POPCORN 1

Question 1

Feather-edged colonies usually surrounded by zone of green discoloration; produces a highly characteristic, fruity odor resembling apples or strawberries:
A. Achromobacter denitrificans
B. Pseudomonas alcaligenes
C. Pseudomonas pseudoalcaligenes
D. Alcaligenes faecalis

Answer 1

D. Alcaligenes faecalis

Question 2

Convex, smooth, gray, nonhemolytic; rough and mucoid variants can occur; may have a musty or mushroom odor:
A. Pseudomonas aeruginosa
B. Clostridium difficile
C. Pasteurella multocida
D. Chromobacterium violaceum

Answer 2

C. Pasteurella multocida

Question 3

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

Answer 3

C. Proteus spp.

Question 4

Oxidase positive, urease negative:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these

Answer 4

A. B. pertussis

Question 5

Oxidase and urease positive:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these

Answer 5

C. B. bronchiseptica

Question 6

Oxidase negative, urease positive:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these

Answer 6

B. B. parapertussis

Question 7

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

Answer 7

D. Haemophilus influenzae

Question 8

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

Answer 8

B. Proteus

Question 9

Cetrimide medium is primarily used to isolated and purify ______ from contaminated specimens.
A. C. diphtheriae
B. P. aeruginosa
C. S. agalactiae
D. Y. enterocolitica

Answer 9

B. P. aeruginosa

Question 10

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

Answer 10

B. Bacillus cereus

Question 11

A 55-year-old man who is being treated for adenocarcinoma of the lung is admitted to a hospital because of a temperature of 38.9°C (102°F), chest pain, and a dry cough. Sputum is collected. Gram’s stain of the sputum is unremarkable and culture reveals many small Gram-negative rods able to grow only on a charcoal yeast extract agar. This organism most likely is:
A. Klebsiella pneumoniae
B. Mycoplasma pneumoniae
C. Legionella pneumophila
D. Chlamydia trachomatis
E. Staphylococcus aureus

Answer 11

C. Legionella pneumophila

Question 12

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

Answer 12

A. #0.5 McFarland standard

Question 13

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

Answer 13

C. 1% sulfuric acid and 1.175% barium chloride

Question 14

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

Answer 14

D. Urease test

Question 15

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

Answer 15

A. Guillain-Barré syndrome

Question 16

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

Answer 16

B. Hippurate hydrolysis test

Question 17

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

Answer 17

B. C. jejuni

Question 18

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

Answer 18

A. Bordetella pertussis

Question 19

Most often, ______ are “dead-end” hosts.
A. Ticks
B. Mice
C. Sheep
D. Human

Answer 19

D. Human

Question 20

A wound (skin lesion) specimen obtained from a newborn grew predominantly β-hemolytic colonies of gram-positive cocci on 5% sheep blood agar. The newborn infant was covered with small skin eruptions that gave the appearance of a “scalding of the skin.” The gram-positive cocci proved to be catalase positive. Which tests should follow for the appropriate identification?
A. Optochin, bile solubility, PYR
B. Coagulase, glucose fermentation, DNase
C. Bacitracin, PYR, 6.5% salt broth
D. CAMP, bile-esculin, 6.5% salt broth

Answer 20

B. Coagulase, glucose fermentation, DNase

Question 21

Small, gray, glistening; colonies tend to dip down in the center and RESEMBLE A DOUGHNUT(umbilicated) as they age; if organism has a polysaccharide capsule, colony may be mucoid; ALPHA-HEMOLYTIC:
A. Streptococcus pyogenes
B. Streptococcus agalactiae
C. Streptococcus pneumoniae
D. Staphylococcus aureus

Answer 21

C. Streptococcus pneumoniae

Question 22

The most critical step in obtaining accurate Gram stain results is the application of which of the following?
A. Safranin
B. Crystal violet
C. Gram’s iodine
D. Acetone/ethanol

Answer 22

D. Acetone/ethanol

Question 23

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

Answer 23

C. Actinomyces spp.

Question 24

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

Answer 24

D. H2S production

Question 25

A sputum culture from a 13-year-old cystic fibrosis patient grew a predominance of short, gram-negative rods that tested oxidase negative. On MacConkey, chocolate, and blood agar plates, the organism appeared to have a lavender-green pigment. Further testing showed:
Motility = +
Glucose = + (oxidative)
Lysine decarboxylase = +
DNase = +
Maltose = + (oxidative)
Esculin hydrolysis = +
What is the most likely identification?
A. Stenotrophomonas maltophilia
B. Acinetobacter baumannii
C. Pseudomonas aeruginosa
D. Burkholderia (P.) cepacia

Answer 25

A. Stenotrophomonas maltophilia

Question 26

The respiratory culture of a patient with cystic fibrosis yielded gram-negative bacilli with the following reactions:
* Oxidase: Positive
* Glucose OF open: Positive
* Pigment: Metallic green
* Growth at 42C: Positive
* MacConkey agar: Positive
* Gelatin hydrolysis: Positive
* Arginine dihydrolase: Positive
Which of the following is the most likely identification of this organism?
A. Burkholderia cepacia
B. Pseudomonas aeruginosa
C. Acinetobacter baumannii
D. Stenotrophomonas xylosoxidans

Answer 26

B. Pseudomonas aeruginosa

Question 27

Production of exotoxin A, which kills host cells by inhibiting protein synthesis and production of several proteolytic enzymes and hemolysins that destroy cells and tissue are factors that contribute to pathogenicity of which of the following organisms?
A. Pseudomonas aeruginosa
B. Burkholderia cepacia
C. Ralstonia pickettii
D. Burkholderia mallei

Answer 27

A. Pseudomonas aeruginosa

Question 28

Which single test best separates Klebsiella oxytoca from Klebsiella pneumoniae?
A. Urease
B. Sucrose
C. Citrate
D. Indole

Answer 28

D. Indole

Question 29

An 80-year-old male patient was admitted to the hospital with a fever of 102°F. A sputum culture revealed many gram-negative rods on MacConkey agar and blood agar. The patient was diagnosed with pneumonia. The following biochemical results were obtained from the culture:
* H2S = Neg
* Citrate = +
* Motility = Negative
* Lactose = +
* Indole = +
* Resistance to ampicillin and carbenicillin
* Urease = +
* VP = +
What is the most likely identification?
A. Klebsiella oxytoca
B. Proteus mirabilis
C. Escherichia coli
D. Klebsiella pneumoniae

Answer 29

A. Klebsiella oxytoca

Question 30

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

Answer 30

A. Mycobacterium tuberculosis

Question 31

The mycobacterial species that occur in humans and belong to the M. tuberculosis complex include which of the following?
A. M. tuberculosis, nontuberculous Mycobacteria, M. bovis, and M. africanum
B. M. tuberculosis, M. gordonae, M. bovis BCG, and M. africanum
C. M. tuberculosis, M. bovis, M. avium, and M. intracellulare
D. M. tuberculosis, M. bovis, M. bovis BCG, and M. africanum

Answer 31

D. M. tuberculosis, M. bovis, M. bovis BCG, and M. africanum

Question 32

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

Answer 32

D. M. leprae

Question 33

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

Answer 33

C. Mycobacterium avium complex

Question 34

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

Answer 34

D. M. gordonae

Question 35

Black belts dedicate _______ of their time to quality improvement projects, proactively addressing process and quality problems.
A. 10%
B. 20%
C. 70%
D. 100%

Answer 35

D. 100%

Question 36

Green belts contribute ______ of their time to improvement projects while delivering their normal job functions.
A. 10%
B. 20%
C. 70%
D. 100%

Answer 36

B. 20%

Question 37

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%

Answer 37

B. 30 to 50%

Question 38

Trichophyton rubrum and T. mentagrophytes may be differentiated by the:
A. Consistently different appearance of their colonies
B. Endothrix hair infection produced by T. rubrum
C. Fluorescence of hairs infected with T. rubrum
D. In vitro hair penetration by T. mentagrophytes

Answer 38

D. In vitro hair penetration by T. mentagrophytes

Question 39

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

Answer 39

C. Bacillus cereus

Question 40

A vancomycin-resistant gram-positive coccobacillus resembling the Streptococcus viridans group was isolated from the blood of a 42-year-old female patient undergoing a bone marrow transplant. The PYR and leucine aminopeptidase (LAP) tests were negative.
The following results were noted:
* Catalase = Neg
* Esculin hydrolysis = Neg
* Hippurate hydrolysis = Neg
* CAMP = Neg
* Gas from glucose = +
* 6.5% salt broth = Neg
What is the correct identification?
A. Leuconostoc spp.
B. Enterococcus spp.
C. Staphylococcus spp.
D. Micrococcus spp.

Answer 40

A. Leuconostoc spp.

Question 41

An emergency department physician suspected Corynebacterium diphtheriae when examining the sore throat of an exchange student from South America. What is the appropriate media for the culture of the nasopharyngeal swab obtained from the patient?
A. Chocolate agar
B. Thayer–Martin agar
C. Tinsdale medium
D. MacConkey agar

Answer 41

C. Tinsdale medium

Question 42

Which of the following amino acids are required for growth of Francisella tularensis?
A. Leucine and ornithine
B. Arginine and lysine
C. Cysteine and cystine
D. Histidine and tryptophan

Answer 42

C. Cysteine and cystine

Question 43

Smooth gray colonies showing no hemolysis are recovered from an infected cat scratch on blood and chocolate agar but fail to grow on MacConkey agar. The organisms are gram-negative pleomorphic rods that are both catalase and oxidase positiveand strongly indole positive. The most likely organism is:
A. Capnocytophaga spp.
B. Pasteurella spp.
C. Proteus spp.
D. Pseudomonas spp.

Answer 43

B. Pasteurella spp.

Question 44

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

Answer 44

A. M. chelonae–fortuitum complex

Question 45

A sputum specimen from an 89-year-old male patient with suspected bacterial pneumonia grew a predominance of gram-positive cocci displaying alpha-hemolysis on 5% sheep blood agar. The colonies appeared donut shaped and mucoidy and tested negative for catalase. The most appropriate tests for a final identification are:
A. Coagulase, glucose fermentation, lysostaphin
B. Penicillin, bacitracin, CAMP
C. Optochin, bile solubility, PYR
D. Bile esculin, hippurate hydrolysis

Answer 45

C. Optochin, bile solubility, PYR

Question 46

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

Answer 46

D. Toxoplasma gondii

Question 47

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

Answer 47

C. 180 rpm for 4 minutes

Question 48

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

Answer 48

D. 180 rpm for 8 minutes

Question 49

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

Answer 49

B. 100 rpm for 8 minutes

Question 50

What is used to zero the spectrophotometer before reading the test sample?
A. Calibrator
B. Sample blank
C. Reagent blank
D. Standard

Answer 50

C. Reagent blank

Question 51

This is used to zero an instrument during a test procedure:
A. Calibrator
B. Sample blank
C. Reagent blank
D. Standard

Answer 51

B. Sample blank

Question 52

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

Answer 52

C. CCFA: yellow, ground glass colonies

Question 53

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

Answer 53

B. 240 Todd units

Question 54

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

Answer 54

C. 320 Todd units

Question 55

Respiratory specimens are best collected with what type of swabs?
A. Calcium alginate swabs
B. Dacron- or polyester-tipped swabs
C. Swabs with cotton tips or wooden shafts
D. All of the above are acceptable

Answer 55

B. Dacron- or polyester-tipped swabs

Question 56

A patient presents with diarrhea and abdominal cramping. The organism isolated from the stool culture is identified as S. dysenteriae (group A). The TSI reaction would have indicated:
A. K/K
B. K/NC H2S+
C. A/A
D. K/A

Answer 56

D. K/A

Question 57

Which of the following is the key pathogen that infects the lungs of patients with cystic fibrosis?
A. B. cepacia
B. B. pseudomallei
C. P. fluorescens
D. P. aeruginosa

Answer 57

D. P. aeruginosa

Question 58

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

Answer 58

D. C. albicans, C. dubliniensis

Question 59

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

Answer 59

B. Proteus

Question 60

The filovirus that has a characteristic “shepherd’s hook” morphology when viewed by electron microscopy is:
A. Ebola Zaire virus
B. Ebola Reston virus
C. Ebola Sudan virus
D. Marburg virus

Answer 60

D. Marburg virus

Question 61

A 65-year-old male with HIV presents to the emergency department with night sweats, a nonproductive cough, and a low-grade fever. PCP is suspected. Which of the following is the best specimen for diagnostic staining for Pneumocystis jiroveci?
A. Urine
B. Sputum
C. Bronchial alveolar lavage fluid
D. Blood
E. Nasopharyngeal swab

Answer 61

C. Bronchial alveolar lavage fluid

Question 62

What virus traditionally causes viral parotitis?
A. Influenza virus
B. Parainfluenza virus
C. Rhinovirus
D. Mumps virus

Answer 62

D. Mumps virus

Question 63

Which dimorphic fungus may be contracted by people who clean chicken coops?
A. Blastomyces dermatitidis
B. Histoplasma capsulatum
C. Coccidioides immitis
D. Paracoccidioides brasiliensis

Answer 63

B. Histoplasma capsulatum

Question 64

Which of the following is a fungus known to cause chromoblastomycosis?
A. Curvularia spp.
B. Acremonium spp.
C. Bipolaris spp.
D. Cladosporium spp.

