message has changed somewhat. Several in the laboratory are upset and complain to the laboratory manager. Which of the following actions is the most appropriate way to handle such a situation? A. Nothing should be changed, it was handled appropriately B. The manager should have posted the change on the bulletin board in the break room C. The manager should have announced the policyon each shift D. The manager should have discussed and distributed the policy at a laboratory meeting, or several laboratory meetings, so that all employees heard the policy from the manager

What is the most important role of the manager in charge? A. Independent decision making B. Communication C. Informal discussions D. None of the above

The four essential functions of a manager are: A. Staffing, decision making, cost analysis, evaluating B. Directing, leading, forecasting, implementing C. Planning, organizing, directing, controlling D. Innovating, designing, coordinating, problemsolving

Point-of-care testing (POCT) refers to: A. All testing done to the patient to save time B. All lab testing done in the central lab C. Any clinical lab testing done at the patient’s bedside D. Satellite lab testing

1. Papanicolaou staining consists of how many stains? A. 1 B. 2 C. 3 D. 4 2. Ratio of nuclear to cytoplasmic stains in Papanicolaou staining: A. 1:2 B. 1:3 C. 2:1 D. 3:1 3. Ratio of cytoplasmic to nuclear stain in Papanicolaou staining: A. 1:2 B. 1:3 C. 2:1 D. 3:1 4. What is the second stain in Papanicolaou staining procedure? A. Sudan III B. Harris hematoxylin C. OG-6 D. Eosin azure

C, A, C, C

An unknown pigment in tissue section that can be bleached with a saturated alcoholic solution of picric acid is most likely: A. Melanin pigment B. Hemosiderin C. Formalin pigment D. Mercury pigment

All mercurial fixing solutions lead to the formation in tissues of diffuse BLACK granules and these mercury deposits must be removed BEFORE STAINING. Removal of mercuric chloride deposit is accomplished by: A. Saturated solution of iodine B. Sodium thiosulfate C. Distilled water D. Saturated solution of picric acid

Acridine orange demonstrates: A. Cell wall B. Mitochondria C. Nucleic acid D. Flagella

1. AMINOETHYLCARBAZOLE (AEC), which is __________ in color, is a common chromogen for peroxidases. A. Red B. Brown C. Orange D. Pink 2. DIAMINOBENZIDINE (DAB), which is __________ in color, is a common chromogen for peroxidases. A. Red B. Brown C. Orange D. Pink

A, B

1. If the cell or tissue antigen of interest is detected by directly binding a labeled primary antibody specific for that antigen: A. Direct immunohistochemistry B. Indirect immunohistochemistry C. Both of these D. None of these 2. Uses an unlabeled primary antibody that is detected bound to its antigen with labeled secondary antibodies: A. Direct immunohistochemistry B. Indirect immunohistochemistry C. Both of these D. None of these

A, B

In immunohistochemistry: ______ are raised against specific cellular _____ and then conjugated with a _______. A. Antigen, antibody, visual marker B. Antibody, antigen, visual marker C. Visual marker, antigen, antibody D. Antigen, visual marker, antibody

Elastic cartilage except: A. External ear B. Epiglottis C. Walls of the Eustachian tubes D. Intervertebral discs

Thyroid follicles are lined by this type of epithelium: A. Simple squamous epithelium B. Simple cuboidal epithelium C. Simple columnar epithelium D. Transitional epithelium

Molecular death: A. Flat ECG B. Flat EEG C. Absent breath sounds D. Rigor mortis

Ripening of hematoxylin is a process of: A. Hydrolysis B. Oxidation C. Mordanting D. Reduction

In the ripening of hematoxylin, alkaline (basic) solutions will affect for a _______ oxidizing process A. Slower oxidizing process B. More rapid oxidizing process C. Few hours D. None of these

1. Dip and dunk tissue processor: A. Fluid-transfer B. Tissue-transfer C. Specimens are held in a single process chamber or retort and fluids are pumped in and out as required D. All of these 2. Enclosed tissue processor: A. Fluid-transfer B. Tissue-transfer C. Specimens are transferred from container to container to be processed D. All of these

B, A

Frozen sections are stained by hand because: A. Staining is more accurate B. Prevent overstaining C. Faster for one or a few individual sections D. Predictable colors

Stain for demonstration of Helicobacter pylori: A. Dieterle method B. Grocott methamine silver (GMS) stain C. Toluidine blue, cresyl violet acetate D. Congo red

Warthin-Starry method: A. Mycobacterium B. Nocardia C. Spirochetes D. None of these

1. These knives are used to cut block for ELECTRON MICROSCOPY (EM): A. Disposal blades B. Steel knives C. Diamond or glass knives D. Magnetic blades 2. Microtome knives for PARAFFIN SECTIONING are usually made of: A. Carbon steel B. Diamond C. Glass D. Iron

C, A

Tissue is soft when block is trimmed: A.Incomplete fixation B.Incomplete dehydration C.Incomplete clearing D.Incomplete impregnation

Tissue is opaque, section cutting is difficult due to the presence of alcohol. A.Incomplete fixation B.Incomplete dehydration C.Insufficient clearing D. Incomplete impregnation

MSDS information includes: A. General and emergency information. B. Highly technical chemical formulas. C. Information on competitor products. D. Product manufacturing conditions.

When the chain of infection is broken, an: A. Individual is immune to that microbe. B. Individual is susceptible to infection. C. Infection is prevented from happening. D. Infection will most likely be the result.

Class C fires involve: A. Combustible metals. B. Electrical equipment. C. Flammable liquids. D. Ordinary materials.

This equipment is required when one is collecting a specimen from a patient in airborne isolation. A. Eye protection B. Full face shield C. Mask and goggles D. N95 respirator

What is the proper order for putting on protective clothing? A. Gloves first, then gown, mask last B. Gown first, then gloves, mask last C. Gown first, then mask, gloves last D. Mask first, then gown, gloves last

The blue quadrant of the NFPA diamond-shaped symbol for hazardous materials indicates a: A. Fire hazard. B. Health hazard. C. Reactivity hazard. D. Specific hazard.

Which class of fire occurs with combustible metals? A. Class A B. Class B C. Class C D. Class D

What is the correct order for removing protective clothing? A. Gloves, gown, mask B. Gown, gloves, mask C. Gown, mask, gloves D. Mask, gown, gloves

Alcohol-based antiseptic hand cleaners can be used in place of hand washing if: A. Gloves were worn during the prior activity. B. Hands are first cleaned with detergent wipes. C. Hands were washed after the prior activity. D. No dirt or organic matter is seen on the hands.

Which of the following is a disinfectant? A. Benzalkonium chloride B. Chlorhexidine gluconate C. Household bleach D. Hydrogen peroxide

Going without food or drink except water for 8 to 12 hours is defined as: A. Fasting. B. NPO. C. Routine. D. TDM.

A patient who is NPO: A. Cannot have any food or drink. B. Cannot have anything but water. C. Is in critical but stable condition. D. Is recovering from minor surgery.

Which specimen has priority over all other specimens during processing and testing? A. ASAP B. Fasting C. STAT D. Timed

At 0730, the phlebotomist receives requests for a cortisol level on Unit 4B, a fasting blood sugar (FBS) on Unit 4A, and a stat crossmatch in the ER. In which order should the phlebotomist collect these samples? A. Cortisol, FBS, crossmatch B. FBS, cortisol, crossmatch C. Crossmatch, FBS, cortisol D. FBS, crossmatch, cortisol

Mixed respiratory and nonrespiratory disorders ________ arise from more than one pathologic process and represent the most serious of medical conditions as compensation for the primary disorder is failing. A. Mostly B. Frequently C. Occasionally D. Rarely

If left unprotected from light, bilirubin values may reduce by _____ per hour. A. 10 to 30% B. 30 to 50% C. 50 to 70% D. 70 to 90%

Which statement CORRECTLY describes the mode of action of the antibiotic listed for modified Thayer-Martin medium? A. Colistin inhibits gram positive bacteria B. Nystatin inhibits fungi and molds C. Vancomycin inhibits gram negative bacteria D. Trimethoprim lactate inhibits gram positive bacteria

Which of the following is associated with GRANULOMATOUS DISEASE IN ANIMALS and have been associated with SOFT TISSUE INFECTION IN HUMANS FOLLOWING ANIMAL BITES? A. Actinobacillus B. Cardiobacterium C. Haemophilus D. Vibrio

Which of the following tests helps identify certain species of Enterobacteriaceae, such as Proteus spp., and other important bacteria such as Corynebacterium urealyticum and Helicobacter pylori? A. Indole test B. Hippurate hydrolysis test C. Oxidase test D. Urease test

Which of the following diseases is BEST diagnosed by serologic means? A. Q fever B. Pulmonary tuberculosis C. Gonorrhea D. Actinomycosis

Which mycobacterium is associated with Crohn’s disease? A. M. marinum B. M. paratuberculosis C. M. avium D. M. gordonae

Microscopically, numerous smooth, thin-walled, club-shaped, multiseptate (2 to 4 μm) macroconidia are seen. They are rounded at the tip and are borne singly on a conidiophore or in groups of two or three. MICROCONIDIA ARE ABSENT, spiral hyphae are rare, and chlamydoconidia are usually numerous. A. Epidermophyton floccosum B. Microsporum canis C. Trichophyton mentagrophytes D. Trichophyton rubrum

Acid-fast positive bacilli were recovered from the sputum of a 79-year-old man who had been treated for pneumonia. Which of the following test reactions after 3 weeks of incubation on Löwenstein–Jensen agar are consistent with Mycobacterium tuberculosis? A. Niacin +, Nitrate reduction +, Photochromogen negative B. Niacin negative, Optochin +, Catalase + C. PYR +, Urease +, Bacitracin + D. Ampicillin resistant, Penicillin resistant

In pharmacokinetics, the concentration ________ as the rate of elimination and distribution exceeds absorption. A. Rises B. Spuriously rises C. Declines D. Spuriously declines

SIX SIGMA ROLES 1. Black belts dedicate _______ of their time to quality improvement projects, proactively addressing process and quality problems. A. 10% B. 20% C. 70% D. 100% 2. Green belts contribute ______ of their time to improvement projects while delivering their normal job functions. A. 10% B. 20% C. 70% D. 100%

D, B

1. Fluorophore-labeled thyroxine competes with patient thyroxine for antibody in homogeneous system. Antibody-bound labeled thyroxine rotates slowly, emitting lower energy light. A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA) 2. Fluorogenic substrate–labeled TSH is competing with patient TSH for antibody in this homogeneous assay. Only unbound (leftover) labeled TSH reacts with the enzyme to form fluorescent product. There is a direct relationship between fluorescence and the amount of TSH present in the test sample. A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA) 3. Peroxidase-labeled antibody binds with patient hormone (antigen) to form complex (similar to ELISA). Addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time. A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA) 4. Similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone: A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA)

A, B, C, D

Diluted bleach will inactivate HBV in __ minutes and HIV in ___ minutes. A. 2 minutes, 8 minutes B. 8 minutes, 4 minutes C. 10 minutes, 2 minutes D. 8 minutes, 2 minutes

Most frequently used test in the identification of Gardnerella vaginalis, Streptococcus agalactiae, Campylobacter jejuni, and Listeria monocytogenes: A. Indole test B. Hippurate hydrolysis test C. Oxidase test D. Urease test

1. Which of the following tests is most helpful in differentiating C.jejuni from the other Campylobacter spp.? A. Nitrate reduction B. Urease activity C. Hippurate hydrolysis D. Susceptibility to nalidixic acid 2. A positive hippurate hydrolysis is a characteristic of: A. Campylobacter coli B. Campylobacter jejuni C. Campylobacter lari D. Campylobacter fetus

C, B

Which group of tests best differentiates Helicobacter pylori from C. jejuni? A. Catalase, oxidase, and Gram stain B. Catalase, oxidase, and nalidixic acid sensitivity C. Catalase, oxidase, and cephalothin sensitivity D. Urease, nitrate, and hippurate hydrolysis

Ethanol concentration associated with coma and possible death: A. 0.09 to 0.25% B. 0.18 to 0.30% C. 0.27 to 0.40% D. 0.35 to 0.50%

Mycobacterium tuberculosis is differentiated from Mycobacterium bovis by: A. Growth rate B. Hydrolysis of Tween 80 C. Niacin and nitrate reduction tests D. Catalase test at 68°C

LATEX AGGLUTINATION for cryptococcal _____ is now recommended test for Cryptococcus neoformans. A. Polysaccharide capsule B. Antigen C. Antibody D. Nucleic acids

Most common cause of ASEPTIC MENINGITIS, an inflammation of the brain parenchyma: A. Arenavirus B. Cytomegalovirus C. Enterovirus D. Herpes simplex virus 2

Which of the following fungal organisms is best diagnosed by an ANTIGEN detection test as opposed to an antibody detection assay? A. Histoplasma B. Cryptococcus C. Candida D. Aspergillus

Current recommendations include the combined detection of mannan and anti-mannan antibodies for the specific identification of _____ species in serum samples: A. Bordetella B. Candida C. Cryptococcus D. Mycobacterium

All of the following are metallic fixatives except: A. Carnoy's fluid B. Zenker's fluid C. Orth's fluid D. Regaud's fluid

RETICULIN FIBERS IN GOMORI’S silver impregnation stain: A. Pink B. Black C. Blue D. Red

COCCIDIANS Cryptosporidium and Isospora species are difficult to detect without special staining. Which of the following stains may be used to demonstrate these organisms? A. Trichrome stain B. Chlorazol-black E stain C. Iron hematoxylin stain D. Modified acid-fast stain

The CDC recommends that "standard precautions" be exercised by all healthcare workers to prevent transmission of hepatitis B virus, HIV, and other bloodborne pathogens. What do these precautions include? A. Wearing protective clothing when testing blood specimens from patients in specific areas B. Using special precautionary methods when testing blood specimens with a biohazard label C. Handling every patient blood specimen as if it were infectious D. Carefully recapping needles before discarding

CONGO RED An 87-year-old male develops worsening heart failure. Workup reveals decreased left ventricular filling due to decreased compliance of the left ventricle. Two months later the patient dies, and postmortem sections reveal deposits of eosinophilic, Congo red–positive material in the interstitium of his heart. When viewed under polarized light, this material displays an apple-green birefringence. What is the correct diagnosis? A. Amyloidosis B. Glycogenosis C. Hemochromatosis D. Sarcoidosis E. Senile atrophy

Which of the following organs must be fixed before “grossing” or sectioning: A. Brain B. Heart C. Liver D. Lungs

It is due to edema fluid and connective tissue proliferation: A. True hypertrophy B. False hypertrophy C. Physiological hyperplasia D. Pathological hyperplasia

The first and most critical step in histotechnology: A. Fixation B. Dehydration C. Clearing D. Infiltration

The independent variable is plotted along the: A. Horizontal axis B. Vertical axis C. Y-axis D. Ordinate

Which one of the following viruses is the leading cause of congenital malformations? A. Rabies B. Rhinovirus C. Cytomegalovirus D. Respiratory syncytial virus E. Mumps

This virus is the most important cause of gastroenteritis in infants and young children. It causes infections that are often severe and may be life threatening, especially in infants. A. Echovirus B. Norwalk virus C. Rotavirus D. Orbivirus E. Parvovirus

HAND, FOOT & MOUTH DISEASE Several children in a day care center for preschoolers developed fever, irritability, lack of appetite, and a vesicular rash found on their hands, feet, and mouth . With which virus were these children most likely infected? A. Coronavirus B. Coxsackievirus C. Respiratory syncytial virus D. Rhinovirus

The Von Kossa’s stain is used to demonstrate: A. Calcium B. Amyloid C. Glycogen D. Fats

First clinical laboratory in the Philippines: A. San Lazaro Hospital B. Manila Public Health Laboratory C. Research Institute for Tropical Medicine D. National Reference Laboratory

Introduced medical technology practice in the Philippines after World War II: A. Dr. Pio de Roda B. Dr. Mariano Icasiano C. Dr. Prudencia Sta. Ana D. 26th Medical Laboratory of the 6th US Army

Which of the ff. published standards for GOOD LABORATORY PRACTICE (GLP)? A. CDC B. DOH C. WHO D. OSHA

Which of the following ISO standard applies to the clinical laboratory? A. ISO 9000 B. ISO 7000 C. ISO 15189 D. ISO 15436

1. Specimens from patients receiving treatment for urinary tract infections frequently appear: A. Clear and red B. Viscous and orange C. Dilute and pale yellow D. Cloudy and red 2. Specimens containing _________ produce a yellow foam when shaken, which could be mistaken for bilirubin. A. Phenazopyridine (Pyridium) B. Phenindione C. Methyldopa D. Metronidazole (Flagyl) 3. PLEASE REFER TO STRASINGER Anticoagulant, orange in alkaline urine, colorless in acid urine. A. Phenazopyridine (Pyridium) B. Phenindione C. Methyldopa D. Metronidazole (Flagyl)

B, A, B

LABORATORY CORRELATION OF URINE COLOR Argyrol an antiseptic, black urine color disappears with: A. Acetic acid B. Ethanol C. Ferric chloride D. Sodium hydroxide

1. NRL for Dengue, Influenza, Tuberculosis and other Mycobacteria, Malaria and other parasites, Bacterial enteric diseases, Measles and other Viral exanthems, Mycology, Enteroviruses, Antimicrobial resistance and Emerging Diseases; NRL for confirmatory testing of blood units. A. RITM B. EAMC C. NKTI D. SLH 2. NRL for HIV/AIDS, Hepatitis, Syphilis and other Sexually Transmitted Infections (STls) A. RITM B. EAMC C. NKTI D. SLH 3. NRL for Hematology including Immunohematology, Immunopathology and Anatomic Pathology: A. RITM B. EAMC C. NKTI D. SLH 4. NRL for Biochemistry: A. EAMC B. NKTI C. SLH D. LCP

A, D, C, D

National Reference Laboratory for Environmental and Occupational Health; Toxicology and Micronutrient Assay A. RITM B. San Lazaro Hospital C. East Avenue Medical Center D. Lung Center of the Philippines

It refers to the individual from whom a specimen for drug testing is collected. A. Practitioner B. Pusher C. Protector/coddler D. Donor/client

According to RA 9165, a person who knowingly and willfully consents to the unlawful acts and uses his/her influence, power or position in shielding, harboring, screening or facilitating the escape of any person he/she knows, or has reasonable grounds to believe on or suspects: A. Practitioner B. Pusher C. Protector/coddler D. Donor

Any person who sells, trades, administers, dispenses, delivers or gives away to another, on any terms whatsoever, or distributes, dispatches in transit or transports dangerous drugs or who acts as a broker in any of such transactions. A. Practitioner B. Pusher C. Protector/coddler D. Donor

Methylenedioxymethamphetamine (MDMA) or commonly known as: A. Cannabis B. Shabu C. Meth D. Ecstasy

1. A blood service facility duly authorized by the DOH – Center for Health Development (CHD), whose main function is to collect blood from volunteer non-renumerated blood donors: A. Blood Bank (BB) B. Blood center (BC) C. Blood collection unit (BCU) D. Blood station (BS) 2. A blood service facility duly authorized by the DOH – CHD, whose main function is the storage, issuance, transport and distribution of whole blood and packed red cells: A. Blood Bank (BB) B. Blood center (BC) C. Blood collection unit (BCU) D. Blood station (BS) 3. A non-hospital-based blood service facility, licensed by DOH Bureau of Health Facilities and Services (BHFS), whose main function is to process blood units into blood components and testing these units for five (5) infectious disease markers: A. Blood Bank (BB) B. Blood center (BC) C. Blood collection unit (BCU) D. Blood station (BS)

C, D, B

1. An Act Regulating the Collection, Processing and Sale of Human Blood, and the Establishment and Operation of Blood Banks and Blood Processing Laboratories A. RA 5527 B. RA 1517 C. RA 7719 D. RA 8504 2. AN ACT PROMOTING VOLUNTARY BLOOD DONATION, PROVIDING FOR AN ADEQUATE SUPPLY OF SAFE BLOOD, REGULATING BLOOD BANKS A. RA 5527 B. RA 1517 C. RA 7719 D. RA 8504

B, C

A drug test is valid for _________. A. Three months B. Six months C. One year D. Two years

Whenever the drug testing laboratory result is challenged, _______ shall make the final decision. A. Crime laboratory of PNP B. Crime laboratory of NBI C. East Avenue Medical Center D. San Lazaro Hospital

Primum non nocere comes from the Hippocratic Oath and means: A. Do first things first. B. First do no harm. C. Quality is foremost. D. Ready to serve.