Answer 64

D. Cladosporium spp.

Question 65

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

Answer 65

B. Filoviridae

Question 66

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

Answer 66

B. Corynebacterium diphtheriae

Question 67

All of the following are medically dimorphic fungi except:
A. Histoplasma capsulatum
B. Blastomyces dermatitidis
C. Coccidioides immitis
D. Aspergillus niger

Answer 67

D. Aspergillus niger

Question 68

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

Answer 68

B. Sporothrix schenckii

Question 69

Psittacosis is a lower respiratory infection in humans caused by contact with what animal?
A. Swine
B. Seals
C. Cats
D. Birds

Answer 69

D. Birds

Question 70

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

Answer 70

C. Fever, headache, and rash

Question 71

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

Answer 71

D. Nonhemolytic and nonmotile

Question 72

Transmission of Orientia tsutsugamushi is associated with what vector?
A. Ticks
B. Fleas
C. Lice
D. Chiggers

Answer 72

D. Chiggers

Question 73

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

Answer 73

C. Rickettsia rickettsii

Question 74

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

Answer 74

D. L1

Question 75

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

Answer 75

D. Ancylostoma duodenale

Question 76

Seventy (70) percent recirculated to the cabinet work area through HEPA; 30% balance can be exhausted through HEPA back into the room or to outside through a canopy unit:
A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 76

B. BSC Class II, A1

Question 77

Thirty (30) percent recirculated, 70% exhausted. Exhaust cabinet air must pass through a dedicated duct to the outside through a HEPA filter.
A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 77

C. BSC Class II, B1

Question 78

No recirculation; total exhaust to the outside through a HEPA filter.
A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 78

D. BSC Class II, B2

Question 79

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

Answer 79

A. BSL-1

Question 80

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

Answer 80

B. BSL-2

Question 81

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

Answer 81

C. BSL-3

Question 82

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

Answer 82

D. BSL-4

Question 83

An ordered sequence of events makes up the cell cycle. Which of the following describes the correct sequence of events starting at G1?
A. G1, G2, S, M
B. G1, S, G2, M
C. G1, M, G2, S
D. G1, S, M, G2

Answer 83

B. G1, S, G2, M

Question 84

The tetraploid DNA is checked for proper replication and damage, ____ takes approximately 4 hours.
A. G1 (gap 1)
B. S (synthesis)
C. G2 (gap 2)
D. M (mitosis)

Answer 84

C. G2 (gap 2)

Question 85

DNA Replication (S)
A. 10 hours
B. 8 hours
C. 4 hours
D. 1 hour

Answer 85

B. 8 hours

Question 86

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

Answer 86

B. Increased

Question 87

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

Answer 87

D. Hypoalbuminemia

Question 88

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

Answer 88

B. Tests in the electrolyte profile (sodium, potassium, chloride, and bicarbonate)

Question 89

Which of the following conditions will cause an increased anion gap?
A. Diarrhea
B. Hypoaldosteronism
C. Hyperkalemia
D. Renal failure

Answer 89

D. Renal failure

Question 90

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

Answer 90

A. Metabolic acidosis

Question 91

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

Answer 91

E. Methanol

Question 92

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

Answer 92

C. Na+ 145, K+ 4.0, Cl- 90, CO2 content 15

Question 93

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%

Answer 93

D. pO2 will fall 7% and pCO2 will rise 3%

Question 94

ANAEROBES usually cannot grow in the presence of O2, and the atmosphere in anaerobe jars, bags, or chambers is composed of:
A. 5% to 10% H2, 5% to 10% CO2, 80% to 90% O2, and 0% N2
B. 5% to 10% H2, 5% to 10% CO2, 80% to 90% N2, and 0% O2
C. 5% to 10% N2, 5% to 10% CO2, 80% to 90% H2, and 0% O2
D. 5% to 10% H2, 5% to 10% N2, 80% to 90% CO2, and 0% O2

Answer 94

B. 5% to 10% H2, 5% to 10% CO2, 80% to 90% N2, and 0% O2

Question 95

Precursor cell of oval fat bodies:
A. Neutrophils
B. Eosinophils
C. Transitional epithelial cells
D. Renal tubular epithelial cells

Answer 95

D. Renal tubular epithelial cells

Question 96

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

Answer 96

D. Renal tubular epithelial cells

Question 97

Oval fat bodies are associated with:
A. Liver cirrhosis
B. Nephrotic syndrome
C. Acute pyelonephritis
D. Acute tubular necrosis

Answer 97

B. Nephrotic syndrome

Question 98

Bubble cells are associated with:
A. Liver cirrhosis
B. Nephrotic syndrome
C. Acute pyelonephritis
D. Acute tubular necrosis

Answer 98

D. Acute tubular necrosis

Question 99

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

Answer 99

D. Fuchsin

Question 100

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

Answer 100

C. Cystine

Question 101

Yellow to brownish red and are moderately hard stone:
A. Cystine stones
B. Calcium oxalate stones
C. Phosphate stones
D. Uric acid and urate stones

Answer 101

D. Uric acid and urate stones

Question 102

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

Answer 102

C. Test for choline, iodine and potassium iodide reagent

Question 103

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

Answer 103

B. Test for spermine, picric acid and trichloroacetic acid reagent

Question 104

Location of sperm nucleus:
A. No nucleus
B. Head
C. Neck
D. Tail

Answer 104

B. Head

Question 105

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

Answer 105

C. Varicocele

Question 106

Which of the following is the most common cause of female infertility?
A. Polycystic ovary syndrome (PCOS)
B. Failure to ovulate
C. Orchitis
D. Menopause

Answer 106

B. Failure to ovulate

Question 107

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

Answer 107

A. Half of the head and cover approximately two-thirds of the sperm nucleus

Question 108

The purpose of the acrosomal cap is to:
A. Penetrate the ovum
B. Protect the the nucleus
C. Create energy for tail movement
D. Protect the neckpiece

Answer 108

A. Penetrate the ovum

Question 109

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

Answer 109

C. 10 minutes, 2 minutes

Question 110

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

Answer 110

C. Every 3 months, weekly

Question 111

Increased in pCO2 in a patient most commonly results in which of the following primary acid-base abnormalities?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis

Answer 111

A. Respiratory acidosis

Question 112

Which set of results is consistent with uncompensated respiratory alkalosis?
A. pH 7.70 HCO3- 30 mmol/L pCO2 25 mm Hg
B. pH 7.66 HCO3- 22 mmol/L pCO2 20 mm Hg
C. pH 7.46 HCO3- 38 mmol/L pCO2 55 mm Hg
D. pH 7.36 HCO3- 22 mmol/L pCO2 38 mm Hg

Answer 112

B. pH 7.66 HCO3- 22 mmol/L pCO2 20 mm Hg

Question 113

Which set of results is consistent with uncompensated metabolic acidosis?
A. pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg
B. pH 7.30 HCO3- 16 mmol/L pCO2 28 mm Hg
C. pH 7.45 HCO3- 22 mmol/L pCO2 40 mm Hg
D. pH 7.40 HCO3- 25 mmol/L pCO2 40 mm Hg

Answer 113

A. pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg

Question 114

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

Answer 114

B. Respiratory acidosis, uncompensated

Question 115

Which of the following measurements is necessary to evaluate the cause of hypernatremia?
A. Chloride
B. Glucose
C. Plasma/serum osmolality
D. Urine osmolality

Answer 115

D. Urine osmolality

Question 116

Hyponatremia can be classified according to:
A. Chloride
B. Glucose
C. Plasma/serum osmolality
D. Urine osmolality

Answer 116

C. Plasma/serum osmolality

Question 117

Leadership:
A. Planning
B. Directing
C. Organizing
D. Controlling

Answer 117

B. Directing

Question 118

Which of the following best represents the reference (normal) range for arterial pH?
A. 7.35–7.45
B. 7.42–7.52
C. 7.38–7.68
D. 6.85–7.56

Answer 118

A. 7.35–7.45

Question 119

Lemon shaped crystals:
A. Calcium phosphate
B. Calcium oxalate
C. Triple phosphate
D. Uric acid

Answer 119

D. Uric acid

Question 120

LEUKOREDUCED RED CELLS is a product in which the absolute WBC count in the unit is reduced to ____, and contains at least ______ of the original RBC mass.
A. 1 x 10 10th, 85%
B. 3.0 x 10 11th, 85%
C. 5.5 x 10 10th, 85%
D. 5 x 10 6th, 85%

Answer 120

D. 5 x 10 6th, 85%

Question 121

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

Answer 121

B. 123 nmol/L

Question 122

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

Answer 122

D.Apo-B100

Question 123

Structural protein in chylomicrons:
A.Apo-A1
B.Apo-A2
C.Apo-B48
D. Apo-B100

Answer 123

C.Apo-B48

Question 124

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

Answer 124

B. 7, 2

Question 125

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%

Answer 125

D. 0.35 to 0.50%

Question 126

Moderate specificity for the liver, heart and skeletal muscles
A. AST
B. ALT
C. CK
D. ALP

Answer 126

A. AST

Question 127

Moderate specificity for the heart, skeletal muscles and brain
A. AST
B. ALT
C. CK
D. ALP

Answer 127

C. CK

Question 128

A trend in QC results is most likely caused by:
A. Deterioration of the reagent
B. Miscalibration of the instrument
C. Improper dilution of standards
D. Electronic noise

Answer 128

A. Deterioration of the reagent

Question 129

Determines whether there is a significant difference between the standard deviations of two groups of data.
A. Mean
B. Median
C. f-test
D. t-test

Answer 129

C. f-test

Question 130

SAFEST method to ensure that NO INFECTIVE MATERIALS REMAIN in samples or containers when disposed:
A. Autoclave
B. Incineration
C. Pasteurization
D. Filtration

Answer 130

B. Incineration

Question 131

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

Answer 131

A. Actinobacillus

Question 132

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

Answer 132

D. Entamoeba histolytica

Question 133

A patient has been diagnosed as having amebiasis but continues to be asymptomatic. The physician has asked for an explanation and recommendations regarding follow-up. Suggestions should include:
A. Consideration of Entamoeba histolytica versus Entamoeba dispar
B. A request for an additional three stools for culture
C. Initiating therapy, regardless of the patient’s asymptomatic status
D. Performance of barium x-ray studies

Answer 133

A. Consideration of Entamoeba histolytica versus Entamoeba dispar

Question 134

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

Answer 134

D. Dracunculus medinensis

Question 135

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

Answer 135

C. Schistosoma intercalatum

Question 136

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

Answer 136

B. Iodamoeba butschlii

Question 137

The BAERMANN TECHNIQUE yields a good concentration of the living larvae of:
A. Angiostrongylus cantonensis
B. Brugia malayi
C. Enterobius vermicularis
D. Strongyloides stercoralis

Answer 137

D. Strongyloides stercoralis

Question 138

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

Answer 138

C. Ascending loop of Henle

Question 139

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

Answer 139

B. Descending loop of Henle

Question 140

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

Answer 140

A. DiGeorge syndrome

Question 141

If 0.02 mL of serum is diluted with 0.08 mL of diluent, what dilution of serum does this represent?
A. 1:4
B. 1:5
C. 1:10
D. 1:20

Answer 141

B. 1:5

Question 142

If 0.4 mL of serum is mixed with 15.6 mL of diluent, what dilution of serum does this represent?
A. 1:4
B. 1:40
C. 2:70
D. 1:80

Answer 142

B. 1:40

Question 143

A 1:750 dilution of serum is needed to perform a serological test. Which of the following series of dilutions would be correct to use in this situation?
A. 1:5, 1:15, 1:10
B. 1:5, 1:10, 1:5
C. 1:15, 1:10, 1:3
D. 1:15, 1:3, 1:5

Answer 143

A. 1:5, 1:15, 1:10

Question 144

What is the final dilution of serum obtained from the following serial dilutions: 1:4, 1:4, 1:4, 1:4, 1:4, 1:4?
A. 1:24
B. 1:256
C. 1:1,024
D. 1:4,096

Answer 144

D. 1:4,096

Question 145

What is the titer in tube No. 8 if tube No. 1 is undiluted and dilutions are doubled?
A. 64
B. 128
C. 256
D. 512

Answer 145

B. 128

Question 146

SI basic unit for mass:
A. Meter
B. Mole
C. Gram
D. Kilogram

Answer 146

D. Kilogram

Question 147

The basic unit of temperature in the SI system:
A. Celsius
B. Fahrenheit
C. Kelvin
D. Any of these

Answer 147

C. Kelvin

Question 148

Basic unit for length:
A. Second
B. Millimeter
C. Meter
D. Kilometer

Answer 148

C. Meter

Question 149

The standard unit of measurement for the amount of a (chemical) substance in the SI system:
A. Gram
B. Kilogram
C. Mole
D. Millimole

Answer 149

C. Mole

Question 150

Beer’s law is expressed as A = abc.
A (capital A) in Beer’s law is:
A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 150

A. Absorbance

Question 151

Beer’s law is expressed as A = abc.
A (small a) in Beer’s law is:
A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 151

B. Absorptivity constant

Question 152

Beer’s law is expressed as A = abc.
b (small b) in Beer’s law is:
A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 152

D. Length of light path

Question 153

Beer’s law is expressed as A = abc.
c (small c) in Beer’s law is:
A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 153

C. Concentration

Question 154

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

Answer 154

B. Bell-shaped

Question 155

Which Westgard rule detects random error?
A. 1:3s
B. 4:1s
C. 2:2s
D. 10:x

Answer 155

A. 1:3s

Question 156

Pre-analytical variables in laboratory testing include:
A. Result accuracy
B. Report delivery to the ordering physician
C. Test turnaround time
D. Specimen acceptability

Answer 156

D. Specimen acceptability

Question 157

Which of the following is NOT a potential source of post-analytical error?
A. Excessive delay in reporting or retrieving a test result
B. Interpretation of result
C. Verbal notification of test result
D. Labeling the specimen at the nurses’s station

Answer 157

D. Labeling the specimen at the nurses’ station

Question 158

According to OSHA, what type of warning sign should be posted in an area where an immediate hazard exists and where special precautions are necessary?
A. Red, black and white “DANGER” sign
B. Yellow and black “CAUTION” sign
C. Green and white “SAFETY INSTRUCTION” sign
D. Orange and black “BIOHAZARD” sign

Answer 158

A. Red, black and white “DANGER” sign

Question 159

Metabolism of glucose molecule to pyruvate or lactate for production of energy
A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 159

D. Glycolysis

Question 160

Formation of glucose-6-phosphate from noncarbohydrate sources
A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 160

A. Gluconeogenesis

Question 161

Breakdown of glycogen to glucose for use as energy
A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 161

B. Glycogenolysis

Question 162

Conversion of glucose to glycogen for storage
A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 162

C. Glycogenesis

Question 163

Which of the biochemical processes below is promoted by insulin?
A. Glycogenolysis
B. Gluconeogenesis
C. Esterification of cholesterol
D. Uptake of glucose by the cells

Answer 163

D. Uptake of glucose by the cells

Question 164

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

Answer 164

C. Flammable liquids

Question 165

A fire occurs in the laboratory. The first course of action is to:
A. Evacuate the entire area
B. Pull the fire alarm box
C. Remove persons from immediate danger
D. Contain the fire by closing doors

Answer 165

C. Remove persons from immediate danger

Question 166

Which of the following wavelengths is within the ultraviolet range?
A. 340 nm
B. 450 nm
C. 540 nm
D. 690 nm

Answer 166

A. 340 nm

Question 167

Whole blood fasting glucose level is _________ than in serum or plasma.
A. 10 – 15% lower
B. 10 – 15% higher
C. 5 – 10% lower
D. 5 – 10% higher

Answer 167

A. 10 – 15% lower

Question 168

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

Answer 168

A. Hexokinase

Question 169

Which of the following is characteristic of type 1 diabetes mellitus?
A. Requires an oral glucose tolerance test fordiagnosis
B. Is the most common form of diabetes mellitus
C. Usually occurs after age 40
D. Requires insulin replacement to prevent ketosis

Answer 169

D. Requires insulin replacement to prevent ketosis

Question 170

Which of the following is characteristic of type 2 diabetes mellitus?
A. Insulin levels are consistently low
B. Most cases require a 3-hour oral glucose tolerance test to diagnose
C. Hyperglycemia is often controlled without insulin replacement
D. The condition is associated with unexplained weight loss

Answer 170

C. Hyperglycemia is often controlled without insulin replacement

Question 171

Which of the following isolates light within a narrow region of the spectrum?
A. Photomultiplier tube
B. Monochromator
C. Photovoltaic cell
D. Detector

Answer 171

B. Monochromator

Question 172

Which of the following lamps provides a continuous spectrum of radiant energy in the visible, near IR, and near UV regions of the spectrum?
A. Tungsten-filament
B. Hydrogen
C. Deuterium
D. Mercury vapor

Answer 172

A. Tungsten-filament

Question 173

Nephelometry is based on the measurement of light that is:
A. Absorbed by particles in suspension
B. Scattered by particles in suspension
C. Produced by fluorescence
D. Produced by excitation of ground-state atoms

Answer 173

B. Scattered by particles in suspension

Question 174

When measuring K+ with an ion-selective electrode by means of a liquid ion-exchange membrane, what antibiotic will be incorporated into the membrane?
A. Monactin
B. Nonactin
C. Streptomycin
D. Valinomycin

Answer 174

D. Valinomycin

Question 175

In serum protein electrophoresis, when a buffer solution of pH 8.6 is used, which of the following characterizes the proteins?
A. Exhibit net negative charge
B. Exhibit net positive charge
C. Exhibit charge neutrality
D. Migrate toward the cathode

Answer 175

A. Exhibit net negative charge

Question 176

Identification of which of the following is useful in early stages of glomerular dysfunction?
A. Microalbuminuria
B. Ketonuria
C. Hematuria
D. Urinary light chains

Answer 176

A. Microalbuminuria

Question 177

What is the compound that comprises the majority of the nonprotein-nitrogen fractions in serum?
A. Uric acid
B. Creatinine
C. Ammonia
D. Urea

Answer 177

D. Urea

Question 178

In the Berthelot reaction, what contaminant will cause the urea level to be falsely elevated?
A. Sodium fluoride
B. Protein
C. Ammonia
D. Bacteria

Answer 178

C. Ammonia

Question 179

What is the end product of purine catabolism in humans?
A. Urea
B. Uric acid
C. Allantoin
D. Ammonia

Answer 179

B. Uric acid

Question 180

During chemotherapy for leukemia, which of the following analytes would most likely be elevated in the blood?
A. Uric acid
B. Urea
C. Creatinine
D. Ammonia

Answer 180

A. Uric acid

Question 181

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

Answer 181

D. 165–180 mg/dL

Question 182

Of the following blood glucose levels, which would you expect to result in glucose in the urine?
A. 60 mg/dL
B. 120 mg/dL
C. 150 mg/dL
D. 225 mg/dL

Answer 182

D. 225 mg/dL

Question 183

A sample of blood is collected for glucose in a sodium fluoride tube before the patient has had breakfast.
The physician calls 2 hours later and requests that determination of blood urea nitrogen (BUN) be performed on the same sample rather than obtaining another specimen.
The automated analyzer in your laboratory utilizes the urease method to quantify BUN. What should you tell the physician?
A. Will gladly do the test if sufficient specimen remains
B. Could do the test using a micromethod
C. Can do the BUN determination on the automated analyzer
D. Cannot perform the procedure

Answer 183

D. Cannot perform the procedure

Question 184

A patient’s total cholesterol is 300mg/dL, his HDL cholesterol is 50 mg/dL, and his triglyceride is 200 mg/dL.
What is this patient’s calculated LDL cholesterol?
A. 200
B. 210
C. 290
D. 350

Answer 184

B. 210

Question 185

Which monochromator specification is required in order to measure the true absorbance of a compound having a natural absorption bandwidth of 30 nm?
A. 50-nm bandpass
B. 25-nm bandpass
C. 15-nm bandpass
D. 5-nm bandpass

Answer 185

D. 5-nm bandpass

Question 186

Which of the following is considered a lipid?
A. Chylomicrons
B. LDL
C. Cholesterol
D. HDL

Answer 186

C. Cholesterol

Question 187

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

Answer 187

A. HDL

Question 188

What is the most appropriate fasting procedure when a lipid study of triglycerides, total cholesterol, HDL, and LDL tests are ordered?
A. 8 hours, nothing but water allowed
B. 10 hours, water, smoking, coffee, tea (no sugar or cream) allowed
C. 12 hours, nothing but water allowed
D. 16 hours, water, smoking, coffee, tea (no sugar or cream) allowed

Answer 188

C. 12 hours, nothing but water allowed

Question 189

Which disease may be expected to show an IgM spike on an electrophoretic pattern?
A. Hypogammaglobulinemia
B. Multicystic kidney disease
C. Waldenström’s macroglobulinemia
D. Wiskott–Aldrich syndrome

Answer 189

C. Waldenström’s macroglobulinemia

Question 190

In a person with normal glucose metabolism, the blood glucose level usually increases rapidly after carbohydrates are ingested but returns to a normal level after:
A. 30 minutes
B. 45 minutes
C. 60 minutes
D. 120 minutes

Answer 190

D. 120 minutes

Question 191

In a person with impaired glucose metabolism, such as in type 1 diabetes, what is true about the blood glucose level?
A. It increases rapidly after carbohydrates are ingested but returns to a normal level after 120 minutes.
B. It increases rapidly after carbohydrates are ingested and stays greatly elevated even after 120 minutes.
C. It does not increase after carbohydrates are ingested and stays at a low level until the next meal.
D. It increases rapidly after carbohydrates are ingested but returns to a normal level after 30 minutes.

Answer 191

B. It increases rapidly after carbohydrates are ingested and stays greatly elevated even after 120 minutes.

Question 192

Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6.
A. - Chylomicrons→pre-β →β→α +
B. - β→pre-β→α→chylomicrons +
C. - Chylomicrons →β→pre-β→α +
D. - α→β→pre-β→chylomicrons +

Answer 192

C. - Chylomicrons →β→pre-β→α +

Question 193

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

Answer 193

C. Gas chromatography with mass spectroscopy(GC-MS)

Question 194

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

Answer 194

D. Diagnosis of monoclonal gammopathies

Question 195

Which of the following pairs of concepts are corrrectly matched
A. Sensitivity: prevent false negatives :: specificity:prevent false positives
B. Sensitivity: prevent false positives :: specificity:prevent false negatives
C. Sensitivity: precision :: specificity: accuracy
D. Sensitivity: coefficient of variation :: specificity: standard deviation

Answer 195

A. Sensitivity: prevent false negatives :: specificity:prevent false positives

Question 196

In an adult, if total bilirubin value is 3.1 mg/dL and conjugated bilirubin is 1.1 mg/dL, what is the unconjugated bilirubin value?
A. 2.0 mg/dL
B. 4.2 mg/dL
C. 1.0 mg/dL
D. 3.4 mg/dL

Answer 196

A. 2.0 mg/dL

Question 197

The Beer-Lambert (Beer’s) law states that the concentration of a substance is:
____ to the amount of light absorbed or
A. Directly proportional
B. Inversely proportional
C. Not proportional
D. Proportional to half of the concentration of a substance

Answer 197

A. Directly proportional

Question 198

____ to the logarithm of the transmitted light.
A. Directly proportional
B. Inversely proportional
C. Not proportional
D. Proportional to half of the concentration of a substance

Answer 198

B. Inversely proportional

Question 199

A characteristic of absorbance is that it:
A. Decreases as the concentration of a colored solution decreases
B. Increases as the concentration of a colored solution increases
C. Contains a known strength
D. Detects amplicons

Answer 199

B. Increases as the concentration of a colored solution increases

Question 200

A characteristic of percent transmittance is that it:
A. Decreases as the concentration of a colored solution decreases
B. Increases as the concentration of a colored solution increases
C. Contains a known strength
D. Detects amplicons

Answer 200

A. Decreases as the concentration of a colored solution decreases

Question 201

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

Answer 201

C. Third-trimester pregnancy

Question 202

In the visible light spectrum, the color red is in what nanometer range?
A. 380-440 nm
B. 500-580 nm
C. 600-620 nm
D. 620-750 nm

Answer 202

D. 620-750 nm

Question 203

Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?
A. Chloride
B. Potassium
C. Sodium
D. Bicarbonate

Answer 203

C. Sodium

Question 204

It is the major extracellular anion. It is involved in maintaining osmolality, blood volume, and electric neutrality.
A. Potassium
B. Sodium
C. Calcium
D. Chloride

Answer 204

D. Chloride

Question 205

Which of the following is a marker for bone resorption?
A. β-trace protein
B. Adiponectin
C. Fibronectin
D. Crosslinked C-telopeptide

Answer 205

D. Crosslinked C-telopeptide

Question 206

Which of the following is a marker for bone formation?
A. Osteocalcin
B. Tartrate resistant acid phosphatase (TRAP)
C. Urinary pyridinoline and deoxypyridinoline
D. Urinary C-telopeptide and N-telopeptide crosslinks (CTx and NTx)

Answer 206

A. Osteocalcin

Question 207

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

Answer 207

D. β-Trace Protein

Question 208

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

Answer 208

D. Fetal fibronectin

Question 209

Variants demonstrate a wide variety of cellular interactions, including roles in cell adhesion, tissue differentiation, growth, and wound healing:
A. Adiponectin
B. Fibronectin
C. Crosslinked C-telopeptide
D β-trace protein

Answer 209

B. Fibronectin

Question 210

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

Answer 210

B. 160 mmol/L

Question 211

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

Answer 211

A. Diuretic use

Question 212

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

Answer 212

C. Hypocalcemia

Question 213

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

Answer 213

C. Hyperkalemia

Question 214

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

Answer 214

C. 2.5 mmol/L

Question 215

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

Answer 215

D. Kidney

Question 216

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

Answer 216

C. Lung

Question 217

What is the best use for potentiometry?
A. Enzymes
B. Proteins
C. Electrolytes
D. Lipids

Answer 217

C. Electrolytes

Question 218

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

Answer 218

B. Bicarbonate, K+, Cl-

Question 219

Electrolytes for coagulation:
A. Na+, Cl-, K+
B. Bicarbonate, K+, Cl-
C. Bicarbonate, Cl-
D. Ca2+, Mg2+

Answer 219

D. Ca2+, Mg2+

Question 220

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

Answer 220

D. Cyanide

Question 221

The most probable explanation for a patient who presents with an elevated osmolal gap, metabolic acidosis, and calcium oxalate crystals in the urine is:
A. Methanol intoxication
B. Ethanol overdose
C. Ethylene glycol intoxication
D. Cyanide poisoning

Answer 221

C. Ethylene glycol intoxication

Question 222

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

Answer 222

D. HPLC

Question 223

PREFERRED METHOD of measuring HbA1c:
A. Immunoassay
B. Electrophoresis
C. Affinity chromatography
D. HPLC

Answer 223

C. Affinity chromatography

Question 224

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%

Answer 224

B. 50%

Question 225

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

Answer 225

B. Folin-Wu

Question 226

Copper reduction method for glucose that uses arsenomolybdic acid:
A. Folin-Wu
B. Nelson-Somogyi
C. Neocuproine
D. All of these

Answer 226

B. Nelson-Somogyi

Question 227

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

Answer 227

A. Type 1 diabetes

Question 228

DETECTABLE C-peptide:
A. Type 1 diabetes
B. Type 2 diabetes

Answer 228

B. Type 2 diabetes

Question 229

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

Answer 229

A. Type 1 DM

Question 230

The most widely used test of overall renal function is:
A. Urea
B. Creatinine
C. Proteinuria
D. Cystatin C