1. Aspects of this principle: Providing benefits Balancing benefits and risks/harms This principle supports the following moral rules or obligations: Protect and defend the rights of others Prevent harm from occurring to others Remove conditions that will cause harm Help persons with disabilities Rescue persons in danger A. Autonomy B. Beneficence C. Non-maleficence D. Justice 2. This principle holds that there is an obligation not to inflict harm on others. It is closely associated with the maxim primum non nocere (first do no harm). This principle supports the following rules: Do not kill Do not cause pain or suffering Do not incapacitate Do not cause offense A. Autonomy B. Beneficence C. Non-maleficence D. Justice

B, C

RESPECT the decisions (self-determination) of individuals who have decision-making capacity. A. Autonomy B. Beneficence C. Non-maleficence D. Justice

Subject to RANDOM drug test: A. Applicants for firearm’s license B. Officers and members of the military, police and other law enforcers C. Candidates for public office whether appointed or elected both in the national or local government D. Students of secondary and tertiary schools

1. A hormone which regulates water reabsorption in the collecting duct: A. Aldosterone B. Antidiuretic hormone C. Growth hormone D. Prolactin 2. A system that stimulates water reabsorption by the collecting tubules: A. ADH B. RAAS C. Growth hormone D. Thyroid hormone

B, B

Part of the nephron that functions as SIEVE: A. Glomerulus B. Proximal convoluted tubule C. Loop of Henle D. Distal convoluted tubule

The test most commonly associated with tubular secretion and renal blood flow is the: A. Creatinine clearance B. Inulin clearance C. Fishberg and Mosenthal test D. p-aminohippuric acid (PAH) test

1. Specific gravity of 1.022 ± 0.001: A. Distilled water B. 3% NaCl C. 5% NaCl D. 9% sucrose 2. Specific gravity of 1.034 ± 0.001: A. Distilled water B. 3% NaCl C. 5% NaCl D. 9% sucrose

C, D

Phenol derivatives found in certain intravenous medications produce ______urine on oxidation. A. Yellow B. Orange C. Green D. Purple

In three-glass urine collection to detect the presence of prostatitis, which tube(s) serves as control for bladder and kidney infection: A. First B. Second C. Third D. First and third

All of the following should be discarded in biohazardous waste containers except: A. Urine specimen containers B. Towels used for decontamination C. Disposable lab coats D. Blood collection tubes

First function affected in renal disease: A. Glomerular filtration B. Tubular reabsorption C. Tubular secretion D. None of these

A lack of any urine odor may indicate: A. Acute tubular necrosis B. Isovaleric acidemia C. Methionine malabsorption D. Phenylketonuria

In the urinalysis laboratory the primary source in the chain of infection would be: A. Patients B. Needlesticks C. Specimens D. Biohazardous waste

The primary chemical affected by the renin-angiotensin- aldosterone system is: A. Chloride B. Sodium C. Potassium D. Hydrogen

Antidiuretic hormone regulates the reabsorption of A. Water in the collecting tubules B. Sodium in the collecting tubules C. Sodium in the distal convoluted tubule D. Water and sodium in the loop of Henle

All of the following are reabsorbed by active transport in the tubules except: A. Urea B. Glucose C. Sodium D. Chloride

Urine clarity grading: “few particulates, print easily seen through urine” A. Clear B. Hazy C. Cloudy D. Turbid

SSA turbidity: "Turbidity with granulation and flocculation" A. 1+ B. 2+ C. 3+ D. 4+

REAGENT PAD reading time: 30 seconds A. Bilirubin B. Ketones C. Specific gravity D. pH

Alkaline urine: A. Meat B. Cranberry C. Vegetables D. All of these

A urine specimen with a pH of 9: A. Indicates metabolic acidosis B. Should be recollected C. May contain calcium oxalate crystals D. Is seen after drinking cranberry juice

Drug associated with rhabdomyolysis: A. Chloramphenicol B. Penicillin C. Statins D. Aspirin

Chemical test in urine that requires patients on diet that contains green vegetables: A. Protein B. Glucose C. Urobilinogen D. Nitrite

1. The most frequent parasite encountered in the urine: A. Schistosoma haematobium B. Trichomonas vaginalis C. Enterobius vermicularis D. Giardia lamblia 2. Fecal contamination of a urine specimen can also result in the presence of ova from intestinal parasites in the urine sediment. The most common contaminant is: A. Schistosoma japonicum ovum B. Schistosoma haematobium ovum C. Enterobius vermicularis ovum D. Giardia lamblia trophozoite

B, C

1. Precursor cell of oval fat bodies: A. Neutrophils B. Eosinophils C. Transitional epithelial cells D. Renal tubular epithelial cells 2. Precursor cell of bubble cells: Bubble cells appear to represent injured cells in which the endoplasmic reticulum has dilated prior to cell death. A. Neutrophils B. Eosinophils C. Transitional epithelial cells D. Renal tubular epithelial cells 3. Oval fat bodies are associated with: A. Liver cirrhosis B. Nephrotic syndrome C. Acute pyelonephritis D. Acute tubular necrosis 4. Bubble cells are associated with: A. Liver cirrhosis B. Nephrotic syndrome C. Acute pyelonephritis D. Acute tubular necrosis

D, D, B, D

Pathologically, these casts are increased in congestive heart failure: A. Hyaline cast B. Granular cast C. Cellular cast D. Waxy cast

1. Glitter cells in KOVA stain (Sternheimer-Malbin) A. Cannot be stained B. Pink C. Purple D. Light blue 2. Sternheimer-Malbin stain produces a ____ color in hyaline casts. A. Blue B. Green C. Pink D. Orange-red

D, C

1. Cetyltrimethylammonium bromide (CTAB) test: A. Homogentisic acid, transient blue B. Mucopolysaccharides, blue spot C. Mucopolysaccharides, white turbidity D. PKU, blue-green color 2. Positive result in the metachromatic staining procedure for mucopolysaccharides: A. White turbidity B. Yellow turbidity C. Blue spot D. Red spot

C, C

LEUKOCYTE ESTERASE + Esterases also are present in which parasite? A. Enterobius B. Giardia C. Schistosoma D. Trichomonas

STERNHEIMER-MALBIN (KOVA/SEDI-STAIN) 1. Blood (hemoglobin) casts in Sedi-stain: A. Pink B. Pale purple C. Orange-red D. Light blue-green 2. Trichomonas in Sedi-stain: A. Pink B. Pale purple C. Orange-red D. Light blue-green

C, D

Principle of Micral test: A. Agglutination B. Enzyme immunoassay C. Immunochromatography D. Radioimmunoassay

Bence Jones protein precipitates at temperatures between ___, and redissolves at near ___ ° C. A. Precipitates at 100-120C, and redissolves at 60C B. Precipitates at 10 to 20C, and redissolves at 100C C. Precipitates at 80-100C, and redissolves at 60C D. Precipitates at 40 to 60C, and redissolves at 100C

Patients should avoid banana, pineapples and tomatoes when testing for: A. 5-HIAA B. Mucopolysaccharides C. Phenylalanine D. Melanin

Genetic disorder showing lamellated and THINNING glomerular basement membrane: A. Alport syndrome B. Membranous glomerulonephritis C. Membranoproliferative glomerulonephritis D. Minimal change disease

Anti–glomerular basement antibody is seen with: A. Wegener’s granulomatosis B. IgA nephropathy C. Goodpasture’s syndrome D. Diabetic nephropathy

Antineutrophil cytoplasmic antibody (c-ANCA): A. Associated with multiple myeloma B. Marker for Wegener’s granulomatosis C. Characteristic of untreated systemic lupus erythematosus D. Diagnostic of Dressler’s syndrome or rheumatic fever

Sperms in urine: A. Do not report B. Averaged per LPF C. Averaged per HPF D. Present, according to lab protocol

1. Largest cell in urine sediment: A. Squamous epithelial cells B. Transitional epithelial cells C. Renal tubular epithelial cells D. None of these 2. Largest RTE cells originate from the: A. Proximal convoluted tubule B. Distal collecting tubule C. Collecting duct D. None of these

A, A

1. RTE cell from the proximal convoluted tubules: A. Columnar or convoluted B. Cuboidal C. Round or oval D. None of these 2. RTE cell from the distal convoluted tubules: A. Columnar or convoluted B. Cuboidal C. Round or oval D. None of these 3. RTE cells from the collecting duct: A. Columnar or convoluted B. Cuboidal C. Round or oval D. None of these

A, C, B

Cholesterol crystals are soluble in: A. Ammonia B. Chloroform C. Dilute HCl D. Acetic acid

URINE CLARITY Many particulates, print blurred through urine: A. Hazy B. Cloudy C. Turbid D. Milky

Which urine specimen has the highest actual specific gravity? A. Undiluted urine with a reading of 1.035 B. Diluted urine 1:2 with a reading of 1.025 C. Diluted urine 1:5 with a reading of 1.008 D. Same specific gravities

Hemoglobin in urine can be differentiated from myoglobin using: A. 80% ammonium sulfate to precipitate hemoglobin B. o-Dianisidine instead of benzidine as the color indicator C. Sodium dithionite to reduce hemoglobin D. Microscopic exam

BLOOD REAGENT PAD 1. UNIFORM/HOMOGENOUS green to a strongly positive green-blue appears on the blood reagent pad: Hematuria Hemoglobinuria Myoglobinuria A. 1 and 2 B. 1 and 3 C. 2 and 3 D. 1, 2 and 3 2. SPECKLED pattern on the blood reagent pad: A. Hematuria B. Hemoglobinuria C. Myoglobinuria D. All of these

C, A

1. Volume of urine for urinometry: A. 1 to 2 drops B. 1 to 2 mL C. 3 to 5 mL D. 10 to 15 mL 2. Volume of urine for refractometry: A. 1 to 2 drops B. 1 to 2 mL C. 3 to 5 mL D. 10 to 15 mL

D, A

Which of these sugars cannot be detected in urine using the copper reduction test? A. Fructose B. Galactose C. Arabinose D. Sucrose

Sucrose is considered a disaccharide that on hydrolysis yields which of the following sugars? A. Glucose B. Galactose and glucose C. Maltose and glucose D. Fructose and glucose

The following urinalysis biochemical results were obtained from a 4-month-old infant who experienced vomiting and diarrhea after milk ingestion and failed to gain weight: pH: 6 Protein: negative Glucose: negative Ketone: negative Bilirubin: negative Clinitest: 2+ These results are clinically significant in which of the following disorders? A. Diabetes mellitus B. Ketosis C. Starvation D. Galactosemia

Which of the following tests is affected least by standing or improperly stored urine? A. Glucose B. Protein C. pH D. Bilirubin

In renal tubular acidosis, the pH of urine is: A. Consistently acid B. Consistently alkaline C. Neutral D. Variable, depending upon diet

The normal renal threshold for glucose is: A. 70 to 85 mg/dL B. 100 to 115 mg/dL C. 130 to 145 mg/dL D. 165 to 180 mg/dL

Urine sediment characterized by pyuria with bacterial and WBC casts indicates: A. Nephrotic syndrome B. Pyelonephritis C. Polycystic kidney disease D. Cystitis

The presence of tyrosine and leucine crystals together in a urine sediment usually indicates: A. Renal failure B. Chronic liver disease C. Hemolytic anemia D. Hartnup disease

Which of the following conditions is associated with the greatest proteinuria? A. Acute glomerulonephritis B. Chronic glomerulonephritis C. Nephrotic syndrome D. Acute pyelonephritis

Following a head injury, which protein will identify the presence of CSF leakage through the nose? A. Transthyretin B. Myelin basic protein C. Tau protein D. C-reactive protein

Which of the following conditions is commonly associated with an EXUDATIVE EFFUSION? A. Congestive heart failure B. Malignancy C. Nephrotic syndrome D. Cirrhosis

Which is the reference method for determining fetal lung maturity? A. Human placental lactogen B. L/S ratio C. Amniotic fluid bilirubin D. Urinary estriol

What is the most common cause of male infertility? A. Mumps B. Klinefelter’s syndrome C. Varicocele D. Malignancy

Which carbohydrate measurement is clinically useful when performing a seminal fluid analysis? A. Glucose B. Galactose C. Fructose D. Maltose

Which of the following is commonly associated with occult blood? A. Colon cancer B. Atrophic gastritis C. Pernicious anemia D. Pancreatitis

Classic web-like pellicle is associated with ____________ meningitis and can be seen after overnight refrigeration of the fluid. A. Bacterial meningitis B. Fungal meningitis C. Tubercular meningitis D. Viral meningitis

These cells are elevated in BAL of CIGARETTE SMOKERS, in cases of bronchopneumonia, toxin exposure and diffuse alveolar damage: A. Eosinophils B. Lymphocytes C. Mast cells D. Neutrophils

The most frequently seen cell in a BAL is: A. Bronchial epithelial cell B. Lymphocyte C. Macrophage D. Neutrophil

A listless 12-month-old boy with a fever of 103°F was taken to the emergency department. He had been diagnosed with an ear infection 3 days earlier. A spinal tap was performed, but only one tube of CSF was obtained from the lumbar puncture. The single tube of CSF should be submitted first to which department? A. Chemistry B. Microbiology C. Hematology D. Cytology/Histology

1. Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of: A. Alpha-fetoprotein B. Bilirubin C. Cells for cytogenetics D. Lecithin 2. Why are amniotic specimens for cytogenetic analysis incubated at 37°C prior to analysis? A. To detect the presence of meconium B. To differentiate amniotic fluid from urine C. To prevent photo-oxidation of bilirubin to biliverdin D. To prolong fetal cell viability and integrity 3. Specimens for FLM testing are delivered to and stored in the laboratory: A. Delivered on ice and refrigerated B. Immediately centrifuged C. Kept at room temperature D. Delivered in a vacuum tube

B, D, A

AMNIOTIC FLUID BILIRUBIN Max absorbance of bilirubin and oxyhemoglobin (interference). A. Bilirubin 450 nm, oxyhemoglobin 540 nm B. Bilirubin 540 nm, oxyhemoglobin 450 nm C. Bilirubin 450 nm, oxyhemoglobin 410 nm D. Bilirubin 410 nm, oxyhemoglobin 450 nm

Responsible for the amniotic fluid increase in absorbance at 650 nm: A. Lecithin B. Oxyhemoglobin C. Bilirubin D. Lamellar bodies

CSF GLUTAMINE Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome? A. Ammonia B. Lactate C. Glucose D. Alpha-ketoglutarate

CSF must be _____ if a delay in CELL COUNTING is anticipated: A. Frozen B. Incubated at 37 oC C. Maintained at room temperature D. Refrigerated

To assess the permeability of the blood/brain barrier (BBB), the CSF level of which of the following proteins will be measured by the laboratory? A. Albumin B. IgG C. Transferrin D. Prealbumin

Second most prevalent protein in CSF: A. Ceruloplasmin B. Haptoglobin C. Prealbumin D. Transferrin

The most common composition of renal calculi is: A. Calcium oxalate B. Magnesium ammonium phosphate C. Cystine D. Uric acid

The hormone aldosterone is responsible for: A. Hydrogen ion secretion B. Potassium secretion C. Chloride retention D. Sodium retention

1. PRC function: Administers, implements, and enforce the laws and policies with respect to the regulation and licensing of the various professions and occupations, including the enhancement and maintenance of professional and occupational standards and ethics. A. Quasi-Legislative B. Quasi- Judicial C. Executive D. None of these 2. PRC function: Investigates motu proprio or upon the filing of a verified complaint, any registered professional, any member of the professional regulatory boards, officers and employees under the jurisdiction of the Commission; Issues summons, subpoena and subpoena duces tecum; May hold in contempt erring party or person; May revoke or suspend certificates of registration and professional licenses. A. Quasi-Legislative B. Quasi- Judicial C. Executive D. None of these 3. PRC function: Formulates rules and policies on professional regulation. Reviews, revises and approves resolutions embodying policies promulgated by the Professional Regulatory Boards. A. Quasi-Legislative B. Quasi- Judicial C. Executive D. None of these

C, B, A

PLEURAL FLUID APPEARANCE: 1. Brown pleural fluid: A. Hemothorax B. Microbial infection C. Malignant mesothelioma D. Rupture of amoebic liver abscess 2. Black pleural fluid A. Aspergillus infection B. Hemorrhagic effusion C. Chylous material from thoracic duct leakage D. Pseudochylous material from chronic inflammation

D, A

A pleural fluid submitted to the laboratory is milky in appearance. Which test would be most useful in differentiating between a chylous and pseudochylous effusion? A. Fluid to serum triglyceride ratio B. Fluid WBC count C. Fluid total protein D. Fluid to serum LD ratio

1. Pleural fluid triglycerides <50 mg/dL: A. Hemothorax B. Hemorrhagic effusion C. Chylous effusion D. Pseudochylous effusion 2. Pleural fluid triglycerides >110 mg/dL: A. Hemothorax B. Hemorrhagic effusion C. Chylous effusion D. Pseudochylous effusion

D, C

Stool specimens that appear ribbon-like are indicative of which condition? A. Bile-duct obstruction B. Colitis C. Intestinal constriction D. Malignancy

Positive result for the guaiac test for fecal occult blood: A. Green B. Blue C. Purple D. Red

No clearing of gelatin in the x-ray film test, indicates lack of which enzyme? A. Gastrin B. Trypsin C. Pepsin D. Elastase

A clean-catch urine is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hours later, the specimen is sent to the microbiology department for culture. The specimen should: A. Be centrifuged, and the supernatant cultured B. Be rejected due to the time delay C. Not be cultured if no bacteria are seen D. Be processed for culture only if the nitrate is positive

A 24-hour urine from a man who had no evidence of kidney impairment was sent to the laboratory for hormone determination. The volume was 600 mL, but there was some question as to the completeness of the 24-hour collection. The next step would be to: A. Perform the hormone determination, since 600 mL is a normal 24-hour urine volume B. Check the creatinine level; if it is <1 g, do the procedure C. Report the hormone determination in mg/dL in case the specimen was incomplete D. Check the creatinine level; if it is >1 g, do the procedure

A patient with uncontrolled diabetes mellitus will most likely have: A. Pale urine with a high specific gravity B. Pale urine with a low specific gravity C. Concentrated urine with a high specific gravity D. dark urine with a high specific gravity

A patient’s urinalysis revealed a positive bilirubin and a decreased urobilinogen level. These results are associated with: A. Hemolytic disease B. Biliary obstruction C. Hepatic disease D. Urinary tract infection

A urine specimen with an elevated urobilinogen and a negative bilirubin may indicate: A. Obstruction of the biliary tract B. Viral hepatitis C. Hemolytic jaundice D. Cirrhosis

An eosinophil count may be requested on urine from a patient with suspected: A. Acute glomerulonephritis B. Cystitis C. Renal lithiasis D. Acute interstitial nephritis

Which of the following aids in differentiating a spherical transitional cell from a round renal tubular cell? A. Spherical transitional cell is larger B. Eccentrically-placed nucleus in the renal tubular cell C. Eccentrically-placed nucleus in the spherical transitional cell D. Round renal tubular cell is larger

Which of the following casts most frequently appears to have a brittle consistency? A. Hyaline B. Granular C. Waxy D. Fatty

Following ingestion of ethylene glycol (antifreeze) numerous crystals are found in the urine. The shape of these crystals is: A. Flat with notched corners B. Oval, dumbbell C. Coffin-lid D. Rosettes, rhomboid

Amniotic fluid is evaluated using a Liley graph and change in absorbance at 450 nm. What is being evaluated, and why? A. Bilirubin, which increases in HDN B. AFP, which increases in spina bifida C. HCG, which increases in Down syndrome D. Lamellar bodies, which increase with fetal lung maturity

What calculation is used to determine if there is a breach in the blood-brain barrier? A. IgG index B. CSF/serum albumin index C. Fluid/serum LD ratio D. Albumin gradient

Which pair does NOT match with respect to amniotic fluid? A. Colorless – normal B. Dark red-brown – fetal death C. Dark green – hemolytic disease of the newborn D. Blood-streaked – traumatic tap

CSF COLLECTION To avoid falsely elevated spinal fluid cell counts: A. Use an aliquot from the first tube collected B. Use only those specimens showing no turbidity C. Centrifuge all specimens before counting D. Select an aliquot from the last tube collected

BACTERIA, WBC and WBC CASTS The following urine results were obtained on a 25-year-old female: pH: 7.0 Color: yellow Appearance: cloudy Protein: 1+ Glucose: negative Blood: small Specific gravity: 1.015 Microscopic findings: Bacteria: many WBC casts: 0 to 3/LPF WBCs: 30 to 40/HPF These results are most compatible with: A. Glomerulonephritis B. Renal calculus C. Cystitis D. Pyelonephritis

1. JC Virus: A. Hemorrhagic cystitis B. Progressive multifocal leukoencaphalopathy C. Keratoconjunctivitis D. Lymphocytic choriomeningitis 2. BK Virus: A. Hemorrhagic cystitis B. Progressive multifocal leukoencaphalopathy C. Keratoconjunctivitis D. Lymphocytic choriomeningitis

B, A

Two months after a kidney transplant, a 47 y.o. man developed NEPHROPATHY. Up to 5% of renal allograft recipients develop nephropathy. A viral cause of some of the nephropathy cases has been identified as: A. Polyomavirus BK B. Human papillomavirus, all types C. Human papillomavirus, low-risk types D. Hepatitis C virus E. Human cytomegalovirus

A urine sample is received in the laboratory with the appropriate custody control form, and a request for drug of abuse screening. Which test result would be cause for rejecting the sample? A. Temperature after collection 95°F B. pH 5.0 C. Specific gravity 1.005 D. Creatinine 5 mg/dL

D All of the values listed are within the limits of an acceptable sample with the exception of creatinine. Temperature (90°F–100°F) pH (4.5–8.0), specific gravity (1.003–1.019), and creatinine (≥20 mg/dL).

When testing for drugs of abuse in urine, which of the following test results indicate dilution and would be cause for rejecting the sample? A. Temperature upon sample submission 92°F B. Specific gravity 1.002; Creatinine 15 mg/dL C. pH 5.8; temperature 94°C D. Specific gravity 1.012, creatinine 25 mg/dL

B A specimen is too dilute for testing if the creatinine is below 20 mg/dL and specific gravity below 1.003. A sample is considered substituted if the creatinine is below 5.0 mg/dL and the specific gravity less than 1.002.

Which condition is most often associated with gastric ulcers A. Cancer of the stomach B. H. pylori infection C. Zollinger–Ellison (Z–E) syndrome D. Pernicious anemia

In which condition is the highest level of serum gastrin usually seen? A. Atrophic gastritis B. Pernicious anemia C. Zollinger-Ellison syndrome D. Cancer of the stomach

Which of the following semen analysis results is abnormal? A. Volume 1.0 mL B. Liquefaction 40 minutes at room temperature C. pH 7.6 D. Motility 50% progressive movement

Subacute sclerosing panencephalitis (SSPE) is a progressive, disabling, and deadly brain disorder related to ______ infection. A. Chickenpox (varicella) B. Smallpox (variola major) C. German measles (rubella) D. Measles (rubeola)

1. The minimum concentration of antimicrobial agent needed to prevent visually discernible growth of a bacterial or fungal suspension. A. Minimum bactericidal concentration (MBC) B. Minimum inhibitory concentration (MIC) C. Both of these D. None of these 2. The minimum concentration of antimicrobial agent needed to yield a 99.9% reduction in viable colony-forming units of a bacterial or fungal suspension. A. Minimum bactericidal concentration (MBC) B. Minimum inhibitory concentration (MIC) C. Both of these D. None of these

B, A

Noncultivatable nontuberculous Mycobacteria: A. M. avium B. M. chelonae C. M. fortuitum D. M. leprae

ssDNA virus, icosahedral capsid, no envelope: A. Adenoviridae B. Herpesviridae C. Papovaviridae D. Parvoviridae

In the foam or shake test, amniotic fluid is mixed with: A. 1% NaOH B. 3% acetic acid C. 70% ethanol D. 95% ethanol

A maximum of ___ mL of amniotic fluid is collected in sterile syringes. A. 10 mL B. 20 mL C. 30 mL D. 50 mL

Calibration of centrifuge ____; disinfection of centrifuge ____. A. Monthly, weekly B. Monthly, daily C. Every 3 months, weekly D. Every 3 months, daily

The concentration of myoglobin in the urine must be at least ___ before the red pigmentation can be visualized. A. 10 mg/dL B. 15 mg/dL C. 20 mg/dL D. 25 mg/dL

Of all the urine sediment elements, ___ are the MOST DIFFICULT TO RECOGNIZE. A. Bacteria B. Epithelial cells C. RBCs D. WBCs

It produces a THREE-DIMENSIONAL MICROSCOPY IMAGE and layer by-layer imaging of a specimen: A. Bright-field microscope B. Phase contrast microscope C. Interference contrast microscope D. Polarizing microscope

For POSTVASECTOMY SEMEN ANALYSIS, specimens are routinely tested: A. Beginning at 1 month post-vasectomy and continuing until two consecutive monthly specimens show no spermatozoa. B. Beginning at 2 months post-vasectomy and continuing until two consecutive monthly specimens show no spermatozoa. C. Beginning at 2 months post-vasectomy and continuing until three consecutive monthly specimens show no spermatozoa. D. Beginning at 3 months post-vasectomy and continuing until three consecutive monthly specimens show no spermatozoa.

Qualification of BOARD EXAMINERS (Board of MT) EXCEPT: A. Filipino citizen, good moral character B. Qualified pathologist or duly RMTs C. In practice of laboratory medicine or MT for at least five years prior to his appointment D. Not a member of the faculty of any medical technology school for at least two years prior to appointment

The chairman and members of the BOARD OF MT shall hold office for ___ year(s) after appointments or until their successors shall have been appointed and duly qualified. A. 1 year or until their successors shall have been appointed and duly qualified B. 2 years or until their successors shall have been appointed and duly qualified C. 3 years or until their successors shall have been appointed and duly qualified D. 5 years or until their successors shall have been appointed and duly qualified

Yellow ground-glass colonies on cycloserine cefoxitin fructose agar (CCFA): A. Bacillus anthracis B. Bacillus cereus C. Clostridium difficile D. Clostridium perfringens

POPCORN Qualification of BOARD EXAMINERS (Board of MT) EXCEPT: A. Filipino citizen, good moral character B. Qualified pathologist or duly RMTs C. In practice of laboratory medicine or MT for at least five years prior to his appointment D. Not a member of the faculty of any medical technology school for at least two years prior to appointment

POPCORN The chairman and members of the BOARD OF MT shall hold office for ___ year(s) after appointments or until their successors shall have been appointed and duly qualified. A. 1 year or until their successors shall have been appointed and duly qualified B. 2 years or until their successors shall have been appointed and duly qualified C. 3 years or until their successors shall have been appointed and duly qualified D. 5 years or until their successors shall have been appointed and duly qualified

POPCORN Urobilinogen is ______ and labile. A. Colorless B. Yellow C. Green D. Brown

POPCORN Characteristics of a good fixative, EXCEPT: A. It must be cheap, stable and safe to handle B. It must permit rapid and even penetration of tissues C. It must render the tissue sensitive to subsequent processing D. It must inhibit bacterial decomposition and autolysis

POPCORN It is recommended for fixing chromosomes, lymph glands and urgent biopsies: A. Formalin B. Bouin’s fluid C. Carnoy’s fluid D. Regaud (Moller’s) fluid

POPCORN 1. Positive nitrite: A. Gram-positive bacteria B. Gram-negative bacteria C. Random urine specimens D. Heavy bacterial infections 2. A positive nitrite test and a negative leukocyte esterase test is an indication of a: A. Dilute random specimen B. Specimen with lysed leukocytes C. Vaginal yeast infection D. Specimen older than 2 hours

B, D

POPCORN Powdered anticoagulants should not be used for synovial fluid because they may produce artifacts that interfere with: A. Cell count B. Crystal analysis C. Glucose analysis D. Protein analysis

POPCORN 1. Normal synovial fluid will be able to form ____ cm STRING. A. 1 to 2 cm B. 3 to 4 cm C. 4 to 6 cm D. 6 to 10 cm 2. Hyaluronate polymerization can be measured using a ROPES, or MUCIN CLOT TEST. When added to a solution of 2% to 5% acetic acid, normal synovial fluid forms: A. No clot B. Friable clot C. Soft clot D. Solid clot surrounded by clear fluid

C, D

Calibration = Every 3 weeks

Disinfection = Weekly basis

POPCORN Severe hemolysis and suggests a severely affected fetus. Intervention through induction of labor or intrauterine exchange transfusion must be considered. A. Zone 1 of Liley graph B. Zone 2 of Liley graph C. Zone 3 of Liley graph D. None of these

POPCORN Amniotic fluid bilirubin is measured by: A. Turbidimetric method B. Dye-binding method C. Spectrophotometric analysis D. Fluorometric analysis

POPCORN Family history of chromosome abnormalities, such as trisomy 21 (Down syndrome), amniocentesis may be indicated at: A. 1 to 14 weeks B. 15 to 18 weeks C. 20 to 42 weeks D. Any of these

POPCORN With the two-slide qualitative fecal fat determination, the first slide produces a normal amount of staining fat present, whereas the second slide, following acid addition and heat, produces an abnormally increased amount of fat. These results indicate: A. Malabsorption B. Maldigestion C. Parasitic infestation D. Disaccharidase deficiency

POPCORN When diluting a synovial fluid WBC count, all of the following are acceptable EXCEPT: A. Acetic acid B. Isotonic saline C. Hypotonic saline D. Saline with saponin

POPCORN 1. Fluid: serum protein and lactic dehydrogenase ratios are performed on serous fluids: A. When malignancy is suspected B. To classify transudates and exudates C. To determine the type of serous fluid D. When a traumatic tap has occurred 2. The recommended test for determining whether PERITONEAL FLUID is a transudate or an exudate is the: A. Fluid: serum albumin ratio B. Serum:ascites albumin gradient C. Fluid: serum lactic dehydrogenase ratio D. Absolute neutrophil count

B, B

POPCORN Which of the following tests is used to differentiate between an effusion caused by cirrhosis and one caused by peritonitis? A. Absolute neutrophil count B. Fluid-to–serum bilirubin ratio C. Serum-ascites gradient D. Serum to LD ratio

POPCORN Round cells that are of concern and may be included in sperm counts and morphology analysis are: A. Leukocytes B. Spermatids C. RBCs D. Both A and B

POPCORN 1. Low to absent fructose level in the semen: A. Low sperm concentration B. Low sperm motility C. Low sperm viability D. Presence of antisperm antibodies 2. Specimens for fructose levels should be tested within 2 hours of collection or _______ to prevent fructolysis. A. Refrigerated B. Frozen C. Incubated at 37C D. Maintained at room temperature 3. Specimens can be screened for the presence of fructose using the resorcinol test that produces an _______color when fructose is present. A. Blue B. Black C. Green D. Orange

A, B, D

POPCORN 1. Living sperm cells in the Modified Bloom's test: A. Unstained, bluish-white B. Purple on a red background C. Purple on a black background D. Red on a purple background 2. Dead sperm cells in the Modified Bloom's test: A. Unstained, bluish-white B. Purple on a red background C. Purple on a black background D. Red on a purple background

A, D

POPCORN Wet preparation for demonstration of fecal leukocytes: A. Methylene blue B. Gram stain C. Wright's stain D. All of these

POPCORN Number of orange-red fat droplets in direct fat stain indicative of steatorrhea: A. Greater than 10/hpf B. Greater than 50/hpf C. Greater than 60/hpf D. Greater than 100/hpf

POPCORN 1. Most frequently performed chemical analysis on urine: A. Protein B. Glucose C. Uric acid D. Blood 2. Most frequently performed chemical test on CSF: A. Protein B. Glucose C. Uric acid D. Blood 3. Most frequently requested test in synovial fluid: A. Protein B. Glucose C. Uric acid D. Blood

B, A, B

POPCORN Most frequently performed fecal analysis is the detection of: A. Fats B. Leukocytes C. Occult blood D. Carbohydrates

POPCORN Positive lactoferrin agglutination test in patient stool: A. Fecal fats - steatorrhea B. Fecal occult blood - colorectal cancer C. Fecal leukocytes - diarrhea caused by Vibrio D. Fecal leukocytes - diarrhea caused by Salmonella

POPCORN Sensitivity of Multistix albumin pad: A. 10 to 14 mg/dL albumin B. 15 to 30 mg/dL albumin C. 20 to 30 mg/dL albumin D. 45 to 50 mg/dL albumin

POPCORN Sensitivity of the Multistix bilirubin reagent pad: A. 0.1 to 0.5 mg/dL B. 0.4 to 0.8 mg/dL C. 4 to 8 mg/dL D. 8 to 16 mg/dL

POPCORN Excess CSF should be: A. Discarded B. Refrigerated C. Frozen D. Maintained at room temperature

POPCORN A specimen delivered to the laboratory with a request for prostatic acid phosphatase and glycoprotein p30 was collected to determine: A. Prostatic infection B. Presence of antisperm antibodies C. A possible rape D. Successful vasectomy

POPCORN 1. Initial magnification: A. Ocular B. Objective C. Condenser D. Rheostat 2. Further magnification: A. Ocular B. Objective C. Condenser D. Rheostat

B, A

POPCORN Which of the following gathers, organizes, and directs light through the specimen? A. Eyepiece B. Objective lens C. Condenser D. Optical tube

POPCORN Type of microscope that forms HALO of light around an object: A. Bright-field B. Dark-field microscope C. Polarizing microscope D. Phase-contrast

POPCORN Converting a brightfield microscope for polarizing microscopy requires: A. Two polarizing filters—one placed below the condenser and one placed between the objective and the eyepiece B. A special condenser, two polarizing filters, and a Wollaston prism between the objective and the eyepiece C. An annular diaphragm in the condenser and a phase-shifting element in the objective D. A slit aperture below the condenser, a polarizing filter, and a modulator

POPCORN A bright-field microscope is easily adapted for dark-field microscopy by replacing the: A. Ocular B. Objective C. Condenser D. Polarizing filters

POPCORN Only elements found in the urinary sediment that are unique to the kidney: A. Red blood cells B. White blood cells C. Casts D. Crystals

POPCORN 1. Physiologic failure of pH to fall below 3.5 or 1.0 pH unit with gastric stimulation: A. Anacidity B. Achlorhydria C. Euchlorhydria D. Hypochlorhydria 2. Physiologic failure of pH to fall below 3.5, although it decreases 1.0 pH unit or more upon gastric stimulation: A. Anacidity B. Achlorhydria C. Euchlorhydria D. Hypochlorhydria 3. Failure of the stomach acidity to fall lower than 6.0 in a stimulation test: A. Anacidity B. Achlorhydria C. Euchlorhydria D. Hypochlorhydria

B, D, A

POPCORN Amniotic fluid for Lamellar bodies determination: 1. OD 650 A. Mixed with 95% ethanol B. Mixed with 1% NaOH C. Centrifuged D. Gentle inversion, tube rocker 2. Lamellar Body Count (LBC) by impedance or optical principle: A. Mixed with 95% ethanol B. Mixed with 1% NaOH C. Centrifuged D. Gentle inversion, tube rocker

C, D

CASE STUDY A 60-year-old man with a history of alcoholism is seen in an urgent care clinic; he complains of extreme pain in his upper abdomen. He has been experiencing pain on and off for the past 10 days. Now he is yellow (jaundiced) and feels extremely ill. He also mentions that his stool specimens have lost their normal color and look like clay. Blood is drawn for testing and urine collected for urinalysis. The following urinalysis results were obtained: Physical Appearance • Color: Brown (yellow-brown) • Transparency: Clear • Foam: Abundant yellow foam Chemical Screening • pH: 6.5 • Specific gravity: 1.020 • Protein (reagent strip): Negative • Blood: Negative • Nitrite: Negative • Leukocyte esterase: Negative • Glucose: Negative • Ketones: Negative • Bilirubin: Large • Urobilinogen: Normal Microscopic Examination • Red blood cells: 0-2 per hpf • White blood cells: 0-2 per hpf 1. The abnormal urine color is caused by which of the following? A. Unconjugated bilirubin B. Conjugated bilirubin C. Urobilinogen D. Protein 2. The lack of color in the feces is caused by an absence of which of the following? A. Bilirubin glucuronide B. Free bilirubin C. Unconjugated bilirubin D. Urobilinogen 3. From the patient history and the urinalysis, this patient’s jaundice is probably the result of which of the following? A. Acute alcoholism leading to a cirrhotic liver B. Hemolytic jaundice C. Infectious hepatitis D. Obstructive jaundice

B, D, D

Failure of the stomach acidity to fall lower than 6.0 in a stimulation test: A. Anacidity B. Achlorhydria C. Euchlorhydria D. Hypochlorhydria

PHASE OF GASTRIC SECRETION that involves VAGUS NERVE STIMULATION caused by stimuli such as taste, smell, or sight: A. Cephalic phase B. Gastric phase C. Intestinal phase D. None of these

The modification of diet in renal disease (MDRD) formula for calculating eGFR requires which four parameters? A. Urine creatinine, serum creatinine, height, weight B. Serum creatinine, age, gender, race C. Serum creatinine, height, weight, age D. Urine creatinine, gender, weight, age

What substance may be measured as an alternative to creatinine for evaluating GFR? A. Plasma urea B. Cystatin C C. Uric acid D. Potassium

Useful early predictor of ACUTE KIDNEY INJURY (AKI) and has prognostic value for clinical endpoints, such as initiation of dialysis and mortality: A. Cystatin C B. Neutrophil gelatinase-associated lipocalin (NGAL) C. Urea D. Creatinine

Seminal fluid are collected following a period of sexual abstinence of: A. 1 to 3 days B. 3 to 5 days C. 2 to 7 days D. 7 to 10 days

Semen collection: A. First portion of the ejaculate B. Middle portion of the ejaculate C. Third portion of the ejaculate D. Complete ejaculate

It surrounded by a MITOCHONDRIAL SHEATH that produces the ENERGYrequired by the sperm tail for motility: A. Head B. Acrosome C. Neckpiece D. Midpiece

Watery seminal fluid; grading for its viscosity: A. 0 B. 1 C. 3 D. 4

Slow forward progression with noticeable lateral movement. A. a B. b C. c D. d

1. Reagent for the APT's test: A. Guaiac B. 1% sodium hydroxide C. 95% ethanol D. 10% eosin 2. Fetal hemoglobin (Hb F) in Apt's test A. Pink solution B. Pink precipitate C. Yellow-brown supernatant D. Yellow-brown precipitate 3. Adult hemoglobin (Hb A) in Apt's test A. Pink solution B. Pink precipitate C. Yellow-brown supernatant D. Yellow-brown precipitate

B, A, C

Decreased mesothelial cells and increased plasma cells in pleural fluid: A. Pancreatitis B. Pulmonary infarction C. Tuberculosis D. Pneumonia not responding to antibiotics

These cells are increased in effusions resulting from PANCREATITIS: A. Lymphocytes B. Mesothelial cells C. Neutrophils D. Eosinophils

1. The mucin clot test determines the presence of synovial fluid ______________. A. Protein B. Glucose C. Fibrinogen D. Hyaluronic acid 2. Before testing, very viscous synovial fluid should be treated with: A. Normal saline B. Hyaluronidase C. Distilled water D. Hypotonic saline 3. What is added to synovial fluid to determine the viscosity? A. Sodium hydroxide B. Acetic acid C. Hydrochloric acid D. Hyaluronic acid

D, B, B

IRIS/SYSMEX UF-100 URINE CELL ANALYZER uses laser-based FLOW CYTOMETRY along with: A. Impedance detection B. Impedance detection and light scatter C. Light scatter and fluorescence D. Impedance detection, light scatter and fluorescence

1. Green with carbocyanine: A. DNA B. DNA and nuclear membrane C. Nuclear membrane and mitochondria D. Nuclear membrane, mitochondria and cell membrane 2. Orange with phenathridine: A. DNA B. DNA and nuclear membrane C. Nuclear membrane and mitochondria D. Nuclear membrane, mitochondria and cell membrane

D, A

Enumeration of bacteria in automated slideless microscopy: A. Spectrophotometric method B. Small particle histogram C. Nitrite determination D. Reflectance photometry

Elevated compound in congenital erythropoietic porphyria A. D-ALA and porphobilinogen B. D-ALA and protoporphyrin C. Protoporphyrin D. Uroporphyrin and coproporphyrin

The OSHA HAZARD COMMUNICATION STANDARD, the “right- to-know” rule, is designed for what purpose? A. To avoid lawsuits B. To protect laboratory staff C. To protect patients D. To establish safety standards

The glomerular capillaries are covered by the inner layer of Bowman’s capsule, forming a semipermeable membrane that allows passage of all substances with molecular weights less than ____ daltons. A. <70,000 daltons B. <90,000 daltons C. <100,000 daltons D. <150,000 daltons

Aldosterone-secreting adrenal adenoma: A. Conn’s syndrome B. Cushing’s syndrome C. Addison’s disease D. Hashimoto’s thyroiditis

A patient presents with Addison disease. Serum sodium and potassium analyses are performed. What would the results reveal? A. Normal sodium, low potassium levels B. Low sodium, low potassium levels C. Low sodium, high potassium levels D. High sodium, low potassium levels

Assuming the kidney is functioning normally, which of the following urine volume will be expected to have the highest specific gravity reading? A. 10 mL B. 20 mL C. 50 mL D. 100 mL

Blood vessel that supply blood to the kidney: A. Renal artery B. Renal vein C. Peritubular capillaries D. None of these

Dense crystalline concretions in sputum: A. Asthma B. Broncholithiasis C. Fungal pneumonia D. Tuberculosis

Charcot-Leyden crystals are pointed eosinophilic masses characteristic of sputum of patient with: A. Alveolar proteinosis B. Asthma C. Broncholithiasis D. Pneumococcal pneumonia

Nonpathologic pigment associated with red-brown urine in children: A. Hemoglobin B. Myoglobin C. Melanin D. Fuchsin

Black color of Argyrol, an antiseptic, disappears with addition of: A. Copper sulfate B. Ferric chloride C. Sodium nitroprusside D. Trichloroacetic acid