Answer 230

B. Creatinine

Question 231

It is a measure of overall glucose homeostasis:
A. Random blood sugar
B. Fasting blood sugar
C. Oral glucose tolerance test
D. Glycosylated hemoglobin

Answer 231

B. Fasting blood sugar

Question 232

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

Answer 232

A. Pre-renal azotemia

Question 233

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

Answer 233

B. Renal azotemia

Question 234

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

Answer 234

C. Post-renal azotemia

Question 235

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

Answer 235

B. Cystatin C

Question 236

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

Answer 236

B. Myoglobin

Question 237

Which of the following conditions is characterized by primary HYPERaldosteronism caused by adrenal adenoma, carcinoma, or hyperplasia?
A. Cushing’s syndrome
B. Addison’s disease
C. Conn’s syndrome
D. Pheochromocytoma

Answer 237

C. Conn’s syndrome

Question 238

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

Answer 238

C. Low sodium, high potassium levels

Question 239

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

Answer 239

C. Fluorometer

Question 240

Which of the following best represents the reference (normal) range for arterial pH?
A. 7.35–7.45
B. 7.42–7.52
C. 7.38–7.68
D. 6.85–7.56

Answer 240

A. 7.35–7.45

Question 241

What is the normal ratio of bicarbonate to dissolved carbon dioxide (HCO3–:dCO2) in arterial blood?
A. 1:10
B. 10:1
C. 20:1
D. 30:1

Answer 241

C. 20:1

Question 242

Which formula is most accurate in predicting plasma osmolality?
A. Na + 2(Cl) + BUN + glucose
B. 2(Na) + 2(Cl) + glucose + urea
C. 2(Na) + (glucose ÷ 18) + ( BUN ÷ 2.8 )
D. Na + Cl + K + HCO3

Answer 242

C. 2(Na) + (glucose ÷ 18) + ( BUN ÷ 2.8 )

Question 243

Identify the enzyme deficiency responsible for type 1 glycogen storage disease (von Gierke’s disease).
A. Glucose-6-phosphatase
B. Glycogen phosphorylase
C. Glycogen synthetase
D. β-Glucosidase

Answer 243

A. Glucose-6-phosphatase

Question 244

Which of the following abnormal laboratory results is found in von Gierke’s disease?
A. Hyperglycemia
B. Increased glucose response to epinephrine administration
C. Metabolic alkalosis
D. Hyperlipidemia

Answer 244

D. Hyperlipidemia

Question 245

Which of the following would cause an increase in only the unconjugated bilirubin?
A. Hemolytic anemia
B. Obstructive jaundice
C. Hepatitis
D. Hepatic cirrhosis

Answer 245

A. Hemolytic anemia

Question 246

One of two controls within a run is above +2s and the other control is below –2s from the mean. What do these results indicate?
A. Poor precision has led to random error (RE)
B. A systematic error (SE) is present
C. Proportional error is present
D. QC material is contaminated

Answer 246

A. Poor precision has led to random error (RE)

Question 247

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

Answer 247

A. Levy–Jennings

Question 248

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

Answer 248

B. Tonks–Youden

Question 249

Which plot will give the earliest indication of a shift or trend?
A. Levy–Jennings
B. Tonks–Youden
C. Cusum
D. Histogram

Answer 249

C. Cusum

Question 250

Select the primary reagent used in the Jaffe method for creatinine.
A. Alkaline copper II sulfate
B. Saturated picric acid and NaOH
C. Sodium nitroprusside and phenol
D. Phosphotungstic acid

Answer 250

B. Saturated picric acid and NaOH

Question 251

Urea is produced from:
A. The catabolism of proteins and amino acids
B. Oxidation of purines
C. Oxidation of pyrimidines
D. The breakdown of complex carbohydrates

Answer 251

A. The catabolism of proteins and amino acids

Question 252

Blood ammonia levels are usually measured in order to evaluate:
A. Renal failure
B. Acid–base status
C. Hepatic coma
D. Gastrointestinal malabsorption

Answer 252

C. Hepatic coma

Question 253

Uric acid is derived from the:
A. Oxidation of proteins
B. Catabolism of purines
C. Oxidation of pyrimidines
D. Reduction of catecholamines

Answer 253

B. Catabolism of purines

Question 254

Which of the following protein methods has the highest analytical sensitivity?
A. Refractometry
B. Folin–Lowry
C. Turbidimetry
D. Direct ultraviolet absorption

Answer 254

B. Folin–Lowry

Question 255

Which of the following dyes is the most specific for measurement of albumin?
A. Bromcresol green (BCG)
B. Bromcresol purple (BCP)
C. Tetrabromosulfophthalein
D. Tetrabromphenol blue

Answer 255

B. Bromcresol purple (BCP)

Question 256

Which of the following mechanisms accounts for the elevated plasma level of β lipoproteins seen in familial hypercholesterolemia (formerly type II hyperlipoproteinemia)?
A. Hyperinsulinemia
B. ApoB-100 receptor defect
C. ApoC-II activated lipase deficiency
D. ApoE3 deficiency

Answer 256

B. ApoB-100 receptor defect

Question 257

Which enzyme deficiency is most commonly associated with familial hypertriglyceridemia associated with fasting plasma cholomicrons (formerly type I hyperlipoproteinemia)?
A. β Glucocerebrosidase deficiency
B. Post–heparin-activated lipoprotein lipase deficiency
C. Apo-B deficiency
D. Apo-C-III deficiency

Answer 257

B. Post–heparin-activated lipoprotein lipase deficiency

Question 258

Which of the following enzymes is considered most tissue specific?
A. Creatine kinase (CK)
B. Amylase
C. Alkaline phosphatase (ALP)
D. Alcohol dehydrogenase (ADH)

Answer 258

D. Alcohol dehydrogenase (ADH)

Question 259

Which substrate is used in the Bowers–McComb method for ALP?
A. p-Nitrophenyl phosphate
B. β-Glycerophosphate
C. Phenylphosphate
D. α-Naphthylphosphate

Answer 259

A. p-Nitrophenyl phosphate

Question 260

Which of the following buffers is used in the IFCC recommended method for ALP?
A. Glycine
B. Phosphate
C. 2-Amino-2-methyl-1-propanol
D. Citrate

Answer 260

C. 2-Amino-2-methyl-1-propanol

Question 261

Which route of administration is associated with 100% bioavailability?
A. Sublingual
B. Intramuscular
C. Oral
D. Intravenous

Answer 261

D. Intravenous

Question 262

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)

Answer 262

B. CA-15-3

Question 263

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

Answer 263

C. HER-2/neu

Question 264

Which tumor marker is associated with cancer of the urinary bladder?
A. CA-19-9
B. CA-72-4
C. Nuclear matrix protein
D. Cathepsin-D

Answer 264

C. Nuclear matrix protein

Question 265

Osmolality can be defined as a measure of the concentration of a solution based on:
A. The number of particles present
B. The number and size of particles present
C. The density of particles present
D. The isoelectric point of a particle

Answer 265

A. The number of particles present

Question 266

An increased osmole gap is most commonly seen in which of the following?
A. Type 2 diabetes
B. Pancreatitis
C. Presence of toxins such as ethanol and ethylene glycol
D. Liver failure

Answer 266

C. Presence of toxins such as ethanol and ethylene glycol

Question 267

Which of the following is measured using glutamate dehydrogenase and is a measure of advanced stages, poor prognosis, and coma in liver disease?
A. Total bilirubin
B. Ammonia
C. Unconjugated bilirubin
D. Urea

Answer 267

B. Ammonia

Question 268

Which of the following analytes is the best indicator of hepatobiliary damage?
A. AST
B. ALT
C. ALP
D. Bilirubin

Answer 268

C. ALP

Question 269

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

Answer 269

A. Serum AST and ALT levels

Question 270

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

Answer 270

D. Bicarbonate/carbonic acid

Question 271

To maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with which of the following?
A. TCO2
B. Sodium
C. Chloride
D. Phosphate

Answer 271

C. Chloride

Question 272

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

Answer 272

C. Tyrosine

Question 273

In patients with developing subclinical hyperthyroidism, TSH levels will likely be ______, and fT4 will likely be ______.
A. Decreased, increased
B. Increased, decreased
C. Decreased, normal
D. Increased, normal

Answer 273

C. Decreased, normal

Question 274

Which of the following conditions is a result of cat- echolamine excess, includes two classifications (MEN 1 and MEN 2), and may result in death from severe cardiovascular complications?
A. Cushing’s syndrome
B. Conn’s syndrome
C. Addison’s disease
D. Pheochromocytoma

Answer 274

D. Pheochromocytoma

Question 275

Which of the following enzymes catalyzes the conversion of p-nitrophenyl phosphate to a colored p-nitrophenol product?
A. AST
B. ALT
C. ALP
D. GGT

Answer 275

C. ALP

Question 276

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.

Answer 276

C. Clostridium and Bacteroides spp.

Question 277

Which mycobacterium of the M. tuberculosis complex fails to grow in culture and has a characteristic “croissant-like” morphology in stained smears?
A. M. africanum
B. M. microti
C. M. bovis
D. M. leprae

Answer 277

B. M. microti

Question 278

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

Answer 278

B. M. paratuberculosis

Question 279

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.

Answer 279

A. Call out the patient’s name softly and shake the bed gently.

Question 280

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

Answer 280

B. Hot formalin

Question 281

A collective group of injuries involving the musculoskeletal and/or nervous system in response to long-term repetitive twisting, bending, lifting, or assuming static postures for an extended period of time:
A. Biologic hazard
B. Chemical hazard
C. Mechanical hazard
D. Ergonomic hazard

Answer 281

D. Ergonomic hazard

Question 282

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

Answer 282

C. Dry chemical

Question 283

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

Answer 283

C. Flammable liquids and electrical

Question 284

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

Answer 284

B. Iodine

Question 285

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

Answer 285

B. Muscle striations

Question 286

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

Answer 286

B. Black

Question 287

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

Answer 287

B. 45 to 50C

Question 288

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

Answer 288

D. Non-acidified hematoxylin

Question 289

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

Answer 289

A. Calcium

Question 290

Stain for Helicobacter:
A. Masson-Fontana
B. Toluidine blue
C. Wade-Fite
D. Von Kossa

Answer 290

B. Toluidine blue

Question 291

Stain for Leprosy bacillin and Nocardia:
A. Gomori
B. Van Gieson
C. Wade-Fite
D. Warthin-Starry

Answer 291

C. Wade-Fite

Question 292

Stain for Spirochete:
A. Feulgen
B. Verhoeff
C. Wade-Fite
D. Warthin-Starry

Answer 292

D. Warthin-Starry

Question 293

Excess copper deposition can often be demonstrated by:
A. Prussian blue
B. Rhodanine stain
C. Trichrome stain
D. von Kossa stain

Answer 293

B. Rhodanine stain

Question 294

All of the following are naturally occurring opiates except:
A. Morphine
B. Codeine
C. Heroin
D. Opium

Answer 294

C. Heroin

Question 295

Which of the following is considered as ENVIRONMENTAL POLLUTANTS?
A. Elemental mercury
B. Mercurous mercury
C. Mercuric mercury
D. Alkyl mercury

Answer 295

D. Alkyl mercury

Question 296

All of the following are immunosuppressive agents, EXCEPT:
A. Cyclosporine
B. Tacrolimus
C. Rapamycin
D. Carbamazepine
E. Leflunomide

Answer 296

D. Carbamazepine

Question 297

Which of the following conditions is the result of alpha1-antitrypsin level lower than 11 mmol/L?
A. Emphysema
B. Asthma
C. Pulmonary edema
D. Sarcoidosis

Answer 297

A. Emphysema

Question 298

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

Answer 298

B. Respiratory acidosis

Question 299

The following conditions are all causes of alkalosis. Which condition is associated with respiratory (rather than metabolic) alkalosis?
A. Anxiety
B. Hypovolemia
C. Hyperaldosteronism
D. Hypoparathyroidism

Answer 299

A. Anxiety

Question 300

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

Answer 300

D. Excessive vomiting

Question 301

Severe diarrhea causes:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Answer 301

A. Metabolic acidosis

Question 302

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

Answer 302

D. Respiratory alkalosis

Question 303

Drugs given for patients with asthma:
1. Digoxin
2. Procainamide
3. Theobromine
4. Theophylline
A. 1 and 2
B. 1, 2 and 4
C. 3 and 4
D. 4 only

Answer 303

C. 3 and 4

Question 304

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

Answer 304

C. Quality assessment/assurance

Question 305

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

Answer 305

B. Quality control

Question 306

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

Answer 306

A. Quality systems

Question 307

A procedure with minimal complexity, instrumentation, and personnel requirements so that the results can be quickly determined:
A. Waived test
B. Nonwaived test
C. Definitive test
D. Presumptive test

Answer 307

D. Presumptive test

Question 308

Highly sensitive and specific test in which results can be used as legal evidence:
A. Waived test
B. Non-waived test
C. Definitive test
D. Presumptive test

Answer 308

C. Definitive test

Question 309

Nondestructive technique for determining the structure of organic compounds:
A. Scintillation counter
B. Freezing point osmometer
C. Mass spectroscopy
D. Nuclear magnetic resonance

Answer 309

D. Nuclear magnetic resonance

Question 310

A patient sample is assayed for fasting triglycerides and a triglyceride value of 1036 mg/dL. This value is of immediate concern because of its association with which of the following conditions?
A. Coronary heart disease
B. Diabetes
C. Pancreatitis
D. Gout

Answer 310

C. Pancreatitis

Question 311

Only carbohydrate directly used for energy:
A. Glucose
B. Maltose
C. Fructose
D. Lactose