Anticoagulant, orange in alkaline urine, colorless in acid urine: A. Phenol B. Phenindione C. Pyridium D. Rifampin

Urine for pregnancy test should have a specific gravity of at least: A. 1.002 B. 1.003 C. 1.010 D. 1.015

Unique portion of HCG: A. Glycoprotein portion of alpha subunit B. Glycoprotein portion of beta subunit C. Amino acid portion of alpha subunit D. Amino acid portion of beta subunit

Foods that are high in ascorbic acid, tomato and asparagus can increase formation of these crystals: A. Calcium phosphate B. Calcium oxalate C. Uric acid D. Triple phosphate

The physician is concerned that a pregnant patient may be at risk for delivering prematurely. What would be the best biochemical marker to measure to assess the situation? A. Inhibin A B. Alpha-fetoprotein C. Fetal fibronectin D. Human chorionic gonadotropin

1. The most commonly used dilution for sperm concentration is _____ prepared using a mechanical (positive-displacement) pipette. A. 1:10 B. 1:20 C. 1:100 D. 1:200 2. For sperm concentration, both sides of the hemocytometer are loaded and allowed to settle for 3 to 5 minutes; then they are counted, and the counts should agree within ____. A. Within 10% B. Within 15% C. Within 20% D. Within 25%

B, A

Normal sperm vitality requires _________ living cells and should correspond to the previously evaluated motility. A. 30% or more B. 40% or more C. 50% or more D. 100%

Normal % of lymphocytes in BAL: A. 1 to 2% B. Less than 3% C. 1 to 15% D. 56 to 80%

The etiologic agent most commonly associated with septicemia and meningitis of newborns is: A. Streptococcus agalactiae B. Streptococcus bovis group C. Streptococcus pneumoniae D. Streptococcus pyogenes

Which of the following is the most commonly isolated species of Bacillus in opportunistic infections such as bacteremia, post-traumatic infections of the EYE, and endocarditis? A. B. circulans B. B. cereus C. B. licheniformis D. B. subtilis

Staphylococcus saprophyticus, a recognized pathogen, is a cause of: A. Furuncles B. Impetigo C. Otitis media D. Urinary tract infections

Staphylococcus aureus, when present, could most likely be recovered from a stool sample if the primary plating medium included: A. Bismuth sulfite B. Phenylethyl alcohol C. Thiosulfate citrate bile salts sucrose D. Xylose-lysine-desoxycholate

A negative PYR (L-pyrolidonyl-beta-naphthylamide) test is demonstrated by: A. Enterococcus faecalis B. Enterococcus faecium C. Streptococcus pyogenes D. Viridans streptococci

Which of the following organisms is able to hydrolyze sodium hippurate to benzoic acid and glycine? A. Streptococcus agalactiae B. Streptococcus pneumoniae C. Listeria monocytogenes D. Enterococcus faecalis

Cystine-tellurite blood agar plates are recommended for the isolation of: A. Corynebacterium diphtheriae B. Streptococcus agalaciae C. Streptococcus pyogenes D. Group D streptococci

An example of a halophilic microorganism is: A. Morganella morganii B. Plesiomonas shigelloides C. Vibrio parahaemolyticus D. Yersinia pestis

HEPA filter removes most particles larger than __ μm in diameter. A. 0.01 µm B. 0.03 µm C. 0.1 µm D. 0.3 µm

Iodophors are composed of iodine and: A. A phenolic compound B. A detergent C. 70% alcohol D. 90-95% alcohol

When cleansing skin with alcohol and then iodine for collection of blood culture, the iodine (or iodophor) should remain intact on the skin for at least: A. 10 seconds B. 30 seconds C. 60 seconds D. 5 minutes

The two cations known to influence the activity of AMINOGLYCOSIDES are: A. Sodium and potassium B. Calcium and potassium C. Calcium and magnesium D. Sodium and magnesium

Mechanism of action for TETRACYCLINE is inhibition of: A. RNA synthesis B. Cell wall synthesis C. Protein synthesis D. Membrane function

A positive hippurate hydrolysis is a characteristic of: A. C. coli B. C. jejuni C. C. lari D. C. fetus

What is the safe volume of blood to be drawn for pediatric blood cultures? A. <1 mL B. 1 to 5 mL C. 5 to 10 mL D. 10 to 20 mL

The unique chemical structure of the cell wall of Mycobacterium spp. is associated with the presence of: A. N-glycolylmuramic acid and a decrease in lipid content B. N-acetylmuramic acid and a decrease in lipid content C. N-glycolylmuramic acid and an increase in lipid content D. N-acetylmuramic acid and an increase in lipid content

Which organism, associated with tuberculosis in cattle, causes tuberculosis in humans, especially in regions where dairy farming is prevalent? A. Mycobacterium avium–intracellulare complex B. Mycobacterium kansasii C. Mycobacterium marinum D. Mycobacterium bovis

All of the following Mycobacterium spp. produce the enzyme required to convert niacin to niacin ribonucleotide except: A. M. kansasii B. M. tuberculosis C. M. avium–intracellulare complex D. M. szulgai

Growth inhibition by thiophene-2-carboxylic hydrazide (T2H) is used to differentiate M. tuberculosis from which other Mycobacterium specie? A. M. bovis B. M. avium–intracellulare complex C. M. kansasii D. M. marinum

The urease test is needed to differentiate Mycobacterium scrofulaceum from which of the following mycobacteria? A. M. gordonae B. M. kansasii C. M. avium–intracellulare complex D. M. bovis

Which of the following Mycobacterium spp. would be most likely to grow on a MacConkey agar plate? A. M. chelonae–fortuitum complex B. M. ulcerans C. M. marinum D. M. avium–intracellulare complex

Which mycobacterium is associated with Crohn’s disease? A. M. marinum B. M. paratuberculosis C. M. avium D. M. gordonae

Which nonpathogenic Mycobacterium specie is isolated most often from clinical specimens and is called the “tapwater bacillus”? A. M. kansasii B. M. avium–intracellulare complex C. M. leprae D. M. gordonae

Which is the most appropriate nonselective medium for recovery of mycobacteria from a heavily contaminated specimen? A. Löwenstein–Jensen agar B. Middlebrook 7H10 agar C. Petragnani’s agar D. American Thoracic Society medium

Which of the following drugs are first-line antibiotics used to treat classic tuberculosis for which susceptibility testing is performed by the disk diffusion method on Middlebrook 7H10 or 7H11 agar plates? A. Ampicillin, penicillin, streptomycin, and carbenicillin B. Ampicillin, penicillin, and methicillin C. Vancomycin, methicillin, and carbenicillin D. Isonicotinic acid hydrazide (INH), rifampin, ethambutol, and pyrazinamide

The gram-positive non–spore-forming anaerobic rods most frequently recovered from blood cultures as a contaminant are: A. Propionibacterium acnes B. Clostridium perfringens C. Staphylococcus intermedius D. Veillonella parvula

Which of the following tests will rapidly differentiate micrococci from staphylococci? A. Catalase B. Coagulase C. Modified oxidase D. Novobiocin susceptibility

Note: Smelling plates in a clinical setting can be dangerous and is strongly discouraged. BAILEY'S Beta-hemolytic streptococci - distinctive buttery odor Proteus - “chocolate cake” or “burnt chocolate” smell P. aeruginosa - fruity or grapelike smell, corn tortilla-like odor Burkholderia cepacia complex - dirtlike odor Alcaligenes faecalis - fruity odor res. apples or strawberries

Chromobacterium violaceum - smell of ammonium cyanide (almond-like) Eikenella corrodens - chlorine bleach odor Pasteurella multocida - musty or mushroom odor Haemophilus influenzae - mouse nest odor Neisseria animaloris - odor resembles popcorn

Clostridium difficile - horse stable odor Stenotrophomonas maltophilia - ammonia smell S. aureus - old sock P. aeruginosa - fruity or grapelike

P. mirabilis - putrid Haemophilus - musty basement, “mousy” or “mouse nest” Nocardia spp.- freshly plowed field

The toxic shock syndrome toxin-1 is an important virulence factor in staphylococcal disease. This toxin is classified into which of the following groups of toxins? A. Cytolytic toxin B. Leukocidin C. Phospholipase D. Enterotoxin

The bacterial species that can be described as able to hydrolyze hippurate, beta-hemolytic, a major cause of neonatal meningitis and sepsis, and producer of the CAMP factor is which of the following? A. Streptococcus pneumoniae B. Streptococcus pyogenes C. Streptococcus agalactiae D. Viridans streptococci

The swarming gram-negative bacillus that can be described as oxidase-negative, nitrate-positive, indole-negative, and H2S-positive is mostly likely which of the following? A. Proteus aerogenes B. Proteus vulgaris C. Proteus mirabilis D. Escherichia coli

Which organism is most often responsible for impetigo? A. Staphylococcus epidermidis B. Streptococcus pyogenes C. Enterococcus faecalis D. Streptococcus agalactiae

The culture of which sample routinely uses quantitation or the counting of bacterial cells present to assist in the interpretation? A. Blood B. Sputum C. Urine D. Abscess

C Most patient samples for bacteriology cultures only can be semi-quantitated, because of sampling and plating limitations. Urine cultures, however, are routinely quantitated to aid the differentiation of true infection from contamination.

1. Propionobacterium acnes is most often associated with: A. Food poisoning B. Post-antibiotic diarrhea C. Tooth decay D. Blood culture contamination 2. A patient has a suspected diagnosis of subacute bacterial endocarditis. His blood cultures grow non-spore-forming pleomorphic gram-positive bacilli only in the anaerobic bottle. What test(s) will give a presumptive identification of this microorganism? A. Beta-hemolysis and oxidase B. Catalase and spot indole C. Esculin hydrolysis D. Hydrolysis of gelatin

D, B

A community hospital microbiology laboratory is processing significant numbers of stool cultures because of an outbreak of diarrhea following heavy rains and flooding in the country. A media that should be incorporated in the plating protocol is: A. Colistin nalidixic acid for Listeria B. MacConkey agar with sorbitol for Campylobacter C. Mannitol salt agar for Enterococcus species D. Thiosulfate citrate bile salts sucrose for Vibrio species

An autopsy performed on an 8-year-old child revealed Waterhouse-Friderichsen syndrome. Blood and throat cultures taken just prior to death were positive for which organism A. Neisseria gonorrhoeae B. Neisseria meningitidis C. Haemophilus influenzae D. Klebsiella pneumoniae

Which feature distinguishes Erysipelothrix rhusiopathiae from other clinically significant non-spore-forming, gram-positive, facultatively anaerobic bacilli? A. “Tumbling” motility B. More pronounced motility at 25ºC than 37ºC C. Beta-hemolysis D. H2S production

The following results were obtained from a culture of unknown origin: Gram stain: gram-negative diplococci Indophenol oxidase: positive Glucose: positive Maltose: negative Sucrose: negative The most likely source of the specimen would be the: A. Respiratory tract B. Blood C. Genitourinary tracy D. Cerebrospinal fluid

The characteristic that is most commonly associated with the presence of strict anaerobic bacteria and can be taken as presumptive evidence of their presence in a clinical specimen is the: A. Presence of a single bacterial species B. Production of gas in a thioglycollate broth culture C. Growth on a blood agar plate incubated in an anaerobic jar D. Presence of a foul, putrid odor from tissue specimens and cultures

Unopened, sliced BACON, packaged in material somewhat highly resistant to oxygen permeability, is spoiled mostly by A. Lactobacilli B. Micrococci C. Fecal Streptococci D. Molds

A gastroenterologist submits a gastric biopsy from a patient with a peptic ulcer. To obtain presumptive evidence of Helicobacter pylori, a portion of the specimen should be added to which media? A. Urea broth B. Tetrathionate C. Selenite D. Tryptophan

A Campylobacter species isolated from a stool culture gives the following biochemical reactions: Nalidixic acid: susceptible Cephalothin: resistant Oxidase: positive Catalase: positive Hippurate hydrolysis: positive This biochemical profile is consistent with: A. Campylobacter fetus B. Campylobacter jejuni C. Campylobacter coli D. Campylobacter laridis

1. A single ASO titer is considered to be moderately elevated if the titer is at least _____ Todd units in an adult. A. 200 Todd units B. 240 Todd units C. 320 Todd units D. 340 Todd units 2. A single ASO titer is considered to be moderately elevated if the titer is at least _____ Todd units in a child. A. 200 Todd units B. 240 Todd units C. 320 Todd units D. 340 Todd units

B, C

1. The Mantoux test for Mycobacterium tuberculosis is based on a: A. Type I hypersensitivity reaction B. Type II hypersensitivity reaction C. Type III hypersensitivity reaction D. Type IV hypersensitivity reaction 2. The Mantoux skin test to identify infection with Mycobacterium tuberculosis is: A. Cell-mediated B. An IgG response C. An IgE response D. An IgM response

D, A

Anti-CCP (cyclic citrullinated proteins) is specifically associated with which autoimmune disease? A. Rheumatoid arthritis B. Myasthenia gravis C. Autoimmune hepatitis D. Goodpasture’s syndrome

1. In chronic active hepatitis, high titers of which of the following antibodies are seen? A. Antimitochondrial B. Anti-DNA C. Anti-smooth muscle D. Anti-parietal cell 2. In primary biliary cirrhosis, which of the following antibodies is seen in high titers? A. Antimitochondrial B. Anti-smooth muscle C. Anti-DNA D. Anti-parietal cell

C, A

Lupus-like syndrome, recurrent infections and atherosclerosis are associated with: A. C2 deficiency B. C3 deficiency C. C5 deficiency D. C1 inhibitor deficiency

A fastidious gram-negative bacillus was isolated from a case of periodontal disease, which upon darkfield examination was noted to have gliding motility. The most likely identification of this etiologic agent would be: A. Capnocytophaga B. Chromobacterium C. Kingella D. Plesiomonas

The classic toxigenic strains of which serogroup are implicated in epidemic infections of Vibrio cholerae? A. O1 B. O2 C. O3 D. O4

The optimal specimen for the recovery of Bordetella pertussis is: A. Anterior nares swab B. Blood C. Expectorated sputum D. Nasopharyngeal swab

Colonies that are said to resemble "droplets of mercury" are characteristic of: A. Bordetella pertussis B. Burkholderia cepacia C. Campylobacter jejuni D. Yersinia pestis

When clinical specimens are processed for the recovery of Mycobacterium tuberculosis, the generally recommended method for digestion and decontamination of the sample is: A. 6%NaOH B. HCl C. NALC-NaOH D. Trisodiumphosphate

Which one of the following drugs is not considered as primary anti-mycobacterial therapy? A. Isoniazid B. Kanamycin C. Rifampin D. Pyrazinamide

In the decontamination and digestion procedure for the isolation of mycobacteria from sputa samples, what is the role of NALC? A. Bactericidal for normal flora B. Liquefies mucus C. Growth stimulant D. Neutralizes pH to prevent damage to mycobacteria

Susceptibility to thiophene-2-carboxylic acid hydrazide (T2H) is characteristic of which of the following mycobacteria? A. M. avium-intracellularae complex B. M. bovis C. M. kansasii D. M. tuberculosis

The characteristic colony morphology of Actinomyces israelii on solid agar resembles: A. "Medusa head" B. A molar tooth C. A fried egg D. Ground-glass

Which of the following is the most potent bacterial exotoxin known? A. Botulinum toxin B. Erythrogenic toxin C. C. difficile toxin B D. C. perfringens alpha-toxin

Which one of the following microorganisms cannot be cultivated on artificial cell-free media? A. Chlamydia trachomatis B. Mycoplasma hominis C. Mycoplasma pneumoniae D. Ureaplasma urealyticum

A suspension of the test organism for use in broth dilution and disk diffusion testing is adjusted to match the turbidity of a: A. #0.5 McFarland standard B. #1.0 McFarland standard C. #2.0 McFarland standard D. #3.0 McFarland standard

The pH of the agar used for the Kirby-Bauer test should be: A. 7.0-7.2 B. 7.2-7.4 C. 7.4-7.6 D. 7.6-7.8

The phenomenon of bacterial resistance to the bactericidal activity of penicillins and cephalosporins, with only inhibition of the organism's growth, is known as: A. High-level resistance B. Intrinsic resistance C. Inducible resistance D. Tolerance

The minimum bactericidal concentration (MBC) of an antimicrobial agent is defined as the lowest concentration of that antimicrobial agent that kills at least: A. 95.5% B. 97% C. 99.9% D. 100%

OFTEN RECOVERED FROM PATIENTS WITH MALIGNANCIES OF COLON Anaerobic gram-positive bacilli with subterminal spores were recovered from several blood cultures obtained from a patient diagnosed with a malignancy of the colon. The following results were recorded: Indole = Neg Urease = Neg Lipase = Neg Catalase = Neg Lecithinase = Neg Growth on blood agar = Swarming colonies What is the correct identification? A. Clostridium septicum B. Clostridium perfringens C. Clostridium sordellii D. Propionibacterium acnes

Which one of the following organisms does not require susceptibility testing to the antimicrobial indicated when isolated from a clinically significant source? A. Staphylococcus aureus - clindamycin B. Proteus mirabilis - gentamicin C. Streptococcus pyogenes - penicillin D. Escherichia coli - levofloxacin

McFarland turbidity standard is prepared by mixing _________ to obtain a solution with a specific optical density. A. 1% hydrochloric acid and 1.175% barium chloride B. 2% hydrochoric acid and 2.175% barium chloride C. 1% sulfuric acid and 1.175% barium chloride D. 2% sulfuric acid and 2.175% barium chloride

The formation of arthroconidia is not an important characteristic in the identification of: A. Coccidioides B. Geotrichum C. Trichosporon D. Sporothrix

A black pigment produced by colonies growing on bird seed agar is due to: A. Urease B. Phenol oxidase C. Sucrose assimilation D. Arthroconidia production

Which of the following stains greatly enhances the visibility of fungi by binding to the cell walls, causing the fungi to fluoresce blue-white or apple green? A. Rhodamine-auramine B. Warthin-Starry C. Calcofluor white D. Periodic acid-Schiff

Which organism is most commonly associated with human disease, particularly in immunocompromised patients, such as those infected with HIV? A. Nocardia asteroides B. Rhodococcus equi C. Gordonia sp. D. Tsukamurella sp.

The appearance of Koplik spots in the oral mucosa of patients is characteristic of infection with what viral agent? A. Hepatitis B. Measles C. Rabies D. Smallpox

The type of cell culture that best supports the growth of cytomegalovirus is: A. HeLa cells B. HEp-2 cells C. Human fibroblast cells D. Primary monkey kidney (PMK) cells

Which of the following viruses is predominantly associated with respiratory disease and epidemics of keratoconjunctivitis? A. Adenovirus B. Molluscum contagiosum virus C. Norwalkvirus D. Rotavirus

Which hepatitis B marker is the best indicator of early acute infection? A. HBs Ag B. HBe Ag C. Anti-HBc D. Anti-HBs

During the “window phase” of HBV infection, which of the following may be the only detectable marker? A. Anti-HBc B. Anti-HBe C. Anti-HBs D. HBsAg

Which surface marker is a reliable marker for the presence of high levels of hepatitis B virus (HBV) and a high degree of infectivity? A. HBe Ag B. HBs Ag C. HBc Ag D. Anti-HBs

The disappearance of HBsAg and HBeAg, the persistence of anti-HBc, the appearance of anti-HBs and often anti-HBe indicate: A. Early acute HBV hepatitis B. Early convalescent phase HBV hepatitis C. Recovery phase of acute HBV hepatitis D. Carrier state of acute HBV hepatitis

To ensure accurate diagnosis of viral disease, it is imperative to collect specimen during the ____ phase of the infection. A. Acute phase B. Chronic phase C. Adjustment phase D. Incubation phase

PROGRESSIVE ENDOPHTHALMITIS It is a serious pathogen of the eye, causing progressive endophthalmitis: A. Bacillus anthracis B. Bacillus cereus C. Bacillus subtilis D. Bacillus thurigiensis

Mycobacterium tuberculosis is differentiated from Mycobacterium bovis by: A. Growth rate B. Hydrolysis of Tween 80 C. Niacin and nitrate reduction tests D. Catalase test at 68°C

Several children in a day care center for preschoolers developed fever, irritability, lack of appetite, and a vesicular rash found on their hands, feet, and mouth. With which virus were these children most likely infected? A. Coronavirus B. Coxsackievirus C. Respiratory syncytial virus D. Rhinovirus

Sterilization of a vacutainer: A. Ethylene glycol B. Autoclave C. Gamma irradiation D. All of the above

A patient complains to his dentist about a draining lesion in his mouth. A Gram stain of the pus shows a few gram-positive cocci, leukocytes, and many-branched gram-positive rods. Branched yellow sulfur granules are observed by a microscope. Which of the following is the most likely cause of the disease? A. Actinomyces israelii B. Corynebacterium diphtheriae C. Propionobacterium acnes D. Staphylococcus aureus

A patient was hospitalized after an automobile accident. The wounds became infected and the patient was treated with tobramycin, carbenicillin, and clindamycin. Five days after antibiotic therapy was initiated, the patient developed severe diarrhea and pseudomembranous enterocolitis. Antibiotic-associated diarrhea and the more serious pseudomembranous enterocolitis can be caused by: A. Clostridium sordellii B. Clostridium perfringens C. Clostridium difficile D. Staphylococcus aureus E. Bacteroides fragilis

Pregnant women and immunocompromised patients should avoid eating which of the following foods to prevent Listeria infection? A. Feta cheese B. Peanuts C. Pickles D. Ice cream

Which of the following viruses are thought to predominately cause gastroenteritis? A. Hepadnaviruses B. Filoviruses C. Noroviruses D. Arboviruses

A landscaper noticed a hard, unmovable lump under the skin of his index finger but decided to ignore it. A month later, the lump ulcerated to present a necrotic appearance, and two more lesions developed further up the wrist and forearm. A histologic stain of material from deep in the lesions showed elongated yeast cells resembling cigars. What disease is suspected? A. Mycetoma B. Sporotrichosis C. Chromoblastomycosis D. Blastomycosis

Which of the following is a key characteristic of Coccidioides immitis? A. Has a higher dissemination rate in white females B. Is endemic in the northeastern United States C. Produces endosporulating spherules in tissue D. Forms foot cells

TAPEWORM SCOLEX 1. Spatulate, 3 × 1 mm; no rostellum or hooklets; has 2 shallow grooves (bothria) 2. Quadrate, 1-2 mm in diameter; no rostellum or hooklets; 4 suckers 3. Quadrate, 1-mm diameter; has rostellum and hooklets; 4 suckers 4. 0.2-0.5 mm in diameter; has conical/retractile rostellum armed with 4-7 rows of small hooklets; 4 suckers 5. Knoblike but not usually seen; has rostellum and hooklets; 4 suckers 6. Knoblike but not usually seen; has rostellum but no hooklets; 4 suckers

1. D. latum 2. T. saginata 3. T. solium 4. D. caninum 5. H. nana 6. H. diminuta

Which of the following is the specimen of choice for detecting rotavirus? A. Throat swab B. Urine sample C. Bronchoalveolar wash D. Feces sample

The worm has a characteristic, thick cuticle and a large uterus that fills the body cavity and contains rhabditoid larvae: A. Ascaris lumbricoides B. Enterobius vermicularis C. Ancylostoma duodenale D. Dracunculus medinensis

It resembles egg of S. haematobium, but acid-fast positive: A. Schistosoma japonicum B. Schistosoma mansoni C. Schistosoma intercalatum D. Schistosoma mekongi

Entamoeba dispar is most easily confused morphologically with: A. Entamoeba coli B. Entamoeba hartmanni C. Dientamoeba fragilis D. Entamoeba histolytica E. Blastocystis hominis

Symptoms and signs mimic those of TUBERCULOSIS, and should always be suspected in patients with tuberculosis who are non-responsive to treatment: A. Ascaris lumbricoides B. Necator americanus C. Strongyloides stercoralis D. Paragonimus westermani

Infection may mimic acute viral enteritis, bacillary dysentery, bacterial or other food poisoning, acute intestinal amebiasis, or “TRAVELER’S DIARRHEA” (ETEC). However, the type of diarrhea plus the lack of blood, mucus, and cellular exudate is consistent with: A. Amebiasis B. Ascariasis C. Balantidiasis D. Giardiasis

The drug of choice for treatment of Paragonimus infections is: A. Metrifonate B. Praziquantel C. Bilarcil D. Niclosamide

It causes alveolar hydatid disease which is the most lethal of all helminthic diseases: A. Taenia saginata B. Taenia solium C. Echinococcus granulosus D. Echinococcus multilocularis

Intermediate host of Echinococcus multilocularis: A. Dogs B. Foxes C. Coyotes D. Rodents

Risk factors included a history of drinking impure water, eating frog or SNAKE MEAT, or using frog or snake meat as a poultice: A. Echinococcus granulosus B. Spirometra mansonoides C. Taenia saginata D. Taenia solium

1. More likely to contain trophozoites: A. Liquid/diarrheic stool B. Formed stool C. Soft stool D. None of these 2. May contain trophozoites and cysts: A. Liquid stool B. Diarrheic stool C. Formed stool D. Soft stool 3. More likely to contain cysts (less likely to contain trophozoites) A. Liquid stool B. Diarrheic stool C. Formed stool D. Soft stool

A, D, C

Oocysts survive in the environment for several months to more than 1 year and are resistant to disinfectants, freezing, and drying. However, they are killed by heating to 70° C for 10 minutes. A. Balamuthia mandrillaris B. Cryptosporidium parvum C. Isospora belli D. Toxoplasma gondii

Which of the following viruses causes an acute febrile rash and produces disease in immunocompetent children but has been associated with transient APLASTIC CRISES in persons with sickle cell disease? A. Rubeola B. Varicella-zoster C. Parvovirus D. Rubella E. Herpes simplex

Progressive multifocal leukoencephalopathy: A. BK virus B. JC virus C. RSV D. Enterovirus

1. Added to SDA to inhibit most contaminating bacteria: A. Dextrose B. Chloramphenicol C. Cycloheximide D. Nystatin 2. Added to SDA to inhibit saprophytic fungi: A. Dextrose B. Chloramphenicol C. Cycloheximide D. Nystatin

B, C

What is in the top layer in formalin-ether/ethyl acetate concentration technique (FECT)? A. Ether B. Debris C. Formalin D. Sediment

Top to bottom layers obtained in FECT: A. Debris/fats, ether, formalin, sediment B. Ether, debris/fats, formalin, sediment C. Ether, formalin, debris/fats, sediment D. Formalin, ether, debris/fats, sediment

A virus that causes human cancer associated with a nervous system disorder called TROPICAL SPASTIC PARAPARESIS. That virus is: A. Polyomavirus JC B. Polyomavirus SV40 C. Herpes simplex virus D. Human T lymphotropic virus

Alcaligenes faecalis (formerly A. odorans) is distinguished from Bordetella bronchiseptica with which test? A. Urease (rapid) B. Oxidase C. Growth on MacConkey agar D. Motility

What is the normal ratio of T cytotoxic cells to T helper cells? A. 1:2 B. 2:1 C. 1: 4 D. 4: 1

Salmonella Shigella (SS) agar is a modification of: A. Blood agar plate B. Chocolate agar plate C. Desoxycholate citrate agar D. Eosin methylene blue agar

Which of the following lipoproteins is the smallest of all the lipoproteins and is composed of 50% protein? A. HDL B. Chylomicrons C. LDL D. Triglycerides

Which of the following would be most adversely affected by a nonfasting sample? A. HDL B. LDL C. Cholesterol D. Triglycerides

Exogenous triglycerides are transported in the plasma in which of the following forms? A. VLDL B. Chylomicrons C. LDL D. Cholesteryl esters

Which of the following laboratory tests is the best marker to detect patients with diabetes who are at risk for developing diabetic nephropathy? A. Creatinine B. BUN C. Microalbuminuria test D. Glucose

Which of the following renal conditions is associated with a recent group A beta-hemolytic streptococcus infection? A. Kidney obstruction B. Acute renal failure C. Uremic syndrome D. Acute glomerulonephritis

Which of the following buffer systems is themost important physiologic buffer system in the body? A. Hemoglobin B. Protein C. Phosphate D. Bicarbonate/carbonic acid

The major intracellular cation is which of the following? A. Potassium B. Sodium C. Chloride D. Bicarbonate

When encountering a patient with a fistula, the phlebotomist should: A. Apply the tourniquet below the fistula B. Use the other arm C. Collect the blood from the fistula D. Attach a syringe to the T-tube connector

A nurse calls the laboratory technologist on duty asking about blood collection for the analysis of enzymes (AST, ALP, ALT, GGT, CK). Which of the following tubes would you suggest the technologist collect? A. Red top B. EDTA C. Oxalate D. Fluoride

Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do? A. Ask the patient to state her name; if it matches the requisition, continue. B. Ask the patient’s nurse to attach an ID band and proceed when it is attached. C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed. D. Tell the nurse that you will not collect the specimen and return to the lab.

B Patient identification should never be based on information that is not attached to the patient. If the patient is not wearing an ID band, ask the patient’s nurse to make positive identification and attach an ID band before the specimen is drawn.

A phlebotomist who encounters a comatose patient with no ID band should: A. Notify the phlebotomy supervisor B. Check the patient’s identify with the patient’s roommate C. Leave the requisition at the nurse’s station D. Ask the nurse to band the patient

Your inpatient is asleep when you arrive to draw blood. What do you do? A. Call out the patient’s name softly and shake the bed gently. B. Cancel the test and ask the nurse to resubmit the requisition. C. Check back every 15 minutes until the patient has awakened. D. Fill out a form stating that the specimen was not obtained and why.

A It is acceptable procedure to wake a patient for a blood draw. If an inpatient is asleep, call out his or her name softly and shake the bed gently. Do not shake the patient because you may startle him or her, which can affect test results. Never attempt to collect a blood specimen from a sleeping patient. Besides not having consent for the draw such an attempt can also startle the patient, and you or the patient may be injured.

Select the coupling enzyme used in the kinetic AST reaction: A. LD B. Malate dehydrogenase C. Glutamate dehydrogenase D. G-6-PD

Which instrument requires a primary and secondary monochromator? A. Spectrophotometer B. Atomic absorption spectrophotometer C. Fluorometer D. Nephelometer

The ion-selective membrane used to measure potassium is made of: A. High-borosilicate glass membrane B. Polyvinyl chloride dioctylphenyl phosphonateion exchanger C. Valinomycin gel D. Calomel

What is the confirmatory method for measuring drugs of abuse? A. HPLC B. Enzyme-multiplied immunoassay technique(EMIT) C. Gas chromatography with mass spectroscopy(GC-MS) D. TLC

Which electrolyte level best correlates with plasma osmolality? A. Sodium B. Chloride C. Bicarbonate D. Calcium

Which of the following is the reference method for measuring serum glucose? A. Somogyi–Nelson B. Hexokinase C. Glucose oxidase D. Glucose dehydrogenase

Select the coupling enzyme used in the hexokinase method for glucose. A. Glucose-6-phosphate dehydrogenase B. Peroxidase C. Glucose dehydrogenase D. Glucose-6-phosphatase

Which of the following is classified as a mucopolysaccharide storage disease? A. Pompe’s disease B. von Gierke disease C. Hers’ disease D. Hurler’s syndrome

Which form of hyperbilirubinemia is caused by an inherited absence of UDP-glucuronyl transferase? A. Gilbert’s syndrome B. Rotor syndrome C. Crigler–Najjar syndrome D. Dubin–Johnson syndrome

Which type of cancer is associated with the highest level of AFP? A. Hepatoma B. Ovarian cancer C. Testicular cancer D. Breast cancer

A AFP is increased in all persons with yolk sac tumors and over 80% of those with hepatoma. Levels above 1000 ng/mL are diagnostic of hepatoma.

Glucose is metabolized at room temperature at a rate of ___ mg/dL/hour and at 4C at a rate of ___ mg/dL/hour. A. 2, 7 B. 7, 2 C. 3, 8 D. 8, 3

The most important step in phlebotomy is: A. Cleansing the site B. Identifying the patient C. Selecting the proper needle length D. Using the correct evacuated tube

Which combination best describes a Gaussian (normal) distribution? A. Median > mode B. Mean = median = mode C. Median > mean D. Mode > mean

This diagnostic stage of Strongyloides stercoralis is best seen in stool using fecal concentration techniques: A. Eggs B. Rhabditiform larvae C. Filariform larvae D. Adult worms

A tumor marker for the diagnosis of urinary bladder cancer: A. CA 19-9 B. HER-2/neu C. Calcitonin D. NMP

A comatose 27-year-old woman is brought to the emergency room by paramedics, and the strong odor of bitter almonds is present. The differential diagnosis must include the possibility of poisoning by: A. Ethylene glycol B. Carbon monoxide C. Carbon tetrachloride D. Cyanide E. Arsenic

Peak levels of this analyte typically occur around 0800 hours. A. Bilirubin B. Cortisol C. Eosinophil D. Glucose

A Gaussian distribution is usually: A. Rectangular B. Bell-shaped C. Uniform D. Skewed

Oocysts of Cryptosporidium spp. can be detected in stool specimens using: A. Modified Ziehl–Neelsen acid-fast stain B. Gram stain C. Methenamine silver stain D. Trichrome stain

What is the stain that binds to the nucleic acid of organisms but does not discriminate between gram-positive or gram-negative organisms called? A. Ziehl-Neelsen stain B. Auramine-rhodamine stain C. Gram stain D. Acridine orange stain

Which of the following blood samples would serve best to assay lipoproteins because this anticoagulant acts to preserve lipoproteins? A. EDTA plasma sample B. Heparin plasma sample C. Citrate plasma sample D. Fluoride plasma sample

A patient presents to his physician for a lipid profile. The following results are received: HDL: 50 mg/dL Total cholesterol: 300 mg/dL Triglycerides: 200 mg/dL The calculated LDL cholesterol is: A. 200 B. 210 C. 290 D. 350

Which of the following hemoglobin A1c results represents an IMPAIRED STATE according to the American Diabetes Association? A. 4.5% B. 5.5% C. 6.0% D. 6.5%

C According to the American Diabetes Association, A1c results between 5.7% and 6.4% indicate an impaired state (prediabetes).

Which of the following liver conditions shows an increase in both conjugated bilirubin and ALP, manifests with antimitochondrial antibodies, and shows a characteristic lipoprotein X on electrophoresis? A. Hemochromatosis B. Primary biliary cirrhosis C. Alcoholic fatty liver D. Hepatic tumors

Thyroid hormones are derived from which of the following? A. Histidine B. Cholesterol C. Tyrosine D. Phenylalanine

Which of the following conditions can “physiologically” elevate serum alkaline phosphatase? A. Hyperparathyroidism B. Diabetes C. Third-trimester pregnancy D. Nephrotic syndrome

C Elevated alkaline phosphatase (ALP) levels may be seen with bone and liver disorders. In addition, ALP will also be increased physiologically during periods of bone growth, when bone fractures are healing, and in pregnancy.Elevated alkaline phosphatase (ALP) levels may be seen with bone and liver disorders. In addition, ALP will also be increased physiologically during periods of bone growth, when bone fractures are healing, and in pregnancy.

Psuedohyperkalemia is most commonly a result of which of the following? A. Metabolic acidosis B. Hemolysis C. Hyperaldosteronism D. Hyperparathyroidism

1. Pipettes have a cylindrical glass bulb near the center of the pipette that helps to distinguish them from other types of transfer pipettes: A. Serological measuring pipettes B. Mohr pipettes C. Volumetric transfer pipettes D. Ostwald-Folin transfer pipettes 2. Pipettes are used for delivering small volumes of viscous solutions such as protein or whole blood standards. There is a rounded bulb that is positioned closer to the delivery tip. A. Serological measuring pipettes B. Mohr pipettes C. Volumetric transfer pipettes D. Ostwald-Folin transfer pipettes

C, D

1. Beta cell destruction, usually leading to absolute insulin deficiency: A. Type 1 diabetes B. Type 2 diabetes 2. May range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance: A. Type 1 diabetes B. Type 2 diabetes 3. Diabetics are younger (<18 years old when diagnosed) and thinner: A. Type 1 diabetes B. Type 2 diabetes 4. Usually older (>40 years old when diagnosed) and more likely to be obese: A. Type 1 diabetes B. Type 2 diabetes

A, B, A, B

A method for the estimation of glucose in body fluids; glucose in the protein-free filtrate reduces cupric ion to cuprous ion. The cuprous ion then reduces PHOSPHOMOLYBDIC ACID to molybdenum blue which can be estimated colorimetrically. A. Dubowski method B. Folin-Wu C. Nelson-Somogyi D. Neocuproine

In performing a glucose tolerance test, the fasting specimen is drawn at 0815 hours and the patient finishes the glucose beverage at 0820 hours. When should the 1-hour specimen be collected? A. 0915 hours B. 0920 hours C. 0945 hours D. 0950 hours

Hyponatremia due to increased water retention, EXCEPT: A. Diuretic use B. Nephrotic syndrome C. Hepatic cirrhosis D. Congestive heart failure

C, D

Which of the following can cause cardiac arrest in the absence of warning symptoms or signs? A. Hypernatremia B. Hyponatremia C. Hyperkalemia D. Hypokalemia

Following a head injury, which protein will identify the presence of CSF leakage through the nose? A. Transthyretin B. Myelin basic protein C. Tau protein D. C-reactive protein

BIOCHEMICAL MARKER OF BONE RESORPTION that can be detected in serum and urine: A. Crosslinked C-telopeptides (CTX) B. Fibronectin C. Troponin D. β-Trace Protein

The “gold standard” in the diagnosis of acute coronary syndrome (ACS): A. Fibronectin B. Cystatin C C. Troponin D. β-Trace Protein

As a cardiac biomarker, ________ has been used in conjunction with troponin to help diagnose or rule out a heart attack. A. BNP B. Myoglobin C. Troponin D. Adiponectin

Variants demonstrate a wide variety of cellular interactions, including roles in cell adhesion, tissue differentiation, growth, and wound healing: A. Fibronectin B. Cystatin C C. Troponin D. β-Trace Protein

The protein present in vaginal secretions that can identify patients who are at risk for preterm delivery is: A. Human chorionic gonadotropin B. Estrogen C. PAMG-1 D. Fetal fibronectin

If elevated, which laboratory test would support a diagnosis of CONGESTIVE HEART FAILURE? A. Homocysteine B. Troponin C. Albumin cobalt binding D. B-type natriuretic peptide

Recently, it was established as an accurate marker of CSF leakage: A. Fibronectin B. Cystatin C C. Troponin D. β-Trace Protein

1. It is the result of POOR PERFUSION of the kidneys and therefore diminished glomerular filtration. The kidneys are otherwise normal in their functioning capabilities. Poor perfusion can result from dehydration, shock, diminished blood volume, or congestive heart failure. A. Pre-renal azotemia B. Renal azotemia C. Post-renal azotemia 2. It is caused primarily by DIMINISHED GLOMERULAR FILTRATION as a consequence of acute or chronic renal disease. Such diseases include acute glomerulonephritis, chronic glomerulonephritis, polycystic kidney disease, and nephrosclerosis. A. Pre-renal azotemia B. Renal azotemia C. Post-renal azotemia 3. It is usually the result of any type of OBSTRUCTION in which urea is reabsorbed into the circulation. Obstruction can be caused by stones, an enlarged prostate gland, or tumors. A. Pre-renal azotemia B. Renal azotemia C. Post-renal azotemia

A, B, C

In the United States, the NGSP, with the Diabetes Control and Complications Trial (DCCT) _____ method, is used as a PRIMARY REFERENCE METHOD for measuring HbA1c. A. Immunoassay B. Electrophoresis C. Affinity chromatography D. HPLC PREFERRED METHOD of measuring HbA1c: A. Immunoassay B. Electrophoresis C. Affinity chromatography D. HPLC

D, C

Which of the following values is the threshold critical value (alert or action level) for low plasma potassium? A. 1.5 mmol/L B. 2.0 mmol/L C. 2.5 mmol/L D. 3.5 mmol/L

Which of the following values is the threshold critical value (alert or action level) for high plasma sodium? A. 150 mmol/L B. 160 mmol/L C. 170 mmol/L D. 180 mmol/L

Electrolytes are an essential component in numerous processes: ---------------------- Volume and osmotic regulation Sodium [Na+], chloride [Cl−], potassium [K+] ---------------------- Myocardial rhythm and contractility Potassium [K+], magnesium [Mg2+], calcium [Ca2+] ---------------------- Cofactors in enzyme activation Mg2+, Ca2+, zinc [Zn2+]

Regulation of adenosine triphosphatase (ATPase) ion pumps (Mg2+) ---------------------- Acid–base balance (bicarbonate HCO3−, K+, Cl−) ---------------------- Blood coagulation (Ca2+, Mg2+) ---------------------- Neuromuscular excitability (K+, Ca2+, Mg2+) ---------------------- Production and use of ATP from glucose e.g., Mg2+, phosphate PO4−

1. Electrolytes for acid-base balance: A. Na+, Cl-, K+ B. Bicarbonate, K+, Cl- C. Bicarbonate, Cl- D. Ca2+ Mg2+ 2. Electrolytes for coagulation: A. Na+, Cl-, K+ B. Bicarbonate, K+, Cl- C. Bicarbonate, Cl- D. Ca2+ Mg2+

B, D

1. Which of the following is a marker for bone resorption? A. β-trace protein B. Adiponectin C. Fibronectin D. Crosslinked C-telopeptide 2. Which of the following is a marker for bone formation? CHECK YOUR HARR A. Osteocalcin B. Tartrate resistant acid phosphatase (TRAP) C. Urinary pyridinoline and deoxypyridinoline D. Urinary C-telopeptide and N-telopeptide crosslinks (CTx and NTx)