Answer 311

A. Glucose

Question 312

Enzyme assay useful in forensic clinical chemistry:
A. CK
B. ACP
C. ALT
D. AST

Answer 312

B. ACP

Question 313

The largest major nonimmunoglobulin protein in plasma:
A. Alpha1-antitrypsin
B. Alpha1-acid glycoprotein
C. Alpha2-macroglobulin
D. Transferrin

Answer 313

C. Alpha2-macroglobulin

Question 314

Sodium is a threshold substance, meaning that no sodium will be excreted in the urine until the renal threshold (a plasma sodium concentration of approximately ____ mmol/L) is exceeded.
A. 90 mmol/L
B. 100 mmol/L
C. 105 mmol/L
D. 120 mmol/L

Answer 314

D. 120 mmol/L

Question 315

1:3S
1. One observation exceeds 3 SD from the target value
2. Three observations exceed 1 SD from the target value
3. Imprecision or systematic bias
4. Not recommended
A. 1 and 3
B. 2 and 4
C. 1 and 4
D. 1, 3 and 4

Answer 315

A. 1 and 3

Question 316

8:1S
1. Range between two observations exceeds 4 SD
2. Eight sequential observations for the same QC sample exceed 1 SD
3. Imprecision
4. Bias trend
A. 1 and 3
B. 2 and 4
C. 1, 3 and 4
D. 2, 3 and 4

Answer 316

B. 2 and 4

Question 317

Copper reduction method for glucose that uses arsenomolybdic acid:
A. Folin-Wu
B. Nelson-Somogyi
C. Neocuproine
D. All of these

Answer 317

B. Nelson-Somogyi

Question 318

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

Answer 318

B. Folin-Wu

Question 319

Glucose measurements can be ____ mg/dL erroneously higher by reducing methods than by more accurate enzymatic methods.
A. 1 to 5 mg/dL
B. 5 to 15 mg/dL
C. 20 to 25 mg/dL
D. 30 to 35 mg/dL

Answer 319

B. 5 to 15 mg/dL

Question 320

It is increased in hemolytic anemias:
A. B1
B. B2
C. Both fractions
D. None of these

Answer 320

A. B1

Question 321

It is increased in bile duct obstruction:
A. B1
B. B2
C. Both fractions
D. None of these

Answer 321

B. B2

Question 322

Increased in hepatitis:
A. B1
B. B2
C. Both fractions
D. None of these

Answer 322

C. Both fractions

Question 323

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

Answer 323

B. Over 200 mg/dL

Question 324

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

Answer 324

D. Over 400 mg/dL

Question 325

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

Answer 325

D. Over 400 mg/dL

Question 326

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

Answer 326

A. 5 minutes

Question 327

When is the best time to release the tourniquet during venipuncture?
A. After the last tube has been filled completely
B. After the needle is withdrawn and covered
C. As soon as blood begins to flow into the tube
D. As soon as the needle penetrates the skin

Answer 327

C. As soon as blood begins to flow into the tube

Question 328

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

Answer 328

B. HDL cholesterol <35 mg/dL

Question 329

Sensitive early marker for liver disease:
A. Platelet count
B. PT
C. PTT
D. Thrombin time

Answer 329

B. PT

Question 330

Which of the following is the finger of choice for skin puncture?
A. Middle and ring finger
B. Middle and index finger
C. Ring and index finger
D. None of the above

Answer 330

A. Middle and ring finger

Question 331

A properly tied tourniquet:
A. Tied like a ribbon
B. Ends pointing towards the shoulder
C. Ends pointing away from the shoulder
D. Loop towards the shoulder

Answer 331

B. Ends pointing towards the shoulder

Question 332

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

Answer 332

B. Use the other arm

Question 333

The ideal site of capillary puncture in infants is the medial or lateral plantar surface of the heel, with a puncture no deeper than ____ mm beneath the plantar heel-skin surface.
A. 2.0 mm
B. 2.4 mm
C. 2.6 mm
D. 3.0 mm

Answer 333

A. 2.0 mm

Question 334

User passwords should be:
A. Shared with others
B. Kept confidential
C. Posted at each terminal
D. Never changed

Answer 334

B. Kept confidential

Question 335

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 onthe 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

Answer 335

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

Question 336

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.
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

Answer 336

B. Communication

Question 337

You are the lead chemistry MLS. Your laboratory manager has asked you to evaluate two new methods for cholesterol analysis.
In your evaluation, you found that method A was very accurate and precise and that method B was not very accurate and precise. However, the laboratory will make more money by investing in method B.
Which of the following decisions would exhibit professionalism?
A. Recommend method A to your laboratory manager. It is important that the laboratory produce the most accurate and precise results.
B. Recommend method B to your laboratory manager. It is important that the laboratory make as much money as possible.
C. State that you are unable to make a recommendation, because no difference in the methods was noted.
D. Recommend that you need more time to evaluate both methods.

Answer 337

A. Recommend method A to your laboratory manager. It is important that the laboratory produce the most accurate and precise results.

Question 338

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

Answer 338

B. Manila Public Health Laboratory

Question 339

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

Answer 339

D. 26th Medical Laboratory of the 6th US Army

Question 340

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

Answer 340

B. RA 1517

Question 341

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

Answer 341

C. RA 7719

Question 342

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

Answer 342

A. Renal artery

Question 343

Which substrate is used in the Bowers–McComb method for ALP?
A. p-Nitrophenyl phosphate
B. β-Glycerophosphate
C. Phenylphosphate
D. α-Naphthylphosphate

Answer 343

A. p-Nitrophenyl phosphate

Question 344

Which of the following buffers is used in the IFCC recommended method for ALP?
A. Glycine
B. Phosphate
C. 2-Amino-2-methyl-1-propanol
D. Citrate

Answer 344

C. 2-Amino-2-methyl-1-propanol

Question 345

All of the following bacterial cell walls contains mycolic acid, EXCEPT:
A. Nocardia
B. Rhodococcus
C. Streptomyces
D. Corynebacterium

Answer 345

C. Streptomyces

Question 346

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

Answer 346

C. N-glycolylmuramic acid and an increase in lipid content

Question 347

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

Answer 347

A. Renal artery

Question 348

Which substrate is used in the Bowers–McComb method for ALP?
A. p-Nitrophenyl phosphate
B. β-Glycerophosphate
C. Phenylphosphate
D. α-Naphthylphosphate

Answer 348

A. p-Nitrophenyl phosphate

Question 349

Which of the following buffers is used in the IFCC recommended method for ALP?
A. Glycine
B. Phosphate
C. 2-Amino-2-methyl-1-propanol
D. Citrate

Answer 349

C. 2-Amino-2-methyl-1-propanol

Question 350

Thoroughly clean between the fingers and under the fingernails for at least ______ ; include thumbs and wrists in the cleaning.
A. 1 minute
B. 2 minutes
C. 10 seconds
D. 20 seconds

Answer 350

D. 20 seconds

Question 351

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

Answer 351

B. Albumin accepts hydrogen ions from the indicator

Question 352

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

Answer 352

C. Lysis of yeast cells by acetic acid

Question 353

The reagent strip reaction that requires the longest reaction time is the:
A. Bilirubin
B. pH
C. Leukocyte esterase
D. Glucose

Answer 353

C. Leukocyte esterase

Question 354

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

Answer 354

D. WBC casts

Question 355

Which of the following would be least affected in a specimen that has remained unpreserved at room temperature for more than 2 hours?
A. Urobilinogen
B. Ketones
C. Protein
D. Nitrite

Answer 355

C. Protein

Question 356

5-HIAA is a degradation product of:
A. Heme
B. Indole
C. Serotonin
D. Melanin

Answer 356

C. Serotonin

Question 357

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

Answer 357

A. Calcium oxalate

Question 358

Crystals associated with severe liver disease include all of the following EXCEPT:
A. Bilirubin
B. Leucine
C. Cystine
D. Tyrosine

Answer 358

C. Cystine

Question 359

The primary reason for performing a Clinitest is to:
A. Check for high ascorbic acid levels
B. Confirm a positive reagent strip glucose
C. Check for newborn galactosuria
D. Confirm a negative glucose reading

Answer 359

C. Check for newborn galactosuria

Question 360

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

Answer 360

C. Goodpasture syndrome

Question 361

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

Answer 361

C. Dry chemicals

Question 362

Hurler, Hunter, and Sanfilippo syndromes are hereditary disorders affecting metabolism of:
A. Porphyrins
B. Purines
C. Mucopolysaccharides
D. Tryptophan

Answer 362

C. Mucopolysaccharides

Question 363

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

Answer 363

B. Ferric chloride

Question 364

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

Answer 364

D. 25 mg/dL

Question 365

Blood (hemoglobin) casts in Sedi-stain:
A. Pink
B. Pale purple
C. Orange-red
D. Light blue-green

Answer 365

C. Orange-red

Question 366

Trichomonas in Sedi-stain:
A. Pink
B. Pale purple
C. Orange-red
D. Light blue-green

Answer 366

D. Light blue-green

Question 367

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

Answer 367

B. Viscous and orange

Question 368

Specimens containing _________ produce a yellow foam when shaken, which could be mistaken for bilirubin.
A. Phenazopyridine (Pyridium)
B. Phenindione
C. Methyldopa
D. Metronidazole (Flagyl)

Answer 368

A. Phenazopyridine (Pyridium)

Question 369

Anticoagulant, orange in alkaline urine, colorless in acid urine.
A. Phenazopyridine (Pyridium)
B. Phenindione
C. Methyldopa
D. Metronidazole (Flagyl)

Answer 369

B. Phenindione

Question 370

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

Answer 370

D. Acridine orange stain

Question 371

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.

Answer 371

B. Erysipelothrix sp.

Question 372

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

Answer 372

B. Proteus

Question 373

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.

Answer 373

C. Clostridium and Bacteroides spp.

Question 374

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

Answer 374

C. Diamond or glass knives

Question 375

Microtome knives for PARAFFIN SECTIONING are usually made of:
A. Carbon steel
B. Diamond
C. Glass
D. Iron

Answer 375

A. Carbon steel

Question 376

Papanicolaou staining consists of how many stains?
A. 1
B. 2
C. 3
D. 4

Answer 376

C. 3

Question 377

Ratio of nuclear to cytoplasmic stains in Papanicolaou staining:
A. 1:2
B. 1:3
C. 2:1
D. 3:1

Answer 377

A. 1:2

Question 378

Ratio of cytoplasmic to nuclear stain in Papanicolaou staining:
A. 1:2
B. 1:3
C. 2:1
D. 3:1

Answer 378

C. 2:1

Question 379

What is the second stain in Papanicolaou staining procedure?
A. Sudan III
B. Harris hematoxylin
C. OG-6
D. Eosin azure

Answer 379

C. OG-6

Question 380

Turnaround time (TAT) is of value in:
A. Large organs
B. Autopsy
C. Frozen sections
D. None of these

Answer 380

C. Frozen sections

Question 381

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

Answer 381

C. Faster for one or a few individual sections

Question 382

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

Answer 382

B. Oxidation

Question 383

CSF tube subject to VDRL test:
A. Tube 1
B. Tube 2
C. Tube 3
D. Any of these

Answer 383

A. Tube 1

Question 384

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

Answer 384

C. Frozen

Question 385

If only a small amount of CSF is obtained, which is the most important procedure to perform first?
A. Cell count
B. Chemistries
C. Immunology
D. Microbiology

Answer 385

D. Microbiology

Question 386

Guaiac tests for detecting occult blood rely on the:
A. Reaction of hemoglobin with hydrogen peroxide
B. Pseudoperoxidase activity of hemoglobin
C. Reaction of hemoglobin with ortho-toluidine
D. Pseudoperoxidase activity of hydrogen peroxide

Answer 386

B. Pseudoperoxidase activity of hemoglobin

Question 387

Green peritoneal fluid: (CHECK YOUR STRASINGER)
A. Microbial infection
B. Lymphatic trauma and blockage
C. Malignancy
D. Gallbladder or pancreatic disorders

Answer 387

D. Gallbladder or pancreatic disorders

Question 388

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

Answer 388

B. Sodium

Question 389

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

Answer 389

C. 2 to 7 days

Question 390

Eosinophils may be increased in CSF in fungal infections primarily with:
A. Candida albicans
B. Coccidioides immitis
C. Cryptococcus neoformans
D. Histoplasma capsulatum

Answer 390

B. Coccidioides immitis

Question 391

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

Answer 391

Trichomonas

Question 392

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

Answer 392

A. Liver cirrhosis

Question 393

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

Answer 393

D. C. albicans, C. dubliniensis

Question 394

Which organism produces the CAMP factor enhancing beta hemolysis in the presence of the S. aureus beta lysin?
A. Group A streptococci
B. Group B streptococci
C. Group C streptococci
D. Group D streptococci

Answer 394

B. Group B streptococci

Question 395

Necrotizing fasciitis is a serious infection associated with:
A. Streptococcus agalactiae
B. Streptococcus mitis
C. Streptococcus pyogenes
D. Staphylococcus epidermidis

Answer 395

C. Streptococcus pyogenes

Question 396

What virus traditionally causes viral parotitis?
A. Influenza virus
B. Parainfluenza virus
C. Rhinovirus
D. Mumps virus

Answer 396

D. Mumps virus

Question 397

Which of the following is the key pathogen that infects the lungs of patients with cystic fibrosis?
A. B. cepacia
B. B. pseudomallei
C. P. fluorescens
D. P. aeruginosa

Answer 397

D. P. aeruginosa

Question 398

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

Answer 398

C. Mycobacterium avium complex

Question 399

Most laboratories use which type of fire extinguisher?
A. Type A
B. Type B
C. Type C
D. Combination ABC