D, A

Which of the following types of analyzers offers RANDOM-ACCESS CAPABILITIES? A. Discrete analyzers B. Continuous-flow analyzers C. Centrifugal analyzers D. All of these

Urea is only a rough estimate of renal function and will not show any significant level of increased concentration until the GLOMERULAR FILTRATION RATE IS DECREASED BY AT LEAST ____. A. 30% B. 50% C. 60% D. 80%

Highest elevation of ALP is seen in: A. Healing bone fracture B. Hepatitis and cirrhosis C. Paget’s disease D. Biliary tract obstruction

1. Errors in LDL-c become noticeable at triglyceride levels: A. Over 150 mg/dL B. Over 200 mg/dL C. Over 350 mg/dL D. Over 400 mg/dL 2. Errors in LDL-c become unacceptably large at triglyceride levels: A. Over 150 mg/dL B. Over 200 mg/dL C. Over 350 mg/dL D. Over 400 mg/dL 3. Friedewald formula is not valid for triglycerides: A. Over 150 mg/dL B. Over 200 mg/dL C. Over 350 mg/dL D. Over 400 mg/dL

B, D, D

1. Blood alcohol concentration associated with mental confusion, dizziness, strongly impaired motor skills (staggering, slurred speech): A. 0.09 to 0.25% B. 0.18 to 0.30% C. 0.27 to 0.40% D. 0.35 to 0.50% 2. Blood alcohol concentration associated with vomiting and impaired consciousness. The patient is unable to stand. A. 0.09 to 0.25% B. 0.18 to 0.30% C. 0.27 to 0.40% D. 0.35 to 0.50% 3. Blood alcohol concentration associated with coma and possible death: A. 0.09 to 0.25% B. 0.18 to 0.30% C. 0.27 to 0.40% D. 0.35 to 0.50%

B, C, D

Current NCEP guidelines recommend patients be seated for how many minutes before sampling for cholesterol to prevent hemoconcentration: A. 5 minutes B. 10 minutes C. 15 minutes D. 20 minutes

A 30-year-old woman is admitted to the hospital. She has truncal obesity, buffalo humpback, moon face, purple striae, hypertension, hyperglycemia, increased facial hair, acne, and amenorrhea. The physician orders endocrine testing. The results are as follows: Urine free cortisol — increased Serum cortisol (8 A.M.) — increased Plasma ACTH — decreased Dexamethasone suppression test: Overnight low dose — no suppression of serum cortisol High dose — no suppression of serum cortisol What is the most probable diagnosis? A. Pituitary adenoma B. Ectopic ACTH lung cancer C. Adrenocortical carcinoma D. Addison disease

This gland produces “fight or flight” hormones. A. Adrenal B. Pancreas C. Pituitary D. Thyroid

Carbon dioxide for extinguishers are suitable for use with the following hazards: A. Cloth and electrical B. Wood and flammable gas C. Flammable liquids and electrical D. Paper and natural gas

A class ABC fire extinguisher contains: A. Sand B. Water C. Dry chemical D. Acid

1. One-step method for cholesterol: (C) A. Pearson, Stern and Mac Gavack B. Bloors C. Abell-Kendall D. Schoenheimer Sperry, Parekh and Jung 2. Two-step method for cholesterol: (C + E) A. Pearson, Stern and Mac Gavack B. Bloors C. Abell-Kendall D. Schoenheimer Sperry, Parekh and Jung 3. Three-step method for cholesterol: (CE+S) A. Pearson, Stern and Mac Gavack B. Bloors C. Abell-Kendall D. Schoenheimer Sperry, Parekh and Jung 4. Four-step method for cholesterol: (CES+P) A. Pearson, Stern and Mac Gavack B. Bloors C. Abell-Kendall D. Schoenheimer Sperry, Parekh and Jung

A, B, C, D

Gravid proglottids characteristically contain a centrally located uterine structure that frequently assumes a ROSETTE formation. A. Dipylidium caninum B. Diphyllobothrium latum C. Taenia saginata D. Taenia solium

1. Hepatocellular damage may be best assessed by which of the following parameters? A. Serum AST and ALT levels B. GGT and ALP C. Bilirubin, GGT, and ALP D. Ammonia and urea 2. Which of the following analytes is the best indicator of hepatobiliary damage? A. AST B. ALT C. ALP D. Bilirubin

A, C

1. Eggs can be confused with POLLEN GRAINS: A. Diphyllobothrium latum B. Dipylidium caninum C. Hymenolepis nana D. Taenia spp. 2. Gravid proglottids resemble RICE GRAINS (dry) or CUCUMBER SEEDS (moist): A. Diphyllobothrium latum B. Dipylidium caninum C. Hymenolepis nana D. Taenia spp.

D, B

Best indication of OVERALL GLUCOSE HOMEOSTASIS: A. Fasting blood glucose B. Oral glucose tolerance test C. Glycosylated hemoglobin D. Fructosamine

Which substance has the longest detection time? A. Amphetamines B. Cocaine C. Benzodiazepines D. Marijuana

1. In the Henderson-Hasselbalch equation, the numerator denotes _____ functions. A. Brain B. Pituitary C. Lung D. Kidney 2. In the Henderson-Hasselbalch equation, the denominator denotes _____ functions. A. Brain B. Pituitary C. Lung D. Kidney

D, C

Which of the following blood gas disorders is most commonly associated with an abnormal anion gap? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

A patient with emphysema who has fluid accumulation in the alveolar sacs (causing decreased ventilation) is likely to be in which of the following acid-base clinical states? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis

Which of the following mechanisms accounts for the elevated plasma level of beta-lipoproteins seen in hyperbetalipoproteinemia (Fredrickson’s type II lipoproteinemia)? A. Elevated insulin found in these patients B. Apo B-100 receptor defect C. Apo C-II–activated lipase deficiency D. LCAT deficiency

Which of the following apoproteins is inversely related to risk for coronary heart disease and is a surrogate marker for HDL? A. Apo A-I B. Apo B C. Apo B100 D. APO E

A 68-year-old obese woman visits her doctor reporting increased urination (especially at night), increased thirst, and increased appetite. Her glucose on examination was 210 mg/dL (fasting). Which of the following statements best fits with the given information above? A. The patient most likely has type 1 diabetes mellitus B. The patient would show a positive glucose in her urine C. The patient would have a decreased glycated hemoglobin D. Additional testing of this patient should include assessment of hypoglycemia

B An obese, elderly patient with report of increased urination at night, increased thirst, and increased appetite is indicative of a diagnosis of diabetes, most likely type 2 diabetes in this case. With the patient being 68 years of age and obese with only mildly elevated levels of glucose, the diagnosis of type 1 is unlikely. Patients with diabetes would have increased glycated hemoglobin. With a fasting glucose of 210 mg/dL, the assessment of hypoglycemia is unwarranted.

A plasma glucose result is 100 mg/dL. The corresponding glucose in whole blood would approximate: A. 58 mg/dL B. 87 mg/dL C. 98 mg/dL D. 114 mg/dL

Which of the following methods is virtually specificfor glucose and employs G6PD as a second coupling step requiring magnesium? A. Hexokinase B. Glucose oxidase C. Glucose dehydrogenase D. Pyruvate kinase

Gross hemolysis and extremely elevated bilirubin may cause ______ in HEXOKINASE results. (Bishop) A. False increase B. False decrease C. No effect D. Variable

Catalase positive, lactose negative, xylose positive: A. Haemophilus aegypticus B. Haemophilus ducreyi C. Haemophilus parainfluenzae D. Haemophilus influenzae

1. As little as 0.1 mL of CSF combined with one drop of _______ produces an adequate cell yield when processed with the cytocentrifuge. A. 10% formalin B. 40% formalin C. 10% albumin D. 30% albumin 2. A DAILY CONTROL SLIDE FOR BACTERIA IN CSF: A. 95% ethanol B. 30% albumin C. 0.2 mL saline and 2 drops 95% ethanol D. 0.2 mL saline and 2 drops 30% albumin

D, D

The worms are incapable of maturation within the human host and migrate aimlessly, causing tissue damage and inflammation: A. Ancylostoma duodenale B. Dracunculus medinensis C. Gnathostoma spinigerum D. Trichinella spiralis

Wastes of Lean: Defects Waiting Motion Emotion A. 1 and 3 B. 2 and 4 C. 1, 2 and 3 D. 1, 2, 3 and 4

Xanthelasma A. Hyperbilirubinemia B. Dyslipidemia C. Hyperglycemia D. Hyperaldosteronism

1. Round or oval RTE cells; can be mistaken for WBCs and spherical transitional epithelial cells: A. RTE cells from proximal convoluted tubule B. RTE cells from distal convoluted tubule C. RTE cells from collecting duct D. Any of these 2. RTE cells having a rectangular shape and are referred to as columnar or convoluted cell: A. RTE cells from proximal convoluted tubule B. RTE cells from distal convoluted tubule C. RTE cells from collecting duct D. Any of these 3. Cuboidal and are never round; frequently seen as large sheets of cells: A. RTE cells from proximal convoluted tubule B. RTE cells from distal convoluted tubule C. RTE cells from collecting duct D. Any of these

B, A, C

Chylomicron retention disease presents in childhood with fat malabsorption and low levels of plasma lipids. This syndrome is distinct from abetalipoproteinemia, as only apoB-48 appears to be affected: A. Tangier disease B. Anderson's disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

Rare autosomal recessive disorder characterized by complete absence of HDL: A. Tangier disease B. Anderson disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

Abetalipoproteinemia, patients present with undetectable plasma apoB containing lipoproteins: A. Tangier disease B. Anderson disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

Flocked swab: A. Flocked with cotton B. Flocked with gauze C. Flocked with cotton and gauze D. Flocked with nylon

The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity: A. Choramphenicol B. Penicillin C. Sulfonamide D. Vancomycin

1. An example of a PREANALYTICAL (PREEXAMINATION) ERROR is: A. Malfunction of a microprocessor that affects accuracy in testing B. Incorrect identification of a patient C. Transposition of a numeric critical value in transmitting a report D. Verbally reporting a laboratory result over the telephone 2. An example of an ANALYTICAL (EXAMINATION) ERROR is: A. Malfunction of a microprocessor that affects accuracy in testing B. Incorrect patient identification C. Transposition of a numeric critical value in transmitting report D. Use of the wrong anticoagulant in the patient sample tube 3. An example of a POSTANALYTICAL (POSTEXAMINATION) ERROR is: A. Malfunction of a microprocessor that affects accuracy in testing B. Incorrect patient identification C. Transposition of a numeric critical value in transmitting a report D. Use of the wrong anticoagulant in the patient sample tube

B, A, C

1. Which of the following plots is best for detecting all types of QC errors? A. Levy–Jennings B. Tonks–Youden C. Cusum D. Linear regression 2. Which of the following plots is best for comparison of precision and accuracy among laboratories? A. Levy–Jennings B. Tonks–Youden C. Cusum D. Linear regression 3. Which plot will give the earliest indication of a shift or trend? A. Levy–Jennings B. Tonks–Youden C. Cusum D. Histogram

A, B, C

Which of the following conditions is the result of a LOW α1-ANTITRYPSIN LEVEL? A. Emphysema B. Asthma C. Pulmonary edema D. Sarcoidosis

1. Lactate dehydrogenase (LD): A. Oxidoreductase B. Transferase C. Hydrolase D. Aldolase 2. Creatine kinase (CK): A. Oxidoreductase B. Transferase C. Hydrolase D. Aldolase 3. Acid phosphatase (ACP): A. Oxidoreductase B. Transferase C. Hydrolase D. Aldolase

A, B, C

Skull and crossbones indicates which type of hazard: A. Carcinogens B. Flammables C. Exploding bombs D. Acute toxicities (fatal or toxic)

A triangle with an outline of a person inside the triangle in the hazards identification system indicates which type of hazard? A. Flammability B. Reactivity-stability hazard C. Special hazard information D. Health hazard

CHAIN-OF-CUSTODY procedures must be followed for: A. Blood specimens for alcohol level determination B. Routine urinalysis for glucose and ketones C. Therapeutic drug threshold determinations D. Throat swabs of group A beta streptococcus screening

At pH 8.6, proteins are _________ charged and migrate toward the _________. A. Negatively, anode B. Positively, cathode C. Positively, anode D. Negatively, cathode

A delta check refers to: A. Checking the wristband with the requisition. B. Comparing current test results with previous one. C. Documenting all of the results of the QC checks. D. Reporting new infection control precautions.

Biodegradable wastes like leftover food, used cooking oil, fish entrails, scale, fins, fruits, vegetable peelings, rotten fruits, and vegetables: A. Orange B. Red C. Green D. Black Non-biodegradable wastes like paper or paper products (newspaper, tetra packs, etc.), bottles (glass and plastics), and packaging materials (Styropor, candy wrapper, aluminum cans): A. Orange B. Red C. Green D. Black Radioactive wastes or medical equipment contaminated or exposed in radioactivity: A. Orange B. Red C. Green D. Black Pharmaceutical and chemical wastes: A. Yellow B. Yellow with black band C. Red D. Orange

C, D, A, B

Infectious and pathological wastes such as used test strips, used beads or plates, used reaction pads or foils, used swabs, used gloves, used cord clamp, used plaster, used masks: A. Yellow B. Yellow with black band C. Red D. Orange

Waste container for sharp materials like needles, syringe and scalpel blades: A. Yellow B. Yellow with black band C. Red D. Orange

Any disease with an unknown cause or mechanism: A. Idiopathic B. Iatrogenic C. Cryogenic D. Ergonomic

Beer-Lambert law (Beer’s law) Mathematically establishes the relationship between concentration and absorbance in many photometric determinations Beer’s law is expressed as A = abc 1. A (capital A) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path 2. a (small a) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path 3. b (small b) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path 4. c (small c) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

A, B, D, C

1. What is used to zero the spectrophotometer before reading the test sample? A. Calibrator B. Sample blank C. Reagent blank D. Standard 2. This is used to zero an instrument during a test procedure: A. Calibrator B. Sample blank C. Reagent blank D. Standard

C, B

Method of choice for individual assays of anticonvulsants: A. GC B. HPLC C. Immunoassay D. None of these

Direct measurements of free T4, EXCEPT: A. Immunoassay B. Dialysis C. Uptake D. Ultrafiltration

C The FTI has been largely replaced by the direct measurement of free T4 by immunoassay, dialysis, or ultrafiltration. [Henry]

1. Main estrogen found in nonpregnant women: A.Estrone B.Estradiol C.Estriol D.Dehydroepiandrosterone 2. Main estrogen found in pregnant women: A.Estrone B.Estradiol C.Estriol D.Dehydroepiandrosterone

B, C

Optical density, according to Beer's law is: A. Inversely proportional to the concentration B. Directly proportional to the concentration C. Proportional to the square of the concentration D. Proportional to the square root of the concentration

Colligative properties include all of the following, EXCEPT: A. Osmolality B. Vapor pressure C. Freezing point D. Osmotic pressure

Because of its ANTITUSSIVE AND ANALGESIC PROPERTIES, it is one of the most frequently prescribed opiates in the world; it is frequently combined with nonopiate analgesic agents such as aspirin and acetaminophen. A. Codeine B. Heroin C. Morphine D. Oxycodone

Which of the following laboratory values is considered a positive risk factor for the occurrence of coronary heart disease? A. HDL cholesterol >60 mg/dL B. HDL cholesterol <35 mg/dL C. LDL cholesterol <130 mg/dL D. Total cholesterol <200 mg/dL

What is the HDL cholesterol cutoff that constitutes a risk factor for CAD as recommended by NCEP? A. Less than 30 mg/dL B. Less than 40 mg/dL C. Less than 30 mg/dL for males and less than 40 mg/dL for females D. Less than 45 mg/dL for males and less than 50 mg/dL for females

Minor lipoproteins: A. LDL and HDL B. VLDL and chylomicrons C. VLDL and Lp (a) D. IDL and Lp (a)

Major roles of ______ is to maintain the equilibrium of cholesterol in peripheral cells by the REVERSE CHOLESTEROL TRANSPORT pathway: A. Chylomicrons B. LDL C. VLDL D. HDL

LDL-cholesterol can be estimated using the Friedewald formula: LDL = total cholesterol - HDL - (TAG/5) This calculation should not be used when: A. HDL-cholesterol is greater than 40 mg/dL B. Triglyceride level is greater than 400 mg/dL C. Plasma shows no visible evidence of lipemia D. Total cholesterol is levated based on the age and sex of the patient

Effect of excess lipids or proteins to sodium value measured by flame photometry and indirect ISE: A. Hypernatremia B. Hyponatremia C. Pseudohypernatremia D. Pseudohyponatremia

Which method of analysis will provide the most accurate electrolyte results if a grossly lipemic sample is used? A. Direct ISE B. Indirect ISE C. Flame emission photometry D. Atomic absorption

SURVEILLANCE PROCEDURES COVERING WHOLE TRANSFUSION CHAIN: A. Blood cold chain B. Health vigilance C. Hemovigilance D. Pharmacovigilance

A 24-year-old drug abuser is brought into the emergency department unconscious. He has shallow breaths, looks pale, and is "clammy." Blood gases show the following results: pH = 7.29 pCO2 = 50 mmHg HCO3- = 25 mmol/L What condition is indicated by these results? A. Metabolic alkalosis,partially compensated B. Respiratory acidosis, uncompensated C. A dual problem of acidosis D. An error in one of the blood gas measurements

Which of the following would be elevated in the blood in medullary carcinoma of the thyroid? A. Calcitonin B. Thyroxine C. Catecholamines D. Secretin

Precursor for serotonin and melatonin: A. Glutamine B. Threonine C. Tryptophan D. Tyrosine

Precursor of the adrenal hormones epinephrine, norepinephrine, and dopamine and the thyroid hormones, including thyroxine: A. Proline B. Tyrosine C. Tryptophan D. Serine

What is the predominant form of thyroid hormone in the circulation? A. Thyroxine B. Triiodothyronine C. Diiodotyrosine D. Monoiodotyrosine

1. Main (predominant) hormone produced by the thyroid: A. T3 B. T4 C. Calcitonin D. None of these 2. In terms of biologic activity, what is the most potent thyroid hormone? A. T3 B. T4 C. Calcitonin D. None of these

B, A

Which of the following conditions is associated with hypokalemia? A. Addison’s disease B. Hemolytic anemia C. Digoxin intoxication D. Alkalosis

All of the following are emergency situations, except: A. Glycosuria B. Ketoacidosis C. Hypokalemia D. Hyperkalemia

In ketoacidosis, the anion gap would most likely to be affected in what way? A. Unchanged from normal B. Increased C. Decreased D. Balanced

Calculation of the anion gap is useful for quality control for: A. Calcium B. Tests in the electrolyte profile (sodium, potassium, chloride, and bicarbonate) C. Phosphorus D. Magnesium

An elevated anion gap may be caused by all of the following except: A. Uremia/renal failure B. Ketoacidosis in case of starvation or diabetes C. Alcohol or salicylate poisoning D. Hypoalbuminemia

Laboratory examination of a 46-year-old male who presents with decreasing vision and photophobia finds a high anion–gap metabolic acidosis. These findings are most consistent with this individual having ingested: A. Cadmium B. Nickel C. Mercury D. Cobalt E. Methanol

1. Which of the following is a cause of metabolic alkalosis? A. Late stage of salicylate poisoning B. Uncontrolled diabetes mellitus C. Renal failure D. Excessive vomiting 2. Severe diarrhea causes: A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

D, A

In salicylate overdose, what is the first acid-base disturbance present? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Which of the following is the primary mechanism causing respiratory alkalosis? A. Hyperventilation B. Deficient alveolar diffusion C. Deficient pulmonary perfusion D. Parasympathetic inhibition

DISK DIFFUSION SENSITIVITY TESTING The pH of MHA should be 7.2 to 7.4. Decreased pH can lead to: A. Decreased activity of tetracyclines. B. Decreased activity of aminoglycosides, erythromycin and clindamycin. C. Some MRSA may go undetected. D. False resistance to sulfonamides and trimethoprim.

Sodium citrate in the concentration of a _____ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies. A. 1.5% B. 15% C. 3.2% D. 3.8%

EDTA is used in concentrations of __ of blood. A. 0.5 mg/1 mL of whole blood B. 1.5 mg/1 mL of whole blood C. 2.5 mg/1 mL of whole blood D. 3.5 mg/1 mL of whole blood

Which of the following veins are listed in the proper order of selection for venipuncture? A. Basilic, cephalic, median cubital B. Cephalic, median cubital, basilic C. Median, median basilic, cephalic D. Median cubital, cephalic, basilic

Cortisol production: A. Zona glomerulosa B. Zona fasciculata C. Zona reticularis D. All of these

C-peptide is formed during the conversion of pro-insulin to insulin. The amount of circulating C-peptide provides reliable indicators for pancreatic and insulin secretions (β-cell function). It is decreased in: A. Type 1 DM B. Type 2 DM C. Insulinoma D. Ingestion of hypoglycemic drugs

1. VERY LOW OR UNDETECTABLE C-peptide: A. Type 1 diabetes B. Type 2 diabetes 2. DETECTABLE C-peptide: A. Type 1 diabetes B. Type 2 diabetes

A, B

1. It is increased in hemolytic anemias: A. B1 B. B2 C. Both fractions D. None of these 2. It is increased in bile duct obstruction: A. B1 B. B2 C. Both fractions D. None of these 3. Increased in hepatitis: A. B1 B. B2 C. Both fractions D. None of these

A, B, C

Most sensitive marker of acute alcoholic hepatitis: A. ALT B. ALP C. LD D. GGT

Pathological level are decreased from the normal values by as much as 80 to 90%. A. Amylase B. Lipase C. Cholinesterase D. Creatine kinase

Neuromuscular irritability, which may become clinically apparent as irregular muscle spasms, called tetany is associated with: A. Hyponatremia B. Hypernatremia C. Hypocalcemia D. Hypercalcemia

Delivery of the drug to the tissues: A. Liberation B. Absorption C. Distribution D. Metabolism E. Excretion

Transport of the drug from site of administration to the blood: A. Liberation B. Absorption C. Distribution D. Metabolism E. Excretion

KEY PROCESSES INVOLVED IN DRUG DISPOSITION LIBERATION Release of the dug ABSORPTION Transport of the drug from the site of administration to the blood

DISTRIBUTION Delivery of the drug to the tissues METABOLISM Chemical modification of the drug by cells EXCRETION Drugs and its metabolites are excreted from the body

Single best hormone to determine whether ovulation has occurred; THERMOGENIC EFFECT, in which basal body temperature rises after ovulation. This effect is of clinical use in marking the occurrence of ovulation. A. Estrogen B. Progesterone C. Testosterone D. Thyroxine

Hirsutism, which can be quantified using a measurement technique known as the: A. Ferriman-Gallwey scale B. Liley graph C. T-score D. Z-score

All of the following inhibit growth hormone secretion, except: A. Glucose loading B. Insulin, nutritional deficiencies C. Thyroxine deficiency D. Amino acids, sleep, exercise

Please answer the ff. questions: 1. Mega: A. 10 3 B. 10 -3 C. 10 6 D. 10 -6 2. Micro: A. 10 3 B. 10 -3 C. 10 6 D. 10 -6

C, D

It is added as a preservative to formaldehyde. This will prevent its decomposition to formic acid or precipitation to paraformaldehyde. A. Butanol B. Ethanol C. Methanol D. Acetone

Fixatives that give the best results with metachromatic staining and are the routine fixatives of choice for preservation of detail for photography: A. Formalin fixatives B. Mercurial fixatives C. Lead fixatives D. Chromate fixatives

This fixative is highly explosive when dry, and therefore must be kept moist with distilled water or saturated alcohol during storage. A. Osmic acid B. Mercuric chloride C. Picric acid D. Acetone

Excessive exposure to this clearing agent may be extremely toxic to man and may become carcinogenic or it may damage the bone marrow resulting in aplastic anemia. A. Benzene B. Toluene C. Xylene (xylol) D. Chloroform

Temperature of the flotation water bath: A. 35 to 37C B. 45 to 50C C. 55 to 60C D. At boiling point

1. It is considered to be as the best vital dye. A. Janus green B. Neutral red C. Nile blue D. Toluidine blue 2. It is used for demonstrating mitochondria during vital staining: A. Janus green B. Neutral red C. Nile blue D. Toluidine blue

B, A

It is probably the OLDEST of all stains, originally used for microscopic study of starch granules. It stains amyloid, cellulose, starch, carotenes and glycogen. A. Iodine B. Malachite green C. Orcein D. Neutral red

The Feulgen’s reaction is the most reliable and specific histochemical staining for: A. DNA B. RNA C. DNA and RNA D. None of these

It is a special form of cell death produced by the TUBERCLE BACILLLUS. A. Coagulation necrosis B. Liquefaction necrosis C. Fat necrosis D. Caseous necrosis

Valuable combination in therapy and follow-up in patients with germ cell tumors of the testes: A. CEA and PSA B. CEA and AFP C. AFP and β-HCG D. CEA and CA-125

It is the most commonly used fluorochrome to demonstrate DNA and RNA in fresh or fixed tissues. A. Auramine B. Rhodamine C. Calcofluor white D. Acridine orange

1. Microtome for cutting paraffin embedded tissues, and is the MOST COMMON type used for routine work: A. Rocking microtome B. Rotary microtome C. Sliding microtome D. Freezing microtome 2. Microtome for cutting serial sections of large blocks of paraffin embedded tissues, SIMPLEST TYPE among the different types of microtome: A. Rocking microtome B. Rotary microtome C. Sliding microtome D. Freezing microtome

B, A

A 53-year-old woman with no prior illnesses has a routine checkup by her physician. On examination she has a blood pressure of 150/95 mm Hg. If her hypertension remains untreated for years, which of the following cellular alterations would most likely be seen in her myocardium? A. Dysplasia B. Fatty change C. Hyperplasia D. Hypertrophy E. Metaplasia

Due to chronic trauma induced by ill-fitting dentures: A. Hypertrophy B. Hyperplasia C. Dysplasia D. Metaplasia

It occurs in the bronchi of cigarette smokers as cellular adaptation to smoke: A. Hypertrophy B. Hyperplasia C. Dysplasia D. Metaplasia

1. A 55-year-old male with early stage prostate cancer diagnosed by biopsy had his prostate gland removed (simple prostatectomy). His PSA prior to surgery was 10.0 ng/mL. If the surgery was successful in completely removing the tumor cells, what would the PSA result be 1 month after surgery? A. Undetectable B. 1 – 3 ng/mL C. Less than 4 ng/mL D. Less than 10 ng/mL 2. A patient has a prostate-specific antigen level of 60 ng/mL the day before surgery to remove a localized prostate tumor. One week following surgery, the serum PSA was determined to be 8 ng/mL by the same method. What is the most likely cause of these results? A. Incomplete removal of the malignancy B. Cross reactivity of the antibody with anothertumor antigen C. Testing too soon after surgery D. Hook effect with the PSA assay

A, C

A, B

C, A, C, C

Stain for demonstration of Helicobacter pylori: A. Dieterle method B. Grocott methamine silver (GMS) stain C. Toluidine blue, cresyl violet acetate D. Congo red

B, A

A, B

Which of the ff. published standards for GOOD LABORATORY PRACTICE (GLP)? A. CDC B. DOH C. WHO D. OSHA

Which of the following ISO standard applies to the clinical laboratory? A. ISO 9000 B. ISO 7000 C. ISO 15189 D. ISO 15436

Formalin pigment may be removed from tissue by: A. Running water B. Alcoholic picric acid C. Alcoholic iodine D. Potassium permanganate

1. Stain for Helicobacter: A. Masson-Fontana B. Toluidine blue C. Wade-Fite D. Von Kossa 2. Stain for Leprosy bacillin and Nocardia: A. Gomori B. Van Gieson C. Wade-Fite D. Warthin-Starry 3. Stain for Spirochete: A. Feulgen B. Verhoeff C. Wade-Fite D. Warthin-Starry

B, C, D

Ripening of hematoxylin is a process of: A. Hydrolysis B. Oxidation C. Mordanting D. Reduction

The phosphotungstic acid hematoxylin (PTAH) is useful for demonstrating: A. Edema fluid B. Muscle striations C. Ground substance D. Reticulin network

Acetic acid is normally used in conjunction with other fixatives to form a compound solution. It solidifies at ____, hence the name glacial acetic acid. A. 7C B. 7F C. 17C D. 17F

The DRY celloidin embedding method is employed chiefly for the: A. Bones and teeth B. Large brain blocks C. Whole organs D. Eyes

Enzyme histochemistry A. Celloidin section B. Paraffin section C. Frozen section D. Ultrathin section

This organ is usually suspended whole in 10% buffered formalin for 2 to 3 weeks to ensure fixation and some hardening prior to sectioning. A. Lungs B. Liver C. Brain D. Amputated foot

Which of the following organs should not be dissected before they are fixed? A. Eyes B. Lungs C. Heart D. Liver

Harris hematoxylin is used on tissue sections to stain: A. Fats B. Glycogen C. Nuclei D. Cytoplasm

Which of the following immunoglobulins is most efficient at activating complement via the classical pathway? A. IgG2 B. IgG4 C. IgM D. IgA

Which cell surface membrane marker is used for enumeration of hematopoietic progenictor cell (HPC) enumeration? A. CD4 B. CD8 C. CD34 D. CD45

Which complement protein is present in the greatest concentration in human serum? A. C1 B. C2 C. C3 D. C4

Which of the following complement components is a strong CHEMOTACTIC FACTOR as well as a strong ANAPHYLATOXIN? A. C3a B. C3b C. C5a D. C4a

Acute phase reactants elevated up to 1,000x in inflammation: A. CRP and fibrinogen B. CRP and serum amyloid C. Serum amyloid and ceruloplasmin D. Albumin and prealbumin

Incompatible blood transfusions are examples of: A. Type I hypersensitivity reactions B. Type II hypersensitivity reactions C. Type III hypersensitivity reactions D. Type IV hypersensitivity reactions

Mantoux test: A. Type I hypersensitivity B. Type II hypersensitivity C. Type III hypersensitivity D. Type IV hypersensitivity

Serum sickness: A. Type I hypersensitivity B. Type II hypersensitivity C. Type III hypersensitivity D. Type IV hypersensitivity

All the following are a function of T cells, except: A. Mediation of delayed-hypersensitivity reactions B. Mediation of cytolytic reactions C. Regulation of the immune response D. Synthesis of antibody

Immunodeficiency with thrombocytopenia and eczema is often referred to as: A. DiGeorge syndrome B. Bruton agammaglobulinemia C. Ataxia telangiectasia D. Wiskott-Aldrich syndrome

Combined immunodeficiency with loss of muscle coordination is referred to as: A. DiGeorge syndrome B. Bruton agammaglobulinemia C. Ataxia telangiectasia D. Wiskott-Aldrich syndrome

He discovered complement as a heat labile component in the natural serum; described the phenomenon of complement fixation and its diagnostic possibilities: A. Edward Jenner B. Jules Bordet C. Robert Koch D. Ellie Metchnikoff

A patient with joint swelling and pain tested negative for serum RF by both latex agglutination and ELISA methods. What other test would help establish a diagnosis of RA in this patient? A. Anti-CCP B. ANA testing C. Flow cytometry D. Complement levels

Antibodies to cyclic citrullinated proteins (anticyclic citrullinated peptide antibody [anti-CCP or ACPA]) are associated with: A. SLE B. Sjogren's syndrome C.Wegener’s granulomatosis D. RA

All of the following are sites for bone marrow aspiration. 1. Preferred for adults: A. Anterior iliac crest B. Posterior iliac crest C. Sternum D. Tibia 2. Infants younger than 18 months: A. Anterior iliac crest B. Posterior iliac crest C. Sternum D. Tibia

B, D Sites for bone marrow aspiration in adults: 1. Posterior iliac crest (preferred) 2. Anterior iliac crest 3. Sternum --------- Infants younger than 18 months: Tibia

A woman with breast cancer is treated with a monoclonal antibody to HER2. This is an example of: A. A cancer vaccine B. An immunotoxin C. Passive immunotherapy D. Active immunotherapy

What is the most likely interpretation of the following syphilis serological results? RPR: reactive VDRL: reactive MHA-TP: nonreactive A. Neurosyphilis B. Secondary syphilis C. Syphilis that has been successfully treated D. Biological false positive

In the RPR test, what is the gauge of the needle for antigen delivery? A. 16 B. 18 C. 20 D. 21

1. Speed and time of rotation for serum VDRL test: A. 100 rpm for 4 minutes B. 100 rpm for 8 minutes C. 180 rpm for 4 minutes D. 180 rpm for 8 minutes 2. Speed and time of rotation for CSF VDRL test: A. 100 rpm for 4 minutes B. 100 rpm for 8 minutes C. 180 rpm for 4 minutes D. 180 rpm for 8 minutes 3. Speed and time of rotation for RPR: A. 100 rpm for 4 minutes B. 100 rpm for 8 minutes C. 180 rpm for 4 minutes D. 180 rpm for 8 minutes

C, D, B

1. What could be the possible interpretation? HBsAg: negative Anti-HBc: positive Anti-HBs: positive A. Recovering from acute HBV infection B. Immune because of natural infection C. Immune because of hepatitis B vaccination D. Chronically infected 2. What could be the possible interpretation? HBsAg: negative Anti-HBc: negative Anti-HBs: positive A. Recovering from acute HBV infection B. Immune because of natural infection C. Immune because of hepatitis B vaccination D. Chronically infected

B, C

An HIV-positive patient with a viral load of 100,000 copies/mL of HIV RNA and a drop in his CD4 T-cell count from 240 to 50/μL has been diagnosed with Pneumocystis jiroveci pneumonia. Which of the following is the best description of the stage of this patient’s HIV disease? A. HIV infection, stage 1 B. HIV infection, stage 2 C. HIV infection, stage 3 (AIDS) D. HIV infection, stage unknown

What is the main difficulty associated with the development of an HIV vaccine? A. The virus has been difficult to culture; antigen extraction and concentration are extremely laborious B. Human trials cannot be performed C. Different strains of the virus are genetically diverse D. Anti-idiotype antibodies cannot be developed

Which method is used to test for HIV infection in infants who are born to HIV-positive mothers? A. ELISA B. Western blot test C. Polymerase chain reaction D. Viral culture

After a CNS diagnostic procedure, which of the following might be seen in the CSF? A. Choroidal cells B. Ependymal cells C. Spindle-shaped cells D. All of the above

What is the most common cause of male infertility? A. Mumps B. Klinefelter’s syndrome C. Varicocele D. Malignancy

Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome? A. Ammonia B. Lactate C. Glucose D. Alpha-ketoglutarate

1. Which of the following conducts Proficiency Workshops in HIV and Hepatitis Testing for all medical technologists? A. LCP B. NKTI C. RITM D. SACCL-SLH 2. Which of the following conducts EQAS on infectious markers for transfusion transmissible diseases as an input to Quality Assurance of all BLOOD SERVICE FACILITIES (BSFs) performing donor blood testing? A. LCP B. NKTI C. RITM D. SACCL-SLH

D, C

To assess the permeability of the blood/brain barrier (BBB), the CSF level of which of the following proteins will be measured by the laboratory? A. Albumin B. IgG C. Transferrin D. Prealbumin

Urinary sediment that contains red blood cells, red blood cell casts and protein is characteristic of: A. Acute glomerulonephritis B. Bladder infection C. Nephrotic syndrome D. Prostatic hypertrophy

Which of these sugars cannot be detected in urine using the copper reduction test? A. Fructose B. Galactose C. Arabinose D. Sucrose

Which of the following reagents can be used to measure protein in CSF? A. Biuret B. Coomassie brilliant blue C. Ponceau S D. Bromcresol purple

Primary urinalysis result in patient with Henoch-Schonlein purpura: A. Cellular and granular casts B. Waxy and broad casts C. Oval fat bodies, fat droplets, fatty and waxy casts D. Macroscopic hematuria, proteinuria, RBC casts

Stain for demonstration of Helicobacter pylori: A. Dieterle method B. Grocott methamine silver (GMS) stain C. Toluidine blue, cresyl violet acetate D. Warthin-Starry

Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following EXCEPT: A. Observation of budding in yeast cells B. Increased refractility of oil droplets C. Lysis of yeast cells by acetic acid D. Lysis of RBCs by acetic acid

Which of the following is the most common application of immunoelectrophoresis (IEP)? A. Identification of the absence of a normal serum protein B. Structural abnormalities of proteins C. Screening for circulating immune complexes D. Diagnosis of monoclonal gammopathies

The principle of the protein error of indicators reaction is that: A. Protein keeps the pH of the urine constant B. Albumin accepts hydrogen ions from the indicator C. The indicator accepts hydrogen ions from albumin D. Albumin changes the pH of the urine

The presence of _____ increases the OD of the amniotic fluid. Specimens are centrifuged at 2,000 g for 10 minutes and examined using a wavelength of 650 nm. A. Bilirubin B. Oxyhemoglobin C. Lamellar bodies D. None of these

As a result of the brittle consistency of the cast matrix, they often appear fragmented with jagged ends and have notches in their sides. With supravital stains, these casts stain a homogenous, dark pink. A. Hyaline B. Cellular C. Granular D. Waxy

For post-vasectomy semen analysis, specimens are routinely tested at monthly intervals, beginning at ___ months post-vasectomy and continuing until ___ consecutive monthly specimens show no spermatozoa. A. 2 months, 2 months B. 2 months, 3 months C. 3 months, 2 months D. 3 months, 3 months

The principle of refractive index is to compare: A. Light velocity in solutions with light velocity in solids B. Light velocity in air with light velocity in solutions C. Light scattering by air with light scattering by solutions D. Light scattering by particles in solution

A person submitting a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment EXCEPT: A. Hyaline casts B. Granular casts C. RBC casts D. WBC casts

Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus? A. No hemolysis B. Mildly affected fetus C. Moderately affected fetus that requires close monitoring D. Severely affected fetus that requires intervention

Variables that are included in the MDRD-IDSM estimated creatinine clearance calculations include all of the following except: A. Serum creatinine B. Weight C. Age D. Gender

Elements containing concentric striations of collagen-like material can be seen in benign conditions and are also associated with ovarian and thyroid malignancies: A. Rice bodies B. Psammoma bodies C. Ochronotic shards D. Creola bodies

SYNOVIAL FLUID What is the normal amount of fluid in the adult knee cavity? A. Less than 1.5 mL B. Less than 2.5 mL C. Less than 3.5 mL D. Less than 5.5 mL

Blood specimen for the creatinine clearance is collected: A. At the start of the urine collection period B. At the end of the urine collection period C. At about 12 hours into the urine collection period D. Any time during the urine collection period

Deposition of IgA on the glomerular membrane resulting from increased levels of serum IgA: A. Alport syndrome B. Berger disease C. Focal segmental glomerulosclerosis D. Minimal change disease

He discovered the effect of attenuation by accident during his studies of chicken cholera. After returning from a summer vacation in 1881, he noticed that he had left a culture of the bacteria that cause chicken cholera, now known as Pasteurella multocida, on his laboratory bench. Instead of disposing of the aged culture, he decided to use it to inoculate chickens. The chickens did not develop the disease. A. Edward Jenner B. Louis Pasteur C. Robert Koch D. Jules Bordet

1. PRC function: Administers, implements, and enforce the laws and policies with respect to the regulation and licensing of the various professions and occupations, including the enhancement and maintenance of professional and occupational standards and ethics. A. Quasi-Legislative B. Quasi-Judicial C. Executive D. None of these 2. PRC function: Investigates motu proprio or upon the filing of a verified complaint, any registered professional, any member of the professional regulatory boards, officers and employees under the jurisdiction of the Commission; Issues summons, subpoena and subpoena duces tecum; May hold in contempt erring party or person; May revoke or suspend certificates of registration and professional licenses. A. Quasi-Legislative B. Quasi-Judicial C. Executive D. None of these 3. PRC function: Formulates rules and policies on professional regulation. Reviews, revises and approves resolutions embodying policies promulgated by the Professional Regulatory Boards. A. Quasi-Legislative B. Quasi-Judicial C. Executive D. None of these

C, B, A

Signal amplification differs from target amplification when designing protocols for identification of nucleic acids. Which of the following is an example of a signal amplification technique? A. Branched-chain DNA detection B. Ligase chain reaction C. Polymerase chain reaction D. Reverse-transcriptase PCR

Which technique involves PROBE amplification rather than target amplification? A. Southern blot B. PCR C. Transcription-mediated amplification D. Ligase chain reaction

The detection of the DNA from cytomegalovirus (CMV) and human papillomavirus (HPV) is typically performed using the Hybrid Capture assay. What type of assay is Hybrid Capture? A. Target amplification assay B. Signal amplification assay C. Reverse transcriptase assay D. Viral load assay

B, C

Unique amino acid sequence that is common to all immunoglobulin molecules of a given class in a given species: A. Allotype B. Idiotype C. Isotype D. None of these

The hinge region has a high content of _______ which allows for flexibility. A. Pheylalanine B. Tyrosine C. Glutamine D. Proline

CYFRA 21-1 A. Colorectal cancer B. Ovarian cancer C. Lung cancer D. Prostate cancer

A tumor marker for the diagnosis of urinary bladder cancer: A. CA 19-9 B. HER-2/neu C. Calcitonin D. NMP

Sialyated Lewis blood group antigen: A. CEA B. CA 15-3 C. CA 19-9 D. HER2/neu

In production of hybridoma, plasma cells are derived from: A. Rabbit kidney B. Rabbit liver C. Mouse liver D. Mouse spleen