Answer 399

D. Combination ABC

Question 400

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

Answer 400

C. Rickettsia rickettsii

Question 401

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

Answer 401

A. Chromoblastomycosis

Question 402

DIC (disseminated intravascular coagulation) is a complication of bloodstream sepsis and is most often caused by:
A. Gram-negative bacteria
B. The virus CMV
C. Gram-positive bacteria
D. Parasites

Answer 402

A. Gram-negative bacteria

Question 403

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

Answer 403

D. L. monocytogenes

Question 404

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

Answer 404

B. Corynebacterium diphtheriae

Question 405

Dark-field microscopy is used for the microscopic examination of what types of bacteria?
A. Gram-positive cocci such as Staphylococcus aureus
B. Yeast such as Candida tropicalis
C. Gram-negative bacilli such as Escherichia coli
D. Spirochetes such as Treponema pallidum

Answer 405

D. Spirochetes such as Treponema pallidum

Question 406

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

Answer 406

B. Small, curved, motile gram-negative bacilli

Question 407

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

Answer 407

D. Nonhemolytic and nonmotile

Question 408

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

Answer 408

B. Filoviridae

Question 409

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

Answer 409

D. Charcoal particles

Question 410

What step in the Gram stain distinguishes between gram-positive and gram-negative organisms?
A. Fixing of the cells to the slide using heat or methanol
B. Decolorization using alcohol or acetone
C. Counterstain of the Gram stain using safranin
D. Application of the mordant, Gram’s iodine

Answer 410

B. Decolorization using alcohol or acetone

Question 411

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

Answer 411

C. Fever, headache, and rash

Question 412

Optochin sensitivity is used to differentiate:
A. Streptococcus pneumoniae from other alpha-hemolytic streptococci
B. Streptococcus pyogenes from Streptococcus pneumoniae
C. Streptococcus agalactiae from Streptococcus pyogenes
D. Enterococci from non–group D enterococci

Answer 412

A. Streptococcus pneumoniae from other alpha-hemolytic streptococci

Question 413

The complete clearing of media around bacterial colonies on a blood agar plate is referred to as:
A. Alpha hemolysis
B. Beta hemolysis
C. Gamma hemolysis
D. Delta hemolysis

Answer 413

B. Beta hemolysis

Question 414

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

Answer 414

A. Feta cheese

Question 415

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

Answer 415

B. Beneficence

Question 416

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

Answer 416

C. Non-maleficence

Question 417

RESPECT the decisions (self-determination) of adults who have decision-making capacity.
* Moral rules or obligations:
* Tell the truth
* Respect the privacy of others
* Protect confidential information
* Obtain consent for interventions with patients
A. Autonomy
B. Beneficence
C. Non-maleficence
D. Justice

Answer 417

A. Autonomy

Question 418

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.

Answer 418

B. First do no harm.

Question 419

Assignment of credit unit shall use the Matrix of CPD Activities as provided in Resolution No. 1032, series of 2017 as reference.
Generally, a maximum of _____ credit unit(s) per hour of activity may be given.
A. 0.5 cu
B. 1 cu
C. 2 cu
D. 3 cu

Answer 419

B. 1 cu

Question 420

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

Answer 420

C. Executive

Question 421

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

Answer 421

B. Quasi-Judicial

Question 422

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

Answer 422

A. Quasi-Legislative

Question 423

The Professional Regulation Commission, otherwise known as the PRC, is a ____-man commission attached to office of the President for general direction and coordination.
A. Two-man
B. Three-man
C. Four-man
D. Five-man

Answer 423

B. Three-man

Question 424

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

Answer 424

D. Donor/client

Question 425

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

Answer 425

C. Protector/coddler

Question 426

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

Answer 426

C. One year

Question 427

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

Answer 427

C. 3 years or until their successors shall have been appointed and duly qualified

Question 428

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

Answer 428

C. In practice of laboratory medicine or MT for at least five years prior to his appointment

Question 429

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

Answer 429

D. Students of secondary and tertiary schools

Question 430

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

Answer 430

C. Green

Question 431

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

Answer 431

D. Renal medulla

Question 432

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

Answer 432

B. Serum creatinine, age, gender, race

Question 433

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

Answer 433

B. Weight

Question 434

Urine specific gravity by the URINOMETER is 1.032. The urine temperature is 26C and chemical tests indicate presence of 2 g/dL protein. What is the corrected specific gravity?
A. 1.024
B. 1.026
C. 1.028
D. 1.029

Answer 434

C. 1.028

Question 435

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

Answer 435

C. 5% NaCl

Question 436

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

Answer 436

D. 9% sucrose

Question 437

A urine specimen diluted 1:2 with a reading of 1.025, would have an actual specific gravity reading of:
A. 1.012
B. 1.025
C. 1.050
D. 1.075

Answer 437

C. 1.050

Question 438

Which one has the highest actual urine 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

Answer 438

B. Diluted urine 1:2 with a reading of 1.025

Question 439

Positive result in the Ictotest:
A. Green
B. Orange
C. Purple
D. Red

Answer 439

C. Purple

Question 440

Cyanide-nitroprusside (+):
A. Tryptophan disorders
B. Cystine disorders
C. Purine disorders
D. Mucopolysaccharidoses

Answer 440

B. Cystine disorders

Question 441

Synovial fluid of high viscosity (i.e., normal fluid) forms a “string” of _____ cm before breaking.
A. 1 to 2 cm
B. 2 to 4 cm
C. 4 to 6 cm
D. 8 to 10 cm

Answer 441

C. 4 to 6 cm

Question 442

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

Answer 442

D. Pseudochylous effusion

Question 443

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

Answer 443

C. Chylous effusion

Question 444

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

Answer 444

C. Tuberculosis

Question 445

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

Answer 445

A. Cephalic phase

Question 446

Physiologic failure of pH to fall below 3.5 or 1.0 pH unit with gastric stimulation:
A. Achlorhydria
B. Hypochlorhydria
C. Anacidity

Answer 446

A. Achlorhydria

Question 447

Physiologic failure of pH to fall below 3.5, although it decreases 1.0 pH unit or more upon gastric stimulation:
A. Achlorhydria
B. Hypochlorhydria
C. Anacidity

Answer 447

B. Hypochlorhydria

Question 448

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

Answer 448

C. Anacidity

Question 449

Urine volume for urinometry:
A. 1 to 2 drops
B. 1 to 2 mL
C. 10 to 15 drops
D. 10 to 15 mL

Answer 449

D. 10 to 15 mL

Question 450

Urine volume for refractometry:
A. 1 to 2 drops
B. 1 to 2 mL
C. 10 to 15 drops
D. 10 to 15 mL

Answer 450

A. 1 to 2 drops

Question 451

Specific gravity of 1.015 ± 0.001:
A. Distilled water
B. 3% NaCl
C. 5% NaCl
D. 9% sucrose

Answer 451

B. 3% NaCl

Question 452

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

Answer 452

C. 5% NaCl

Question 453

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

Answer 453

D. 9% sucrose

Question 454

Normal neutral fats with increased amount of fatty acids:
A. Malabsorption
B. Maldigestion
C. Both of these
D. None of these

Answer 454

A. Malabsorption

Question 455

What is the normal color of gastric fluid?
A. Pale gray
B. Colorless
C. Yellow
D. Amber

Answer 455

A. Pale gray

Question 456

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

Answer 456

B. To classify transudates and exudates

Question 457

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

Answer 457

B. Serum:ascites albumin gradient

Question 458

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

Answer 458

A. Absolute neutrophil count

Question 459

The mucin clot test determines the presence of synovial fluid ______________.
A. Protein
B. Glucose
C. Fibrinogen
D. Hyaluronic acid

Answer 459

D. Hyaluronic acid

Question 460

Before testing, very viscous synovial fluid should be treated with:
A. Normal saline
B. Hyaluronidase
C. Distilled water
D. Hypotonic saline

Answer 460

B. Hyaluronidase

Question 461

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

Answer 461

B. Acetic acid

Question 462

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

Answer 462

A. Low sperm concentration

Question 463

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

Answer 463

B. Frozen

Question 464

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

Answer 464

D. Orange

Question 465

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

Answer 465

A. Unstained, bluish-white

Question 466

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

Answer 466

D. Red on a purple background

Question 467

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%

Answer 467

C. 50% or more

Question 468

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

Answer 468

A. Methylene blue

Question 469

Microscopic screening reveals presence of fecal leukocytes in diarrhea caused by all of the following organisms, EXCEPT:
A. Shigella, Yersinia
B. Campylobacter
C. Enteroinvasive E. coli
D. Staphylococcus aureus

Answer 469

D. Staphylococcus aureus

Question 470

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

Answer 470

D. Fecal leukocytes - diarrhea caused by Salmonella

Question 471

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

Answer 471

A. Bilirubin

Question 472

UNIFORM/HOMOGENOUS green to a strongly positive green-blue appears on the blood reagent pad:
1. Hematuria
2. Hemoglobinuria
3. Myoglobinuria
A. 1 and 2
B. 1 and 3
C. 2 and 3
D. 1, 2 and 3

Answer 472

C. 2 and 3

Question 473

SPECKLED pattern on the blood reagent pad:
A. Hematuria
B. Hemoglobinuria
C. Myoglobinuria
D. All of these

Answer 473

A. Hematuria

Question 474

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

Answer 474

C. 4 to 6 cm

Question 475

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

Answer 475

D. Solid clot surrounded by clear fluid

Question 476

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

Answer 476

A. Acetic acid

Question 477

Oligoclonal banding in cerebrospinal fluid but not in serum, EXCEPT:
A. Multiple myeloma
B. Encephalitis
C. Neurosyphilis
D. Guillain-Barre disease

Answer 477

A. Multiple myeloma

Question 478

Oligoclonal bands are significant in the diagnosis of multiple sclerosis when:
A. They are seen in both the serum and CSF
B. At least five bands are seen in the CSF
C. They are seen in the CSF and not in the serum
D. They appear in both the albumin and globulinfractions of serum and the CSF

Answer 478

C. They are seen in the CSF and not in the serum

Question 479

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

Answer 479

B. Broncholithiasis

Question 480

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

Answer 480

D. Nuclear membrane, mitochondria and cell membrane

Question 481

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

Answer 481

A. DNA

Question 482

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

Answer 482

B. Small particle histogram

Question 483

Glitter cells in KOVA stain (Sternheimer-Malbin)
A. Cannot be stained
B. Pink
C. Purple
D. Light blue

Answer 483

D. Light blue

Question 484

Sternheimer-Malbin stain produces a ____ color in hyaline casts.
A. Blue
B. Green
C. Pink
D. Orange-red

Answer 484

C. Pink

Question 485

Glitter cells are neutrophils:
A. Exposed to urine with high specific gravity
B. Exposed to urine with low specific gravity
C. Containing lipids
D. Containing non-lipid vacuoles

Answer 485

B. Exposed to urine with low specific gravity

Question 486

GRANULAR, DIRTY, BROWN CASTS representing hemoglobin degradation products are associated with:
A. Cystitis
B. Acute pyelonephritis
C. Acute interstitial nephritis
D. Acute tubular necrosis

Answer 486

D. Acute tubular necrosis

Question 487

All are components of CLINITEST, except:
A. Copper sulfate
B. Sodium carbonate, sodium citrate
C. Sodium hydroxide
D. Lactose

Answer 487

D. Lactose

Question 488

Which of the following is a component of ACETEST?
A. Copper sulfate
B. Sodium carbonate, sodium citrate
C. Sodium hydroxide
D. Lactose

Answer 488

D. Lactose

Question 489

Benedict’s test 1+:
A. Blue
B. Green
C. Yellow
D. Orange

Answer 489

B. Green

Question 490

What chemical can be used to preserve a specimen for a culture and a routine urinalysis?
A. Boric acid
B. Formalin
C. Sodium fluoride
D. Thymol

Answer 490

A. Boric acid

Question 491

Preserves protein and formed elements well:
A. Boric acid
B. Formalin
C. Thymol
D. Toluene

Answer 491

A. Boric acid

Question 492

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

Answer 492

A. Ammonia

Question 493

45 seconds reading time:
A. Glucose
B. Ketone
C. Specific gravity
D. pH

Answer 493

C. Specific gravity

Question 494

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

Answer 494

C. Enterovirus

Question 495

Positive result for the acid-albumin and CTAB test for mucopolysaccharides:
A. White turbidity
B. Yellow turbidity
C. Red spot
D. Blue spot

Answer 495

A. White turbidity

Question 496

Positive result for the METACHROMATIC STAINING SPOT TEST for mucopolysaccahrides:
A. White turbidity
B. Yellow turbidity
C. Red spot
D. Blue spot

Answer 496

D. Blue spot

Question 497

Elevated compound(s) in congenital erythropoietic porphyria:
A. Protoporphyrin
B. ALA, porphobilinogen
C. ALA, protoporphyrin
D. Uroporphyrin, coproporphyrin

Answer 497

D. Uroporphyrin, coproporphyrin

Question 498

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

Answer 498

C. Casts

Question 499

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

Answer 499

A. Albumin

Question 500

CASE STUDY
An 8-year-old girl complains of feeling like she needs to urinate all the time. Her urine burns when she does void, and it is cloudy. She is seen at her pediatrician’s office, where urine is collected for routine urinalysis and culture. The following urinalysis results were obtained:
Physical Appearance
* Color: Pale
* Transparency: Cloudy
Chemical Screening
* pH: 7.5
* Specific gravity: 1.010
* Protein (reagent strip): Trace
* Protein (SSA): Trace
* Blood: Negative
* Nitrite: Positive
* Leukocyte esterase: Positive
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Normal

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 50-100 per hpf; clumps of white cells seen
* Casts: None seen
* Crystals: Moderate amorphous phosphates
* Bacteria: Many rods

1. The positive reagent strip test for nitrite in this patient is probably caused by which of the following?
   A. An infection from gram-negative bacteria
   B. An infection from gram-positive bacteria
   C. A yeast infection
   D. An old urine specimen, unsuitable for examination

Answer 500

A. An infection from gram-negative bacteria

Question 501

CASE STUDY
An 8-year-old girl complains of feeling like she needs to urinate all the time. Her urine burns when she does void, and it is cloudy. She is seen at her pediatrician’s office, where urine is collected for routine urinalysis and culture. The following urinalysis results were obtained:
Physical Appearance
* Color: Pale
* Transparency: Cloudy
Chemical Screening
* pH: 7.5
* Specific gravity: 1.010
* Protein (reagent strip): Trace
* Protein (SSA): Trace
* Blood: Negative
* Nitrite: Positive
* Leukocyte esterase: Positive
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Normal

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 50-100 per hpf; clumps of white cells seen
* Casts: None seen
* Crystals: Moderate amorphous phosphates
* Bacteria: Many rods

2. The positive reagent strip test for leukocyte esterase in this patient is caused by the presence of which of the following?
   A. Bacteria
   B. Protein
   C. Red blood cells
   D. White blood cells

Answer 501

D. White blood cells

Question 502

CASE STUDY
An 8-year-old girl complains of feeling like she needs to urinate all the time. Her urine burns when she does void, and it is cloudy. She is seen at her pediatrician’s office, where urine is collected for routine urinalysis and culture. The following urinalysis results were obtained:
Physical Appearance
* Color: Pale
* Transparency: Cloudy
Chemical Screening
* pH: 7.5
* Specific gravity: 1.010
* Protein (reagent strip): Trace
* Protein (SSA): Trace
* Blood: Negative
* Nitrite: Positive
* Leukocyte esterase: Positive
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Normal

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 50-100 per hpf; clumps of white cells seen
* Casts: None seen
* Crystals: Moderate amorphous phosphates
* Bacteria: Many rods

3. This patient’s alkaline pH is caused by the presence of which of the following?
   A. Bacteria
   B. Leukocyte esterase
   C. Nitrite
   D. Protein

Answer 502

A. Bacteria

Question 503

CASE STUDY
An 8-year-old girl complains of feeling like she needs to urinate all the time. Her urine burns when she does void, and it is cloudy. She is seen at her pediatrician’s office, where urine is collected for routine urinalysis and culture. The following urinalysis results were obtained:
Physical Appearance
* Color: Pale
* Transparency: Cloudy
Chemical Screening
* pH: 7.5
* Specific gravity: 1.010
* Protein (reagent strip): Trace
* Protein (SSA): Trace
* Blood: Negative
* Nitrite: Positive
* Leukocyte esterase: Positive
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Normal

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 50-100 per hpf; clumps of white cells seen
* Casts: None seen
* Crystals: Moderate amorphous phosphates
* Bacteria: Many rods

4. Which of the following conditions is exhibited by this patient?
   A. Lower urinary tract infection
   B. Acute drug-induced interstitial nephritis
   C. Acute glomerulonephritis
   D. Acute pyelonephritis

Answer 503

A. Lower urinary tract infection

Question 504

CASE STUDY
A 20-year-old female college student with a sore throat is seen in the student health service. A throat swab is cultured and reported positive for group A β-hemolytic streptococci. She is treated with an intramuscular injection of penicillin. Two weeks later, she wakes up in the morning and finds that she has decreased urine volume, and her urine is dark red. She also has a fever and swelling in her feet. She returns to the student health service, where urine is collected for urinalysis. The following urinalysis results were obtained (SSA, Sulfosalicylic acid; hpf, high-power field; lpf, low-power field):
Physical Appearance
* Color: Red
* Transparency: Cloudy

Chemical Screening
* pH: 6
* Specific gravity: 1.025
* Protein (reagent strip): 100 mg/dL
* Protein (SSA): 2+
* Blood: Large
* Nitrite: Negative
* Leukocyte esterase: Negative
* Glucose: Negative
* Ketones: Trace
* Bilirubin: Negative
* Urobilinogen: Normal

Microscopic Examination
* Red blood cells: 10-25 per hpf; dysmorphic forms present
* White blood cells: 0-2 per hpf
* Casts: 2-5 red blood cell casts per lpf
* Crystals: Moderate amorphous urates

1. Based on the patient’s history and laboratory data what is the most probable cause of this patient’s proteinuria?
   A. Glomerular damage
   B. Lower urinary tract disorders
   C. Prerenal disorders
   D. Tubular (or interstitial) damage

Answer 504

A. Glomerular damage

Question 505

CASE STUDY
A 20-year-old female college student with a sore throat is seen in the student health service. A throat swab is cultured and reported positive for group A β-hemolytic streptococci. She is treated with an intramuscular injection of penicillin. Two weeks later, she wakes up in the morning and finds that she has decreased urine volume, and her urine is dark red. She also has a fever and swelling in her feet. She returns to the student health service, where urine is collected for urinalysis. The following urinalysis results were obtained (SSA, Sulfosalicylic acid; hpf, high-power field; lpf, low-power field):
Physical Appearance
* Color: Red
* Transparency: Cloudy

Chemical Screening
* pH: 6
* Specific gravity: 1.025
* Protein (reagent strip): 100 mg/dL
* Protein (SSA): 2+
* Blood: Large
* Nitrite: Negative
* Leukocyte esterase: Negative
* Glucose: Negative
* Ketones: Trace
* Bilirubin: Negative
* Urobilinogen: Normal

Microscopic Examination
* Red blood cells: 10-25 per hpf; dysmorphic forms present
* White blood cells: 0-2 per hpf
* Casts: 2-5 red blood cell casts per lpf
* Crystals: Moderate amorphous urates

2. The presence of dysmorphic red blood cells (RBCs) and RBC casts indicates which of the following?
   A. Bleeding from kidney stone formation
   B. Kidney disease located in the glomerulus
   C. Kidney infection
   D. Probable menstrual contamination

Answer 505

B. Kidney disease located in the glomerulus

Question 506

CASE STUDY
A 20-year-old female college student with a sore throat is seen in the student health service. A throat swab is cultured and reported positive for group A β-hemolytic streptococci. She is treated with an intramuscular injection of penicillin. Two weeks later, she wakes up in the morning and finds that she has decreased urine volume, and her urine is dark red. She also has a fever and swelling in her feet. She returns to the student health service, where urine is collected for urinalysis. The following urinalysis results were obtained (SSA, Sulfosalicylic acid; hpf, high-power field; lpf, low-power field):
Physical Appearance
* Color: Red
* Transparency: Cloudy

Chemical Screening
* pH: 6
* Specific gravity: 1.025
* Protein (reagent strip): 100 mg/dL
* Protein (SSA): 2+
* Blood: Large
* Nitrite: Negative
* Leukocyte esterase: Negative
* Glucose: Negative
* Ketones: Trace
* Bilirubin: Negative
* Urobilinogen: Normal

Microscopic Examination
* Red blood cells: 10-25 per hpf; dysmorphic forms present
* White blood cells: 0-2 per hpf
* Casts: 2-5 red blood cell casts per lpf
* Crystals: Moderate amorphous urates

3. Which of the following conditions is exhibited by this patient?
   A. Acute cystitis
   B. Acute drug-induced interstitial nephritis
   C. Acute glomerulonephritis
   D. Acute pyelonephritis

Answer 506

C. Acute glomerulonephritis

Question 507

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

Answer 507

B. Conjugated bilirubin

Question 508

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

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

Answer 508

D. Urobilinogen

Question 509

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

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

Answer 509

D. Obstructive jaundice

Question 510

CASE STUDY
A 12-year-old boy has a history of several infections in the past few months. He is now very lethargic and swollen, with generalized edema. He tells his mother that his urine is very foamy when he urinates and that he feels “awful.” He is seen by his pediatrician, and urinalysis is performed with the following results:

Physical Appearance
* Color: Pale
* Transparency: Cloudy
* Foam: Abundant white foam

Chemical Screening
* pH: 6.0
* Specific gravity: 1.010
* Protein (reagent strip): >2000 mg/dL
* Protein (SSA): 4+
* Blood: Trace
* Nitrite: Negative
* Leukocyte esterase: Negative
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Negative

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 0-2 per hpf

Casts:
* 5-10 fatty casts per lpf
* 2-5 hyaline casts per lpf
* Epithelial cells: Few renal epithelial cells; many oval fat bodies present
* Other: Moderate free fat globules seen

1. The abundant white foam in this urine specimen is caused by the presence of which of the following?
   A. Blood
   B. Casts
   C. Fat
   D. Protein

Answer 510

D. Protein

Question 511

CASE STUDY
A 12-year-old boy has a history of several infections in the past few months. He is now very lethargic and swollen, with generalized edema. He tells his mother that his urine is very foamy when he urinates and that he feels “awful.” He is seen by his pediatrician, and urinalysis is performed with the following results:

Physical Appearance
* Color: Pale
* Transparency: Cloudy
* Foam: Abundant white foam

Chemical Screening
* pH: 6.0
* Specific gravity: 1.010
* Protein (reagent strip): >2000 mg/dL
* Protein (SSA): 4+
* Blood: Trace
* Nitrite: Negative
* Leukocyte esterase: Negative
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Negative

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 0-2 per hpf

Casts:
* 5-10 fatty casts per lpf
* 2-5 hyaline casts per lpf
* Epithelial cells: Few renal epithelial cells; many oval fat bodies present
* Other: Moderate free fat globules seen

2. The edema seen in this patient is caused by the presence of which of the following?
   A. Blood
   B. Casts
   C. Oval fat bodies
   D. Protein

Answer 511

D. Protein

Question 512

CASE STUDY
A 12-year-old boy has a history of several infections in the past few months. He is now very lethargic and swollen, with generalized edema. He tells his mother that his urine is very foamy when he urinates and that he feels “awful.” He is seen by his pediatrician, and urinalysis is performed with the following results:

Physical Appearance
* Color: Pale
* Transparency: Cloudy
* Foam: Abundant white foam

Chemical Screening
* pH: 6.0
* Specific gravity: 1.010
* Protein (reagent strip): >2000 mg/dL
* Protein (SSA): 4+
* Blood: Trace
* Nitrite: Negative
* Leukocyte esterase: Negative
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Negative

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 0-2 per hpf

Casts:
* 5-10 fatty casts per lpf
* 2-5 hyaline casts per lpf
* Epithelial cells: Few renal epithelial cells; many oval fat bodies present
* Other: Moderate free fat globules seen

3. The presence of fatty casts, oval fat bodies, renal epithelial cells, and free fat in this case indicates which of the following?
   A. A lower UTI
   B. An allergic reaction
   C. An upper UTI
   D. Severe renal dysfunction, probably glomerular

Answer 512

D. Severe renal dysfunction, probably glomerular

Question 513

CASE STUDY
A 12-year-old boy has a history of several infections in the past few months. He is now very lethargic and swollen, with generalized edema. He tells his mother that his urine is very foamy when he urinates and that he feels “awful.” He is seen by his pediatrician, and urinalysis is performed with the following results:

Physical Appearance
* Color: Pale
* Transparency: Cloudy
* Foam: Abundant white foam

Chemical Screening
* pH: 6.0
* Specific gravity: 1.010
* Protein (reagent strip): >2000 mg/dL
* Protein (SSA): 4+
* Blood: Trace
* Nitrite: Negative
* Leukocyte esterase: Negative
* Glucose: Negative
* Ketones: Negative
* Bilirubin: Negative
* Urobilinogen: Negative

Microscopic Examination
* Red blood cells: 0-2 per hpf
* White blood cells: 0-2 per hpf

Casts:
* 5-10 fatty casts per lpf
* 2-5 hyaline casts per lpf
* Epithelial cells: Few renal epithelial cells; many oval fat bodies present
* Other: Moderate free fat globules seen

4. Which of the following conditions is exhibited by this patient?
   A. Acute drug-induced interstitial nephritis
   B. Acute glomerulonephritis
   C. Acute pyelonephritis
   D. Nephrotic syndrome

Answer 513

D. Nephrotic syndrome

Question 514

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

Answer 514

D. Waxy cast

Question 515

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

Answer 515

A. #0.5 McFarland standard

Question 516

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

Answer 516

C. 1% sulfuric acid and 1.175% barium chloride

Question 517

LILEY GRAPH: indicates NON-AFFECTED or MILDLY affected fetus:
A. Zone I
B. Zone II
C. Zone III
D. None of these

Answer 517

A. Zone I

Question 518

LILEY GRAPH: indicates MODERATE hemolysis and require CAREFUL MONITORING anticipating an early delivery or exchange transfusion upon delivery: (requiring close monitoring)
A. Zone I
B. Zone II
C. Zone III
D. None of these

Answer 518

B. Zone II

Question 519

LILEY GRAPH: indicates SEVERE HEMOLYSIS and suggests a severely affected fetus. INTERVENTION through induction of labor or intrauterine exchange transfusion must be considered
A. Zone I
B. Zone II
C. Zone III
D. None of these

Answer 519

C. Zone III

Question 520

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

Answer 520

C. Bilirubin 450 nm, oxyhemoglobin 410 nm

Question 521

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

Answer 521

D. Lamellar bodies

Question 522

A light yellow colony from a skin lesion grew aerobically and tested as catalase positive and coagulase negative. The organism gram stained as positive cocci in clusters. The organism was modified oxidase positive, bacitracin susceptible and resistant to lysostaphin. What is the identification of this organism?
A. Staphylococcus aureus
B. Micrococcus luteus
C. Staphylococcus epidermidis
D. Peptostreptococcus anaerobius