Highest levels of Class II MHC molecules on their surface: A. B lymphocytes B. Monocytes, macrophages C. Thymic epithelium D. Dendritic cells

A biomarker that exhibits greater specificity than other proinflammatory markers in identifying patients with sepsis and can be used in the DIAGNOSIS OF BACTERIAL INFECTIONS: A. Ceruloplasmin B. Cytokines C. CEA D. Procalcitonin

Which immunoglobulins are characteristically present on mature (virgin) B cells, which are B lymphocytes that have not yet been exposed to the appropriate antigen? A. IgA and IgE B. IgD and IgA C. IgE and IgG D. IgG and IgM E. IgM and IgD

B lymphocytes are stimulated to produce antibodies to HIV, which can usually be detected in the host’s serum by ___ after primary infection. A. Three days B. Three weeks C. Six weeks D. Six months

The fourth-generation ELISA tests for HIV detects: A. HIV-1 and HIV-2 antigens B. HIV-1 and HIV-2 antibodies C. p24 antigen D. HIV-1 and HIV-2 antibodies, p24 antigen

Marker to identify memory cells because they are similar in appearance to mature B cells: A. CD 16 B. CD 27 C. CD 34 D. CD 40

1. Physiologic failure of pH to fall below 3.5 or 1.0 pH unit with gastric stimulation: A. Anacidity B. Achlorhydria C. Euchlorhydria D. Hypochlorhydria 2. Physiologic failure of pH to fall below 3.5, although it decreases 1.0 pH unit or more upon gastric stimulation: A. Anacidity B. Achlorhydria C. Euchlorhydria D. Hypochlorhydria 3. Failure of the stomach acidity to fall lower than 6.0 in a stimulation test: A. Anacidity B. Achlorhydria C. Euchlorhydria D. Hypochlorhydria

B, D, A

PHASE OF GASTRIC SECRETION that involves VAGUS NERVE STIMULATION caused by stimuli such as taste, smell, or sight: A. Cephalic phase B. Gastric phase C. Intestinal phase D. None of these

POPCORN The amount of amniotic fluid increases in quantity throughout pregnancy, reaching a peak of approximately ____ mL during the third trimester, and then gradually decreases prior to delivery. A. 400 to 800 mL B. 800 mL to 1,200 mL C. 1,200 to 1,500 mL D. 2,000 to 4, 000 mL

A maximum of ___ mL of amniotic fluid is collected in sterile syringes. A. 10 mL B. 20 mL C. 30 mL D. 50 mL

Portion of the amniotic fluid arises from all of the following, EXCEPT: A. Fetal urine B. Fetal respiratory tract C. Amniotic membrane D. Umbilical cord E. Bone marrow

Dark red brown amniotic fluid: A. Meconium B. Bilirubin C. Traumatic tap D. Fetal death

The only tissue in the body that is hypertonic with respect to normal plasma (i.e., its osmolality is greater than 290 mOsm/kg): A. Glomerulus B. Convoluted tubules C. Renal cortex D. Renal medulla

Black color of Argyrol, an antiseptic, disappears with addition of: A. Copper sulfate B. Ferric chloride C. Sodium nitroprusside D. Trichloroacetic acid

Anticoagulant, orange in alkaline urine, colorless in acid urine: A. Phenol B. Phenindione C. Pyridium D. Rifampin

1. What type of antigen is used in the RPR card test? A. Live treponemal organisms B. Killed suspension of treponemal organisms C. Cardiolipin D. Tanned sheep cells 2. The rapid plasma reagin assay for syphilis does not need to be read microscopically because the antigen is: A. Cardiolipin B. Complexed with latex C. Complexed with charcoal D. Inactivated bacterial cells

C, C

1. Specific gravity of 1.022 ± 0.001: A. Distilled water B. 3% NaCl C. 5% NaCl D. 9% sucrose 2. Specific gravity of 1.034 ± 0.001: A. Distilled water B. 3% NaCl C. 5% NaCl D. 9% sucrose

C, D

Acid-fast staining of a smear prepared from digested sputum showed slender, slightly curved, beaded, red mycobacterial rods. Growth on Middlebrook 7H10 slants produced buff-colored microcolonies with a SERPENTINE PATTERN after 14 days at 37°C. NIACIN AND NITRATE REDUCTION TESTS WERE POSITIVE. What is the most probable presumptive identification? A. Mycobacterium tuberculosis B. Mycobacterium ulcerans C. Mycobacterium kansasii D. Mycobacterium avium–intracellulare complex

What is added to synovial fluid to determine the viscosity? A. Sodium hydroxide B. Acetic acid C. Hydrochloric acid D. Hyaluronic acid

B Hyaluronic acid is responsible for synovial fluid viscosity. PERO ang tanong dito yung REAGENT to determine viscosity... remember the ROPE'S TEST...

SYNOVIAL FLUID Crystals that appear needle-shaped under polarized light and are yellow when aligned with the slow vibration of compensated polarized light are: A. Monosodium urate B. Calcium pyrophosphate C. Hydroxyapatite D. Corticosteroid

Distinct odor that is often referred to as a “chocolate cake” or “burnt chocolate” smell: A. Burkholderia cepacia B. Eikenella corrodens C. Proteus sp. D. Staphylococcus aureus

All of the following are associated with febrile agglutinins except: A. Brucella melitensis B. Mycoplasma pneumoniae C. Salmonella typhi D. Rickettsia ricketsii

Microscopically, immature spermatogenic cells are often difficult to distinguish from: A. Bacteria B. Erythrocytes C. Leukocytes D. Epithelial cells

Hops or cabbage odor of the urine: A. MSUD B. Isovaleric acidemia C. Methionine malabsorption D. Tyrosinemia

Crystals seen in urine of patients with leukemia who are receiving chemotherapy: A. Monohydrate CaOx B. Dihydrate CaOx C. Uric acid D. Triple phosphate

With which crystals are urinary cystine crystals often confused? A. Calcium pyrophosphate B. Uric acid C. Cholesterol D. Calcium oxalate

D, B, B

1. Initial freezing temperature, frozen RBCs - High Glycerol A. -196C B. -120C C. -80C D. -65C 2. Maximum STORAGE temperature, frozen RBCs - High Glycerol A. -196C B. -120C C. -80C D. -65C 3. Initial freezing temperature, frozen RBCs - Low Glycerol A. -196C B. -120C C. -80C D. -65C 4. Maximum STORAGE temperature, frozen RBCs - Low Glycerol A. -196C B. -120C C. -80C D. -65C 5. Shelf-life of Frozen RBCs A. 1 year B. 2 years C. 5 years D. 10 years

C, D, A, B, D

Antigens were shown to be located on complement receptor 1 (CR1): A. Diego B. Indian C. Cromer D. Knops

Antigens are related to human leukocyte antigens (HLA) on RBCs: A. Bg B. Di C. Sd D. Xg

Antigens are not intrinsic to the RBC membrane. Rather, they are on the fourth component of complement (C4), and are adsorbed onto RBCs from plasma: A. Dombrock B. Chido/Rodgers C. Gerbich D. Cromer

RBCs of the Gerbich or Leach phenotypes have WEAK EXPRESSION OF _____BLOOD GROUP ANTIGENS, A. DIEGO B. KIDD C. KELL D. LUTHERAN

DOUBLE RBC PHERESIS All of the following apply to a double red cell unit apheresis collection EXCEPT: A. The hematocrit must be at least 38% B. The weight for a female is at least 150 lbs C. The height for a male is at least 5 ft 1 in. D. The deferral period following collection is 16 weeks

DONOR CRITERIA FOR PLASMAPHERESIS Frequent plasma donors have a total serum protein of at least ___ g/dL: A. 2 g/dL B. 3 g/dL C. 6 g/dL D. 10 g/dL

SAFEST method to ensure that NO INFECTIVE MATERIALS REMAIN in samples or containers when disposed: A. Autoclave B. Incineration C. Pasteurization D. Filtration

1. Florence test: A. Test for spermine, iodine and potassium iodide reagent B. Test for spermine, picric acid and trichloroacetic acid reagent C. Test for choline, iodine and potassium iodide reagent D. Test for choline, picric acid and trichloroacetic acid reagent 2. Barbiero's test: A. Test for spermine, iodine and potassium iodide reagent B. Test for spermine, picric acid and trichloroacetic acid reagent C. Test for choline, iodine and potassium iodide reagent D. Test for choline, picric acid and trichloroacetic acid reagent

C, B

Green peritoneal fluid: A. Microbial infection B. Lymphatic trauma and blockage C. Malignancy D. Gallbladder or pancreatic disorders

Biochemically speaking, what type of molecules are Rh antigens? A. Glycophorins B. Simple sugars C. Proteins D. Lipids

Excluding ABO, ___ is rated second only to Rh(D) in terms of immunogenicity: A. Lewis B. Kidd C. Kell D. Duffy

What may be found in the serum of a person who is exhibiting signs of TRALI (transfusion-related acute lung injury)? A. Red blood cell alloantibody B. IgA antibody C. Antileukocyte antibody D. Allergen

Treatment for Hepatitis C and Kaposi's sarcoma: A. IFN-alpha B. IFN-beta C. G-CSF D. GM-CSF

Efficacious in treating multiple sclerosis: A. TNF-alpha B. TNF-beta C. IFN-alpha D. IFN-beta

1. Most common and easiest method to detect varicella-zoster virus (VZV) antibodies: A. Enzyme-linked immunosorbent assay (ELISA) B. Fluorescent ab to membrane ag (FAMA) C. Hemagglutination D. Polymerase chain reaction (PCR) 2. It is considered as the reference method for VZV antibody; most sensitive and most reliable: A. Enzyme-linked immunosorbent assay (ELISA) B. Fluorescent ab to membrane ag (FAMA) C. Hemagglutination D. Polymerase chain reaction (PCR)

A, B

1. Method of choice for diagnosis of congenital toxoplasmosis: A. Latex agglutination B. EIA C. IFA D. PCR 2. Prenatal congenital toxoplasmosis can be diagnosed by performing ______ on amniotic fluid to detect T. gondii DNA: A. Latex agglutination B. EIA C. IFA D. PCR 3. Method of choice to detect T. gondii DNA in CSF: A. Latex agglutination B. EIA C. IFA D. PCR

B, D, D

Only blood component capable of transmitting Treponema pallidum infection: A. Cryoprecipitate B. Leukopoor RBCs C. Platelets D. Whole blood

Temperature of the refrigerated centrifuge should be: A. 2°C B. 4°C C. 6°C D. 8°C

1. In preparation of packed RBCs, if CPDA-1 is used, how many mL of plasma can be removed from whole blood? A. 50 to 100 mL B. 100 to 150 mL C. 200 to 250 mL D. 250 to 300 mL 2. In plateletpheresis, the total amount of plasma that can be removed along with the platelets is limited to: A. 200 mL B. 250 mL C. 400 mL D. 500 mL

C, D

For platelet concentrates, if the product contains ______ of RBCs, a pilot sample must be attached to the product and used by the transfusing facility to crossmatch the product with the intended recipient. A. More than 0.1 mL B. More than 1 mL C. More than 1.5 mL D. More than 2 mL

A donor taking Feldene will not be able to donate platelets for: A. 2 days B. 7 days C. 2 weeks D. 4 weeks

DONOR DEFERRAL 1. Confirmed positive HBsAg A. No deferral B. 1 month deferral C. 12 months deferral D. Permanent deferral 2. Sexual contact with individual with hepatitis A. No deferral B. 1 month deferral C. 12 months deferral D. Permanent deferral 3. Close (household) contact with individual with hepatitis A. No deferral B. 1 month deferral C. 12 months deferral D. Permanent deferral 4. Present or past clinical or laboratory evidence of infection with HIV A. No deferral B. 1 month deferral C. 12 months deferral D. Permanent deferral 5. Sexual contact with individual with HIV A. No deferral B. 1 month deferral C. 12 months deferral D. Permanent deferral 6. Close contact with individual with HIV A. No deferral B. 1 month deferral C. 12 months deferral D. Permanent deferra

D, C, C, D, C, A

1. If the donor has received a live attenuated vaccine for GERMAN MEASLES (RUBELLA) or chickenpox, there is _____ deferral. A. 2 weeks B. 4 weeks C. 12 months D. No deferral, if donor is symptom - free and afebrile 2. If a potential donor has received a live attenuated or bacterial vaccine such as MEASLES (RUBEOLA), MUMPS, oral polio, typhoid, or yellow fever, there is ____ deferral. A. 2 weeks B. 4 weeks C. 12 months D. No deferral, if donor is symptom - free and afebrile

B, A

A potential donor has received vaccination for yellow fever: A. 2 weeks deferral B. 4 weeks deferral C. 8 weeks deferral D. No deferral

Donor deferral for first-trimester or second-trimester abortion or miscarriage: A. 2 weeks deferral B. 6 weeks deferral C. 12 months deferral D. Not cause for deferral

Treatment with this drug is a cause of permanent donor deferral: A. Accutane B. Propecia C. Proscar D. Tegison

The use of plasma from only male donors for transfusion is a preventive method for which type of transfusion reaction: A. Febrile B. Allergic C. TRALI D. TACO

Which transfusion reaction presents with fever, maculopapular rash, watery diarrhea, abnormal liver function, and pancytopenia? A. Transfusion-associated sepsis B. Transfusion-related acute lung injury C. Transfusion-associated graft-versus-host disease D. Transfusion-associated allergic reaction

Cardiopulmonary bypass is an essential system for open heart surgery. Which of the following prevents coagulation during CPB? A. ACP B. CPD C. CPDA-1 D. Heparin

Anti-Sd has been identified in patient ALF. What substance would neutralize this antibody and allow detection of other alloantibodies? A. Saliva B. Hydatid cyst fluid C. Urine D. Human breast milk

The following are all bacterial PHENOTYPIC characteristics EXCEPT: A. Microscopic morphology and staining characteristics B. Environmental requirements for growth C. Nutritional requirements and metabolic capabilities D. The presence of a particular nucleic acid sequence

What is the number of bacteria needed to cause turbidity in broth culture and to be seen with an unaided eye? A. 10^2 organisms B. 10^4 organisms C. 10^6 organisms D. 10^8 organisms

What temperature is used to achieve DNA denaturation to a single strand? A. 74 °C B. 92 °C C. 94 °C D. 102 °C

A widely used hemagglutination test for detecting antibody to Treponema pallidum is: A. MHA-TP test B. FTA-ABS test C. VDRL test D. Hemagglutination inhibition assay

What substance added to the antigen in the RPR test allows for more macroscopically visible flocculation? A. Latex particles B. Extracellular antigens C. Heparin-magnesium chloride particles D. Charcoal particles

The mechanism of action for tetracycline is inhibition of: A. RNA synthesis B. Cell wall synthesis C. Protein synthesis D. Membrane function

All of the following can be used to detect toxin from C. diphtheriae except: A. Guinea pig lethality test B. Elek test C. Modified Tinsdale D. PCR

Which organism exhibits end-over-end tumbling motility when incubated in nutrient broth at room temperature for 1 to 2 hours A. C. diphtheriae B. C. jeikeium C. Arthrobacter sp. D. L. monocytogenes

Pregnant women and immunocompromised patients should avoid eating which of the following foods to prevent Listeria infection A. Feta cheese B. Peanuts C. Pickles D. Ice cream

All of the following media used for the cultivation of Micrococcaceae are SELECTIVE, EXCEPT: A. 5% sheep blood agar B. Phenyl-ethyl alcohol agar C. Mannitol salt agar D. Colistin nalidixic acid agar

Necrotizing fasciitis is a serious infection associated with: A. Streptococcus agalactiae B. Streptococcus mitis C. Streptococcus pyogenes D. Staphylococcus epidermidis

EYE CULTURE, GRAM-POSITIVE, AEROBIC, MOTILE & BETA-HEMOLYTIC A large, aerobic, beta-hemolytic, gram-positive rod is isolated from an eye culture. Subsequent testing reveals it is motile and produces a wide zone on egg yolk agar. The most likely identification of this organism is: A. Bacillus anthracis B. Escherichia coli C. Bacillus cereus D. Clostridium perfringens

The most appropriate therapy for inhalation anthrax is: A. Ciprofloxacin B. Tetracycline C. Vancomycin D. Erythromycin

A large, aerobic, gram-positive, spore-forming rod is isolated from ablood culture. It can be further confirmed as B. anthracis if it is: A. Hemolytic and motile B. Hemolytic and nonmotile C. Nonhemolytic and motile D. Nonhemolytic and nonmotile

Which of the following is the only catalase-negative, gram-positive, non-spore-forming rod that produces H2S on TSI? A. Gardnerella sp. B. Erysipelothrix sp. C. Lactobacillus sp. D. Arcanobacterium sp.

Which of the following organisms has multiple colonial morphologies and may have alpha-hemolytic colonies resembling streptococci? A. Lactobacillus sp. B. Gardnerella sp. C. Arcanobacterium sp. D. Bifidobacterium sp.

Which organisms may stain partially acid-fast when stained with a modified acid-fast stain? A. Gordonia sp. B. Rhodococcus sp. C. Nocardia sp. D. All of the above

Infection caused by non–acid-fast aerobic actinomycetes is usually chronic, granulomatous lesions of the skin referred to as: A. Mycelium B. Necrosis C. Impetigo D. Mycetoma

Incubation of which organism at 25°C produces a characteristic yellow pigment? A. C. sakazakii B. P. shigelloides C. E. aerogenes D. H. alvei

Which of the following conditions is viewed as a risk factor for systemic disease caused by Pasteurella multocida subsp. multocida? A. Liver cirrhosis B. End-stage renal disease C. Hyperlipidemia D. Hereditary hemochromatosis

Which encapsulated type of H. influenzae is most common? A. Type a B. Type b C. Type c D. Type d

Which of the following is an effective drug for treating chancroid? A. Ampicillin B. Erythromycin C. Amoxicillin D. Tetracycline

Sulfur granules in a clinical specimen indicate the presence of: A. Clostridium spp. B. Fusobacterium spp. C. Actinomyces spp. D. Peptostreptococcus spp.

In patients who are HIV positive or who have AIDS, chronic pulmonary disease may be associated with infection as a result of: A. Mycobacterium gordonae B. Mycobacterium kansasii C. Mycobacterium avium complex D. Mycobacterium fortuitum

Which organism causes Rocky Mountain spotted fever? A. Chlamydia trachomatis B. Ehrlichia chaffeensis C. Rickettsia rickettsii D. Coxiella burnetii

Which triad of symptoms is associated with rickettsial infections? A. Urethral discharge, fever, and dysuria B. Coughing, production of sputum, and chest pain C. Fever, headache, and rash D. Genital lesion, swollen inguinal lymph nodes, and headache

Transmission of Orientia tsutsugamushi is associated with what vector? A. Ticks B. Fleas C. Lice D. Chiggers

Babesia is an organism that has been implicated in disease from both splenectomized and nonsplenectomized patients. Morphologically, the parasites resemble: A. Plasmodium falciparum rings B. Leishmania donovani amastigotes C. Trypanosoma cruzi trypomastigotes D. Plasmodium vivax developing rings E. Trypanosoma brucei gambiense trypomastigotes

A 60-year-old Brazilian patient with cardiac irregularities and congestive heart failure suddenly dies. Examination of the myocardium revealed numerous amastigotes, an indication that the cause of death was most likely: A. Leishmaniasis with Leishmania donovani B. Leishmaniasis with Leishmania braziliense C. Trypanosomiasis with Trypanosoma brucei gambiense D. Trypanosomiasis with Trypanosoma cruzi E. Any of the above

Plasmodium vivax and Plasmodium ovale are similar because they: A. Exhibit Schüffner’s dots and have a true relapse in the life cycle B. Have no malarial pigment and multiple rings C. Commonly have appliqué forms in the red cells D. Have true stippling, do not have a relapse stage, and infect old red cells E. Have a 72-hour periodicity cycle in the RBCs

Which of the following roundworms is capable of autoinfection, hyperinfection, and a heavy worm burden with characteristic larval migration required in the life cycle? A. Ancylostoma duodenale B. Enterobius vermicularis C. Strongyloides stercoralis D. Ascaris lumbricoides

Which of the following can bypass the need for an intermediate host? A. D. latum B. D. caninum C. H. diminuta D. H. nana

Which tapeworm cannot be identified to the species level based on its egg morphology; instead, proglottids must be examined? A. Diphyllobothrium B. Dipylidium C. Hymenolepis D. Taenia

Infection with Clonorchis or Opisthorchis may result from eating raw or undercooked: A. Aquatic vegetation B. Crabs C. Crayfish D. Freshwater fish

What are the optimal temperature and incubation time before a fungal blood culture is reported as negative? A. 37°C; 21 days B. 37°C; 7 days C. 30°C; 21 days D. 30°C; 7 day

Adding specimen scrapings to 10% KOH to show the presence of sclerotic bodies that resemble copper pennies is useful in the diagnosis of: A. Chromoblastomycosis B. Phaeohyphomycosis C. Mycetomas D. Zygomycosis

MOVIE, COFFEE Flashcards

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