Answer 522

B. Micrococcus luteus

Question 523

An aspirate of a deep wound was plated on blood agar plates and incubated aerobically and anaerobically. At 24 hours there was growth on both plates. This indicates that the organism is a/an:
A. Nonfermenter
B. Obligate anaerobe
C. Aerobe
D. Facultative anaerobe

Answer 523

D. Facultative anaerobe

Question 524

Fluid from the prostate gland, contains all of the following, EXCEPT:
A. Acid phosphatase
B. Acetic acid
C. Citric acid
D. Zinc

Answer 524

B. Acetic acid

Question 525

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

Answer 525

A. 5-HIAA

Question 526

Which autoantibodies are strongly associated with granulomatosis with polyangiitis (Wegener’s granulomatosis)?
A. ANA
B. ANCA
C. AMA
D. SMA

Answer 526

B. ANCA

Question 527

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

Answer 527

C. Goodpasture syndrome

Question 528

A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?
A. Lesch-Nyhan syndrome
B. Modification of diet in renal disease
C. Maple syrup urine disease
D. Reye’s syndrome
E. Megaloblastic anemia

Answer 528

A. Lesch-Nyhan syndrome

Question 529

Mucopolysaccharidoses, EXCEPT:
A. Hunter syndrome
B. Hurler syndrome
C. Lesch-Nyhan syndrome
D. Sanfilippo syndrome

Answer 529

C. Lesch-Nyhan syndrome

Question 530

Neutrophils lyse rapidly in:
A. Acetic acid
B. Ether
C. Dilute acid urine
D. Dilute alkaline urine

Answer 530

D. Dilute alkaline urine

Question 531

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

Answer 531

A. Acetic acid

Question 532

Serous fluid for pH determination:
A. Must be maintained at room temperature
B. Must be maintained at body temperature, 37C
C. Maintained aerobically in ice
D. Maintained anaerobically in ice

Answer 532

D. Maintained anaerobically in ice

Question 533

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

Answer 533

C. 30 mL

Question 534

Family history of chromosome abnormalities, such as TRISOMY 21 (DOWN SYNDROME), amniocentesis may be indicated at:
A. 1 to 7 weeks gestation
B. 7 to 14 weeks gestation
C. 15 to 18 weeks gestation
D. 20 to 42 weeks gestation

Answer 534

C. 15 to 18 weeks gestation

Question 535

Bacterial, viral, and protozoan infections produce increased secretion of water and electrolytes, which override the reabsorptive ability of the large intestine, leading to:
A. Osmotic diarrhea
B. Secretory diarrhea
C. Either of these
D. None of these

Answer 535

B. Secretory diarrhea

Question 536

Secretory diarrhea is caused by:
A. Antibiotic administration
B. Lactose intolerance
C. Celiac sprue
D. Vibrio cholerae

Answer 536

D. Vibrio cholerae

Question 537

Maldigestion (impaired food digestion) and malabsorption (impaired nutrient absorption by the intestine) contribute to:
A. Osmotic diarrhea
B. Secretory diarrhea
C. Either of these
D. None of these

Answer 537

A. Osmotic diarrhea

Question 538

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

Answer 538

C. Intestinal constriction

Question 539

Appearance of stool in pancreatic disorders:
A. Ribbon-like
B. Bulky/frothy
C. Pale, gray
D. Blood-streaked

Answer 539

B. Bulky/frothy

Question 540

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

Answer 540

B. Trypsin

Question 541

The normal brown color of the feces is produced by:
A. Cellulose
B. Pancreatic enzymes
C. Undigested foodstuffs
D. Urobilin

Answer 541

D. Urobilin

Question 542

The normal composition of feces includes all of the following except:
A. Bacteria
B. Blood
C. Electrolytes
D. Water

Answer 542

B. Blood

Question 543

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

Answer 543

A. Alport syndrome

Question 544

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

Answer 544

E. Bone marrow

Question 545

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

Answer 545

D. 95% ethanol

Question 546

SITUATION: 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

Answer 546

D. Creatinine 5 mg/dL

Question 547

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°F
D. Specific gravity 1.012, creatinine 25 mg/dL

Answer 547

B. Specific gravity 1.002; Creatinine 15 mg/dL

Question 548

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

Answer 548

D. Marijuana

Question 549

Reagent for the APT’s test:
A. Guaiac
B. 1% sodium hydroxide
C. 95% ethanol
D. 10% eosin

Answer 549

B. 1% sodium hydroxide

Question 550

Fetal hemoglobin (Hb F) in Apt’s test
A. Pink solution
B. Pink precipitate
C. Yellow-brown supernatant
D. Yellow-brown precipitate

Answer 550

A. Pink solution

Question 551

Adult hemoglobin (Hb A) in Apt’s test
A. Pink solution
B. Pink precipitate
C. Yellow-brown supernatant
D. Yellow-brown precipitate

Answer 551

C. Yellow-brown supernatant

Question 552

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

Answer 552

C. Greater than 60/hpf

Question 553

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

Answer 553

B. 800 mL to 1,200 mL

Question 554

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

Answer 554

A. 0

Question 555

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

Answer 555

C. Fructose

Question 556

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

Answer 556

D. Complete ejaculate

Question 557

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. Agree within 10%
B. Agree within 15%
C. Agree within 20%
D. Agree within 25%

Answer 557

A. Agree within 10%

Question 558

Casts increased in CONGESTIVE HEART FAILURE:
A. Hyaline casts
B. Granular casts
C. WBC casts
D. RBC casts

Answer 558

A. Hyaline casts

Question 559

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

Answer 559

B. Proteus

Question 560

A culture of a decubitus ulcer grew a gram-negative facultative bacillus. On TSI it produced an acid slant, acid butt, and gas. Test reactions in other media were as follows:
* Citrate: negative
* Indole: positive
* Urease: negative
* ONPG: positive
* Voges-Proskauer: negative
The organism was identified as
A. Enterobacter cloacae
B. Escherichia coli
C. Citrobacter (diversus) koseri
D. Providencia stuartii

Answer 560

B. Escherichia coli

Question 561

During the summer break, several middle-aged elementary school teachers from the same school district attended a 3-day seminar in Chicago. Upon returning home, three female teachers from the group were hospitalized with pneumonia, flulike symptoms, and a nonproductive cough. Routine testing of sputum samples revealed normal flora. Further testing using buffered CYE agar with L-cysteine and α-ketoglutarate in 5% CO2 produced growth of opaque colonies that stained faintly, showing thin gram-negative rods. What is the most likely identification?
A. Legionella pneumophila
B. Haemophilus influenzae
C. Eikenella corrodens
D. Streptococcus pneumoniae

Answer 561

A. Legionella pneumophila

Question 562

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

Answer 562

A. Clostridium perfringens

Question 563

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

Answer 563

C. HIV infection, stage 3 (AIDS)

Question 564

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

Answer 564

D. 0.3 µm

Question 565

Transcription is:
A. Producing DNA from DNA
B. Producing proteins from RNA
C. Creating chromosomes from DNA and histone proteins
D. Producing RNA from DNA

Answer 565

D. Producing RNA from DNA

Question 566

Nonspecific immunity includes all of the following except:
A. Inflammation
B. Phagocytosis by neutrophils
C. B-cell activation to produce antibodies
D. Resident normal flora

Answer 566

C. B-cell activation to produce antibodies

Question 567

All of the following are differential media except:
A. Blood agar
B. Chocolate agar
C. MacConkey’s agar
D. Eosin methylene blue agar

Answer 567

B. Chocolate agar

Question 568

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

Answer 568

D. Acridine orange stain

Question 569

What step in the Gram stain distinguishes between gram-positive and gram-negative organisms?
A. Fixing of the cells to the slide using heat or methanol
B. Decolorization using alcohol or acetone
C. Counterstain of the Gram stain using safranin
D. Application of the mordant, Gram’s iodine

Answer 569

B. Decolorization using alcohol or acetone

Question 570

Dark-field microscopy is used for the microscopic examination of what types of bacteria?
A. Gram-positive cocci such as Staphylococcus aureus
B. Yeast such as Candida tropicalis
C. Gram-negative bacilli such as Escherichia coli
D. Spirochetes such as Treponema pallidum

Answer 570

D. Spirochetes such as Treponema pallidum

Question 571

Which type of enrichment media is used to isolate Neisseria and Haemophilus organisms?
A. Hektoen enteric (HE) agar
B. Todd Hewitt broth
C. Regan Lowe agar
D. Chocolate agar

Answer 571

D. Chocolate agar

Question 572

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

Answer 572

D. Charcoal particles

Question 573

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

Answer 573

C. Calcium and magnesium

Question 574

The mechanism of action for tetracycline is inhibition of:
A. RNA synthesis
B. Cell wall synthesis
C. Protein synthesis
D. Membrane function

Answer 574

C. Protein synthesis

Question 575

Which of these antimicrobial agents inhibits DNA synthesis?
A. Fluoroquinolones
B. Beta-lactam agents
C. Aminoglycosides
D. Glycopeptides

Answer 575

A. Fluoroquinolones

Question 576

Methicillin-resistant Staphylococcus aureus is detected using agar containing:
A. Penicillin and sodium chloride
B. Ampicillin and magnesium chloride
C. Nafcillin and magnesium chloride
D. Oxacillin and sodium chloride

Answer 576

D. Oxacillin and sodium chloride

The MRSA Screen agar uses oxacillin and promotes the growth of the resistant population by the addition of 2% to 4% NaCl. This medium is then incubated at 35°C for a full 24 hours in order to determine the oxacillin-resistance pattern.

Question 577

A chromogenic cephalosporin is used to detect resistance to:
A. Macrolides
B. Aminoglycosides
C. β-lactams
D. Tetracyclines

Answer 577

C. β-lactams

Question 578

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

Answer 578

A. 5% sheep blood agar

Question 579

Necrotizing fasciitis is a serious infection associated with:
A. Streptococcus agalactiae
B. Streptococcus mitis
C. Streptococcus pyogenes
D. Staphylococcus epidermidis

Answer 579

C. Streptococcus pyogenes

Question 580

When streaking a throat culture on 5% sheep blood agar, stabbing the agar plate provides enhanced detection for:
A. Bile solubility
B. Bile esculin hydrolysis
C. DNase activity
D. Streptolysin O
E. Streptolysin S

Answer 580

D. Streptolysin O

Question 581

Which organism produces the CAMP factor enhancing beta hemolysis in the presence of the S. aureus beta lysin?
A. Group A streptococci
B. Group B streptococci
C. Group C streptococci
D. Group D streptococci

Answer 581

B. Group B streptococci

Question 582

Optochin sensitivity is used to differentiate:
A. Streptococcus pneumoniae from other alpha-hemolytic streptococci
B. Streptococcus pyogenes from Streptococcus pneumoniae
C. Streptococcus agalactiae from Streptococcus pyogenes
D. Enterococci from non–group D enterococci

Answer 582

A. Streptococcus pneumoniae from other alpha-hemolytic streptococci

Question 583

Which organism is able to hydrolyze esculin and is a serious nosocomial pathogen?
A. S. bovis
B. S. mitis
C. E. faecalis
D. S. pneumoniae

Answer 583

C. E. faecalis

Note:
Enterococci are one of the most feared nosocomial pathogens isolated from the urinary tract, peritoneum, heart tissue, bacteremia, endocarditis, and intra-abdominal infections.

Question 584

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

Answer 584

B. Woolsorters’ disease

Question 585

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

Answer 585

D. Nonhemolytic and nonmotile

Question 586

The virulence factor associated with B. cereus is:
A. Edema toxin
B. Lethal toxin
C. Protective antigen
D. Enterotoxin

Answer 586

D. Enterotoxin

Note:
B. cereus produces several toxins implicated in the diarrheal symptoms, including hemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe), and cytotoxin K (CytK). The three toxins are believed to act synergistically, with Nhe responsible for the major symptoms in the diarrheal presentation of the infection.

Question 587

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

Answer 587

B. Bacillus cereus

Question 588

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

Answer 588

C. Bacillus cereus

Question 589

The most appropriate therapy for inhalation anthrax is:
A. Ciprofloxacin
B. Tetracycline
C. Vancomycin
D. Erythromycin

Answer 589

A. Ciprofloxacin

Question 590

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

Answer 590

C. Modified Tinsdale

Question 591

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

Answer 591

D. L. monocytogenes

Question 592

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

Answer 592

A. Feta cheese

Question 593

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.

Answer 593

B. Erysipelothrix sp.

Question 594

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.

Answer 594

A. Lactobacillus sp.

Note:
Lactobacillus - RESEMBLES ALPHA HEMOLYTIC STREP.

Arcanobacterium - RESEMBLES BETA HEMOLYTIC STREP.

Question 595

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

Answer 595

D. All of the above

Note:
If the modified acid-fast stain results are positive, the isolate is a probable partially acid-fast aerobic actinomycete (i.e., Nocardia, Rhodococcus, Tsukamurella, or Gordonia sp).

Question 596

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.

Answer 596

A. Nocardia sp.

Question 597

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.

Answer 597

B. Rhodococcus equi

Note:
To date, Rhodococcus equi has been the organism most commonly associated with human disease, particularly in immunocompromised patients, such as those infected with the human immunodeficiency virus (HIV).

Question 598

Enterobacteriaceae are typically gram negative and:
A. Non–glucose fermenters
B. Capable of reducing nitrates to nitrites
C. Catalase negative
D. Oxidase positive

Answer 598

B. Capable of reducing nitrates to nitrites

Question 599

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

Answer 599

A. Cronobacter (Enterobacter) sakazakii

Question 600

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

Answer 600

C. Phenylalanine deaminase and H2S